Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0133 LOVELL'S ROAD
o 3 3 gave- i oFz WMEr Town .of ]Barnstable Pernut# Expires 6 months from issue date Regulatory Services Fee ,/.-,//, * snxNsrnsr.e, Thomas F. Geiler,Director ' � MASS. i6 9• Buildin Division A g Fp 't O44 Serry,CBO, Building Commissioner pp ® 200 Main Street,Hyannis,MA 02601 r NOV 14 2008 www.town.bamstable.ma.us Office: 508-862.4038 Fax: 508-790-6230 *T0VVNC&4&W1W APPLICATION = RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel,Number 05 3 Property Address 1 f d (o�U i Residential Value of Work ,C) Minimum,fee of$25.00 for work under.$6000.00 Owner's Name&Address U1 CA,,-'1'i.1 �. C��"e �.� c (�.` ,y Contractor's Name i (, Telephone Number S � � Home Improvement Contractor License#(if applicable) 1 i U21workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ [have Worker's mpensation Insurance Insurance Company Name 1-4M poyj a' M5,..`'�t�s Workman's Comp. Policy# Copy o:insurance Compliance Certificate must be oh7 file. Permit Request(check box) �rRe-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note Property Owner must sign Property Owner Letter of Permission. A copy,of the Home Improvement Contractors.Licen,se is required. SIGNATURE: Q:\WPHLESTORMS\building permit forms\EXPRESS.doc Revise020108 r - Mussachusetts- Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License License: CS 100648 Restricted to: 00 y BRENDAN KIERCE 4 HITCHCOCK LANE FOXBORO, MA 02035 Expiration: 7/10/2012 ('runn�issiuncr °'Tr#: "100648 . ''`` ✓lie �o7i�nza�uirea� o��/ '' q_Y,.. Board o'r Emltling RcbuWionsand_Standp►(Is' tki HOME IMPROVEMENT 'CONTRACTOR fii' a Registrat or�t 139241 , Cpiratioh 6/25/2099 Ti#�'13773E . . Jt i ,Type D#BAD tl "xJ0^AN KIERGE �i JR REMODE ING^ } B'RENDL N KIERCE JF2 1 Vti 4 H TCHOCK LN o f r BORO RI 02035 i�dtmi�is t�r f i L�censc or r�gist,atwn� lid for mdtvttt+tl us tiv before the expirlttou:date If found retut n ro Board of I3ut;ling Regulations and Stand�� s O�c 4shburtonl'lace`Rm 13s 1 r+ ston,Ma 0210$ W. 3]]] I; q Not valid witkout stignll re 3 / : r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations' ' 600 Washington Street Boston,MA 02111 s� �� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): ' 4...d IrVo01C Address: i C [ocl!C �. City/State/Zip: Phone.#: Are you an employer? Chec the appropriate box: Type of project(required): 1.Gfam a employer with 4. ❑ I am a general contractor and I employees(full and/or art-tim.e).* have hired the sub-contractors 6. ❑New construction .2.❑ I am a sole proprietor or partner-' listed on the attached sheet. 7. . -Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in an capacity. employees and have workers' Y P ty• $ 9. El Building addition [No workers'comp.insurance comp.insurance. 10. Electrical repairs or additions required.] 5. ❑ We are a corporation and its ❑ P 3.0 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12,gJ.R�of repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] "Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tcontractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is provi ing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: /`W4 ZW11 A,SVJ-4j1 l 4ti Policy#or Self-ins.Lic.#: 0015 Expiration Date: Job Site Address: / 3 �veLS ��, City/State/Zip: �� � Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi nder the pains and penalties of perjury that the information provided above is true and correct signafore: r°� � Date: [cl Lo Phone#: Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health. 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: v . / Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as "...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more -ofthe foregoing-engaged— -E7a-ornt ente�nse-and-uzclu3rn-=the le al-r�r-esentative of a-degas -employer, or_rthe— -- . J rP- � g g P - ed- __...._ receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not.more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced.acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies.(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617--727-4900 ext 406 or 1-977-MASSAFE Fax#617-727-7749 Revised l 1-22-06 www.mass.gov/dia f { t li oFI METati Town of Barn-stable Regulatory Services s�xrrsres f Thomas F. Geiler,Director 94''°rE 16 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder I, V/ tG� ( �1 as Owner of the subject J property hereby authorize srtAak� Kcrr( to act on my behalf, in all matters relative to work authorized by this building permit application for: 33 tDoe(5 rd (Address of Job) Si ture of Owner D to tJ✓t�L-. Gir4"( A Print.Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FOR MS:OVJNERPERMISSION Town of Barnstable " �OF THE r � Regulatory Services � t sAaxsTAsre. ; Thomas F.Geiler,Director HAS& Building Division �PrfD►,M'i A Tom Perry,Building Commissioner MA-02601 ____._ .__. ._-_._.___ .__..-__ ___..----- _._-. .._. ..�.._.__,.._,_- www.town.b arnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 ' HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: _ number street village "HOMEOWNER" name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWWER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that.hr./she understands the.Town of Barnstable,Building Department. minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q. Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it Would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certifr cation.for use in your community. Q:fonns:homeexempt ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 11/13/2008 PRODUCER 781-326-2002 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION FRANK BINGHAM INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE .CERTIFICATE 875 PROVIDENCE HWY, L-10 ..,. ....'"`" HOLDER.-THIS CERTIFICATE DOES NOT AMEND, EXTEND OR DEDHAM, MA 02026 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. DEDHAM, MA 02026 INSURED INSURERS AFFORDING COVERAGE NAIC# - INSURERA: FARM FAMILY CASUALTY B. KIERCE REMODELING INSURERB: 4 HITCHCOCK LANE INSURERC: FOXBORO, MA 02035 INSURER D: INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED,.BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' - LTR TYPE OF I POLICYNUMBER POLICYEFFECTIVE POLICYEXPIRATION LIMITS '- GENERAL LIABILITY � EACH OCCURRENCE ,$ 300,000 06/24/2008 06/24/2009 A COMMERCIAL GENERAL LIABILITY 2O11XOO89 DA A R D ,. PREMISES Ea occurence $ _ 50,000 CLAIMS MADE OCCUR - MEDEXP(Any one person). $ 5,000 PERSONAL&ADVINJURY $ GENERAL AGGREGATE $ 600,000 GEN'L AGGREGATE LIMIT APPLIES PER: _ PRODUCTS>COMP/OP AGG $ 300,000 POLICY JECT 17 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) - ALLOWNEDAUTOS - - BODILY INJURY HEDULEDAUTOS ....................."...:. .:. .... (Per person) $ HIREDAUTOS NON>OWNEDAUTOS - BODILYINJURY $ (Per accident). PROPERTY DAMAGE - $ (Per accident) GARAGE LIABILITY AUTO ONLY)EA ACCIDENT $. ANY AUTO - OTHER THAN EA ACC $ AUTOONLY: AGG $. EXCESS/UMBRELLA LIABILITY - - - - EACH OCCURRENCE $ OCCUR' ❑CLAIMS MADE AGGREGATE $ DEDUCTIBLE - " • - -• RETENTION $ WORKERS COMPENSATION AND - WC STATU> OTH, A EMPLOYERS'LIABILITY 2011W6.102 06/24/2008 06/24l2009 TOR LIMITS ER - ANY PROPRIETOR/PARTNER/EXECUTIVE -OFFICER/MEMBER EXCLUDED E.L.EACH ACCIDENT $ 100,000 - - _ If yes,describe under - - E.L.DISEASE)EA EMPLOYEE $ 500 000 OTHERSPECIAL PROVISIONS below OTHER - E.L.DISEASE,POLICY LIMIT $- 100,000 • � - � - DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BYENDORSEMENT/SPECIAL PROVISIONS . - - - WORKERS COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR BRENDAN KIERCE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF.THE A30VE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION _ - DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 20 DAYS WRITTEN ROBERT NECHID' NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 22 LOVELLS ROAD IMPOSE-NO OBLIGAT!ON OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR COTUIT, MA REPRESENTATIVES. . AUTH9RIZE PRESENTATIVE ACORD 25(2001l08) - 2 -�.� 'ACORD CORPORATION 1988 "� r SS ! P�OFISE ro Town of Barnstable *Permit# �.� "'F P 1 7' Z n 11 Expires 6 months from issue date BAFtNS&ABI , �� Regulatory Services Fee l`il gr ' C . BARN !ABLghomas F. Geiler, �e39• �� Director` ' Building Division `L Tom Perry, Building Commissioner © ,�1 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 " Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red&Press Imprint Map/parcel Number Property Address �� 1 l Residential Value of Work Owner's Name&Address A �r l V� �/���IN Contractor's Name 7!Z � �� (�A Telephone Home Improvement Contractor License#(if applicable) INolu J Construction Supervisor's License#(if applicable) u �� ❑Workman's Compensation Insurance Check one: ❑ I am a sole.proprietor ❑ I am the Homeowner ®'I have Worker's Compensation Insurance AA Insurance Company Name MFT lD N I I, C% H 6-2 A LRV#1� Workman's Comp.Policy Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to . ❑Re-roof(not stripping. Going over existing layers of roof) Re-side l (K Replacement Windows. U-Value A t (maximum.44) Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property caner must sign Property Owner Letter of Permission. Signature . Q:Forms:expmtrg Revised121901 Client#: 12032 2BISHOPRICST A%CORD.M CERTIFICATE OF LIABILITY INSURANCE F A Ik(MM;uUiyyyy) 07113/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PHODUCEH CON IACI NAME' Dowling&O'Neil PHONE FA11 Arc Nu Exl:508 775-1620 A;C Ny: 5087781218 Insurance Agency k"MAIL ADDRE33: 973 lyannough Rd., PO Box 1990 INSURER(S)AFFORDING COVERAGE NAIC 8 Hyannis, MA 02601 INSURER A:National Grange Mutual Insure nc I INSURED INSURER 8 Steven J. Bishopric, Inc. A!O Chestnut INSURER C Bay Cabinet Co., Inc. INSURER D 1112 Main Street, Unit 18 INSDHEH I:Osterville,MA 02655 INSUHkH F. I COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDiC;ATEU. NOTWITHSTANDING; ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE (POLICIES DESCRIBED HEREIN IS SUB.IECT TO ALL THE TERMS, E:CCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MA`., HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDLSUB POLICY NUMtlEH POLICY EFF POLICY EXP LIMITS LTR INSR WVD IMMlDDIYYYY) (MMIDDIYYYY) A akNkRALLIAUILIIY MST4295K 1/01/2010 11/0112011 FAi;No(i:uRRFNi;F $1000,000 1)AMA(ii-IORFNIFI) XI COMMERCIAL GENERAL LIABILITY PRFMI(;FR F❑nrnl mnrr. s 200 000 I CLAIMS MADE 7X OCCUR MED EXr(Ain ul,ywuun) $5 000 XI PD Ded:250 PFR:i(iNA1 P.ADV IN.IURY $1,000 000 GENERALAGGREGATE $2000,000 IiFN'I A(;(PFfiA I F I IM I I AP PI IFfi PFR: F'KOUI IC I;i-COMP/OP A6(i $2,000,000 PR(1 t'0L,'CYI JE17 Au 1 UMOMILk LIAHILI I Y COMBINED SINGLE LIMIT (Fn Ir.ndmf) $ AN,AMC 80DILY INJURY(r' yw auu) $ ALLOWNED SCHEDULED Howl Iwt imy(Prrnrctdent) $ All IOt; Al l 10"; NON-OWNED _ PRi1PFRrruAMAGF $ HIRED AUTO; At I I0c; f`a-6u— $ UMHHkLLA LIAR i ICCUR FACH(1(;011hh:FNCF $ EXCESS LIAS CI AIM!i MAl1F A66NI-6A I I- $ DED I I RETENTION $ A 'NORKERS COMPENSATION WCT4295K 711912011 07/191201 X NC.S;'TU CTH AND EMPLOYERS'LIAHILI I Y YIN IFH AI.1,PPOFP.+I OHNAP.I NFHrF 7 K III IVI- E.L.EACH ACCIDENT $500,000 .. t!FFiCErUMEMBEn E.r.CLUDEco N J1 NIA (Mdndat-Y In NN) - F.I.UI:iF ASiF.FA FMPI OYFF $500 000 If yx,de-r:1iLv und. ' I1F'-:S:Ff!F'I ON(WF OPF F:AI ION:i te.11- E.L.DISEA;E.r 0LICY LIMIT $500,000 I UL&C.RIP I IUN OF OPERA I IONS I LOCA I IONS I VEHICLES(Attach ACOHU'1111,Addlt—11 HY .1rkt SehadUta,If more&P.na If raqulrad) Insurance coverage is limited to the terms, conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The House Carpenters THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1112 Main Street, Unit 18 ACCORDANCE WITH THE POLICY PROVISIONS. Osterville, MA 62655 AU I H()HILEUHEPHESEN I A 1IVk (�)1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 oft The ACORD name and logo are registered marks of ACORD #S835591M83558 LS1 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): SU�it1 Ql S}}e PAC:. Address: 1t►2 miiTJ S)' Suter US7 FLU)a(;, City/State/Zip: Ai- Phone Are y u an employer' Check the appropriate box: Type of project(required): 1.L�J l am a employer with 4• ❑ 1.am a general contractor and 1 employees (full and/or part-time).* have hired the sttb-contractors 6. 0 New construction '. listed on the attached sheet. 7. ❑ Remodeling El [am a sole proprietor or partner- ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers' comp. insurance comp. insurance." required.] 5. corporation We are a oration and its 10.❑ Electrical repairs or additions ❑ P 3.❑ I am a homeowner doing all work officers have exercised their 1 LE] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] c. 152, §1(4), and we have no q ] employees. [No workers 13.❑ Other' comp. insurance required.]' *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must.submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: : -6:0wou (4md-2, Policy #or Self=ins. Lic. #: W 6T k ZQ6—)< Expiration Date: ) Job Site Address: I ip Po�• o- City/State/Zip:_c8owo .Z£� 115 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c: 152 can lead to the imposition of criminal penalties of a tine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pa rs and penalties of perjury that the information provided above is true and correct. •'n Signature: - kmjhi Date: Phone#: Official use only. Do nut write in this area, to be completed by city or town of frcial. City or Town: Permit/License# Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: �, ✓f t Sumer Affairs & 'n",ss Regulation License or registration valid for individul use only <�..\_ Office of Consumer;t,fFairs S BQsiness Kegulation h HOME IMPROVEMENT CONTRACTOR before the e.gis ation date. If found return to: I _ Office of Consenter Affairs and Business Regulation Registration: 106141 Type: g =s: i0 Park Plaza-Suite 5170 if Expiration: 7/22/2012 Private Corporati,;t Boston,N1:�02116 S7EVEN J. BISHOPRIC INC. Steven Bishopric 1112 MAIN ST UNIT 18 1�t OSTERVILLE, MA 02655 Undersecretary Not valid without ignature 1 nt of Public safct\ 1 Board of 13"ildin'U Kr uL(tiuns and stantlards Construction Supervisor License License: CS 47928 S TEVEN J BISHOPR IC 1112 MAIN ST UNIT 18 OSTERVILLE, MA 02655 ;: Expiration: 9/29/2013 ( ..I]lilt nrr Tr-,: 1010 oxTME �tvsrns�. 19. Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO ,. Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, N%ANS y - '�W'10 ,as Owner of the subject property hereby authorize J 1 G � J �IS �C to act on my behalf, in all matters relative to work authorized by this building permit application for:, 33 �Gv �t�s W'o Cal 1;A#- (Address of Job) Signature of Owner I6ate a P . t Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the . reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.0utlook\DDV87AAZ\EXPRESS.doc Revised 072110 ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 0'�s, Parcel 015-3 Application #a I C b" GG Health Division Date Issued l®/ .tq S- Conservation Division Application Fee Planning Dept. Permit Fee 3e o 0 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis �Y Project Street Address Village C�z k U \ Owner S U L )MSIN/) Address 1 ES 19 U)4644TO S • 0%1 � Telephone Permit Request P_VJUV))TIaA) Square feet: 1 st floor: existing 16Wproposed y 2nd floor.existing !Wproposed —O Total new Zoning District Flood Plain Groundwater Overlay )S Project Valuation 3d dad Construction Type W00 Lot Size Q Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Ud Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes No On Old King's Highway: ❑Yes ❑ No Basement Type: ip Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: .Full: existinger 'new � Half: existing �`� 'Kew Number of Bedrooms: existing new Total Room Count (not including baths): existing new d First Floor(Room Count) Heat Type and Fuel: O Gas ❑Oil ❑ Electric ❑ Other - ea Central Air: ❑Yes j_No Fireplaces: Existing New 0 Existing wood%coal stoye�,; ❑Yes Ut No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size — Barn: ❑ existing ❑ new size_ Attached ara e: M existing ❑ new size Shed: ❑ existing ❑ new size Other: 9 9 g — 9 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use G!Aim oc u PL D APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address A%A) 1;7r, SM-Vt j 1�/ License # I1 7 6 9- 046 Home Improvement Contractor# jOGI� i Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE bmb DATE ��Ighy I C FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED MAP/PARCELNO. ADDRESS VILLAGE ` OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION /NS �� so T FIREPLACE ll f ELECTRICAL: ROUGH FINAL - `= PLUMBING: ROUGH FINAL GAS: ROUGH FINAL t FINAL BUILDING DATE CLOSED OUT ' a ASSOCIATION PLAN NO. .'. ' The Commonwealth of Massachusetts . Department of Industrial Accidents Office of Investigations t 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit:.Builders/Contractors/Electricians/Plumber P s Applicant Information Please Print Legibly Name (Business/Organization/individual): Address: V2- AA�iN S)- &Utl''L- Ci /State/Zi ty p: ��iL�,UI�� ��- �✓ - Phone #: AWrarn a an employer? Check the appropriate box: Type of project(required): 1. a employer with 4• ❑ I am a general contractor and 1 employees(full and/or part-time).* have hired the sub-contractors 6. �New construction ?.❑ I am a sole proprietor or partner-., Listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9. [:] Building addition [No workers' comp. insurance comp. insurance.+ " ❑ We are a corporation required.] 5. oration and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 Ln Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] + c. 152, §I(4), and we have no 13.❑ Other employees. [No workers' comp. insurance required.] *Any applicant that.checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. if the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. ` 11 Insurance Company Name: :y /V+L Au"tIAL Policy#or Self-ins. Lic. #: twf ZQ jj .. Expiration Date: 1?AU 1' Job Site Address: 0_ 91 NHS City/State/Zip: Csu U)LL£ PO Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pa'is and penalties of perjury that the information provided above is true and correct. Signature ht Date: i�� Phone #: Official uce`ont y. Do not write in this area, to be completer/by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: Client#: 12032 2BISHOPRICST ACOROTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 08/23/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Dowling&O'Neil H/ 14i Ext;508 775-1620 F Insurance Agency E-MAIL ac,No: 5087781218 ADDRESS: 973 lyannough Rd., PO BOX 1990 Hyannis,MA 02601 INSURER(S)AFFORDING COVERAGE NAIL# INSURER A:National Grange Mutual Insuranc INSURED INSURER B: Steven J. Bishopric,Inc. 1112 Main Street,Unit 18 INSURER C: OSterVille, MA 02655 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT.TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LT RR ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/DD MM/DDlYYYY LIMITS A GENERAL LIABILITY MST4295K 11/01/2010 11/01/2011 EACH OCCURRENCE $1 OOO 000 X COMMERCIAL GENERAL LIABILITY DAMAI E T RENTED PREMISES Ea occurrence $200000 CLAIMS-MADE OCCUR ME EXP(Any one person) s5,000 X PD Ded:250 - PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $2,000,000 POLICY JE OT 7 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS - Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED RETENTION$ - $ A WORKERS COMPENSATION WCT4295K 7/19/2011 O7/19/2O1 X. WC STATU-. OTH- AND EMPLOYERS'LIABILITY y/NIQBY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENL $500 OOO OFFICER/MEMBER EXCLUDED? � N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE s500 OOO If yes,describe under - DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) Operations performed by the named insured subject to policy conditions and exclusions. CERTIFICATE HOLDER + CANCELLATION Town Of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 Tree ACORD name and logo are registered marks of ACORD #S84853/M84852 LS1 ��.�N Office of Consumer Afrairs& t;6siness Regulation License or registration valid for indtvidul use only -_ HOME IMPROVEMENT CONTRACTOR before the c..piration date. If found return to: Type: Office of Consumer Affairs and Business Regulation Registration: -t106141 yp 10 Park Plaza-Suite 5170 Expiration: 712212012 Private Corporati.:1 Boston,NIA 02116 STEVEN J. BISHOPRIC INC. Steven Bishopric 1112 MAIN ST UNIT 18AQ OSTERVILLE,MA 02655 Vt;ndersecretar} Not vald w thout ignature J *=: �la�.arhu.rt(. - Dcli:u•tnirnt of Puhlic afch Bu:u'd of Buil(lin., Rc_uLatinn. and Standard" Construction Supervisor License License: CS 47928 STEVEN J BISHOPRIC 1112 MAIN ST UNIT 18 OSTERVILLE,MA 02655 Expiration: 9/29t2013 C nuni..inu•r Tr-,: 1010 } r• °fj► �° Town' of Barnstable Regulatory Services rBAIL ss L��= Thomas F. Geiler,Director 9 s639.�'� . Building Division Tom Perry; Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the,subject property hereby authorize c5-Tn N 6 155 0 to act on my behalf, in all matters relative to work authorized by this building permit application for (address of job) t3� �GUu's Q76 CMi I r Sign of Owner - Date J. Print Name r A , CNN OF MAS. r -. MICHEIE {��•� CUDN_Q i Y C) Z, No.34;';a w CrJ ''E! STRUC(URAI/j c C t O !cn� \ S, 34 Zn 07 k �i H �7, 14-Y FLU s H io �' � ' ��f °R ,2� -F,62<� v oLo fiL{ -o m o C; o o C 5 r oti o C �b `P P�MA'�r4 J m f1 d - 0 1 ►-.5 0 (D � 1 � _ 3 �yUFy� fl2 MICH�LB • sip - CUDILO Y No.3477d ; v STRUCrURei1 _+ ¢ I , I t X�WWJLCA J I I N 101T3 rL E`p� � sfY wep STI000AED> CKl`t !1 1 jryr 2-Zx'tcJ `•3 `� ` A t s c_ "1 Of /v )t 1GLT [ srm - I DfZt fl C►F� Bc� t1� • _r ~ r rTAIt 'lZu x 4-' x 0, _ I "Lo (R,4 ) CA COQTD1G. oa L+ coKTiwous vrZ1 raorwc ++ �I mat P,. ---X---X---= u NOTE 1. ALL WORKMANSHIP TO CONFORM WITH AMERICAN INSTITUTE OF STEEL CONSTRUCTION AND MASSACHUSETTS STATE BUILDING CODE LATEST EDITION REQUIREMENTS. 2. STRUCTURAL STEEL: ASTM 572 (FY=50 KSI); Optional: SHOP PAINT WITH RUST INHIBITIVE PAINT., 3. EXPANSION BOLTS: "ASTM A510 3/4 OIA.x6 EMBEDMENT IN CONCRETE: THRU-BOLTS:ASTM A307 1/2" DIA, 4, PUNCHED HOLES IN PLATES = 9/16"' DIAMETER," 5. ALL WELDS E70XX ELETRODES.. SHOP WELD CAP AND BASE PLATES TO COLUMNS 45� 5: COORDINATE ALL DIM /DIMENSIONS W/ ARCHITECTURAL DRAWINGS, AND FIELD VERIFY WHERE REQUIRED. t , MICHELE CUDILO;'_ P.E. Consulting Structuroi Engineer : Centerville, Mossochusetts 02632-1979 rncudiloCcomcost.net PROPOSED MODIFICATIONS Drawn By: MC Date: 09/28/1 1 Drawing, 133 Lov'ell's Road Scale: None Rev. 0 COTUIT, MA S K_`" 11 File Nomea _ Project No.2011-174 w. ._ Cape Cod Insulation, Inc , . Date 45 S 'Yarmouth Road Hyannis _Ma. . 02601 P1 . 1 -800-696-66I 1 l a . 1-5082778-5735 CD - - TO: - wilding De p arti-ent, y f C) Please accept.this s foam sta Job prY teme. t. L o' catio t , n CD Builder S PC Keith Pr } . ,. . . esswood .• : Vice President of Sales ke' ithpresswood verizon.net IoAgflkbalahoi�� Spraffoam Insulation: Installed Insulation Statement Location of Insulation Thickness Total R-value Approximate Sq.Ft. Walls 3'l Z*x 4.45= 5 ss Q3 Attic-,Floor or Roof Deck (oircle one) x 4.45 = ,Q Cathedral Ceiling x 4.45 = �N ISM 5 5' — x 4.45 - IN o o 80 1 x 4.45 R-value=4.45 per inch Tensile Strength=3.87 psi L/ Density = 0.67 0.8 Ib/fe Compressive Strength= 1.86 psi DEMILEC-Batch# ( � {'t Andek Batch# (if applicable) ..m Company Name WSighatunev Applicator Name �( 7 D to Print K Page 1 of 1 Subject: New Message 4 �_ From: capecodinsulatio10@pm.sprint.com (capecodinsulatio10@pm.sprint.com) To: robcharkat@yahoo.com; Date: Friday, November 4, 2011 2:25 PM Sprint)7> Ir � t You have a Picture Mail from capecodinsulatio1 pm.sprint.com , Message: ' r - View Entire Message t Send and receive Pictures and Videos through 'r Picture Maitsm. For more information go to " www.sprint.com/picturemail. Please be aware your friends can forward your picture, video, and album share invitations to others or post the unique Web link to your share invitation on any number of sources (e.g. blogs), through which others could also gain access to your online photos. If you have private or sensitive,photos you are sharing, please share them only with those you trust. d - - ©2011 Sprint.All rights reserved. http://us.mg4.mail.yahoo.com/neo/launch?.rand=elbhunhOaspd4 - 11/4/2011 f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel v J Permit c - /�. 1 o4- �Health Division '-30�w Date Issued ' See Conservation Division ?_ 30 FeeC,/)� Tax Collector �0©r Gay Treasurer K Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis t.: Project Street Address 153 to&% Village Owner 0 5 P'lc-f�`^ Address i 3 3 "V-,-i 15 &� Telephone SO "la Permit Request ?)QSe4,f_*, -o-�,� 1Vt� c J'281-k ry — ` f `001"s ,of®&9XA -) ;+NO tSf�O rev k0AAS Wr6-. 0,-i y a,&A �mV►r r4 v. SJ�vr,rHE' (�1�✓►S Square feet: 1 st floor: existing lrgvy prroRosed 2nd floor: existing ),,t;cc proposed Total new Valuation a5,a°�'�"0 O�P�Zoning District Flood Plain Groundwater Overlay Con;,truction Type Lot Size Grandfathered: ❑Yes . ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family M Two Family ❑ Multi-Family(#units) Age of Existing Structure 13 r5 Historic House: ❑Yes No On Old King's Highway: ❑Yes ❑ No Basement Type: 0 Full ❑Crawl '❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: q Full: existing new Half: existing new Number of Bedrooms: existing `� new Total Room Count(not including baths): existing 13 new First Floor Room Count Heat Type and Fuel: Nf Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes 4 No Fireplaces: Existing _— New Existing wood/coal stove: ❑Yes No Detached garage:❑existing ❑new size D Pool: ❑existing ❑new size y Barn:❑existing ❑new size D Attached garage:❑existing ❑new size _Shed:O existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name 1�a7���� �i M ef%LAC Telephone Number ` bl 3yI lady Address License# C.5, 0 13 5 3 f a-I Home Improvement Contractor# t d a 3 1 Worker's Compensation# 1-u �01 10 L ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO -,J SIGNATURE �' d DATE t FOR OFFICIAL USE ONLY f PERMIT NO. DATE ISSUED w MAP/PARCEL NO. ADDRESS .: VILLAGE , OWNER T r DATE OF INSPECTION FOUNDATION K FRAME U INSULATION ; FIREPLACE 'a ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL _ y" FINAL BUILDING _ .i DATE CLOSED OUT t d 4l ASSOCIATION PLAN NO. t TOWN OF BARNSTABLE BUILDING DEPARTMENT INA1110TAU TOWN OFFICE BUILDING rua raj .639. `� HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: /Building Department DATE: (D � An Occupancy Permit has been issued for the building authorized by Building Permit #...! _ ...1,,, ..... . ............................................................................................. ... ...... issued to µel f ,.......y+...........yT ...._. ... _.. _.. _� Please release the performance bond. t LCA- 4�- q j ■, � �T•t :4i F�rcM1 a^,��. -`°'�ir. ..".. .qC p', ;F s .F "N.-m... T, .;c . ... Y' ... . - f .-.. .-..... �.. TOWN OF BARNSTABLE Permit No. ....31035.... BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ................ 7 Yl ��O63Y HYANNIS.MASS.02601 Bond .......x....... CERTIFICATE OF USE AND OCCUPANCY Issued to Warren Jacobson Address lot #4 133 Lovell's Road, Cotuit USE•GROUP FIRE GRADING 'OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. MaY". l 88 .. .............. 19................. Buil ffig Inspector i+,�r�Y1, w'wrr�r,�;..,,� sx:�{K".*�•.rxy.��.'�„�C�e�t,'S�;atFi°p.y.�°r�"9�1`�j�P�,i �'ti''!'fi'�'tfi'i'wi'-G1:�..jflKv��^y�-t"�'�"`sl,aV*,�'tF=' .hX:�.�gza5p -'+f.�.. .. ,�;w.:.y�,_ ,�,� .- 5y M A ,� E>o TOWN OF BARNSTABLE 31035 Permit No. .....:.......... AUrf . BUILDING DEPARTMENT a.aan t TOWN OFFICE BUILDING Cash '�owr HYANNIS,MASS.02601 Bond x CERTIFICATE OF USE AND OCCUPANCY Issued to Warren Jacobsoni I Address lot #4 133 Lovell's 10ad, Cotuit Nv USE.GROUP.. FIRE GRADING OCCUPANCY`L'OAD _,ot_ 'THIS PERMIT W[Lli NOT BE, VALID, AND THE BUILDING SHALL"NOT BE OCCUPIED UNTIL , SIGNED BY THE BUILDING INSPECTOR UPON! SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. �A March 1 88 r 19................. ......�Y � ...... ...................... Building Inspector z 3 r �o a TOWN OF BARNSTABLE Permit No. 3 q0 5 4 BUILDING DEPARTMENT .,. / TOWN OFFICE BUILDING Cash .v ... HYANNIS,MASS.02601 Bond . CERTIFICATE OF USE AND`OCCUPANCY Issued to «ar� Jacobsop� Address Lot #4, ' Lovell° s Road CotuiMass. USE GROUP / FIRE GRADING! OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILD'_ ..G SHALL NOT BE OCCUPIED UNTIL SIGNED BYIIE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. March 1 88 ........................... 19................. - ........................... Building Inspector THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I m F-�L DATA A. TOWN OF BARN$TABLE, MASSACHUSETTS U 1 L D�I N G li'tRTLICENS DATE v lll`/ L J, 19 87 PERMIT ■ Y•'Y APPLICANT �t Ot 1': (.J11 it. lll;::'1i7,'1--- 1_ ADDRESS- 4. 4 i3z.'L 0e'.Tr°,� Sciut1re,, CC:"i".it-c!—"VT .1( IN0.) - (STREET), (CONTR' NUMBER OF PERMIT TO tSllllid DWi�1.1.1ilLj ( 1i) STORY f'Jl:iC u.CJ r7:; ili'/ liLy('_.L.illii DWELLING UNITS 1 (TYPE-OF IMPROVEMENT) N0. i (PROPOSED USE) w < ZONING AT (LOCATION) j20t 1 L0vF=�1 a :°,l.+Cl(.: l.t ."i,;u,i.'i_� DISTRICT (NO.) (STREET) - BETWEEN AND (CROSS STREET) (CROSS STREET) _ SUBDIVISION LOT LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY _ FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION - TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: -IT i:f CYS l;.i AREA OR VOLUME V2`' :.."':1� '-�-�:. i:J.i l)(_%'J . UI:i FEE MIT $ ESTIMATED COST (CUBIC/SQUARE FEET) •i t'ici L�:.=ii .)c-i...�l;.iLi:;:: - =i;. OWNER a.Lt-lii:iJLi cii.i � !x'•ilili�.1.., BUILDING DEPT. ' ADDRESS l" BY I THIS PERMIT.CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARI OR PE4RMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER-THE BUILDING CODE, MUST B P P O'VED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBT ED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDI NS - OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL IAP K: F �`� ELECTRICAL, PLUMBING PLUMBING REQUIRED PROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARA INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE " I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF.OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH.BUILDING SHALL NOT BE OCCUPIED UNTIL.MEMBERS(READY TO LATH).. (FINAL INSPECTION HAS BEEN MADE. ., EC-TION BEFORE - - ST THIS CARD SO IT IS VISIBLE FROM STREET ['yam B IL ING� i PECTIONI/AJPPPROVALS PLUMBING INSPECTION APPROVALS �. � ELECTRICAL INSPECTION APPROVALS Ryry-� /f-*71A// / d1 _ l 2�. a 2 -- ` / 2 — V es Q / 3 HEATIN CTIUN APP), VA ENGINEERING DEPARTMENT OTHER BOARD H LTH q } WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT WILL BECOME NULL ANr•,Vr!^ IF CONSTRUCTION INSPECTIONS INDICATED ON THIS C N BE TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WI tiles.•`.. MONTHS F DATE THE ARRANGED FOR BY TELEPHONE ITTEN 6 CONSTRUCTION: PERMIT IS ISSN) AS NOTED-f B0VE. NOTIFICATION. , t ppNZ� 71 ti } �� v PLOT PLAN OF TO THE BEST OF MY KNOWLEDGE, THE FOUNDA TION - L OCA TED IN'' , p SHOWN ON THIS PLAN IS AS IT ACTUALLY EXXSTS.+ AN �ZN OF t r h, BARNS TA E..CO,TUI T, MA 5S, r' THA T I T CONFORMS TO THE TOWN OF BARNSTABL E ZO y t t a t _ REGULATIONS, REGARDING YAHO SETBACKS" °AVID PREPARED FOR sArvIcK WARREN LJA COBSEN DA TE.•MA Y.2B,. 1987, 28085 - L.S. p��o FCIST ER`�� DA TE.•MA Y 2B , 1987 SCALE.• J"� 100 FT. i - - �4L LANQ S - CAPE 6 ISLANDS- 'SURVEYING FLOOD ZONE C NON—HAZARD S; TEA TICKET k' � °• .. ry?: 7�t ..,E r Y sSessor's•offioe (1st floor): Assessor's mapaand lot number ...�r .u��.........e...5 ��, Q�oFTNE>o�` Board of Health (3rd floor): SUBJECT 70 APPROVE Sewage Permit number ...51....�.�............................. BARNSTABLE L�S� COMMISSION t BAUST11DLE, i Engineering Department (3rd floor):/ / moo Me House number ............................I��1 .........,,G ..`.D.............. d l YPY APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M.-only A P P R , , E ;'OWN OF -BARNSTABLE men servatioa ssi UILDING- INSPECTOR q ' ignedA"LION FO ..R%RMIT TO .............. .................�. ✓)5 �.`" C ......1.tv � .mac........... ... �. .... .. TYPE OF CONSTRUCTION ............../.4'.6AAJ..... .�... '....1. J....... ' � ............. .................19.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ................... a..!........... d............/, . G.., ..5...... ... ...................... .�v.!...!.................................... .. ProposedUse ....................4D.!n .�z................................................................................................................................... Zoning District T........................................Fire District (�t) _4f -- II J N.o P.5Q 1.1 , I f Name of Owner .............f�.4........4'�!................ ........,..........Address .......(�/.Ll. JA .....b,1.1Aq....... )�• r✓i• � . • l Name of Builder /l f ��VC f0�.........Address 2 `1f l'erJ.. I� Nameof Architect ...................................................................Address .................................................................................... Number of Rooms .........-I/'-...j3cv.....................Foundation Exley ior .....................�....`'............ Roofing Floors .............QN..K...j.....C.l ..(z ..T..............................Interior . ... .............. .. ... ...... Heating . ..........:.........................................Plumbing .........�.. .. .............. ......................................... //...� �©(�, Fireplace ...............�t-.�.......................................................Approximate Cost .......... �....... ... ..a......... Definitive Plan Approved by Planning Board ---___ Ate------- Area r . ........ ........ .... Diagram of Lot and Building with Dimensions Fee ... ..:........ SUBJECT TO APPROVAL OF BOARD OF HEALTH 1c=� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 0 Name ...... :......... Construction Supervisor's License ..d.`7°%2..y:s.. ...... jACOBSCN, WARREN ,FNo Permit for 1. .. .Stor.y ... .. t........ ........ Single F��M��jy� D w n(j ................ ............ ........ ........ ........ qR 14 - I Location ZM L o v e 11 ' s Road' .............. ...................... ......................Cotuit................ . ......... ...................... Owner .... Warren J.aqbnSqfrn ....................... Type of-Construction FiZLme ..........1.P.�................... ................................... .....M...... ....................... Plot ........... Lot ................................ Permit Granted ......ju4_Y... ..................19 87 Date of Inspection ... .........� 19 Date Complet ... 9r. ........19 17 % Z j < 0 tv 4 !9 Assessor's offioe (1st floor): /�j L Assessor's map and lot number ...C/. �` 4, - , ofTMETo Board of Health (3rd floor): d� Sewage Permit number ....�.. ' '?.......... ........_.:........::......... . Z BAUSTSDLE, i Engineering Department (3rd floor): o rasa r O 1639. \0 House number .........................: 5 .......... .................. o OR°'• APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPPL CATION FOR PERMIT TO ... 99 � �. ....�.Ct......140.�:'!�:.c................................. TYPE OF CONSTRUCTION .............. �E....................... S. .. ........................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...............................11ll....................... ........ ............................................. ...............!........................................ ProposedUse ....................T�p.!�.z................................................................................................................................... ZoningDistrict ........................................................................Fire District ............................................................................. >t Name of Owner .......!! (4(�! J (�(O� SO/ ...Address �.�....�!V....:...R.�..�,. .. f� f� 2 1 Name of Budder �� l� C4?�I��••��vC......... .........Address 2 `� '.✓.�.`�.d f f.Zl?'. ....5aq!l'?P Nameof Architect ..................................................................Address ........`.......................................................................... Number of Rooms ..........1.�...i3.r<) ^'-�� ........................................Foundation ...................... ................................................ :..... Exterior ............t/1.Jc'bcJ...........C �. .�1.. �? 2.�.........Roofing ................................................. ............................................. ...................... Floors ............. ...........................Interior .........v......................................................................... Heating ..! 5...................................................Plumbin •-yr....g Fireplace �t .......................................................Approximate Cost ......r:.. Definitive Plan Approved by Planning Board ____V_.!_t�1 19_�_7 . Area .......................................... Diagram of Lot and Building with Dimensions - Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH i i l l OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations`of the Town of Barnstable regarding the above construction. Name < � �!-'�. ....L. .......... /............... .. .�. Construction Supervisor's License .. S..!o...... a JACOBSON, WARREN A=025-053 No 31035 permit for .. 1 z Story ............... Single Family Dwelling .......................................................................... Location ,.Lot #4, Lovell ' s Road ................................................. Cotuit .....................................................................I......... - Owner Warren Jacobson ................................................... .......... Type of Construction Frame ................................................................................ Plot ............................ Lot ................................ July 29 , 87s Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 r. �= __ j lie Lommonwe=j of massachusTm±7 Department of IndusvidAcrjdej= • � , -=� � o�caallansrr�ro�s r a 600 Warhington Street «= Boston,Mars. 02111, r- Workers' Cnmensadan Insurance Afridavit --------------------- . nn loc�orr 133 Lovc \`S (0 city chotte�! I am a ham=wac p au wont=Yscm I am a sole mflaaetor and have ac oae madd=in my caaacity I am an employer .:::.............::. ... ...:A:??.:. ¢ •YIW,...« •A�iM1:.,�• this .L•MT:/ .t:y:.�TT::...... Gl1>aIIBIIV'�18taG'. !..: ...r.•:. ..�:,,,,...x.:..: •:. •• '.---:~;�y :;:<:d::'.. .. ••.::,•: . •a�• "Lv ''�bagx���•��'ksct'•�'' r�•�l��t { •��Y#,i':;a�+ti:c:}•::t::.::'?::co-r:; 57i ,�.a:3�3eedsoF'+�'disK ..:i.: ..........::••,�._.:::.�:•:.: v :.i.::v.,vr::is i':•:.. '' -}••;. +rk{ti{ .AK+.}+' .........:•:,. A.. :.,• :+x:;.. A. ... ... ?,}Jma .. ..: R�2•'v�it .:axyr,,.{:�.?'C•i;i., ;.;:;�':............ •"ixiooa+oe�"N+�'ea' TOAxx,�,.k� i`iurv:: ...y. ''v JM'vM:t...wy dtv—...::AKr^C':A.- ? •..... � �.,.� ... :+O(M.+lti:•.' ... .' '•7Wv' S,G!'p}f"?y:;R;%tAw�SJinr •::.:........ ..;:v:..v?.�=:4.• - t?7yt-•u{�,"'''Lry,KiPlY.,i. .............{LK:•. {:i.:...:} ,y, {:.... ��.• �.A: •\�?}...:•:.�:.:• •.:+.y^^!i::KF7wAuy.�:i.� -xr.nix,�.T:.�:..._:. - , 1astaIImr:4. .:. .... ....«: 'y« 'r'•... •;r.; .. .. N\hv??? V'M:j22..}y': .:A•MIOr.. r7MMrpOp ♦ �� � v7.!!�YVC'Q+fw.':t'•v'{+.'A•.':A�ri}::::'rit.'titii:�"'_:..' ❑ I am a sole general caanactor, have t�dr�aa dDave�the r=aartaa lisz� fclL:°wmgwohe T.te�aon ..::v::'-Y.}......: •A•.Yyry;.:Z^}-Q'}Y7.' vYi:SA .•.:'; 'O:!!.w,MC!!!!7!.wvA:.yn}.. ....:.,Ay,x,:tiiji:4:;}vK•'•'-+' 'ti':Y+.... }..?M� -. :•A1,EOS�:OrOK 'r•...: �L� N• � L�'�OIM .. M2..... i......:..•::.... ............. .v.,v.;v:{•y:�h•:4;{n•}.vm}v.:Y..v::'{L.iT,,.yyk yii . .,.;A•A:�:.::+x•::^.,,9'""a:;ek:fiR3r'axxmTTcyT:.:.::• •.vy?Yip:•y:}.y:;:�.x•}.L.;{;.:y?y... .,... . ...:....... ...,,••:i:�:rn�;«;;;:.itw�o ..... .. .,..•.: -:'�..``•+oocNifw:•`:iSer .. ::`.;:::: A: {:tKiti.Y{•TOv. ":'}�:�`�'bf^^!L,�Lti�fjq^y .n???7id�^!q;;,:r•}C6.:.•..:. .::i•::.:•y9CC:•n::j?:{:•?4::••,:'^•L}::,:a?V7iiVwtUM.��•+:'�v fi AV:•:•.+n}T}x.?%;.y?:.y?.:.w:%`. .. A. -:..:y:'?:•;y::j;<?.:}}v?4;.'+,Sy:�iooi�.i•:v.K:}.`s,{,'Ta6,.,0.4;�`.',.:, .. -vv.,n!!Vn:{'Y!}.'..T""pfY.N'\••.....'.:;.::::: ,iJuuW?Cv7$ArtiiTy .•.:•:.. .. .... .,.•x .r.,• ..... ... yk"xi*wtiiiainti :y�2:��:'^';>: dlIIPB?!tT•t�.. .... ..:. :w.w.w:>;4•??•..:.: ., , .:. .. '?x::;;:a�Lt.;ui�rw�'. •ay .. ....::A:•r. .:v:.......y,: {• xW:•:^v b'•iM00ip''3 vc•.... ..•::::•.:.,:...::::..::•:•:.;•:..,�+.•>?y?::::R•?;;:,:}vR•"tr3.1•; Cu=!i4v.A '';4'..:.... yxT,�""'•awNc�amek�tif:>\::•fir.:::};:`�x>Y:i: ' mg;�:6 tflit"S:\:?>::, !�c....,...aw:iraooawgwx�c:- .w' �+;rReo•.::4:;;:::`;c>:rY:s :: ::. ..:..:. ..... ....:..•# :NR{`{�lW, - .. ... .L ,' ': .iiMRml4�Rrwva•'?'•?:??:4::X::;4T::. ?;`:::.;.':..,.;:.;..�a•fi}o:r:: :. .�'r;:ti:^. •;'R�w!c�nv+' �t4iQR4:1:: ,avR:z?::L{;.{tt•:R?:r5;. .:.v::• ...:. A:.....: .w. : ..... •>:. : �::..:.::.A.:.. ........:A..r..a•^.�r>:Ri..yy;A•t• •AS;.+yTfa:;.y?, L••+ra.. _ ...{,yty. ;>a!aa:.;•.L;,tiv:;•:;•:t::�:i?:::.::;:_v.:;?.::. ar•:�xr.. . .. �,'RLV �.. !wkNczw\:'1,C.v:.•+::�t :.... ...: �ttlSt'.° •::.t v .tCa ..: K�.•»a::;:;:.�,:;r:••:;•: :..:. ................. .. . :•..,..::...::..:.. ,•:::.,::•:::........::............ A:.... A•::-:::�. ............. .o .. .. :•x{{,ta�x4rTava::;-Karx;;;•r.:_r::.»,....•:x:«,::. .•::::::,,........... .. ...........>eTi.:::•::i;{.>:.;:.:y:?.loan:•;... ......;.::{::?y::.�...... ........ .... ..:. .... ......,�: :......nvxy.o..yyy..,;.Ra >. ....A.aw ..A.....A. :;.y.. •................... .:, :.::..^?M:aiyi:4::;i•:•:;:{:i;yY�y ia<ti .::••:iti{w t..:.v. .... ?iC)Y;......:::::::.. '{•:N.}M^vS'r.•..{,'•l.'{''.:•'..........,' 'wrV ...... .i:....:.....•i:?i•::•::4:;.. Q�rs}tre•�.. .::.::..::•::.^,r:{•:rv..:-:14...R.ry;.;v\;�..,Yry ...:.] :/vim •::.��i1(ri:� y,.y .......: x ,.:... ........:...:.. ..•.: I�i.. mow. ••�'K�,M^" .;........... vw,aL:OSJ:{Wty%'.wrJiSi:- f Fai>mrtoseesase�esa;ess aderSeettassLSAofMGLL4s l=dtotba tmopodttaaofcdmmaigmaittts afa8aa up to SLIM meymn'tmpr0 tmmxxv aasctvapmaltlrstntheformofasropWOGSOR mmdagmot3lO 00adeyagatmitme. I=dmm copy of this ssa—M easy be f0marded to the OnIm oflatesttpdg=of am=&fort�+esa� ®. Ida nerr3v carify rrsder rhrF=U peaaldrr of per*7ikattheuform dad pravided abovr is trap=d cmrr= Sipe Hate 4 s AJ) O indai use only do not w me in tdia area to be completed by cfty cr to oMcbd cim or town:. pesmitAlanse�t • OBuildta=Depss'a¢ chec',if LnmedLse response is required ❑Llc�sm;Ba+� ❑Sdeetmm's O!S!u ❑Hsaith Depussncn contact person: photteo; — ❑ Other 1 I 11 1 1 • 1 1 1 / • • • .I M• •1• q • •• .11••• • M • • • • • • •1 •••1 _t• •It • • • • • • •1•• • ,11 J / / mad •�••••�• •w •1• •• • •1•�• - • 1• • •1 • ••�• •1 • •M -•• •la • •• _I• •1• • • •w L: .0414 91 • so ••• • As • !r • • ♦d • 1.1 w•Ity • • .0 Is go• •bsd • • - •r. • w•0•9a•to • • «�•c �• HI• • •► lad • • H• •1 •.• •• •, • 1• •.• ..• •n • • • �1 w•r. w•1• •• •• • 1• • • • ••• •• J/ ••1 Id•:• •d•w•Ik .IJ • / • wJ1 •w ••w wa1 •1 d• •« •I•.••1 • ip="Vm U •• • • • • ••••H • • • •Id 1• . • • 1• JI•IawaYal r •••1a b .1••♦ «• •r1 •1 •Y.♦• • •1• 01• -Ia • • •molffenfle6 • •1• •• I • N • • •• • _I.1 • .I•• • � •1• •w..;al v •1 '/l «• w•U• • • lA wal • • _ _ mow••�• .• • .I• w1•Id • •w • • • •1• • Y♦/H /Ia;t J •:Il 1 1 r: IIJI Y11 • ' JI 1 ol 1 I • 1 I r 1 • I • •• •1 1 • I • 1 Y11 r l II •1 ra I • 1 r 1 111 • 11 J- 11 dl r1 IIIr1 1 • • • 1 : • ♦ 1 Y 1 rrlllla :/1 r 1•I •1 II II :11 rI' MI • J _ • 1 • •• 1•slat i •••-• • t • •• •• • 1• •• I•.. 1• • •1 ♦v •r. +rr w•Iaw uu• .0 wr♦nr. « 1.1 •• •w t• ••• .•• • r • ••• •. does • • r•n••• .0 • U• •• aJ l`I aJ►:ul �• •a• —•••.walA •1 ••1 «•v.•• ay •% • • • • N • 1• d •••a•n•C tl• H •• • •N.•.•w ••nu•wuc•• •n .•�• •r. / ..•1.11• .+• a • «• .•u • •1 pig 0. dar.• _1• • n �IN•ca• •r• .•• • •M•H• Q • ••• ••• y .a• • • /1•n• al•n• •ww •rll• • n1 �w •a• .ter• el n 1• .•• ••-. 1 I� • • , •.• N• •• •1 1a •III.`I••v. wl•1�.•a•. 1•I r•la•-•••//✓U •rr •1 1• `111•:•al ••• •�•�: • • a 11 •♦ • d I • moves 0 lost v 1 •aY.• •r .r• • w•1 •1• 1.1 •••11 •1 . 1 •• � •%• ••• •1 •/ ♦1 •la •/••% « •�••1•. 1/ •11 1 • •11 •r •1 • 1 r• •111. •• ••1a••• •1•.•w•, •••1.11•w•►-r:l•1.1• • • • .'! 1 11 1 • •I• • • •••I.11• .rr • •1•••11�• �•J • •• • d••d ••w• floe•• •w a/ r• 1 AL—• ,♦ 4—IL•wow•w•1 •11•a6 • •k ♦•Y. • ••••• • • H • ago `1. •1.1 w .••v•• Iwo• •aa, •✓ .Ole . . h• . • .a• • . . .. . . • ... •d•• .•• • r.•' •lN•• •w 1 1 I 1 1 1 1 1 • 1 1 • 1 11 • / 1 41 ESTIMA TEO PROJECT COSWORKSI-lEET Value LIVING SPACE square fee SI15/sq. foot= DOO (high en construction) above averag construction) square eet X S96/sq. foot ( avers a constructio - s feet X S57/sq. foot= 9 s feet X:S25/sq. foot= GARAGE (UNFINISHED) square feet X S20/sq. foot= ` PORCH square feet X S15/sq. foot= DECK square feet X S??/sq. foot= o o b OTHER Total E ted Project Value The Town of Barnstable 4 91� 9- ire$ Re.utatorp Services Eo,an{ Thomas F. Geller,Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street.Hyannis MA 02601 Office: 508-862-4038 Fax: 508-7 90-6230 Permit no. Date t I D AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGI,c. 142.A requires that the ,reconstruction,alterations.renovation.repair.modernization.conversion. improvement.removal,demolition.or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to snvetures which are adjacent to such residence or building be done by registmsed contractors.with certain exceptions.along with other requirements. Type of Work: . �S cw�.n�- Estimated Cost9'a`' Address of Work: Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law [3Job Under S1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME I11FROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of.the owner. l d913 � Date Contractor Name Registrauon No. OR Date Owner's Name • MtzuApps aj TsblsJ=b(C=dnmd) 5 prrsaipu a i?szkaM for Cis m d Tia~FamilT llaidamid Baildla $rarsd with F0=1 Faso MAXIMUM ! M12YIht[1M ( =Ztg ale Ceiiia8 wall Floor g� SubFlaaa�Cxi::.; Am,(}S) U vaiac R•vsia� IGvxbzo R.vat wj Wall P ..•••— P=ase &vsiva+ &vsiar 5"1 to 6RD Hambm Deem Dark Q 1T.'• I a40 1 31 13 19 t0 I 6 I NO=zi R I2:'. I OM I 30 19 19 t0 I 6 ( Nar:si s 12% I ass 1 3s 1 13 19 i to I 6 I U AME r 1rs ash I 31 1 13 21 WA I Wa I Narssi U 139.16 0A6 I 31 19' I 19 10 I 6 1 Nosassl v 130/ I a a4 In It3 ZS WA 1 WA I CAME w 13% I asz I 30 1 19 19 I t0 I 6 1 u AME - x 18% I am I 31 13 25 I WA 1 WA ! Nm= i Y IMa 1 GAZ 31 19 25 I WA I WA ( N=m:d Z 11% 1 OAZ 32 13 #19 t9 to I 6 I 90AFUE AA ism. 1 asa I 34 19 1 10 I 6 1 90AFETE - t P. 1..ADDRESS OF PROPERTY: coke\ Z SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAMG: I u '` 30 4. %GLAZING ARE.-k(#3 DIVIDED 13Y#Z): S. SELE=PACKAGE(Q—AA-see r.�art move):=7 NOTE: OTHER IMORE INVOLVED MMODS OF DETERMINING ENERGY GY REQUMMIMM ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPE'Oi OR APPROVAL: YES: NO: 780 CMR Appendix J Footnotes to Table J511b: Glazing area is the ratio of the area of the glaring assemblies (including sliding glass doors, skviights. and basement windows if located in walls that enclose conditioned space, but excluding opaque doors) to the gross wall area, expressed as a percentage. Up to I%of the total glazing area may be excluded from the U-value requirement. For example,3 it'of decorative glass may be excluded from a building design with 300 IF of glaring area.. After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedurr, or taken from Table J1S.3a. U-values are for whole units: center-of-glass U-values cannot be used ' The ceiling.R-values do not assume a raised or oversized truss construction. If the insulation achieves the foil insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (lf used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the:roof: •Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, strueanal sheathing,and interior drywall For=ample,an R I9 requirement could be met EITHER by R-19 cavity insulation OR R-I3 cavity inmu Plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. °* 'the floor requirements apply to floors over unconditioned spacers(such as unconditioned crawlspaces, basements, or garages).Floors over outside air must meet the ceiling regttinesnents. •The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must nee: the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned bascmcnu must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. The R-value requirements art for unheated slabs.Add an additional R-2 for heated slabs ' If the building utilizes electric resistance heating use compliance approach 3, 4, or S. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the Iowest a efrlcicncy must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table JS.Z.la ..NOTES: a) Glazing areas and U-values are maximum aeceptabk level. Insulation R values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. . b) Opaque doors in the building envelope must have a U-value no greater than 035. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table JI{.3b. If a door contains glass and an aggregate U-value raring for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(Le.,may have a U-value greater than 0.35). c) If a ceiling, wall, floor, basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component Glaring or door components comply if the area-weighted average U- value. or all windows or doors is less than or equal to the U-value requirement(035 for doors). f - 4 MAScheck. COMPLIANCE REPORT i permit # Massachusetts Energy Code MAScheck Software Version 2 .01 Release 3 Checked by/Date CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 4-10-2001 COMPLIANCE: Passes Maximum UA = 179 Your Home = 175 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA --------------------------------------- CEILINGS 1276 19.0 1{ 0.0 65 WALLS: Wood Frame, 16" O.C. 1165 11.0 t 0.0 104 GLAZING: Windows or Doors is 0.350 6 COMPLIANCE STATEMENT The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. 6AU G 411,101 Builder/Designer Date IV new cti•�µ� � S d Li<<��S % y, i i ar `�� �o.►tllS [tc� /� s apt 1�3 ao x 1, E Co •�' rrA Is x ►a` �. LIMERICK CARPENTRY f, 499 CANTON ST. I� STOWHTON.MA 02072 L i Z z$X 13 C L04> o g o � c �y�15 15 ti 0 new ,,ac1t -� .L s to c� 'Tho�a� Mai n aO, ao x %► E c�}w,�- MA O 1 LIMERICK CARPENTRY p 499 CANTON ST. . UMGHTON,MA 02072 J, Sri r 0 o � G aO x ,► Cn1"• A . S L E 15x1�` S �• LIMERICK CARPENTRY O 499 CANTON ST. STOUGHTON,MA 02072 f 'Gal 81 t alp Rt\yr�'i� CG)) J Z .Zsx i3 --F�o I W oo 5'•C�ot ° r0sg* S�' - o ly�Is 15' C 0 new CD— oo v� 1 V b cl ./ i / / a�a� Mar r, Sc`V ap` �3 Lo,to\ [t ao X It rCIL-5 LIMERICK CARPENTRY p 499 CANTON ST. . $TOUQHTON,MA 02072 L/ / /0 �or 0 \lA wail U4 CA C LoSti't rr O rn a i Go t • y .. �%, �ominzoorusea i a�✓ ao sac�iticaelta BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 073531 Birtttdfate: 08/09/196 Expi /09/2002 Tr.no: 73531 To: 00 RGBERT P LIMERICK 499 CANTON ST STOUGHTON, MA 02072 Administrator. HONE INPROVENENT CONTRACTOR a Registration: 12 Expiration: S/26/O1 4 Type: In . k Robert P. Limerick ,� Robert Limerick ADMINISTRATOR fiE 499 Canton Street §t Stoughton NA 02072" 1 t Frnm-nnvilinD InsiimnCP Tn•Mi1rhPllA Trnfl nave'4111/n1 Time 1-51-5A PNA Pape 1 nf7 AC-OR Dm CERTIFICATE OF LIABILITY INSURANCE 04/11/2001 PRODUCER (781)8 48-76 5 24 FAX (781)380-8783 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 44 Adams Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P 0 Box 850962 Braintree, MA 02 19 5-0962 INSURERS AFFORDING COVERAGE INSURED Limerick, Kobert N (C.) Iir,niRFRA' Commerce Insurance Company 499 Canton St k2 INSURER B: Stoughton, MA 02072 INSURER C: PdSURER D: Iracur.Erz c. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOP.THE POLICY PERIOD INCICATED.NOTWITHSTANDING ANY KtUUIKLMtN I, I tKM VK UVNUI I IVN VF ANY UVN I"AU I UK V I MI K UU(UMtN 1 VVI1 M Ktv YtC:1 1 V VVHIVM I Mlv VtK I IYIU.AI t MAY Ift I"UEU UK MAY PERTAIN,THE Ih1£URANOL AFFORDED BY THE nOLIOIE£DE£ORIBED HEREIN IS£UBJEOT TO ALL THE TERM£,EXCLUSION£AND CONDITION£OF£UVH POLI CI ES.AGGREGATE LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMEER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE MM/DD/Y`/I DATE MM/DD/YY GENERAL LIABILITY NH3403 05/24/2000 05/24/2001 EACH OCCURRENCE $ 300,00 X l.l'IINMFPCIAI CFNFRAI 11A 11 ITY rlRF 11AMAPor(Ally one file) a 50,000 CLAMS MADEFT1 OCCUR I MELD EXP(Any ono porcon) ; 5,000 A PERSONAL&ADV INJURY $ 300,000 OCN1111 AOORCOATC a 300,000 �>PIV'I AC C Rf-0ATP I IWT AFFI IF5 PFR �nn,runn r'l,l Ic: r7 JtCI - AUTOMOBILE LIABILITY COIdIBINEO SINGLE LIMIT NO'ALIIU (EO ci—itloN) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per parson! I HIRED AUTOS HUUILY INJURY a NON-OWNED AUTOS (Pei-—6,1-0 (Par accllient� • �^ $ uue uAeslLu r I i - W_:Tli ru��r-eil Arr ICienIT a ANY AUTO OTHER THAN EA ACC $ AUTO()Ni',' AGG $ EXCESS LIABILITY CAI-'!Ir]f_`r_LIFF.CNf_"C OCCUR ❑CLAIM3 MACE AGGRCGATC 3 $ r)Fr)I ICTIRIF RETENTION $ $ - EMPLOVERS'LIABILI7Y� E.L.EACH ACCIDENT $ E.L.DISEASE EA EMPLOYEE $ E.L DISEASE-POLICY LIMIT $ OTHER -------------- orkers comp. will follow from^Travelers�Insurance Company �^ G6RTIPI�—^TE MOLDER GAN GEiILATl0+1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Town or B:r rb;L abl rd 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. M i Lc hel 1 A. T ro L L OL'T FAILURE TO MAIL BUCM NOTICE SMALL IMPOCC NO OOLICATIObi OR LIABILITY 367 Main St ril OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. I-lyanni c. MA n;)4;01 AUTHORIZED REPRESENTATIVE -- 3Ohn -0owlin /BECKY (fJ ACORD 25•S(7/97) ©ACORD CORPORATION 1988 I From:Dowling Insurance To:Mitchell A.Trott Date:4/11/01 Time:1:51:58 PM Page 2 of 2 IMPORTANT If thA cartifinntP holder is an Ar-)r)iTIONAI INSHRF"), tht.pnliry(iPs) must ha andnrsad A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION 13 WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endersementf,$). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insuier(s),authorized representative or producer,and the certificate holder, nor Goes it affirmatively or ncgatively amend,extend or alter the coverage afforded by the policies iistcd thereon. ACORD 25•S(7197) . ... DATE(MM\DD\Y1� ® T FICATE 0 I�S R�►N 04-13-01 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE DOWLING INSURANCE AGCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 44 ADAMS ST ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO BOX 850962 BRAINTREE MA 021850962 COMPANIES AFFORDING COVERAGE COMPANY 25S4F A THE TRAVELERS INDEMNITY COMPANY OF ILLINOIS INSURED COMPANY LIMERICK, ROBERT P B 499 CANTON ST #2 ' COMPANY STOUGHTON MA 02072 C COMPANY D COVERACaIES .. _ =. .: ... .. : . THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION LTA POLICY NUMBER DATE(MM\DD\YY) DATE(MM\DD\YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. $ CLAIMS MADE F7 OCCUR. PERSONAL&ADV.INJURY $ OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ MED.EXPENSE(Any one person) $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) $ HIRED AUTOS BODILY INJURY $, NON-OWNED AUTOS (Per Accident) PROPERTY DAMAGE $ GARAGE LIABILITY - AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND A EMPLOYER'S LIABILITY (LIB-643X941-1-00) 06-22-00 06-16-01 STATUTORY LIMITS EACH ACCIDENT s:a: III 100,000 1 THE PROPRIETOR/ PARTNERS/EXECUTIVE INCL DISEASE-POLICY LIMIT $ 500,000 OFFICERS ARE: X EXCL DISEASE-EACH EMPLOYEE s 100,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIORCERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE.' CERTIFICATE HOLDER ., CA ECELLA'FION _.... . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL TOWN OF BARNSTABLE • 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE MITCHELL A TROTT LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR 367 MAIN STREET LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. .HYANNIS MA 02601 , AUTHORIZED REPRESENTATIVE 51" ..::... .... ACRIS S(3/93). l9 GIRD CRRPQRA77QN 9993,. . ... Tr2velersPr0PertyCasualty 1 01027-AM w eeme..&Truve[ersGroup 1000 LEGION PLACE ORLANDO FL 32801 TOWN OF BARNSTABLE MITCHELL A TROTT 367 MAIN STREET HYANNIS MA 02601 ACORD CERTIFICATE OF INSURANCE (On Reverse) 3 L��.�ts —e,; v n t.1. 4� S W l� ) 1 f C,LC�Jt l� �-Z C�`r�-c-�l c�� �U•�n� 0.•�1 ` rc bli5eou4. r,Jln.dv'^'S t.�l � Lbw ek ke tk4r� v;r� 1� CC f J � 00lt7nt w4t1 _ r r .. . . % . . . . . . . I � . .-- . ,W * . . . .. . . I . .. .. . . . .. . . . 1. I. I I .. � - . � . I - I . . �. '. . : . . . � . . � . . I I 1. �. . i. I � I I � ., I . - I.I � . . .. . 1. . . ,. . - - . . I� . I . � . ... .I .. -.. ,� . 1. I 1. :. . I I I . . . - . . . .� . . . I � . I� �. I .. . . . . I �� . . - . . . . . . . .. : �. �. . . . � ,-,.I . i. . . .I I �. .. . . . .�� .�: . I � :,— , �I. � �. � � .� I . . .I I � . I . . � . . . ., � I . � . . � . . � - I . � . I ., . . . - . .. „ . .:I . . . . . 1. 1. .I . a . . . . . . I � .1 . .. I I . . . . . I , � I I I � ... � .. I 1''. . I .�, . . .. . .. � 1. _ . . . . ,a . . . - - �t711 � , ,....... I . � I I I . . I -. . .. .Magic Core ... .. - - .. I �-.,11.1..,I..�.... .I II�-I...q.:. I.I ��.rI I.Z T- :*.:. �I .. �.;.I.,.�,..tI� :�I� ..I .. C .. . .. .. � - s ce Rack . . - -_ , _ _ - . . ®�.�..�I..,,.I��.�;.��I..�1I�kI-'..-�.,�r.'i'.I.�..�.E��I�-�,Id.:.,..r I',I.......—:.F..�..,�..........'. ,.: _ .. ���.If..�....�.I.rII.I..r I-......,IrI;���.II r-...,.I.�:II��..--.��..��.,I I%L�I..I.,I.�.2.���&I�..I/�- ......:......1:-I::::.::..:I.-....-....:..:.s-......:....I.....*.,I—�'...,-:....rI��,..*,..:-r.,.r.--.��-..'..I.I,..I.��I,..--....I,.�I..I.,-I..,.rI...��r I I-.*..II�I..a....�.II.�:I,I I,:,.II r-.:...�...,.,,.I-I�fl..*a.�....,,..,-.-.-�.I-...:..f I rII I.:�.,I.I II,..:I-..-I,rI q11�I..I.I-I._.::.�.—.�.,,I._.I-.�:I.I.�:I..,,.:�.: '-.,�.��I��.:.;,�Ir 1:..�.I,I I�I-.'.I..�..i,.I�.�I I..,��..I'.�.::..P,%..�.:.'.'-r.:�...II.r.I�...r.�:*..�.,.1'...-.',.I....-,.�Ir.�.'I.I.I:-.,I...�'11.,1 I...rr t.�.I I..r,r.".D...,r.....'.,,.�.I.,,..�I�.6..I�I..,.......'.I'r,�,��.-:..r.I�..r�.1.,..;�:......-.....�1I'_...I�..�I..-..�.�II..._Ir r�.'....I'..,I I�I��'.-.f...�I�"N:�.I..-.��I..1�.r 1 �r.:.1I�t-�I I...I:.1�I.....r.,��....I.rI�.I..-1 r...I�r�-.I.II.I.�I......I II�-I..�I1.-���..�.1.�.:�I.�.I��.,I I....,.�I,I..�..I��..I..:.,�......I�...�I��.I.I,..,.,�rI1,I����.I......1.,...:���...,I:.I-..P...I..��I...�..��.�:...I..:I.....II�".,I...,...,�..I�..1�.I m,,.....�.��...1.�r�I,.�,...I*...:.I,........II.,-.,..I��.�,.I..I-IL.I 1..�II.r 1.�.'-.I.Ir.�-.I I.....I..I�.I.�-r I�.II�.,.I.I.....�.,II,.1.I.%.�.,...�r.I1.�I:....I.�..I..,�I.��-I.%.�.,.�I.�-.I-��.�...I.I,.A.1..:r.2..II,r��,I�.�,�..:-.-.�:,.I1I-.�.-.,�p�.I I..I r.I 1.I I..I.-I 1.II:.1,�...I.;.��r..�rI..-.,I'r�.-...II.I,i I��-.�,..I.I....,:..I I.�.I-..I.tI�.I—,.....I,�—.�I.�.I L,.�I...��.r I rI.�..I.�I..-I...�I rI I 2 I��.r.-.....�...:..-...,I:..,I,..r;-�...'-.I,.-,...I.,L,,....,,..II I�...:.,I.L,L. �I.-...IIr,.I I...,:..III..�r I i.-I I.,..I..—..�1.I.I.".:I..:...I..'::=�1I�1:..I:........::...I..-..IF�..r�I.-II1��..,:��I�..;...,r�Ir�DD - - - - I. I. �.....I I.II.)I I . ® . i DR Table ® , . . . .. - ,. rI . . .. : _ .. r . _ _ - . - - .e. Wait/ '. - ' - . . • .. I. .. .. . . : - t . . .. . .. . .. .. .. - . _ . _i d - - . .. - ., .. $4. - .p I .. .. ... .. - _ _ .. -. . . - - , 4� . _ . " { . ;.. -• Ham Trash DBL : p ... . .. .. . : utch , . _ y . . . . t •: ... . L . ' . . . . .. - . . : . . . . . . . . . . . . r . . . .. . . . . . . . . .... . . . . .17. • . Existing Fireplace . ... . . I Stackable W/ 3 oat Closet . ., . 3 ir .4: a 'il ... .. . '.:- r.. I - . z _ ,a „ 7,1. . . . . g n . . .. :. .. ^.... I. r .. -' :"• Wel Bar sink add eler and ice maker.,Unit w' ,nepki . ; \5\1 G . . �:`� . . . , . . . . S%r-*St'TEM PROF IL tZ_ NOT TO SCA L E TOP FDN. FINISH GRADE CaCj. �� FINISH GRADE OVER EL . r FINISH GRADE OVER 0- 'Z DIST. BOX FINISH GRADE OVER 6 0 SEPTIC TANK LEACHING PIT V ........... 7� N_Y1 _N 0 VARIES \\\YIIA\\ -11A -\W//\ N IA\\ yjj,%-77�\77� \7 OF .1/8 112 12- MAX 3 0_� SHED PEA S TONE PRECAST CONC. OR BRICK & MORTAR 311 Ito* OUTLET PIPE LEVEL TO 12" BELOW GRADE 0. FOR 2 Fr. ivim 4=5 .0. -.8 5p�•DO +b' .a .p•� T[/ u •�i �'!•.,. �.T O •.T,.TlT.. 57. 55 I. OR PVC TEES ,57 Z_6 ..A 0 BSMT. FLR. GALLON TN 3 ION A EL 54-or) o DISTPIBUi INSTALL ON LEVEL BASE 'A 314" TO 1-112" % :0 PPECA S T C PRECAST S'T WASHED H- 10 REINFORCED CRUSHED CONCPETC o �'. - STONE � : ., 0:op, H— l 0 REINF. 40-- S EP TIC TA NK 4 INS TA L L ON L E VEL BASE NO TE: EXCA VA TE TO EL E V. -q D '± OR 4 .,.L!j 46 LOWER TO REMOVE-' ALL TMPEPVICUS EL.5 5. z' _ - - \� _O��LL 5MA TEPIA L BE NEA TH THE L EA CHING A PEA PoQ D Z'- 0" /� --- \\ \\ \ PEPL A CE EXCA Ve TED MA TEPIA L WI TH 54- \,\ CL EA N, CL A Y FREE SAND :\ �\ A SINGLE NOW OF HA L4T\ 0 EFFEC TI VE \E�AirEP —STAKED,-- &_MAINTA4rNEDN4��R.ArNi"OAISTR0, 5T/%!ZQAY 0\ \\ reu � NIP TO REMAIN GENEP A, L NOTES L EA CHINO 1-:4IT _x(v T -91RAL ST47E A L L EMBANKMENT AREAS DISTURBED J. A l- 11VS TALL ON LEVEL P4SE DURING CONSTRUCTION TO BE 40 IL ELEVATIONS SHOWN ARE BASED ON 26 ALL PIPES IN THE S YS TEM MU„T BE T .7PC,'IV RE VEGE TA TED TO THEIR k PrEvzour coivcrrra,., OP SC: 11 E 40 P',Ir. VAJ .1 PIT 0h 3. THE BOARD OF HEAL TH MUST BE NO TIFIED 41HEN CONSTRUCTION IS COMPLETE PPI,9F TO BA PERCOL A TION RA TE: DRYWELLS FOR ROOF z T --PRO VED 'N THIS PLAN MUS. z MIN./IN. -__44 4. ANY CHANGES 1�` \,gUNOFF (7 REO'D.) ___A__ -4(�� 4e WITNESSED B Y, BY THE BOARD OF HEALTH AND CAP,: 6,' ISLAN','S N_ 0Q ?7 � l _-Z;S 4 SURVEYING CO., INC. FF_( O 2 D 5. MATEPIALS AND INSTALLATION SHALL 3E- IN COMPLIANCE WITH THE STATE SANITkC?y A,�2 �I� BRD. OFHEAL TH DESIGN DA TA 000DE - TITLE V - AND LOCAL APPLICABLE DA (e,(19 e2�� / U • RULES AND REGUL A TIONS 0 6. NORTH ARROW IS FROM RECORD PLANS AND o" NUMBER OF BEDROOMS IS NOT To BE USED FOR SOLAR PURPCSES F5 0( L GA RBA GE DISPOSA L Q 0 6.7- 7. FLOOD HAZARD ZONE r_� 155 0 L DAILY FL ON LGAL . 4's k �o B. WA TER SUPPL Y 70 2 V1 Ll tfz Ly SEPTIC TANK REO 'D. 5() GAL . P GAL . SEPTIC TANK !:�'OVIDED c� (p( 40T _i�0, 5 2 4 LEA CHING PEOLI.,PED 1500 GAL .V GPD. PRECA S T CONCRETE TIC TANK 5AQD fL27 F 0 SIDENA L L ARE, 2 S.F. `� `� 1 3 S. F. X 2 .5 GIS. F. GPD 50770 1 OF- 574,12WAY BOTTOM AREA. REA 2: f- - 5TiZlk4r4t-FZ6 70 M:' 1'tAIQLEGEND S. F. F. X n F. - -7 t3 GPNECA\ST CONCRETEPO A50Vt �E-X16T. (�W(DUIQD 7 -Z �JA i-EA CHING PIT E-L. 47. 5 LEACHING PROVIDEP, (o 0GpD PROPOSED EL EVA TION lz P I 76 = 720 cj P C) EXISTING CON TOUR �7 44 24' OBSER V,4 TION PIT cl DISTRIBUTION BOX OF PROPOSED SEW GE DI S" L S YS TEM (n LEACHING PIT 16 RICHARD - --!- :'T t jm,,�_: s A['9MA' D PREPARED FOR 29894 �Z J F-o o SEPTIC TANK GISTU, A FCMIC) FL. 55. ss/ i WARREN _1A COBSON i6 20 Z' Nil tRp) RESERVE 1--*,) C) .. I J�� LOT 4 LOVELL 'S ROAD ... 54 ?2_011`I L11- OF' 15 T E-F,5 A [DOC IZ DAV;D CO TUI T BA PNS TA BL E MA 6GALE , )77�717 s 5000 PIPE INVERT OIV - i� CHARL 3 1 L', SXNL,-K,l c_ DA TE.' PLOT PLAN CAPE 6 ISLANDS SURVEYING, INC. SCAL NOTED AN SCALE., I z out~tti E A."; P. C. BOX 334 5S.zc�, r:� A. PLAN NO. �5 TEA T!CKE T, MA 5 C Pt/, LOT He Z