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0211 OXFORD DRIVE
ACTIvE Town of Barnstable $L�11d1I1 enxvsr�e. : Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept g Posted Until Final Inspection Has Been Made.. Permit Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. - B-20-1510 Applicant Name: Roland Langevin Approvals Date Issued: 06/17/2020 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 12/17/2020 Foundation: Location: 211 OXFORD DRIVE,COTUIT Map/Lot: 021-029 Zoning District: RF Sheathing: Owner on Record: Carli, Paul Contractor Name: Framing: 1 Address: 65 CHELSEA STREET APT 301 Contractor License: 2 CHARLESTOWN, MA 02129 Est. Project Cost: $4,827.00 Chimney: Description: R-13 FG and rigid Board to'kneewall,finishedikneewall access, Permit Fee: $85.00 ventilation chutes 6" Fiberglass R-19 and Ri id to Kneewall Slope, Insulation: g g p Fee Paid:. $85.00 Air Sealing,transisitons-Floored Date: 6/17/2020 Final: Project Review Req: Plumbing/Gas Rough Plumbing: Building Official d Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within.six months after issuance. All work authorized by this permit shall conform to the approved applycation and they 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. 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: 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 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 Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Pe racting 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 I-P� - All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Town of Barnstable *Permit# 08 01 Expires 6 months from issue date Regulatory Seiviccs Fee v Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 f www.town.barnstable.ma.us , Office: 508-862-4038 Fax 508-790-6230 1 EXPRESS PERNUT APPLICATION RESIDENTIAL ONLY Not Valid without Re_d X-Press Imprint Map/parcel Number O a /Q a,7 ' Property Address Q �- I2 esidential Value of Work '' \\ � Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address �►V�IJ s 0' G "� Contractor's Name- F•/�,6t Telephone Number 50 Home Improvement Contractor License#(if applicable)_'' o� .CS 3 Construction Supervisor's License#(if applicable)__ [AWorkman's Compensation Insurance Ched one: PRESS. PERMIT ❑ I am a sole proprietor ❑ I am the Homeowner MAR 11 260$ EkI have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name T Lrz Q- Workman's Comp.Policy# 5 5 O L- 35 5 o I. Copy of Insurance Compliance Certificate must be an file. Permit Request(check box) [&Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping; Going over_ existing layers ofroof) Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations;i.e.Historic,Conservation,etc. " q ***Note: Property Owner tnust.sign Property Owner Letter of Permission.: - A copy of the Home improvement Contractors License is required. r ' ` SIGNATURE: Q:Forms:expmtrg Revise061306 • 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): F-RftSErL C�_Q/Q',--,'r LULC_t I d /lJ Address: � Zj City/State/Zip: c dL 1•-�- A- QZ 3 Phone #: Are you an employer?Check the appropriate box: Type of project(required): 1.0I am a employer with,!!9 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. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.T 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 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' 13.0 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: 7�LN Z 4/q-�Py P_ Policy#or Self-ins. Lic.#: d 25 0 L S S.50 Expiration Date: ' o�2 Co Job Site Address: ! City/State/Zip: Attach a copy of the workers' com ensation 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi er the ains and flies of perjury that the information provided above is true and correct. Signature: Date: • ll ' . Phone#: Jc-� � r � oo� /o� Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: 130 o-f_a U Staudar 130sto-n- Place - oon, 1301 dq •Home1lassachusetts 021 vetent'Co °act ®� ® ® SERegistration: 112536 i �N j=RASE P.Box ����CONSTRUCTION Co.�® '�7°n 3/2OOg Th# 127 MA 02535 s2o DPB.C,A7 sy BOAQ..ps/OB-P08480 _' ��$�Addrem�d r "Gard of AddressRenewal&n ED cog d,10�ap&s ®n for Chan card Regiatr�tioea: ACT®i �e or aegut,,ta� 12538 beforeV2Hd for daaMda�atf= uze omm Bard Of s: -ki 7 127920 ®n�b � 1$tiOII®an Zf d Stn sret t®o dards USER CONSTRUC-1 j a® ®21®g �� 13®1 EAN FRASER CO' -� 455 6 RT . 28 ay COTUIT,MA Q2635 - - 9slrahmr -- .1�7®t d�itha�t agg�g� , i aQ ;4 :PRODUCER >:: :?:• - ,. :r WISE & TFIIS CERYIFICATE IS+ISSUED AS ql'QUINN INS AGCV 10-15-07 449 PLEASANT ST ONILV ARIA CON9FERS NO RI®FITS MATTER OF 1119FORMATIOid FIOLDER. THIS CERTIFICAYE DOES Mpg R THE CERTIFICATE BROCKTON ALYER EC OVERAGE AFFORDED®y 7FIE POLICIE�®ELOIflI, AMEND EXTEND OR 24WCB Ma o2301 COMPANIES AFFORDIN®COVERAGE INSURED COMPANY `4 HARTFORD UNDERWRITERS INSURANCE COMPANY FRASER CONSTRUCTION LLC COMPANY PO BOX 1845 COTUIT MA 02635 COMPANY C ' •.,. ':`:%?f:•^•• ::Sid%;�:?v:,:• COMPANY D IS 13 TO CERTIFY THA ,.::f>:; .:.:t _4:£xg>:s.:'2 '•?{L; ys^`,:n :s}3:r> ::r.: INDICATED. NO T THE POLICIES OF IN :4..w:....D wa:4:4,s: :r:.: � 'r�• 3•':•:<:>3✓s�:%'�i:Yf�/:h^...;�>?>•s:?.;.M.,..,:...:.. TWITHSTANDING ANY INSURANCE LISTED BELO z, „>,;,.;;: ., f.{;:::>:•:r;::•;s M:: .. •;« :;::::••: ._;;• :.:4-:.::.:...REQUIREMENT, - W HAVE BEEN ISSU ::.xz:»:33::-::•::<;•::;:«;::>K.. l t SI NS MAY BE ISSUED OR RM OR CO ED TO THE INSURED MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED FI �. NDITION OF ANY CONTRACT D OTHER DOCUMENT WITH RESPECT TO WHICH THIS CLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMBS SHOWN MAY NAMED ABOVE FOR THE POLICY PERIOD HAVE BEEN REDUCED BY PAID CLAIMS, HEREIN IS SUBJECT TO ALL THE TERMS, LTR TYPE OF INSURANCE POLICY NUMBER POLICV EFFECTIVE POLICY EXPIRATION GENERAL LIABILITY' DATE(MUWDIYV DATE(MMWDIVW LIMITS COMMERC �- `r{r IAL GENERAL LIABILITY CLAIMS MADE 0OCCUR. GENERAL^AGGREGATE $ OWNER'S&Cp PRODUCTS'COMP/OP AGG• NTRACTOR'8 PROT. � PERSONAL&ADV.INJURY • EACH OCCURRENCE � AUTOMOBILE LIABILITY FIRE DAMAGE(Any one fire) ANY AUTO $ (Any one Person) S ALL OWNED AUTOS MED,EXPENSE COMBINED SINGLE SCHEDULED AUTOS LIMIT HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per Person) $ BODILY INJURY (Per Accident) $ GARAGE LIABILITY DAMAGE ANYAUTO PROPERTY D � AUTO ONLY•EA ACCIDENT S OTHER THAN AUTO ONLY: ;.'•-•?•'' } EXCESS LIABILITY `��'#-:.r shfr�C EACH ACCIDENT UMBRELLA FORM AGGREGATE OTHER THAN UMBRELLA FORM EACH OgCURRENOE WDRKER's COMP AGGREGATE A EMPLOVER'S COMPENSATION AND ✓6 VABDJTV (6S60US—OB50L35-5— THEPROPRIETOR/ 07) 09-26_07 09— Og PARTi�IERBtp(EpUTIVE INCL 26— STATUTORY OFFICERS ARE: TUTORYLIMffB ": ?::o^';:.Y:3'%;;<:;c:;-•: X EXCL EACH ACCIDENT OTHER DISEASE—POLICY LIMIT. DISEASE— 1; I EACH EMPLOYEE $ 50 00 i )ESCRIPiLON OF OPERA•IONS/►,OCAll iONS/1/EHICLES/RESTRICTIONS/SPECULL ITEMS • I I T HI S R EP - LACES ANY PRIOR CERTIFICATE ISSUED •- ..... :....::.:..�;::.:.: LDER AFFECTING WO ER5 COMP ... ::.aS;::;:5>ti; �f�'.•,�,�f$,}so:"���'�.: -�.'•i`{ .c?`. THE ABOVE-•DESCRIBED POLICIES -''''''"`•:`"``:-"'^��:'-.'-4 ERASER ENTERPRISES LLC �IRATION DATE THEREOF, THE Isau1N® COpgppNVV INIlEL1ED BEFORE THE '0 BOX 1845 10 DAYS WRITTEN NOTICE'PO THE CERTIFICATE HOLD ENDEAVOR TOIMAIL I :OTUIT LEFT, BUY FAILURE TO ER NAMED To THE MA 02635 L.IABILIN OF MAIL SUCH NOTICE SHAIJ, IR9POSE ANY KIND UPON THE COLMP NO OBLIGATION OR ANY,ITS AGENTS OR REPRESENTATIVES. I AUTbIIOR1�ED REPRESEN 1 1!111•r ... .... .... t � - k .......:::.::{::::::.:�::.:::�:::::::.:::::.:::::�:._:.�::::::.�.�.:�..�.�:.::::::.:::::::::::.:'.�::v::•gin�:.:::;+.. ........:.�:::.:}:�.t�:�::::.:i::�:is is ivii:::w:?ti�:iiir}{.:?rr:::i}:.'•:.^.:?:i�::::.:::i:'ii::?::4iv:^i'•} ....:::;••;•?.i'.i'tiiii.:r::ii}::ti?:ii4:div::j{::::jtii:v Y.::;::S:i?::ti:ii:�?}tii: CONSTRUCTION Fraser Construction Roofing & Siding Specialists P.O. Box 1845, Cotuit MA. 02635 508-428-2292 Email: fraser construction a yerizon net www.ftaserroofing.com Phone 1-508-428-2292 & FAX 1-508-428-0123 RE-ROOFING PROPOSAL DATE: November 16, 2007 NAME: Mike Mulay PRONE: 508-428-3422 MAIL ADDRESS: same Cell: 508-292-2884 JOB ADDRESS: 211 Oxford Dr. Cotuit, MA. 02635 FRASER CONSTRUCTION hereby proposes to perform the following services in a neat and professional like manner and in accordance with the manufacturer's specifications and local building code. -Remove and Haul away all of the old roofing material -Re-nail all plywood sheathing as needed. Supply and Install - CERTAINTEED LANDMARK ULTIMATE: Lifetime Warranty, 10 year sure start protection, CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, triple-layer thickness, Laminated Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPERXERAMIC Stones with a Full 15-year Warranty against ALGAE Containment. 10 year 110 mph wind-resistance warranty. See actual warranty for specific details and limitations. lU, 11 C cAdt W "� h 0010 Color: U_J,0_4 -� Lo ev-4 PRICE-$14,950 Initial ****Price includes a new rain diverter**** �� ge oppe p o alt 'ad C - n Supply & Install - CertainTeed Winter- Guard: (ice &, water shield) -Waterproof Underlayment System (3ft. on eves and. valleys, 18" on rakes, walls, and skylights) Supply & Install - Roofer's Select Underlayment Paper (as recommended by CertainTeed) Supply & Install - hick's Ventilated Drip Edge or 8" Aluminum Drip Edge Supply & Install - Aluminum & Neoprene Soil Pipe Flashing Supply & Install-Air Vent Ridge Vent (as recommended by CertainTeed) Clean & Remove - Debris from work area daily.,,,,_. .. X4 Star Warranty Upgrade will be applied if proposal is signed and returned within 10 days. (see enclosed brochure) 2% Discount if paid by check immediately upon completion NO MONEY DOWN- NO Payment at the start or part way thru Payments accepted are: CASH- CHECK- MASTERCARD -VISA-AMERICAN EXPRESS *Any payments not made within 30 days of completion will be charged 18%for every 30 days the payment is late. Possible Extra-After the shingles are removed from the roof, we will lift one sheet of plywood to make sure that the insulation is not up against the plywood sheathing preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$4.00 per panel including Materials 8v Labor. There are 6 Panels per sheet of plywood. Possible Extra-Any rotted or otherwise deteriorated trim boards sheathing, plywood ng, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$50.00 per hour, plus materials, plus 20% overhead mark-up on total extras. FRASER CONSTRUCTION Warranties the labor for 12 years FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years. CERTAINTEED Warranties the shingles and labor 100% through the Sure Start Warranty duration. CERTAINTEED Warranties the shingles to be ALGAE resistant for the duration of the Sure Start Warranty depending on the shingle that was purchased. Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: I3®rneo er Fraser Con traction TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Y1__`1 lee— Permit# `t Health Division Date Issued 7hY Jdl Conservation Division r-s, ® Fee :551 Tax Collector G � Treasurer— �t �%C�C c L� '�/�o/Zod I 1NST�L�p Sri �u �° IT � roGt Planning Dept. �/IT Ifll COMPLIAN'c 0 ENGINEERING 004 ENv1,g0 TITLE If i�Sti1C" Date Definitive Plan Approved by Planning Board � ��ENTAL �0 ; Historic-OKH Preservation/Hyannis ALL Project Street Address Ox HOC.o Q)i1 /eZ s- Village Owner Address �11 ���c n r✓ Telephone Permit Request PCNoA -e )3 G.cw Sw>�..� 1,.►, po�L -� lLc/cZt)N OBe— s r f Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Estimated Project Cost 6UO Zoning District Flood Plain Groundwater Overlay Construction Type �l No If yes, attach supporting documentation. Lot Size �l 5U0 } Grandfathered: ❑Yes 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.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing \7 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:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ \ I Commercial ❑Yes No If yes,site plan review# Current Use Proposed Use cSLJ�M Mi N p G e, e BUILDER INFORMATION Namec�N C\,flo<, {� Telephone Number 1;� tcb—(Q 11Qp Address�uc Ar— License# C)'19 bq9NN Home Improvement Contractor# i3211)L? Rol--P Worker's Compensation#W C 13a`� gv�� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Ca.•� S��� SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. 44'� DATE MUED T MAP/PARCEL NO. ADDRESS VILLAGE ` OWNER .� s DATE OF INSPECTION%: FOUNDATION 17 /.►/ - FRAME3 INSULATION '� } FIREPLACE lwl - �' ELECTRICAL: ROUGH- �. : _ FINAL PLUMBING: ROUGH. "• FINAL - - GAS: ROUGH FINAL r FINAL BUILDING \. I5 . - _ Via I EMU j DATE CLOSED OUT " ASSOCIATION PLAN NO. P`O*IHETpk� The Town of Barnstable '• BAR S 1 MASS. a Department of Health Safety and Environmental Services 9 S. 0 679• �0 plEo MAy Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: '> (\� mule u Map/Parcel: Project Address: �a lt1 oy-c Builder: The following items were noted on reviewing: 1 C-M'\R 1, ► 0, 1 (9. 1' A0 Accc4-s An Dev,,) 1 optic) +n +y � Reviewed by: f r 1(A Date: .41 q:building:forms:review J _ The Town of Barnstable i g�r'ax�TABLE. � �A 9. . � Department of Health Safety and Environmental Services rEa Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. (� Type of Work: Estimated Cost\1� , Address of Work: Owner's Name: Date of Application: G I hereby certify that: Registration is not required for the following reason(s): Work excluded by law blob Under S1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEM OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav „,• .ip,._z .,rs _yp3 s .atq�i. , ” r: t � .. e ' �F�}u";'`%'� ra1rF�.F'"�"fi�'SL.K.�s �+ �.R 0, .3 # � k �3-es' �1Ut_ , T b 4 (� `rr Q WN 9F BARNSTABLENc d A) LOCATION- QW , 1 SEWAGE # VILLAGE ASSESSOR'S MAP &.LOTA 1 «O� INSTALLER'S NAME&PHONE:NO. Z�US 'SEPTIC TANK CAPACITY �3 b LEACHING FACILITY: (type): l� (size) C006N E. .NO.OF.BEDROOMS Bu1I DER PR OWNER '£ PERMIT DATE: COMPLIANCE ATE: .:. Separation Distance Bt-41etween the i7 :3j maximum Adjusted Groundwater Table and Bottom of Leaching Facility` Feet Private Water Supply Welland Leaching Facility (If any wells exist on site or within 200 feet of leaching.facility) ; Feet Edge of Wetland and Leaching Facility(If any wetlands.exist within 300 feet of leachin g facility.) Feet Furnished by i t� N3J . . r ✓Ite Vr awo�vea ola&aaduaeCta oard of Building Regulations and Standards One Ashburton Place — Room 1301 Boston , Massachusetts 02108 Home Improvement Contractor Registration Registration: 132476 Expirat-ion: 02/13/2003 �� , Type: Individual HOME INPROYEMENT CONTRACTOR Registration: 132476 TIMOTHY RICE Expiration: 02/13/2003 TIMOTHY RICE Type: Individual 197—B RT . 6A DENNIS MA 02638 TIMOTHY RICE wOTHY RICE -8 RT. 6A ADMINISTRATOR DENNIS MA 02638 BOARD OF BUILDING REGULATIONS t' License: CONSTRUCTION SUPERVISOR Number: CS 077899 Birthdate: 08/28/1969 Expires:08/28/2004 Tr.no: 77899_ Restricted To: 00 TIMOTHY P RICE 197 B RT 6A DENNIS, MA 02638 Administrator w TI,c• Cunrn,unwea tb of"4fassacll,lrtclfs s"rif 'j•.� {' ' Department of'Industrial Accidents Office OfIQYCSD9al offs 61ill If i NN11,1 t„n Street Bus7nn.Afi,s-S 02111 �--' Workers' Compensation Insurance AlMdavit Aj2n]s-��� �������a.��—��--•-- .... .. Plc-�e 1�RINT1�b1,L.;,, - • name Manion- cin• Co l nhnnc#-2 \> ZZ ❑ 1 am a homeowner performing all'work myself. ❑ I am a sole proprietor and have no one working in any capacity�..� _. ❑ 1 am an employer providing workers' compensation for my employees working on this job. \u13 L2 n (Uv N;a CZ city! phone incur•rnre ro C- ���� \ y G� nniicS•# 1 �� 1 => > ��. ❑ 1 am a sole proprietor.general contractor,or homeowner(c,trie one)and have hired the contractors listed below wr the following workers' compensation polices: CMD.Inv Sit Rhone�t• policy# - turnnre rA - a,�rs�s,Fs�.e•-•�-TIgCi+e++ cn- m my na e- address- nhone#- inc trolley# %tiach addiddaal sfieet ff neewar y ' failure io scenre coverage as required under Section 25A of AWL 152 an lad to the imposition of anmmd petuddes of a line up to SI.500.110 une}•eats'imprisonment as well as civil pen 'a the form of a S7 OP WORK ORDER and a line olSI00A0 a day t *an ma I understand copy of this statement may be forwarded the ce of lavesdgatimts of the DIA for coverage veritiatioa. 4 I do herebr e:crtij•under the pains n pen of perjury that the inforntarion provided above is Ime and convxL 'Sienature Eta Print namePhone# � �v 11L0 �.. otlicial•use only do not�Mtc in this area to be completed by city ortoera oil CW city or torn: permit4lemw# r'ttiadding Department DUcemdag littard 0 check if immediate response is required �5deetmeo'a Office l3tlnith Department phoneN: contact person• nOther___ 2 , 193 �� \ �Spi a in 14�'pine \20 �•,�: 3Q � I �E le i=2r�74 L 0 T 14 +1 QQ 0 pkeinII' p a �— Elwt.z 43.6 L O T 26 •� \ 1 � � o 45.5' OUSE � .�_ �.... :'►s 6'dlam.x 4'deep y;M. '4,— 134.0 LEACHING PIT e -',.' ;IO�min. I �Qxq w w i t h 4 f I.of w a s hoc ( Code g` stone all around. 10 dal' f?�E,AR. 46 2 T F EN KES {)H17-1 TEST LOT 24 HOLE I A! ESTHOLE*I IWIN 112.3vs i 1 \ Pf e�S plinq��I BENCH MARK N.E.Corner of Elec. Pad Elev.=4&32 sl 'I: \ Stake set 125.0 Stake set 0 X - FO.RD (Private'-4.6'wide) DRIVE j I �G.56. • `��SN OF MSS SVUoturbl Design Approved +hen installed in ' J' TIMOTHY 1% �y strict Acccrdarxe with O / WALKER u• Kisnu!ecturer's Insnuctiona I CIVIL T. tvd:er, P.E. 31376 J 1119. COPING LAYOUT �� f•l ��/x✓-/JS•CORNER MOr gr 29 l'/: /6 6 7� . T T q'3' 3' .32 d r PANEL LAYOUT • /3S•AN6Lf F7L1fR(7YV) 3'y" T B 8• 7 " �{I. Lu X•BRACE 1 . I••^8' F- Lt' '.I a—� DETkL A MWU to 1[SA10, wv¢01 ones Pool Pool ,•■• ,a4W/r W WTUVL Area Capacity 500 17,500 M,L ° +t••� I. Sq.Ft. Gallons TIKAOW fAMam / �ll oi( EDITION POOL tstcv+r taanea' THIS BROCHURE IS FOR ILLUSTRATIVE PURPOSES ONLY »rat ..aR The manuychxw makes only those representatlaro wNrh are stated In As widen warranty.Arty other reprasenlatlons,statements,or contracts made by the dealer and/or the contractor to the customer lIl'r ra•r Ir reg-d'eq any materials produoed by the manutachrer are attributable to the dealer and/a the contrao i r towwrt taarul 16' X 32' G R ECIAN for only.The dealer or eantr=lor who sea or Installs yotr pod is an it dependent contractor and not an t� agent or employee of p»martulachrer.The cautruction methods slwtrated we suppestWw and apply ' only b normal grotr4 cordilko There may be additional precautions and/or methods of construction r aorta,tunas IM'r Ia•11 ak s/r.r ear sotT The responsblity Is UIe contractors. r•'LWAUD yam! s/r our a""""m""° SCALE: NONE 1991 j,r•- ``fit t1(lr n7A`SS Structural Design ApFro�ed • F, only v:hen installed In J' TIRMOTHY�.,�yG strict Acccndanre with O / WALKER v Manu!erlurcr's Instructions ICIVIL T. N't;6 e•. P.E. q .\�MO. 313764v u \ C:Is y'3 G.Ise t�3 `\ 6' y'3' yo9. COPING LAYOUT �2- \ Y 81 ,/�� 7' . T T ` _ 6I• 6• s' 32'6` PANEL LAYOUT ' /3S'ANGLfF/L1fR(lY) ly -7 by '3 ,4 y � �. 1 x BRACE EU DETA4 A a orm To K eu0. -.6 ta.vn OR pna Pool Pool tt xxowAwntuawL Area Capacity S 0 0 /7,500 'srta a V rAmmlaM mmirrou Sq.Ft. Gallons Nor t.edtusemavtnl THIS BROCHURE IS FOR ILLUSTRATIVE PURPOSES ONLY Its pia{ EDITION POOL craw corents //� oar: run The marwbcm m res rw makes orgy dross representations which we stated In its written warranty.Any Other �/J representations•statements•or ocrtimcta made by the dealer and/or the contractor to the customer h1•.ra•r tr regardwg any materials produced by the manufacturer are attributable to the dealer and/or the eontrar i r tmraatt Moro R run 16' X 32' G R ECIAN to only.The dealer or edntraetor who sells or installs your pod It an krdependerrt contractor and not an is agent or anptoyee of De nranufachver.The construction methods iluslmled are suggestws and apply only to normal ground conditions There may be additional precautlona and/or m ltr ds of construction r manom Iu tim tor•.Ia•Ir G 3/r.r scat eat The responsibility isthe Contractors tutwxueramt ,t/r nor' "°'r""m"'a° SCALE: NONE 1991 micpomcleap TM VERTICAL GRID D . E . FILTERS Micro-Clear is a high-perform- ° ance filter series that provides � superior water clarity, efficient flow and large cleaning capacity v ids' � 'iy for pools of all types and sizes. Micro-Clear filter tanks are now - molded from PermaGlass XL7 "¢ a glass reinforced copolymer, providing the ultimate in strength, durability, and long life. Micro-Clear filters also combine high technology ' features with a "service-ease" design for ` dependable AM r . r me,oy „ass m operation and aa°"P°°0 low maintenance. a - Plus, Micro-Clear filters are avail- 4-A able with the unique SP-74ODE Selecta-Flo control valve, the ! sw only filter control valve designed specifically for D.E. filters. For the quality conscious pool a owner, Micro-Clear filters are an + unparalleled filtration value. ■ DE-6000 Micro-Clear Vertical Grid D.E. filter with optional SP-740DE Selecta-Flo'M4-position control valve. fit y Featuring PermaGlass;:=d-:' 4 Filter Tank Material • 0 HAYWARD pp Hydrogen,Oxygen and Hayward. The elements of clear water Tm Wpo-ClearTM Vertical -G'rid D.E . FiIters Automatic Air Relief purges any trapped air during filter operation. • Screenless design eliminates clogging. Integral Lift Handles and Uniform Low Profile Tank Base _ make removal of grid nest fast and simple. High-Strength Filter Tank molded of PermaGlass X11m provides extra durability for dependable,corrosion-free performance. High Impact Grid Elements designed for up-flow filtration and s top-dawn backwashing for maximum efficiency. Heavy-Duty Tamper-Proof Bolted Center Flange Clamp securely fastens tank top and bottom together.Allows quick access to all internal components without disturbing piping or connections. 44 Union Locknuts make disassembly and reassembly of filter from I piping fast and easy. I 1 Noryl6 Bulkhead Fittings for extra strength and heat resistance. [ Inlet Diffuser Elbow distributes flow of incoming unfiltered water upward and evenly to all filter elements. Parabolic tank base design provides for even distribution of D.E..to grids. Full-Size 11/2"Integral Drain provides fast, 100%clean out and easier, ' flushing of tank. Convenient Valve and Plumbing Options allow for customized control.2"internal piping and plumbing for maximum flow performance. Specificationsi r D.E.Filters • FILTER TYPE: Vertical Grid Diatomite:24,36,48,60 ft2(2.23,3.35,4.46,5.58m2). r FILTER TANK: Injection molded PermaGlass XL FILTER ELEMENTS: Monofi lament cover fitted over 8 curved, polypropylene high-impact grids ° CONTROL VALVE: 1'/2"or 2"6-Position Vari-Flo;M 2"4-Position Selecta-FloT' 2"2-Position slide valve.May also be plumbed singularly or in series ' with quick-connect union couplings(less valve). e ;0 PERFORMANCE RANGE: Y2 TO 3 HP(30 to l20 GPM) DIMENSIONS: DE-2400—31 Yz"H x 23"W(800 mm x 584 mm) DE-3600—36W H x 23"W(927 mm x 584 mm) DE-4800—42W H x 2T W(1080 mm x 584 mm) v. DE-6000—48W H x 23"W(1232 mm x 584 mm) Above dimensions are for filter only.Overall width with slide valve is 30"(762 mm); overall width with either 4-or 6-position multiport valve is 33"(838 mm) Performance4 fit,Data w :. . Effective Design Turnover Model Filtration Area Flow Rate 8 Hours 10 Hours Number ft2 m2 GPM LPM gallon kilo liter gallon kilo liter DE- 0 24 2.23 48 182 23,040 87 28,800 109 Plumbing Versatility.Select from a wide array DE-3600 36 3.35 72 273 34,560 131 43,200 164 of valve options for customized control of your D - 800 48 4.46 96 363 46,080 174 57,600 218 filtration system,including Hayward's 2,2 position DE-6000 60 5.58 120 454 57,600 218 72,000 273 slide valve. *Determined by pump size and piping system hydraulics. 2"piping is recommended for flow rates of 90-GW or more. Flow rates above 120 GPM are not usually required for residential pools. MHAYWARD POOL PRODUCTS INC. Hayward Pool Products,Inc. Hayward Pool Products,Inc. Hayward Pool Products Canada Hayward S.A. 900 Fairmount Avenue 2875 Pomona Boulevard 2880 Plymouth Drive Zone Industrielle de Jumet Elizabeth,NJ 07207 Pomona,CA 91768 Oakville,Ontario L6H 5194 B-6040 Charleroi,Belgium 8-97 ©1997 Hayward Printed in U.S.A. I JUL-03-2001 09-05 FREDERICKS 21 GERA'RDI INS. 508 584 2187 P.01i01 AQQRq CERTIFICATE OF LIABILITY INSURANCE ®A3/M of PRODUCER (508)584-2300 FAX (508)584-2187 THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION Fredericks & Gera rdi ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Insuranc® Agency Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICES BELOW. 1313 Belmont Strl:et BrocktoN, MA 023411 INSURER$AFFORDING C®VERAGE INsuARD Anchor Desilln III PooT =nc INSURER A; American Casualty o Reading, PA 143 Upper Glunty Road MURER8: Transcontinental Insurance Co. Dennisport, MA 02539 INSURERC: Transportation INSUrance Co. INSURER D: 1 INSURER E: COVERAIIES THE POLICIES Or INSURA!CE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAM99 ABOVE FOR THE POLICY PERICO INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERN I OR CONDITION OF ANYCONTWY OR OTHER DOCUMeNT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUZO OR MAY PERTAIN,THE INSUR%NCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 13 SUPJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LE ATS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, TNM TYPE OF INSURAI ICE P061CY NUMBER POLICY P T LIMITS 011IN911ALLIADILf" C1030715576 04/09/2001 04/09/2002 EACHoccuRRENCE S 1,000,000 MCOMMGACIALGENER4LLIABILITY FIRE DAMAGE(Any one flra) S 100,00 CLAIMS MOM [7 OCCUR MEO CXP(Any pne pww) S 5,000 A PERSONAL d ADV INJURY S 1.00010 f GENERAL AGGREGATE S 2,000,00 OEIYL AGGREGATE LIMIT A PAI.IES PER' I PRODUCTS.OOMPIQP AOO S 2,000 ,000 POLICY ECT LOC AUTpMOBILiLIABILITV 3279516 04/09/2001 04/09/2002 � SINGLE LIMIT ANY AUTO i 1 000 00 ALL OWNED AUTOS BODILY INJURY g X SCWIMULSDAUTOS (PorPelavn) F X HIRm ALITO3 BODILY INJURY X NON43WNEDAU1= (PeraewierM f (P OP�E WwRDAMAGE 5 GARAN LIAbUn AUTO ONLY.EA ACCIDENT S ANY AUTO TY R THAN EA ACC $ AAuurrvv ONLY' Arw a FACUSLJAI51LITY C1030728106 04/09/2001 04/09/2002 EACH OCCURRENCE S 1,050,005 C T OCCUR CL ALAS MADE AdORfiGATE s 1,000,000 S DEDucrleLe R�TpJTIC+N 8 10,0005 -- 6 WORNFRSCOMPENSAM AND WC13071togo 04/09/2001 04/09/2002 X rORY LIMITS OMPLOYERW LIABILITY IR C ELeACHACGDEW S 100.000 G,L,D46ASE.EA EMPLOY 6 100,560, OTHER Et DISEASE.PoucY LIMIT I S 500,000 7ESCRIPTION OF OPERATION61L1"TION&VEHICUMUCLUSIONS ADDED BY ENDORSEMENTIdPECIAL PROVISIONS :ERTIFICATE HOLDER ADDITIONAL INSURFD:INSURER LETTER CANCELLA71ON SHOULD ANY OF TH6 A®OVF DESCAIMM POL►DIE9 BE CANCELLCD BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL FNDIIAyOR To MA L TaAn of Barnstable l0 DAYSWRIYTCN NOTICE TO THE CER r ATEHOLOMNAMEDTOTHELEFT. Building Dep:lrtment YUTFAILURG TO MAIL SUCH NOTICE G L IM IOATIOM OR LIABILITY North Street OFARY KIND UPON THECMPANY,I Ao an* PRE86NTAnvEs. Hyannis, MA (12601 IIUTFItlId- REPRESENTATIVE _ Patricia Corr ICOROZS-S(7ro7) lw FAy.: (508)760-3459 insd EIACORO CORPORATION TOTAL P.01 ORDER NO.. SALES AGREEMENT 'FULLY INSURED tt BONDED DATE ❑ 133 UPPER COUNTY ROAD SOUTH DENNIS,MA 02660•(508)394-4800•FAX(508)394-6735 FENCE CO; L 835 WOBURN STREET•WILMINGTON,MA 01887•(781)933-1234•(978)657-5410 FAX:(978)658-9932 � IN,CQRPORATED NAME a !/ SHIPTO., , STREET STREET CITY STATE ZIP CODE * CITY STATE ZIP.CODE INSTALLATION HOMEPHONE BUSINESS PHONE ' 1�,•, � TELEPHONE ' NOTIFICATION :^ .. STYLE NO.OFRAILS HEIGHT ft. : ON YOUR PROPERTY_IN ACCORDANCE WITH QUANTITIES AND.LAYOUT SHOWN BELOW QUANTITY. DESCRIPTION UNIT- TOTAL • - �"' f&✓ V . ,- .. DEPOSIT TOTAL SALE. BALANCE. On Completion' TAX TERMS TOTAL ONE HALF WITH ORDER.BALANCE ON,COMPLETION LAYOUT-INDICATE ON LAYOUT PICKET FACING ON EACH LINE OF FENCE CHECK LIST CLEAR FENCE LINE TREE/STUMPS _ IN FENCE LINE k� TAKE DOWN EXISTING FENCE SJACK. BUILD SECTIONS -ON JOB TOP OF FENCE TO. PC FOLLOWGROUND •; RACK SECTIONS, STEP SECTIONS ! CURYE'SECTIONS FACE FINISH \ hl SIDE, BARB TOP- KNUCKLE TOP' -i UNDERGROUND PIPES OR CABLES BRING COMPRESSOR GATE SCALLOPED' .y GATE;STRAIGHT ERECTING CONDITIONS GALVANIZED OR VINYL ! TAKE AWAY i OLD FENCE All quotations subject to conditions:beyond our control:.CUSTOMER IS RESPONSIBLE FOR establishing property lines and fence lines,and for conforming with local zoning bylaws.Pro Fence ,is not responsible for damage to undergroundutilities,'.septic systems,�drairi pipes,-or-propane lines,unless notified'im.writing by.the Customer as to their location,before work is started.This quotation does not include costs met in extraordinary conditions-striking ledge which may require the cementing of posts or the use of a compressor for drilling and.pinning posts,or clearing trees:brush other obstructions from the working area.This contract embodies the entire understanding between parties,and there are no verbal agreements or representations in connection therewith. BY 1G.✓ ACCEPTED BY On accou Is over 30 days;finance charges are computed at a periodic rate of 1 V2%per month-Annual'rite 18%-Plus any additional costs incurred for collection,including reasonable Attorneys fees. • li.y �c,r». � u 1 1 1 1 . • `I a 6�av�au ua :..:,: • S .,' M � tj�7�� t , ea.�se,„ .;,;,��•,��.Z < {Y,Fj',}i. 1 �I! r r r t i`�4 �• �'c �# ! a� �, iY'^AY'�V.�l.. SF� R f C� �' > .. . 1� � .:� .L'�h i•,sy%� ;� S -�s•{r�a'j„T � pe*-S '� } p. 9�' 'r!'i s>iJ w r �y � , HI a.,. �� ,���+. ,�"Va. ,� ��".�` -01'� r '�`ie+`a 11 a�•^' �� ,� '"^ivQ:f,.h,aV' ,w.�y,k ��. MUC 19 • b .►U r arj } ir. °.!ms I G TSIs�T,z�t z rC ay' t 2+.R�d' +d w 1 1 �� r�f �,�� �.}Y• .��I N e rR e� z`.�i.%�(r,�KC?ts^i�"ii i i i:fe�'6l'�'.•.j} r x�.ri �z.��`�: '�.e tarF' ' +�c.'s� .� K"''yG�v ei's �` v3 "� �Y'"'�' �' ".1LI `�«tY�r� ��.5,9'� fS � (�' iw.` ,�r 3e+s n,� R'•t y<�". A"'r.W� G � ` f� �,..r•.�y,e,F s--� 4,��j�� c ;;. r we ? a.>� i I.:dt'19 `� �f. (•'Q��'.�7t i� r � ',�.' v a„ a :,i ,r �` ..,,tr t R..?• � $r�"1�4v�e�r7'd aA g z � � s'� �^ °" i �w w - . �t�!t:� �^^(�,:,,,� � �a3✓.w� �7:rf�•:. '�3� 'F %nx`1r��,� �'�1.t 1a �0 ' tiw SC' y 1 Ccovc�C cOe Ck MA 1�6 O - I-D GJ�T�Ac�C O I ? TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 'P � Permit# Health Division 00 J/_r� Date Issued Conservation Division CO ( Fee . /. O`" Tax Collector �. .�. K7P�,ICE SEPTIC SYSTEM MUST,BE Treasurer INSTALLED IN COMPLIANCE Planning Dept. WITW TITLE 6 ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic-OKH Preservation/Hyannis w Project Street Address Village Owner Address �0. . v Telephone Permit Request Square feet: 1 st floor: existing proposed 2nd floor:existing proposed Total new Estimated Project Cos f' C3 acYv Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: O Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 8r--' Two Family` ❑ Multi-Family(#units) Age of Existing Structure 1 �S Historic House: ❑Yes Cr1Clo On Old King's Highway: El Yes U-W6 Basement Type: 2'Full ❑Crawl ❑Walkout ❑Other 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 Sv new First Floor Room Count Heat Type and Fuel: ❑Gas ®'Oil ❑Electric ❑Others Central Air: ❑Yes Fireplaces: Existing _� New Existing wood/coal stove: P Yes ❑ No Detached garage:2/existing ❑new size Xl(_K FPool:❑existing ❑new size ' Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing O new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No s If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name rd w // C, Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE _TS 6 4f - FOR OFFICIAL USE ONLY r .• - PERMIT NO.'- DATE ISSUED _ MAP/PARCEL NO. .--t 1 ADDRESS VILLAGE OWNER ev- DATE OF INSPECTIOIp r FOUNDATION FRAME ; INSULATION FIREPLACE ELECTRICAL: R0U(Z _ FINAL a '4 a 0 gq PLUMBING: ROU FINAL , M, = GAS: ROUs M or FINAL FINAL BUILDING .r� "7 (2��'1� m.or 0 tt. DATE CLOSED OUT '? i` A fit ASSOCIATION PLAN NO. The Commonwealth of Massachusetts �_=.�. _ Department of Industrial Accidents =_ elute allaresliaw aos 600 Washington Street ' r y` Boston,Mass•, 02111 Workers' Co m ensation Insurance davit ` EN name location &C, CQ city � 0. hone# I am a homeowner pesformin all work myself ❑ I am a sole rietor and have no one worlds in anv achy 'co ensation for my employees working on this job. : <>:.... I am ::...::. comoanv name. s .....:::...........................................:..... .....::... .........: one#. : insurance co ...... ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have olives: :.;:::.:>:.:.:;:;.:;.;.>:.;;:.; .... ,,... .. win workers ensation p mom= ;;.>:.:»: :;.;;; .the folio g e°mP ::.::.....,..:::::::::.:::: :.:,.:.::: ...:,........:,... . ::::.......:,.. anv n amen....... ::.:.........:...:...:.::..:....:...::..::::..:....:. comb .. e dd .. . a " ............................. .,.............................. h :... d <:;;;;>; ......:. ....... .... : ::<:i::::i::isi:}:i{{�ii:i::¢::•:i:•.�4::r`::::::';::ii::%is`.j:::.}?:4:i:i'::i:>i:tv:...:.::..:•:::::::,.:v.::...y. .. .... insurance,ca .::.::.................. / .:.:::::.:.:.::::::::.::<•..::::::.._::.::.:::::::::::.:.:::::::.::.::::.:.::::::::::.:.:;:.::::.:::::.::::::.::::::.:::,.::::::::,.:<.::...:... address.: city: _................. . ...................................................................................................:. oli i Fapnre to secure coverage as required mtder Section 25A of MGL 152 cats lead to the impt of eiiatinal penalties of a fine lip to si soo.00 andt'or one years'imprisomnent as well as dva penalties in the form of a STOP WORK ORDER and a tine of S100.00 a day against me. I tmdet�d a copy of this statement may be forwarded to the Omee of Investigations of the DIA for coverage veriflcatlon. 1 do hereby c under t pmns p ofPeJury the the infor»ra ton provided above gas tru:and correct -� v,O) Date - Sigoatiire % Phone# Print name official use only do not write in this area to be completed by city or town omdal permitllicente# ❑Building Department city or town: OUcensing Board ❑Selectmen's Office ❑check if immediate response is required ❑Health Depamnent contact person: phone#; ❑Other (tensed 9l95 P]A) Information and Instructions .: Massachusetts General Laws chapter 152 section 25 requires`all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of ano#iier under any contract of hire. et-press 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 hazing 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 section 25 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,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of inmi*ance as all affidavits may be submitted to the Department of Industrial Accid for cmfirmation 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 Depattcient 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. City or Towns 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 member which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you 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 Imlest1gadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 of 1HE?I The Town of Barnstable snaivsrABv_ - 9� 1659 `0$ Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-862-4038 Building Commissioner, Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL.c. 142A requires that the`reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. p - l �� ,,� tJ� Cost D Type of Work: �-�C� � C � � � C � Estimated Address of Work: �L t,t C Owner's Name: ( Cam ' ' " ` g Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law r1Job Under$1,000 (3Bpffding not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED i CONTRACTORS THE ARBITRATIONROGRAM OR GUARANTY EMENT WORK DO NOT E ACCESS RANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. t Date Contractor Name Registration No. Date Owner'qaA�-. q:forms:Affidav �-d�.e Wet l /p =-_ _. 56� s �L 0 T 14 - ..+1 ... �,. _.. .. . .. 0 mike («pine. 40 Elek 43.6 � 0 T 26 p 45.5' .. p/ OUSE' 6'diom.z 4'dee �f LEACHING PIT oias�r itOmin. N � <:"� p.z with4ft.ofwosh stone all around. 2 ' E 48 $e_ ; 27.7 8 T� LOT 24 p HOLE 148 4� EST W 4 HOLE#1 112.3' o i Pi SI PUr;ig BENCH MARK J ff 1 N.E.Corner o Elec..Pod Elev.=45.32 Stake set {25.00\ Stake set V,4 V I ZED ft� TC N %1�1M c�0 I S 1 D Dl. )E" 1/V ��4G= G�!`Ttf l �� Sc it�c OS '! eR©s%S (Y'1�-k 7 ' ©,C, ' 141, = 1000 l)si L = 1.,300,000 psi 1 ypival values 1*01- S0Lldle1-1)-YcI1UW I'iile #2 (1'ressure 7'reate(l) Exterior use (e.g. decks) Joist Size .)gist } Spacing i 2x6 W 2x1U 2x1.2 I2" S-G 1 1 -; '14-3 17-4 01 � 74 '1 U-0 - '12-4 '15-0 20 6-7 8-11 11-0 13-5 24" - 6-0 -2 aU-1. 12-3 o &P'ElqrE-1�1 q90 VF- 3 OR ! // f� Jo1ST �kmlv N I1 SoN o ! j',3FS The Town. o Barnstable UMMEr Department of Health Safety and Environmental Services Building Division EAMS''mom ' 367 Main Street,Hyannis MA 02601 w►ss. v� z639. �0$prED & Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION / Please Print DATE: (� 'T f / � JOB LOCATION: number street / [ village "HOMEOWNER": _v`kCtA,0,,ej v -fr��-� `T,"�"?) T Z�—� LF '-'If name_ home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF 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 minim a inspection procedures and requirements and that he/she will comply with said procedures and req nts. Va Signature of Home Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will.be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN • Assessor's map and lot number .......A!.-.21........ SE.' PTIC SYSTEM MUSTqB ej�pLIANC Q�OF THE ropy INSTAL�.ED Sewage Permit number ....................�'�:-�8...... � Wff", b AL CODE • hh / RO�E.�' BA" ABLE, House number .............ol �.......... -A...�(............... ENVI TOWN REGULATIONS 'o 9 NAY k� TOWN :OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR.PERMIT TO .... .`.A. .......5.�!n .t�.�. .. 4.1..... Q...... .... .......:t.......I.......... :... TYPE OF CONSTRUCTION ......................................!'�I.. ..................................................................................... ..............................7 ..�.�....19... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location' ....�,r�.l.....a...Q.... ... . 7D."ue .......ca—tai.j................................................................................... Proposed Use ...IZV1.. .�fG,...... ..01.`.�!!1.5l� .... ..60-Y.1 .. .............................................................................................. ZoningDistrict .....:. ..:.......................r.................................Fire District ... ..�....--II �.//.�__.1......................................................... Name of Owner hc.r( ... Ll� :u^1 N�1.!�N..Address VJ ................... v �� Name of Builder sue.!!` ...................................Address ...:............................../ ... ............................................ .... Nameof Architect ........... .:..................................Address .................................................................................... Number of Rooms .............b..... F:.... ........ i�...........Foundation .. Q1..lC.. 'C,<1.ti�...t...................... Exterior .......Lo ..".Cl' ... /...[ .CIAs.f.. S...............Roofing ..... .4.Q.CJ S 12tLz p � Floors .4..........................................................................Interior �.14� 1 �C.r Fieating .. ........d.4.1..........................................Plumbing ................oC..... ... 7.tT�.:..................:.................. Fireplace ........1.....Q:�..4�1 . .�.....ln� ....,� ,v,J i �,.Approximate Cost ........ d..0a.:..�'L�i......... . Definitive Plan Approved by Planning Board -----------I _________19/_ _. Area ....... .. . .la. ...5`.."........ Diagram of Lot and Building with Dimensions Fee '--� SUBJECT TO APPROVAL OF BOARD OF HEALTH � OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. r.; �•h Namec7..� doj y C7 v 13 9X Construction Supervisor's License ................ .. ......... WELLINGTON, CHARLES 0. 28413 11 Story No ................. Permit for ....... ........................... Single Family Dwelling ............................................................................... Location .....Lot...2.5........2.1.1...ox.f.ord...Dr iv.e..... Cotuit ............................................................................... Owner 0. Wellington .............................................................. Type of Construction FRame. .......................................... ................................................................................ _ -ems < ." Plot ............. .............. Lot *............................... 7 Permit,Granled ........S.eptemher...L2.,...19 85 7 Date of Inspection .............................. .....19 Date Completed � ...................19 tot (U M (0 cu >- d"t Cr do Ilk, 4ssessor's map and lot number I !" THE ra....... .:.................. ro Sewage Permit number .................................... Ml /) BASB9TAIiLE. i Housenumber .............�.(.................................. ........ ........... rasa O 1639• 9� O WAR a\ TOWN O --BARNSTABLE 4 BUILDING INSPECTOR APPLICATION FOR PERMIT TO FO :.!. ....... .:.`!!..�. ....... G� "� ,�, .....lJ. .......... +.. ............ TYPE OF CONSTRUCTION ....w.d U ...... .CC't' ................................ . ..... ......... . . . ............................. ..,.. t f f� ..........-j..!.....:..! 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location . Cl t� '1 �)x o r Clr � Q ProposedUse ..)cv... {..6 ... .G.......... a....... .f? ........................................ ..................................................... i . ZoningDistrict ...... Co...................................................:.............Fire District :..... .........v '.........:.................................................. Name of Owner (ti(. :. ....(t•.. �?.fi.�.L.lr-f.."�• rlJl ..Address ...�.: ��.... ✓- C:" ,...`�.C^ � '��.1..!�.:.:.... Name of BuilderC, wig....:. ........................Address .........:.......................................................................... ............................ ....... Name of Architect Ae!� VI-L ................Address".................................................................................... ot C e- ..........� ..................Foundation t �. f :i ) Number of Rooms ................... . ..•....:............. ............................................... V i Exterior ....... .r.. . �C1 ..S..r ..... .L. .f'�{^�..�: .. ...Roofin ..... .h. .''. .... ............................. Floors ........Interior e':S T Heating .................................:?.... ..........................................Plumbing ...............�..... ...H1•r{ ............................................. Fireplace 1 0n c ,, /.I.....6..d.✓7.C�.!::�...:�).�?.� ....Approximate. Cost cO C) . P.9 • C? r, .. ..... ................................. .. . Definitive Plan Approved by Planning Board _____�_'___ '___________19� _. Area ........................ ..... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH nX� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 1 � # Name r �.� ..... �. �.. ) . • f fJ(-7 !,C�q Construction Supervisor's License ..... �U..}.. 1 ... . ........ � - ` . ' ' 111?17 ` i ° TOWN OF BARNSTABLE Permit No. __-_28413___ { � = Building Inspector Cash --------------- f�eja OCCUPANCY PERMIT Bond ------- �r_ _ Issued to Charles 0. Wellington Address Lot #25, 211 Oxford Drive, Cotuit Wiring Inspector Inspection date Plumbing Inspector ' � Inspection date Gas Inspector �+�` Inspection date Engineering Department '�.� Inspection date Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. r�7.... ... / l .. ../..�...,... _ :. _... ._ Building Inspector TOWN OF BARNSTABLE BUILDING DEPARTMENT S rsaaar TOWN OFFICE BUILDING erg► rb 9 �� HYANNIS, MASS. 02601 �a r�r►. MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy,Permit has bO en issued for the building authorized by Building Permit _.�.. � _ .. _ . .._...... .. .........»_. »� _ �. issued to ...Q! Please release. the performance bond. ----- ----- M a r s h 9e /p -�f wet 'Ond wll� 2p \ PPGE `/O 2 \ lg3,y \ pike in 14"pine \20 30 ` --E le .=2 .74 LOT 14 48, f�F +I \ 3 N O Spike in Il' p 4Q Elev.= 43.6 — L 0 T 26 1 \ U-) �20' \ N \ \ o/% \ M 7-I =/Pro osed = /HOUSE _ i t 34-2 / s 6 diam.x 4 deep 5 45 \ R LEACHING PIT — oisr. lOmin. N ao - with4ft. of washed `I-Q- 27 r.. ..,: stone all around. ( _. ; --- 1000 Gal. - 2A 4 2 •• ` :SEPTIC Prop. a I "i. , 48 d \ G a r N // \ TEST A� HOLE# 1 L 0 T 2 4 til TEST HOLE#I 3', L 112'± \ 0 F6 CL+ Pine Sopl rENle.E. NCH MARK � m9 BENCH Corner of lec. Pad v.=45.32 Stake sit'-- .r 1125.0 Stake set 7/24/85 Changed size of leaching pit . R.S.J. �?+-6 j NOTES: OXFORD (Private-40'wide) D R I V E DATE DESCRIPTION Drown by Checked by ----------- R E V I S 1 0 -N S 1 . ZONING DISTRICT: R F. s'z7 s?6 2 . FLOOD HAZARD ZONES : A I I I EL. I I a C . PLOT PLAN 3 . ASSESSORS MAP NO . : 21 - 29 OF PROPOSED SEWAGE DISPOSAL SYSTEM 4. HOUSE NO . : 21I PREPARED FOR 5. THE NORTH ARROW IS DERIVED FROM RECORD PLANS C H A R L ES 0. WELL ( N G T N OR DEEDS . THE NORTH ARROW SHALL NOT BE USED FOR ORIENTATION FOR SOLAR HEATING PURPOSES . FOR LOT 25 0 X F 0 R D DRIVE 6. REFERENCE: SUBDIVISION PLAN "KINGS GRANT" PL. BK. 271 PG. 56. IN 7. CONTOURS AND ELEVATIONS FROM ACTUAL ON THE GROUND INSTRUMENT SURVEY COT U I T BAR N STABLE , MASS. BASED ON THE NATIONAL GEODETIC VERTICAL DATUM . 8. PERCOLATION TEST N° P 4413 . SCALE: 1 40' DATE: J ULY 10, 1985 `�r� Of holmes and me9 rath inc A001ERT civil engineers and land surveyors ANK 200 main street Mo. ao CIVIL falmouth, ma 02540 DRAWN: R.S. J. CHECKED: RA Q • � �� i JOB N°85293 DWG.N236-3-29 SHEET 1 OF 2 G1u : r I'M a s h �E d e -� Of /Q We t 1/nd �_ \1 10 1 /93.y \ Spike in 14`pine \20 3Q \lei.=Z .74 �. L 0 T 14 5`as�F. I ce^t� ;�• that the HOUSE IS loCated on the lot as shown 3p ke in' II"p a \\; 40 � Elev.: 43.6 and t;,at LTS :.c,cation conformS L 0 T 26 _ to tale minimum setback requirements -� \� 1 \ of the BARNS?'AeLE Zoning Bylaw . 27 Date eg s ere an rve r 4 .5' 45.5' HOUSEOUND �\ 34.0 45.4E 45.6 n,r LEACHING PIT _ .e� min. i ;IO ni with4ft.ofwashe o5 28. stone all around. ( M 'IOOOGaI /L EPTIC, I certify i f y that the HOUSEF, A� + • IS lucs ..ed in. Flood Plain Zone Cas shown on Food Insurance ` Na e Marl Cummur:ity Panel No . TEST # " LOT 24 250001-00158 and that Flood Plain Zone 6I HOLE '�� W_ AW , 148.4' TEST C is not a special Flood Ho2ard Area. � HOLE�I sti q DateRegistered Lon yor 0 BENCH MARK `I I P1 ne 5 piing E. Elec. Pad ��;�� Elev.=45.32 Stake set 126.0 Stake set 8/26/85 Offsets and Certifications P. J. B. 7/24/85 Changed size of leaching pit. R.S.J. NOTES: OXFORD (Pri vote -40'wide) D R.' V .E DATE DESCRIPTION Drown by Checked by R E V 1 S 1 0 •N S 1 . ZONING DISTRICT: R F. a ,PLOT PLAN HAZARD ZONES ' A II EL. 11 C . 2. FLOOD H l 3. ASSESSORS MAP NO . : 21 - 29 OF PROPOSED SEWAGE DISPOSAL SYSTEM 4. HOUSE NO 21I PREPARED FOR 5. THE NORTH ARROW IS DERIVED FROM RECORD PLANS C H A R L ES O. W E L L I N G T O N OR DEEDS . THE NORTH ARROW SHALL NOT BE USED FOR ORIENTATION FOR SOLAR HEATING PURPOSES . FOR LOT 25 OXFORD DRIVE 6. REFERENCE: SUBDIVISION PLAN "KINGS GRANT" PL. BK. 271 PG.56. I N 7. CONTOURS AND ELEVATIONS FROM ACTUAL ON THE GROUND INSTRUMENT SURVEY COT U I T BARN S T A B L E MASS.. BASED ON THE NATIONAL GEODETIC VERTICAL DATUM . SCALE: 1 ��= 40' DATE: J ULY 10, 1985 �K of 8. PERCOLATION TEST N2 P 4413 . holmes and mcgrath, inc dee+�rt civil engineers and land -surveyors MAIM WII 30 200 main street civi `Sb falmouth, ma . 02540 C DRAWN: R.S. J. CHE KED fi JOB N285293 DWG.N236-3-29 I SHEET 1 OF 2 G..� a