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HomeMy WebLinkAbout1500 MAIN STREET (COTUIT) isa� �5�,� sr 4` �y Town of Barnstable Bull n g r q Post`This Card So That it isFVis�bleFrom the Street Ap�proved�PlansMust 6e Retained on Job andahis Card Must:be Kept EARN • Posted Until'F,rna ,,Jnspection Has,Been Made .- r� ,� , Permit Where a Certificate of O ccupancy is Required,such Buildings hall Not be Occupied^unfit a Final.Inspection hasbeen made Permit No. B-19-4082 Applicant Name: James Koulopoulos Approvals Date Issued: 12/27/2019 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 06/27/2020 Foundation: Residential Map/Lot: 017-014 Zoning District: RF Sheathing: Location: 1500 MAIN STREET(COTUIT),COTUIT Con tractorName: KVC Builders LLC - Framing: 1 Owner on Record: NEW RUSHY MARSH REALTY.LLC LL Contractor-License:, 196078 2 Address: 1500 MAIN STREET P 000.00 Est Project Cost: $80, Chimney: COTUIT, MA 02635 I Permit Fee: $458.00 Description: Renovate "attic" level gym. Removal of finishes and conversion into Insulation: S Zp Fee Paid: - $458.00 a bedroom space. Add a bathroom attached to the bedroom. Final: ( Date:, 12/27/2019 Project Review Req: Smoke required in new bedroom. S and CO within 10'of f bedroom. Plumbing/Gas Windows must meet emergency escape,requirements �[ Rough Plumbing: Building Official _ Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced withrn'six months after`issuance. All work authorized by this permit shall conform to the approved application and the`approved construction documents for which.this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by laws and codes. r Final Gas: This permit shall be displayed in a location clearly visible from access street or road:and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. ¥ Electrical The Certificate of Occupancy will not be issued until all applicable signature`s by the,Buildmg and Fire Officials are provided on this;permit. Minimum of Five Call Inspections Required for All Construction Work:j , Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed final' 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" M(as set forth in GL c.142A). Fire Department Building plans are to be available on site �,-r�s �' Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT o r..� Iry Town of Barnstable Building aPost;This Card So That_it isV�sible_From;the Street-Approved PlansMust;be&Retamed on Job and this,Card Must be Kept am Posted Until'F�nallnspection Has Been Made Permit Where a Certificate of Occupancy is Requited,such Building§shall N`ot be Occupied until a Final Inspectionhas been made , „ Permit No. B-19-4224 Applicant Name: James Koulopoulos Approvals Date Issued: 01/03/2020 Current Use: Structure Permit Type: Building-Addition/Alteration, Residential Expiration Date: 07/03/2020 Foundation: Location: 1500 MAIN STREET(COTUIT),COTUIT Map/Lot: 017-014 Zoning District: RF Sheathing: Owner on Record: NEW RUSHY MARSH REALTY LLC Contractor Name�',�,,KVC Builders LLC Framing: 1 j� Q Address: 1500 MAIN STREET Contractor License 196078 2 COTUIT, MA 02635 Est Protect Cost: $ 60,000.00 Chimney: Description: Remove interior closets,install built-in millwork to replace'closets, l Permit.Fee: $356.00 Insulation: add lighting,add 1 exterior window 7)19 Fee Paide $356.00 Project Review Req: s Date.- 1/3/2020 Final: Plumbing/Gas 3 Rough Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by tI,i permit'is o menced wiihm six rnonthsaftePRffi;e.Official Final Plumbing: All work authorized by this permit shall conform to the approved application and therapproved construction documents for=which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local z n'ing by-laws.and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street or.road and shall be maintained open for public inspection for the entire'duration of the Final Gas: work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signatures-by the Building_and Fire,Officials are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing „ Service: 2.Sheathing Inspection ` 3.All Fireplaces must be inspected at the throat level before firest flue lirn_ng is installed y m Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final' 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation _ Low Voltage Rough: 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Low Voltage Final: Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ®��� Final: ..... The Townof Barnstable Department of ftblic Works i BARNBTADLE, 382.Falmouth Road.Alyannis,`MA 02'061. i AD1�T STABLE MAC www town.barnstable ma.us tb a< 1bss� � . Arfa�ra Daniel W. Santos, P.E. OfEice 508.790.6400 Director Fax. 508.790.6343 SUBJECT: Numbering of Buildings Map No, 017 Parcel No. 014 Date; June 3, 2016 Dear Property.Owner, Notice is :hereby given in accordance with the Code.of the Town of Barnstable, Chapter' 51,Numbering g of Buildings, adopted August I8, 1994. Public convenience and necessity requires the assignment of number 1500 for your property located on Main Street, Cotust: This number should be affixed to your building so that it is visible form the ,street as outlined in exhibit "E",.Town of Barnstable Rules and Regulations for,Niumbering of Buildings. Please contact the Engineering Division of the Department of Public Wofks.at(508)_790= 6400 and be prepared to provide all telephone numbers at;this location.so that.your E-911 account record scan be confirmed when the correct.number is.posted'. Sincerely, Roger D. Parsons, P.E. Towel Engineer Encl: Town of Barnstable Rules and Regulations: ❑ Common Addres§1 Questions ❑ Site map z Assessors Change Form I PatcelEdit Page 1 ofa MIM 1- ! o07 (/�Vc , nAftriat tt 1 x # {� t Oahr ats?m /l• .. "a Fw a @.._.r�(/' U�E/i�'fiV�C/tLV A ��q �:: s vi Logged In As: . . Friday,]ne 3 016 Parcel I Apolication Center toad 5vstem Reports `Ro6d Svstern Parcel Dkaii _ Sewer .. Parcel ID; i0170 14 �Acct: _ lT(R; Io Updat2 Devel Lot: CLOT F& 10 Owner: GRIFFIN,WILLIAM F JRI Co owner: NEW RUSHY MARSHYR� Street: IC/0 MCCOURT GROUP City: ''BEVERI Y HILLS �`state CA zlp 90212 ..._.... _...__ [�___.._�........ . ___.... ... (Location: 1500 - - Vlilage: Cotuit V� MAIN STREET(COTUIT Road Index: Lo 51 Ph . Frontage: 980 To set road you can also enter:road-index�and:tab out df field.. Secondary Road, Sec Index: 2000- '.Sec Frontage;�a Visions Locatlon: i15 MAIN STREET(CC1 LaSW.pdated ............... ... No.eldgs: 1 Account No 4569 Lotslze)(acies)f 14 29001377 State Class: 0101 { Added: '909 Fire DI t`__.... ...... _ _...._...... Deed Date: 11/6!2600 Deed Ref C159659 Land value: 13814300 Blags II2918600 extra Features 336400 1_............. Value 12^.. ......... _ ._. ..: (S(S ( 4F- ---------- Condo Complex; ( I Bultdlog __ J Unit I:..:...:.. ....._.. f UWdate Y http;//issg12/intraitet/pt-opcl�ita/pledit.aspx?ID=PL51'1. :6/3/016 OI'� Commonwealth of Massachusetts . ley oiy She*"geg%t c� Date: `f' Eeii�f ��4�6� Estimated Job Cost: $ to, 00 0 BAN 9 20I f ennit Fee: $ S.DD Plans Submitted: YES NO ✓ 'j'owN ���A ns Reviewed: YES NO ✓ ((-- ��usrABLE aM Business License# W Applicant License# Business Information: I ' I (` Property Owner/Job Location Informationn:',� Name: U ern cm L t11��de • _ , Name: MC C j �6Ue � , t I I f a Street: g t�11 I( h �I f�C� street: City/Town: bo C�ha ham City/Town: 00 Telephone: �(�f Telephone: n jo Photo I.D.required/Copy of Photo I.D. attached: YES NO Staff Initial J-1 /M-1-unrestricted license- -- - J=2/M-2-restricted to dwellings 3-stories or.less and commercial up to 10,000 sq._ft./2-stories or less Residential:-1-2 family. • Multi-family... - Condo/.,Townhouses. Other Commercial: Office• Retail Industrial. Educational Institutional Other Square Footage: under 10,000 sq.ft. V over 10,000 sq. ft. Number of Stories: Sheet metal work to be completed: New Work: V Renovation: HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: INSURANCE COVERAGE: I have a current liabilitV insurance policy or its equivalent whicli"iheets the requirements of M.G.L.Ch.112 Yes No❑ If you have checked Yes, indicate the type of coverage by checking the appropriate box below: A liability insurance policy lk Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does.not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my,signature`on this permit application waives this requirement. 3 Check One Only Owner ❑ Agent ❑ Signature of Owner or Owners Agent By checking this box(],I hereby certify that all of the details and information 1 have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation:YES NO Progress Inspections Date - Comments .. Final Inspection - - - Date - - - - - - - - - - Comments - Type of License: By ❑ Master . Title ❑ Master-Restricted �_� v�/ A41 City/Town ❑Journeyperson Signature of Licensee Permit# ❑Journeyperson-Restricted License Number: Fee$ ❑ Check atwwvr.mass.-govfdDI Inspector Signature of Permit Approval THE. Town of Barnstable RegylatoryServices Thomas V.Geiser,Director . . btu BllRdin' DI4'1S Oil + x s . . s Tottz 'e,ry,�inlding: ommissiouer - 200 ivy S �,Ixyanels,i+ A 0260; . C)�ic ,SQB-$S�-�Q38 Fax: 50 -:I .Q-6230 ro e Own f us:t " C6mipleie � `h7 Sec. io H. in A-Build er fr t.a s t t `tj,7 w. c � �cnces aid aiac xhexesporisibc;r ofthe apc2t ?cls ale rt t€� tie' IZ 4•1),te rence x8 in 8t0ed anti pools at nGt to befilt � 4 ed 61 a1 a1 z pest s arc exfom�etx a d acce th d; � } j Ovmm six ?• n` a } - i � S Sig^slm ,-ram'-1PAtc2;�� t � = Awl Eric ��h► i Ise P*-: : sae - a 10 a a; = COMMONWEALTH OF MASSACHUSETTS `• a a s •o o :o -a a SHEET METAL WORKERS �'AS A BUSINESS ISSUESTHE ABOVE LICENSE TO: ERIC 'T WHITELEY W VERNON WHITELEY PLB'6, AND. 28 VI`LLAGE LANDING {�. PO BOX 1266 I..: W CH-ATHAM MA 02669 OOU 160 12/22/14 :. , 292,629 a o a e f— --:-------'-- _-- ------ — COMMONWEALTH Off- MASSACHUSETTS SHEET METAL WORKERS AS A MASTER-UNRESTRICTED . ISSUES THE ABOVE LICENSE TO: E;RIC T -WHITELEY PO. BOX 248 .W.EST. CHATHAM MA 02669-0248 2967 02/28/14 119423 r.. Fold,Then Detach Along All Per'mrations - _ 7 WVERNON-01 CLEDDUKE 14C7�R®` DATE @IP�IlDDIYI'YY) I CERTIFICATE OF LIABILITY INSURANCE 101212013 j 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. I IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to I 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 I CONTACT NAM E: Donna Pearse f (Rogers &Gray Ins.-Dennis Branch PAH0NN , : 508 398 7980 FAX No: 877 816-2156 I434 Rte 134 South Dennis,MA 02660 ADDR E•IOR ro Y•ESS: p @ g �d earse ers ra com I I INSURERS AFFORDING COVERAGE NAIC k 1 l INSURER A•ARBELLA PROTECTION INSURED INSURER B W.Vernon Whiteley Plumbing&Heating Co,Inc. INSURER C: ) I Chatham Sheet Metal,Inc. � INSURERD: I j P.0.Box 1266 West Chatham,MA 02669-1266 I INSURER E I INSURER 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 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, i EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.UlvIITS SHOWN MAY HAVE BEEN REDUCED BY RAID CLAIMS. INSR I ADDL SUBR POLICY EFF I POLICY EXP LTR TYPE OF INSURANCE VvVD POLICY NUMBER MMJDO/YYYY MD41001YYYY I - LIMITS GENERAL LIABILITY I EACH OCCURRENCE 'i 1,000,0001 A X ANIAGE TO RENTED COMMERCIAL GENERAL LIABILITY 8500052832 I 10I112013 ( 101112014 PREMISES((Ea occurrence)nce) I S 50,0001 CLAR.IS.MADEi a OCCUR I I j MED EXP(Any one person) is 5,000i ' I I PERSONAL&ADV INJURY IS 1,000,000 GENERAL AGGREGATE 13 2,000,000I i I GEN'L AGGREGATE LIMIT A.PPLIESPER:. I PRODUCTS-CONIPJOPAGGI3 2,000,000 I POLICY PRO- LOC I j I i S I I MBINED SINGLE LIMIT I3C 1,000,000IAUTOAOBILE LIABILITY (EOc A ANY AUTO 1020006356 11/1112/13 11/1112014 I BODILY INJURY(Per person) Is ALL OWNED X I ^ ISCHEDULED I ( BODILY INJURY(Per accident)!I$ AUTOS NUTOS NON-OWNED PROPERTY DAMAGE S HIREDAAUTOS (PER ACCIDENT) I,! _ I X UPABRELLALIAB OCCUR j I EACH OCCURRENCE j 3 4,000,000! A EXCESS LIAR CLAIMS-MADE 4600052833 1101112013 1161112014 I AGGREGATE is 4,000,000! DIED I X I RETENTIONS 10,000 NlORKERSCOhAPENSATION I i I j j WCSTATU- I iOTH-i i TORY LIMITS ER ! I AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR;PARTNER'EXECUTIVE(�7 I - I E.L.EACH ACCIDENT I S ! OFFICERIMEMBER EXCLUDE[ -I N!A I 1 ' (Mandatory in NH) s - ! j. ;E.L.DISEASE•EA EMPLOYEE!S If�/es,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT I S I I I �IESCRIPTION OF OPERATIONS I LOCATIONS[VEHICLES (Attach ACORD 101,Additional Remarks Schedule,it more space Is required) .. :Dlanket Additional Insured Status is included when required bywritten contract. (Worker's Compensation certificate will be issued and sent to you directly by the insurance company. I i CERTIFICATE HOLDER CANCELLATION I I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN I ACCORDANCE WITH THE POLICY PROVISIONS. 200 Plain Street Hyannis,MA 02601-0000 AUTHORIZED REPRESENTATIVE I I I _ ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Rightfax N1-1 10/4/2013 7: 19: 41 AM PAGE 51/055• Fax Server acoR& CERTIFICATE CIF LIABILITY INSURANCE 10-04.2013 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: ROGERS&GRAY INS AGCY PHONE FAX 434 ROUTE 134 tA;C. No. A'c r;ol: SOUTH DENNIS,MA 02660 E r.LIL n6AF SS INSURER(S)AFFORDING COVERAGE NAIL."+. INSURER A:ACE ANIERICAN INSUP..A:NCE GOIAPAN`! INSURED INSURER e: NJ VERNON WHITELEY PLUMBING& INSURERC: HEATING CO INC&CHATHANi SHEET METAL INC INSURER O: PO BOX 1266 INSUP.ERE: WEST CHATHAM.MA 026.69 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUk18ER: THIS IS TO CERTIFY THAT 7HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NJ ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAININSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR IADDL SUBf� POLIC NSVOD Y EFF I POLICY EXP LIil11T5 LTR TYPEOFINSURANCE INSR NNO POLICY NUMBER (p,1tN00(YYYY) 7YYYY1 GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY DA.VAGE TO RENTED S t PREMISES I_a cccurnre.1 CLAIMS4,IADE OCCUR MED EXP(Any one perscn) S PERSONAL&A.D'•:I.\IAJRY S GENEP.4L AGGREGATE R - GEN"L AG'OP,EGAT-=LIidIT APPLIES PER: FP,ODUCTS-CO>dP;OP AGG S .I POLICY I PRE T I I LOC S O h. I�NEO SII:GLE LIMIT .B AUTOMOBILE LIABILITYGan:-ridCrai MIT S A14Y AUTO BODILY wiuR1'(Perpeman) S ALL O':NNED SCHEDU_ BODILY INJURY(Peracdden:1 S AUTOS AUTOS HIREDAUTOS NON-GYt(NED - PAOFg B,?ANIAGE S AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LIAB CLbJh•IS4.3AOE AGGREGATE S DELI RETENTIONS S WORKERS COMPENSATION X 4VC STATU- GTH- AND EMPLOYERS'LIABILITY Y IN TC.RY LIMITS ER ANY PROPRIETORIPAFTNEP'=RECUT I'•1-� E.L.EACH ACCIDENT $500,000 OFFICERIbIENIBER EXCLUDEC? I-1 N f A 6S62UB 10-01-2013 10-01-2014 -- (Mandslory in NH) - 9972Lo64 E.L.DISEASE-EA E•IPLOYE- $500,000 It yrs-dcscritc under $'500,000 DESCRIPTIO:M OF OPERAT1GNS belrn E.L.CIS EASE•POLIrY LIMIT.. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Addltlonal Remarks Schedule,If more space Is regtllred) CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE 200 MAIN STREET CANCELLED BEFORE THE EXPIRATION DATE THEREOF, HYANNIS,MA 02601 NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESDITATIVE I C11988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 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/Organizatiomindividual): V� V e Yl n o n l.0 L i e j e P a m Y,s " �� ] n A C 0 1 c— Address: a£s V, 0n 5,L- �1_ Po R o x )a U. -- City/State/Zip: Phone#: (hog) cc) Are you an employer? Check the appropriate box: Type of project(required): 1.�] I am a employer with 4. ❑ I am a general contractor and I 6 New construction jnj employees(full and/or part-time):* have hired the sub-contractors listed on the attached sheet. 7. ❑Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity.acitY employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance.= required.] 5. We are a corporation and officers its 10.❑Electrical repairs or additions have exercised their : 11. Plumbing repairs or additions 3.❑ 1 am a homeowner doing all work ❑ myself [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] ' c. 152, y 1(4),and we have no employees. [No workers' _ li.❑ Other •comp. insurance required.] *Any applicant that checks box 41 must also fiu 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. Lf 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: A 4e= YYI-L,L I c c\ )L 4 1-)L,/ - ��^l Policy#or Self-ins. Lic.# 91 'A•t-1, /, Expiration Date: 14 Job Site Address: y A (-1 o 1_;s 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 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$250.00 a day against the viotc rZ ivised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for ins no �/ vierification. I do hereby certify under t pain ruul e s perjury that the information provided above is true and correct Sianatur Date: I I 1 (3 Phone#- \ a$� 9 q ) 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#: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �� Parcel (3 Application ` Health Division Date Issued Conservation Division Application Fee 1 DQ Planning Dept. Permit Fee 3 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address f Jca y 14►� ��f eQ,'1 &gb4ry�t Villa e P g ���11� - Owner W r iaft F. ( R; if.► aR T� Address clo 1►/cCaudaouD -Telephone- 503 — Lf Permit Request C S 1� Qt VQ � c 61'6 P'%AJ C fi O( +0 ® 5 w-ef N00 1 VJ r S I" to 4 CiAL ®JS S-2G0J0 leg � 0O(' . Gvv� TIfSI 'Moor Ct1f'`LD f Square feet: 1 st floor: existing proposed 4W W 2nd floor: existing proposed �5 Total new q� Zoning District e I Flood Plain 'Groundwater Overlay Project Valuation 3� , 5G� Construction Type W04 Rqm-Q. Lot Size I a y 4 ("5 Grandfathered: '❑Yes dNo If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure N A Historic House: ❑Yes 21(No On Old Kirks' Highwap" ❑�;gs )ZNo Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other W>A Basement Finished Area(sq.ft.) NA Basement Unfinished Area (sq ft) z"? Number of Baths: Full: existing s new Half: existing new Number of Bedrooms: NA existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ?Gas ❑ Oil 12CElectric ❑ Other 9 / Central Air: ❑Yes No Fireplaces: Existing New Existing wood/coal stove: ❑ C�Yes No Detached garage: ❑ existing ❑ new -size 6 Pool: ❑ existing ❑ new size ® Barn: ❑ existing ❑ new size b Attached garage: ❑ existing ❑ new size Shed: ❑ existing ❑ new size Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑ 14 Yes No If yes, site plan review # Current Use Proposed Use �s� `^���%� Cgbgoc , APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name K� Telephone Number 78/ 6.2'o Address YwC 10C. License # C's r4 y6-73&5" I?-0X (Z-O AD Home Improvement Contractor# VJA-t-X A^A i MA- 02-4 1 Worker's Compensation # <=Wc 3 ► FS 1$ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C." L L'L- ?Y- 6—( 10►1 1 M ;rim B L,-"p. 13OVa r , M,q 0;?�5Y2- SIGNATURE �� DATE ZZ FOR OFFICIAL USE ONLY APPLICATION# m E -M DATE ISSUED a MAP/PARCEL NO. •r 4 t4 ADDRESS 'VILLAGE OWNER � � r DATE OF INSPECTION: r.�FOUNDATION C: f FRAME z L 0 INSULATION /'f FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL' FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. —-- -- ? - s — The-Commonwealth-qf-Massachusetts-- DOartment of Industrial Accidents Office of Investigations. 600 Washington Street Boston, 1M 02111 www.mass.gov/din Workers' Compensation Insurance Affidavit:.Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly Name (Business/orgmizahon/Individual): Kl�_drJ e74 VD►.1>A (pogT/Loc 1)6ts j tf c Address: l F-DX... V. .41). City/State/Zip: Mi-714AM, MA- 0PA51 Phone#: 78I Are you an employer?Check the.appropriate box: Type of project(required): L[-I am a employer with J� 4. ❑ I am a general contractor and I 6 New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ 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' [No workers' comp. insurance comp. insurance. 9. Building addition required.] 5• ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work. officers have exercised their 1 L❑Plumbing repairs or additions myself. ' right of exemption per MGL Y �o workers comp. 12.0 Roof repairs insurance required.]t c. 152, §1(4), and we have no employees. [No workers' 13.7 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 providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: S .�f'rSytej Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: 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 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 overage verification. I do hereby certify u the pa' pen f perjury that the information provided abov ' true a correct Siy atcre: Date: Z. Of 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#: 1-ilform-a io-ri' alyd-Instr --- Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. pursuant to this-statate,.an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." association,corporation or other legal entity,or any two or more An employer is defined.as"an individual,partnership) of the foregoing engaged in anoint enterprise,and including the legal representatives of a deceased employer,or the artnershi association or other legal entity,employing employees. However the receiver or trustee of an individual,P P� owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house dwelling house of another who employs persons to do maintenance,construction or.repair work on such ant thereto shall not because of such employment be deemed to be an employer." or on the grounds or building appurten MGL chapter 152, §25C(6) also states that"every state or.locaI licensing agency shall with 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 in requirements of this chapter have been presented to the contracting authority." I Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply toy our situation and, if necessary,supply sub-contractors)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' number listed below. Self-insured companies should enter their compensation policy,please call the Department at the i 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 permit/license number which will be used as a reference number. In addition,an applicant that mus£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 quired to complete this affidavit (i.e. a dog license or permit to bum leaves etc.)said person is NOT re 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. 4 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 4-24-07 WVVw.mass.gov/dia . '4`�® CERTIFICATE OF LIABILITY INSURANCE ��Zi2oi3 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 Construction NAME: Eastern Insurance Group LLC pHONE . (508)651-7700 aAiXX N 233 West Central Street E-MAIL ADDRESS: ` INSURERS AFFORDING COVERAGE NAIC# Natick MA 01760 INSURERA:Unlon Insurance Co INSURED ` INSURER B Acadia Insurance Company - 31325 Kenneth Vona Construction Inc. INSURER C: 11 Fox Road r •• INSURER D:EastGuard 14702 INSURER E: Waltham MA 02451 INSURERF: COVERAGES CERTIFICATE NUMBER:Master 2013 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 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DDIYYYY MM/DDIYYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 300 000 PREMISES Ea occurrence $ A CLAIMS-MADE OCCUR PA0296259-14 /1/2013 /1/2014 MED EXP(Any one person) $ 15,000 _ PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,;000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1 000 000 ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED 0300197-14 /1/2013 /1/2014 AUTOS X AUTOS BODILY INJURY(Per accident) $ X X NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident Medical payments $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ D WORKERS COMPENSATION - X I WC STATU- OT H- AND EMPLOYERS'LIABILITY Y/N ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) WC318878 • 0/4/2012 0/4/2013 E.LDISEASE-EA EMPLOYE9$ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN KENNETH VONA CONSTRUCTION INC ACCORDANCE WITH THE POLICY PROVISIONS. 11 FOX ROAD WALTHAM, MA 02451 AUTHORIZED REPRESENTATIVE Rosemary Fulham/BC4 ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS095 r9mnns ni Tl n Arnion nnmc nnrl Inn^era rnnicfarnrl morl—of arnon i Town of Barnstable - Re ato Services ass Thomas F.Geiler,Director: Bdilding'Division Tom,Perr' Bnildmg'Commissioner'. 200 Main'Stzeei,Hydnnis,MA-02601:1 "WWW.fown'aarastable ma.us Office: 508-862-4038 Fax .5087790-6230 Property Owner Must Corrplete acid Sign,This Section If Using A.Builder I, as Own=of the:snbjectpropeztq h=ebq authorize` - to act on,mq:behalf, in ail-matters relative to wo.tk'author zed by this building peimit S (Address;of job), Pool fences.and.alarms are the respo;r�sibility of the•applicant. Pools are not to be filled or utiaed.before fence iEi installed and 0 final inspections are performed and accepted. Signatu. e Ovine Signature of 4plicant ' Ic..y(_t P� ' . Jle Pant Name �` 1 Print:Naj e �,YST2Q Date QTORM&O:WNERPER2OSIONP00LS 620I2 :'how of Barnstable Regulatory Services MASK � Thomas R.Geiler,Director. - -- D Building-Division Tom Perry,Building Commissioner '200 Main Street,Hyan*MA-02601 �nvwaown.barnstable.ma.us Office: 508-862-4038 Fax .50.8-790-6230 Property Owner Must Complete'ari-d Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behA is aE matters relative to work authotized by this building permit 1�Zyi �-E-r Co TU (Address of job). #Tool fences.and alarms are the responsibility of the.applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Sigaat=e of Owner S tote of AppFicant- Print Name Print Name Date Q:FORMS:OWXMPERMISSIONPOOLS 62012 '�'o�a of Barnstable Re atorY-Services t 11AR}1rr;7xrx s` Thomas.F.Geiler,Director Building Division Tom Perry,.Bi ilding Commissioner. 200 Maio Street, Hyarmis,MA 02601 W W W.town.barnstable.ma.us Office; 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: .JOB LOCATION: ' number - shut. village "HOMEOWNER": name home phone# work phone# CURRENT MAMING ADDRESS: city/town state zip code The current•exemption far"homeowners".-was extended to include owner-occrmied 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. DEFD=ON OF HOMEOWNER 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 constmcts 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 he/she understands the Town of Barnstable Building Department minimrtm 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 "Airy homeowner performing work for whicb.a building peanut is required shall be exempt from the provisions of this section(Section'l 09.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware drat 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/sbe understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may caret amend and adopt such a forri/certificatim for use in your community. QIbrms.homeexempt Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction Supern•isor 1& 2 Family License- CSFA-057385 = NA 1 11 FOX RD ; IJ WALTHAM MA702451V .1 01 el Expiration Commissioner 07/19/201.5 i Restricted-One-and two-family dwellings or any, accessory building thereto, irrespective of size. Failure to possess a current edition of the'Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: WWW.Mess.Gov/DPS � f ��.f-` lflUY)I/)II¢IIfIK.'lllf�,,���''af'(f,.1(1,,,,1l1{rl@ 1 Office o onsumer fWl's&�u4ineSs egu'Inhon License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 116519 Type: Office of Consumer Affairs and Business Regul"anon .. Expiration 6122120'14 Private Corporation 10 PRO Plaza Suite 5170 Boston;MA 02116 KEN METH VONA CONSTJNC KENNETH VONAs'..'� zi ,' i+i :11 FOX RD: Ji WALTHAM,MA 02451 4; Undersecrctnry Not valid without signature y } CCHTRACTDR SMALL PLANT NWE OF AMMOPHILA la BRENIINLATA(..'CAN BEACH CRASS)/JIO S i wAlx SA ibT CH REAMER^IN `t^•^ f I`I n.: ...il�p!'vAp S OFNAtt K MPEf NWS FOR NIXf A W_ . NINSCNIA TOMWi0 TAGGFAED ROWS ONE r OX CEN1E11 T I I (AS YARKFD CAP I LOCUS r SECTION A-A aer.m Ex E raxuaeroMtx l w+ncALE M, :AvmAaxxoxxr - x•wArw SERMCE fAPwwNwtE LOGnM!) ww� Lr' NawzourAi t•-Ala >ERwAr ,.t_i•% rirwrAU /(sr DeArAA) /�6 I'�a. `l NEID Xc LSCEAND xULLr QETBIL - EIeSRNc rREE To BE RWotED(TWNAL) i" � IIII µSnNG OVERHEAD.. TO BE REMOVED R1E5) D REPLACED wTH uxomI sERMcc r W/ �PRaoaDUrErnsrr �Y LOCUS MAP E%ISnNG weUlE PWE A,SPRUCE NOT TO SCALE r ~'/SEET ENS—PML robe/A.BE REMOVD _ "ORTIi•";T MIT-ATON PL ANTNr-AREA f15B03 SF1 J MAIN © X ME vRo=DSED rr GDwGN PLw,wP a:<.mAa.G - - wwrosv wAzww4r v®M . ENSTNG COTTAGE TO BE DEPOUSI— RED !�afuzl RUG PRGrosrn sAwA ^�`� 1 - i .—G ARBONMIAE'S ORAwAI A— / [ STONE BOUND W 1X rA�u vavL.AR Y-Y CAL a I� xaf rauxD rz SPRUCE- w ` m-m ac_r-4• - �, ,� �:�, //°'�6n ugd`• Yei• mwx RED mX anars w«n xs aea ax•-r ciL O 1 1a " / rw.. / @' `�� /' w OT} � a•ac-r-.'as —' Tl ®•"' '� \ p euw.,\ i O �� '@d / �`1'® Q. un m Roar/nr/EA¢ m awAG ae a x CAL sa • , \ , Wu 7 1� r Ti \ u.Plf-tzwED uwowYDm wRRwe. s-r e.e-r-r as . 1 2 PROPOSED DUNE AREAS . a +'"y'�'a ^ `. ,°."`t A � �01 b w,'� /1 ' ♦ A►e ��a aAa ague era cA �N rs", Pawosma YINT�WTION .�, rwe 1 1g�•,, u sms e��su y. � p 'P w 1 .� ../ r mvrwwi mmmx ®^•w) (I.seo:nr.) I A` a RFMDHD .�L M � / A .nxtti rAU 9YrP r.x' - aDM�A flYOlirarAs . ,B.f -' 4x '; •��� \ � `� �-�WR®Rraww,w N r R�I \ 3 p m w'�"xo�A I PxwDsfD e.B ` ARoroQaDL.¢v a... I \ �6p1 PROA'o.S[D cvwr/ ` 'A\''e• r I _ '-___ �� 1\ \`, \ �" �qS`- �� ' � • � I s r.rms /® ` 1` r�s�\4q P1AH h �) �•UFi , I:P �- / v f' •;� 'fT l•.\ �` "�['h�B �/ � - P\\�s•.+•r.�.yi..wan,a-.>°w.w(L"°I�.a"'.we"' _ MG; a . y`�� a! \ `2, mom ,•' e "`\ / '^ IAND SUMCT m I D i s-l�ts wA Pun i Yo � G uc uau \ a b kP� �� ` 6 COABTK STORM iIOWAQ r ``S`` L BORooDNO VEQTARB rEnAND a a _ �,� T Y'�l ` L DATE DESCRIPTION ra a ka ` a °Ab I s� ` ` � REVISIONS PLAN ` A T OF PROPOSED SEWAGE DISPOSAL SYSTEM \ PREPARED FOR 4 'xD'S0g NEW RUSHY MARSH REALTY TRUST FOR PARCEL H{,/1524 MAIN STREET 1.HOUSE NUMBER:1524 {JE¢/Jl\ '\ ' ` \ a CANIT BARNSTABLE MA 2.ASSESSORS NUMBER:017 014 '.NV,* 5.ZONING DISTRICT:RF a \ W' o-/ 'I SCALE:V-20• DATE:APR.5,2015 4,FLOOD HAZARD ZONES:C.A15(EL15)NB V17(EL15) _ yI F115 \ p S.S' GRAPHIC$L•• holmes OOf) mCproth. inc. �~ 5.BENCHMARK: SEE PLAN a av L' �Jr� CIA gh— d lord verve__ e.TOPOGRAPHIC INFORMATION COMPILED FROM AN j / \ rolSt �rB ON THE GROUND INSTRUMENT SURVEY. p, `d 1'�{% 4A. [qW! x0 tD 0 m ID I .om,�ado nRB M F.518--IMOM) 7.ELEVATIONS SHHOVM ARE BASED ON THE LO' / ;'1 ascA,� \JSi• >.a (mow Ex:r R NATIONAL GEODETIC VERTICAL DATUM. DRAWN: uC CHECKED: a REFERENCE: LC PLAN teal-D JOB NO: z12t 25 DWG.N0.:7{-a-21D SHEET t a. I CERTIFY THAT THE STRUCTURES ARE n Z_ LOCATED ON THE LOT AS SHOWN.AND o fEs� THAT THEIR LOCATION CONFORMS TO THE / OM VAR MINIMUM SETBACK REQUIREMENTS OF QS� socO 9� LOT 11 THE BARNSTABLE ZONING BY-LAW. ewMo�WHo SHEET t� pe+e•'n HOLMES AND McGRATH.INC. to MAIN 4 vRaurm A,wesE cnn a I :.; �Yz��s/s (PUBLIC-WIDiH VARIES) _ % 1 MICHAEL B.M M t, MAIN STREET LDDe s0 y.r :. - ..-. ..-. o r r \ oai m.m iM g Regl L-d P ..men ce rrN asK roar - _ -.,- -.- - P.aGVD.YO.wncnnw- /Y•`• ra"i 0 L, _ a rw - _ - 7• O /eynge Ml£y i b[I faip I CERTIFY THAT ME HOUSE AND COTTAGE \ PLAIN/ ARE LOCATED IN FLOOD PLAIN ZONE C AS \O /) / PROW>tD BGadl GIBANA SHOWN ON FLOOD INSURANCE RATE MAP COMMUNITY PANEL NO.250001 DD22 D �,g _ / ✓ .sto AND THAT FLOOD PLAIN ZONE C IS NOT A 4C+' \. \ w� - SPECIAL FLOOD HAZARD AREA. 1p♦�' \ - - / �'"-�" P�- 1 CERTIFY THAT THE CABANA FRAMING IS LOCATED IN FLOOD PLAIN ZONE VI7(EL15) \ -•/ _ ' b♦ '� I' i JQ AS SHOWN ON FLOOD INSURANCE RATE MAP COMMUNITY PANEL NO.25DOOI 0022 D AND THAT FLOOD PLAIN ZONE VI7(EL15) \ • p IS A SPECIAL FLOOD HAZARD AREA 1 .. /.,• / \` -a„-- l `/.'/ 'r••�"" (":1• it aN�iaF�.a NOWES AND MdRATH,INC. i • / /. "Rb 'rY+� ..,.. /` \':`•r /' MICHAEL a ue ATH R.gMLeree'P r.e.1-W DO. PARCEL m Le SM,Vnyw WRORAN en W.HOPE - RUSH,'MARSH / DUNES ARPRD%MA E POW - � / / • 279R PRaPmTr uHE / $ / OT 10 TOTAL AREA 16.7t ACRES oLTr.esn TIDN Nat La Na 1 / 1. AS SHOWN ON. L.C.PLAN 18041-D a+t` DEEP C RVAMKH Hat LDD Nw 2 - -.-d •cam - 1 _ I l ROW 12.-10 RENEE a ATw ENCLDAIRt Access PATH uc h. Sf},D Aaa A uc MRM I I ypH DATE DESCRIPTION row ecke • ,ott AL - I - r� _TL� R E V I S I O N S SITE PLAN OF PROPOSED MODIFICATIONS PREPARED FOR r Dew aesTn aw Nat La Nw. TRUST DESIGN CRITERIA - / iro n`•� NEW FOR PAARCELM14.1524 MAINLSTMTREETT 9r.1 '�mY .°� aw'ND E,A...., ,ro�•.imr I j ,.eP-r 1 a-nIr•a ea an,•ia•, _ _ - coTUlr BARNSTABLE MA APPRomIATE r M SCALE:T•-50' DATE-APR.5,2017 fa°'"N,-,,-M^al -,,,;, a,,,•,i.e, /' ,�^"'°'°'"�' 1�': PRCPExTYUNE GRAPwC SCALE holmes and MC a qrth, FIG.1 y�r^ - y I .n.. �. nTZ7r W 10-gm.- a lend.urveTv. Syue res Rw.n�Om-��r(]m as. N i ace'•(mF1�wn pr•M,e) I , e e2'02'20•W 210. PMal le 'e0 ZS D 90 t]0 WvmIW D odle M.S�Ieb75B/01@E) � •e Squo ivA Preto-a em..l1Y t.%e mn / / " � = out D�enAcoaN 1 rya aaa n DRAWN: AC I CHECKED: KKKlll JOB NO: 212126 IDWG.N0.:74-7-21D sH 2 a a I . •\ �`- 1p1 c6xrnE1E 90uaD xix " - - D c 'D"•\ Drm1 HOLE roux0 I ARRaooMATE Lau1IDx j i ' .m.r"'a rdp e! a x•eAm+swwcc j r i awNo°F¢L�v..�iw ,.E®�.j� Nc osTRNEAD wars ro eE aEMocD REI-CED MM wOEa(.1twND SERNCE. SiFiEET .. _ / °°'" ,� _ fR. Irw[ (TO BEGPElr 6s/A �4R°A x ..., °ram, I ® :,� Kw.Nl •\ .© .I-ExDura lnl D.U. aLc—D °ewA '.�� Q$ TOP OF CONfAEIE X�; 6.8 6.2 5.0 Rlw .II -� ••`�.��I ``_jID Snip, PY 1. MfQ� { 4 .\ \ r eu+DclDNo NT¢TARn wERAND s ` °' LAND we.ecT To - COASTAL STORM ROWADE e •'@' / \ \ e / / `/. 7)�DSe1Gwh•�(�1 e.ro a w ' 4S 4.�� �\�'.'0 `, \ `�. Z4 R)er P.'^T°�.w�Ir w w.n A•w er •'.0 \ y S15-I] UPDAIE E>OSTWC CONp110N5 LAC DATE DESCRIP110N row ecke •, RUSITYdlAR-W A / \ e.� REVISIONS �\ �' HAZARo c .\ D� PLAN POND A7A�K Eyls \ �d OF EXISTING CONDITIONS PREPARED FOR A'^�C NEW RUSHY MARSH REALTY TRTUST 1].]C T : - A. / Win'" ��O '�•" \` >.D FOR PARCEL 14.#1 24 MAIN STREET •, 1.HOUSE NUMBER:1524 - j'r / R°a - \ comrt BARNSTABLE MA 2.ASSESSOR'S NUMBER 017 014 - , / A ^� \ \, \ 3.ZONING DISTRICT:Rf \\ \ 4.FLOOD HAZARD ZONES:C,A13(EL11)k V17(EL15) + // \ SCALE:1•.20' 1 DALE:APR.S,2017\` 5,BENCHMARK: SEE PLAN - \ / GBAPEBC SCATS 6.TOPOGRAPHIC INFORMATION COMPILED FROM AN - A' _ cOITE9 and Inc rat—h, Inc. ON THE GROUND INSTRUMENT SURVEY. /// a \ LOT \./ to O x0 e0 205 e^wn 9min 4owL ake µ4Pgq 7.ELEVn NS SHDM ARE DDEPC YERT�DAN ON HE - /. \ 'pq TH - ` �n Im) ftlmou Dn 02540 S6 548-9672 �l &REFERENCE LC.PLAN 18041-D r I _w DRAWN: LAC CHECKED aT>i21xSSPe. JOB NO: 212126 1 DWG.NO.,76-3-21D SHEET]K 4 - - 2'PK LENT w.n awro ew.wrp�e ro.nr-.ww/a•.ei rt...n✓a (mu4t(IMv xrGevl aumc/ 7HE vJc aP•(4wl Mrol Mw11ae�1[w^ a...sm�'.lNvhTP ro.we✓A.wy o-l-N Rwmwd.v mxr PUBYg.6odm TO]BEE 11 I.P.4'PK % n.4 a MmF r n eve poor PANG NWNIEB gtSTALLID IN ROro PWNS CONTNVEs w COTTAGE ISY m a Pnpu O-Do.: ANB01crflEVAnwAnarN� ` """"^ a✓a,m. `>a1.ae,k �'",)PI"" NATa cB�'n)o nlnsN cRAOE ``.. / �'i (NATOI Rt0.NAnA1NM•NAr1APggaF) .: ouw N 162 a al MM E%ISnNG GTVOVNO URFatt gFACt1 CAB.WA A 1J Lr.a'PK 0.M EIfN..160 .iI�fa'tpK PlVVe {{: SNx NSINOS MOpEL OHo)1F-q] L— :.P Ate_ T 0 BY PxEa 99 ENNRON7,ONE C (ae 1m swl tEnr AYPE k lsrosoou=crelwa ' .�y soo Gm s.p r µ q _ ram• -lo q. ro Haug > • (eL1W rABAxy i ' � .tm.� fn ,l,u�� a'auNrt sxse u.c to uo P9 M-5-0.5 s uaN w fmlDm mr4c�smc y -set - � -II°LF.-IX'gShcA/M1Z.[dtY ,• _ �-, b IX•PM FiW1 Y,W _ ROT LLV)AMKlS[Y(® F detbr !C 54otic tmk k'Jl• n-!Ni 30O LH/ar[Tan - e a .. a xn•.e,00� ROee-5 .TON SEPTIC PROFLE - COTTAGE E s '` 5 HOLE OISTRIBUTON BOX ... ..-., ,.... - FORCEMAIN PROFILE - BEACH CABANA 1. scAEE:r-r Not To scup ,. Ae,gplaur O ` s . - 14. zeT GENERAL NOTES ^w u rm.ar m) 1) N.Mange b Ule vyelmn Mall Dv mode unleea J,JCa GALLON dR>'1K rAnM A< q,proved M wrltinq by names end mcgrath,Ne 2) SuD).ct to Wupallon ,—cwaW tt Dy Me Bawd a(HwIU and Nolmn and mograM.inc � tAC OVf E N.oamvr pl sm uuw a.✓aws wm - �.]) H O urezu ar d�,a m:mt ®�e eavy eauipment anal)not trawl F'f. SIOWE ALL AAYX^O dleP..O Poam.,t eyetsn during a ana .M NAus Ala r ma 4) Btrpoaa.y.tem I.D.canswcbd n.ccwdw�a. / 500 GALON CHAMBER wM Title S of Ne State Envkamnwtd Coda. nIPL0124JfF Yd@eAAY sCAtE 1/t'-1 _ 5) A copy of Ue.e plan.must b,kept _ -._... ..... :.•... durinq Na tMe a/wnaWclbn. , h` LO C G G 0 E7 O C3 C7 0 O 6) A aapy of tn®p—moat by NrnLMW to Ne 5 may, i / `:)�"/�• �9 k,, ti C3 cm O C7 O M M C7 C7 IM ° awt.aatw wnawatmq Me di„poam syetwn. / / ep8' M O C7 O O O M C3 E7 1-3 4 7) Before baMknmq,the coniwclw Moo natlry ,bap 4DTN i 7 nAY '. - o C= o 0 0 0 o coo Agwt to b q ec Ua.yet.m as cwetmct.d. C3 0 I= C3 O C7 G G C3 G e) a the cano-acb.wcountere any wnauan batwew •r Me atlatfiq wndltlme Mom m M wd.tn. _1r N9YCnOI room / candltlwe wwunlered an be Bite, wy awdltlw dill^wl Nw Mown m Ue wq 1.% TYPICAL 500 GALLON LEACHING CHAMBER' any ativer.e eep,INe cm4ectw Mail ImmWlOtely SCAtE 1/2'.I' contact nalmea and mcgrab,Inc Molmee and mcgraM.ine wM vNmnNa Ue eoq wMitkn \ rAkn.�f+2 z nm m rmNunva 11'-0' - and rapart to Ue awnw any su99eeled reNalana. 3P)A^AbY OM55lkG 'Qy PR1]aOTED JX'PK Ftw FY,w ITT''•^ !'°*LF cuvnvuos FAOII TYPICAL DRYWELL I I or ro scA E f-2-24'Di—t^AaceaJ Halea I' Ir i - i� m .. GPALC urro�l•lo r• ALL ACCESS MANHOLE GONERS FOR V EVi<C ED SIet'rAlnP $Zor.PdOYA%E tm wnm INLET OUTLET SEPTIC TANK.DISTRIBUTION BOX = saT AwAr P>Aar n£su lroN - / \ / AND LEACHING STRUCTURE SET MORE SEPTIC DETAIL AT COTTAGE Al T0°FI. —E THAN 6'BELOW FINISHED GRADE, OM SHALL BE RAISED TO WITHIN 6'OF BALLAST CALCULATIONS Mlddle Ar>.m Hds I' - FINISHED GRADE AwxN P r 3OT -.T 6 WSPUCED ATEe-NTN R Of sunbl q'mHWnum dbnsb 5))#lY BUOYANT FgtCE-2gg5 W L-------_----J - °Pry PosnK rm¢.xra m.(aetlen.n 0+d]a m.(emoa.mgnq -_- -'—— — ——• iifANE m. 6 46 1(wq 2.2g5 .ekNt)-A56d m. STEEL REINFORCED PRECAST CONCRETE 01ER•Tr rla raJ• iACTtli SAFETY-a,SeB/ -2 PLAN VIEW 1O1'"xr _ NOTICE '—IIAC .A°•roEEn g �9, �l`��a�-..8....aa,ae a...,w }1}t] M15E SEPIIt OETAm A PROBIE AT iarTAGE UC mn.aeaa�w rewum •. wtEr.r $ _.v. DATE DESCRIPTON heck our r_n ewt m wu.t__ E - 5i, _� ^r mNaml R E V I S 1 0 N S E t1cuM I.wl "T ounEr T - T o * CONSTRUCTION DETAILS To n-o' - 14• �i, s'-o• - � K OF PROPOSED SEWAGE DISPOSAL SYSTEM a rl• �I PREPARED FOR •_°•m a•_r m1n. �' vl� NEW RUSHY MARSH REALTY TRUST LquM dapM - n•'-nh tlaeM eqU , - _ FOR PARCEL 14.V524 MAIN STREET N cAs BAFFLE F y �'-JJ COTUIT BARNSTABLE MA I F LF.RiO°i05ED SE1XF tB[ CAL'IAO'AJP 6 4' w a s-O01(SEE PxMtq tl�. ' SCALE:1'-n DATE:APR. . 2013 1V4 3'-Y TE1EC1>K,Or SEPTIC DETAIL .,Dimes and mC rat.,, inc. CROSS-SECTION END-SECTION AT BEACH CABANA mN gapA,.ar W'•"•+� alw eneMwn ana land.I";,N; ttWmtJ/,W/dv P,uYG sulF:t•-tC 915 aaamis-1.Nate M SBB 5IB-3564(FIB f - rorffrff Lrmeuwxv w nDo ENVIRONMENT ONE mm 02540 sae sf6-efi72 pq TYPICAL 1.500 GALLON SEPTIC TANK MODEL• DH071F-93 STATION DRAWN: LAC CHECKED scuE:1/Y-r(N-w LOAwNo) - or m swE JOB N: Ac_ DWG. EDt]4-3-21D SHEET a 0i a REScheck Software Version 4.4.4 Compliance Certificate LVJ Project Title: MCCourt Beach Cabana Energy Code: 2009 IECC Location: Cotuit,Massachusetts Construction Type: Single Family Project Type: New Construction Conditioned Floor Area: 160 U Glazing Area Percentage: 6% Heating Degree Days: 6137 Climate Zone: 5 Permit Date: Construction Site: Owner/Agent: Designer/Contractor: Cotuit,MA Shope Reno Wharton 18 Marshall St South Norwalk,CT 06854 203 852 7250 Compliance: 3.8%Better Than Code Maximum UA: 53 Your UA: 51 The%Better or Worse Than Code Index reflects how clo=_e to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Envelope Assemblies . .. Ceiling 1:Flat Ceiling or Scissor Truss 160 30.0 0.0 5 Skylight 1:Wood Frame:Double Pane with Low-E 7 0.340 2 SHGC:0.00 Wall 1:Wood Frame, 16"o.c. 340 19.0 0.0 17 Window 1:Wood Frame:Double Pane with Low-E 19 0.230 4 SHGC:0.00 Door 1:Solid 45 0.340 15 Floor 1:All-Wood Joist Truss:Over Unconditioned Space 160 19.0 0.0 8 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 2009 IECC requirements in REScheck Version 4.4.4 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date Project Notes: REScheck provided by Wishing Well Energy consultants 203 253 4800 Project Title: MCCourt Beach Cabana Report date: 07/20/13 Data filename: C:\Documents and Settings\John.Russo\Desktop\McCourt Beach Cabana.rck Page 1 of 8 REScheck Software Version 4.4.4 Inspection Checklist Requirements: 0.0% were addressed directly in the REScheck software Text in the"Comments/Assumptions"column is provided by the user in the REScheck Requirements screen. For each requirement,the user certifies that a code requirement will be met and how that is documented,or that an exception is being claimed.Where compliance is itemized in a separate table,a reference to that table is provided. ei ifei d� Fied�erifietl Y . 2009 IECCs% Pre-inspection/Plan Review Complies?" Comments/AssumpUoris Value Value 103.2 Construction drawings and ❑Complies [PR1]' documentation demonstrate energyx , ❑Does Not Comply code compliance for the building 01 " F, ❑Not Observable envelope. ❑Not Applicable 103.2, Construction drawings and l ❑Complies 403.7 documentation demonstrate energy "❑Does Not Comply: [PR3]' code compliance for lighting and �; '❑Not Observable mechanical systems.Systems serving z E ' ❑Not Applicable multiple dwelling units must demonstrate compliance with the commercial code. _ _ �_ 403 6 Heating and cooling equipment is — Heating: Heating: ;,[]Complies [PR2}z ;sized per ACCA Manual S based on Btu/hr Btu/hr '❑Does Not Comply ?loads per ACCA Manual J or other Cooling: Cooling: :❑Not Observable approved methods. Btu/hr Btu/hr ;❑Not Applicable t Additional Comments/Assumptions: ___._ -_.__—....._____ __._.....-..___... ._.. ___.... _..._..... ......____..__. 1 High Impact(Tier 1) 2,;;Medium Impact(Tier 2) 3. Low Impact(Tier 3) ..................................::...:..:::...................................................................................................................:::.:..:::......................................................................).........................� Project.Title: MCCourt Beach Cabana Report date: 07/20/13 Data filename: C:\Documents and Settings\John.Russo\Desktop\McCourt Beach Cabana.rck Page 2 of 8 r . 2009 IE6G Foundation Inspection Complies? Comments/Assumptions ' ,.. , 303.2.1 A protective covering is installed to ❑Complies [F01112 protect exposed exterior insulation ❑Does Not Comply: ;and extends a minimum of 6 in.below Not Observable ;grade. ❑Not Applicable 403 8 Snow-and ice-melting systems ❑Complies [F012J? r controls installed. ❑Does Not Comply F 1 ❑Not Observable ; ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2' Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: MCCourt Beach Cabana Report date: 07/20/13 Data filename: C:\Documents and Settings\John.Russo\Desktop\McCourt Beach Cabana.rck Page 3 of 8 2' PI'ans Verified Field Verified 009:IECG . Framing/Rough In Inspection. y Comphesl Comments/Assumptions Value:* Value 402.1.1, Door U-factor. U- ; U- ;❑Complies See the Envelope Assemblies table for 402.3.4 :❑Does Not Comply.values. [FR1J' ;❑Not Observable ❑Not Applicable 402.1.1, Glazing U-factor(area-weighted U- U- ;❑Complies See the Envelope Assemblies table for 402.3.1, average). ;❑Does Not Comply values. 402.3.3, 402.5 :❑Not Observable [FR2]' ;❑Not Applicable z 303.1.3 U-factors of fenestration products are ❑Complies [FR4]' determined in accordance with the �y ❑Does Not Comply: NFRC test procedure or taken from , ❑Not Observable the default table. ;, ❑Not Applicable 402.1.1, Skylight U factor. U U- ;❑Complies °See the Envelope Assemblies table for 402.3.3, i❑Does Not Comply.values. 402.5 ;❑Not Observable [FR5]' ❑Not Applicable 402.3.5 Sunrooms enclosing conditioned U- U- []Complies [FR8]' space have a maximum fenestration El Does Not Comply: U-factor of 0.50 in Climate Zones 4-8. New glazing separating the sunroom 3 :❑Not Observable from conditioned space must meet ❑Not Applicable code requirements. ............._..............._........:..._....................._._.........................._..._._...------._...._...........................................o......................................_......................................................................................._...__................_........._................................................ <........................._..................................................................................._.......................... 402.3.5 Sunrooms enclosing conditioned U- U- ;❑Complies [FR9]' space have a maximum skylight U- ;❑Does Not Comply: f1041; actor of 0.75 in Climate Zones 4-8. ;❑Not Observable ❑Not Applicable 402.4.4 i Fenestration that is not site built is a rKEl Complies [FR20]' listed and labeled as meeting ❑Does Not Comply AAMA/WDMA/CSA 101/I.S.2/A440 or ❑Not Observable has infiltration rates per NFRC 400 5� " ❑Not Applicable that do not exceed code limits. - ----------------- 402 4 5 'IC-rated recessed lighting fixtures ❑Complies [FR16f sealed at housing/interior finish and u k ❑Does Not Comply. labeled to indicate 2.0 cfm leakage at ❑Not Observable -, 75 Pa _ _.......... ................_................................................................_............ ._. 3..: —]Not Applicable w _.. _ ........................................ .. .......................................................... .......... ............................... 403.2.1 Supply ducts in attics are insulated to R- R- ;❑Complies [FR12]' R-8.All other ducts in unconditioned R_ 1 R ;❑Does Not Comply; spaces or outside the building ; ;❑Not Observable `. envelope are insulated to R-6. ❑Not Applicable 403.2.2 All joints and seams of air ducts.air ❑Complies [FR13]' handlers,filter boxes,and building a . `❑Does Not Comply cavities used as return ducts arepw � � ❑Not Observable sealed. ag ^[]Not Applicable 403 2.3 Building cavities are not used for 3 r ❑Complies [FR15]3 supply ducts. ❑Does Not Comply Via. srt El Observable w Not Applicable 403 3 3 HVAC piping conveying fluids above R- ; R ;❑Complies fR17]2 �,,105 OF or chilled fluids below 55 OF ❑Does Not Comply jare insulated to R-3. ❑Not Observable ;❑Not Applicable 4t23 4 Circulating service hot water pipes are R- R- ❑Complies [FR1B],, ainsulated to R-2. El Does Not Comply ;❑Not Observable ❑Not Applicable 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3. Low Impact(Tier 3) Project Title: MCCourt Beach Cabana Report date: 07/20/13 Data filename: C:\Documents and Settings\John.Russo\Desktop\McCourt Beach Cabana.rck Page 4 of 8 f 2009 IEM Framing/Rough fi Inspection' Plans Verified Field Verified ComphesT, mme ContslAssumptions � Value" Value 403 5 Automatic or gravity dampers are 1`4❑Complies [FR19)2 installed on all outdoor air intakes and ❑Does Not Comply sexhausts. X� ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2: Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: MCCourt Beach Cabana Report date: 07/20/13 Data filename: C:\Documents and Settings\John.Russo\Desktop\McCourt Beach Cabana.rck Page 5 of 8 Fiel V Plans Verified d Insulation Inspection a erifietl Complies?,} Comments/Assumptions" �.. Value ,a Valu 2009 IECCe 303 1 All installed insulation is labeled or the " ❑Complies [IN13]2 5 installed R-values provided. ❑Does Not Comply j ❑Not Observable it ❑Not Applicable 402.1.1. Floor insulation R-value. R- R- ;❑Complies See the Envelope Assemblies table for 402.2.5, Wood ;❑ Wood El Does Not Comply,values. 402.2.6 p y [IN1]' ❑ Steel ❑ Steel I❑Not Observable t❑Not Applicable 303.2, Floor insulation installed per , ❑Com plies 402.2.6 manufacturer's instructions,and in ❑Does Not Comply: [IN2]' .substantial contact with the underside ❑Not Observable of the subfloor. �s a ❑Not Applicable 402.1.1, Wall insulation R value.If this is a R- R- ;❑Complies See the Envelope Assemblies table for 402.2.4, mass wall with at least'/z of the wall Wood ❑ Wood ;❑Does Not Comply:values. ; 402.2.5 insulation on the wall exterior,the [IN3]' exterior insulation requirement ❑ Mass ❑ Mass ❑Not Observable applies. Steel ❑ Steel :[:]Not Applicable f 3 1 i 3 303.2 Wall insulation is installed per ' "❑Complies [IN4]' manufacturer's instructions. z Y< � ❑Does Not Comply: m .. --,-.A❑Not Observable . ONot Applicable .......... ................................................ ............................................__........._ .................... � . + _ 402.2.11 Sunroom wall insulation has a R- R- ;❑Complies [IN8]' minimum R-value of.R-13.New walls ;❑Does Not Comply: ;separating the sunroom from ; ;❑Not Observable conditioned space must meet code 1 :❑Not Applicable requirements. ; 303.2 Sunroom wall insulation installed per ❑Complies [IN9]' manufacturer's Instructions. ❑Does Not Comply: Q ❑Not Observable ❑Not Applicable 402.2.11 :Sunroom ceiling minimum insulation R- R- ;❑Complies [IN10]' R-value of R-19 in Climate Zones 1-4, 3 ❑Does Not Comply and R-24 in Climate Zones 5-8. ;❑Not Observable ]Not Applicable ............................................................................................................_..........._ 303.2 Sunroom ceiling insulation is installed k s ❑Complies [IN11]' per manufacturer's instructions. x El Does Not Comply: ❑Not Observable `. ORE ❑Not Applicable Additional Comments/Assumptions: r - — - ---- --- - - 1 High Impact(Tier 1) 2" Medium Impact(Tier la act(Tier 3) Project Title: MCCourt Beach Cabana Report date: 07/20/13 Data filename: C:\Documents and Settings\John.Russo\Desktop\McCourt Beach Cabana.rck Page 6 of 8 .. F,mal Irispe� Plans Verified . Field Verified 2009IECC; tlon Pro lsions kF Complies? CommertslAssumr) 6h . . Uatue Value ,< 402.1.1, Ceiling insulation R-value.Where>SR-: R- R- ❑Complies See the Envelope Assemblies table for 402.2.1, 30 is required,R-30 can be used if ❑ Wood =❑ Wood ❑Does Not Comply values. 402.2.2 insulation is not compressed at eaves.!FI Steel ❑ Steel ❑Not Observable [FI1]1 R-30 may be used for 500 ft2 or 20% 1 (whichever is less)where sufficient ;❑Not Applicable space is not available. a i ............... ......... ...... 303.1.1.1, Ceiling insulation installed per ❑Complies 303.2 manufacturer's instructions.Blown «a ❑Does Not Comply: [Fl2]1 insulation marked every 300 It'. ❑Not Observable Not Applicable ...._....._.......... 402.2.3 Attic access hatch and door insulation ; R- R- ;❑Complies __ [FI3]1 R-value of the adjacent assembly. ;❑Does Not Comply ❑Not Observable ;❑Not Applicable 402.4.2, —;Building envelope tightness verified ACH 50= ACH 50= '❑Complies 402.4.2.1 by blower door test result of<7 ACH a❑Does Not Comply [FI17]1 at 50 Pa.This requirement may P y instead be met via visual inspection, :❑Not Observable in which case verification may need to ;❑Not Applicable occur during Insulation Inspection. 402 4 3' Wood burning fireplaces haveF ❑Complies [F18]z sgasketed doors and outdoor El Does Not Comply combustion air. r: w❑Not Observable w r ❑Not Applicable _ ... -.........__.._. _ �, 403.2.2 Post construction duct tightness test cfm — cfm ;❑Complies [Fl4J1 result of 8 cfm to outdoors,or 12 cfm ❑Does Not Comply across systems.Or,rough-in test '❑Not Observable result of 6 cfm across systems or 4 cfm without air handler.Rough-in test ;❑Not Applicable verification may need to occur during , .Framing Inspection. _._......_.�___� ____._.._._.._....__...___.__._.__._Y.._.....____.......... 403 i 1 #Programmable thermostats installed m ❑Complies [F19] on forced air furnaces. „., ❑Does Not Comply ❑Not Observable El Not Applicable 403 1 2 ;Heat pump thermostat installed on s ;❑Complies [F1'10]2 heat pumps. 1 ` �, ❑Does Not Comply PY; ❑Not Observable �� '❑Not Applicable .................................. ..... . .... . ........ ............. ................................................................... ........................ ... Circulating service hot water systems ' mow, ❑Complies [FI11]2 have automatic or accessible manual ❑Does Not Com py� controls. ❑Not Observable ..... ❑ otApplicable _ N ❑Com les 403 9 1 Readily accessible switch on heaters pi [FI12]3 for swimming pools. ❑Does Not Comply: ❑Not Observable ❑Not Applicable 403.9.2 Timer switches on pool heaters and ? ❑Complies [FI19]3 pumps are present. r ❑Does Not Comply ❑Not Observable .::'......................................................_................................................... w ❑Not Applicable I ................... .... ..................................................... .. ................... .. .............. i 4019.3..3 Heated swimming pools have a cover. ❑Complies [F120]3 Covers on pools heated over 90 OF b ' E ❑Does Not Comply I { are insulated to R-12. � ❑Not Observable I (]Not Applicable 404.1 !50%of lamps in permanent fixtures ` r ` ❑Complies [FI6]1 are high efficacy lamps. "'❑Does Not Comply ❑Not Observable ❑Not Applicable 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: MCCourt Beach Cabana Report date: 07/20/13 Data filename: C:\Documents and Settings\John.Russo\Desktop\McCourt Beach Cabana.rck Page 7 of 8 f Plans Verified Field Verified 2009 IECC Final Inspection Provisions,;, Value, Value Comphes7; ComnientslAs§umptions ram. . 41013 Compliance certificate posted. g ❑Complies [FIy7J2 r �_ ❑Does Not Comply: y` >❑Not Observable ❑Not Applicable —.__......... 3083 Manufacturer manuals for mechanical +'11' � 5� ❑Complies [FI18]3 and water heating equipment have y#❑Does Not Comply been provided. t r " ❑Not Observable :... . , .. :;a❑Not Applicable Additional Comments/Assumptions: i 1 High Impact(Tier,1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: MCCourt Beach Cabana. Report date: 07/20/13 Data filename: C:\Documents and Settings\John.Russo\Desktop\McCourt Beach Cabana.rck Page 8 of 8 2009 IECC Energy Efficiency Certificate Wall 19.00 Floor 19.00 Ceiling/Roof 30.00 Ductwork(unconditioned spaces): Window 0.23 Door 0.34 Skylight 0.34 Heating System: Cooling System: Water Heater: Name: Date: Comments: t t r VoncA_ Co nnionovealth of Massachusetts / Sheet Metal Permit Date: �� /� .. t PeI7nit r 3 0 ,W S I Estimated Job Cost: S +� Permit Fee: S �� Plans Submitted: YES NO ✓ v 2p1� Plans Reviewed: YES NO Business License - !&C icense T Businessdnforination -vo)NOF Property Owner/Job Location Information: Name: VErn c)n. Loft NeJe " Imo, : Name: m C Cnu,rt Street: VJ W� � � Street: �) / C.c ' J` //-- City/Town: W. C��a�'ha�ti1 City/Town: ,/ r Telephone: ��g, 9y - Telephone: n Lq p Photo I.D. required/Copy of Photo I.D. attached: YES NO SuffInitial J-1 /M-1-unrestricted license J-2 /M-2-restricted to dwellings '---stories or less and commercial up to 1.0,000 sq. ft./2-stories or less. Residential: 1-2 familytv/ Multi-familyCondo/Totiviuhouses Ocher Commercial: 0fiice Retail Industrial Educational Institutional Other Square Footage: under 10,000 sq.ft. over 10,000 sq. ft. ' INumber of ies,: Sheet metal w.ork to be'completed: New Work: Renovation: HVAC V Metal Watershed Roo-m Kitchen Exhaust,System Metal Chimney/Vents Air Balancing Pxo-vide detailed description*of�•�ork to be done: - `_j � �• i,$%', ' .fir �r .�= ?. �"t . - .., e.r r• `._''.. r INSURANCE COVERAGE: I have a current liability insurance'policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes No❑ If you have checked Yes, indicate the type'of coverage by'checking the appropriate box below: l ❑ A liability insurance policy Other type of indemnity Bond ' I OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and.that my signature on this permit appFication waives this requirement. Check One Only i Owner ❑ Agent ❑ Signature of Owner or Owners Agent By checking this box0,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Proaress Inspections Data: Comincnts t r t Final Inspection Comments _ e Type of License.- By ❑ Master j Title ❑ Master-Restricted __2 IVA � CitylTown v ❑Journeyperson Signature of Licensee Permits n �7 ❑Joumeyperson-Restricted License Number: 0/� � 1 Fee S ❑ Check at-wviw,rnass,aoy1d 1 I i i 1 i Inspector Signature of Permit Approval i l - i COMMONWEALTH OF MASSACHUSETT:S: E:•., ". :S.HEET METAL WORKERS r :? AS A BUSINESS . .,; ISSUES THE ABOVE LICENSE T0: .. - _ r '. - -•: i� r ;'btu ER IC T..WHI,T.ELEY W,...,VERNON 41HITELEY PLBG AND . 28":VILLAGE LANDING PO BOX ..'1266 W,,CHATH.AM MA 02669=000 '160 12/22/14 292b29 _-- -----'--------------------- ;COUMONWEALTH OF MASSACHUSETTS .. SHEET METALWORKERS AS A MASTER-UNRESTRICTED ISSUES THE ABOVE LICENSE TO: ERIC_ T:`WHJTELEY .PO B 0 X 248 WEST CHATHAM MA 02669-02.48 2967 02/28/14 11942-3 Po!d,Then Detach Along All Pe iorations ' , n Barnstable Ulatory Se rvices. " o` T of tas F.Geller,S?lrector` x Bllgdmg Dlyn1{327 Tom Til 200 St�oe4 Hy is,T jk 62601 fov�aibarnstttib�c.nca. s% fJs S08 HS2-4.3x `5 $ 79:Ow623 .: .. o� Must er letc tad i� This Secd0h:; If3sx� :Axde i .: 41 wbwn 6t a fthe sub`ect 1 I�: x2a sae �atztharzd " �. f a i jp I �k ,aa enc axed P la ar ;tze z orxsb of " cant:;:,,, 'c� Is F sate � c wed 3accefr�ce a� zzztaIled axad gas ;re b pp tIed; at .aia x� 1. ectn' aafm�d ac eetd. I I S :af£?der ,. 1 �App�vej� ,cala�.' � pr�at al c r F � ;S 'ate.,, l' 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): W `t e- Yl non LU K t e e P u , v- I 1 n c-- Address: a is V, 6,,.` 1 Po R o x )d r (, City/State/Zip: -A k Phone#: (�c g) J' L1 > >I 36 . Are you an employer? Check the appropriate box: Type of project(required): 4. I am a general contractor and I to er ith 5 ❑1� I am a emp y w _�_ 6. ,�New construction employees(full and/or part-time). have hired the sub-contractors 2-❑ 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 an capacity. -employees and have workers' Y P Y 9. ❑ Building addition [No workers' comp.insurance comp:insurance. . required.] 5. ❑ We area corporation and its 10.0 Electrical repairs or additions officers have exercised their I L 3.❑ I am a homeowner doing all work f ❑ 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 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 anew 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 providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Ace_ Arne,�, c Ar-) Co r.l A Policy#or Self-ins. Lic.#: b S=(� : U - °i cj -7 d L1,b_ - /J Expiration Date: 0 /111,14 .Job Site Address: A f-1 o 1,s 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 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 viol r. vised that a copy of this statement maybe forwarded to the Office of Investi ations of the DIA for ins n c v rification. I do hereby certify un�1�7t e s perjury that the information provided above is true and correct Signatur Date: Phone#: G 6 g 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#: s C WVERNON-01 CLEDDUKE i DATE lalrlroom•YY) CERTIFICATE OF LIABILITY INSURANCE1012r2013 i 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 j REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. i IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to I the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not cohfer rights to the I certificate holder in lieu of Such endorsement(s). i PRODUCER I CONTACT Donna Pearse I I NAME: Rogers &Gray Ins.-Dennis Branch A/CNN E<. 508 c No):(877 816 2156 398-7980 FAX (434 Rte 134 Af South Dennis,MA 02660 ADOREss dpearse@rogersgray.com INSURER(S)AFFORDING COVERAGE I NAIC" 1 INSURER A:ARBELLA PROTECTION INSURED - - I INSURER B W.Vernon Whiteley Plumbing&Heating Co,Inc. INSURERC: Chatham Sheet Metal,Inc. P.O.Box 1266 INSURER D } I West Chatham,MA 02669-1266 I INSURERE: INSURER F• j 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 j I 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, i EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I IDISR I - ADDL SUBR - POLICY EFF I POLICY EXP - I LS TYPE OF INSURANCE I SR 'PAID POLICY NUIVIBER Nl MfD01YYYY dAPd 10 DfYY'(Y I LIIv1175 GENERAL LIABILITY - I I EACH OCCURRENCE I5. 1,000,0001 A X COMMERCIAL GENERAL LIABILITY, 8500052832 I 1n(l(201.1 10/1/2014 DAMA E 0R NTEO i 50,000j PREMISES fEz cccurr nc 1 is CLAI,NIS4,1ADEi OCCUR I ,. I j MEO EXP(Any one person) j S 5,000; PERSONAL&ADVINJURY is 1,000,000•. I I GENERAL AGGREGATE I s 2,000,000; 2,000,000 I GEN'L AGGREGATE LIMIT APPLIES PER: i I PRODUCTS-COP.IPIOP AGG s _ PRO- POLICY S I _ POLICY JECT LOC j I I ' AUTONIOSILE LIABILITY - ! IF,P.,idEn SINGLE LhdIT j 1,000,000', I fEzzccidentl S A P.i4Y AUTO j 102000634t5 j 10/112013 11011/2014 I BODILY INJURY(P r parson) IS ALL OWNED '�SCHEDULED I I i BODILY INJURY(Per accident)!5 AUTOS u AUTOS .I I (PROPERTY DAMAGE X I I NCH-OYINEO I i S ' i HIRED AUTOS I AUTOS I I I fPER ACCIDFi ITI i IS I X UMBRELLALIAB OCCUR I i i EACH OCCURRENCE SH 4,000,000' Excess uAe 101112013 101112014 AGGREGATE is 4,000,000! j A CLAIMS-,WADE 4600052833 i I j i- DIED X RETENTIONS 10,000 ! S TATU ,WORKERS COMPENSATION I O LIMIT 1 TH•j- l i .TURY LIMITS j �P. . i AND ENIPLOYERS'LIABILITY ANY PROPRIETOF'PARTFIER'EXECUTIVE Y(7 I I j E.L.EACH ACCIDENT i"a OFFICERINIEMBER EXCLUDED? L� NIA I E.L.DISEASE•EA EPi1PL0YEc^S (Mandatory in NH) I ! - - tt yes,descflbe under DESCP,IPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMITS i I I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,It more spate is required) - !Blanket Additional Insured Status is included when required bywritten contract. Worker's Compensation certificate will be issued and sent to you directly by the insurance company. j I I ! CERTIFICATE HOLDER CANCELLATION I l I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ! Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED iPJ ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street I Hyannis,MA 02601-0000 I"AUTHORIZED REPRESENTATIVE 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Rightfax N1-1 10/4/2013 7:19:41 AM PAGE 51/055 Fax Server Ac fl� CERTIFICATE OF LIABILITY INSURANCEFAT 13 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: ROGERS&GRAY INS AGCY PHONE Fax 434 ROUTE 134 Ac No Ext: A'c Not SOUTH DENNIS,MA 02660 4Ct INSURER(S)AFFORDING COVERAGE NAIC k INSURERA:ACE AMERICAN INSURANCE COMPANY - INSURED INSURER B: W VERNON W'HITELEY PLUMBING& INSURERC: HEATING CO INC&CHATHAM SHEET METAL INC INSURER D PO BOX 1266 INSURERE: WEST CHATHAM,MA 02669 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 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. INSR ADDL SUB POLICY EFF POLICY EXP LTR TYPEOFINSURANCE INSR WVD POLICY NUMBER IMwDoryYYY) MMIDDIY - LIMITS GENERAL LIABILITY EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY - DAMAGE TO RENTED'' S ]CLAIMS -iADE I OCCUR PREMISE'S Ea occurrence' - _J MED EXP(Any one person) S PERSONAL&ADV INJURY S - - GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP,'OP AGG S POLICY PERO- LOC JCT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT g -Ea acudenb ANY AUTO - BODILY INJURY(Per person) S ALL OWNED SCHEDULED - 4 AUTOS AUTOS. BODILY INJURY(Peraccident) HIRED AUTOS NON-OWNED p�OPEI TY .4MAGE S AUTOS .- cr arri.ent S - UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS.LIAB CLAIMS-MADE AGGREGATE S DIED RETENTIONS S WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY - Y.rN TORY LIMITS ER ANY PROPRIETORrPARTNEPJEXECUTI'JI��N� E.L.EACH ACCIDENT $500,000 OFFICERIMEMIBER EXCLUDED? 7N NIA 6S62UB- 10-01-2013 10-01-2014 (Mandatory in NH) 9972L664 E.L.DISEASE-EA EMPLOYEE $500,000 If ycs,descrihe under DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more spacels required)' CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE 200 MAIN STREET CANCELLED BEFORE THE EXPIRATION DATE THEREOF, •HYANNIS,MA021301 NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD q � G TOWN OF BARNSTABLE Building Department - Foundation Permit Date 2-yJ13 Permit # 2_01 3 o S77Z Name KEAJNETW VDNA Location /,SIN ST GOTu�—T Insp. of Bldgs. Anderson 781-857-1000 >e � - Faz 781-857-1054 ' Emulatio Inc. , www:andersoninsul.com , 706 Brockton Ave IPO 13ox 2003 Abington, MA"02351' Insulation Cevficate WORK AREA ITEM INSTALLED Main Ceiling R-40.5 Icynene Closed Cell Spray Foam Insulation MDC "'6in` B&.Walls 2x6 R-20.3 Icynene Closed Cell Spray Foam Insulation.MDC-3in T. Floor R-30.4 Icynene Closed Cell Spray Foam Insulation MDC=4.5in Main Ceiling R-40.5'Icynene Closed Cell Spray Foam Insulation MDC bin f f EXT.Walls 2x6 R-20.3.Icynene Closed Cell Spray Foam Insulation MDC-3in'. k _ _ Floor, R-30.4 Icynene Closed Cell Spray Foam Insulation MDC-4.5in Customer: Kenneth Vona Construction,Inc. z lob Plumber:., 198964' Job Address', McCourt Guest.Cottage and Cabana Date Completed: ; Ir>sta ler Signature '' Anderson 781-857-1000. ® Fax 781-857-1054 insulation, Inc. www.andersoninsul.com 706 Brockton Ave -TOWN OF RARNSTAFTE. PO Box 2003 Abington, MA 02351 2014 raA ; 411 It s 0 5 WORK AREA ITEN INSTALLED Underside of Roof R 37.1 Icynene posed Cell Spray FgaitrF,MDC=5: n9 Gable End Walls R 21.6 Icynene Closed Cell,Spray Foam Insulation MDC-3.2in EXT.Walls 2x6 R-21.6 Icynene Closed Cell Spray Foam Insulation MDC-3.21n Blockers/Rim Joist R-21.6 Icynene Closed Cell Spray Foam Insulation MDC-3.2in Main Ceiling R 19 6 X 15 Unfaced Fiberglass Batts Interior Partitions R-19 6 X 15'Unfaced Fiberglass Batts Basement Ceiling R-3010 X 16 Kraft Faced Fiberglass Batts Custorneir= Kenneth Vona Construction,Inc. lob Number- 1.98964 Job Address McCourt Guest Cottage and Cabana bate Completed: Installer Sipna re q . Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program X260831 Chapter 91 Waterways License Application 310 CMR 9.00 —Transmittal N°_ -- Water-Dependent, Nonwater-Dependent,Amendment G. Municipal Zoning Certificate Wiliam F. Griffin, Jr.,Trustee, New Rushy Marsh Realty Trust Name of Applicant 1524 Main St, Cotuit;Barnstable Rushy Marsh Pond Barnstable Project street address Waterway City/Town Description of use or change in use: The proposed construction and maintenance of of a fixed timber pier, ramp,float and pilings in Rushy Marsh Pond is for private, non-commercial, recreational use. To be completed by municipal clerk or appropriate municipal official: "I hereby certify that the project described above and more fully detailed in the applicant's waterways license application and plans is not in violation of local zoning ordinances and bylaws." Thomas Perry, Barnstable Building Commissioner WIS C/ Printed Name of Municipal Official D e Building Commissioner Barnstable Signature of Municipal OlYidial Title City/Town i . r CH91App.doc•Rev. 08113 Page 6 of 13 CI Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program X260831 Transmittal No. Chapter 91 Waterways License Application -310 CMR 9.00 Water-Dependent, Nonwater-Dependent,Amendment Important:When filling out forms A. Application Information (Check one) on the computer,. use only the tab NOTE: For Chapter 91 Simplified License application form and information see the Self Licensing key to move your Package for BRP WW06. cursor-do not use the return key. Name(Complete Application Sections) Check One Fee Application# WATER-DEPENDENT- General (A-H) ® Residential with < 4 units $215.00 BRP WW01a ❑ Other $330.00 BRP WW01 b For assistance ❑ Extended Term $3,350.00 BRP WW01c incompleting this -----._.._.._.._.._..-------------•-----------.._.._.._.._..-------------------._.._.._..------------------.._..---------------------------------- application,please Amendment(A-H) ❑ Residential with <4 units $100.00 BRP WW03a see the "Instructions". EJ Other $125.00 BRP WW03b NONWATER-DEPEN DENT- Full A=H( ) . El Residential with<4 units $665.00 _.BRP WW15a ❑ Other $2,005.00 BRP WW1.5b El Extended Term $3,350.00 BRP WW15c . . . Partial (A-H) ❑ Residential with < 4 units S665.00 BRP WW14a - - ❑ Other $2,005.00 BRP WW14b ❑ Extended Term $3,350.00 BRP WW14C Municipal Harbor Plan. A-H p ( ) ❑ Residential with <4 units $665.00 BRP WW16a ❑ Other $2,005.00 BRP WW16b Extended Term $3,350.00 BRP WW16c Joint MEPA/ElR A-H ❑ Residential with< 4 units $665.00 BRP WW17a Other $2,005.00 BRP WW17b ❑Extended Term $3,350.00 BRP WW17c Amendment(A-H) ❑ Residential with <4 units . $530.00 BRP WW03c. ❑:Other $1,000.00 BRP WW03d ❑ Extended:Term . $1,335.00 BRP:WW03e. . . CH91App.doc-Rev.:08/13 Page 1 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program X260831 Chapter 91 Waterways License Application - 310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment B. Applicant Information Proposed Project/Use Information r 1. Applicant: William F. Griffin, Jr., Trustee wgriffin@davismalm.com Name E-mail Address New Rushy Marsh Realty Trust, c/o The McCourt Group 9420 Wilshire Blvd Ste 300 Mailing Address Note:Please refer Beverly Hills CA 3 to the"Instructions" City/Town State Zip Code M Telephone Number Fax Number 2. Authorized Agent(if any): Jeffrey L. Johnson, Holmes and McGrath Inc. jjohnson@holmesandmcgrath.com Name E-mail Address 205 Worcester�Ct, Suite A4 Mailing Address Falmouth MA 02540 City/Town State Zip Code 5085483564 5085489672 Telephone Number _ Fax Number C. Proposed Project/Use Information 1. Property Information (all information must be provided): Same as applicant Owner Name(if different from applicant) 0017 014 41.60133N 70.44368W Tax Assessor's Map and Parcel Numbers Latitude Longitude 1524 Main St., Cotuit, Barnstable MA 02635 Street Address and Cityrrown State Zip Code 2. Registered Lands ❑ Yes ❑ No 3. Name of the water body where the project site is located: Rushy Marsh Pond 4. Description of the water body in which the project site is located (check all that apply): Type Nature Designation ❑ Nontidal river/stream ® Natural ❑Area of Critical Environmental Concern ❑ Flowed tidelands ❑ Enlarged/dammed ❑ Designated Port Area ❑ Filled tidelands ❑ Uncertain ❑ Ocean Sanctuary ® Great Pond ❑ Uncertain ❑ Uncertain CH91App.doc•Rev.08/13 Page 2 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program X260831 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment C. Proposed Project/Use Information (cont.) Select use(s)from Project Type Table 5. Proposed Use!Activity description on pg.2 of the "Instructions" Construction and maintenance of a fixed timber pier, ramp,float and pilings for private, non- commercial recreational use. 6. What is the estimated total cost of proposed work(including materials & labor)? $less than $100,000 7. List the name &complete mailing address of each abutter(attach additional sheets, if necessary). An abutter is defined as the owner of land that shares a common boundary with the project site, as well as the owner of land that lies within 50' across a waterbody from the project. Victoria W. Hope P.O. Box 526, Cotuit, MA 02635 Name Address David J. &Anne B. Nisula P.O. Box 1400, Cotuit, MA 02635 Name Address Dale D. Bragdon, et al c/o Leslie W. Vieth, 3 Landmark Rd, Westford, MA 01886 Name Address D. Project Plans 1. I have attached plans for my project in accordance with the instructions contained in (check one): ® Appendix A(License plan) ❑ Appendix B (Permit plan) 2. Other State and Local Approvals/Certifications ❑401 Water Quality Certificate Date of Issuance ®Wetlands 3-5179 File Number ❑Jurisdictional Determination JD- File Number ❑ MEPA File Number ❑ EOEA Secretary Certificate Date ❑ 21 E Waste Site Cleanup RTN Number CH91App.doc•Rev.08/13 Page 3 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program X260831 Chapter 91 Waterways License Application .310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment E. Certification All applicants, property owners and authorized agents must sign this page. All future application correspondence may be signed by the authorized agent alone. "I hereby make application for a permit or license to authorize the activities I have described herein. Upon my signature, I agree to allow the duly authorized representatives of the Massachusetts Department of Environmental Protection and the Massachusetts Coastal Zone Management Program to enter upon the premises of the project site at reasonable times for the purpose of inspection." "I hereby certify that the information submitted in this application is true and accurate to the best of my knowledge." Applicant's signature Date Property Owner's signature(if different than applicant) Date Agent's signature(if applicable) Date CH91App.doc-Rev.08/13 Page 4 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program X260831 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment F. Waterways Dredging Addendum 1. Provide a description of the dredging project ❑ Maintenance Dredging(include last dredge date& permit no.) ❑ Improvement Dredging Purpose of Dredging 2. What is the volume (cubic yards) of material to be dredged? 3. What method will be used to dredge? ❑ Hydraulic ❑ Mechanical ❑ Other 4. Describe disposal method and provide disposal location (include separate disposal site location map) 5. Provide copy of grain size analysis. If grain size is compatible for beach nourishment purposes, the Department recommends that the dredged material be used as beach nourishment for public beaches. Note: In the event beach nourishment is proposed for private property, pursuant to 310 CMR 9.40(4)(a)1, public access easements below the existing high water mark shall be secured by applicant and submitted to the Department. CH91App.doc•Rev.08/13 Page 5 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program X260831 Chapter 91 Waterways License Application - 310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment G. Municipal Zoning Certificate Wiliam F. Griffin, Jr., Trustee, New Rushy Marsh Realty Trust Name of Applicant 1524 Main St, Cotuit, Barnstable Rushy Marsh Pond Barnstable Project street address Waterway City/Town Description of use or change in use: The proposed construction and maintenance of of a fixed timber pier, ramp,float and pilings in Rushy Marsh Pond is for private, non-commercial, recreational use. To be completed by municipal clerk or appropriate municipal official: "I hereby certify that the project described above and more fully detailed in the applicant's waterways license application and plans is not in violation of local zoning ordinances and bylaws." Thomas Perry, Barnstable Building Commissioner Printed Name of Municipal Official Date Building Commissioner Barnstable Signature of Municipal Official Title City/Town CH91App.doc-Rev.08/13 Page 6 of 13 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program X260831 Chapter 91 Waterways License Application .310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment H. Municipal Planning Board Notification Notice to Wiliam F. Griffin, Jr.,Trustee, New Rushy Marsh Realty Trust Applicant: Name of Applicant Section H should 1524 Main St, Cotuit, Barnstable Rushy Marsh Pond Barnstable be completed and Project street address Waterway City/Town submitted along with the original Description of use or change in use: application material. The proposed construction and maintenance of of a fixed timber pier, ramp,float and pilings in Rushy Marsh Pond is for private, non-commercial, recreational use. To be completed by municipal clerk or appropriate municipal official: "I hereby certify that the project described above and more fully detailed in the applicant's waterways license application and plans have been submitted by the applicant to the municipal planning board." Art Traczyk Printed Name of Municipal Official Date Town Planner Barnstable Signature of Municipal Official Title City/Town Note: Any comments, including but not limited to written comments, by the general public, applicant, municipality, and/or an interested party submitted after the close of the public comment period pertaining to this Application shall not be considered, and shall not constitute a basis for standing in any further appeal pursuant to 310 CMR 9.13(4)and/or 310 CMR 9.17. CH91App.doc•Rev.08/13 Page 7 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program X260831 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment Appendix A: License Plan Checklist General View ® PE or RLS, as deemed appropriate by the Department, stamped and signed, in ink, each sheet within 8 1/2 inch by 11 inch border ® Format and dimensions conform to"Sample Plan" (attached) ® Minimum letter size is 1/8 of an inch if freehand lettering, 1/10 of an inch if letter guides are used ® Sheet number with total number in set on each sheet ® Title sheet contains the following in lower left: Plans accompanying Petition of[Applicant's name, structures and/or fill or change in use, waterway and municipality] ® North arrow ® Scale is suitable to clearly show proposed structures and enough of shoreline, existing structures and roadways to define its exact location ® Scale is stated &shown by graphic bar scale on each sheet ® Initial plans may be printed on bond; final plans due before License issuance must be on 3mil Mylar. l Structures and Fill ® All Structures and Fill shown in full BLACK lines, clearly labeling which portions are existing, which are Proposed and indicating Existing Waterways Licenses ® Cross Section Views show MHW*and MLW*and structure finish elevations ❑ Dredge or Fill,actual cubic yardage must be stated and typical cross sections shown ® All Structures and Fill shown in full BLACK lines, clearly labeling which portions are existing, which are Proposed and indicating Existing Waterways Licenses ® Cross Section Views show MHW*and MLW*and structure finish elevations ❑ Dredge or Fill, actual cubic yardage must be stated and typical cross sections shown ® Actual dimensions of structures(s)and or fill and the distance which they extend beyond MHW*or OHW* ® Change in Use of any structures on site must be stated *See 310 CMR 9.02, Waterways Regulations definitions of High Water Mark, Historic High Water Mark, Historic Low Water Mark, and Low Water Mark. Note: DEP may, at its discretion, accept appropriately scaled preliminary plans in lieu of the plans described above. In general, DEP will accept preliminary plans only for non-water dependent projects and projects covered by MEPA to address site design components such as visual access, landscaping &site coverage. Anyone wishing to submit preliminary plans must obtain prior approval of the DEP Waterways Program before submitting them with their application. CH91App.doc•Rev. 08/13 Page 8 of 13 LlMassachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection-Wetlands MassDEP File#:003-5179 WPA Forth 5-Order of Conditions eDEP Transaction#:643067 Massachusetts Wetlands Protection Act M.G.L.c. 131,§40 City/Town:BARNSTABLE A. General Information 1.Conservation Commission BARNSTABLE 2.Issuance a. F OOC b.I— Amended OOC 3.Applicant Details a.First Name WILLIAM F. b.Last Name GRIFFIN,JR.,TRUSTEE rn Organization NEW RUSHY MARSH REALTY TRUST d.Mailing Address 1 BOSTON PLACE,37TH FL. e.City/rown BOSTON f.State MA g.Zip Code 02108 4.Property Owner . a First Name WILLIAM F. b.Last Name GRIFFIN,JR.,TRUSTEE c.Organization NEW RUSHY MARSH REALTY TRUST d.Mailing Address I BOSTON PLACE,37T`H FL. e.City/rown BOSTON f.State MA g.Zip Code 02108 5.Project Location a.Strect Address 1524 MAIN STREET,COTUIT b.City/Town BARNSTABLE c.Zip Code 02635 d.Assessors Map/Plat#017 e.Parcel/lot# 014 f.Latitude 41.60133N g.Longitude 70.44368W 6.Property recorded at the Registry of Deed for. a.County b.Certificate c.Book d.Page 159659;LOTS E&F;LCP BARNSTABLE 2875-C;159659;LOT 10; LCP 18041-D 7.Dates a Date NOl Filed:2/27/2014 b.Date Public Hearing Closed: 3/18/2014 c.Date Of Issuance:4/8/2014 8.Final Approved Plans and Other Documents a.Plan Title: b.Plan Prepared by: c.Plan Signed/Stamped by: d.Revised Final Date: e.Scale: REVISED SITE HOLMES& MICHAEL B.MCGRATH,P.E.3/20/2014 1"=20' PLAN(2 SHEETS) MCGRATH,INC. B. Findings Page l of 9 0 ELECTRONIC COPY LlMassachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection-Wetlands MassDEP Fife#:003-5179 WPA Form 5-Order of Conditions cDEP Transaction i1:643067 Massachusetts Wetlands Protection Act M.G.L.c. 131,§40 CiVrown:BARNSTABLE 1.Findings pursuant to the Massachusetts Wetlands Protection Act Following the review of the the above-referenced Notice of Intent and based on the information provided in this application and presented at the public hearing,this Commission finds that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that apply: a. r Public Water Supply b. r Land Containing Shellfish c.r Prevention of Pollution d. r Private Water Supply _ e. r Fisheries f. r Protection of Wildlife Habitat g_r Ground Water Supply IL r Stone Damage Prevention i. F Flood Control 2.Commission hereby finds the project,as proposed,is: Approved subject to: a.i-F The following conditions which arc necessary in accordance with the performance standards set forth in the wetlands regulations. 'ibis Commission orders that all work shall be performed in accordance with the Notice of Intent referenced above.the following General Conditions,and any other special conditions attached to this Order.To the extent that the following conditions modify or differ from the plans,specifications,or other proposals submitted with the Notice of lntent,these conditions shall control. Denied because: b.r The proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations.Therefore, work on this project rimy not go forward unless and until a new Notice of Intent is submitted which provides measures which are adequate to protect interests of the Act,and a final Order of Conditions is issued.A description of the performance standards which the proposed work cannot meet Is attached to this Order. c.r The information submitted by the applicant is not sufficient to describe the site,the work or the effect of the work an the interests identified in the Wetlands Protection Act Therefore,work on this project may not go forward unless and until a noised Notice of Intent is submitted which provides sufficient information and includes measures which are adequate to protect the interests of the Act,and a final Order of Conditions is issued A description of the specific information which is lacking and why it Is necessary is attached to this Order as per 310 CMR 10.05(6)(c). 3.I— Buffer Zone Impacts:Shortest distance between limit of project disturbance and the wetland resource area specified in 310CMR10.02(l)(a). a.linear feet inland Resource Area Impacts:(For Approvals Only): Resource Area Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 4. r sank a.linear feet b.linear feet C.linear feet d linear feet 5.17 Bordering Vegetated Wctland 300 300 . 0 0 a.square feet b.square feet c.square feet d.square feet 6. l✓Land under Waterbodies and Waterways 200 200 0 0 a.square feet b.square feet c.square feet d.square feet 0 0 c.dy dredged f.cly dredged Page 2 of 9* ELECTRONIC COPY LlMassachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection-Wetlands MassDEP File q:003-5179 WPA Form 5-Order of Conditions eDEP Transaction#:643067 Massachusetts Wetlands Protection Act M.G.L.c. 131,§40 City/fowwBARNSTABLE 7.r Bordering Land Subject to Flooding a square feet b.square feet c.square t d.square feet Cubic Feet Flood Storage e.cubic feet f.cubic feet g.cubic feet h.cubic feet 8.r Isolated Land Subject to Flooding a.square feet b.square feet Cubic Fat Flood Storage a cubic feet d.cubic feet e.cubic feet E cubic fat 9.r Riverfront Area a.total sq.feet b.total sq.feet Sq ft within 100 ft c.square feet d.square feet c.square feet f.square feet Sq ft between 100-200 ft g.square feet h.square feet i.square feet j.square feet Coastal Resource Area Impacts: Resource Area Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement l o.r Designated Port Areas Indicate size under Land Under the Ocean,below 11.r Land Under the Ocean a square feet b.square feet c.c/y dredged d.cly dredged 12.r Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below 13.r Coastal Beaches a.square feet b.square feet c.cly nourishment d.cly nourishment 14.r Coastal Dunes a.square feet b.square feet c.cly nourishment d.cly nourishment 15.r Coastal Banks a linear feet b.linear feet 16.r Rocky Intertidal Shores a square feet b.square feet 17.r Salt Marshes a square feet b.square feet c.square feet d.square feet 18.r Land under Salt ponds a squ=fat b.square feet c.cly dredged d.cly dredged 19.r Land Containing Shellfish Page 3 of 9'ELECTRONIC COPY LlMassachusetts Department of Environmental Protection Provided byMassDEP: Bureau of Resource Protection-Wetlands MassDEP File#:003-5179 WPA Form 5-Order of Conditions eDEP Transaction q:643067 Massachusetts Wetlands Protection Act M.G.L.c. 131,§40 City/fown:BARNSTABLE a.square feet b.square feet c.square feet d.square feet Indicate size under Coastal Banks,inland Bank,Land Under the 20.r Fist Ruts Ocean,and/or inland Land Under Waterbodies and Waterways, above c.c/y dredged d.c/y dredge 21.r Land Subject to Coastal Storm Flowage a.square feet b.square feet 22. r Restoration/Enhancement(For Approvals Only) If the project is for the purpose of restoring or enhancing a wetland resource area in addition to the square footage that has been entered in Section B.5.c&d or B.I7.c&d above,please entered the additional amount here. a.square feet of BVW b.square feet of Salt Marsh 23. f'Streams Crossing(s) If the project involves Stream Crossings,please enter the number of new stream crossinonumber of replacement stream crossings. a number of new strearn crossings b.number of replacement stream crossings C. General Conditions Under Massachusetts Wetlands Protection Act The following conditions are only applicable to Approved projects I. Failure to comply with all conditions stated herein,and with all related statutes and other regulatory measures,shall be deemed cause to revoke or modify this Order. 2. The Order does not grant any property rights or any exclusive privileges;it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state,or local statutes,ordinances,bylaws,or regulations. 4. The work authorized hereunder shall be completed within throe years from the date of this Order unless either of the following appl),. a.the work is a maintenance dredging project as provided for in the Act;or b.the time for completion has been extended to a specified date more than three years,but less than five years,from the date of issuance.If this Order is intended to be valid for more than three years,the extension date and the special circumstances warranting the extended time period are set forth as a special condition in this Order. S. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. If this Order constitutes an Amended Order of Conditions,this Amended Order of Conditions does not exceed the issuance date of the original Final Order of Conditions. 7. Any fill used in connection with this project shall be clean fill.Any fill shall contain no trash,refuse,rubbish,or debris,including but not limited to lumber,bricks,plaster,wire,lath,paper,cardboard,pipe,tires,ashes,refrigerators,motor vehicles,or parts of any of the foregoing. 8. This Order is not final until all administrative appeal periods from this Order have elapsed,or if such an appeal has been taken, until all proceedings before the Department have been completed. Page 4 of 9•ELECTRONIC COPY Massachusetts Department of Environmental Protection Provided by MassDEP: But eau of Resource Protection-Wetlands MassDEP File#.003-5179 WPA Form 5-Order of Conditions eDEP Transaction#:643067 Massachusetts Wetlands Protection Act M.G.L.c. 131,§40 Ciryflown:BARNSTABLE Ll 9. No work shall be undertaken until the Order has become final and then has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located,within the chain of title of the affected property.In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done.In the case of the registered land,the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done.The recording information shall be submitted to the Conservation Commission on the form at the end of this Order,which form must be stamped by the Registry of Deeds, prior to the commencement of work.. 10. A sign shall be displayed at the site not less then two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection" [or'MassDEP"] File Number:"003-5179" It. Where the Department of Environmental Protection is requested to issue a Superseding Order,the Conservation Commission shall be a party to all agency proceedings and hearings before Mass DER 12. Upon completion of the work described herein,the applicant shall submit a Request for Certificate of Compliance(WPA Form 8A)to the Conservation Commission. 13. The work shall conform to the plans and special conditions referenced in this order. 14. Any change to the plans identified in Condition#13 above shall require the applicant to inquire of the Conservation Commission in writing whether the change is significant enough to require the filing of a new Notice of Intent. 15. The Agent or members of the Conservation Commission and the Department of Environmental Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours to evaluate compliance with the conditions stated in this Order,and may require the submittal of any data deemed necessary by the Conservation Commission or Department for that evaluation 16. This Order of Conditions shall apply to any successor in interest or successor in control of the property subject to this Order and to any contractor or other person performing work conditioned by this Order. 17. Prior to the start of work,and if the project involves work adjacent to a Bordering Vegetated Wetland,the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging.Once in place,the wetland boundary markers shall be maintained until a Certificate of Compliance has been issued by the Conservation Commission. 18. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully stabilized with vegetation or other means.At no time shall sediments be deposited in a wetland or water body.During construction,the applicant or hislher designee shall inspect the erosion controls on a daily basis and shall remove accumulated sediments as needed The applicant shall immediately control any erosion problems that occur at the site and shall also immediately notify the Conservation Commission,which reserves the right to require additional erosion and/or damage prevention controls it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of work line has been approved by this Order. NOTICE OF STORMWATER CONTROL AND MAINTENANCE REQUIREMENTS 19. The work associated with this Ordcr(the"Project")is(1) r is not(2)r subject to the Massachusetts Stormwater Standards. if the work is subject to Stormwater Standards,then the project is subject to the following conditions; a) All work,including site preparation,land disturbance,construction and redevelopment,shall be implemented in accordance with the construction period pollution prevention and erosion and sedimentation control plan and,if applicable,the Stormwater Pollution Prevention Plan required by the National Pollutant Discharge Elimination System Construction General Permit as required by Stormwater Standard 8.Construction period erosion,sedimentation and pollution control measures and best management practices(BMPs)shall remain in place until the site is fully stabilized. b) No stormwater runoff may be discharged to the post-construction storrnwater BMPs unless and until a Registered Professional Engineer provides a Certification that:i.all construction period BMPs have been removed or will be removed by a date certain specified in the Certification For any construction period BMPs intended to be converted to post construction operation for stormwater attenuation,recharge,and/or treatment,the conversion is allowed by the MassDEP Stormwater Handbook BMP specifications and that the BMP has been properly cleaned or prepared for post construction operation, including removal oral]construction period sediment trapped in inlet and outlet control structures;ii..as-built final construction Page 5 of 9• ELECTRONIC COPY LlMassachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection-Wetlands MassDEP File#:003-5179 WPA Form 5-Order of Conditions eDEP Transaction#:643067 Massachusetts Wetlands Protection Act M.G.L.c. 131,§40 City/Pown:BARNSTABLE BMP plans are included,signed and stamped by a Registered Professional Engineer,certifying the site is fully stabilized;W. any illicit discharges to the stormwater management system have been removed,as per the requirements of Stormwater Standard 10;iv,all post-construction stormwater BMPs are installed in accordance with the plans(including all planting plans)approved by the issuing authority,and have been inspected to ensure that they arc not damaged and that they are in proper working condition;v.any vegetation associated with post-construction BMPs is suitably established to withstand erosion. c) The landowner is responsible for BMP maintenance until the issuing authority is notified that another party has legally assumed responsibility for BMP maintenance.Prior to requesting a Certificate of Compliance,or Partial Certificate of Compliance,the responsible party(defined in General Condition 19(e))shall execute and submit to the issuing authority an Operation and Maintenance Compliance Statement("O&M Statement")for the Stormwater BMPs identifying the party responsible for implementing the stormwater BMP Operation and Maintenance Plan("O&M Plan")and certifying the following:i.)the O&M Plan is complete and will be implemented upon receipt of the Certificate of Compliance,and ii.)the future responsible parties shall be notified in writing of their ongoing legal responsibility to operate and maintain the stormwater management BMPs and implement the Stormwater Pollution Prevention Plan. d) Post-construction pollution prevention and source control shall be implemented in accordance with the long-term pollution prevention plan section of the approved Stormwater Report and,if applicable,the Stormwatcr Pollution Prevention Plan required by the National Pollutant Discharge Elimination System Multi-Sector General Permit. e) Unless and until another party accepts responsibility,the landowner,or owner of any drainage casement,assumes responsibility for maintaining each BMP.To overcome this presumption,the landowner of the property must submit to the issuing authority a legally binding agreement of record,acceptable to the issuing authority,evidencing that another entity has accepted responsibility for maintaining the BMP,and that the proposed responsible party shall be treated as a pemuttee for purposes of implementing the requirements of Conditions 19(o through 19(k)with respect to that BMP.Any failure of the proposed responsible party to implement the requirements of Conditions 19(t)through 19(k)with respect to that BMP shall be a violation of the Order of Conditions or Certificate of Compliance.in the case of stormwater BMPs that are serving more than one lot,the legally binding agreement shall also identify the lots that will be serviced by the stormwater BMPs.A plan and easement deed that pants the responsible party access to perform the required operation and maintenance must be submitted along with the legally binding agreement 0 The responsible party shall operate and maintain all stormwater BMPs in accordance with the design plans,the O&M Plan, and the requirements of the Massachusetts Stormwater Handbook. g) The responsible party shall: 1.Maintain an operation and maintenance log for the last three(3)consecutive calendar years of inspections,repairs, maintenance and/or replacement of the stormwater management system or any part thereof,and disposal(for disposal the log shall indicate the type of material and the disposal location); 2.Make the maintenance log available to MassDEP and the Conservation Commission("Commission")upon request;and 3.Allow members and agents of the MassDEP and the Commission to enter and inspect the site to evaluate and ensure that the responsible party is in compliance with the requirements for each BMP established in the O&M Plan approved by the issuing authority. h) All sediment or other contaminants removed from stormwater BMPs shall be disposed of in accordance with all applicable federal,state,and local laws and regulations. ) Illicit discharges to the stomwater management system as defined in 310 CMR 10.04 are prohibited J) The stormwater management system approved in the Order of Conditions shall not be changed without the prior written approval of the issuing authority. k) Areas designated as qualifying pervious arms for the purpose of the Low Impact Site Design Credit(as defined in the MassDEP Stormwater Handbook,Volume 3,Chapter 1,Low impact Development Site Design Credits)shalt not be altered without the prior written approval of the issuing authority. ) Access for maintenance,repair,and/or replacement of BMPs shall not be withheld.Any fencing constructed around stomwater BMPs shall include access gates and shall be at least six inches above grade to allow for wildlife passage. Page 6 of 9•ELECTRONIC COPY Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection-Wetlands MassDEP File#:003-5179 WPA Form 5-Order of Conditions eDEP Transaction#:643067 Massachusetts Wetlands Protection Act M.G.L.c. 131,§40 City/Town:BARNSTABLE Special Conditions: D. Findings Under Municipal Wetlands Bylaw or Ordinance I. Is a municipal wetlands bylaw or ordinance applicable?r Yes 17 No 2. The Conservation Commission hereby(check one that appliccl• a. T- DENIES the proposed work which cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw specifically: 1.Municipal Ordinance or Bylaw 2.Citation Therefore,work on this project may not go forward unless and until a rcvisod Notice of Intent is submitted which provides measures which are adequate to meet these standards,and a final Order or Conditions is issued Which are necessary to comply with a municipal ordinance or bylaw: b. r APPROVES the proposed work,subject to the following additional conditions. 1.Municipal Ordinance or Bylaw TOWN OF 2.Citation S.237-1-237-14 y BARNSTABLE 3. The Commission orders that all work shall be performed in accordance with the following conditions and with the Notice of Intent referenced above.To the extent that the following conditions modify or differ from the plans,specifications,or other proposals submitted with the Notice of Intent,the conditions shall control. The special conditions relating to municipal ordinance or bylaw are as follows: SEE PAGES 7.1 AND 7.2 Page 7 of 9 ELECTRONIC COPY SE3-5179 Name: William Griffin,Jr.,Tr.,New Rushy Marsh Realty Trust Approved Plan= March 20, 2014 Revised Site Plan (2 sheets)by Michael B.McGrath,P.E. Special Conditions of Approval I. Preface Caution: Failure to comply with all Conditions of this Order of Conditions may result In(serious consequences. Such consequences may include issuance of a Stop Work Order,fine(s),the requirement to remove unpermitted structures,requirement to re-landscape to original condition,the inability to obtain a Certificate of Compliance,and more. The General Conditions of this Order begin on Page 4 and continue on Pages 5 through 6. The Special Conditions,if necessary,are contained on Pages 7.1,7.2 and 7.3 All Conditions contained herein require strict compliance. II. Prior to the start of work,the following conditions shall be satisfied: 1. Within one month of receipt of this Order of Conditions,and prior to the commencement of any work approved herein,General Condition Number 9(recording requirement)on Page 4 shall be complied with. 2. It is the responsibility of the applicant,the owner and/or successor(s),and the project contractor,to ensure that all conditions of this Order are complied with. The applicant shall provide copies of the Order of Conditions and approved plans(and any approved revisions thereof)to project contractors prior to the start of work. Barnstable Conservation Commission Forms A and B shall be completed and returned to the Commission prior to the start of work 3. General Condition No. 10 on Page 5(sign requirement)shall be complied with. 4. The Conservation Commission shall receive written notice one(1)week in advance of the start of work. III. The following additional conditions shall govern the project once work begins: 5. General Conditions Nos. 13 and 14(changes in plan)on Page 5 shall be complied with. 6. The Conservation Commission,its employees,and its agents shall have a right of entry to inspect for compliance with the provisions of this Order of Conditions. 7. Unless extended,this permit is valid for three years from the date of issuance. 8. Cut phragmites along the traverse shall be collected and appropriately disposed of. Page 7.1 9. CCA-treated piling and structural timber(greater than three[3] inches thick)are allowed. Otherwise,no CCA-treated or creosote-treated materials shall be used. 10. Deck grating shall provide at least 50%light-penetration. 11. The seasonal components shall be stored at a suitable upland site. Floats shall not be stored on banks and wetlands;they may be stacked on the pier. The following special conditions(in italics)shall govern boat use at the approved pier. These conditions shall continue over time. Note: for purposes of this Order of Conditions,the term"pier" shall refer not only to the linear pile-supported structure,but also to any of its components or appendages,such as the float(s),ell,tee,ramp,outhaul piling,etc. 12. Motorized craft shall not be used or berthed at the approved pier. 13. Berthed boats shall not ground at low tide. 14. Lead piling caps shall not be used. If plastic caps,only black shall be used. IV. After all work is completed,the following condition shall be promptly met: 15. At the completion of work,or by the expiration of this Order,the applicant shall request in writing a Certificate of Compliance for the work herein permitted. Barnstable Conservation Commission Form C shall be completed and returned with the request for a Certificate of Compliance Where a project has been completed in accordance with plans stamped by a registered professional engineer,architect,landscape architect or land surveyor,a written statement by such a professional shall be submitted,certifying substantial compliance with the plans,setting forth what deviation(s),if any,exists with the approved plans. This statement,along with Form C,shall accompany the request for a Certificate of Compliance. Page 7.2 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection -Wetlands SE3-5179 WPA Form 5 — Order of Conditions MassDEP He# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Barnstable City/Town E. Signatures Important: This Order is valid for three years,unless otherwise specified as a special APR - 8 2014 When filling out condition pursuant to General Conditions#4,from the date of issuance. 1.Date o fIIssuance forms on the .7 computer,use Please indicate the number of members who will sign this form. only the tab key This Order must be signed by a majority of the Conservation Commission. 2.Number of Signers to move your cursor-do not The Order must be mailed by certified mail(return re elpt reque ey. sted)or hand delivered to kse return the applicant.A copy must be mailed,hand deliver filed electronically at the same time with the ap to MassDEP Regional Office I1=-51 Signatures: ICI ❑ by hand delivery on by certified mail,return receipt requested,on APR - 8 2014 Date Date F. Appeals The applicant, the owner,any person aggrieved by this Order,any owner of land abutting the land subject to this Order,or any ten residents of the city or town in which such land is located,are hereby notified of their right to request the appropriate MassDEP Regional Office to issue a Superseding Order of Conditions.The request must be made by certified mail or hand delivery to the Department,with the appropriate filing fee and a completed Request of Departmental Action Fee Transmittal Form,as provided in 310 CMR 10.03(7) within ten business days from the date of issuance of this Order.A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant,if he/she is not the appellant. Any appellants seeking to appeal the Department's Superseding Order associated with this appeal will be required to demonstrate prior participation in the review of this project.Previous participation in the permit proceeding means the submission of written information to the Conservation Commission prior to the close of the public hearing,requesting a Superseding Order,or providing written information to the Department prior to issuance of a Superseding Order. The request shalt state clearly and concisely the objections to the Order which is being appealed and how the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act(M.G.L.c. 131,§40),and is inconsistent with the wetlands regulations(310 CMR 10.00).To the extent that the Order is based on a municipal ordinance or bylaw,and not on the Massachusetts Wetlands Protection Act or regulations,the Department has no appellate jurisdiction. wpaUgs.doc-rev.0202MID LlMassachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection-Wetlands MassDEP File#:003-5179 WPA Form 5-Order of Conditions eDEP Transaction#:643067 Massachusetts Wetlands Protection Act M.G.L.c. 131,§40 City/Town:BARNSTABLE E. Signatures This Order is valid for three years from the date of issuance,unless otherwise specified 4/8/2014 pursuant to General Condition#4.if this is an Amended Order of Conditions,the Amended Order expires on the same date as the original Order of Conditions. I•Date of Original Order Please indicate the number of members who will sign this forth.This Order must be signed by 5 a majority of the Conservation Commission. 2.Number of Signers The Order must be mailed by certified mail(return receipt requested)or hand delivered to the applicant.A copy also must be mailed or hand delivered at the same time to the appropriate Department of Environmental Protection Regional Office,if not filing electronically,and the property owner,if different from applicant. Signatures: LAURENCE MORIN DENNIS R.HOULE LOUiSE R.FOSTER FAT PIU LEE PETER SAMPOU I'•' by hand delivery on f-by certified mail,return receipt requested,on Date [)We F. Appeals The applicant,the owner,any person aggrieved by this Order,any owner of land abutting the land subject to this Order,or any ten residents of the city or town in which such land is located,are hereby notified of their right to request the appropriate MassDEP Regional Office to issue a Superseding Order of Conditions.The request must be made by certified mail or hand delivery to the Department,with the appropriate filing fee and a completed Request for Departmental Action Fee Transmittal Form,as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this Order.A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant,if helshe is not the appellant. Any appellants seeking to appeal the Department's Superseding Order associated with this appeal will be required to demonstrate prior participation in the review of this project Previous participation in the permit proceeding means the submission of written information to the Conservation Commission prior to the close of the public hearing,requesting a Superseding Order,or providing written information to the Department prior to issuance of a Superseding Order. The request shall state clear) and concise) the objections to the Order which is being re9 Y Y J g appealed and how the Order doer not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act(M.G.L.c. 131,§40),and is inconsistent with the wetlands regulations(310 CMR 10.00).To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations,the Department has no appellate jurisdiction. Page 9 of 9 0 ELECTRONIC COPY LlMassachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection-Wetlands MassDEP File#:003-5179 WPA Form 5-Order of Conditions eDEP Transaction it:643067 Massachusetts Wetlands Protection Act M.G.L.c. 131,§40 City/rown:BARNSTABLE G. Recording Information This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property.In the case of recorded land,the Final Order shall also be noted in the Registrys Grantor Index under the name of the owner of the land subject to the Order.In the case of registered land,this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions.The recording information on this page shall be submitted to the Conservation Commission listed below. BARNSTABLE Conservation Commission Detach on dotted line,have stamped by the Registry of Deeds and submit to the Conservation Commission. To:.................................................................................................................................................................................................... BARNSPABLE Conservation Commission Please be advised that the Order of Conditions for the Project at: 1524 MAIN STREET,COTUIT 003-5179 Project Location MassDEP File Number Has been recorded at the Registry of Deeds of: county Book Page for. Property Owner WILLIAM F.GRIFFIN,JR.,TRUSTEE and has been noted in the chain of title of the affected property in: Book Page In accordance with the Order of Conditions issued on: Date If recorded land,the instrument number identifying this transaction is: Instrument Number If registered land,the document number identifying this transaction is: Document Number Signature of Applicant Ray.u1a010 Page 9 of 9 ELECTRONIC COPY. 11 Fox Road Waltham, Maooachuoctto 02451 . office: 781.690.5599 — www.kenvona.com — fax: 781.890.1125 CO_S`f`PRUON f ills:eJa': .. f:�..l'.: ♦......,ems August 28, 2014 Town Of Barnstable Attn:Jeffrey Lauzen �_ ._ C/O�Bc;lciirsb GL�) itm�tit . 200 Main Street Hyannis, Ma 02601 Re:41524 Main Street,_Cotuit MA 02635 Dear Mr. Lauzen, We are writing to follow up on requested information during final the inspections of the Main house at 1524 Main St. Enclosed you'll find a letter from the window manufacturer Tischler.This letter states the window located in "her bath" near tub was tempered glass and goes on to state that the installers did place this window in correct location. Please feel free to contact me with any other questions. Sincerely, Matt Kaufmann Project Manager TISCHLER _ SOHN TISCHLER LIND SOHN(U.S.A.)LIMITED j yY y ' ' S i MSS• Y F.r - }. Y f y Kenneth Vona Construction- 1 LFox Road >r J Waltham;MA 02451 CONTRACT McCOURT RESIDENCE Cotuit,MA To Whom It May Concern This.letter.serves as confirmation of the i lass so ecfications for Window L(1 iset @ HerJBath 209)per g shop drawing elevation attached"are ' Interior Pane 1/4""Tempered Exterior Pane Lammated: 3/16"clear;glass/.090 PVB/3/16'.'clear glass Our installers have,confirmed that the Widow L referenced above was placed at this correct location'° Since`rely; Timothy K:Carpenter Pres'd :` - TKC/st .t _1• 4 k Six Suburban Avenue Stamford, CT.06901 USA Telephone 203/674/0600 Telefax 203/674/0601 Y TOWN, off' AM���nr n o sus,.. ° 23 7J r h DeStefla s AM 3- 1" h> -beri l DIVIcop April 14,2014 Michael 0. McClung,AIA Shope Reno Wharton Associates , 18 Marshall Street South Norwalk,CT 06854 ` Re: McCourt Residence—1524 Main Street,Cotuit, MA Beach Cabana T . Dear Mike, DeStefano&Chamberlain, Inc.served as the structural engineer of record for the new Beach Cabana ' located at 1524 Main Street in Cotuit. We engineered the structural framing and foundations for the building, and prepared the structural drawings that were submitted for permit. ' z, During the course of construction,our office inspected and logged helical pile installation Cictober 10 and November 5, 2013. We also reviewed the structural framing on April 2,2014-a few issues were identified with the framing,,which have since been corrected to.our satisfaction. , Based on our inspections and site visits,we have determined that the structural framing and foundations have been completed in substantial conformancewith our design,and can.resist the structural loads prescribed by Chapter 16 of the Massachusetts State Building Code 780 CMR 81h Edition. Please contact our office with any questions. Sincerely, Kevin H. Chamberlain, P.E.,SEC'BJAMES B. °Ss ` I )eSTEFAPJO$TRUGTURA'NO.34.11 i2W Jam S efano,P.E. SECS ` SrUAt cc: en Vona Construction file 5truct. uraI and- Architectural Engineering 50 Thorpe..Street.Fairfield,CT 06824 a Tel.203.254.7131 a Fax 203.254.0263 a www.dcstructural.com 4' TOWN OF BARM 2014 APR h6i' Chamberlain. April 14, 2014 ' Michael 0. McClung,AIA Shope Reno Wharton Associates` " 18 Marshall Street South Norwalk,Cr 06854 Re: McCourt Residence-1524 Main Street, Cotuit, MA t Guest Cottage _ b, 4. '3 ' Dear Mike, j DeStefano&:Chamberlain, Inc. served as the structural engineer of record for the new Guest Cottage located at 1524 Main Streetin.Cotuit. We engineered the structural framing and foundations.for`the'building, and prepared the structural drawingsthat were submitted for permit. During the course of construction,'our office performed site visits on October 31,2013 and April 2, 2014 to review the progress of foundations and framing. Based on our site visits,we have determined,that the structural framingpand foundations have.been completed in substantial conformance with our design,-and can resist the structural loads prescribed by Ch6ptec;16 of the y Massachusetts State Building Ode' 780 CMR'8`h Edition. ' > Please contact our office'with any quesitions. .Sincerely, evin H. amberlain, P.E.,SECB ; �=g' ?�• `� �i JAMES NO 34112 Jam e, efano; P.E.,SECB. f, q `' SfDNAV ,5 r cc: Ken Vona Construction °. ,° -§rye _ K•- ,w,y •+ .,.�. file . «Strue,turaI and Af chit ectura1 . Engi nee ring ' 50 Thorpe Street.Fairfield_,CT 06824 a TeL.203.254.713i a Fax 203.254.0263 a www.dcstructural.com ` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �°16 & YJl Map �I Parcel (3 I Application U306.Vo Health Division to Issued AV-0 —5�' Conservation Division V5��' ; Application Fee Planning Dept. Permit Fee 00 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis ,,Y, 77)// Ay Project Street Address I5a''nn 1►�U (��2.$, �o�� Village ca� 114 / m A i Owner Wt i f uM f C3K►k o �1�(� TI` Address Q& AGA (-4Z°'p, PAve[ih Hoes,. CA goala 7 Telephone 544 - q 30 Permit Request o ; uv ^►.,f 4 noo M h � foou►1 0 a COV4 AL( NW op trevi I "Room Iro0 M Cd�q Square feet: 1 st floor: existing q37 proposed 2nd floor: existing WA proposed° IV Total nitiV 7�0� Zoning District 9F Flood Plain Groundwater Overlay --F- 7 d Project Valuation 57-0,, (b4 Construction Type:(,:):0a-7KAYWt --, �+ .xa Lot Size I I � � C�' 9C S Grandfathered: X Yes No If yes, attach s pportinggDcurnentation. Dwelling Type: Single Family Two Family 0 Multi-Family(# units) / Ko Age of Existing Structure Iq 5 ❑ J 0 Historic House: Yes 6� No On Old King's Highway: ❑Yes ® No Basement Type: A Full ❑ Crawl ❑Walkout ❑ Other �f1 ` Basement Finished Area (sq.ft.) NA Basement Unfinished Area (sq.ft) i Number of Baths: Full: existing new Half: existing 0 new d ® Number of Bedrooms: existing / new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil J Electric ❑ Other Central Air: 0 Y s 91 No Fireplaces: Existing 0 New o Existing wood/coal stove: ❑Yes ❑ No cel ep4rb s;_4^1�►� Detached garage: ❑ existing ❑ new sized Pool: ❑ existing ❑ new size 0 Barn: ❑ existing ❑ new size Attached garage: ❑ existing. ❑ new size 0 Shed: ❑ existing ❑ new size rJ Other: C� O� Zoning Board of Appeals/Authorization ❑ Appeal # Recorded ❑ Commercial ❑ J Yes No If yes, site plan review # Current Use (4 L4 _Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name KcN��1�'� V 9Nf'r Telephone Number 55-9 Address KV C I rs c License # C Sri — o5�3&S i t-ax Home Improvement Contractor# I S 19 V A•L I AM . AA_ 02JL45 I Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 90L)"t c.rnJoFi LL- T 20/ 0ZS,5Z SIGNATURE DATE 2- I I FOR OFFICIAL USE ONLY t APPLICATION# t DATE ISSUED <>. MAP PARCEL NO. r • l ADDRESS VILLAGE OWNER r t - qi DATE OF INSPECTION: FOUNDATION 0lly I - s' FRAME a '-I LV/ INSULATION �!Y i - t FIREPLACE ^ s ELECTRICAL: ROUGH FINAL P 4 PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING is DATE CLOSED OUT ASSOCIATION PLAN NO. - The-Commonwealth-o Massachusetts__ Department of IndustrialAccidents Office of Investigatiods.. 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): K&MtJEN VX-0, Cow —twGT(0 I of c. Address: / City/State/Zip: Wf4OMMA MA 02-451 Phone#: I- 810 -5579 Are you an employer?Check the.appropriate box: Type of project(required): LIZ I am a employer with Sy. 4. � I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. gNew 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 g. Demolition working for me in any capacity. employees and have workers' comp. insurance.$ 9. ❑Building addition [No workers'comp. insurance P• required.] 5. EJ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I 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.❑ Roof 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. $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: .S Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address:_ J52-`f NW-{7/'/ 5 i, 607-L'/%= City/State/Zip: A4,4 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 fine a of up to$250.00 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 overage verification. I do hereby certify u the p ena4les o p rjury th the information provided abo a is true d correct Signature: !/ Date: Phone#: 78-1 89 D—SS9 q 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#: or air d In I Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. °� person in the service of another under.any contract of hire, as ...every tote .an employee is defined �3'P Pursuant to this eta express or implied,oral or written." association,corporation or other legal entity, or any two or more « An employer is defined.as an individual,partnership, ed in a joint enterprise,and including the legal representatives of a deceased employer,or the I of the foregoing engaged ) rP employees. However the receiver or trustee of an individual,partnership,association or other legal entity,employing who resides therein,or the occupant of the owner of a dwelling house having not more than three apartments and dwelling house of another who employs persons to do maintenance,construction ymepab 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.locaI licensing agency shall withhold the issuance or any renewal of a license or permit to operate a.business or to construct buildings in the commonwealth for d 7 applicant who has not produced acceptable evidence of compliance with the insurance coverage require 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-contractors)name(s),address(es)and phone number(s)along with their certificate(s).of insura„ce. .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' the Department at the number listed below. Self-insured companies should enter their compensation policy,please call t i self-insurance license number on the appropriate line.. City or Town Officials Please be sure that the afEdavit 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 permit/license 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 necessary)and under"Job Site Address"the applicant should write"all locations in_(city or town)."A copy of the affidavit that has been official#y 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 relaxed 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 021.11 Tel.#617-7274900 ext 406 or 1-877-MNSSAFE Fax 4 617-727-7749 Revised 4-24-07 www.mass.gov/dia '� a® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD"YYY) 7/2/2013 ✓°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 Construction NAME, Eastern Insurance Group LLC PHONE (508)651-7700 AIc No: 233 West Central Street E-MAIL ADDRESS: f t ' . INSURERS AFFORDING COVERAGE NAIC# Natick MA 01760 INSURERA:Union Insurance Co INSURED - INSURER B Acadia Insurance Company,p31325 Kenneth Vona Construction Inc. INSURER C: 11 FOX Road f" INSURERD:EastGuard 14702 INSURER E: Waltham MA 02451 INSURERF: COVERAGES CERTIFICATE NUMBER:Master 2013 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 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. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD MMIDD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 300,000 PREMISES Ea occurrence $ A CLAIMS-MADE FX1 OCCUR PA0296259-19 /1/2013 /1/2014 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 11000,000 ANY AUTO BODILY INJURY(Per person) $ 8 ALL OW SCHEDULED 0300197-14 /1/2013- /1/2014 BODILY,INJURY(Per accident) $ AUTOS F7X AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS N AUTOS Per accident $ Medical payments $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE ` AGGREGATE $ DED I I RETENTION $ D WORKERS COMPENSATION X WC STATU-YLIMiTST OTH- AND EMPLOYERS'LIABILITY Y I N ER- ANY OFFICER/MEIMBOER PROPREXCLUDED?ECUTIVE a N/A E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) KEWC318878 0/4/2012 0/4/2013 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN KENNETH VONA CONSTRUCTION INC ACCORDANCE WITH THE POLICY PROVISIONS. 11 FOX ROAD WALTHAM, MA 02451 AUTHORIZED REPRESENTATIVE Rosemary Fulham/BC4 ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INSA2.5 rgninnFt ni The Arrio l n—Anil Inn^ern r ;cf—A—Ira^f Af`f%Pfl Town of Barns d"ble _ Regulatory. emees +as Thomas F.Gek'r,Director. t63¢ `eg A Building"Dwision" Tom Fori•y,,Bui ding Commissioner`. 200 Maia.'Street Efyaaais,MA'02601 wvewaown:b"arnstWe.ma_i s Office: 508-862-4038 Fax: 508 790-6230 Property C)wner Must Complete`and Sign This Section If Using A Builder' " wA; `,T � vir. '. �. :" as Owner o I , f the subjectpsope� hereby`autho-�ze to act on:my be}salf, in all matters relative to work authorized by this.building permit. p _ (Acldress of.Job):. 4 Pool fences,and alarms are the respotisib lity of the applicant. Pools are not to be'filled or utilized before.fence is installed and all final inspections are performed"and accepted. 5ignatare f Own.er S, tuxe of.Applicant` " Pent"Nate r(- � Pxint.:Narae Da QFQRMS:OWNERP-T;F SSIONP00L5 6W12 ,I : :Town of Ba' r astable : Regulatory Services MABS Thomas F.Geller,Director. lding�DIP1S10I1 Bu Tom Ferry,Building Commissioner. 200 Main Sweet;Hyannis,MA-0260I www:town.barnstable.ma.ns Office: 508-862-4038 Fax:.508-790-6230 Property Owner Must Complete acid Sign This Section If Using A Builder I, ;.as Owner of the sub)ectproperty hereby authorize to act on my behalf, in aE matters relztive to work authorized by this building permit .(Address of Job). Pool fences.and alarms are the responsibility of the.applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner t¢re of ppkant ��NNrTII w,✓fF Pant Name Print Name Dabe QFORMS.0' I PII2M7SSIONPOOLS 6012 - .Tov�a ofB=. stable _ _ .:.. . . -. Regi 46ry Services t Thomas F.Geller,Director Building Division . Tom Perry,.$uildmg Corimiissioner. 200 Main Street, Hyaffiis,M- 02601 www.town.barnstable.mams Office: 508-862-4.038 Fax: 508-790-6230 E1OMEOw1KER LIMSL EXXhO ION : - Please Print DATE: JOB LOCATION: number - street. village "HOMTAwNER': name home phone# work phone# CURRENT MAII.ING ADDRESS: city/town state zip code The curreut•exeruption far"homeowners"was extended to include owner-occupied dwellin4 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 HOMEOWNER 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 he/she understands the Town of Barnstable Building Department mTnirrrrrm 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 ' gon�owxlvRIs Zt x TroN The Code'sta]es 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 persons)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 seraous 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 farm/certification for use in your community. Q:forms.homeexempt { ffit Massachusetts-Department of Public Safety JJ Board of Building Regulations and Standards Construction Supervisor i &2 Family _ License: CSFA-057385 KENNETH B VOl� 11 FOX RD 5 WALTHAM MA7024a1 t= Expiration Commissioner 07/19/201.5 i Restricted-One-and two-family dwellings or any accessory building thereto, irrespective of size. Failure to Possess a current edition of the'Massachusetts , State Building Code is cause for revocation of this license.For DPS Licensing information visit; www.Mass.Gov bPs i i ✓�. )! r�usea�l� 4j�✓� afcr�ft,�de� Office ol'C�onsumer�ffnirs&.1u4inessegulafton License or registration valid for individul use.only HOME IMPROVEMENT CONTRACTOR before;the expiration date. If found return to' Registration ?16519 Type: office of Consumer Affairs and Business Regulation Expiration 6122%2014 Pdvale,Corporation 10 Park laza-'Suite 5170 i pro ston;MA 021f6; KEI METH VONA CONST,jNC t. � KENNETH VONA J'f 11 FOX RD, s-t z' } Q � " WALTHAM,MA 02451 [Inersecretary Not valid without signature a � i July 31, 2013 Attn: Jeffrey Ford Re: 1524 Main St., Cotuit, MA. This letter is to notify you that after our.investigation it has been determined that there is no gas being supplied to 1524 Main St., Cotuit, MA. Gas Customer Fulfillment US National Grid Sep. 25. 2013 2: 45PM NSTAR—SUMSW3 No, 7063 P. 2 IW NSTAR . Ona N Electric&Gas CompenY One STAR Way,Weslwooa,Massachusens 02090-8230 EL EC rRIC OAS September 25, 2013 • r Frank.McCourt 1524 Main St, Barnstable, Ma RE: 1524 Main St, Barnstable, Ma Dear Frank McCourt: This letter will serve as confirmation that the electric service at 1524 Main St, Barnstable, Ma, has been removed as of 09/25/13. Based on this Information, there is no electric power to this building and you may proceed with the demolition. If you have any questions, please contact me at (888) 633-3797 Sincere] 1 Char IneFortes S New onnections Office CICf)=New Template .+�.OFT�#. (ITaor#fit# cmvrr ME DLWMCT v 1"6 4300 FALMOUTH ROAD, P.O. BOX 451 COTUIT, MASS..02635 PHONE 508-428-2687 FAX 508-428-7517 September 10, 2013 Mr.Frank McCourt 13808 Fairlane Ct. Wellington,FL 33414 RE. 1524 Main Street,Cotuit,MA_Acc#0405 Dear Mr.McCourt, _ The water service and all related materials were disconnected and removed at your home at 1524 Main Street in Cotuit on 9/4/13. Sincerely. . "Chris Wiseman Superintendent n � essage Page 1 of 1 Fair, Marylou From: Fair, Marylou Sent: Friday, August 09, 2013 4:19 PM To: 'jford21 @verizon.net' Subject: 1524 Main St Jeff, Heard back from Jessica on the cottage and she also believes it was built in 1950 and no need to file an Intent to Demolish.form with the BHC. Marylou LAW OFFICES OF MICHAEL FORD ATTORNEYS AT LAW 72 MAIN STREET, P.O. BOX 485 WEST HARWICH, MA 02671 TEL. (508)430-1900 FAX (508)430-9979 lawofficeofmichaelford@verizon.net i JEFFREY M.FOR D t Barnstable arns able Historical Commission August 8 20131 .w� 200 Main Street + Hyannis, MA 02601 Re: 1524 Main Street Demolition/Building Permit Application ' Dear Marylou: Enclosed please find a copy of the letter prepared by the Architect for the owner of the property located at 1524 Main Street, Cotuit, MA. As indicated when we last spoke, our office represents the property owner of 1524 Main Street, who is proposing to raze and replace the existing cottage located on that property. After a review of the structure with the Architect, owner, builder and those with first hand knowledge of the site, it is believed that the cottage was constructed at a later date than the main house (which the assessor's database lists as 1909). The assessor's field card does not show any year of construction for the cottage on the property. However, based on the attached it is believed the cottage was constructed sometime in the forties or fifties. I was informed that your next available meeting is on August 20, 2013, for which we would need to file an NOI application by August 15, 2013 if necessary. If you could kindly pass this request on to the Chair for a determination as to whether or not we need to file it would be greatly appreciated. If we can provide you with any additional information to assist with your review just let us know. Thanks as.always for your time & consideration, Vey truly your , • CC: Clients Jeffrey r . Ford, Esq. h .. a , sV - _ • - —A.—SMALL PLANT CUwS OF AYPOPHILA ._ ... BREMuauTA(—CAN BEACH GRASS)AND . [x"N'CAME - DSONIA TOYENTOSA(BEACX HEATHER A n� LEI ,\z o a THREE cows HaLE r N STAOGEREO ROWS ONE FOOT ql CENTER'T ' EN511T PER IN ' r (AS YAR%FD'1'1 q s _ ._ c w WATER Yux do cAv $ LOCUS . - mrAu'�v DRaL HALE Pwxo t KAnC$CAI: 1' r NA-SAME(IPPROFYAEE LOCAnOx) v HORlzoxru,,,,-,°' P.ero6 a R>rwAr "� vwroos0 EHRG/REW nxE lR»ruJ e0A®NAix •:. , (JE£OEA]AAJ ,y,sy" \' EleSTNI PNES AND Noun S` QETAIL - E%IBTN.il3£fi BE..—(TYPICAL) �- SANG OVERHEAD IBRES To BE REYDYED 4• � NARIESI' I,,' DREPLACED UHDEDER SERMCE .�' p ,�PAa=D:mA/r Ywrs lrx I/�r LOCUS MAP,+ B / (PUBLIC' I /• ,.�,•- - �N[V '• E%STNG wH TE NNE k SPRUCE - NOT TO SCALE ` EET M1 Eusm G Po E,ohs/A.BE REYOKD i; IN/S� ALL A PRw�OSEB DA— I NORTHWEST 'n1fAT10N P N71NG FA(1 B04 F\ A N J FK SSE/-E NO E vlANmc ! ORAv.� AAruA "U saEA,B,C NAPE Ds PRMOSED WA/DlWAY Ate` r e 1 EWSTWG COTEAGE TO BE Dw04SNED A. ,,y AEaI wONW pas Y Y (SEE DEIAHJ .+w PAavasED SiAPPA 1 /N —TING AP 0-TAE'S .. 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A,a,! •l Aim m�OPvs"rA�ic'r�a+e ._ , `� 1' rm• � U \ / A /// 1'v '\u'aoY AmA ♦�,oeoML-- v MJ NH �� , /d:'9, 6.9 5 \a ; / 7.: \m qi: h 1\ •. \�N PN I� 1 \ � I ♦ 2r60 3 NL Z-. �" P i Sri' ` ,yy«`fifiTT • _ \ 5 WATERWAY I C 1E f - I ♦ AA,N 1 e T nwa�/ 1 Nm veM PRNWID N �W nua ♦� .I I ; REGn/sIRUCIED ,♦♦•�` A).0 ' - v\. J'AIDE BOAROW fA'.. `RPGWSD pA•/f v«�e �• I ♦ LAC / '� • t 8 I/ T Y Nc Y • \T •E} EA k R TAM•S' {1 1Wrf! 55 I U C YB ( •\ AA 1. , `, , YAIER SERN U T Y<1K W AGE yT ' k, ' BJEG AA "`\ �' 1 / LAND suT To AD \�BOPOERING xEOtT�im NE DESCRIPTION TLAND a 1 ; 6 ♦ COASTLL STORM ELOW GES� \B / fa eck i ` I DATE . \\ I `♦�`♦ f _REVISIONS \ `� �\ Jete / I -- D \♦ PLAN ry,� n \ 9 _ ./ I oa'Y'H/wrnaxoa e�♦` / OF PROPOSED P E�WAGE DISPOSAL SYSTEM c �" -\" fi.fi /'• AE NEW.RUSHY MARSH REALTY TRUST ��T�� N.., FOR PARCEL 14./1524 MAIN STREET - NOTES 4I\ I D COTUIT � .BARNSTABLE MA.• 1.HOUSE NUMBER:1524 i lQIJ� •FN \ 6. w,.n _ - 2 ASSESSOR'S NUMBER:017 014 - 3.ZONING DI57RICT:RF SCALE:1-20' - DATE:APR 5.2013 4.FLOOD HAZARD ZONES:C.A13(EL13)@ V17(EL15) N EL15 \ 0! 5,BENCHMARK: SEE PLAN y ' _h P5' GRAPHIC 3C I�" holm es and meGd Toth, Inc. _ 6.TOPOGRAPHIC INFORMATION COMPILED FROM AN \ u x0 0 Zo 60 IM ginaen Alan wrw,vrk ' ON THE GROUND INSTRUMENT SURVEY. y LGY�� �e% 205 a cYrai:eWla A4 SOB 518-3'508 SIB-9572 ..b4O 7.ELEVATIONS SHOMN ARE BASED ON THE d / •`;/H �.oy.`"'^+ \`{I, 7.0 idmeBM 025W u . NATIONAL GEODETIC VERTICAL DATUM. %r1 \ /// - o-r \ ,m/.e m In DRAWN: uc_ CHECKED: B.REFERENCE; LC.PLAN 18341-1) , ej"b / \ _ Izlzs=P.e. JOB.NO: 212126 DM:'NO.:74-3-21D SHEET 1 a . A I CERTIFY THAT THE STRUCTURESOT AS SHOWN. N ARE ` NAT THEIR LOCATION CONFORMS TO - r OZQ • .. - w " MINIMUM SETBACK SETBACK ON THE LREOU REQUIREMENTS OF THE . •. - T 11 THE BARNSTABLE ZONING BY-LAW..N q /�_ ,MOTH vA � _.R,EsI 'LO •- HOLMES AND'MCGRATH,INC. Q C- .. M� � MAIN SHEET ��f axwaan uasr ron ce« /�j/�Zs�.. t r'i qr • `—'�' . •MOTH VARIES) _ MAIN STREET. (Pueuc % mP`Bd0 R.�BILEL.e'uw .ReoTHna Dnt. 3°° ee MTH oisx F vA•cwasm.,rvzwAnew I CERTIFY NAT THE HOUSE AND COTTAGE ARE LOCATED IN FLOOD PUIN ZONE C AS \. - ♦ // .-/. o ® '( �: ppyhgD gLNLW CA6,,NA SHOWN ON FLOOD INSURANCE RATE MAP / \\. \ _ _ _ - /. �. • • - COMMUNITY PANEL NO.250001 W22 D THAT FLOOD PLAT ZONE A _\ a//.. •� V AND N CIS NOT SPECIAL FLOOD HAZARD AREA.--- . 1.\ - • / "� ��II( 'o& I CERTIFY THAT THE CABANA FRAMING 15 \ / ; LOCATED � -. �M• \ _ .\ '. � - , ,.�/ n • ,y ' / 1 I �,/� � AS SHOWN NON FLOOD INSURANCE RATE MAP •; \ \ �F,P! I.I 2-y2 COMMUNITY PANEL NO.250001 0022 D ' AND NAT FLOOD PLAIN ZONE V17(EL15) Y - __ - IS A SPECIAL FLOOD HAZARD AREA. , . w 1 \ ',\ 1•+-`.,_ / ii d HOLMES AND McGRATH.INC. _ x - '/ /_ - .� ..r / I• - MICHAEL Mc ATH + • •/ /:' // i ' PARCEL z0 RegUIU r.1 ��oj.nW Date w. / ' Z a{ � H— RMATERUSHY MARH DUNES PROERTr uN E279R r 1 TOTAL AREA 16.7t ACRESIf �' ;• .EEP aasFRNAnw HIXE Lx Nu < - _ le - r AS SHOWN ON. 'LC.PLAN 18041-D v' oaP oeSmvATwH Halo I6 No.: • - - + 1 ' a . I - - •/ Y . PC na'nui p M v nN,w,x lae 3•,. ' aeapYAnw N4E M o Ya 3 POND wx,. t.S •6� ,, 5-25-13 1—CENM—t FNCL WM A—PAIN LAc (v 5-15-13 yTp C WN W LAC YaY Sp�gq I ICr '� DATE I DESCRIPTION O ecke REVISIONS SITE PLAN cn�•��xa�¢a 44 I ` Pa Of PROPOSED MODIFICATIONS ' PREPARED FOR oEep DescRYATIw Nac Lao Na{ DESIGN CRITERIA - • / - ` .", . NEW RUSHY MARSH REALTY TRUST TE i� g1 .•/ter I _ 1_ j FOR PARCEL.14;IN p 52{MAIN STREET - o• �w•xo I __ coNIT -BARNSTABLE MA' sa m+o.m...—iii�°� N0 5O'•�aov / -- -_- s, - —MATE SCALE 7-50` SATE:APR 5,201J" m,°+i° 1ys•t PpoPERrr UNE : GRAPHIC SCALE Inc. - •�,r> I /, Pe°L °N 9Y2 -N e33)' w hoolmes and mcgroth t;a:P�«`°°0 1,zoo° �. •.. _ W :�o.oD' '°' 'x 2s 5 50 ,�. "gin... d I- .Y,..yore a=v.=ylkn°°°w�':(e�'M°N°.°�'nn.a) I•. s ez'°z'zo PMCEL 1a 205 Pvue[s sort, pe.A4 118 SIB-SSB{pxalCH c fwnal 025/0 SOB S 15112 OAIE D.enAmSN ,mHma w DRAWN: LAC CHECKED. u ucouaT mzlxasP.a. JOB N0: 2i 2,2B DWG.N0.:74-3-ztD SH z DF• y r 3 , - �• , - ,. �` •_ - - `\,\�`i nEA �� aF z w 1ER ssAna lOP a COxCRE1F . BWND EIEV.�xe0 a e nrt;°° 6 VENNEA E E 4 O - VAR\ES)_ ANo REPucED MTx uxoExcxouND SE-sERwcE. C aWaert 11 \ I U B , Bantu rand P =x - � xTx T \ E _ 1N 5 L,r \ - ' E%ISTNG Pa.E 1065/A (TO BE RE—D). 0. 50TPo�6LL=1M, 999 ggr4� Vwr •`/ r ���/// I ' n r I s I R6 a6. 1,2 v Cw^ w T _ s IXNEAING VECET—wEllANO SUBJECT TO 6 '-a/w COASTAL —AGE B � 5 4S �N424RD \ a• I° lB)tub --EN- E.. vw�x VK. s-s IS VP Al Enrnll xc DAIS DESCRIPTION - , raw edie RUSITYMARSf1 y ` \ EB.� REVISIONS"• POND Eiu d " PLAN xA2AR Eos OF EXISTING REPA CON�DI110N5 y NEW RUSHY MARSH REALTY TRTUST NOTES A / \\,4 bsCv" o-r \ Y 0 FOR PART 14.TIS24.MAIN STREET 1.HOUSE NUMBER:1524 jr// `'•\\ `x4gy \ PCOTUIi N MA 2 ASSESSOR'S NUMBER:017 014 y "^ - �BARNSTABLE , 3.ZONING DISTRICT:RF / / 6's ,\\ 4.FLooD HAZARD ZONES:C.A13(EL13)k V17(EL15) y / SCALE:1'e20' DATE:APR.5:201J a 5.BENCHMARK: SEE PUN GRAPI�C�'� ,�hOITe9 and fTIC fOth, Inc. 8.TOPOGRAPHIC INFORMATION COMPILED ROM A _ zo 10 o zo ao IA dg ON THE GROUND INSTRUMENT SURVEY. // y „ LOT F 5.3 �B—Im awl wIte A4 3�IB-3584(R� - 7.ELEVATIONS SHOWN ARE BASED ON THE \ P"� NATIONAL GEODETIC VERTICAL DATUM. ,\ _ nm� � .-uJ B.REFERENCE. L.C.PLAN 18041-D y AT/y s mee�r)a DRAWN:.LAC CHECKED: RT 2111265P,er JOB N0:-212126 -DWG.NO.:74-J-2TD SHEET 3 a s m r � • r vtc Iran tsNr . .A•c P.+..r....e�rro.rr.,,rs+...•�«.,.a.ra (vAAurE mpN Nrwpv 'rm evf w-.s saw WlK M.(gAIN J BDTE.' ag',:w ra:..A�rM ro rN sA-wq a•I-N P11YP 5 O6WlFD OJBE w r.....-. -- ."•" rune a.une,s.•. wsrAum w Raco Rz:ws wNiuw[s io mn¢ pmpo..a o eou wu -. .� ,. _--- s a_ .` m ..- _ ma pANFl ... -_ wsnrAaE laanoN - w 6'vl flnbbeaNgna. OV bbk 1�«e�waA� ABOVE EtEVAMYI 16 NGYO ATCH tD<EP TO ISN ORAOE ._ (ruTa To BE rATmnaT a rATOaAoor) nNc cl:a,I incr eEAcx-.A ao. a LGp4�ptC s No �R Drat DEv..+e.a 4•evsc P11vv _ _ sun mrANg M OY "PLAN SECTION IR -T) Y 1 umu ERWPONMENT ONE CWiP. (ox T«mp cU+tEr re6 ��..r°Na, Y s.pm T.N R rye _ LT..•.-+o.m ro ilaug +,aa.rmm RRmAN ma '� pRevr®rIbIE H.v � a� JarrA+rovaaa �aS .'u mv�«ar smE Bec-.a n.sev JM LF.-J,Y•pSU'pfl2[.v.E _ saT rovJA+salsrW Bus IB Sgelk Tmrk JI• O-Bvr YAP/Er 3G0 GaYm ITWnEY a ..r CROSS-SECTION SEPTIC PROFILE - COTTAGE a c 5 HOLE DISTRIBUTION BOX scAlc /i•- , FORCEMAIN PROFILE - BEACH CABANA NOT To scAtE ' olaprM O ` Ia 126T GENERAL NOTES `�oo� rle,.atmf °J 1) Np la Mm Munn vnml be mane vnlem I,rM GVLaY 3TAC T.IAA' °eeW wrc a• apprvvM—1 m siting by nolmu one mvpoN,He r � 2) s.epct to mq..oam aUrinq[enaln,cum by ue ygsEy • a o 0 atmye.0 .H }H oevlen ona 3) n t' ma megrou,ma p/sln�,yay a�r r� O e-o.T.cmawctbn ewlpmmt anal not uo.•d a vsrovE,vA ABanm ' r r oNe aewo.a.yelnn sung«on«[onowcllon. � .. Au r.0 Ae.r Tlml 4) DI p-d Mtem to De conewctea m act«aanu / 500 GALLON CHAMBER _ I Twe 6 or It.state Enwonm.ntw waa I. IEAalc.vaerrA c .. r-e 6) A poor of tne.e plan.mud be N.pt / - . mlmg ue ume oe[onmu scA�.+/ O [7 0 O f7 C O G O O 6) A copy f ueee plmi. .t bo mmebea to m.r vRcnasra / \��J'/ A r I,aIE O-BOY G G C L7 C7 O O O C7 C7 ?' convect«cm.WCHnq ue ampoe.l.yaton. / O G C 0 0 0 O O O O >) B.f«.bacNmling,ue cantrcel«enrol.oufr O 17 O [7 C7 [7 f'7 G C 1: Agent to W.psl u,.Mtem a.conetn,nea. G f7 [7 1:7 G O C7 ' O O C7 B) Rue ram—mco t-a'+y m.U.bobem 1 - the mlelMq ommuw..ne.n on u.plan wa ue wsEenov mtm r-e' -'p •mnmuen.acwmo.a on ue.na«may.eg e• / / TYPICAL 500 GALON LEACHING CHAMBER_' con°Itl°n sCAlE 1/Y-1' any ed .e edl,Ne conlrvct«a 01 enmeablay .txt nvlmev and mcg—.me Halme.ona \ - mcpotn,be rgl cNamina Nv voA conailbn ����IaH�''�� r ou rwm m am not Imo--III 1��0�--—- vna rvpart I.tha em«any vuggaetea reNeima ,gtp pgIj _ mom e� .^ + I ♦'� PRGi0.4D IX•PM AAPCEI/AbV Y.'.g.. r , 'Ey Jworosm �� TYPNpAL DRYWELL 2-24'Diameter Ac....Holee - mALL ACCESS sGuc ii oeARF yArr m ee I•m 4• 5-) OUTLET SEPTIC TANK�STRIUTIONANHOLE BOKORC2D rJu rAIFR VINLET AND LEACHING STRUCTURE SET MORE HATaH cOtFn m fir.9t GAAOE / THAN 6•BELOW FINISHED GRADE, SEPTIC DETAIL AT COTTAGE (IWTOelOSulfA0IX1AJ/AT—Or) - - scar r-,a �_ @ALLAST CALCULATIONS SMALL BE RAISED 1D WITHIN 6'Of Amv Na. FINISHED GRADE wAtr Artarsor eve nenrn ale.n.te I-.� vrov sr mr � ATny�pm¢®-XR-evaT OF srAnoH J. P.smE iaxct-g>o le.(.late.,.aWt).aJ•m.(Iweo.t..qnq L________�____• FRAtaamwm a0.aaa(.ee r.get)-a.xe u. ', - STEEL REINFORCED PRECAST CONCRETE ogT:n'rs Icz J iAtlOR Oi SAfETY-a,66fi/g,2g5-g _ PLAN VIEW $ .ArNr< ��.ta•a b.n..�...a- -r�u«O w�cRETE $ °xB•m1EB 9 ��� �_rep`i.w roi:.aver..n...l.,.�.s.,.r. 'Aa owp am g q•6 CFI P tdK 5-+5-1J RENSE SEPTC.OETA1 b.PeoNF AT COTTAQ lAC m ni0i'aemro"'^aiYi°— ;� RR''INIET•T• o>a+x..n DATE DESCRIPTION ro ecke .asr J rmn..wtmwu.t .T ouTur --- ___ a "a mieiOl R E V I S I O N S CONSTRUCTION DETAILS OF PROPOSED SEWAGE DISPOSAL SYSTEM '-?mn a'-.'rove E-I e- AroI rAlt)p PREPARED FOR `trma a.pm nTE tw�Ha aepu GWEPuvP wmn ay.n,r ` _ - -s. NEW RUSHY PHMARA5 REALTY N ANTM- UST TuG-BAFFE OARCELI424MSTREET GA COTUIT BARNSTABLE MA .. •' s vac a PBn•osa sENEv[VIE ' emn en'AAvnv - ' s-aoa(.SEE PRm[BJ 6�: SCALE:1.-2o I DATE:APR.5.2013 +B�• 6,-Y SEPTIC DETAIL aRmen rm� ra2rma'camxr ' .cn.e (A•Aae w•Pn0 holmes and meGrath, inc. - CROSS-SECTION END-SECTION naP�, ,vAnQ AT BEACH CABANA aw englne«e ana I.n2.Nrwy«e m rx oeaRl nEo« .,..r.'•-1° ENVIRONMENT ONE 205 swe+/z•-r(H-m LOAwNc) HroURT r _ JOB Nv0:u�2m1C2s1w2 6I A4 � W:ma gMTYPI AI 1.500GALLON SEPTIC TANK MODEL DH071 CE-9 HK DWG.NO-1- 9¢ET•a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map l�I Parcel ion # Health Division Date Issued3 k3 Conservation Division Application Feeexi S� Planning Dept. Permit Fee l 2-0, Date Definitive Plan Approved by Planning Board /{nh 3 �[- Historic - OKH _ Preservation / Hyannis Project Street Address Village C O+kA + T W'1IIiHm F. OP;i ;�-JUR 791 ass wewV1sH Marsh Owner au o wr o Addressr1s��i r�, BlvdSure 3�0 Telephone �icvt l� N ih , CA ''0D► a Permit Request 14n1ovc d gvoj I1,4_%k)h tOW ©f Ntw Root 0( barV -P rS 1 / J c� k 1� mwd 'l� iS 1vv f S CJ Su M/44ed . Square feet: 1 st floor: existing proposed ya/& 2nd floor: existing proposed ✓ Total new 0 Zoning'District R E Flood Plain Groundwater Overlay Pr©ject Valuation hod 10 o'6 Construction Type �0� 2C1 K< LogSize ` y a. / S Grandfathered: ❑Yes YNo If yes, attach supporting documentation. Dwelling Type: Single Family M/ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: JYes ❑ o On Old King's Highway: ❑Yes No Basements ype: .Full ❑ Crawl ❑Walkout ❑ Other Base ent Finished Area (sq.ft.) ® Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new D Half: existing / new Number of Bedrooms: existing 0 new Total Room Count (not including baths): existing new Q First Floor Room Count Heat Type and Fuel: ❑ Gas XOil ❑ Electric ❑ Other J Central Air: ❑Yes XNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes No Detached garage: ❑ existing ❑ new size o Pool: ❑ existing ❑ new size a Barn: ❑ existing ❑ new size D Attached garage: ❑ existing ❑ new size Shed: ❑ existing ❑ new size O Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes C No If yes, site plan review # Current Use RQ Si d,&4 ( Proposed Use ^C) 1 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ✓w VoNw C&35-mumovs Telephone Number Address C l r D>14o✓ o License# �' ® 0 2-®2_SP Home Improvement Contractor# 1 G!D 645rc,A,.>P Worker's Compensation # Pbl_%cH tC VX2-13-ri& ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO c� / SIGNATURE OW� l/ _ - - DATE 21,3 ' _ J :1 FOR OFFICIAL USE ONLY -APPLICATION# DATE ISSUED f MAP PARCEL NO. ADDRESS VILLAGE t .. -OWNER = R DATE OF INSPECTION: i _ FOUNDATION: .r FRAME G INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ` ASSOCIATION PLAN NO. ,$ i .Bastol,MA 02111, Zvi, _ tvtvw.rnassgav/da: 'Workers' Compels ti, �:su auce Affi:davitt,Builders/Contractors/Electricians�'lnmbers A-pplicant rnformation y ^ Please I'rMt Le2ibl NaMe(BusinessVOrg=ization/Individuid): t� .l�dtiress: ' City/State/Zip:, W�`k�n.o� k 6,24 Phone w:- Are you tun employer?Check:thg appropriate box: Type of project(i equixed) 4, r a canal contra all *d T 1. l am a t mployer whiz 6, New construction.'. employees(f n and/ot part-trme'i, have hired the sttb-contractors i 2:El am,a"sole proprietor.or'partod lxsted:on the;attmchE;rl shoat T [)Remodeling r ship and have no employees 'lliese SA--contractors have .�]Dernolit oiz `working for mein.any capacity: erzlaloyces mid have workers' 9, El I3u ldir�aiichtiau [No work el s' comp.insuznu c comp.insuranCO", ie are tad t :: ' 1QJ lecc0 excttixeJ.] icii rpairs;ar additjons: 3. am a homeowner•doing all warl:' . acic'ers b ivc exercised their 1;1.®�'luuibnig,repairs caz additions myself No workeis' corrT, ` rlt lit bf exemption per MGf ingC rclaairs zasurance rcrluir&L.]i c, 152,§l(A);and we have'no �pl;aye t s, [Na work er5.' l3. ] Other erx __ � �, cainp`.�iustiranct:a'cguixed.J ... , : .. � •.; , *Any applicant thatcbccks box Ill roust also Till out the mcdo below showuxh their workers..'compms;rtion,ppticy infprtnaIim. 1 klcu�c%twricrt whq subrrtit this ttrffficlavit ndicatit�} tlicy to c daitxi all work artd tlEers hire outside cuntrttYprs muit subrniE a:ucw atlitlavit ittdic [iul tiuctt: rt aatntcwrs that check this box.must attadhod as all'ditional shcct showiup tilt Hama ofitte sub-cotitntctors anti st-r1e whcthc_r cr nv_t dmvc entities have + p y must p to ors the providc r{tcir tirotkml couv.iiali.y number.,t ern loyecs, if tYtcsab-c;untruc.wrs ltsnfo ent y , X run an-employer ticat is.prr,Adit�r:-g workers'cornpensation insurance for nay empl pyc�es. ��laYv is lce.poTil�r and job site irrfr,rm.atinn, _ See 0.-T�"Ck-e d a Txtsorancc:Company Name, _ alolicy 3#or S:lf ins Lie. apa e:rn Dat Yob SitcAddress: Csi lState/yi tlti.txch !copy a!tltt ti of hers°crihtltenstit3oupblity rlcel ratian,l�age,(showing:ing:the policy nuxriber and expiration date)., l=a tuc:to sccut e.EactvE c e as rcgtti�nrl;tutdt r Sccdd t L�.?t of MGM.c. 152 trwa lead,to the imr ositao of criininal ponoltxes Of a 7:tne tip to$.1;igtl.QQ tut3%or ar�.c-year unprisc�tu�t nt; as tvcll s civ+1 perzr lin s iu lire 1'brai of a STOP WORK OIU)ER and:a f abii ut't3p tci25U:D:l a clay agaizzsi tl;W.�iolator. .13c_advised that-a copy nf'tliis sta.tcancn;t miiyt be fiarwrnrcletl iia tlic Uicie cit` - li)X rtpai2a�the MA for znsura 1 e c veaxficatYon I."ilrr h.r rrby cerxify aced r the far, nd De rrltaca> of utr/rriy that flt�ircfvrnicatir�ri prvvia'erl.uGgva cs true and'rurr at �� , Si..�talur : / �- CJfJi ial rest cinly, 1.)o nat tt�rate qi thfs„rar&aar&a, t.b lie co mpletect by,rdy•ariot�+n rjffrcraC a T City or Town: 1?erinit/Licensc# iwuiog,Au,tltority (circle one): 1. Masud of l ealtla 3;I3tailduig Drspartanen, elf)*/kawn Clet'lc 4,Ialecfl.ical Inspector .5. 'I.timkaing Inspector f%. Other Oont-act Person; r r Phone V s ?, v. ATE , 11%n CERTIFICATE OF LIABILITY INSURANCEF10/10/2012 DIDD L.� 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: Construction Eastern Insurance Group LLC PH(AICN o , (508)651-7700 Alc No): 233 West Central Street ADDRESS: PRODUCER 00032272 Natick MA 01760 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA:Union Insurance Cc INSURER B EastGuard 14702 Kenneth Vona Construction Inc INSURERC: 11 FOX Road INSURER D: INSURER E: Waltham MA 02451 INSURERF: COVERAGES CERTIFICATE NUMBER HASTER 2012.5 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 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. ILTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY MMLDD� LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED r PREMISES Ea occurrence $ 300,000 A CLAIMS-MADE Fx_]OCCUR PA0296259-13 7/1/2012 7/1/2013 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY JEO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ - $ B WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/NTORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE 0 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) WC318878 10/4/2012 10/4/2013 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 000 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN FOR INFORMATIONAL PURPOSES ONLY ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Rosemary Fulham/PMA ACORD 25(2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(200909) The ACORD name and logo are registered marks of ACORD 1 E 1 LAW OFFICES OF MICHAEL D. FORD ATTORNEYS AT LAW ' 72 MAIN STREET, P.O. BOX 485 + WEST HARWICH, MA 02671, ' TEL. (508)430-1900 FAX (508)430-9979_ mdfesqj@verizon.net MICHAEL D.FORD ` JEFFREY M.FORD « January 10, 2013 Tom Perry, Building Commissioner , Town of Barnstable 200 Main Street « Hyannis, MA 02601 Re: 1524 Main Street, Cotuit r W Dear Mr. Perry: Attached please find the Building Permit Application for the above referenced. property, which we now believe to be complete. Thank you for the cooperation of your. staff in assisting us in completing the application. ,t Very trul ours, ' 'Michael D. Ford MDF/mbf Enclosures ` a _ r f Town of Barnstable R AR'.A"S AfIL F Growth Management Department Barnstable Historical Commission_ www.town.barnstable.ma.us/historicalcommission '12 NOV 20 r'0 :f0 NOTICE OF INTENT TO DEMOLISH OR MOVE A HISTORIC BUILDING Date of Application Building Address: 1524 Main Street Number Street Cotuit 02635 Assessor's Map#017 Assessor's Parcel#014 Village , ZIP Property Owner: William F. Griffin Jr TR& New Rushy Marsh Realty Trust C/O MCCOURT GROUP Name C/O Law Office of Michael Ford (508) 430-1900 Phone# Property Owner Mailing Address (if different than building address)Wilshire Blvd., Suite 300, Beverly Hills, CA 90212 Property Owner e-mail address: C/O lawofficeofmichaelford verizon.net Contractor/Agent' Law'Office of Michael Ford Contractor/Agent Mailing Address: 72 Main Street PO Box 485 West Harwich MA 02671 Contractor/Agent Contact Name and Phone#: Michael D. ford; Esq /Jeffrey M. Ford, Esq. 508-430-1900 Name Phone# Contractor/Agent Contact e-mail address: lawofficeofmichaelford verizon.net Existing Building Material: concrete foundation /wood shingle/frame construction Type of New Construction Proposed: See narrative attached Provide information below to assist the Commission in making the required determination regarding the status of the Building in accordance with Article 1, § 112 Year built: Per assessors database (1909) Additions Year Built: ; Is the Building listed on the National Register of Historic Places or is the building located in a National Register District? No Yes 0 Is the Building associated with one or more historic persons or events, or with the broad architectural, cultural, political, economic or social history of the Town or the Commonwealth? The building was built as a summer home by Frank Herbert Wesson who was the grandson of the founder of Smith &Wesson in Springfield. Is the Building historically or architecturally important in.terms of period, style, method of building construction, or association with a famous architect or builder either by itself or in the context of a group of buildings?The applicant is unaware of any historical or architectural importance. December 2011 f , k.+r Narrative 1524 Main Street, Cotuit The building is believed to have been built around 1909 per,the Town Hof Barnstable Assessor"s database. As per plans attached, the Applicant is proposing to re-roof the house, repair the ch•imney(s) and install replacement dormers on the existing dwelling. The roof and chimney repairs are urgently needed to abate further damage to the structure as the house is currently leaking. Accordingly no demolition-of the house is proposed, but to the extent the dormer replacement is viewed as a partial demolition, the Applicant has filed with the Commission. As a result, the applicant would respectfully request that the Commission make a finding that;the proposed alterations and repairs are not of such scope or significance to be subject to further"Commission review. + r December 2011 MCCCURT P _ RESIDENCE i r JMR A J LJ / -- — NORTH - .ELEVATION N _ I � 1 MUM m ELEVATION ION - � � _ � _ _ ♦ .. ... In i u x. SHONE IZENO WHARTON P SOUTH ELEVATION in in Q un im m :W IQ�.. _ 'm ELEWESI VATION ........... } _ - EXISTING ELEVATIONS PR-OPOSED ELEVATIONS r 'P Office of Co r�s& uSln `uTe own° • License or registration valid for individul use only KEPHOME IMPROVEMENT CONTRACTOR' before the expiration date. If found return to: Registration ,:116519 Type: Office of Consumer Affairs and Business Regulation Expiration k!2 2014 •Private Corporation 10 Park Plaza-Suite 5170 , NTH VONA;CdN$T NC Boston,MA OZ116 . KENNETH VONA11 11 FOX RD. WAITHAM,MA 02451 `— -- - Undersecretnry Not valid Without signature r { i jV rr.0 ul.mod!'IUJL"Qu.I.G Regulatory Services swuvsrwsLF y ems. Thomas F.'Geiler,Director $A 039 leo Building"]division Tom Perry;Building Commissioner'' 200 Main Street;Hyannis,MA 02601 www;town,barnstable ma..us; Office: 508-862-4038 Fax.:. 50.8 790.=623`0 Property owner Must Complete,and Sign This:Section If Using A $wilder, I, A1ag leustiy Nlgoers firtobih.TMIJ as.Owner of the sub'ectproperty hereby authorize. Kmn& voa...&thvc, on to.act on my behalf; in all matters.relative to .ork authoaized by tlus:buildang.;pezrnzt`s 1524 Main S�reek, CO+VI+, WN (Address of Job) Pool fences,and alarms are the responsibility,of the applicant.. Pools are not to be filled or utilized before fence is iinstalled:and all final' inspections,are performed and accepted. —TrVA 4L Signa e f ow er. Signature.of Applicant. W,u-c ►�• G�,�=uN,JR f Print Name: Pxint.Name. Ate Q:FORMS.OWISERPERMSSIOWOOLS 6R012: 11 Fox Road Waltham, Maooachuoetto 02451 office: 781.890.5599 — www.kenvona.com — fax: 781.890.1123 CONSMUCTION January 8, 2013 RE: 1524 Main St,Cotuit, Ma 02635 To whom it may concern, Please accept this letter as authorization that James Koulopolous is authorized to act on behalf of the Kenneth Vona Construction Inc. as an employee. Sincerely, Kenneth B.Vona t w a Massachusetts-Department of Public Safety Board of.Buliding Regulations and Standards " C'nnst rOction Superv.6ol, License CS-020280 JAMES.KOUTA�OULO . 11 FOX RD WALTHAM)VIA 02 4 'Expiration " Commissioner 1112912013 -' C�---- - ff i *! �� r 1 t , NOT FOR PUBLIC VIEW t, V 'u VI y 1524 Main Street, Cotuit Map: 017 Parcel: 014 William F. Griffin, Jr, Trustee for the Jamie McCourt General Notes of conversation with Glenn Wood from the law firm Rubin and Rudman (Boston)representing the McCourt Property. This conversation took place on Thursday morning, 09/25/08, shortly after 8 AM. Focus of the conversation was the preliminary plan review dated 9/11/08 given to Philip Miller of Miller-Starbuck Construction the previous week. On this plan review I had addressed the submitted design not meeting the requirements of 780 CMR 5323, Flood- Resistant Construction, specifically being located in the V zone and exposure C. I also addressed the fact that construction details were missing. Glen explained that if his client had to raise the building, or in essence, build it to meet the requirements of the code, it would be aesthetically unappealing and perhaps not be built. I explained that it must meet the code requirements for V zone or perhaps moved to another location on the property, if one existed. I also explained that this decision could be appealed to the State and not the local ZBA (as he thought) if he had any further disagreement. Several times I understood that he wanted me to agree to a statement that he made..."you don't really care if the structure meets the requirements, or how it is built, do you?"... to which I responded that I really did care about how the structure was built and my job is to enforce the provisions of 780 CMR. I also explained that I would not compromise my decision. At one time he mentioned that he had previous experience with FEMA and getting properties in Falmouth new revised designations on the Flood Insurance Rate Maps which allowed development . Bob McKechnie 10/03/08 r PROJECT ^- NAME: ( �^A-- ( Gt, rt.vy\CNNI, ADDRESS: , �J ( �4G`A S C-a PERMIT# O 1 G o�, PERMIT DATE: <4O:%? a LARGE ROLLED PLANS ARE IN: BOX _ � :2 SLOT _ — Data entered in MAPS program on: J BY: q/wpfiles/forms/archive 1 Lfj 12az NAME: y16L a ADDRESS: moo? PERMIT# PERMIT DATE: LARGE ROLLED PLANS ARE IN: BOX `D SLOT ' Data entered in MAPS program on: V1 Y BY: 1 q/wpfiles/forms/archive PROJECT NAME: ADDRESS: PERMIT# oZ O I Ll 6D Cj3 PERMIT DATE:,. ' /P ° M ' LARGE ROLLED P NS A BOX. I SLOT -- , Data entered in-MAPS program, on." D Y: *4 s �'"f - ! 4 Fl. � � �.• .it PROJECT NAME: Gam, ADDRESS: PERMIT# 1 t PERMIT DATE: M/P: LARGE ROLLED PLANS ARE IN: BOX SLOT Data entered in MAPS program on: v� BY: q/wpfiles/forms/archive Y PROJECT NAME: 1� , �l �GI�Q-===� 1 CAS(1✓�. l ADDRESS: PERMIT# a c),A kg PERMIT DATE: / l_ e-(4v- W c 0.1 LARGE ROLLED -PLANS ARE. M + ry. o s � an.. SLOT Data entered 1n }MAPS 'program on: . z ti l - r , i n b i �'A � g; � ��� � r'+,� �• � _ a+ �, a Mtn �� a- t 3<: n/wnf1lac/grPh1N7a PROJECT NAME: ADDRESS: PERMIT# l PERMIT DATE: ( 10 LARGE ROLLED PLANS ARE IN: BOX l y SLOT Data entered in MAPS program on: i BY: C q/wpfiles/forms/archive _^ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map V i Parcel Application # 0/ L-t 0) / L) Health Division Date Issued �3 �;)A J�� Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address t1 5 a ' ,/a/ry S r R- Village_ C o414 �_ r f QNJ Owner W i 1 F, Gk it'I '0 �J � "T/Z Address W a S kl i cis vd St44e gm TArsIn .� us/ Co 6aao , ��I ��%1�S , CA 9 ®a 1 211, Telephone Permit Req est :EM S� f TbA[ �r L �w P� - R�H W ILvi "Mi VV cJtl � r / p tc, 4 MaC4 o� S'�2Uc'�N I Q�wyMN%w�IM Wed S�� - as�� �� Q�v yi �a o wS QUf%AC4r hamPoO� � - Square feet: 1 st floor: existing proposed 56 2nd floor: existing proposed Total new Zoning District R T Flood Plain Groundwater Overlay Project Valuation 2 50,000 Construction Type // Lot Size I a a� ��c.>r'S Grandfathered: ❑Yes ® No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure 1109 Historic Ho ' U/YeS ❑ No On Old Kings Highway: ❑ �No Yes (NU, l70r_, Yother Basement Type: ❑ Full ❑ Crawl ❑Walkout Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new "Number of Bedrooms: existing —new Total.Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn:U 1xisting -`® new© size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Otherr- Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ n Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use V `- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) pgA RaN�rcr Ce19S 2ku dv"f Na;met�� �e �'� `� Telephone Number Address >24 15.. License# 56 ,F-. M6 O Q5 3�- Home Improvement Contractor# 05 8 3 Email Worker's Compensation # U ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ---� SIGNATUREM ---� DATE ?f j ANNE►�RiED ILLON+� Notary Public _%W Commonwealth o My Commission Expires November 15,2015 y FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED s MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: i FOUNDATION ` FRAME S-FCCL a F' INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL T� r } PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING "1 Viq [kf u DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111` t • s www.mass gov1&a Workers' Compensation Insurance Affidavit;Builders/Contractors/EIectricians/Pluinbers Applicant Information Please Print Legibly Nam m,�s ess/Organization/Individual): Ad�diess City/stiff/zip: �,Jrvjodfi-jA'- LAre yo11-4 employer--?-Check-the-approp ate-box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. El New construction 2.❑ I am a sole proprietor or partner- ' listed on the attached sheet 7. ❑Remodeling ship and have no employees. k These sub-contractors have •'' g. Demolition working for me in any capacity. employees and have workers'_ [No workers'comp, insurance comp.insrrance,t = 9. 0 Building addition ' required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I- Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.[?]�,Otlier P- 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 contractor;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 employcm,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 in,ormation. Insvrance Company Name: aT91%'--(,Lavr5 ��Policy#or Self-ins.Lic.#: �l �d�' 0�3?8 3 y I's Expiration Date: 3 " Job Site Address: 15c�P 11i 4-drQe 4 City/State/Zip 04 Attach a copy o vPo.rkers'compe saa fion=policy decla,._ration page-(showing-the-policy_number and_eapiratio' n•dat-D 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 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. -4 7 do hereby certify und3er the airs and penalties of perApy that he rmatFon o "d ab ve is true and correct vt.�.Z Si . ature: NNE MARIE DILLON Date: Z �� P�1 ,, . Notary Pubic Phone#: � Commonwealth of Massachusetts Of iic�use only. Do not write in this area,to a 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#: -Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto 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 of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the 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.locaI 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 certificates)of inct=ce. 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 permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permitllicense 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 bum 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 lavestigations 600 Wasb!Zon Street Boston,MA 02111 Tel,#617-727-4900 eat 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www.mass.gov/dia The Commonwealth ofjpiassachusetis - Department of tndustr ial Ace.ideals ©ffce of Investigations r 600 Washington Street' Boston,AAA.0_7111 "Pw.mass.gov/dia Workers, Compensation nsu,ranee. da-sq --Build. ers/CozEtrs�ctors/ Iec�riclians7PlicEmhers flicant Information _f 'lease� r�Tc�I�.lc(BLS,incss9(7r2:pia:rtio ndivioual : , rintLe My 1 Clay/Sf1it lT1p: CAA C _a 't IVQ ? It r e}orr vz r rrtploycr r t~heck Naa riper olrrrsf t ht7x; 1 l�V I:>Jn.e c,rployt;r with 'c o Tarn.ti ca Y. fProjea(rerrrircEX} g'xeral Contractor arrd; . ) t!aPic,yc s(f-r.`t1 and(or hart lint).* have1arru1 the stab-cuniiactors ?_ 1�m a:soliproprietor or partbcr- f'`. lIetiv construction: listed cm the i ft rclul shc .t. `7_ strip Intl lrzveno errpioyccs x'heseSUIb ce!t Rc>fiodClir. c%have `�, []De volition• ivnrl:iat�= nt;.itr arll+caoac.rt�: em la ces `>r 5 P ydhave td,rkezfi ro µart ers'comp trrsurauci cramp; !nstrauce t 9.• I3t tlt#txr atPdrtorl, .( rr tina.rccL�• 5.. 1�rc`arc;a corporation r,ircl.its O.(�31ectricai rcpai,rs or r d+' Tam lrarneofnc r doinr,all�varl e o hcers haV•c;e5 urcised their `r`rcr s mysck:(No wofkcrs,cE;i,tp; rztrlrt f cxcmptiotr et-, : 11.(_];Plu!nbing renei or edcations �. o rnsr? rrlceregirirrci.. fi c 152,.§lt ).,shad �v lacyc o I2:[ Rooirr;paixa csEnplayces rjlo v piker ' i3» ]C1Ahfi,,.�._„�� comp iEtsura.oc recluiruL] /�i*tt,r c,»p,cunt rhaYnc�ck,�lrirx{! nustulrB rrl!outtnc scctttt,�a lacy tihmt mL inarr�:>'drncrs'r:ottt acztczctirn. tali + t n�l(l lwnc'31Yhi7 tlltr t II1i at'�d.t4 it lad Ltltjn(;tilt t. rtp .11'NAiI;and iACry11 r 2y'IrLD `.tCA. Gv ctn s t t Gltr k tit Se.�n!t st.tuia�ll ei n urldluo th! h=,showing t5-nsrnr tit X1tc�RtiJ^„�dL�ciarr t � ;ui strh;a r ncN:>!C;dajtY '�ILSttn• trnalu�c� TC rc soh cr+rttx co s hava trrsnlarc-s lit moat ,td a r}rs,td L rc t+?!c=Guar n;at i�a c r,isbes rva .-..T.,.:.�,.__..,a�.;...,-....,.........,.-..-x-_^-��------..�,.. P+ &u Gl t�4rkc�-'cnrno.itGYicj'atz�zc.fa:; h• ' !.erntilncoyrlUNrr thedis I lr ork ert carry+ rGrtrtrrlir Ynsltrrrnce fir nry err l*cx _ rlory Gs the n/uy aiid jrib a'r'e it f�ir�nrrfu,rr. E ' Irlsu.mom C'.orrrpinytL*:tt!Q: Pd>t!.cy :nr Sc l:(art .I ic.;'#: ' 9 - ��. .,.. __ _._ w; g >� � ,,,t �� �jf rt,iaiTcAticliass. Jc ciY',1 _ � •fit Yclx f tfrc �--� P-�°Q.. 11 �orkt.ra carrrpeu.cttron i .a�atcore pI;u slrU tYtrr tlae )r r. �-m,,,f � , 1"tirlureta,Ecurt.c o1+Lr.:t t r5rcgrltreduridix�ecaurz25.A afMT l c, 15?ern lcad.to t}a:e 7rnpoci ior2 of - w �� „�� �;�]cy�'�nr�r iiYtct c�rrr~�aran dr��fe). ftrjt ntr�n I,St7A.L?0 wclfor pnc ytnrr arrtlnrisanzrrct:t s r tl ris civil pt baltres in the farm of a 4 . i, WORK 0 7E aln�f� Ox up to 5�,{l.{y0 a day r ;zansCthc v;olstat':Pic atlt stxl ihat a.copy of this st3terrrcnC inrry be nit dW to the O DEI of d a IJne InmstigalrG `. _ ns of the DLA:.for iusuEance'cov=,c,veriEtcabon. alp,hcreh}r rcrl fy antIer tlrc.pat ors nnd;c et1T ally •, . eP Y- r fig tut ry Hurl rla'einfonnreiFon oat r!ab ve a true trod con eC1�—'� < ,,nattrre: : .Yt 71fa.�cs » G'lE UN late Z / .� ;'t nc ii a tl N Iftry}Pub c � .�`.'-"""�----- � •" L.or�?rnrxr;ve�!lr ttt ttaa�tchuselry r (affiri:al use tirll. • ' • r ti:• � rr---•--.-�,..,...� �,_,..�;,_.._--..�.__ } 7Jo rapt write tr this,area,.to a cornpleterl by cit}:nr town Off, City or Tolva: .Pcrnutp:,icense m } TsstrrrtgAuthor-ity(circle one): �` p` y 6.Other l a£:ELe rlth.7. 3uiittin 37e .rrl?neErt is t✓it !1 o't n Clerk 4:Blectrical X:uspector 5.Plutn.binn 7nspcwlor 6.CJfiher . . - i } 3 DATE(M14UDDt`fYs CERTIFICATE OF.LIABILITY INSURANCE FICATE IS ISSUED AS A MATTER OF INFORMATION.ONLY AND GO FERS NO RIGHTS:UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE O. ES Not AFFIWATNELY OR NEGATIVELY AMEND,EXTENp OR ALTER THE COVERAGE AFFORDED BY THE POUtlE5 BE.L This CERTIFICATE OF INSURANCE DOES NOT,COKSTITUTE A CONTRACT BETWEEN TmE ISSUING INSURER(Sj,AUTHORIZED REP ESENTA E OR PRODUCE A THE CE ATE IMPORTANT:If the certif sate hohieT is an ADDITIONAL INSURED,the policy(ies)must be endorsed..If SUBRC3GATiON IS BkfAIVED,subject to <' he terms and conditions of the policy,certain Policies may require and endars ement» A statement on this certtficate"does not confer rights to he certficat$holder in lieu of such endorsemen s. PRODUCER CO IyTACT NAME: D F M INS AGCY INC PMtiNE FAx 668 MAIN ST I",.No,Ext):. (AiC,No). FALMOUTH,MA 02541 EIS AI)PRESS: 29X7X INSURER(S)AFFORDINGCOVERAGE NAis it INSURED INSURER A: TRAVELERS PROPERTY CASUALTY COMPANY OF AMXRI%A REYBNGER,BRIAN DBA RANCrER CONSTRUCTION INSURER 8. RER C. INSURER D: 46 CROW13LL RD EAST FALMOUTH,MA 02536 It"RER F: COVERAGES CERTIFICATE NUMBER. REVISION NUMBER.T .MrSTO MOTOT11 I UHW Aaova FO POLICY fit HOTYHTNSTAND MG ANY REQUIRINIM ;TERIM OR CONDIT�I OF ANY CONTRACTOR OTHER IARTH RESPECT TO vAvcN tFgS CErtTIFICATE MAY 8E t55UE0 OR IMAY. PERTAIN.THE 91SURANCEAFFORDIM BY TKEPOLKM DE5CRnEo Hamm is SrH11E3CT TO�TERISS.EXCLUSIONS AND COUDITIOUS OF SUCH POLICE& LMITS SIf0Y11I MAY. HAVE BEEN REDUCED BY PAID CLAM ADD POI.ICYVF.DATE POLICY EKP DATE LTR INSR TYPE OFIHSURANCE L R POLICYHUMER mor19p1YYy1/I tpgM!}01YYYYI tJMTS GENERAL LIABILITY ACH OCCURRENCE Ct1MhIERCIAC GENERAL LIABILITY - -..�.. CLAIMS MADE OGCIEt: AMAGE 7O RENTED * .3 EMISES tFa:occuitet1t t" ` ED EXP(Arry;une person). S. CEfiI' AGCREGATE LIMIT APPLIES PER: RSONAL&ADV INJURY. $. ENERAL AGGREGATE, S :. PQL°GY "PROJECT�;LOC ODUCTS-OOMPIOPAGG $. A"IJTOr1IOWLE LIABILLTY 1fY AUTO COMBINED SINGLE S. [MIT(Ea accident) RIL.a1MNED AUTOS ILY INJURY`®$ SC 4EDULE AUTOS Per person) s+RED AUTOS !LY IN R1RY $ Per acoderd)Ii�3vtIdED:AUT05 , PROPERTY DAMAGE. S z � i (Pera ddwt) OCCUR" EACH OCCURRENCE $ CLAiIMS-MADE. AGGREGATE g T T S SATFON AND'.,. WC STATUTORY OTHER C�"5�t i48.LTY YA) tf8 4183P834-13 0310920t3 03tt19/2Q14 Ubi1Ts r � Q N!A E.L EACH ACCIDENT $ 500,D00 . C.L.DISEASE-EA EMPLOYEE S 500,000`. T r ( E:L.DISEASE`POLICY LIMIT $ 500,000 F DESCRY �^ 1r;I # FTIOtt�Irl.EStFtESTRrCTtONSiSPECtA1ITJ�5 T;£*S r T Cr3#1 O TIDE CERT4TG►TE xoLI7ER AFFECTINO WORMS COMP COVFRAO TLvYrw �iuTLtViDSCOVLrBACIHFORRBYENBER.BjtIAtO. 9 1 CEfLTIA CAN CELLATWN ,� « f SHpUU1 ANY OF THE A60VE DESCRIBW POLICIES BE CANCELLED BI�ORE.THE EV RATION DATETHEREOF,NOTICE WILL BE DS IVERffi ar IPI CCaRDANGEINITH TTt g AU►t(ORIEED REF RENT E s f'OLtCY:PROtASIWiS. 4r ACORD marks of ACORU 1SEIB-2010 ACORD CORPORATION. A!I rights reser� t Office of Consumer Affairs and usiness Regulation . 10 Park Plaza - Suite 5170 Boston, Massachusetts.02116 Home Improvement Ctntractflr Registration Registration 105838 Type .in dividuM . Expiration. : 1121/2014 Tr# 228721 BRIAN REYENGER Brian Reyenger E FALMOUTH, MA 02538 ___.�. _ ______.__ Update Address and return card.Mark reason for change. Address (j Renewal !: Employment j Lost Card ws-c t w 50M4-04/004-G101216 ...... _ ... _."_... e nsuumerA License or registration valid.for individul use only Office of Consumer Affairs&Business Regulation "km FfiC1RAE IMPROVEMENT Gt7N'FRi4GTfflR before the expiration date. If found return to: Registration v 105838 Type: Office of Consumer Affairs and Business Regulation • Expiration 'iM12014 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 IS fAN REYENGER Bdan Reyenget 46 CROWELL RD E.FALMOUTH,MA 02536 ;: ______.___..!�'�............... __...._� Undersecretary Not valid without gnature .......... i »qyL 4 } 9 Massaci,usetts -Depar ti-nent of P blic Safety F � P Board of Buddin Re uiations � � 3i3f#S�'c�8§£�a3'd5 ta3Fi$'.f}Fs l7a:a ,i�t:3x i t Sstsi' 4 h.r .. 7 Ys License: CSFA-o=so 4; F � f � BRIAN J REVENO 46 CRowELL RI) R m E FALMOUTH MA �e a 0253b 1 F;" _ 3 ion : r��missicne 07/08/M015 Owl s 't k Poll . Town of Barnstable Regulatory Services r' VASS Thomas F.Geller,Director 1639.1. Buff duzg.Division lfiD MIC{ Toro Perry,Balding Commissioner 200 Maim Street,HYamiis,MA.02601 www.town.barnstable.raa.us Office: 508=862-4038 Par. 508-790-6230 Property Owner Must Complete and Sign This Section. R-USILIg A B3 der .30 ic��ex of d�.e.subject property b.creby authoii c P*1 N Vv 0 Q 1 to act on My behzl. -in all zmttas rd tive to-wozk authOET/led by this building pelt. 14 (Address.of fob) r **Pool f6nces and alarms the the responsibility of the applicant. Pools are not to be Mled or utilized before fence is installed and all final inspectiori.s are pefformed and accepted. s. e of Owner �ignatuxe of Applicant ANNE MAAIE 01LLON Notary Public (&T MW-,*Wth of Massachusetts Print.Nam.c Ptiut Name Date Q:rORNS:OWNERPERMISSIOI,IPOOTS 612012 J Tom,, Town of Barnstable of Regulatory Services t jAA111.CT_Mir f MASS g Thomas F.Geiler,Director 1639. 1� ` 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 A Builder as Owner of the subject ptoperty hereby,authorize to act on my beb4 in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner — �fAp) Signature o ph — ANNE MARIE DILLON * Notary Public Conirwiwealth of Massachusetts My Ccm r3 Sion Expires November 15,2015 Print Name Print Name Date QF0RMS:0VrNERPERMMS10NP00LS 62012 Town of Barnstable _ Regulatory Services Thomas F.Geller,Director AUM 16�bP Building Division Tom Perry,Building Commissioner 200 Main Strut, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-79Q-6230 HOMMOWNER LICEM EXMMEfMON Please Print DATE: JOB LOCATION: vivage number stye d "HOMEOWNER": work hone# name home phone# p CURRENT MAU JNG ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or Iess and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFT MON OF HOMEOWNER 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) ibility for compliance with the State Building Code and other applicable codes, The undersigned"homeowner"assumes respons bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signatue 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, art of the o ensure that the homeowner is fully aware of his/her responsibilities,many communities require;as p TSupervisor. On the last age permit application,that tfie homeowner certify that he/she understands the responsibilities of a P of this issue is a form currently used by several towns. You may care t amend and adopt such a form certification for use in your community. C:\Users\de=IIW AppData\Locg Microsoft\Wmdows\Temporary Intranet Files\Contentoutlook\QRE6ZUBN\E)TPESS.doc Revised 053012 ETL LISTED C Y Imo. I POOL ALARM ♦ETL Tested To Be In Compliance With Standard for Safety, CLOSED LOOP UL 2017, and Florida Building Commission Code Requirements, Per ETL Listing Number 3035022 ♦Exceeds Operational Requirements of Model Barrier Codes ♦Microprocessor Controlled ♦Monitors Entry to Pool and Spa Areas ♦Instant On Or 7 Second Delay Models Available Surface or F♦ lush Mount Models ♦ 15 Second Adult Shunt t ♦Built-in Back-up Battery Capable ♦Must Be Hard Wired To Remote 12 Volt maximum 500 mA Source or To Plug In Power Source. Applied Voltage Must Not Exceed 15 VDC. Battery for Backup Only. The new GRI DOOR ALERT/POOL ALARM was designed as an aid for prevention of an unattended access to a pool/spa area by a small child. Monitoring all doors or windows with CLOSED LOOP magnetic reed switches, the DOOR ALERT/ POOL ALARM will sound an alarm should anyone too small to manage the adult pass thru feature attempt access to the pool/spa area. For maximum protection all moveable openings should be protected in such a manner by the GRI DOOR ALERT/POOL ALARM. The 289-1, 289-2, 289-3 and 289-4 can be operated with an on-board 9 volt battery with a 12 volt externally supplied DC power source, in which case the battery will perform a back-up function should the externally supplied source fail for any reason. Both power sources have been designed to maintain a minimum sound pressure level of 85db at 10'. Should the battery voltage drop below 7 volts while in the backup mode,a low battery mode will be initiated and the unit will sound 2 beeps approximately every 3 seconds for one to two weeks prior to total battery failure. Battery must be replaced at this time. It is suggested that some type of surge protection, such as the GRI.CS-1 Current Sensor, be used between the power supply and all GRI Pool Alarms using external power. NOTE: Unit will function at minimum 5VDC at a very limited sounder volume. This power level is considered total battery failure. PART NUMBERS DESCRIPTION 289-1 Recessed DoorAlert/Pool Alarm 7 Second Delay-Closed Loop 289-2 Surface Mount Door Alert/Pool Alarm 7 Second Delay- Closed Loop 289-3 Recessed Door Alert/Pool Alarm- Instant On -Closed Loop 289-4 Surface Mount Door Alert/Pool Alarm - Instant On-Closed Loop 289-1C Recessed DoorAlert/Pool Alarm 7 Second Delay-Closed Loop- With C Form Relay 289-2C Surface Mount Door Alert/Pool Alarm 7 Second Delay -Closed Loop-With C Form Relay 289-3C Recessed Door Alert/Pool Alarm-Instant On-Closed Loop- With C Form Relay 289-4C Surface Mount Door Alert/Pool Alarm-Instant On-Closed Loop-With,C Form Relay WARNING: THIS IS NOT A LIFE SAVING DEVICE. GEORGE RISK INDUSTRIES,INC. TOLL-FREE 1-800-445-5218 • l-800-523-1227 GR.I.PLAZA (308)235-4645 • FAX(308)235-3561 KIMBALL,NE69145 E-MAIL:grisales@megavision.com MADE IN U.S.A. WEB SITE:www.grisk.com I E LISTED � Ft I POOL ATL LARM 1 INSTALLATION z INSTRUCTIONS: 3.380 1.sso zza The GRI DOOR ALERT/POOL ALARM mounts easily to the wall by any door or window which allows access to the pool/ spa area. Using a CLOSED LOOP mag- netic reed switch,the unit will detect and announce an open access by sounding a loud continuous alarm. Two timed op- 3 0 tions are offered: A maximum seven (7) 5.410 second delay mode prior to sounding upon door opening, or an instant alarm sounding upon activation. A surface mount and a recessed mount model are offered in both time options for a total of ' 4 different versions. All versions incor- porate a built-in pass thru feature and deactivation button to allow adult access without alarm sounding. Although the DOOR ALERT/POOL ALARM cannot be turned off, this feature will simply deactivate the alarm function for a maximum of fifteen (15) seconds. During this time span the adult must exit and close the door before alarm sounds. Once the alarm is sounding it can not be silenced by simply closing the door. The deactivation button must also be depressed. The sounder cannot be disabled by holding down the deactivation button. If a screen is present on the opening giving access to the pool, a second CLOSED LOOP switch should be mounted on it and both switches wired in parallel. This configuration will allow the door to be open for ventilation since the unit will activate only when both the screen and the door or window are opened. If multiple openings lead to the area,the GRI DOOR ALERT/POOL ALARM can monitor all by installing CLOSED LOOP switches which are wired in series. in this way, any opening will be detected by the GRI DOOR ALERT/ POOL ALARM. A single deactivation button can also be wired at each opening to utilize the pass thru feature. Additional remote sounders may be wired in to extend sounder coverage. Please contact your local GRI Distributor for information on remote options. Part numbers and wiring diagrams are available from the factory. WARRANTY: One year warranty against workmanship, material and factory defects. TOLL-FREE 1-800-445-5218 GEORGE RISK INDUSTRIES,INC.G.R.I.PLAZA TOLL-FREE 1-800-523-1227 KIMBALL,NE 69145 (308)2354645FAX(308)235-3561 MADE IN U.S.A. E-MAIL:grisales@megavision.com BA-203 Rev C 5/18/2007 WEB SITE:www.grisk.com POOL MINIMUM WIDTHS AUTOMATIC POOL COVER 8' MAX DIVING BOARD MAY BE INTEGRATED INTO CANTILEV6'-0" MAX JUMP BOARD ®A ®B ®C ®D #3016" OC BW CONCRETE 12' 15' 12' 8' POOL DECKING (TYP) 20" MAX 4" FROSTPROOF A WATER LINE B C D TILE (TYP) O) 6" RADIUS N #3010" OCBW & 1 MAXIMUM #4040" OCBW p in N COMPACTED WATERPROOF io a' GRAVEL a PLASTER 2" MIN COVER 1 #4 CONTINUOUS #306" OC VERT & 6'-9" #4010" OC HORZ 5' RADIUS 1'-6" 3'-6" 3'-6" 14'-3" 6'—'0" 12" 28'-9" ao LONGITUDINAL SECTION: DIVING POOL TYPICAL NATURAL _ T ALL DIMENSIONS MINIMUM EXCEPT WHERE NOTED UNDISTURBED SOIL DEEP END WALL SECTION CANTILEVER CONCRETEDECKING (TYP) #3016" OC BW EY�SH OF w�g3 3'-0" ¢" ��Ftus ur, 9cyN #3®6" OC BW 8" u G vlr, #3®10" OC BW & o cl; #4®40" OC BW A No #3010- OC BW & #3®6" • * �• #4®40" OC BW OC BW __ _ iq 12"+ -•.. COMPACTED 03/20/201 4 GRAVEL .• NATURAL UNDISTURBED SOIL r _ I — 8" GRIFFIN PROPERTY .. NATURAL STEPS: TYPICAL nIT MM S ACH MAIN SETTS UNDISTURBED SLOPE & TRANSITION SECTION SOIL STANDARD SHOTCRETE POOL STRUCTURE DETAILS Aim��xmVi rlmYYmw] ! IIOY�WI! nxO I a7�ra ammu 5 odn"'ra E otuuL C Gg tZ� ncv5"STm�ias555waT5c.+ox.w5�5vmnc O'HARA& COMPANY. LTD x u5E•T""aMtA not ioe w5 m®w, no o®.n FIGURE ME aTE �. REV SqN NO. S-1 OYlMOId �@ p , CANTILEVER CONCRETE #3016" OC BW DECKING (TYP) 4" #3®16" OC BW CANTILEVER CONCRETE 4• DECKING (TYP) FROSTPROOF TILE (TYP) #3010" OCBW & iv WATER LEVEL 18" MIN #4040" OCBW WATERPROOF COMP D BONDING PLASTER GRAVEL COMPACTED WIRE 2" MIN COVER GRAVEL o THRU RADIUS #4 CONTINUOUS 1" CONDUIT #3®6" OC VERT & TO JUNCTION BOX • #3012" OC HORZ #3010" OC BW UNDERWATER BEHIND NICHE LIGHT 5' RADIUS 2" MIN COVER ---4 8" i 12" UNDERWATER LIGHT DETAIL ;� A -• =III NATURAL UNDISTURBED SHALLOW END WALL SECTION SOIL #3016" OC BW CANTILEVER CONCRETE HYDROSTATIC TION RELIEF VALVE 4• DECKING (TYP). SUCLINE - #3010" OC. BW & ��I'AOfM,� #4 CONTINUO2" MIN TO PUMP #40'w" OC BW .4 1,ANC IN M.csa COVER WATER LEVEL o 3 1, vir, " FROSTPROOF TILE N NO i�i— COMPACTEDR-3- � #4 CONTINUOUS 2" MIN 0 I GRAVEL COVERSUCTION LINE3®10" OCBW &4040" OCBW 03/20/2014 TO PUMPUNDERFLOW LINE 3/4" GRAVEL 00 4" COMMERCIAL ONLY SUMP LEADER TUBE 7WATERPROOF MAIN DRAIN DETAIL PLASTER (PROVIDE 2 DRAINS GRIFFIN PROPERTY PENTAIR WATER OR EQUAL SKIMMER DETAIL SKIMMER DETAIL 1524 MAIN STREETCOTUIT,MASSACHUSETTS STANDARD SHOTCRETE POOL .. STRUCTURE DETAILS .mPN9 m NmMFD Im _ ' 3w018 1=%7Vr:��°; BY :' ,IY;�`"°�° rF ConsuCti ^"^ �^TME�^^TM�> G� ng O'HARA& COMPANY, LTD 1DG1gNr ec .ME SEE-S E�✓�.•� rox YSE♦i•M' ME _ nw.m xo .am m w nmm m FIGURE ' wunw.Ta am"m .S o> 7T.—E TMrwo —.E.awes 9M. M7E PROJECT NO. NENSpN NO.� ��� OYtNt01• p�p 3 w 2 Copyright©2013 Maverick Integration Corp. GUEST COTTAGE AV/RCP&ALARM Location: COTUIT,MA MA /RICK Pages; i of 1 Drawn: M.CHtEM Date Issued: )UL 25,2013 Revision: A Scale: 1/4"=1'(@ 24"06"1 MCCOURT RESIDENCE �RI C K LOWER FLOOR PLAN FIRST FLOOR PLAN L-200 SCALE:IId'=1'-D' GUEST COTTAGE - ..._........_........_._._..._........._.._...__.............. ._. L�20� SCALE:1ld'=1'-0' GUEST COTTAGE O 67 .......... W uj C M su -- � 'ID T ._.... CENTRAL - I II ... X RACK i I :: t ! s U. f II' Vie—' ._......: ...... ...._ _... - ] 1 I�i I I ] ALAR Y Tj� WY y •ALL NLL(NEAT LOST SENSORS) (2 NEED i0 ON FOLD PANELS IN ry A NDOEry SPACE. •NEED TO COur OI LOCATION FOR()ALARM CONTROL PPNEL$ MECN .® ® @ ® 'REOUIREs A OEO CAIED ISA CIRCUIT, " RDOM S 3 - 7. l _ 3 £ C.'-T T.MA:1 Ncoss: . --6 tl)1eLr:w+a; unrtM txrtGlunox • R;i:,nix CITLc TY cc.,D:r ice_=Rc'.:eD av Ei IX"*eD AEr CE[u"LESS—ED] N-s." • TN_.I_SOU11A<rc= _ '•%r DOORDr —...ASEC( LSN CONIACi O*EDJ - 0-1 v ' o f.Y DL(UNLESS NOT[DI •�tvlE`a P'L'va E��O TwO CETECTOR. - - � flLINO(UxLE55 NOlEO] E" :: MI:; 1 EY:R( ".;, 1».O 80'AEr CCIEIU-wESS ss xOIED] n % r'n- F�aer:iN_aca.Nec' z o enuae(u"L_ss NOWD) W t L .. '� - .• Tm O cn"DUDN�LE LEss ND L.n•en ^nuesscN a:<L._n.e•v.Ta R• .. vEL[uN ED7 a ;M:v>u:ueneN.% T Lost$ENSOi T 3 • L._ENra<_rn::C _ , m.woDI:N EDR vDNT ryNTrss NDrzD] — s d ■ DESIGN ■ MUSIC ■ THEATRE ■ LIGHTING ■ SHADES ■ CONTROL 0 TELECOMS ■ ELECTRICAL ■ I Associated Proposal Alarm 1047 Falmouth Road SystemsHyannis, MA 02601 Phone: 508-775-3442-Fax: 508-790-2330 Estimate Date Estimate# 7/15/2013 5399 Mr. Frank McCourt Mr. Frank McCourt-Guest Cottage 1524 Main Street 1524 Main Street Cotuit, MA 02635 Cotuit; MA 02635 Qty Description Location, 1 Bosch 7412 Alarm System Panel with transformer, Basement enclosure and dual battery harness 1 Bosch Power Supply Module-7412GV4 Panel 2 Rechargeable Back Up Battery 12V 8Ah Panel 1 Bosch 7412 GV4 Enclosure(Universal) For Power Supply 1 Bosch Mounting Skirt Panel 1 Bosch Octo-Relay Module Panel 4 Bosch Zone Expanders i Panel 1 ELK Siren Driver Panel 1 Bosch Graphic Touchscreen Keypad Entry Door 1 Basement: Door Sensor Basement Door(s) 1 Bosch Flush Mount Smoke Detector in White Basement 1 Carbon Monoxide Detector with Siren Basement 2 GRI 2Wire- Water Sensors Basement 1st Floor: 1 Door Sensor Entry Door 2 Door Sensors Porch Door(s) 22 GRI Rece$ed Contact Sensorw/ Magnet 1st Floor Window (s) 1 Bosch Flush Mount Smoke Detector in White Bedroom (outside) k 1 Bosch Flush Mount Smoke Detector in White Bedroom 1 Carbon Monoxide Detector with Siren Bedroom (s)-Outside 1 Heat Loss/Freeze Sensor 1st Floor 1 Wire and Fire Permits-Barnstable Page 1 of 2 I� Associated Proposal larm 1047 Falmouth Road S y S t e,M S Hyannis,MA 02601 Phone: 508-775-3442-Fax: 508-790-2330 Estimate Date Estimate# 2/28/2014 5399 Addendum 376 Mr. Frank McCourt McCourt Residence -Guest Cottage Att: Jeff Ingram 888 Seventh Avenue 1524 Main Street New York, NY 10106 Cotuit, MA 02635 DescriptionQty 1 Pool Door Alarm Sensor Front Door 1 Pool Door Alarm Sensor Living Room Door Subtotal: $300.00 Sales Tax �g 39 Please sign below to indicate your acceptance of this proposal. A full Estimate Total rye contract will be e-mailed or mailed for your signature ©9:39 Customer Signature Date Page IofI lv' ill - f SZ.q ow DeStefano Chamberlain November 5,.20.13 Thomas Perry J ; 200 Main St. Hyannis,MA. 02601, Re: McCourt Residence Beach Cabana Cotuit,Ma. Dear Thomas; Our office has logged the pile installation at the McCourt Residence project n`Cotuit Ma. 1.2 helical micro-piles were driven to a minimum of fifteen(l.5)ton capacity. Two piles were driven to a minimum of ten(10)ton capacity. Please find a copy of the Summary Pile Report and inspection reports enclosed'with this letter. If you have any:questions;please do'not hesitate to contact our office. Sincerely, Rich `Way Ji �tef no,P.E.,A.I.A. w�q t Cc: Conte Construction Ev. k"�YP • Ken Vona Construction a ", Shope Reno Wharton Regulatory Services Building Division Structural an. d Architect+`ural" Engineering 50 Thoroe Street; fairf eld, CT 06924 ®"Tel"'f203'.254=7131 '• fax 203 254-026318 www.dcstructural.com I SPECIAL INSPECTION REPORT JOB NO. . 12-724 . DeStefano& DATE : October 10, 2013 Chamberlain NOW M Structural Engineers •. 50 Thorpe Street Fairfield.CT 06824 (203)254-7131 Fax(203)254-0263 S PROJECT: McCourt Residence PRESENT AT SITE: LOCATION: 1524 Main St. Cotuit, Ma Rick Way—DeStefano&Chamberlain,Inc. TO: Regulatory Services Matt Conte—Conte Construction Building Division Kevin Wynne—Ken Vona Construction 200 Main St. Hyannis,Ma. 02601 An inspection was made at the McCourt Residence to load test the helical pile installation for the beach cabana. This compression test was accomplished by driving 4 reaction piles and assembling a testing rig consisting of several large pieces of structural steel. A hydraulic jack was then used to apply an axial force to the helical pile and a dial gauge to measure the displacement of the pile. Load was increased in 5 ton increments and held while the displacement was recorded. This was repeated up to 133%of the design load. Once this load was reached, it was held for one hour with measurements being made every minute for the first 5 minutes, every 5 minutes for the next 25 and finally every 15 minutes for the last half hour. The displacement during this time was not to exceed 80 thousands of an inch. During the test there were several issues with the testing rig not sitting reliably on the helical pile. This resulted in the test needing to be repeated several times before the test was successful. The load was held at 26.5 tons was held for one hour. The total displacement over that time period was found to be 0.050 inch. A permanent displacement of 0.341 inches was observed when the load was removed from the pile. This allows the maximum load on any given pile to be one half of the test load which equates to roughly 13.3tons or 26.5 kips. Due to the conservative nature of the initial design,this is found to be acceptable. w COPIES: Kenneth Vona Construction, Shope Reno SIGNED: Wharton, File DeStefano&Chamberlain, Inc. Dana 1 of 1 A INSPECTION REPORT JOB NO. : 1.2-724 DeStefano & DATE : November 5,2013 Chamberlain SS . Structural Engineers • 50 Thorpe Street . Fairfield:CT 06824 (203)254-7131 Fax(203)254-0263 PROJECT: McCourt Beach Cabana PRESENT AT SITE: LOCATION: 1524 Main St. Cotuit,Ma Richard Way—DeStefano& Chamberlain, Inc. TO:' Shope Reno Wharton Matt Conte—Conte Construction 18 Marshall Street, Suite 114 Kevin Wynne—Ken Vona Construction South Norwalk, CT 06854 An inspection took place at the McCourt residence on November 5, 2013 to monitor the installation of Helical Piles for the beach cabana. Piles 1-6 and 8 through 14 were drilled. All piles were driven to at least 10 feet below the N.A.V.D. Piles were equipped with a pull down grout casing and were 2" square shaft helical piles. The exception for this was piles 13 and 14 which were 1 3/4" square shaft with no pull down casing`These were un- grouted due to the finished grade not being established at the time of the drilling. Battered piles were driven at a 30'angle. Pile 7 was driven,logged, and tested on a previous date by Conte Construction Company. Piles which were 2" square shaft were driven to a minimum torque of 6000ft-lbs. This equates to roughly 60kips of ultimate carrying capacity. The working capacity of the piles was at least 30kips. Information on the torque to capacity ratio can be found in the attached literature from A.B. Chance's installation manual. Information regarding the pile installation can be found in the attach pile log and summary. All piles were found to be acceptable. COPIES: File, Shope Reno Wharton,Conte Construction SIGNED: Company, Ken Vona Construction ; cam' DeStefano&Chamberlain,Inc. Page 1 of 1 iCA Helical Pile Summary Report November 5, 2013 i DeStefano 8. ` Chamberlain Structural Engineers Project McCourt Residence Beach Cabana 1524 Main St, Cotuit,Ma. U , r Pile type A.B. Chance 200 Galy. 2"square shaft Helical Diameter 10", 12 14" �af� Required Torque 6,000 ft-lbs AL Pile type 2 square shaft A.B. Chance SS200 series , 34112 helical pilesv, c fi4��� Engineer of record DeStefano&Chamberlain,Inc: Pile Installer Conte Construction Matthew Conte . Owner McCourt Residence Special Ins ector/Technician DeStefano&.Chamberlain,Inc. R P Rick Way ' P fess naI Englneei's Seal . Pile No. Date Pile length Top of Final Design Offsets Remarks installed (ft:) pile pressure(psi) Capacity elevation _ tons 1 11/5/2013 15: 2.3' 14211 4 Pull down grout casing 2 11%5/2013 15 2.3' 12076 4 Pull down grout casing 3 11/5/2013 15 2.3' 14592 11 Pulp down grout casing 4 11/5/2013- 16.5. 2.3' 14618 10. Pull down groqt casing 5 11/5/2013 16 2.3' 14662 11 Pull down grout casin 6 11/5/2013 15: 2.3' 14574 15 Pull down grout.casing .8 11/5/2013 16.5 2.3' 14469 15 Pull.down grout casing* 9 11/5/2013 14:5. 2.3' 7432 11 Pull down grout casing 10 11/5/2013 15 2.3 14391 12.5 Pull down grout casing* 11 11/92013 16 2.3' 14488 12.5 Pull down grout casing 12 11/5/2013 15 2:3' 14.128 11 Pull down grout casin 13 11/5/2013 25' 12.6' 7766 2.5 1 '/o'square shaft,no out casing 14 11/5/2013 25' 12.0' 8056 2:5 1 V square shaft,,no rout casing Page 1'of l I w1912 - - 'DOWN.RIONT.SOLIO. J- ATLAS7 C"ANGING NISTORT - INSTALLATION TORQUE/LOAD CAPACITY RELATIONSHIP Before installation, a helical anchor/pile is simply a screw with a discontinuous thread and a uniform pitch. When installed into soil, a helical anchor/pile functions as an axially loaded.end-bearing deep foundation. The helix plates serve a two-fold purpose. The first purpose is to provide the means to install the helical anchor/pile. The second purpose is to provide the bearing element means for load transfer to soil. As such, helical anchor/pile design is keyed to these two purposes, both of which can be used to predict the ultimate capacity. Section 5 detailed how helix plates act as bearing elements. The load capacity is.determined by multiplying the unit bearing capacity of the soil at each helix location by the projected area of each helix. This capacity is generally defined as the ultimate theoretical load capacity because it is based on soil parameters either directly measured or empirically derived from sounding data. This intent of this section is to provide a basic understanding of how installation torque (or installation energy) provides a simple, reliable means to predict the load capacity of a helical anchor/pile More importantly, this prediction method is independent of the bearing capacity method detailed in Section 5, so it can be used as a"field production control" method to verify load capacity during installation. The installation torque-to-load capacity relationship is an empirical method originally developed by the A. B. Chance Company. CHANCE Civil Construction has long promoted the idea that the torsion energy required to install a helical anchor/pile can be related to the ultimate load capacity of an anchor/pile. Precise definition of the relationship for all possible variables remains to be achieved. However, simple empirical relationships have been used for a number of years. The principle is that as a helical anchor/pile is installed (screwed) into increasingly denser/harder soil, the resistance to installation (called installation energy or torque) will increase. Likewise, the higher the installation torque, the higher the axial capacity of the installed anchor/pile. Hoyt and Clemence (1989) presented a landmark paper on this topic at the 12th International Conference on Soil Mechanics and Foundation Engineering. They proposed the following formula'that relates the ultimate capacity of a helical anchor/pile. to it's' installation torque: Quit = Kt x T (Equation 6-1) where: Quit = Ultimate uplift capacity[lb(kN)] Kt = Empirical torque factor[ft_1 (m-')] T = Average installation torque[lb-ft(kN-m)] Hoyt and Clemence recommended Kt= 10 ff' (33 m-')for square shaft (SS) and round shaft(IRS) helical anchors/piles less than 3.5" (89 mm) in diameter, 7 ft-' (23 m-) for 3.5" diameter round shafts, and 3 ft-' (9.8 m')for 8-5/8" (219 mm) diameter round shafts. The value of Kt is not a constant-it may range from 3 to 20 ft-' (10 to 66 m-'), depending on soil conditions, shaft size and shape, helix thickness, and application (tension or compression). For Chance® Type SS square shaft helical anchors/piles, Kt typically ranges from 10 to 12 ff' (33 to 39 m'), with 10 ft_1 (33 m-') being the recommended default value. For Chance°Type IRS pipe shaft helical anchors/piles, Kt typically ranges from 6 to 10 ft-' (20 to 33 m-'), with 8 ff' (26 m-) being the recommended default for Type RS2875; 7 ft-' '(23 m-) being the recommended default for Type RS3500.300; and 6 ft-' (20 m-) being the recommended default for Type RS4500.337. Locating helix bearing plates in very soft, loose, or sensitive soils will typically result in Kt values less than the recommended default. This is because some soils, such as salt leached marine clays and lacustrine clays, are very sensitive and lose considerable shear strength when disturbed. It is better to extend the helical anchor/pile beyond sensitive soils into competent bearing strata. If it's not practical to extend the helical anchor/pile beyond sensitive soils, testing is required to determine the appropriate Kt. ©2006,Hubbell Power Systems, Inc. INSTALLATION METHODOLOGY v1.0 All Rights Reserved 6-5 Oct/2006 Andets®l 1-s =1 0 8 5 00. e Fax 791-857=1054 Ensulatin,o Ince www.andersoninsul.com 706 Brockton Ave PO Box 2003 Abington; MA 02351 .Insulation i,eitscate WORK AREA ITEM INSTALLED Main Ceiling R-19 6 X 15 Unfaced Fiberglass Batts 'Kneewalls R-21 5 1/2 X 15 Kraft Faced FG Batts Hi-Dens Kneewalls Tyvek House Wrap 9x100 Interior Partitions R-19 6 X 15 Unfaced Fiberglass Batts Underside of Roof R-40.5 Icynene Closed Cell Spray Foam Insulation MDC-6in DCT.Walls 2k6 R-21.6 Icynene Closed Cell Spray Foam Insulation MDC-3.2in Second Floor Ceiling R-19 6 X 15 Unfaced Fiberglass Batts Interior Partitions R-19 6 X 15 Unfaced Fiberglass Batts Interior Partitions R-13 3 1/2 X 15 Unfaced Fiberglass Batts Windows and Doors Foamed Great Stuff-Minimal Expansion Foam Underside of Roof R-40.5 Icynene Closed C611 Spray Foam Insulation MDC 6in Overhang R-40.5 Icynene Closed Cell Spray Foam Insulation MDC-61n Exterior Walls R-21.6 IC-nene Closed Cell Spray Foam Insulation MDC-3.2in Exterior Walls R-21.6 Icynene Closed Cell Spray Foam Insulation MDC-3.2in Ceiling R-31.1 Icynene Closed.Cell Spray Foam Insul MDC-5.5in Basement Walls R-21.6 Icynene Closed Cell Spray Foam Insulation MDC-3.2in Crawlspace Walls R-21.6 Icyriene Closed Cell Spray Foam Insulation MDC-3.2in Crawlspace Walls DC 315 Spayed on Ignition Barrier for Foam Blockers/Rim Joist R-21.6 Icynene Closed Cell Spray Foam Insulation MDC-3.2in Finished,Basement Ceiling R-49 6 X.15 Unfaced Fiberglass Batts' Unfinished Basement Ceiling R-30.10 X.16 Poly Faced Encal5 Batts Interior Partitions R-19 6 X 15 Unfaced Fiberglass Batts ' Interior Partitions R-13 31/2 X 15 Unfaced Fiberglass Batts Underside of Roof 11-40.5 Icynene Closed Cell Spray Foam Insulation MDC-6in Kneewalls R-21.6 Icynene Closed Cell Spray Foam Insulation MDC-3.2in Dormer Walls R-21.6,Icynene Closed Cell Spray Foam Insulation MDC-3.2in Underside of Roof DC 315 Spayed on Ignition.Barrier for Foam.- Kneewalls Kneewalls DC 315 Spayed on Igntion.Barrier for Foam Customer: Kenneth Vona Construction,Inc. Job Number: 195003 Sob Address McCourt Residence Main House Cotuit Date Completed: Q � Installer Signa ure DeStefano Charnbeldain January 28, 2014 Michael 0. McClung,AIA Shope Reno Wharton Associates 18 Marshall Street South Norwalk, CT 06854 Re: McCourt Residence—1524 Main Street, Cotuit, MA, Dear Mike, DeStefano& Chamberlain, Inc.served as the structural engineer of record for the renovations and additions to # the existing single-family residence located at 1524 Main Street in Cotuit. We engineered the structural framing and foundations for the renovation and additions,and prepared the structural drawings that were submitted for permit. During the course of construction,our office performed site visits on August 27,September 18,and October 31, 2013. Based on our site visits,we have determined that the structural framing and foundations have been completed in substantial conformance with our design, and can resist the structural loads prescribed by Chapter 16 of the Massachusetts State Building Code 780 CMR 81h Edition. Please contact our office with any questions. Sincerely, evi hamberlain, P.E.,SECB_+- ``� JAMES S. 1;'°t WSTEFANO w STRUCTURAL t0..4112 ' J es eStefano, P.E.,SECS �.�= r� ?f c : Ken Vona Construction file Structural and Architectura.1 EngIne' er .Ing y 50 Thorpe Street. Fairfield,CT 06824 a Tel. 203.254.7131 ® Fax 203.254.0263.a www.dcstructurai.com v v a Rl a� °! My���File n f Detail 4 A "Ircahon 200$Odl$3 I,+ ;A can GC`GENERALCOi t PP a c P ; , w PP ^' VMVr StakJs ` CloselDeny � Owner;° ��� " �� 2275! Department 6300-BUILDING DEPARTMENT �� GRIFFIN WILLIAM LF Workflow- " L Project/Activity 6d9 DEMO ACCESSORY,<STRUCTURE _ - -� Contractor . MILLER STARBUCI ParkinglMisc Descn6666 1 DEMO MOOD FRAMED EXTERIOR SHOWER CABANA ENCLOSURE Busiriess j Description 2 ,, 4JITHI�J;T��HEFOQ?Tf?RINT.QF EXI:5TIt�IG�SHOWER EtJCLOSURE,600 SQ �" 'Property` - Fees effective .©810512008 S a yj � a a n� p,� 6 D M Assigned to. � ,` Business Mast I - Prope Non ConformingDateslh��sC Permits' � _ �Reactivate ��: '"; n.• P LOcatlOn' �524k� �� i Unit„„�� d'ExIStIYIg USe, 0101 gyp: f�1�Xl ffiT ¢ l n� -` 846et MAIN STREET(COTUITJ °. � ' oning RF RESJD F b 4 E scrow Parcel A 017014 `' •memo Misc Ch s Municipality I COT COTUIT Subdivision , flood zone f r! j: .:Paymt�History r .t A "G ya 4 N , . 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'Names Bonds �SubAddrs ryText P Prerequisites [ Plan Review ti [ PriorHist'ory �lnspections ��Violations ,r � Reviews ( Qperiltems ;(Warnings ,FindRelated , 40 JLJ 7,77 ClosejD.enythe current application ,� M My File Edit Tools=Help•, Stakus >n A, F Stakus DENIED rr °t a ". .,xm�,.:�,.,, .-.. �' w"9r,,.»• ak t iiuh ,� �, r '� ' AIq ctual end 03105l2009 t ,Status code CLSD CLOSED APPLICATION a " St akus memo � S 4 anlat��K ce R } Sr tr9 n iP "err -' ark .`F ✓ is.ace>.l`+i)�54, t ttr. �y."_'. `rr AIM , � ,sy '' t "r Zvi w, 'vi;�P1'r" n +rke rt i�*'na r�'un r�"vce` a'a t,air fed"" i t ,pNy�s3 "E•rP.3 t o d z, _ " ' `:xtdr�sw*.+F+��a>n v t *. ktR ' 'a' n °' . +'.t t V > , „•a, tt ° Dehi61 reason.,,,, w*v w xa �iJ Y t w 4 AMR, a� "s r ReaSOn COde �' ,.: F t w' t „<'.,Ert" t •ce! G"s« ,, ce rce S Reason iordenial STRUCTURE REBUILD IS IN A ' "FLOOD ZONE."REFUSAL OF PARTY r. TO REDESIGN FOR CONSTRUCTION IN FLOOD ZONE r rce ` w ur a i.�f�� t it xi e w ° t d, 3 y t `rlMt h. t t fi ,'r .tl �'o, t 1 - .t�'d �j gw%"t dymi,arr+w RIM �7 ,��a y o x M 4 T9 a. 4# z_ . rn� " r aq�,+, r>s' .•,v,'4 �;�'.� v" a. 1 " I "'.."4fi, File Edit Tools Help'' �r "yY;'Y' arv'E'+s p'� +d"&a K-G'"" {� •5+��- 'ue 7j7p' Status IDENIED M€Y ` �Actualnd'� `00I0512D09 H �atdd roux a� u Status code CLSD CLOSED APPLICATION E r ' I i 5tatU3 rYlerYlO :l a k MA'SiW ( + HIV Ca.., #� z xpr " Ir .i'1 `kv „'c 77`"xjx. x ' rerz a ,���+ � � ��9:' '� „..�; t ✓w,. 1�`�''rF�a°��9ia��" ;�" tt uq'w4:ffi �° � "` � t gnk pr.xr� 3. �nO ' nn� _ tilt srR ii ¢ s: ri �� e Un ��_ i.�` Denial reason Reason code �.,�,d�„gx� bra � t '� �.b2, . ,»--.��8'a� �� � N m e imp a� b ' �. � � •.� ..,° ' Reason fordernal D O WAS bONE'!1fITH�u�APPROVAL 'T� HE STRUCTURE IS IN A�1!" r 3 FLOOD ZONE f �- - pe't,a�n day ' 'ae4.`r ✓9s 'uyr.ii e;=", MR dart Eb ;,) - ";.SrP" NO AWI �, A "Al „ u a.,.wk -- 8 )or/°� No ChQ j JS(J�`� C �pto Co h,� Con FerYl�Cy� Marcel Detail Page 1 of 3 MAS Logged In As: Parcel Detail Friday, Aug Parcel Lookup Parcel Info Parcel ID 017-014 Developer'LOT F & 10 Lot Location 1524 MAIN STREET (COTUIT) Pri Frontage '980 Sec Road Sec Frontage village COTUIT Fire District COTUIT Sewer Acct Road Index 0951 ASbuilt Septic Scan: Interactivve ' 017014_1ap Owner Info owner GRIFFIN, WILLIAM F JR TR Co-owner(NEW RUSHY MARSH REALTY TRU Streetl C/O JEFFREY INGRAM MCCOURT COM Street2+600 ATLANTIC AVE City BOSTON State`MA zip 102110 Country j Land Info _ Acres`14.29 use Sln le Fam� MDL-01 _ Zo g Wing RF Ivghbd ;WF13 Topography Level Road Paved utilities Public Water,Gas,Septic Location Waterfront,Excel View Construction Info Building 1 of 1 Year Roof Ext Built 1-909 Struct. Gable/Hip wall 'Wood Shingle Effect 8019 Roof Asph/F GIs/Cmp AC ;None Area -- .__:.__ Cover Type Style Colonial Int Plastered Bed ,10 Bedrooms Wall Rooms Model Residential Int Bath 6 Full + 1 H Floor -- Rooms Grade Exceptional TYpe Hot Water Total Rooms 21 Rooms http://iss 12/intranet/ ro data/ParcelDetail.as x?ID=505 8/1/2008 9 p p p I Parcel Detail Page 2 of 3 AT 22A0]0) iFOPs �' stories 2 Sty w/FAT Heat Oil �� I Found- Typical i — -- Fuel ation tea_ p Permit History Issue Date Purpose Permit# Amount Insp Date Comments Visit History Date Who Purpose 2/11/2005 12:00:00 AM Paul Talbot Meas/Est 4/26/2000 12:00:00 AM Paul Talbot Meas/Listed Sales History Line Sale Date Owner Book/Page Sale P 1 11/6/2000 GRIFFIN, WILLIAM F JR TR 13347/129 2 12/15/1989 WESSON, FRANK LEE &VICTORIA C119417 3 WESSON, MATHILDE O C62030 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parc( 1 2008 $1,709,500 $7,700 $4,200 $8,969,400 $10 3 2007 $1,701,600 $7,700 $4,200 $8,969,400 $10 4 2006 $1,422,700 $7,700 $4,200 $8,863,900 $10 5 2005 $1,815,500 $7,200 $1,100 $8,863,800 $10 6 2004 $.1,744,900 $7,200 $1,100 $10,270,700 $12 7 2003 $1,297,200 $6,800 $1,100 $13,450,900 $14 8 2002 $1,297,200 $6,800 $1,100 $13,450,900 $14 9 2001 $1,297,200 $7,200 $1,100 $13,450,900 $14 1.0 2000 $705,800 $6,500 $500 $2,832,000 $3 11 1999 $705,800 $6,500 $500 $2,832,000 $3 12 1998 $705,800 $6,500 $500 $2,781,000 $3 13 1997 $544,100 $0 $0 $1,866,100 $2 14 1996 - $544,100 $0 $0 "$1,866,100 $2 15 1995 $544,100 $0 $0 $1,866,100 $2 16 1994 $437,100 $0 $0 $1,828,700 $2 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=505 8/l/2008 Parcel Detail Page 3 of 3 17 1993 $437,100 $0 $0 $1,817,600 $2 18 1992 $497,600 $0 $0 $2,017,900 $2 19 1991 $681,300 $0 $0 $2,359,600 $3 20 1990 $681,300 $0 $0 $2,359,600 $3 21 1989 $681,300 $0 $0 $2,359,600 $3 22 1988 $404,700 $0 $0 $1,646,800 $2 23 1987 $404,700 $0 $0 $1,646,800 $2 24 1986 $307,000 - $0 $0 $3,060,000 $3 Photos r F F http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=505 8/l/2008 `M c IN SF 'A ¢ e t N V. t � r f,a N u e�a4 r �"� s �Lp"ry • , � � Nh'� *-fogy, fir. 08/05/2008 09:51 508-548-9672 HOLMES AND MCGRATH PAGE 08 SE3-4747 Name: Williams F. Griffin,Jr.,Trustee New Rushy Marsh Realty Trust Approved Plan— June 17,2008 Site Plan(2 sheets)by Michael B. McGrath,P.L.S. Special Conditions of Approval L Findings No definitive delineation is herein made on the coastal dune. II. Preface Caution:Failure to comply with aU Conditions of this Order of Conditions can have serious conseclueaces. The consequence may'Include issuance of a stop work order,fines,requirement to remove upapermitted structures, requirement to re-landscape to original condition,Inability to obtain a certificate of compliance, and more. The General fMditions of this Order begin on page 4 and continue on pages 5,6 and 7. The 5pgcial Conditions are contained on pages 7.1,7.2 and 7.3 if necessary. All conditions require your compliance. III. Prior to the start of work,the following conditions shall be satisfied: 1. Within one month of receipt of this Order of Conditions and prior to the commencement of any work approved herein,General Condition number 8(recording requirement)on page 4 shall be complied with. 2. It is the responsibility of the applicant,the.owner and/or successor(s)and the project contractors to(insure that all conditions of this Order are complied with. The applicant shall provide copies of the Order of Conditions and approved plants(and any approved revisions thereof)to project contractors prier to the start of work. Barnstable Conservation Commission Forms A and B shall be completed and retu �1 to the �gltttnission g 'o�u r to time start of work 3. General Condition 9 on page 4(sign requirement)shall be complied with. IV. The following additional conditions shall govern the project once work begins: 4. The Conservation Commission, its employees,and its agents shall have a right of entry to inspect for compliance with the provisions of this Order of Conditions. 5. Unless extended,this permit is valid until J1_LLBJL 6. No CCA-treated or creosote-treated materials shall be used. V. After all work is completed,the following condition shall be promptly met: p.7,1 08/05/2008 09:51 508-548-9672 HOLMES AND MCGRATH PAGE 09 7. At the completion of work,or by the expiration of this Order,the applicant shall request in writing a Certificate of Compliance for the work herein permitted. Barnstable Conservation Commission Form C shall be comnlgled and returned with the request for a Certificate of Compliance Where a project has been completed in accordance with plans stamped by a registered professional engineer,architect, lands':ape architect or land surveyor,a written statement by such a professional person certifying substantial compliance with the plans and setting forth what deviation,if any,exists with the record plans approved in the Order shall accompany the request for a Certificate of Compliance.At the time of the e request for a Q,ergfteate of Compliance,ap ppdAted seguence of color nhotographs of the uno Mrbed buffer zone shall be also submitted, p.7.2 i° f-- ELECTRIC Co . I N 9299 08 - 833 -- 40, gk 14 4 s r r - 08/05/2008 09:51 508-548-9672 HOLMES AND MCGRATH PAGE 10 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands Mas;sCt;P File Number: WPA Form 5 - Order of Conditions SE3- 4747 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code E. Issuance Ll :1 *J( This Order is valid for.three years, unless otherwise specified as a special condition pursuant to General Conditions#4, from the date of issuance. is oale of ffisman ��— Please indicate the number of members who will sign this form: This Order must be signed by a majority of the Conservation Commission. 2.Numberoi`signers The Order must be mailed by certified mall (return receipt requested)or hand delivered to the applicant. A copy also must be mailed or hand delivered at the same time to the appropriate Department of Environmental Protection Regional Office, if not filing electronically, and the proparty owner, if different from applicant. Signatures, Notary Acknowledgement Commonwealth of Massachusetts County of BarnstaTblle _ On this be of v bi�. Y Month Year Before me,the undersigned Notary Public, LS - u personally appeared Name of Document signer proved to me through satisfactory evidence of identification,which was/were Description of evidence of Identification � � to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he/she signed it voluntarily for its stated purpose. As member of Barnstable cityrrown Conservation Commission Signature of Notary Public Ile Printed Nameof Notary Public - Place notary seal and/or any stamp above � � My Commission Expires(Date) This Order is Issued to the applicant as follows: by hand delivery on ❑ 'by certified mall, return receipt requested,on Dat® Name, .-.S..-f Signature ! Date -— ---- wpeform®.poo• rev.2/27108 Bam9teble revlsud 4/1112QQ8 - Page a of 10 , 08/05/2008 09:51 508-548-9672 HOLMES AND MCGRATH PAGE 11 Massachusetts Department of Environmental Protection �. Bureau of Resource Protection - Wetlands MasrDEl File Number: WPA Form 5 -- Order'of Conditions SE3-4747 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 ands§ 237-1 to § 237-14 Town of Barnstable Code F. Appeals The applicant, the owner,any person aggrieved by this Order, any owner of land;abutting the land subject to this Order, or any ten residents of the city or town in which such land is located, are heroby notified of their right to request the appropriate MassDEP Regional Office to issue a Superseding Order of Conditions. The request must be made by certified mail or hand delivery to the Departrem, with the appropriate filing fee and a completed Request of Departmental Action Fee Transmittal Form, as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this Order.A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant. Any appellants seeking to appeal the Department's Superseding Order associated with this appeal will be required to demonstrate prior particlpatlon In the review of this project. Previous participation in the permit proceeding means the submission of written Information to the Conservation Commission prior to the close of the public hearing, requesting a Superseding Order or Determination,or providing written,Information to the Department prior to issuance of a Superseding Order or Determination. The request shall state clearly and concisely the objections to the Order which is being appealed and how the Order does not contribute to the protection of the interests identified In the Massachusetts Wetlands Protection Act(M.G.L. c. 131, §40), and Is inconsistent with the wetlands regulations (310 CMR 10,00). To the extent that the Order Is based on a municipal ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. Section G, Recording Information Is available on the following pago. ; wp9fcrm5,doc rev,2/27/08 Barnstable revleeC 4111/2009 Pogo 9 Pt 10 I 08/05/2008 09:51 508-548-9672 HOLMES AND MCGRATH PAGE 12 lMassachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands Ma ssDE:P File Number: WPA Form 5 Order of Conditions SF-3- 4747 Massachusetts Wetlands Protection Act M.G.L. c, 131, §40 - and § 237-1 to § 237-14 Town of Bamstable Code _ G. Recording Information This Order of Conditions must be recorded'in the Registry of Deeds or the Land Court for the district in which the land Is located, within the chain of title of the affected property. In the case of recorded land,the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions.The recording Information on this page shall be submitted to the Conservation Commission listed below. Barnstable Conservation Commission —- Detach on dotted line,have stamped by the Registry of Deeds and submit to the Conservation Commission. -------------•--- - ----- ......-------------- -........ . To: ` Barnstable Conservation Commission - Please be advised that the Order of Conditions for the Project at: 1524 Main Street,Cotuit, MA 02635 SE3 4747 _ Project Location MassDEP File.Number Has been recorded at the Registry of Deeds of: Barnstable County Book Pag® for: Property Owner —----- _ and has been noted in the chain of title of the affected property in: Book Page In accordance with the Order of Conditions issued on: i If recorded land,the instrument number Identifying this transaction is: Instrument Number '�If registered land, the document number identifying this transaction is: Document Number i• - . �^ 3lonature of Applicant w0efcrm5.doc- rev.2/27108 t)emelabla rsv18ed V110008y page 10 of 10 n 08/05/2008 09:51 508-548-9672 HOLMES AND MCGRATH PAGE 01 z Dor_: 1 s t]95.353 08--04-21308 1 O:07 BARNSTABLE LAND COURT REGISTRY Massachusetts Department of Environmental Protection MassDEF File Number: Bureau of Resource Protection : Wetlands WPA Form 5 Order of Conditions SE3_ 474.7 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code A. General Information Important: Barnstable When filling 1.From: Conservation Commission out forms on the computer, 2.This Issuance is for(check one): a. ® Order of Conditions b. ❑ Amended Order of Conditions use only the tab key to 3, To: Applicant: move your cursor-do not William F. Griffin,Jr.,Trustee use the return a.First Name b.Last Name key. New Rusher Marsh Realty Trust c.Organization 600 Atlantic Avenue d.Mailing Address Boston MA 02110 e.City/Town f.State g.Zip Code 4. Property Owner(if different from applicant): a.First Name b.Last Name t c.Organization - HARNOUBIA d.Mailing Address F e.City/Town f.State g.21p Cade S. Project Location: 1524 Main Street Cotuit a.Street Address b.Village 017 014 c,Assessors Map Number d.Assessors Parcel Number Latitude and Longitude, If known: 410 36'07" N 70" 20' 23"W e.Latitude f.Longitude s. Property recorded at the Registry of Deeds for(attach additional information if more than one parcel): Barnstable C169659 P 2675-C lots E $F a.County " P18041-D Lot 10 c.•Book d.Page —-- 7. Dates: June 20 200B July 8, 2008 4 JUL 1 6 2008 a.Date Notice of Intent Filed b.Date Public Hearing Closed c Date of Issuance a: Final Approved Plans and Other Documents(attach additional plan or document references as needed): Site Plan a.Plan Title - Holmes and McGrath;Inc- Michael B. McGrath, P.L.S. b.Prepared By c.Signed and Stamped by June 17, 2008 1 80' d.FinAl Ravirion MOO o.scsl® —--- y F.Additional Plan or Document Title g Date wP9f0rm5.d00 rev.2127106 fdemelobie revleed 41111200e Page 1 of 10 q I 08/05/2008 09:51 508-548-9672 HOLMES AND MCGRATH PAGE 02 Massachusetts Department of Environmental Protection MassDEP File Number- Bureau of Resource Protection - Wetlands WPA Form 5 — Order of Conditions SE3- 4747 ` Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code _ B. Findings 1. Findings pursuant to the Massachusetts Wetlands Protection Act: Following the review of the above-referenced Notice of Intent and based on the information provided in this application and presented at the public hearing,this Commission finds that the areas in which work Is proposed is significant to the following interests of the Wetlands Protection Act. Check all that apply: a. ❑ Public Water Supply b. ❑ Land Containing Shellfish c. ®. Prevention of Pollution a. [] Private Water Supply e. ❑ Fisheries f. ® Protection of Wildlife Habitat g. ❑ Groundwater Supply h. Storm Damage Prevention i, ® Flood Control 2. This Commission hereby finds the project,as proposed,,Is:(check one of the following boxes) Approved subject to: a. ® the following conditions which are necessary in accordance with the performance standards set forth in the wetlands regulations.This,Commission orders that all work shall be performed In accordance with the Notice of Intent referenced above, the following General Conditions, and any other special conditions attached to this Order. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent,these conditions shall control. Denied because: b. ❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations.Therefore,work on this project may not go forward unless and unJI anew Notice of Intent is submitted which provides measures which are adequate to protect these interests, and a final Order of Conditions is issued. A description of the performance standards which the proposed work cannot meet Is attached to this Order. C. Elthe informatlon`submitted by the applicant is not sufficient to describe the site, the,Mork, or the effect of the work on the interests identified in the Wetlands Protection Act.Therefore,-work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides sufficient information and includes measures which are adequate to protect the Act's irterests, and a final Order of Conditions is Issued.A description of.the specific information which Is lacking and why it is necessary is attached to this Order as per 310 CWIR 10.05(e)(c). Inland Resource Area Impacts: Check all that apply below. (For Approvals only) I. ❑ Buffer Zone Impacts: Shortest distance between limit of project disturbance and wetland boundary(if available) a.linear feet Resource Area Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement a. ❑ Bank �. a.linear feet b.linear feet c.linear feet d.linear feet 5. ❑ Bordering Vegetated Wetland z a square Feet b.square feet c.square feet d,square feet s. ❑' Land Under Waterbodies a.square feet b.square feet` c.square feel d.square feet and Waterways e.cry dredged r.cry aredgea wpelorm5,0c• rev.2t27i09 9emste IS Mvlsaa at 112008 Page 2 of 10 08/05/2008 09:51 508-548-9672 HOLMES AND MCGRATH PAGE 03 Massachusetts Department of Environmental Protection MassDEP File Number: �---- Bureau of Resource Protection - Wetlands ' WPA Form 5 - Order of Conditions SE3-_4747 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code M B. Findings (coot.) Resource Area Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 7. ❑ Bordering Land _ Subject to Flooding a.square feet b.square feet c,square feet d,square feet Cubic Feet FloodlStorage e.cubic feet f.cubic feet -~ g,cubic feet _ h.cubic feet 8. ❑ Isolated Land Subject to Flooding a.square feet b.square feet Cubic Feet Flood Storage c.cubic feet d.cubic feet e.cubic feet f.cubic feet 9. ❑ Riverfront area a.total sq.feet b,total sq.feet Sq ft within 100 ft c.square feet d.square feet e.square feet f.square feet Sq ft between 100-200 ff g.square feet h.square feet i,square feet j,square feet Coastal Resource Area Impacts: Check all that apply below. (For Approvals Only) 1o, ❑ Designated Port Areas Indicate size under Land Under the Ocean, below 11. ❑ Land Under the Ocean a,square feet b.square feet c,oty dredged d.cty dredged 12. ❑ Barrier Beaches indicate size under Coastal Beaches and/or Coastal Dunes below 13. ❑ Coastal Beaches cty no -nit,square feet b.square feet c. urlshnit, d.c/y nourishmt. 14. ❑• Coastal Dunes' a,square feet b.square feet a c/y nourishmt. d.c/y nourishmt. 1s. ❑ Coastal Banks' a.linear feet b.linear feet 16. ❑ Rocky Intertidal Shores a,square feet b.square feet 17. ❑. Salt Marshes a.square feet b.5quare feet c.square feet d,square feet 18. ❑ Land Under Salt Ponds a,square feet b.square feet c,c/y dredged d.c/y dredged 19. ❑ Land Containing Shellfish a.square feet b.square feet C.square feet d.square feet 20. ❑ Fish Runs Indicate size under Coastal Banks, Inland Bank, Land Under the Ocean, and/or inland Land Under Waterbodies and Waterways, above x a.c/y dredged b.cly dredged 21. ®Land Subject to Coastal 525 approx_ Storm Flowage a.Square feet e.square feel wparormS.doc• rev.2/27108 6emeleble revised 4/11n008 page 3 or 10 08/05/2008 09:51 508-548-9672 HOLMES AND MCGRATH PAGE 04 Massachusetts Department of Environmental Protection Mas:sDEI' Flle Number: --, Bureau of Resource Protection - Wetlands ' WPA Form 5 - Order of Conditions SE3-- 4747 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code C. General Conditions Under Massachusetts Wetlands Protection Act (only applicable to approved projects) 1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 2, The Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state, or,local statutes, ordinances, bylaws, or regulations. 4. The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: a. the work Is a maintenance dredging project as provided for In the Act;or b. the time for completion has been extended to a specified date more than three years, but less than five years,from the date of issuance. If this Order is Intended to be valid I&more than three years,the extension date and the special circumstances warranting the extended time period are set forth as a special condition In this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to thrice years each upon application to the Issuing authority at least 30 days prior to the expiration elate of the Order, 6. Any fill used in connection with this project shall be clean fill, Any fill shall contain no trash, refuse, rubbish,or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper, ,,ardboard, pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the foregoing. 7. This Order Is not final until all administrative appeal periods from this Order have elapsad, or If such an appeal has been taken, until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Order has become final and then has been recorded in the Registry of Deeds or the Land Court for the district in which the land Is located,within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. In the case of the registered land, the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done.The recording information shall be submitted to this Conservation Commission on the form at the end of this Order, which form must be stamped by the Registry of Deeds, prior to the commencement of work. 9. A sign shall be displayed at the site not less then two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection" [or, "MassDEP"] 3-4747 "File Number SE —" wpakrm5.doc• rev.2/27108 Semstable.revised all V2008 Perya d of 10 t r 08/05/2008 09:51 508-548-9672 HOLMES AND MCGRATH PAGE 05 Massachusetts Department of Environmental Protection H Bureau of Resource Protection - Wetlands MassDE� File Number: WPA Form 5 -- Order of Conditions SE3-_4747 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 toy§ 237-14 Town of Barnstable Code _ C. General Conditions Under Massachusetts Wetlands Protection Act 10. Where the Department of Environmental Protection is requested to issue a Supersedir g Order, the Conservation Commission shall be a party to all agency proceedings and hearing, before MassDEP. 11. Upon completion of the work described herein,the applicant shall submit a Request fo,Certificate of Compliance (WPA Form 8A)to the Conservation Commission. 12. The work shall conform to the plans and special conditions referenced in this order. 13. Any change to the plans identified in Condition#12 above shall require the applicant tc.Inquire of the Conservation Commission In writing whether the change is significant enough to require the filing of a new Notice of Intent. 14. The Agent or members of the Conservation Commission and the Department of Envircnmental Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours to evaluate compliance with the conditions stated in this Order, and may require the submittal of any data deemed necessary by the Conservation Commission or Department for that evalUation. 15, This Order of Conditions shall apply to any successor in interest or successor in contrci of the property subject to this Order and to any contractor or other person performing work conditioned by this Order. 16. Prior to the start of work, and if the project Involves work adjacent to a Bordering Vegetated Wetland, the boundary of the wetland in the vicinity of the proposed work'area shall be marked try wooden stakes or flagging. Once in place, the wetland boundary markers shall be maintained until a Certificate of Compliance has been issued by the Conservation Commission. 17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully stabilized with vegetation or other means. At no time shall sediments be deposited In a wetland or water body. During construction,the applicant or his/her designee shall inspect the!erosion controls on a daily basis and shall remove accumulated sediments as needed. The applicant shall immediately control any erosion problems that occur at the site and shall also Immediately notifl the Conservation Commission,which reserves the right to require additional erosion and/or damage prevention controls it may deem necessary. Sedimentation barriers shall serve as the limit of work unlE:ss E.nother limit of work line has been approved by this Order. 18. The work associated with this Order is(1)[] Is not(2)❑subject to the Massachusetts Stormwater Policy Standards. If the work is subject to the Stormwater Policy, the following conditions apply to this work and are Incorporated into this Order: a) No work, including site preparation, land disturbance, construction and redevelopment, shall commence unless and until the construction period pollution prevention and erosion and sedimentation control plan required by Stormwater Standard 8 is approved in writing by the issuing authority. Until the site Is fully stabilized, construction period erosion, sedimentation and pollution control measures and best management practices(BMPs)shall be implemented in aco)rdance with the construction period pollution prevention and erosion and sedimentation control plan, and if applicable, the Stormwater Pollution Plan required by the National Discharge Elimination System Construction General Permit. wpafonS.0oo- rev.2/27l08 BBmeleble rawsed4/11/2000 Page 5 of 10 08/05/2008 09:51 508-548-9672 HOLMES AND MCGRATH PAGE 06 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands MassDEP File Number: WPA Form 5 — Order of Conditions SE3.• 4747 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code C. General Conditions Under Massachusetts Wetlands Protection Act 1cont.) b) No stormwater runoff may be discharged to the post-constructlon stormwater BMPs until written approval is received from the issuing authority. To request written approval, the follow ng must be submitted: Illicit discharge compliance statement required by Stormwater Standard 10 and as-built plans signed and stamped by a registered professional engineer certifying the:site Is fa;lly stabilized; all construction period stormwater BMPs and any illicit discharges to the stormwater management system have been removed; and all post-construction stormwater BMPs were: installed in accordance with the plans (Including all planting plans)approved by the Issuing authority, and have:been inspected to ensure they are not damaged and will function properly. c) Prior to requesting a Certificate of Compliance, the responsible party(defined'in Gneral Condition 18(e))shall submit to the issuing authority an Operation and Maintenance(G & M) Compliance Statement for the Stormwater BMPs.This Statement shall identify the responsible party for Implementing the Operation and Maintenance Plan and also state that: 1. "Future responsible parties shall be notified in writing of their continuing legal responsibility to operate and maintain the stormwater management BMPs and Implement the Pollution Prevention Plan; and 2. The Operation and Maintenance Plan for the stormwater BMPs Is complete and will be implemented upon receipt of the Certificate." d) Post-construction pollution prevention and source control shall be implemented in :accordance with the long-term pollution prevention plan section of the approved Stormwater P pp Re on;and if p r applicable,the Stormwater Pollution Prevention Plan required by the National Discharge Elimination System Multi-Sector General Permit. e) Unless and until another party accepts responsibility, the issuing authority shall presume that the responsible party for maintaining each BMP is the landowner of the property on wf filch the BMP is located. To overcome this presumption, the landowner of the property must submit to the issuing authority a legally binding agreement acceptable to the issuing authority evidencing that another entity has accepted responsibility for maintaining the BMP, and that the proposed responsible'party shall be treated as a permittee for purposes of implementing the requirements of Conditions 1Bif)through 18(k)with respect to that BMP. Any failure of the proposed responsible party to Implement the requirements of Conditions 18(o through 18(k)with respect to that BMP shall be a violation of the Order of Conditions or Certificate of Compliance. In the case of stormwater BMPs that are serving more than one tot, the legally binding agreement shall also identify the lots that will be .serviced by the stormwater BMPs. A plan and easement deed that grants the responsible party access to perform the required operation and maintenance must be submitted along with the legally binding agreement. f) The responsible party shall operate and maintain all stormwater BMPs in accordance with the design plans,the Operation and Maintenance Plan section of the approved Stormwater Report, and the Massachusetts Stormwater Handbook. g) The responsible party shall: 1. Maintain an operation and maintenance log for the last three years including inspections, repairs, replacement and disposal (for disposal the log shall indicate the type of material and the disposal location); 2. Make this log available to MassDEP and the Conservation Commission upon request; and 3.- Allow members and agents of the MassDEP and the Conservation Commission to enter and inspect the premises to evaluate and ensure that the responsible party compliers with the Operation and Maintenance requirements for each BMP set forth In the Operations and Maintenance Plan approved by the Issuing authority. h) All sediments or other contaminants removed from stormwater BMPs shall be disposed of in accordance with all applicable federal,state, and local laws and regulations. i) Illicit discharges to the stormwater management system as defined in 310 [,MR 10.04 are prohibited. wpa}armo.duc•,rov.2/27/0e 99rneteote ravWV4 d11112008 Page 8 of 10 08/05/2008 09:51 508-548-9672 HOLMES AND MCGRATH PAGE 07 Massachusetts Department of Environmental Protection -� Bureau of Resource Protection - Wetlands MassDEP File Number: WPA Form 5 - Order of Conditions SE3- 4747 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code C. General Conditions Under. Massachusetts Wetlands Protection Act (cont.) j) The stormwater management system approved in the Final Order of Conditions stall not be changed without the prior written approval of the issuing authority. Areas designated gis qualifying pervious areas for purpose of the Low Impact Site Design Credit shall not be altemd without the prior written approval of the Issuing authority. k) Access for maintenance of stormwater BMPs shall not be obstructed or blocked, Any fencing constructed,around stormwater BMPs shall include access gates. Fence(s)shall be at least six inches above grade to allow for wildlife passage. Special Conditions (if you Eneed more space for additional conditions, please attach a taxt document): i — D. Findings Under Municipal Wetlands Bylaw or Ordinance 1. Is a municipal wetlands bylaw or ordinance applicable? ® Yes ❑ No 2. The Barnstable hereby finds(check one that applies): Conservation Commission a. ❑ that the proposed work cannot be conditioned to meet the standards set forth In a municipal ordinance or bylaw specifically: § 237-1 to&237-14 Town of Barnstable Code 1.Municipal Ordinance or Bylaw z.GltaGon Therefore,work on this project may not go forward unless and until a revised Nlotic4;of Intent is submitted which provides measures which are adequate to meet these standards, and a final Order of Conditions Is issued. b. ® that the following additional conditions are necessary to comply with a municipal ordinance or bylaw: 237-1 to §237-14 Town of Barnstable Code 1.Municipal Ordlnance or Bylaw 2 CltatHm 3. The Commission orders that all work shall be performed in accordance with the following conditions and with the Notice of Intent referenced above, To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intelit, the conditions shall control. The special conditions relating to municipal ordinance or bylaw are as follows (if you need more space for additional conditions, attach a text document): See pp. 7.1 and 7.2 wpefono5.d0e• mv.2/27/0e esmafable reWsed 4111=9 page 7 of 10 _ 3 oFtHE T Town of Barnstable Regulatory Services yBA MASS E. . � Thomas F. Geiler,Director f10)M � Building Division Tom Perry, Building Commissioner 20.0 Main Street,. Hyannis, MA 02601, OH-ice: 508-862-4038 Fax: 508-790-6230 October 3, 2008 Philip Miller Miller Starbuck Construction, PO Box 726 Falmouth, MA 02541 RI:: 1524-Main Street, Cotuit Map: 017 Parcel: 014 Application 11200804183, #200804184 Dear Mr. Miller, This letter is to follow upon the above referenced applications submitted to do work at the above referenced address. Unfortunately, the applications cannot be approved at this time because of incomplete construction documents and the fact that the design does not meet the building code requirements for the flood zone in which it is located. If you decide you would like to proceed with the project,,you must first reapply for a building permit. if this office can be of any further assistance please do not hesitate to call. I may be reached at (508) 862-4033: Sincerely, Robert McKechnie Local Inspector � i P l U 4/ -E;w►\ i k jA �. ��-(� .�- �- �-- `�i� - %�``� , �� G� � � � �� � t, y Town of Barnstable oFtHE ro,,, Regulatory Services P� ~ o� Thomas F.Geiler',Director BARNSTABLE, # Building Division 9 MASS. g 039. �m Tom Perry, Building Commissioner `br�D �p 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Y Office: 508-862-4038 Fax:' 508-790-6230 PROCEDURES FOR A DEMOLITION PERMIT 1.. `1`he follo ng de ments, located at 200 Main Street, must sign off on the permit application: nservation Commission: available from 8:30-9:30 AM or 3:30-4:30 PM Health Department: available from 8:30-9:30 AM or 3:30-4:30 PM . Tax Coll, Tr rer istoric Preservation Commission .2. Historic District Commission, 200 Main Street, approval required prior to construction/demolition for any properties located in a Historic District: [iOld Kings Highway Historic District(north of the Mid Cape.Highway) ❑Hyarinis Main Street Waterfront Historic District(See map for boundaries) 3. ❑Specify on.pe rt�where demolition debris is to be disposed of 4. Certi n that all utilities are shut off is required. lectri ❑ arnstable Engineering if on Town Sewer (no certification needed if on-site septic system) L tt,r referen ' g AQ06 submission for commercial projects azardo aterials results for commercial projects 5. orkers Compensation Insurance Affidavit form must be submitted if more than one person will be involv<ie work. 6. rowner must sign Property Owner Letter of Permission 7• ❑Fee to be paid. Note: Dumpsters with a capacity of 6 yards or greater require a permit from the Fire Department having jurisdiction pursuant to 527 CMR 34 I_ ,T Town of Barnstable Regulatory.Services Thomas F.Geiler,Director Building Division Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.banist2ble.ma.us 'Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: flu s T /h*^.t m 7u s T Map/Parcel: - O 7 7' Project Address *Av Jr-� 67r'• Builder: Atlle/- S7 e-� The following items were noted on reviewing: y 144e, . U� tf(,N tiEf�S ?o ilCFr�T � bui��yltEivz� ©F 1/ Za ye eo,vs7�uc770AJ. l�ouN11/►?-T�o,�J %GIN ^ N�`2�s 70 a l 4'sotx- 3 iu6 Marc-tee tf -'r-a fPC—c1F wiivA CObe j6C A;AW CA(0 c) CS &rTeC7- NAz er fl-f 7-Fr-7- 70 61ff-lfrd�,mJ L C�¢t��oat1 GU#OGE C-?.R c G7'C4 2C 1U U-C7- C-�T � fpUd) 4 ZP.,Ve Reviewed by: Date: Q:Forms:Plnrvw 1.;9 9124/-Q')08 16: 49 FAX 6174399556 RUBIN & RUDHAN f j 001/002 'r7s■ � ) ■ FACSIMILE RUBZNAn TRANSMITTAL FORM RUDMANttP ir Attorneys at Law T; 617.330.7000 F: 617.330.7550 50 Rowes Wharf, Boston,MA 02110 FROM: Glenn A. Wood DATE: 9/24/2008 RECEIVING PARTY NAME: RECEIVING PARTY RECEIVING PARTY FAX TELEPHONE #: #: Robert McKechnie 508-790-6230 Client#: Matter#: Pages to follow: 2 Note, Ir you have a question or problem regarding this transmission, please call the Rubin and Rudman Copy Center at(617)330-7053 Original will follow: No MESSAGE: Hi Bob: I will cafl you at 8 am tomorrow to discuss the attached matter. Thanks_ Glenn w: (617) 330-7016 c: (617) 816-4188 "THIS FACSIMILE TRANSMISSION IS INTENDED SOLELY FOR THE USE OF THE SPECIFIC INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED,CONFIDENTIAL,AND EXEMPT FROM DISCLOSURE. If you are not the intended recipient or the employee or agent responsible for delivering the transmission to the intended recipient,you are hereby notified that any disclosure,distribution,dissemination,copying,use or the taking of any action based on the contents of this transmission is strictly prohibited. If you have received this communication in error,please notify us immediately by telephone number(collect)and return the original message to us via the U.S.Postal Service. Thank you.— Disclosure Under IRS Circular 230: To ensure compliance wilh requirements recently imposed by The IRS,we inform you that any tax advice contained In this communication,including any attachments,was not intended or written to be used,and cannot be used,for the purpose of avoiding federal tax related penalties or prornoting.marketing or recommending to another party any tax related rnatters addressed herein. 09j24/?008 16:49 FAX 6174399556 RUBIN & RUDMdAN 002/002 Town of Barnstable Regulatory Services. _ ,vuux • was 1�.Gtner,Direector Building MyWoia Thomas Terry,CBO,RuBding Cbiiaba�oner 200 Mam Street, Hyamms,MA MW l www.tovm.barnsta bisma.us "Office: 508-862-4038 Pax: 508-790-6230 PLAN REVM ; Owner. nI45w�: beh.f-Ks" 7,w,,.sr Map/paruez: - D / 7 O/� Project Add ess 15-11 AWA,-'rr,� Lei. Buildez- Alle/— Surda«/� The Mowing items were noted on reviewing: fE61y 06,"s 7b /lsld-,!!F if GL ��i �l�-ruzX m/C (/ �o/t��` �O�r/.S'•�'J�i.LCTlo�v• . Re . 3• �'�u��ar�e •�Q sow-cis - �viiv,� coDE ' 7��I i�o cl Ttpvi&ed by.-- Date- 9 tv oe COO PERMIT PAYMENT RECEIPT i TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET? 1 HYANNIS, MA 0A601 DATE.: ,08/22/08 ; `TIME: 13:44 -----------------TOTALS----------�= --,-- PERMIT°«$;•PAID y. fQ500 00 A41 TENOERED- �^ �- =250 00 '•; t AMT APPLIED:,, °`250 00 : CHANGE:...,, 7 S.`OOsr,° APPLICATION NUMBER 200804183 + PAYMENT METH: "`'-CHECK ° t PAYMENTlREF 20582 " 'tit ° PERMIT PAYMENT RECEIPT TOWN OF B'ARNS.TABLE BUILDING40EPARTMENT 200 MAIN f TREBT HYANNIS, A 02601 DATE: 08/22/08 ' TIME: 13:45 t ------------------ PERMIT $ PAID 150.00 AMT TENDERED: 150.00 AMT APPLIED: 150.00 CHANGE: .00 APPLICATION NUMBER: 200804184 PAYMENT METH: �'` CHECK PAYMENT REF: 20582 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel t "�" "' _ Applic �) Health Division Date Issued Conservation Division Application Fee (ifolil!!b Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Boards Historic - OKH _ Preservation/ Hyannis Project Street Address Z MA) r� S z Village v T Owner V AM U-c L-LA IZ-+' Address Telephone --x Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type oZ>I.4,NV&� Lot Size + Grandfathered: 0 Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family '❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑/No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl /❑Walkout ❑Other / Basement Finished Area (sq.ft.) �/A Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new vVNumber of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other _ Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No t _ Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑existing,Ll new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: l -Zoning Board of Appeals Authorization ❑ Appeal # Recorded, _u Commercial ❑Yes &,No If yes, site plan review# Current Use HOC, E-&1<7R, c �y� ,� Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name QA�4�S_) . Telephone Number • 5 `� -Iz Addressw� _t) ��.-late License # 3 4�y VAI ``10 ,NAA e):2 J Home Improvement Contractor# Worker's Compensation # csZ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATk - �-6 i 1 FOR OFFICIAL USE ONLY / PLICATION# f DATE ISSUED MAP/PARCEL NO. , } C4 �.. ; 'ADDRESS I VILLAGE i OWNER s � I.3 DATE OF INSPECTION: i } FOUNDATION , FRAME INSULATION - ' -- FIREPLACE ELECTRICAL: ROUGH FINAL j7 PLUMBING: ROUGH FINAL +'z GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT j 1 s ASSOCIATION PLAN NO. ir �. ` + TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map e:) Parcel 0 I -- Applicafibh- ) Health'Division; Date Issued Application Fee 'Conservation Division /' \_ 1 Planning Dept. Permit Fee k7� Date Definitive Plan Approved by Planning Board r Historic - OKH Preservation/Hyannis Project Street Address � '�2�} DiJI A ► r J S F Village c" '-Owner I:TA .t 1 r-� Ui:7 C r:', a _ i Address t_r-,r� A- -'r Telephone _ `' ' +- i. T-o M,4, C�.2_11 c) Permit Request 1 fr ► sa�j �."",,cam. }— � 1 t v�� �;,,:'.---y --,,�,\�'� •h . Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay ' .Project Valuation h-rn T ti t Consrucon ype,ntoora reA � - , )CONrle Ti_I'� Lot Size 10 Ar e c -E- Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation: . Dwelling Type: Single Family ❑ Two Family D Multi-Family(# units) Age of Existing Structure 1 q n/n Hist ric,House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other I ' //A& Basement Finished Area(sq.ft.) JA Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new - Half: existing new Number of Bedrooms: existing new ; Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑ Oil 0 Electric ❑Other n`1A 1' Central Air: ''❑-Yes ❑ No 'Fireplaces: Existing New Existing wood/coal stove: 0 Yes ❑ No Detached.garage. ❑ existing '❑ new size Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: U existing ❑ new size _Shed: ❑existing ❑ new size _ Other:: rt, ,Zoning Board of Appeals Authorization ❑ Appeal # Recorded, Commercial ❑Yes 0 No If yes, site plan review# Current Use d i Q k�n-y ��,o A Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name .M S L I C Ste` �� �c- !� C ��1 ) - Telephone Number 0 F Address4 License # !- � - ; Al Home Improyement.ContraY ctor# 11' ' r w ia35 1 Worker's Compensation # 0 -1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO -420 oP N , SIGNATURE r A !� DATE - -OR' FOR OFFICIAL USE ONLY OPLICATION# DATE ISSUED - MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 4 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, AM 02111 www.m"ass.gov/dia Workers' Compensation.Insurance Affidavit: Builders/Contractors/EIectricians/P.lumbers Applicant Information Please Print Legibly Name (BusinesOorgmizatidnllndividuaI)- I-A ��i J—:;-� �'i�� or l�U T�O� RCC • Address: � C� �c"� �'1(n ' • City/State/Zip: 1 one.#: Are on an employer? Check the appropriate"-fox: 'type of project(required): 414_ ;`I am a general contractor and I 1. I am a employer with I. * eve hired the Sub-contractors 6 New construction employers(full and/or part-time)_ 7. Retnodelin 2 am a'sole proprietor or p ❑ I artner- listed on the attached sheet 0 g ship and have no employees 'These nib-contractors have � g- �Demolition v r employees and have workers' working for mo in any capacity. 9. []Building addition D.-workers' m nrrancc com ur p.uicranoe �� S. We are a corporation and its 10_❑Electrical repairs or additions required] officers have exercised their 11.0 Plumbing repairs or additions 3.0 Z am a homeowner doing all work myself[No workers' comp, right of exemption per MGL 12.0 gDofrepairs incnrancc requned_]t c. 152, §1(4), and we hays no -13.0 Other - - employees.[No workers' comp.insurance required-] *Any applicant tbai cbmia box#1 must also fM out tint station bclow showing thcir warkaa'coropmsation policy inforrration_ t Homcowncrs who submit this affidavit indicating they arc doing all work wind thin hire outside cantr actors must submit a new affidavit indicating such_ �.tmtractors that ebcck this box must attacbcd an additional sbmt showing the name of the sub-c-ootractnaa and statn whether or not those cntitirs bave enTployers. If the sub-contractors havo M-nployces,thry must providb their workc,,comp.policy nranba. I am an employer that is providing workers'compensation insurance for my employees. Below is the pa cy and jab site information Tncn-ance Company Name: -S v e ' S ►2 n P �- CASJeNL 1"1 Policy#or Self-ins. Lie. #: t,0 C- „ �'O O 21 S� Expiration D ate:3- CG Job Site Address: I`�Z�' ���t f-1 S i - City/State/Zip: ��t t� �A Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failurc to sccurc coverage as reT li mi under Section 25A of MGL c. 152 can lead to the imposition of c rirnirial penalties of a fines 4 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 statcmerit may be forwarded to the Offa-cc`of Juvcsti ations of the DIA for insinancc coves e verification. Ido hereby certify under the pains•andpenaldas'ofperjury that the information provided above is true and correct. r Phone# D's� �-- OfTcW use only. Do not write in this area, to be completed by city or town offcclaL City or Town: Perrnit/Liccum# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Towu Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other Phone Contact Person: #: Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees: Pursuant to this statate, an employee is defined as "._.every person in the service of another under any contact 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 of the forcgoing.engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other Iegal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides thcrcin, 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 reneve2l of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has notprodumd•acceptabli'idence of compliance withh'!tthhe insurance coverage.required." Additionally,MGL ohapter 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 in--urance , requircmcnfs of this cbaptcr 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 mib-canfraetor(s)name(s), address(cs) and phone numbers) along with their ecrEfieate(s) of byurance. Limited Liability Coropauies(LLC) or Limited Liability Partnerships(LLP)with no cmployces other than the members or partners, arc not required to carry workers' compensation inmrrance. If an LLC or LLP does have ;mployecs, a policy is required Be advised that this affidavit may be submitted to the Department of Industrial 6Lccidr,nts for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should )e returned to the city or town that the application for the perEDit or license is being requested,not the Department of ndustrial Accidents. Should you have any questions regarding the law or if you arc required to obtain a workers' :ompensation policy,please call the Department at the number listed below. Self-insured companies should enter their cif inrr,rrncc license number on the appropriate line. :ity or Towii Officials 'lease be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom ,f the affidavit for you to fill out in the event the Office of Investigations has to coatact,you regarding the applicant Tease be sure to fill in the permit/licensc number which will be used as a rcfcrence number. In addition, an applicant hat mvst submit multiple penmi-tllicense applications in any given year, need only submit onp affidavit indicating current �olicy information(ifnecessary) and under`Job Site Address" the applicant should writz"all locations in (city or )wn)."A copy of the a$davit that has bccn officially stamped or marked by the city or town may be provided to the pplirant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each ear.Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture _c. a dog liccnse or permit to born leaves etc.) said person is NOT required to complete this affidavit he Office of Investigations would hkc to thank you in advance for your cooperation and should you have any questions, [ease do not hesitate to give us a call. ,e D,-p=, tm=Vs address, tcicphonc•and fax number: 4 � \ ' fTlitlC6mmonwWth of Massachus is u� it`f1 -i ► Dcpaitment of lndustdal Accidents Office of Investigations 600 Washington Stmefi Boston, MA 02111 TeI. # 617-727-490.0 ext 4-06 cr 1-S77-MASSAFE- Fax# 617-727-7745 ;d 11-22-06 www.mass.gov/dia +T.t ACORDM CERTIFICATE OF LIABILITY INSURANCE 06/06/2 a' PRODUCER (781)447-5531 FAX (781)447-7230 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Mason & Mason Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 458 'South Ave. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Whitman, MA 02382 Gwen Vosburgh INSURERS AFFORDING COVERAGE NAIC# INSURED Miller Starbuck Construction, Inc. INSURERA: Mountain Valley Indemnity Co. ' PO Box 726 INSURER B: Star Insurance 000204 Falmouth, MA 02541 INSURERC: 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 ADUL TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY 328002915602 12/01/2007 12/01/2008 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000 CLAIMS MADE a OCCUR PREMISES IF, MED EXP(Any one person) $ 5,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 ` POUCYF_j PRO- LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-0WNED AUTOS (Per accident) - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO ..- OTHER THAN EA ACC $ r AUTO ONLY: + AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WCO220915 03/27/2008 03/27/2009 WCSTATU- OTH- EMPLOYERS'LIABILITY E B ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? OFFICER OF CORP IS E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under SPECIAL PROVISIONS below ' INCLUDED - E.L.DISEASE-POLICY LIMIT $ 500,000 S OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Town of Barnstable BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 200 Main Street OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE [David H Mason ACORD 25(2001/08) ©ACORD CORPORATION.1988 PDF created with pdfFactory trial version www.pdffactory.com IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. 2 ACORD 25(2001/08) PDF created with pdfFactory trial version www.pdffactory.com . Town of Barnstable BABNHrABLB, "6 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 Fak: 508-790-6230 Property Owner p ty O er Must Complete and Sign This Section If Using A Builder I, MY i llm 1A 6 C1`t-A r-- ,as of the subject property hereby authorize CC>AS'T.,to act on my behalf, a m in all matters relative to work authorized by this building permit application for: s S-r. 0D 1 v x -c MA (Address of Job) Signature of Owner Date Print Name Q:Forms:buildingpermits/express Revised 123107 i in a lams an an ar s • Boar o u g gu .One Ashburton Place - Room 1301 ' Boston, Massachusetts 02108 Home Improvement Contractor Registration Registration: 110373 _ Type: Private Corporation Expiration; 10/20/2008 Tr# 133422 MILLER STARBUCK CONSTRUCTION, !NC PHILIP MILLER,JR. P.O. BOX 726 j EAST FALMOUTH, MA 02541 Update Address and return card.Mark reason for change. Address ❑ Renewal Employment r Lost Card 0-DPS-CAt Q 60M-07/7 PC8480 • . �/ie �ovxmaoncvea� a�✓�aaac/auael�a , Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return too Registration:. 110373 Board of Building Regulations and Standards One Ashburton Place Rm 1301 Expiration 1'0/20/2008 Tr# 133422 Boston,Ma.02108 Type: Private Corporation MILLER STARBUCK CONSTRUCTION,INC. PHILIP MILLER,JR 40 MILL POND WAY a EAST FALMOUTH,14'02536 Administrator Not valid without signature } i Boar o Building Regula ons and Standards One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Construction Supervisor License License CS: 43338 Restriction: 00 Birthdate: 3/14/1953 Expiration: 3/14/2009 Tr# 9478 PHILIP M MILLER PO BOX 726 FALMOUTH, MA 02541 Update Address and return card.Mark reason for change. ,CA1 0 5OM-05/06-PC5490 Address Renewal F-1 Lost Card l a 3 rn Reguun�and Standards to 01 g Construction Supervisor License Ucense: CS 43338 Expir`atit�n`: 311 4I2009 Tr# 94� ' Restnotion: 00 pHILIP M MILLER PO BOX 726 FALMOUTH,MA 02541 Commissioner w August 5, 2008 t Town of Barnstable Building Department RE: 1524 Main Street Cotuit,MA 02635 McCourt Residence—Beach Cabana To Whom It May Concern: This letter shall certify that the existing water line as well as the electric line to the Beach Cabana at the above mentioned address have been disconnected from the existing structure and capped. Should you have any questions or concerns,please do not hesitate to contact either of the below, respectively. Sincerely, William ada Kenneth Du e 508.564.2536 508.250.2763 Licensed Electrician Master Plumber MA LIC: 28754E MA LIC: 11012 i L TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ` - . Map 1 Parcel � 2ppliocafil�bS. Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee _(S 29 OS-0- • OD lid Date Definitive Plan Approved by Planning Board o K ��Zz113 Historic - OKH _ Preservation / Hyannis Project Street Address 15a Y MOi i 1N 2rp_L M41 V J CDC Village C U4t. ,i-f' I m b Owner �IJ IL(kim C_R 411 N TX Address`�a M`Ca�rt G2s C Telephone SOf 1 30 Permit Request Nwn, �&,, govd 'ojor WeW+Ioe, to ` � -. 4-="for C,ell, 1;4 V\J 11 4. -1 .11111=0 JW Square feet: 1st floor: existinglt'19 proposed 39L46 2nd floor: existing397Y proposed 122e Total new © Zoning District Flood Plain Groundwater Overlay Project Valuation 5°5 ' �^�°`� Construction Type WOIJ �a� /V\1 a v C7.1 .,� Lot Size y , Gcr�s Grandfathered: ❑Yes No If yes, attach supporting € cunae�tation. Dwelling Type: Single Family fB Two Family ❑ Multi-Family (# units) "!I F^^A ti'1 Age of Existing Structure 19 Historic House: ®Yes ❑ No On Old King"s ighway�.,,❑Yes 3/No (wmi Li•�Q� Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area sft.( q. ) a Basement Unfinished Area (sq.ft) LJ l �, Q Number of Baths: Full: existing new o Half: existing Number of Bedrooms: existing 7 new J Total Room Count (not including baths): existing aQ new c First Floor Room Count Heat Type and Fuel: X Gas ❑ Oil ❑ Electric ❑ Other Central Air: XYes ❑ No Fireplaces: Existing New C Existing wood/coal stove: ❑Yes '4 No Detached garage: ❑existing ❑ new size 0 Pool: ❑ existing ❑ new size 0 Barn: ❑ existing ❑ new size O Attached garage: ❑ existing ❑ new size 0 Shed: ❑ existing ❑ new size 6 Other: Zoning Board of Appeals/Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes No If yes, site plan review # Current Use V�s f e �i}�°� _ _ ____ -Proposed Use Ps? APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ` i-aw Tet V&,w Telephone Number 7�'l-8r10 - SSAl Address KV c I a c• License # C5 F-A D T?3&'S l r-0x rz-oAD Home Improvement Contractor# 116511 InH4 Lil.(gn� MA- 0 2-45-1 Worker's Compensation # 11,eW(-3 18$1 K ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 1300We A►�D u_ 2A►�.5 V ("Prii ii� 2DI ACPr�-�►�i /L g v . 36✓�E M�9 1S3Z SIGNATURE DATE LZtj FOR OFFICIAL USE ONLY i -APPLICATION# ~' L DATE ISSUED MAR/PARCEL NO. k - ADDRESS VILLAGE OWNER '. r - DATE OF INSPECTION: r ��_FOUNDATI.ON��,:�>n��:-:��{r.-r-¢�;4�t;_�,�. __ - • 'FRAME `F rINSULATION:< /3,eai�® IV FIREPLACE ELECTRICAL: ROUGH FINAL 1 PLUMBING: ROUGH FINAL GAS: ROUGH FINAL--jr- FINAL BUILDING - DATE CLOSED OUT. . Y e ASSOCIATION PLAN NO. �` The Commonwealth of Massachusetts Department of IndustrialAccidents ` 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): Kew&i-( V D0V cd+s s a3C-n 114 C Address: (I f_nx 2ti J10 City/State/Zip: 4JftV qM 1 Phone#: �, Tl 0-,551 Are you an employer?Check the appropriate box: Type of project(required): 1.CAI am a employer with 50 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. E.Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp. insurance? 9. Building addition required.] . 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their l 1.❑Plumbing repairs or additions i myself. [No workers' comp. right of exemption per MGL 12.❑Roof 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. lContractors 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: s lGl� Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: 1,Sa-`i &VAi:s 5 T. City/State/Zip: CO—I yif MH" 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$1,50.0.00 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 mi ce coverage verification. I do hereby certi er t p i and n of perjury that the information provided abo ' tru and correct w Si ature: Date: 22' Phone#: - t 0d—53'9 f 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#: I < 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 of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the 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 Liabiliy 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 permitilicense 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, lease do not hesitate to give us a call. P � 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 1-877-MASWE Fax# 617-727-7749 Revised 4-24-07 www.mass.govfdia � r CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY) 7A2/2013 '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 Construction NAME: Eastern Insurance Group LLC IPHONE . (508)651-7700 ac No, 233 West Central Street EMAIL ADDRESS: r { INSURERS AFFORDING COVERAGE NAIC# Natick MA 01760 INSURERA..Union Insurance Co INSURED INSURER B Acadia Insurance Company 31325 Kenneth Vona Construction Inc. INSURER C: it Fox Road INSURERD:EastGuard 14702 INSURER E: Waltham MA 02451 INSURERF: COVERAGES CERTIFICATE NUMBERklaster 2013 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 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY - DAMAGE PREMISESPREMISES Ea occurrence) $ 300,000 A CLAIMS-MADE Fx1 OCCUR CPA0296259-14- /1/2013 /1/2014 MED EXP(Any one person) $ 15,000 PERSONAL 8ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X JECT PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED L0300197-14 /1/2013. /1/2014 AUTOS M AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS AUTOS Per accident) $ Medical payments $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE r $ DED I I RETENTION $ D WORKERS COMPENSATION X WC STATU- I IOTH- AND EMPLOYERS'LIABILITY y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED' [EN N/A (Mandatory in NH) WC318878 0/4/2012 0/4/2013 E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE .EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN KENNETH VONA CONSTRUCTION INC ACCORDANCE WITH THE POLICY PROVISIONS. 11 FOX ROAD WALTHAM, MA' 02451 AUTHORIZED REPRESENTATIVE Rosemary Fulham/BC4j ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INSf125i�n�nn.S�nt Tha anion nmmm nn`I Innn nrn rnnicfarnrl mor4c of at%non �y. Town o'f Barnstable Regulatory Services MAWS $ . Thomas F.Geiler;Director.. ► Buildin Division' Tom Perry,BaDding Commissioner`: 200 Main Steeei,Hyannis,MA'0260-1 www town.barnstable,ma;us Office:; 508-862-403 8 Fax:' 50877910-62,3 0. Property :wner Must �YO Complete`°and Sign This Section If UsiLig A Builder l! Vat� �� r, 4• 1. . Nit as Ownd of the subject p.toperty heLeb authoriie '�� : ., r. • y to;act on my bed. in all:matters.selatve to work autho.6zed by this building p==it YVI (Address of job). **Pool fences.and alarms are the responsibility.of the a'pplicarit. Pools .are not to b-e fi11ed or utilized before fence is installed.and all final inspections are performed'and accepted: Sigm :of Owner Signature of Applicant' P,nnt.Name T��US E Print Name f 71 Date le MU MSIONP00I.r"62012 ` Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction Supen-isor 1 &2 Family License: CSFA-057385 bz KENNETH B VON t �� 11 FOX RD r WALTHAM MA7024� . `J.4,.,. Expiration ' commissioner 07/19/2015 Restricted-One-and hvo-family dwellings or any accessory building thereto, nespectye of size. Failure to possess a current edition of the'Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: w,w.Mass.Gov/DPS f OfMIT fice of/Cfonsumerfi'nirs& a"§inessegutnion License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to Registration. 116519 Type: Office of Consumer Affairs and Business Regulation Expiration 6/22%2014 Private Corporation 10 Park Plaza-Suite$170 �' r n• Boston,MA 02116 KEI NETH VON_A CONST INC . } rid u KENNETH VONAs', 11 FOX R.D. ,T ;. � ;� _ WALTHAM,MA 02451 — Undersea etary Not valid without signature REScheck Software Version 4.4.4 ir Iry Compliance Certificate Project Title: MCCourt Main House Additions and Renovations Energy Code: 2009 IECC Location: Cotuit, Massachusetts Construction Type: Single Family Project Type: Addition Conditioned Floor Area: 0 ft2 Heating Degree Days: 6137 Climate Zone: 5 Permit Date: Construction Site: Owner/Agent: Designer/Contractor: Cotuit,MA Shope Reno Wharton 18 Marshall St South Norwalk,CT 06854 203 852 7250 Compliance: 28.0%Better Than Code Maximum UA: 1558 Your UA: 1122 The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Envelope Assemblies Ceiling 1:Cathedral Ceiling 7,060 42.0 0.0 177 Wine Cellar Ceiling:Flat Ceiling or Scissor Truss 570 35.0 0.0 18 Wall 1:Wood Frame, 16"o.c. 8,691 21.0 0.0 413 Window 1:Wood Frame:Double Pane with Low-E 1,149 0.230 264 SHGC:0.00 Door 1:Solid 67 0.340 23 Door 2:Glass 231 0.230 53 SHGC:0.00 Crawl space and Basement walls:Solid Concrete or Masonry:Interior Insulation 2,068 21.0 0.0 116 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 1,764 30.0 0.0 58 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 2009 IECC requirements in REScheck Version 4.4.4 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date Project Notes: REScheck provided by Wishing Well Energy consultants 203 253 4800 Project Title: MCCourt Main House Additions and Renovations Report date: 07/20/13 Data filename: C:\Documents and Settings\John.Russo\Desktop\RES\McCourt Main House.rck Page 1 of 8 REScheck Software Version 4.4.4 Inspection Checklist Requirements: 0.0% were addressed directly in the REScheck software Text in the"Comments/Assumptions"column is provided by the user in the REScheck Requirements screen-For each requirement,the user certifies that a code requirement will be met and how that is documented,or that an exception is being claimed.Where compliance is itemized in a separate table,a reference to that table is provided. 1 High Impact(Tier 1) 2----'Medium Impact(Tier 2) 3; Low Impact(Tier 3) ............................................................................:::.:::::................................_........ ................................................._................_:::.....:..:.............................................................._............................ Project Title: MCCourt Main House Additions and Renovations Report date: 07/20/13 Data filename: C:\Documents and Settings\John.Russo\Desktop\RES\McCourt Main House.rck Page 2 of 8 20091ECG Pre Ins eetion/Plan eview Plans Verified Field V�er�fed=. p y R' - Value Value Complies? CorriinentslAssumptions .t hK 103.2 Construction drawings and ❑Complies [PR1]' documentation demonstrate energy a �;❑Does Not Comply code compliance for the building \ „❑Not Observable envelope. �� _ , ❑Not Applicable 103.2, Construction drawings and 9� ❑Complies 403.7 documentation demonstrate energy "$ h xr❑Does Not Com I [PR3]' code compliance for lighting and p y mechanical systems.Systems serving r ❑Not Observable multiple dwelling units must ❑Not Applicable demonstrate compliance with theM commercial code. 4q3 6 " Heating and cooling equipment is Heating: Heating: !❑Complies [PR2J2 E sized per ACCA Manual S based on Btu/hr Btu/hr ❑Does Not Comply'. Toads er ACCA Manual J or other p Cooling: Cooling: ❑Not Observable approved methods. Btu/hr j Btu/hr ;❑Not Applicable s.4 i Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) Low Impact(Tier 3) Project Title: MCCourt Main House Additions and Renovations Report date: 07/20/13 Data filename: C:\Documents and Settings\John.Russo\Desktop\RES\McCourt Main House.rck Page 3 of 8 Fountlat� 2009 IECC ion Inspection' .` Comphe? 3 Comments/Assu pUoris . ' . ., ,x 303 2 1 ;A protective covering is installed to ❑Complies [FO11]� protect exposed exterior insulation ❑Does Not Comply and extends a minimum of 6 in.below. ❑Not Observable ;grade. ❑Not Applicable _ 403 8 Snow-and ice-melting system .❑complies 0,12] 21 controls installed. El Does Not Comply ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2°'Medium Impact(Tier 2) Low Impact(Tier Project Title: MCCourt Main House Additions and Renovations Report date: 07/20/13 Data filename: C:\Documents and Settings\John.Russo\Desktop\RES\McCourt Main House.rck Page 4 of 8 W4Ftra:.. Plans Verified Field Verified 2009 IECC Framing 1 Rough In Inspectwn � .• complies? Comments/Assumptions Value Value 402.1.1, Door U-factor. U- U- ;❑Complies See the Envelope Assemblies table for 402.3.4 ❑Does Not Comply values. [FR1]' ;❑Not Observable :(:]Not Applicable 402.1.1, Glazing U-factor(area-weighted U- U- ;❑Complies See the Envelope Assemblies table for 402.3.1, average). El Does Not Comply:values. 402.3.3, 402.5 �❑Not Observable [FR2]' ,❑Not Applicable �4F i 1 303.1.3 U-factors of fenestration products are ` " ❑Complies [FR4]' determined in accordance with the ❑Does Not Comply NFRC test procedure or taken from ❑Not Observable ;the default table. 3❑Not Applicable 402.3.5 Sunrooms enclosing conditioned U- U- ;❑Complies [FR8]' :space have a maximum fenestration :❑Does Not Comply: U-factor of 0.50 in Climate Zones 4-8. ❑Not Observable New glazing separating the sunroom from conditioned space must meet ;❑Not Applicable code requirements. 402.3.5 ;Sunrooms enclosing conditioned U- U- ;❑Complies [FR9]' space have a maximum skylight U- I❑Does Not Comply factor of 0.75 in Climate Zones 4-8. ;❑Not Observable j❑Not Applicable ❑Complies - — --- -- - 402.4.4 Fenestration that is not site built is [FR20]' listed and labeled as meeting Not Comply. AAMANVDMA/CSA 101/I.S.2/A440 or 55 ;has infiltration rates per NFRC 400 r ,,t El Not Observable p []Not Applicable that do not exceed code limits. 402 4 5 IC-rated recessed lighting fixtures "* < r' ❑Complies [FR16Jz ]sealed at housing/interior finish and z Q, ❑Does Not Comply', labeled to indicate 2.0 cfm leakage 75 Pa g ❑Not Observable ❑Not Applicable 403.2.1 Supply ducts in attics are insulated to R- R- ;❑Complies [FR12]' R-8.All other ducts in unconditioned R_ R I❑Does Not Comply spaces or outside the building ❑Not Observable envelope are insulated to R-6. ❑Not Applicable .. . . ....................................... 1 1 I 403.2.2 All joints and seams of air ducts,air Complies [FR13]' handlers,filter boxes,and building El Does Not Comply :cavities used as return ducts are 4,' ❑Not Observable u sealed. ❑ Pp Not Applicable 403.23 Building cavities are not used for as 11 ❑Complies [FR15]3 supply ducts. � ❑Does Not Comply ZINot Observable ❑Not Applicable _ 403 3 HVAC piping conveying fluids above R- R- ;❑Complies —_— [FR17]z i 105 IF or chilled fluids below 55 OF ❑Does Not Comply a, are insulated to R-3. ❑Not Observable ❑Not Applicable 4Q3 4 Circulating service hot water pipes are R- R- ;❑Complies j [FR18]2 `insulated to R-2. ' :❑ oes Comply: Not C I r, pY ❑Not Observable :❑Not Applicable L Automatic or gravity dampers are -� ❑Complies installed on all outdoor air intakes and `❑Does Not Comply exhausts. l ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) Medium Impact(Tier 2) 3'' Low Impact(Tier 3) Project Title: MCCourt Main House Additions and Renovations Report date: 07/20/13 Data filename: C:\Documents and Settings\John.Russo\Desktop\RES\McCourt Main House.rck Page 5 of 8 nsula 2009 IECC Itio s n In `ectton Plans verified Fteld V ' ertfietl a P„ ValueE �� Value Comphes�? :� CommentslAssumpttons 303 1- All installed insulation is labeled or the ❑Complies Ill., ? installed R-values provided. y ❑Does Not Comply' ❑Not Observable []Not Applicable 402.1.1, Floor insulation R-value. R- R- '❑Complies See the Envelope Assemblies table for 402.2.5, ❑ Wood. ;❑ Wood =❑Does Not Comply.values. [IN1]'6 ❑ Steel ❑ Steel t❑Not Observable 1❑Not Applicable 303.2, Floor insulation installed per sF ❑Complies 402.2.6 manufacturer's instructions,and in ❑Does Not Comply [IN2]' substantial contact with the underside . ❑Not Observable of the subfloor. []Not Applicable 402.1.1, :Wall insulation R-value.If this is a R- R- ;❑Complies See the Envelope Assemblies table for 402.2.4. mass wall with at least%of the wall ❑ Wood ;❑ Wood :❑Does Not Comply values. 402.2.5 insulation on the wall exterior,the [IN3]' exterior insulation requirement ❑ Mass mass ❑Not Observable applies. ❑ Steel ❑ Steel 3❑Not Applicable 303.2 Wall insulation is installed per y ❑Complies [IN4]' manufacturer's instructions. ;❑Does Not Comply' N❑ of Observable up .,xm `=a Not Applicable ; 402.2.11 Sunroom wall insulation has a R- R- ;❑Complies [INBJ' minimum R-value of R-13.New walls ❑Does Not Comply: PY separating the sunroom from :❑Not Observable conditioned space must meet code _ ❑Not Applicable requirements. 303.2 Sunroom wall insulation installed per 3 » ❑Complies [IN9]' manufacturer's Instructions. Yy1 y"y ❑Does Not Comply; PY; ❑Not Observable ❑Not Applicable _ 402.2.11 Sunroom ceiling minimum insulation R R- ❑Complies _ T [IN10]' R-value of R-19 in Climate Zones 1-4, !❑Does Not Comply: and R-24 in Climate Zones 5-8. !(:]Not Observable ...................................__................................................-......................................................._:................._. ._.. .__._;._.__._Y-_. ;ONot Applicable 303.2 :Sunroom ceiling insulation is installed �� ❑Co mplies [IN11]' per manufacturer's instructions. ❑Does Not Comply ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) ,.2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: MCCourt Main House Additions and Renovations Report date: 07/20/13 . Data filename: C:\Documents and Settings\John.Russo\Desktop\RES\McCourt Main House.rck Page 6 of 8 � Plans Ver fied Freld Uenfied 2009 IECC Final Inspection Prokvisions Value Complies?k' Comments/Assumptots - Value ' 402.1.1, Ceiling insulation R-value.Where>R R- R- "❑Complies See the Envel ope Assemblies table for 402.2.1, 30 is required,R-30 can be used if ❑ Wood j❑ Wood t❑Does Not Comply.values. 402.2.2 insulation is not compressed at eaves. ❑ Steel ❑ Steel ❑Not Observable [FI1]1 R-30 may be used for 500 ft2 or 2C% (whichever is less)where sufficient ;❑Not Applicable space is not available. _....... ... -..._............_.__................... __ ..................................................._.._..................._... ................................ 303.1.1.1, ;Ceiling insulation installed per ❑Complies 303.2 manufacturer's instructions.Blown '` 4 s ❑Does Not Comply [FI2]1 insulation marked every 300 ftz. '❑Not Observable ;QNotApplicable 402.2.3 Attic access hatch and door insulation R- R- ❑Complies [FI3]1 R-value of the adjacent assembly. '❑Does Not Comply ❑Not Observable ❑Not Applicable -� 402.4.2, Building envelope tightness verified ACH 50= ACH 50= ❑Complies 402.4.2.1 by blower door test result of<7 ACH ❑Does Not Comply: (FI1711 at 50 Pa.This requirement may instead be met via visual inspection, `QNot Observable in which case verification may need to Not Applicable occur during Insulation Inspection. 402 4 3 Wood burning fireplaces have 3 — wo ❑Complies 18]2, gasketed doors and outdoor " ❑Does Not Comply combustion air. p y ❑Not Observable El Not Applicable 403.2.2 Post construction duct tightness test cfm cfm -- ;❑Complies [Fl4]1 result of 8 cfm to outdoors,or 12 cfm '❑Does Not Comply across systems.Or,rough-in test ;❑Not Observable result of 6 cfm across systems or 4 ; cfm without air handler.Rough-in test ❑Not Applicable verification may need to occur during Framing Inspection. 403 1 1 Programmable thermostats installed " `❑Complies [F19 ] F on forced air furnaces. t El Does Not Comply ❑Not Observable []Not Applicable 403 1 2 Heat pump thermostat installed on ❑Complies [FI10Jz heat pumps. K� ❑Does Not Comply. [I Not Observable _.... 31, �liQr 's e QNotApplicable 403 4 Circulating service hot water systems ❑Complies [F,I 1,11]2 have automatic or accessible manuals ❑Does Not Comply. controls. " QNot Observable ❑Not Applicable 4019 1" !Readily accessible switch on heaters ❑Complies [FI12]3 for swimming pools. dz" El Does Not Comply' QNot Observable m '❑Not Applicable 403.9.2 Timer switches on pool heaters and ❑Complies [FI19]3 pumps are present. El Does Not Comply: ❑Not Observable ......... ........................................................_ _ ... j❑Not Applicable 403 9 3 ❑Com lies............ Heated swimming pools have a cover. r , p (FI20f3 Covers on pools heated over 90 OF ❑Does Not Comply ,are insulated to R-12. , ❑Not Observable ,....:.. „s 1❑Not Applicable ��..., 404.1 50%of lamps in permanent fixtures El Complies [FI6]1 are high efficacy lamps. z '❑Does Not Comply : E �r ❑Not Observable ,, ❑Not Applicable ___.._.`------...............1 1 High Impact(Tier 1) 2,�:]Medium Impact(Tier .3..:l Low Impact(Tier 3) Project Title: MCCourt Main House Additions and Renovations Report date: 07/20/13 Data filename: C:\Documents and Settings\John.Russo\Desktop\RES\McCourt Main House.rck Page 7 of 8 I?tans Verified Field Verified ' _` ' 206 IECC Final Inspection Provisions : Com ties? CommentslAssum bons Value' Values p --. _- P � , 40ii 3 Compliance certificate posted. ❑Complies [ l < []Does Not Comply ❑Not Observable ❑Not Applicable _ 303 3 Manufacturer manuals for mechanical ❑Complies [FI18]3 and water heating equipment have ��. ❑Does Not Comply: i been provided. * ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact( 1) 2;Medium Impact(Tier 2) 3' Low Impact(Tier 3) Project Title: MCCourt Main House Addictions and Renovations Report date: 07/20/13 Data filename: C:\Documents and Settings\John.Russo\Desktop\RES\McCourt Main House.rck Page 8 of 8 2009 IECC Energy Efficiency Certificate MW I Wall 21.00 Floor 30.00 Ceiling I Roof 42.00 Ductwork(unconditioned spaces): ®C• 9 . Window 0.23 Door 0.23 Heating System: Cooling System: Water Heater: Name: Date: Comments: I � fy 4S.�j H61 MIWAir " t� s(c 4,<,4 i l ' f .� i�.. � �• 1 4 a � � _ 1 _ � t � 5 � • � i i • ` 1 � � j 1t � ; _ — __ I L TOWN OF BARNSTABLE 2013 3JS 22 At"I 7. 50 N EALCASS 1 NC �� A• 200 Adams St Braintree Ma 02184 �-is1M- 781-794-1432 Attention: Barnstable Building Division From: NEAL CASS Fax: (508) 790-6230 Date: August 21,2013 Phone: ( ) Phone: (781)794-1432 EXT: Comment: Your copy of Notification to the MA DEP for Fax: (781)794-1434 asbestos removal being done in your town. #of Pages, (including cover): Please see copy of the notification for asbestos removal being done on August 26, 2013 The address of the asbestos abatement is: 1524 Main Street,Cotuit Please call our firm with any questions. Thank.you. Commonwealth of Massachusetts ■ 100183185 Asbestos Notification Form ANF-001 Decal Number ImpoMen fining out p taut. A. Asbestos Abatement Description When forms onthe computer,use 1. a. Is this facility fee exempt-city, town,district, municipal housing authority, owner-occupied only the tab key residence of four units or less?2 Yes [:]No to move your cursor-do not b. Provide blanket decal number if applicable: Blanket Decal Number use the return key. 2. Facility Location: GRIFFIN PROPERTY t 1524 MAIN STREET a.Name of Facility b.Street Address !BARNSTABLE !MA 102635 6174388667 c.CitylTown d.State e.Zip Code f.Telephone Number INSTRUCTIONS 3. Worksite Location: 11524 MAIN STREET 1.All sections of this — form must be a.Building Name/Building Location b.Building# C.Wing d.Floor e.Room completed in order to comply with 4. Is the facility occupied? Z Yes !1 No DEP notification requirements of 310 CfdR 7.15 5. Asbestos Contractor and the Division :'N LEA LASS INC 1200 ADAMS S7 of Occupational Safety(DOS) a.Name _ mob.Address notification IBRAINTREE ?02184 I 7817941432 requirements of 453 CMR 6.12 c.City/Town 'd.Zip Code e.Telephone Number AC000810 t DOS g. Contract Type: I Written �;Verbal LicEr�se Number •' i h. Facility Contact Person i.Contact Person's Title NEAL A CASS JAS072613 j 6. a.Name of On-Site SupervisorlForeman b_SupervisorfForeman DOS Certification Number ?GERALD LEBLANC _ j 1AM031931 �Y I 7' a.Name of Protect Monitor b.Project Monitor DOS Certification Number $ ;ENVIROTEST IAA000128 �e a.Name of Asbestos Analytical Lab b.Asbestos Anal&cal Lab DOS Certification Number_ ----r 9. ;8126/2013 j 18/27/2013 a_Project Start Date(mm/dd/yyyy) b.End Date(mmlddlyyyry) o i7-4 7-4 c.Work hours Mon-Fdf_ d_Work hours Sat-Sun. o 10. a. What type of project is this? —0 i Demolitions Renovation Repair !E Other, please specify: b.Describe 11. a. Check abatement procedures: 0 Z Glove bag f—I Encapsulation o Enclosure [ Disposal only r!Cleanup ] Other,specify: Full containment b.Describe � z =Q 12. Is the job being conducted: ✓j Indoors? f I.Outdoors? ■ anf001 ap.doc-1 DI02 Asbestos Notification Form•Page 1 of 3 I i Commonwealth of Massachusetts ■ '100183185 i Asbestos Notification Form ANF-001 Decal A. Asbestos Abatement Description (cont.) 13. Total amount of each type of Asbestos Containing Materials(ACM)to be removed, enclosed, or encapsulated; _ 40D E io a.Total pipes or ducts(linear ft) �157FOUl other su aces square fir c_Boiler,breaching,dud,tank i 1 i I d.Insulating cement i surface coatings Lin.ft. Sq.ft. Lin.ft. Sq.ft. e.Corrugated or layered paper j400 I I i pipe insulation L f.Trowel/Sprayer coatings r in�ft. Sq.ft. Lin_ft. Sq.ft. g.Spray-on fireproofing h.Transite board,wall board Lin.ft. Sq_ft. Lin.ft. t� I.Cloths,woven fabrics j.Other,please specify: — Lin.ft. 'rSq ft^� Lin.ft. Sq.fL k.Thermal,solid core pipe Insulation Lin.ft. Sq.ft. I.Specify 14_ Describe the decontamination system(s) to be used: !GLOVEBAG —3 15. Describe the containerization/disposal methods to comply with 310 CMR 7.15 and 453 CMR 6.14(2) (g): :ALL ACM WET HANDLED, BAGGED, LABELED,AND DISPOSED OF AT AN EPA LANDFILL i 16. For Emergency Asbestos Operations, the DEP and DOS officials who evaluated the emergency: a.Name of DEP Official b.Title i --� c.Date(mm/ddlyyyy)of Authorization d.DEP Waiver# _ I ! i e.Name of DOS Official .DOS Official Title I � � N g.Date(mm/ddlyyyy)of Authorization h.DOS Walver#- -0 17_ Do prevailing wage rates as per M.G.L_ c. 149, §26,27 or 27A—F apply to this project? `?Yes g!No B. Facility Description N -- �o 1. Current or prior use of facility: (CURRENT �o �r 2. Is the facility owner-occupied residential with 4 units or less? ✓i Yes No WILLIAM F GRIFFIN JR 3. a_Facility Owner Name b.Address o F_ a c.Cityjown d.Zip Code_— e_Tele hone Number area code and extension) �---P— 4. a_Name of Facility Owner's Om-Site Manager b.On-Site Manager Address Z F�! �Q c.City/Town d.Zip Code e_Telephone Number(area code and extension)' ■ anf001 ap.doe-10102 Asbestos Notification Form-Page 2 of 3■ Commonwealth of Massachusetts 100183185 Asbestos Notification. Form ANF-001 Decal Number - B. Facility Description (cont.) 5. a.Name of General Contractor ' b.Address c.CitylTown d_Zip Code e.Telephone Number(area code and extension) 3 j I I j 1 s ' f.Contractor's Worker's Comp.Insurer g.Policy Number h.Exp.Date(mm/ddly - i 6. What is the size of this facility? —� �-- I �a.Square Feet b.Number of floors C. Asbestos Transportation.and Disposal 1. Transporter of asbestos-containing material from site to temporary storage site (if necessary): Note:Transfer a. Name of Transporter _ b.Address Stations must comply with the c.City/Town d-Zip Code e.Telephone Number Solid Waste Division 2. Transporter of asbestos-containing waste material from removalftemporary site to final disposal site: Regulations 310 CMR 19.000 :SERVICE TRANSPORT GROUP - _a.Name of Transporter b_Address a Ci /Town d.Zip Code e.Telephone Number _ 3. a.Defuse Transfer Station and Owner b.Address I { i c.CitylTown d.Zip Code e.Telephone Number 4. IMINERVA ENTERPRISES INC a.Final Ej sal Site Location Name b.Final Disposal Site Location Owner's Name_ 9000 MINERVA ROAD iWAYNESBURG _ c.Final Dis osal Site Address d.CityfTown _ ,e.State f.Zip Code g.Telephone Number CO . 0 11 D. Certification N The undersigned hereby states, under the iNEAL CASS IHAYLEY GARDINER t penalties of perjury; that he/she has read the a.Name b.Authorized Signature =o Commonwealth of Massachusetts regulations 1P! RESIDENT 18/912013 for the Removal, Containment or G.Position/Title d.Date(mmldd/yyw) Encapsulation of Asbestos, 453 CMR 6.00 and 7817941432 i 310 CMR 7.15, and that the information 1- contained in this notification is true and.correct e.Telephone Number f.Representing 0 to the best of his/her knowledge and belief. ,200 ADAMS STREET -----� 0 q.Address r �LL #BRAINTREE 102184 ! h.City/Town i.Zip Code Z an oc-10/02 Asbestos Notification Form•Page 3 of 3 f Massachusetts Department of Environmental Protection 1100183185 l Bureau of Waste Prevention —Air Quality Decal Number Project Revision Notification For Asbestos Notification ANF-001 and AQ 06 Important: A. FacilityLocation When filling out forms on the GRIFFIN PROPERTY s computer,use only the tab key 1.Name of Facility to move your 11524 MAIN STREET cursor-do not 2.Sheet Address use the return Z key. ARNSTABLE ( jMA j 3.City 4-State 5.Zip Code 6174388667 6-Telephone Number ;ems INSTRUCTIONS B. Project Cancelled 1- This form is only available for Check here if this project istwas cancelled. online filing of project date revisions. 2. Enter project decal number. C. Project Dates 3. Validate that r- ^' i the project 18/2612013 j 18/27/2013 location is correct 1.Original Start Date(mm/ddlyyyy) 2.Original End Date!mm/dd_yyyy)L_ for the entered 18/28/2013 -1 I812912013 decal. 3,Latest Revised Start Date(mm/ddlyyyy) 4.Latest Revised End Date(mmidd/yyyy) 4. Enteryournew project dates. 5. Certify your notification. D. Revised Project Dates Submit date changes. f 1.Revised Start Date(mmidd/yyyy) 2.Revised End Date Date(mmldd/yyyy) E. Other Project Revisions iFULL CONTAINMENT WILL BE USED ) I it i I F. Revision History !EDEP: 08113/2013 10:03:15 AM i anf06pdm.doc-rev-215104 l j Massachusetts Department of Environmental Protection 1100183185 LLBureau of Waste Prevention —Air Quality Decal Number Project Revision Notification For Asbestos Notification ANF-001 and AQ 06 G. Certification The undersigned hereby states, under the penalties of perjury,that he/she has read the Commonwealth of Massachusetts regulations for the Removal, Containment or Encapsulation of Asbestos,453 CMR 6.00 and 310 CMR 7.15,and that the information contained in this notification is true and correct to the best of his/her knowledge and belief. NEAL CAS j iHAYLEY GARDINER 1. Name Authorized Signature _ PRESIDENT i 18/2112013 2. Positionrritle 3. Dale mmlddl i 7817941432 4, Representing 5. Telephone i200 ADAMS STREET j 6. Address BRAINTREE 102184 7. Cityrrown 8. Zip Code anf06pdm.doc•rev.2/5104 ' - caNTRAcroR sxAu PLANT aws a 41u0Px1u. . Ir BRENMQRA%(ANE (BEAoI EANOI HA--TSIE-E (eEAw HEAMER)w C•16nxt vwE I 6TA0 RED ROwS OxF TOOT ON CENipt Ar A - ••K"r•".:.M •••:'C; ITI Y OMSW Oi iHAEE—IS PEA HOLE 'aa7aa,l;R.a s N va ♦\ a a\ a 3 ain/,/��i -rmava¢p ONR. s\ \ w� \` N WATFA uAIN D+D CAP & - LOCUS SECTION A-A CmlrnEr[ecuxD RM ' _ Y r Ate-+ICE-rY �� �o�'mea°"eA� D�xaE raxB NOM2WTAl: '- tl Y WA1FA SEANCE(NWROxMATE IOCAPpI) SED wA RFWA Y w •% MONIID f1GMrQA'raf(DMwt1 (�—AV �•xw� `��cu I� E%ISPN PINES AND NOLLT DETAIL Enrnxc ma rD az REN-(TWICAF) uAlf:r-s'. EµlOSPHRAO�NERAD MRES TO BE RwOVEO V�1ESl •. ? M UNOEPdiWNO SERNCE Alr mtOxlxB°�ra.o / tpUeLlG- °i 'LI•_ ram., •% '•III�I, AiOn�11Nc NH1,E(PN E sPRLAz J `NOT TO P SCALE / Tf2EET T,xw..` "" E]asTMG PaE labs/A ro BE AEuoHD MAINS A R ` 8 /RMOSEO De xE[ NORTN !T MITIGATIQN R AN71N•AREA f1 5 +•BD e FT R : z�sf luvFrf AA'Ci/NO Cowin xAYE NAxm1C aS a SRAtp Pllttn6ED AIERWAY AREA irmv r YW, '.�• (rYP/GE 6 JJ COTTAGE TO I BE OwWSHED EPSP o .Na ARBORNTAE'S OC- S (i 2•-2 S crL S-2•TONE BOUND MM NOE FaMO Awa i 6PRutE AM4A tlAWi�W t0'-S'O.0- _e. Im Peril � 1 "/ p � >d xbu •.. E�P� P.wVS SMu9Yf ss-C'pC�-a'-6' ` O L / �rxYr �„���"\ ..�, 1 � 1 aD oAA aEM1a Ruwu _ B•-Y e.L �`\, TI \� Mg mmR aE � Q'1 •e�f/ } // • �. .uer a+MJVY/ser rulz xAaE rne-r-a•sa R•W'LA Ts •` € P.�o1 p °` %w // L D¢BTMG ERE? Y�.rLE-LEMm ARRoawotn 1®ia1M a as c:o E os •. �irwa � � ell 9 -'v � .: `\ �: t0(lm�w)� r°.� -. xxERCM aw�RRNMaI NRmNM r ac-:G.L as 1yO pEgOA :,1 \ pO. �xp '�, PROPOSED DUNE AREAS �g�p ♦\ �� u>« �wA r a 1 / rJC� ✓ `" �NN 3 A A /l �O'�: ' ///�o�� •\ � P �,le I xuiB¢WR4 MYS IY90.amKp PROPosFD.-AnaN 1. 1 b y �1 y.. ( -� N .. - RLANrwGs Nn:A � � / ¢ mP al •�' ,' � pram'DI '.9� '� san In T , '1 axnWE i � a AdO1£ensrAe • Kim r uNN E 6.2 1 1 � •. 1 It k �r �RFTF WATERWAY � '•4f :�•( ♦♦\\\ 1y 6. ;/ Y} `ice �� \ ..0 �w��(wl�P p. . f 4,) ` i,TE \°C•. \I(F / , U 1' \..�mb q Imma O,M�v 10 I le/ub pay:..uu w wmnv M xr.e a x.omlu E� - :,(\: " \ ,1•• I ,/ i A�` tans r s-2-3 u uc s ° •y �`' {.1.0p �i' ,�,s \•,• ..1.� i 1 A`� D 1 i me'I _. uc uBY i m BonDEMNG vFa WEnAN TArm D a, \`\ 9 �� ,P' ��8.. IAND SUBJECT TD A6 s-+s-12 w f a m �Hy - ' 6 COAST.LL S—ROWA6ES'// ` 11— DATE DESCRIPTION ak + R E V I S I O N S ra PLAN `<qp •\\ I • P,Pasnsm arm A` A 1 OF PROPOSED SEWAGE DISPOSAL SYSTEM NAv'"'r� `� 6bA6rR10 ?,`..•`v a 3oJo g 'a.6 PREPARED FOR NEW RUSHY MARSH REALTY TRUST NOTES Z 4T� _ \� 56.6 I 0 w W FOR PARCEL 14,N524 MAIN STREET 1.HOUSE NUMBER:1524 ( rJl\ Wn� �x .R • CONIT MA a.AssessDR•s NuueETt mrou A ¢ \\ 6. yxs.. BARNSIN 1 ZONING DISTRICT:RF / \ E a 4.FLOOD HAZARD ZONES:C•A13(EL13)h V17(0-15) \ N AAD „ p,15 \ OF O� S5 e'^m•.,10' SCALE:i'�n DATE:APR.Inc. 013 S.BENCHMARK:SEE PLAN yx GRAPHIC sc !d holmes and me Toth, oa 6.TOPOGRAPHIC INFORMATION COMPILED FROM AN .1 °6 " >An' dG ON THE GROUND INSTRUMENT SURVEY. n �jr�1 � \ [lK 2D ID p 6G 205 amiv wlM cm4.1.At 508 5�15-1564 PWO 7.ELEVATIONS SHOWN ARE BASED ON THE d / :•M 'A'o¢r - \` 7.0 Nina n1v.02540 508 SIB-1172 NATIONAL GEODETIC VERTICAL DATUM. './ "'Q R b o-r \ awM•�M1 i REFERENCE: L.C.PUN teal-D �S / E DRAWN: LAC CHECKED: a,RT 212126- JOB NO: 212126 DWG.N0.:7a-3-2TD 5HEE7 1 DF a • - Npt I CERTIFY THAT THE STRUCTURES ARE •. - LOCATED ON THE LOT AS SHOWN,AND THAT THEIR LOCATION CONFORMS TO THE _ / NH•ryIES� MINIMUM SETBACK REQUIREMENTS OF 0. yg YnDTM LOT 11 THE BARNSTABLE ZONING BY-LAW. �Q Wx�O iOMxD •MEET IWB�(c' XOLMES AND MCf0iA1H,INC. M MAIN 5 ,i Asro=osD dasr d7rrAQ ��� M - _ _µtDTH VARIES) .yY M 1 MICHAEL B.M TH TREET (PUBLIC •', 1 Re9l Lane Date . S - T ye, • .MAIN -' . �ru a w wTN wsx raw+o — _ _ '— —. — _ - •Y^, _ _ rRmosm mnudw /i �� sui rtewo.a I CERTIFY THAT THE HOUSE AND COTTAGE \ \\_ /•I - /; •r \, A stsmu i IAIr ARE LOCATED IN FLOOD PLAIN ZONE C A5 O O /X MO=O.RTI eQH[w CNANA SHOWN ON FLOOD INSURANCE RAZE MAP °`'� COMMUNITY PANEL NO.250001 0122 D // q,; l ✓"� .+ FMO'a¢n din'£ AHD THAT FLOOD PLAIN ZONE C IS NOT A SPECIAL FLOOD HAZARD AREA 1 CERTIFY THAT THE CABANA 7(E-1G IS LOCATED INN FLOOD PLAIN ZONE Vf7 RANCE RATE MA) AS H \ .\ \ •/ Y♦ P.titl90.YD I' `�Q Ay CO SHOWN MMUNITY PANEL NO.25T0DD1 0022 D MAP ' d '\ �•.. `r1Y AND THAT FLOOD PLAN ZONE V17(EL15) ,drOC H ,l 15 A SPECIAL ROOD HAZARD AREA !. ``awE¢Bormm XOLMES AND NaCRATH,INC - ; '\ /./ /._�. \\ ��._ _ � ^' '/ (•�r'•WAW.x, //, tr ow xae rcaW / E \ —.._ /_/ --1gb'+l .a %1. \''•% �' MICHAE Mc ATM •/. .,a / 1 , Rplele,ee P fev=.I Date LC KI Su—yv, •� ` l NCIpaA W.MOPE • !/ � � / \�\ i .o Lid'% /� \ - dac. .,\ � .. RUSHY MARSH / $r O APP^o a LINE 27YR 9R PRDPEA tt MNE - POND / B . LOT 10 t / •/� TOTAL AREA ,, 16.7f ACRES >y x£P wmrvAlmx xo,£um Na 1 ^ / ', AS SHOWN ON I / - L.C.PLAN 18001-D ' a� Dees aemrv.,lw xw£,no Mo.: I a ——A—Ha£um-5 � .l/ POND /; '+30-IJ REND EpE11AiOX Exao M A—PATH uc IAklLA (.. YIS-tJ ypa W C I MOM I DATE DESCRIPTION PrawrtICheCked SDR.gSI • �' �� REVISION S- _ "c^w'6'm°' SITE PLAN OF PROPOSED MODInCATONS `P. PREPARED FOR NEW RUSHY MARSH REALTY TRUST DESION CRITERIA ? FOR PARCEL i{,I01 N24 MAIN STREET �' "tr�S" 'S.- _�.""°° `•"o eoM.,mr'•i«r I I I- coroiT - BARNSTABLE - MA APP__ e � -A1E A ' � SCALE:1'-50' DATE:APR.5,2013 ----- P10P TYUNr DRAPHLC SCALE holmes and mc2roth. Inc. n.ami mwM ae¢ - I ' 2vs. 2TOar N ee3)'M W 'S0 75 0 50 ,50 CIA englnaen and Ion e yor. s..,M s.nm T A.ws.a � oo 705.amtr—1,mite A{508 51b756{V420 T= mArmwm W. aM'.(me.nun w TnM eJ I.. 6 eT02• PARCEL 1 1ym ma 02510- 506 518-%72 �• D—D.II—ON ,m.,p1.m i. DRAWN: LAD CHECKED: I MC—T]I111—.e. 2 of 4 I. ' wAts�K.w`\ omu Knf rwxD � Al rxD �nH APPRON LO a A-r wA1ET-OE - • 6p N Srz60 a w Eµ SING OVEAHE.D vU T)fiE RFNOVEO . VAR1E5) _ m o REPucEO MTH uNDERLRau ctxD sFTM a xn ® " ealxD°�rawm IPUBUCvp •qqyy si � x�w'rt E%iSTxL PORE 1063/A (TOI—D O'>•iovu 1 IT 6.2 L r \ n/ R :.1• ___ �} � i yr $ I c/ " �. B .. �� t�♦tt • / wwa@� � \,E � A. suetcT To ram\ \ eaRofxwc NLCE7A1m rxnAND 6 COASTAL STORM ROWANS. 6 y, +141vIGAft wE s-ts-ts U.A.uPOATE CO..EnrnKc caxanas �~� uL n 4Ts f6L�\ rw-11 \ s.e DATE DESCRIPTION row ecke RUSHY MARSH n , b.> REVISIONS POND PLAN K OF EXISTING CONDITIONS PREPARED FOR ., d� NEW RUSHY MARSH REALTY TRTUST IN a `Y °• \.� D FOR PARCEL.14./1524 MAIN STREET NOTES / 1.HOUSE NUMBER:1524 �i / \\' R„ap >, \\ COTUIT BARNSTABLE MA 2.ASSESSOR'S NUMBER:017 014 3.ZONING DISTRICT:RF - 4.FLOOD HAZARD ZONES:C.A13(EL13)k V17(EL15) // - \\` SCALE:1'=20' DATE:APR.5,2013 5 BENCHMARK SEE F RUN /// n \ LOT F cRAPHic SCALE a TOPOGRAPH1c INFORMATION COMPILED FROM AN holmes and meaarath, Inc. ON THE GROUND INSTRUMENT SURVEY. n _ 2D to o m eo aw anglneerw m10 Imtd 7.ELEVATDTS SHOMN ARE BASED ON THE 203 waaalar 2510 rvtt4 M 518- nv(RKb NATDlAL GEODEIIt YERIICAL DATUM. \ times M1 .�J n B.REFERENCE LC.PLAN 18041-D +• 1 w DRAWN: LAC CHECKED: 212125SP.o. JOB NO: 212126 DWG.NO.:74-3-21D.SHEET 1 OF 2•vtc aao�wvr en r.+•r.-.r�rro.rr�w✓+a+w✓..r.su _M.wrtlwv Wrwun l , m rp.(re✓MW ,NilO�. __ __ sR�mR _ n man eNx.hams ro y-✓�M o-rM Rmwdl, - - E YaI OH ED. ' °'M1�ee Po°° AD niOL PANEL YWNIEO STAMEO i1.000 PWNS CONn UE6 TO COTTAGE .anY •� - P=D--HN T mn�m,r mb r°mtxd H aIT/Jit£LOGnON - — s °9rmIMN prods kkdc (emov e�mmU ABOK FLLM,n01,6 xCYn —COMA TO FINISH—E I (HA101 m ff wnmlrmll k WAIFAPROOf) [%ISnN GROUND SUFFACE BE1W C.— p. unug DEa EIEV.-,a_ firm¢:DNOnF-w ra 1`.� li•1°P..-dm Eli h'^i°` ra (rtow MT) y - -- ENMRONMENT DNE COIR. (w,a �wCaRa NOHOW na ; ,Sd0 Emlan ,.000 rNm Sgt4 TaM �„P� Sq,k Tent IX/S£ l l0 vooA L=71 .��OUNtt S£MW LSE lU I EIEV.-).00 sYN.M-s-0.01 rumr>aampavrlmrma- ., alx�° - a cF-!X'asva.xr car .env u_ IX•PK•POtYI M . _ sar myn+cuis r cm e�Mw, svaa rang Jr o-e°. vua6s• sm cox,a�e> t atx P - :.�:- .:,•�.:�.` Aw-` CROSS-SECTION SEPTIC PROFILE - COTTAGE ¢ c 5 HOLE DISTRIBUTION BOX scut 4•- , FORCEMAIN PROFILE - BEACH CABANA sc•r. .Nr°«wr x0T m scuE O Vim,. r r 2BJ b GENERAL NOTES �°n� v, m °Y 4 1) No M.nae t.t system aksll made unlem EJ'00 G4ftOy SEPTIC nevr W Rlr Mrt appro ed In,oltInlnq by Hahn..and! 1. O .•N..p1aP z)-ab)ect tp mw•edan axrina wnrtrNee by In. - o �� .a✓„m armM. IRISH eema.f H.mu ana Nelm.e ane myreu,me JI a00 4 dlM S W)N 5. OJ) Nwy ent vll not . T SE umERaYw McT d:po.a ym-almq r u cwE d,°roI.iMpro , vwM an pn.eanetmmlpn. / - 500 GAl LON CHAMBER --aeu p- 4) Di. 1.ptam is ba wnewct.d In o.andanc0 � . WItN TO,5 of Me St-E—nmmta Coda .wPERNEAa(E lrF ev w[ / b� seuC Ile-1• " a 5) A copy of thew plaan,must be kept an the Nte ... dYHna In.tune Ff G [7 O O O C"G O O r3 e) A copy.f Ueae plan°—t b.—1—d to ue mrPo6Eo / `$•/ C7 O O o 0 0 o C7 O O it -b-to.canewctk,q u.dlvpoeol vntem. a O O C] G G G C C C3 [7 C3B.fa.beexaglnq,In..canwcm.M.0 notify rA�l qGm ttiW:' NT;eo . - C3 3 G O O D [ G 1-37 r3 Agant m uxmwt u..ptrn G O G [7 C C C3 C C3 [7 e) N u.wnwna ancwn,er.any--.-ba.ean �•p,� / / LI the exmtmq—dmmn.Mom an Nv plan and the mxcnnv COfiEF - - seandltlb ane .—an In.�tv,a'any vM a' / m canmnan mmrmt man Mom N...a lop TYPICAL 500 GALON LEACHING CHAMBER! any'ewes-.u.canoed-Mm bn—tey ��'�• / '!`10 �� ,E om ''" SCALE,/Y-,' cantwt hM.,and mcar.,N,In. Hdmee and mcarvlb,me.01 eaomin.Na so6 rndilian a xn — If-0' and repot to ibv omc any wggealed raMaiana PO4!0.Oy E)AIEF S4.r o<rME t \�. SLPIK RK OP[tS.G MAssraem•,a-- --•= — ——— — �. PR6OSFD 1XPtt Ft7.aSMAN . I �•------1 � 'EA� Piu'ff now - TYPICAL DRYWELL I 2-24-Diamelel Accee.Holes I'I VT Io SCAtE m wv[C ur meF l•rot• ALL ACCESS MANHOLE CO FOR \ eur[leD ant wAleR'OUTLETyE y to.utp INLET 1 / � � OUTLET SEPTIC TANK.DISTRIBUTIONN BOX. BO%. AND LEACHING STRUCTURE SET MORE HATCH FA\ER TD Fnas,LxaOE THAN 6'BELOW FINISHED GRADE, SEPTIC DETAIL AT COTTAGE DuTDImaEEAmmorte.Altwn0o0 .I I SHALL BE RAISED TO WITHIN 6'OF uA�'•-IV T3 BALLAST CALCULATIONS ' Ylem.Aces,Ha. I,i FINISHED GRADE. 3o°£ 9•mHMum dlmutc fAl')1/Snlmw W4GHT K 016PlACED WATER-WflWT OF 6rAnOH L-T__-__----__ ,.q euOrrJlr FORGE.70 lb le. LI P09TM:FORCE.q]0 I6s(,t.tlan°eI6Nl).BN m,(bmFN WNp6t) _ ——_ �'�— —• OIR R COKF ♦1663 1-W pt)-4.066 W STEEL REINFORCED PRECAST CONCRETE oxER•rr !<z l..r sacToa n sutTr 4..a/Z--z PLAN VIEW � 1OY1I"` -PRECAsr cONtJ¢TE a - w wYffI1LwE.y✓ .o.,,.a°,. Axx gsm �, ow� � >,$, "'.�,"'aN pan uy�.✓w.n..ra S.Y a-..,. b• 6 6 9 (U�.v-.w s e-ei ab nr�.,�wm m,,..,.IW+rs sa.� . e• i,�. iva q rEn s-,s-Is uvlsE sEPnc anuL a PRmtE AT mnA¢ uc °i a•aOe' - wtET'Y $ pyp�.,,p t6f DATE DESCRIPTION ro eek wtn r t°^giYae m_"'""t w'mt E = -_ s>, •• �,r�' "e15fVOVm -R E V I S 1 0 N S E - r g M aM - oW° CONSTRUCTION DETAILS 6-0• - I 14. _ j_-- s-c �"fie " T�A' OF PROPOSED SEWAGE DISPOSAL SYSTEM E 1 lY na1O PREPARED FOR 4p�p na-nTE r-c m6. V "O1._'O1ro°P NEW RUSHY MARSH REALTY TRUST Uq.M eb,,tb _ FOR PARCEL 14./1524 MAIN STREET q15 BAFFLE I v E+I e - COTUIT IN _ BARNS MA LF • 1 4•P,2'a RxYtEJ SEPTIC DETAIL lam: SCALE:l'-20' DATE:APR.5,201J ,v-a•• a-z :•curnaccvmur ' CROSS-SECTION FND-SECTION, P AT BEACH CABANA fa.aYa aw cm mes enghban,and anY—�e. m�DTmNIn'm a,rma scAtE:'•-10' ENVIRONMENT ONE ms��>—•Rdt°Ma'06 566-15w OM TYPICAL 1.500 GALLON SEPTIC TANK MODEL• DH071F-93 STATION m`0�0 sro -gfin sc.,r.,/r-f LLO taA SE HOT m scuE DRAWN: uc CHECKE r 2.26---.°. JOB NO, 212126 DWG.NO.:]4-}21D SHEET 4 aF 4 CM �'` `a`• = +�8� �' �' U%gs Ste` r C'7 N x LL cii y^� 3 O M N LU 49 .' - Co Co 00� i ' \ - Z " � ! - - r a e m _ i 3 ( f � Co Co y W = o i �; r} �+ f s y -r--- - - --4 , — _ v � .. — x BY: '�kj rj ®®p®A®®®® DATE: _ a0 pFMASS40y®®® E�11Cw �``��, v JOB NO. ��'1) a G^ o SHEET NO. ;IT 1 . 41 . c RFGIS x'I o cm n Cy) N c) CD 7� N `1-� `? - I� ,i, '� l -' �1 , '� z�s � Y aF:�' ; Lu Ljj a, co ,' iA `o w m " — _ , a �p I, a. pip , A-o--rx-�, Nk- 51 . , _'__ .-, j:'� 7[ \ - :._ _".Y ...__._ i. - •- is y7g -- _. _3 01 Rams., 1 E Qa}�y 99 1 _ _ , 7 , P VT } BY: �? DATE: ° eO _. ® ZH OF Mgss9c ®®® JOB NO. �V fyl � y DOMENIC W. G�� SHEET NO_ 'P I> o DeANGELO m STRUCTURAL`' 7 j No.35062 ApOF�FG/ST i .y N - a 04 f' v / z, / O Rf $��:¢� L '.' w'.�, _ - - •� �—!.J I�CJ� �a'fF+9 JoSr�y' 4� c ��y = p W, mil Al, LU i V -p Op z CD 114, 4. iJ .. .. _ _ . q - t , _ - - - d _ Sri R � 3 e. .5fA 5tJb4 0 JI ' a , I BY: OW DATE: . DATE:P�tN OF MASS ®�® JOB NO. O V @ tl DOMENIC W. e DeANGELO m v STRUCTURAL �' � SHEET NO. 77 ® k No.35062 = . Agp�RFG I T �� +� SS/Q) I j certify that this plan was made in accordance with the rules and regulations of the Registers of Deeds. Date Registered Professional Land Surveyor I SAl TREET LOCO POND PON10 POND #0 MAIN STREET S'� LOCUS -MAP N/F �P\� SCALE: 1 2000' DAVID J. & ANNE B. NISULA #1488 MAIN STREET PO BOX 1400 N/F COTUIT, MA 02635 VICTORIA W. HOPE PO BOX 526 COTUIT, MA 02635 TOTAL AREA APPROXIMATE 16.7± ACRES PROPERTY LINE Z LU PROPOSED #' 0 1524 MAIN STREET Q r' r'"". • � � PIER Y QO / NEW RUSHY MARSH REALTY TRUST / LOT F LC.PL. 2875—C & LOT 10 LC.PL. 18041—D RUSHY MARSH / 9420 WILSHIRE BLVD, STE 300 POND BEVERLY HILLS, CA 90212 r �.. (A OREAT POND) i� NAN760rZ T •� �' / SOUND APPROXIMATE PROPERTY LINE KEY PLAN #130 OREGON WAY SCALE: 1"=400' N/F DALE D. BRAGDON, ET AL GRAPHIC. SCALE LOT A LC.PL. 8502-c 3 ROAD 400 200 0 400 WESTFORD,4 MA 01886 ( IN FEET ) 1 inch = 400 ft. DATUM: PURPOSE:. PRIVATE RECREATIONAL USE NATIONAL GEODETIC VERTICAL DATUM N.G.V.D.. 1929 PLAN ACCOMPANYING PETITION OF NEW RUSHY MARSH REALTY TRUST TO CONSTRUCT A TIMBER PIER IN RUSHY MARSH POND" COTUIT, BARNSTABLE COUNTY, MA PLAN BY: holmes and mcgrath, inc. civil engineers and land.surveyors 205,worcester court suite A-4, - falmouth ma 02540 DATE: MAR. 24, 2014 SHEET: 1 OF 5 A2877 �. I, certify that this plan was made. in accordance with the rules and regulations of the Registers of Deeds. Date Registered Professional Land Surveyor • GRAPHIC SCALE q 20 0 40 i Q A C IN FEET ) O,p '1 inch 40 M. y,, #1524 MAIN STREET017/014 ; LOT F '- L.CPL. 2875-C 17 NEW RUSHY MARSH REALTY TRUST \, ________:__ - - l __-__-- _ -___-- T — PROPOSED 4,_9��,. WIDLv ' BORDERING FIXED PIER , VEGETATED SEE:DETAILS) . �FIp WETLAND ' � � HAZARD ZON . ��Q HAZ R1�ZONE. A13 EL 13 10 _.._.._-_. . ro PROPOSE ., EDGE OF, PHRAGMITES-` <~' - _(0 .ALONG SHO ,��•`` -1.7 =1.7 -0-3-• ,';, ; PUBLIC ACCESS. ,��, -1.3 -1.9 1.9 (2.4) l ' PROPOSED-3'z6' Fp ^_� \% ACCESS RAMP %/ ~ WATER DEPTH �= 62� c -2•1 8 20 2013 (3.9). 1.8 �` {2.1 �-�SEE �QETAIL) /. o� �• (-2.6/ ) (3.9)_1.8 -2.4 PROPOSED 8'A 2' FLOAT (3.7) / SECTION (SEE DETAILS) 1:1 `� v� FLOAT"TO BE ATTACHED .TO 3:1 -2.6 -3.4 4x4 POSTS (TYPICAL 0 355 -.2.5 y /�1h1 \ 3.5 -3.3 3.3 ��Cv/,\ �1.8 - BQRDERIN P�� �� ` \VEGETATED \ '. ,WETLAND 1 5 o I . -3.8 -3.9 4�°� 3.4 13 RUSHY AlARSH -2.8 F POND. O�i�PtiP -3.5 , O i 2 (A ORZA'7'POND) / 1.54.0 i NOTE: -4.1 ,,� x ' -3.7 i '. EDGE OF WA ER RUSHY MARSH POND IS''NOT • � -4•1 i i R�l8/20134.4 1.g i VATION 1 FT. CURRENTLY.OPEN TO THE OCEAN. � (NGVD) BOTTOM. ELEVATIONS -4.4 �8/20/2013) NGVD DATUM) DATUM: PURPOSE: PRIVATE RECREATIONAL USE NATIONAL GEODETIC -VERTICAL",DATUM ` PLAN' ACCOMPANYING PETITION' OF N.G.V.D. 1929 NEW RUSHY MARSH 'REALTY TRUST - TO CONSTRUCT A TIMBER PIER, RAMP,,.FLOAT AND PILINGS IN RUSHY ,MARSH POND (A GREAT POND) -BARNSTABLE, MA COTUIT, PLAN BY: `holmes and mcgrath; inc.. civil engineers and land surveyors t , 205 worcester court suite A-4, falmouth mo 02540 , V DATE: MAR. 24, 2014 SHEET: 2 OF 5 A28717 -1 certify that . this plan was made in accordance 'with the rules, and regulations of the :Registers T of Deeds. , } Date Registered Professional Land Surveyor '/" DIAM STAINLESS STEEL $ PROPOSED PU LIC. LATERAL TENSION CABLES SPACED EQUALLY ACCESS SIGN (SEE- DETAIL) (TYPICAL OF 8) 'TYPICAL OF 2 ACCESS STEP 4"x4" POST 4%4 POST (SEE STAIR DETAIL) @ 1,5.0' O.C. ® 15.0" O.C. MAHOGANY DECKING @ EL DECKING SLOPE HAND RAIL ON „3 CONCRETE PAD 5.6 ,FT. ® 1_20 E-- - - - - - - - —1 EXISTING, PATH _ zz 3x6 YOKES' � o �` 2 151 'QIO C. :WZ 2x6 CROSS o TYPIL OF 4) BRACE {TYP) ago. 3NN 4x6 POSTS o µi 01106 @ 15'-0" O.C. (TYPICAL OF 10) a LJJ Z 4%4" POST �ww� '@,15.0 "0.C. 6' RAMP & DECKING ®. EL 4.1 FT 8 x1.2_FLOAT_SECTION I-- — — — — — — — POST— "x6°EPOS II ® 7.3 O.C. 5:5 O.0 POST TOP FIXED PIER I � l EL.=65 FT. 1 _ELEV.=4.1 - - = - - _ POND GAUGE;HIGH WATER= 25 FT. (NGVD OBSERVED WATER = 2.1` FT. (NGVD) 4x4 ,RAIL. POSTS (TYPICAL OF 18) 0 FLOAT TO BE SECURED LATERALLY TO Q FIVE 4x6 POSTS 2x6 CROSS BRACE _ k4x6 FLOAT POSTS ° (TYP) (TYPICAL OF 5) s 0 w 2' WIDE LADDER , ALL .POSTS INSTALLED TO A c�. MINIMUM DEPTH OF 6 FT. PIER PROFILE 8 4 8 ( IN FEET ) 1 J8 inch = 1 ft. DATUM: NATIONAL GEODETIC VERTICAL DATUM PURPOSE: PRIVATE RECREATIONAL`USE N.G.V.D. 1929 PLAN ACCOMPANYING PETITION OF NEW RUSHY MARSH REALTY TRUST TO CONSTRUCT 'A TIMBER PIER IN RUSHY MARSH POND IN COTUIT BARNSTABLE, MA roe. PLAN BY: holmes and mcgrath, inc. civil engineers and land surveyors 205 :Worcester court suite A-4, falmouth ma 02540 DATE: MAR. 24, 2014 SHEET. - .3 'OF 5 ' r A2877 r certify that this plan was made in accordance with the rules and regulations of the Registers of Deeds. Date Registered Professional Land Surveyor PROPOSED KAYAK CRADLE (SEE DETAIL) PROPOSED PROPOSED 8'x12' 3'x6' RAMP 4 0' FLOAT"SECTION 15.0 O.C._ _ IPE DECKING - A FLOAT A f CONSTRUCTION 46 POSTS ® SHALL BE MADE 14'-0" O.C. IN MODULAR (TYPICAL OF 10) SECTIONS TO 2"x10"x14" SUPPORT /5/4"xl 3" x 10" YOKE 0" FACILITATE WITH BRACE STAGGERED AT AT RAMP END IPE FACIA SEASONAL JOIST MID—SPAN REMOVAL AND FLOAT TO BE 2' WIDE LADDER STORAGE. SECURED -- LATERALLY TO - FIVE 46 POSTS. �_ _ _15.0' O.C._ _ _ _15.0' O.C.. _ --4 , O U O Jul ACCESS STEP 3x6 YOKES 2x10 JOISTS (SEE STAIR DETAIL) PROPOSED PUBLIC ® 15%" O.C. ON 3, CONCRETE PAD LATERAL ACCESS SIGN (TYPICAL OF 4) (SEE DETAIL) TYPICAL OF 2 PIER PLAN VIEW 8 4 0 8 ( IN FEET ) 1/8 inch = 1 ft. DATUM: NATIONAL GEODETIC VERTICAL DATUM PURPOSE: PRIVATE RECREATIONAL USE N.G.VD. 1929 PLAN ACCOMPANYING PETITION OF NEW RUSHY MARSH REALTY TRUST TO CONSTRUCT A TIMBER PIER IN RUSHY MARSH POND COTUIT, BARNSTABLE, MA PLAN BY: holmes and mcgrath, inc. civil engineers and land surveyors 205 worcester court suite A-4, falmouth ma 02540 .DATE: MAR. 24, 2014 SHEET. 4 OF 5 A2877 certify that this plan was made in accordance with the rules and regulations of the Registers of Deeds. Date Registered Professional Land Surveyor SOLID MAHOGANY HANDRAIL Y44" DIAM. STAINLESS STEEL TENSION CABLES SPACES EQUALLY. 4'-g��„ 4x4 RAIL POSTS ® 7.5' O.C. - 1- - 50% LIGHT PENETRATION (TYPICAL OF 18) 4,-091 IPE GRATING (SEE DETAILS) PROPOSED KAYAK RACK_ I; CLEARS o1 ; 4x6 POSTS TO BE CUT 5/4 x10 MAHOGANY � 1 WITH STRINGERS (TYP) LEVEL FACIA I• r� BOLT MAHOGANY HANDRAIL POST THROUGH P.T. 2x10 AND 3x6 YOKE ON EACH SIDE OF 4x6 P.T. POST 4x6 P.T. POST AND THROUGH P.T. 2x10 JOISTS, LAP OVER BOLTED 3x6 YOKE, SECURE WITH 2x6 CROSS BRACE (TYP) GALVANIZED JOIST HANGER (ALTERNATE ANGLE) (TYPICAL OF 4) 1 4x6 P.T. POSTS ® 1.4'-0" O.C. 2", THRU BOLTS WITH (TYPICAL OF 12) WASHER & NUTS (TYP.) 3,_5„ ALL-,POSTS-DRIVEN- TO, A MINIMUM .DEPTH OF 6 FT. TYPICAL. WALKWAY SECTION (A- A) 4 2 0 4 ( IN FEET ) 1/4 inch = 1 ft. 2" x 6" TREAD (2) 1/2" SPACE 3/4" LIP 5"f RISER EXISTING GRADE 3" CONCRETE PAD STAIR DETAIL 2 1 0 2 . ( IN FEET ) 1/2 inch = 1 ft. DATUM: NATIONAL GEODETIC VERTICAL DATUM PURPOSE: PRIVATE RECREATIONAL USE N.G.V.D. 1929 PLAN ACCOMPANYING PETITION OF NEW RUSHY MARSH REALTY TRUST TO LICENSE A TIMBER PIER IN RUSHY MARSH POND COTUIT, BARNSTABLE, MA PLAN BY: holmes and mcgrath, inc. civil engineers and land surveyors 205 worcester court suite A-4, falmouth ma 02540 DATE: MAR. 24, 2014 SHEET: 5 OF 5 A2877 40 0 , col t TO o� i 2a� w CONCRETE v A BOUND FOUND EXISTING FOUNDATION A SEE DETAIL LOCUS \ •/ ( TION COTTAGE R CONSTRUC RUSMY \ \\ 'A STONE BOUND WITH ) o POND MAIN STREET :I DRILL HOLE FOUND �o \ o / ISOLATED DEP -, ,,, • �.. W_(FCt00 w(FC70 W.fFClpp � ,,••• Ep98 COASTAL BANK I. 1 CAB, TOP OF DEP w_1"C r ,r' • •�'• . . COASTAL BANK a PORTION OF LOT ,� E AS SHOWN ON LAND . . . . . .� fFC,p Ak � COURT. PLAN 2875—C AL -� , .� '"'�, n '.' ' w \ ' • . BOUND WITH ,, 160 . 1. , _ a \ . . pRIIL HOLE FOUND . Y . . . . . . . . . . . TOP OF BARNSTABLE o '� \ l� .. . . . . . . . . . . . . . . .. . .. . .'. . .•. . \ COASTAL BANK UNDER AL •y . . . . .. . .. . . . . .. . . . .. .. . . . . 1 . .. . .. . . . . . . . . . . . . . . . . . . . . ..Ak p, / \ \ . . CONSTRUCTION �. � LOCUS MAP �, G #0 MAIN STREET ,� �, . \ �N/F . , \ � \\ . . -..,. , . . .,. . �, NOT TO SCALE • - l DAVID J. & ANNE B. NISULA / F Al •. / ADDITIONS UNDER , . � CONSTRUCTIONAL AL ,� i t .. . /. .. . . . . t�� \ �.. . . Q +,y BORDERING VEGETATED' WETLAND \ .. . . .. . .. . . �`• o �4 7.9 ' • EXISTING 2 CY HOUSE r <v ` • \ 0 0.4' 5.6' 3.2' 14.5' • TOP OF BARNSTABLE A, AL ,� COASTAL BANK , 4.5 & ,� O : Ca / zl , . . IL /1,�. ,�, �� .. ... sus, im 2 00 cn AL "` � -- ? EAk .•. + h 4.5' COTTAGE FOUNDATION LAND suB,�cT , , , FCgp� N�� ,� / � / � . . . . . . .. . . LAND SUBJECT �•; s� `� � UNDER CONSTRUCTION . ' TO COASTAL / gr3AIAR� �. -�_, ,;� • .. _ '��J\•,•,•,••• TO COAST AGE 2C \ N 0.7 .5' ,r / STORM FLOWAGE / ? \ ` \ STORM FLOW 'f^ \ o < PARCEL 20\ 2.5'- 2.5. \ TOP OF DEP N/F o 0 0 =0 7, r COASTAL BANK \ VICTORIA W. HOPE r- ti 30.8' COASTAL LOT F �0"� N n� ►., L, 's• • 1�1 DUNE �P �,. EDGE OF WATER d ' 0.8� ' v+ O� > l `� os os o.s 1� � (DUNE 18, 2013) / - �\ ,� J EDGE OF BORDERING \ AL / � /' VEGETATED WETLAND FOUNDATION PLAN DETAIL SCALE: 1"=10' BUSHY MARSH y /' APPROXIMATE PROPERTY IN . . L E COASTAL DUNE POND / / LOT 10 TOTAL AREA , ,-\o ' 16.7f ACRES CERTIFY THAT THE EXISTING OTTAGE FOUNDATION #1524 MAIN STREET 0 ! HOUSE AND THE C N/F ' \ LOCATED ON THE LOT AS SHOWN, AND TO THE 'tom,�•-- --- � NEW RUSHY MARSH REALTY. TRUST \ THAT THEIR LOCATION CONFORMSLOT F LC.PL. 2875-c MINIMUM SETBACK REQUIREMENTS OF THE BARNSTABLE ZONING BY-LAW. P'�/ HOLMES AND McGRATH, INC. zp/j AL IL BORDERING VEGETATED WETLAND MICHAffa. cGRATHRe istersfessional Date ,� "` / 9 Land Surveyor / CERTIFY THAT THE HOUSE AND COTTAGE FOUNDATION ARE LOCATED IN FLOOD PLAIN ZONE C AS SHOWN ON FLOOD INSURANCE RATE MAP COMMUNITY PANEL NO. 250001 0022 D AND THAT FLOOD PLAIN ZONE C IS NOT A / SPECIAL FLOOD HAZARD AREA. / O NOTICE Unless and until such time as the original (red) stamp of the HOLMES AND McGRATH, INC. responsible Professional Engineer, or Professional'Land Surveyor appears on this plan: POND (A) no person or persons including any municipal or other public officials, may rely upon the information contained herein; and (8) this plan remains the property of Holmes & McGrath, Inc. �! / Ak MICR EL EYMCGRATH Registe Professional Date DATE DESCRIPTION Drawn hecked Land Surveyor / / Q� �� G R E V I S 1 0 N S PLOT PLAN P` OF STRUCURES UNDER CONSTRUCTION \ PREPARED FOR �- / NEW RUSHY MARSH REALTY TRUST NOTES .i ' / FOR PARCEL 14, #1524 MAIN STREET 1. HOUSE NUMBER: 1524 / IN 2. ASSESSORS NUMBER: 017 014 COTUIT BARNSTABLE MA 3. ZONING DISTRICT: RF 4. FLOOD HAZARD 'ZONES: C, A11 EL.11 A13 EL13 & V17(EL.15) / , • ( ) C ) � SCALE. 5. BENCHMARK: SEE PLAN. � � _ _... --- -' 1 -50 DATE NOV. 5, 2013 w �` T TOWN of BARNSTABLE APPROXIMATE 6. TOPOGRAPHIC INFORMATION COMPILED FROM AN PROPERTY LINE / GRAPHIC SCAR h of m es and m c ra th Inc. �_ DRAINAGE EASEMEN y�SSON TO 135 f ON THE GROUND INSTRUMENT SURVEY. •M►LDE OVERTON ,t N " civil engineers and landsurveyors >v. MA 213 , 83 57 30 � 50 25 0 50 150 7. REFERENCE: L.C. PLAN 18041-D / 230.00 W 205 Worcester court, suite A4 508 548-3564(PHONE) 8. THE CABANA IS UNDER CONSTRUCTION • '�„ � S 82.02'30" faimouth, ma. 02540 508 548-9672 FAX . , PARCEL 16 cor�cRE ' Np N/F / n� max ) DRAWN: RLR CHECKED: MBM A µ WITIi DI FOUNQ 1 inch - 50 !t. DALE D. BRAGDON M MCOURT 212126 212126SP.dw JOB NO: 212126 DWG. NO.: 74-3-21J SHEET 1 of 1 �p VI111� i� 1 \ yam• W -� CONCRETE R\ES 1 4 BOUND FOUND v A COTTAGE UNDER 7 CONSTRUCTION LOCUS \ \ RUM MAIN STREET •� \ o pw \ \ �6 6 STONE BOUND WITH oq M a ':�� . w-1EC°, w-LfC° LeC102 / ISOLATED DEP •1,. \ DRILL MOLE FOUND COASTAL BANK `.;. \ �s�, TOP OF DEP �•'• E Ak COASTAL BANK q, PORTION OF LOT AL A ' E AS SHOWN ON LAND f / COURT PLAN 2875—C ,:Ak AL AL ) AL A \ ' / . . . w \ CRETE B1N� WITH \ , !�0 '� '� _ .�.• . . \c. \ ' IXt�l HOLE D /00"0- I' ; ; \ TOP OF BARNSTABLE ;, ,•, J I►,5l \ COASTAL BANK �. ..' ' �,• LOCUSMAP #0 MAIN STREET \ . . �G '� . \ � _ �. .. . '.a .01 \ N/F / "` '' / "` ' f�, NOT TO SCALE DAVID J. & ANNE B. NISULA ' ' .'. "` / ADDITIONS UNDER ;;; ; 9'�'.. 10, \ Ak CONSTRUCTION Iloll "` . �Q- „•1,l BORDERING VEGETATED WETLAND ' •, \ o •. .. , CABANA UNDER \ $ Cb AL Co ? \ '` ✓ �' EXISTING CONSTRUCTION \ " \ , HOUSE • • �`P OF BARNSTABLE ,� ff ' ' ' ' ' ' '. ,i. . . . . . . .' \ \ • / COASTAL BANKAk AL Ak C I AL ,k \ LAND SUBJECT / H ` A / ` TO COASTAL / q 1Z, � . „ 1h\•; LAND COASTAL xx \ "' STORM FLOWAGE 3 / STORM FLOWAGE \ / � f •. < • , \ PARCEL 20\ `:./ \ TOP OF DEP N/F/ 1 COASTAL BANK \ VICTORIA W. HOPE\ LOT F COASTAL DUNE \ \ \ % �P� 1�1 EDGE OF WATER �' 18, 2013)� � l \.. (JUNE EDGE OF BORDERING \ \ ��� \ \ � / VEGETATED WETLAND \ \ ,, RUSf�Y MARSH � AL \ APP OXIMATE \ \ COASTAL PROPERTY LINE POND 41 DUNE \ / 0/ \ LOT 10 \ / a � / TOTAL AREA / CERTIFY THAT THE EXISTING 't 1 6.7f ACRES \ / STRUCTURES UNDER CONSTRUCTION ARE #1524 MAIN STREET / LOCATED ON THE LOT AS SHOWN, AND N/F \ THAT THEIR LOCATIONS CONFORM TO THE NEW RUSHY MARSH REALTY TRUST \ / LOT F LC.PL. 2875-C MINIMUM SETBACK REQUIREMENTS OF ����j i �1 \ THE BARNSTABLE ZONING BY—LAW. HOLMES AND McGRATH, INC. J MICHAEL B. cGRATH / BORDERING VEGETATED WETLAND Registered Professional Date / / Land Surveyor r` '` "� 6 . \ ti CERTIFY THAT THE HOUSE AND COTTAGE A. A, ARE LOCATED IN FLOOD PLAIN ZONE C AS SHOWN ` '� A � ON FLOOD INSURANCE RATE MAP COMMUNITY PANEL NO. 250001 0022 D AND THAT FLOOD PLAIN ZONE C IS NOT A SPECIAL FLOOD HAZARD AREA. \ "` SPECIAL FLOOD HAZARD AREA. \ , / O NOTICE I CERTIFY THAT THE CABANA UNDER CONSTRUCTION \ ,Z�G /� Unless and until such time as the original (red) stamp of the IS LOCATED IN FLOOD PLAIN ZONE V17 (EL.15) AS SHOWN / / � responsible Professional Engineer, or Professional Land Surveyor P appears on this plan: ON FLOOD INSURANCE RATE MAP COMMUNITY PANEL N0. Ak � • ROM9 / (A) no person or persons, including any municipal or other Q' public officials, may rely upon the information contained herein; and 250001 0022 D AND THAT FLOOD PLAIN V17 (EL.15) IS A / / �� / (B) this plan remains the property of Holmes & McGrath, Inc. SPECIAL FLOOD HAZARD AREA. � / � / � � / �� 'C DATE DESCRIPTION j0lrawn hecked, HOLMES AND McGRATH, INC. R E V I S 1 0 N S PLOT PLAN MICHAEL B McATH V OF STRUCTURES UNDER CONSTRUCTION � / `'`Registered Pr fessionol Date ) / PREPARED FOR NEW RUSHY MARSH REALTY TRUST Land Surveyor i / FOR PARCEL 14, #1524 MAIN STREET IN / COTUIT BARNSTABLE MA NOTES • _... SCALE: 1 =50 DATE. APR. 23, 2014 pf BARNSTABt� APPROXIMATE • EASEMENT SSON TO TO`M'i PROPERTY LINE / GRAPHIC SCALE h of m es and m c ra th� inc. 1. HOUSE NUMBER. 1524 \ AINAGE WE 135 f MATMi�E ovERTON ,t 50 25 0 50 150 civil engineers and Ian surveyors 2. ASSESSORS NUMBER. 017 014 . 213 230 00, N 83 57 30 yy / 205 Worcester court, suite A4 508 548-3564(PHONE) � " 3. ZONING DISTRICT: RF S 82'02'30„ W / falmouth ma. 02540 508 548-9672 FAX 4. FLOOD HAZARD ZONES: C, A11 (EL.11), A13(EL.13) & V17(EL.15) a�E N PARCEL 16 / DRAWN: RLR,PJR CHECKED: MBM �� / / ( nor ter ) 5. REFERENCE. L.C. PLAN 18041 D DI�c ��iN� / i iimh - 60 tt. DALE D. BRAGDON M\MCOURT\212126\212126SP.dwq JOB NO: 212126 DWG. NO.: 74-3-21K SHEET 1 OF 1