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Home My WebLink About0081 RALYN ROAD / `)0& 1 ,4 ,.CAPE3 COD , 4, INS ULAT`FON El fN FM /IRRp OIA57 SIAMl154 SPRAY PCAM SUSPINpIp - r - - RATTS _ OUTTIRS INSULATION CIILINO! r a - n 1-80 { °. 0-696-6611 Town of Barnstable' s =Regulatory`Services , s" Building Division v 200 Main St ;a r} Hyannis,.MA' 0260 ' . Y Date.. a A 'Dear Building Inspector _ Y )Please acce t.this Affidavi F P p t as documentation ihat Cape Cod Insulation,,ilnc, performed & `� completed�the insulation and weatherization work at the property listed below. ,Cape Cod ' Insulation did this°in'accordance to the specifications listed on the building permit application;All`work has been inspected by-a�certified Building Perforniance'Institute (BPI)4inspector�All work preformed meets.or exceeds Federal & State Requirements. Property Owner Property Address' Village ti M*4 Insulation Installed•` Fiberglass _'Cellulose R-Value Restricted , Unrestricted CeilinFgs. Slopes b ; Floors Walls F �N�✓�� s �Qr 17wr..��r�r /¢ r J Sincerely H ry E ssi r, President}` pe, =Ins ation;'Inc, -- A112 'y •. V TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map p�n� Parcel ,�')'1,;�', jE Application # Health Division r_ , in Date Issued Conservation Division Application Fee Planning Dept. Permit Fee �k r r Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address P/ z7d Village Owner �vrA o%el J Address Telephone 4/*- Z GG 3eo 5�- Permit Request 66�Z /®D,� © �v Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type /j 46,04 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes 3KNo 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 —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 ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ` �zv::ZZ24k� Telephone Number 00JP 7VS~/Z! cl-- Address& ZW�neZ 4:!,:l/2 License# Home Improvement Contractor# Email Worker's Compensation # / 1491 Y/94,!�5 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE_ / G�� FOR OFFICIAL USE ONLY APPLICATION# ..: DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER A DATE OF INSPECTION: FOUNDATION FRAME w INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. M101 mass save PERMIT AUTHORIZATION FORM I. A. taen atric5 , owner of the property located at: (Owners Name,printed) . (Pro rty Street Address) (City/Town) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. Owners Signature , ' �•ci.,yL�1 cj zt7 t�' , Date' FOR CSG'OFFICE USE ONLY' Conservation Services Group has assigned.the following Mass Save Home Energy Services Participating Contractor to the above referenced project: . r 'CQ /a �A _/}iiu� Cn Participating Contractor Crate Rev.12132011 Massachusetts -Department of Public Safety :.Board of Building Regulattons and Standards .. -, Construction supervis6l, License: CS 100988 HENRY E CASSIDY' 8 SHED ROW WEST YARMOU717H Expiration ' Commissioner r 11/11/2015 r Office of Consumer Affairs and Business Regulation -10 Park Plaza - Suite 5170 ✓ Boston,,Massachuwtts 02116 .Home Improvement Contractor Registration ` Registration: 153567 . Type: Private''Corporation Expiration: 12/16/2016 Tr# 259188 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE ~. SO. YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. 0 Address• E� Renewal, �Employment Lost Card 7. C�le eav"71, euLC�a1C�/t`auJaCXa1jeC(0 Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: l egistration: -153567 Type: Office of ConsumerAffairs and Business Regulation xpiration: .:..:1-2:115/201.6 Private.Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 4PE COD INSULAT.I'ONi;:INC':`:: '` ' ` =NRY CASSIDY 3 REARDON CIRCLE" D.YARMOUTH, MA 02664 Undersecretary AO(validut sign e y The Commonwealth of Massachusetts Department of Industrial Accidents' Office of Investigations 600 Washington Street,. Boston,'AIA 02111 www.`mass.gov/dia Workers' Compensation Insurance Affidavit: Build ers/Con_ traCtors/Electriclans/PlumbeI'S A licant Information Please Print Leyibly Name (Business/Organizadon/Individual): + �' Address: 4<av CV0,1 City/State/Zi •4��V ' Phone #: Are you an employer? Check he appropriate box: - --- 1. I am a employer with �j�j 4• ❑ I am a:general contractor and I Type of project(required): 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 h , � ave 8. [] Demolition working for me in any capacity, employees and have workers'` , [No workers' comp. insurance comp. insurance.t 9•"❑ Building addition required:] 5. ® We are a corporation and its 10.❑ Electrical repairs or additions 3,❑ 1 am a homeowner doing all work, officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12 Roof repairs i insurance required.]t c..152, §1(4), and we have no p 3 a.❑ I am a liomevwner acting as a employees. [No workers' 13. Othei 4� general contractor(refer to#4) - ----..- _ �_.._..._...' comp. insurance required 'Any applicant that checks box#1 must also an out the section below showing their workers'compensationpolicy information'.'.. ;t Homeowners who submit this affidavit indicating they are doing&Twork 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 copolicynumber n►P• I am an employer that is providing workers'compensation insurance for my employees. Below information. is the policy and job site _ r� Insurance Company Name: ��ti t G Policy#or Self-ins. Lic.#: `a/'� �� E - xpiration Date: Job Site Address: / City/State/Zip;�� / O ZG Attach acopy 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 $250.'00 a day against the violator. Be advised that a copy of this statement,may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi un the pains and penalties of perjury that the information provided abov'e is true and correct Si ma , /,, • Date: Phon #: Official use only. Do not write in this area, to be completed by city or town officiai City or Town: PermitfUcense # Issuing Authority(circle one): -- 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: i ' From:Rogers&Gray InsuiaFax: To:+15087785736 Fax: +15087785735 Page 2 of 2 0313012015 1:0:04 AM . CAPECOD-27 BDELAWRENC:E ACORO' DATE(MM/DDPlYYY) CERTIFICATE OF LIABILITY INSURANCE 313012015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TI•113 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the`certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED, subject.to ,I the terms and conditions of the policy,certain policies may require an endorsement, A statement on this certificate does not confer rights to the certificate holder In Ileu of such endorsement(s): + - PRODUCER CONTACT -- Rogers&Gray Insurance Agency,Inc. PHONE 434 Rte 134 E,No Ext: FA/c No): (877)816-2156 South Dennis, MA 02660 ADDRESS: I INSURER($)AFFORDING COVERAGE NAIC u Peerless Insuranc Company INSURER A: e p y-see LIBERTY MUTUAL INSURED INSURER B:SAFETY INSURANCE COMPANY- 39454 Cape Cod Insulation,Inc, INSURER c:Endurance American Specialty Ins. Co, • 1 18 Reardon Circle INSURERD:ATLANTIC CHARTER INSURANCE GROUP South Yarmouth, MA 02664 ------ INSURER E: , y 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 PERIQI7 l INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH.IHIF CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS. EXCLUSIONS AND CONDITIO NS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LTR TYPE OF INSURANCE POLICY NUMBER MMIDDNYYY MM/DDNYYY LIMITS I A X COMMERCIAL GENERAL LIABILITY EACH L)AMAOCCURRENCE $ ;1,000,000. CLAIMS-MADE occ1+R CBP8263063 .04101l2015 04/01/2016 PREMISES EaOCCLIn-ence $ - _ .T 100,000 MED EXP(Any one person). $ PERSONAL&ADV INJURY $. ,,?1 000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 1 N PE 0 LOC POLICY a , GENERAL AGGREGATE. $ 2 OUO,OUQ, OTHER: a PRODUCTS-COMP/OP AGG $ 2,000,000. $• AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,OOOI Ea accident B - �ANY AUTO n TBD - 04/01/2015 04/01/2016 BODILY INJURY(Per person) ' $ ALL OMED X SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $VV i X HIRED AUTOS X NON-OWNED PR AUTOS Pe PERT DAMAGE --'— ra ci lent $ X UMBRELLA LAB X $ 2,00-- —I OCCUR EACH OCCURRENCE 0,00q C EXCESS LIAB CLPAIMS-MADE EXCl0006635000 04/01./2015 %04/01/2016 AGGREGATE $ DED X RETENTION_$ 10,000 A re ate , $ h. 2000,000 WORKERS COMPENSATION- . ..,...._, AND EMPLOYERS`LIABILITY PER STATUTE ORH- �" D OFFICEANY OPRIIMBERIPARTNDEm ECUTIVE YIN N A WCE00431900 06/30/2014 06130/2015 E.L.EACH ACCIDENT $ 1 OOU,000 (M es,decry inNH)and E.L.DISEASE-EA EMPLOYEE $ 1,000.000 If yes,describe under - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,0001 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule,maybe attached 11 more space is required) ` Workers Compensation includes Officers or Proprietors. Additional Insured status is provided under the General Liability and Auto Liability when required by written bontract or agreementwyith the Certificate Holder, CERTIFICATE HOLDER -' • CANCELLATION SHOULDANY OFTHEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation, Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 18 Reardon Circle ACCORDANCE MATH THE POLICY PROVISIONS. South Yarmouth, MA 02664 AUTHOR12ED RFPRFSFNTGTnrP TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ra Map �41Parcel Application Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee In Oy Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis d{� bl�SJj3 Project Street Address Village CO X Owner 'yAeAP:i\ A&_(_VS Address Telephone (VA- CIA06- 11_�OLi Permit Request �4tNAQ_\ T) �r�V-k , 1��1 n�w �j, -VU� A-o �e-Q0 •ne 4 h L e. -�o V\(Kve �oc er 1 r- �. o -t' A-, J ce. �.-J N 2 �SuaC` Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio Do,000 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach,supporting"docun@ntation. Fl.p' Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) 'i q Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑X:a ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other y. Basement Finished Area(sq.ft.) Basement Unfinished Area (sq�!ft) g� _ 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: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) J Name :)�LCep Telephone Number 570"E-7 S?- 34 L4 7 Address Y 00c L-OnQ_ License #_ LS aSV 0�R Home Improvement Contractor# VA O7)H Worker's Compensation # W cy-eG q n y-e- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE 0!J DATE r FOR OFFICIAL USE ONLY F APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE P OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE } ELECTRICAL: ROUGH FINAL t PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING qQ F DATE CLOSED OUT ASSOCIATION PLAN NO. i A 4 Deparbnew of Industrial Accitlenis 0J)ke-oflnves6gations=- --- - - - 600 Washington Street Boston,MA 021Ir - www.massgov/dia Workers' Compensation Insurance Affidavit: BuU'ders/Contractors/Electricians/Pluinbers Applicant Information Please Prinf LeeiblY -Name(Businessbrganizahon4ndivid*: Address: L( (};�r �e L. r.� i�C� I_, F�. 0 TS 72 CLty/S te/ZIT7: PhnnP# 0� -� 5�'- 3 � Are you an employer? Check the appropriate bog: Type of project(required); 1.❑ I am a employer with 4. []I am a general contractor and I employees(full and/or part tine).* have hired the sub-contractors 6• New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. Remodeling shipand have no a to ees These In have mP Y 8. [f Demolition working for me in any capacity, employees and have workers' [No workers'comp.,m�rr'r,ce comp.insurance.t „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 . g 11.[]Plumbing repairs or additions myself. [No workers' comp, right of exemption per MGL 12.[]Roofrepan-s insurance required.]t. � c. 152, §1(4), and we have no . _employees. No workers' 13.0 Other comp,insurance required,] *Any applicant that cheela.box#1 must also fill out the section below showing their workers'compensation policy information t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such, 4-nt-actnrs that cbeck.this box must attached an additional sheet showing the name of the sub-contractors and state whether or oot those entities have . employ=&. If the sub-contractors have employees,they must provide their workers'camp,policy number. I a7n an employer that is providing workers'compensafion insurance for my employees.- Below is the policy and job site information Insurance Company Name: Policy#or Self-ins. Lic.# Expiration Date: Job Site Address: City/State/Zip: r 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'coverage verification I do hereby certify ndi(e-�rthe pains and penalties of perjury That the information provided above is true.and correct • Si afore: .. U - Date: Phone# 0 -7�Z- _Syy'� FE6 only. Do not write in this.are;to be-completed by city or town offciaL n: Pertnit/License# thority.(circle one): Health 2.Building Department'3. City/Town Clerk 4,Electrical Inspector. 5.'Plnrnbing Inspector : rsoa: Phone#: df � Vassachusetts- Department of Puhlic Safetc Board of Building Red- lations and:Standards Construction Supervisor License -� Office of Consumer Affairs&Bu iness Regulation - =—, HOME IMPROVEMENT CONTRACTOR License: CS 62612 . _ =Registration: ;A'40724 Type: Expiration: 11/17/2013 Ltd Liability Corpora JARED E WEST " RA ER CRAFT,LLC ' r' 15 BLACKWATCH WAY MASHPEE, MA 02649 JAR WEST 15 BLACKWATCH WAIF a Q MASHPEE,MA 02649 :ls Expiration: 9/30/2013 Undersecretary .� Commissioner Tr#: 2931 1 Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license Refer to: WWW.Mass.Gov/DPS Regulatory Services Wses: �, Thomas R.Geiler;Director ply►w�" Building Division . Tom Perry,Building Commissioner 2.00 Main Street,Hyannis,MA 02601 www.town.barnstable.maxs Office: 508-862-4038. . _ Fax: 508-790-6230 Property Owner Must Complete and Sxgni This Section ,If Using A Builder q as Owner of the subject property hereby authorize' _fiteS r. to act on my behalf, is all matters relative to work authorized by this building permit (A dress 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. V. Sign at=e of Owner Signatut of Applicant . Print Name Print Name - Date QT0RMS:0WNERPEPMISSI0NP00 S 6/2012 SHE rq�, Regulatory. Services.: -- — -- F —__.--- --- Thomas F.Gefla,Director BUM, Building Division _ Tom Perry,Building Commissioner. 200 Main Street, Hyannis,MA 02601 www.towmbarnstable.ma.ns . Office: 508-862-4038 Fax: 509..-790-6230 HONE OWNERLICENSE E�XEhffnON Please Print DATE: JOB LOCATION: number _ street village "HOMBOWNBR": - name home phone# work phone# CURRENT MAMING 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. e. 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 faim 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 Deparhnent minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note:- Three-family dwellings containilig 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 bomeowner 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 forni/certification for use in your community. Q:forms:homeexempt - kaA n C®Ault Ll ;f a� I.aJ _ Y q n Fly.•A. r .•..-..,. it .. ....w � XcS to � I w ! I Lv� �- - i 1 �G� �7 � � �O � 5 � I ` v � Ste- �2� � 2 S 3 ^�Q�� eYY' �U� �� — - r �r %USl� i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ,OZ'Z Parcel Permit# �.I S 7� Health Division-,fq9 = 2 1 o I(5k1 (AD) on Date Issued Conservation Division /�//s/ '� Application Fee E 00 Tax Collector �, �� /�� Permit Fee 7. 7 Treasurer �� SEPTIC SYSTEM MUST E INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board EIMRONMENTAL CODE ANILTOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address b1 R. utk aoP,0 Village C0-colt- Owner DAY i D M0 lunk`( \,4 aLL5 Address ist i2ky N a0A0 cc),i-U1 7 Telephone Gov, -4Z 6 -4-&qa Permit Request Tb ?OILD A TL&G W44oA Zoom -AiW i i tok ;z> C. -fosL e Q � Square feet: 1st floor: existing proposed iqZ 2nd floor: existing proposed Total new 1 ZoningDistrict Flood Plain Groundwater Overlay `- Y _ Project Valuation 215 000 Construction Type m Lot Size 72 f1c.z Grandfathered: ❑Yes ❑No If yes, attach supporting do"umentatieft r° r rn Dwelling Type: Single Family J Two Family ❑ Multi-Family(#units) Age of Existing Structures. Historic House: ❑Yes &No On Old King's Highway: ❑Yes gNo Basement Type: C�Full KCrawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 1000 Number of Baths: Full: existing new Half:existing 9 new Number of Bedrooms: existing 3 new — Total Room Count(not including baths):existing ' new First Floor Room Count 4- Heat Type and Fuel: W Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes t9 No Fireplaces: Existing o New Existing wood/coal stove: ❑Yes KI No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:13 existing ❑new size Z3 X2y Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes X No If yes,site plan review# Current Use cLL's At Proposed Use BUILDER INFORMATION Name p kt5a�L Telephone Number _ 5'69,-4-2 A- o2 5-3 Address 164- OLZ> OYS is<L RA, License# CS yG 4-S 3g S ce z 01 7 d A o2 l0 3S- Home Improvement Contractor# 13183_3 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING F OM THIS PROJECT WILL BE TAKEN TO 3\Q_NSz A3�t? —i aA-cs k'c —,0-4 ff SIGNATURE _ DATE 10 I C1 10 Z FOR OFFICIAL USE ONLY PERMIT NO. r Uj L DATE'ISSUED - r I MAP/PARCEL NO. ADDRESS ! j VILLAGE OWNER DATE OF INSPECTION: if FOUNDATION \ FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL-1? - J r PLUMBING: ROUGH: F't FINAL GAS: ROUGHS FINAL_� FINAL BUILDING DATE'CLOSED OUTS ASSOCIATION PLAN NO: The commonwealth of Massachusetts =- _--- Department of Industrial Accidents a Office ofl.17=1i90011S•. ' 60'0.Washington Street Boston, Mass. 02111 Workers' Com ensation Insurance Affidavit / Av k G�2a --location: Y►-1 - • ��• hone# So�B' 2 -62��- • ci . . 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ItBtderafsmd Qisit a' copy of this statementmsy be forwarded to the Offic of Investtg • , . ., - . . • •er-o er u th�the-tnformatian- rovtded.abnue_is�cu•�arsd.caireci nder the f P. 1 Ida hereby c"ertifyu . F • Date Cb q a 2 Signature. . .. " •�•• .,. ,. ,'� - ;, ze-62S3 •'Print nine. '' p� 'i ofiiclaluse only do not write in this area to b e.completed by dty or town oMdal permit/license# [3Bu[Ld1ng Depattrne1d city ar town: ❑Licensing S o° c- ❑Se.t{cLnen s contact 13erson: II ' f Information and Instructions Massachusetts General Laws chapter�152 section 25 requires wed as evel�y per on inthe serviceers to provide eof another under any rs' compemation for their em ees.-As quoted from the_`law , an employee is rYP . -nfhire,'express or map a or or artners , association, corporation or other legal entity, or any two or more of An emPlayer is defined as an individual, hip - the foregoing engaged in a joint enterprise,"aad including the Legal representatives of a deceased employer, or the receiver or trustee o£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 repair work on such dweganother who employs persons to do maintenance, construction o eto'shall not because of such employment be deemed to be an employer ouse or onthe:grotmds or building appurtenant ther GL chapter 152 section 25 also stztes that every state or local licensing agency shall withhold t�hie,a u�caat who has M Pt of a license or permit.to operate a business or to construct buildings in the commanwe y pp „ . not roduced acceptable evidence of 6ompliance with the insurance c o�verage act for quirerfors Additionally, di eo a public h work uxiti7 P P commonwealth•nor any of its political subdivisions shall enter into any acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting Applicants please fill in the wbZkers' compensation affidavit completely,by�ecking the box that certificate of insurance as lies all affidavits maybe supplying company names, address and phone numbers along with _.. subbed to the Deparhmeat of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. Tlie•affidavit should•be retuned to the city or town that the appli cationrepermit the o`laRt"o if-yQu being requested,not the Deparment of Industrial Accidents. Should you have any quregarding ob}ain.a workeis' campensationpolioy,please calrtlie Department afihe numlier'listedbelow:.- - are required,fo City or.Towns Please be sure that the affidavit is complete and Pied legibly. The Department has provided a space at the bottom o.the eat the Office of Investigations has to contact you regarding the applicant. Pleasef, you to fill out in the ev _. � y `" affidavit for .effirt�license nuu1ber wliicli will.be used as a reference numb*ei. TFie,i� vits ma-'!;'e'r �t�• . b sure.to fill?n� or FAX wil e's s othei arraiigeatents have b een made: the Dep �, .. ^..s�,.. anal ations would like to thank you in advance for you cooperation and should you have Wn ,uestions. . The Office of Investig• .; . - please do not hesitate to give us a 1.calf. _ The Department's address,telephone and fax number. The'Commonwealth Of Massachusetts Department of Industrial Accidents • puce of inyestlgatlons 600 Washington Street , =` Boston,Ma. 02111 fax 4: (617) 727-7749 "n*nc- ii. (617) 727-4900 ext. 406, 409 of 375 Town of Barnstable Regulatory Services * BnxxsTAs , " Thomas F.Geiler,Director 9 MASS. g 039. A`` Building Division lED MA'S Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date 10 Ot OL 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: 1W� Ao 7 10 Estimated Cost 12 00 s ov YP � Address of Work: 1 R LY�-1 �® ed+u o ! MA ' . ©2(0 3 Owner's Name: AAV%4�l V4 a u.s Date of Application: 1pl g I o Z I hereby certify that: Registration is not required for the following reasou(s): ❑Work excluded by law ❑Job Under$1,000 FIBuilding not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. I SIGNED UNDER PENALT S OF PERJURY I hereby apply for a permit as the agent of the -OT to °2 Registration No. Date Contr for Name g OR Date 0vrr er's 1,4a��_e RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 �� Z Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE l9 Z square feet x$96/sq.foot= 18 43 Z x.0031= - plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x .0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee � 7• l projcost OptHE�O ! The Town of Barnstable 8AH`ASS. 0a E. MASS. : Department of Health Safety and Environmental Services 9 1639. �0 pTED MP Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: P Map/Parcel: Oa-a�1-G z Project Address: if 4Z-)W 610 Builder: D. e s2 e The following items were noted on reviewing: � /M�1 ,! ,,may� 41 jq1 L l rr�PFi�rr'/o s v /// T 2- (✓M D 711 e'xf W PP It 7y4- 5GJ2 rem f 2du A � r�r m �r_s� ' �y /at�c� C'�0 TH dk i t 01 P DO w S �0 5 7" &Z' 7i1A1 F/L r D A y"' d,-A cope 5F"c-, 3G031 -1-61 y, Z P4'e-'f' �.. t i Reviewed by:TAG/e ��a Date: �O�/(��0 Z .57, 141 I q:building:forms:review r i ✓1e 1°�usealC/ o�✓i�aaaac`ivaeCla BOARD OF BUILDING REGULATIONS License: CONSTRUCTION•SUPERVISOR NumbeyCS 1745395 1 Birttidate� 1111'n1955 IL/1x12002 Tr.no: 10996 t, 'R T }'1. estrictetl `�,4 0Qx�f�- � J DAVID F KERR 364 OLD OYSTER COTUIT, MA 02635 Administrator 71. V�am�na�uuecz/b�i o�✓f/ aaae/ivaelta Board of Building Regulations and Standards HOME�LM,p;,P,RVEMENT CONTRACTOR Regrstr 4W 33 833 1 ,Expiration= %26/2004 Type jr idividual DAVID KERR �'F4 + DAVID KE 364 OLD OYSTER RD.`_" _� COTUIT, MA 02635 Administrator �` ONSUN R�IlITFO O - SUNROOMS" aCt1aS 'State` Ulldln CO OCMR pen y` erti0 The Massachusetts State Building Code(780 CAM) includes provisions to ensure that houses and house additions meet energy efficiency standards. This supplemental CONSUMER INFORMATION FORM is to be filed as part of the building permit application when a builder/contractor or homeowner, constructing/installing a house addition with very large percentage of glass to opaque wall,seeks to utilize a special energy conservation exemption option for "sunroom" additions jo,an existing house (780 CMR, Appendix J, Section J1.1.23.1). This FORM is not intended to prevent a homeowner from selecting a "sunroom"of any size, configuration, orientation,form of construction or percent glazing,but rather is only intended to assist homeowners in becoming aware of some of the important energy conservation and year- round comfort considerations involved in selecting and utilizing a"sunroom"addition. The connection of "sunroom" structures to residential buildings may create comfort and energy consumption issues-due to uncontrolled solar gain or uncontrolled radiation cooling of the main house. In the selection and construction/installation of"sunrooms", included below is a non-required, open-ended list of product and design considerations that a homeowner may wish to consider before actually constructing/installing a"sunroom".It is recommended that consumers carefully review these options with their designer, builder, or conractor, in order to minimize potential- energy consumption and/or house discomfort issues. In addition, the qualifications and reputation of the company or individuals to be hired are important considerations. PRODUCT AND DESIGN CONSIDERATIONS RELATED TO"SUNROOMS" • Solar Orientation and Natural Shading - • Type of Glazing • Insulating value • Solar heat gain • Frame materials • Glazing to frame sealing and gasketing materials/seal durability and/or weather tightness of the sunroom • Adequate ventilation Operable windows and fans • Applied Shading Systems •_ Insulation level in floors,walls,and ceilings • -Possible Sunroom isolation from the main house via a wall and/or door or slider • Heating and Cooling Methods: Efficiency,Zoning and Controls Homeowner Acknowledgment The Massachusetts State Building Code, Section J1.1.23.1,..requires that the actual property owner(not the owner's agent or representative)acknowledge receipt of this CONSUMER INFORMATION FORM prior to issuance of a Building Permit for a project that includes "sunroom" additions to an existing residential building. In accordance with this requirement, the undersigned hereby acknowledges that she/he has read the information in this document concerning sunroom comfort and energy conservation. r gnature of Actual Building Owner Date Print Name Address of Permitted Project �-.7-7-- 4-L 9) Owner Address(if different than project location) Owner's telephone number l TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map t Parcel Permit# f'�g Health bivision Date Issued ® a I Conservation Division Fee ��r•®Q °GAG lU Tax Collector Treasurer Planning Dept. , Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address d .Village Owner U 11 1ti—Q L S Address �S k1 M Telephone — 07� Permit Request Square feet: 1st floor:existing proposed 2nd floor: existing proposed Total new "Estimated Project Cost, _ Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑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 Kings 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 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 Cl 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❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name A Telep hone Number Address License# Home Improvement Contractor# J • Worker's Compensation# )Olq /X� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE FOR OFFICIAL USE ONLY PERMIT NQ. DATE ISSUED ' a MAP/PARCEL NO. ADDRESS; VILLAGE + ., OWNER • ' - ,- �Y ,, •. .. . ' ,-. NY DATE OF INSPECTION> I� FOUNDATION FRAME - r INSULATION = v ' FIREPLACE ELECTRICAL: ROUGH - FINAL s r PLUMBING: ROUGH FINALt t " GAS: ROUGH FINAL i FINAL BUILDING - r DATE CLOSED,OUT J ASSOCIATION PLAN NO. f The Town of Barnstable, BARNSTABIA 059.MASS. Department of Health Safety and Environmental Services 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 w 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. �OE ;1E.Y/s i Type of Work: — Estimated Cost ' Address of Work: kJ Owner's Name: DA U I (J �),e Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law r oJob Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the age of the owner: y Date s Contractor ame Registration No.OR , Date , Owner's Name .. X"N .. g1orms:Affidav ' 1Xe -Cammanawald o��e� 1 V HOME IMPROVEMENT CONTRACTORS REGISTRATION Board of Building Regulations and Standards 1 One Ashburton Place — Room 1301 I ' Boston , Massachusetts 02108 1 I, HOME IMPROVEMENT CONTRACTOR Registration 103714 Expiration 07/09/00 I Type — PARTNERSHIP . I HOME IMPROVEMENT CONTRACTOR I Registration 103714 PAUL J . CAZEAULT & SONS ROOFING Type - PARTNERSHIP Paul J . Cazeault I Expiration 07/09/00 22 Giddialt Rd . P .Q. Box 2781' 1 Orleans MA 02653 PAUL J. CAZEAULT & SONS ROOFI ! Paul J. Cazeault ! G� ��7? &pq�qiddialt Rd.. P.O. Box 278 ` I ADMINISTRATOR . Orleans MA 02 653 Q ten ;^'n, r 0i 1'1R 1 MI P11 OF PIWI 1C a i.)I!I , I11 lll, 10[4 1)1,h C L, T I. i ';Gi.i . 1.;U`i .Slll`I:iiV I: 0lr l_ f.C.1 i\l`:;t. I•!I!I I I i l::•I":: , r 1)] Jr+ 'f�':_ - .. i; y —Y ?'l:.i):.i�"' 1�'1+!',?;'1�) ( (J('1 r_ ,�tr+ t ' I1 I:rl , I I I i. I:v c h 3(:+1) 1.o1j i-or I :'(.: i.1.)i: :?Ills :II II . ,, �. :Jltf• C�L10(9llu7tlIMC7CI1t O�.'•((.il;k1C7CIlJI,+('IJ � .. . OEPARTMENT OF PU8LIf. SAFFTY CONSTRUCTION SUPERVISOR'LICF,Vf , . - - Number: ExL•ire,: Fill;,I„LI,. Y'. ,. � ' 3 C$ s;P16J1$ 1Ajiil;i�+'19 1�(,jP.f;054 •I Restricted To: NN i ;:• glNl J WEART 1586 MAIN ST ' =j =-= Department of Industrial Accidents Office atfnYesttgaMons 600 Washington Street Boston,Mass. 02111 ' Workers' Compensation Insurance Affidavit name: ALI-P Z location 1i city 01l / ohone N ❑ I am a homeowner performing all work myself. ❑ I am a sole oroDrietor and have no one workin in aav capacity �//%%///////G/////////'�l//// %/,��c,��///1'� /,�'�///////i��/✓,�//O////%//////',';': ❑ I am an empiger providing workers' compensation for my employees working on this job. ccMnnnv name• K address: D ,:;...::.. :.::.: ::. . :,:::.;<;.::•::::.:.:. . city: insurance cn. oiicv# i ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following Nvorkcrs' compensation polices: comvnnv name, address: City: phone #- insurance crt. .. . oiicv# ,.: '//,C(/.G//:/r://////////.%////.IG:Gf�'(bU//,✓/////////.1//%//////,�l%/.(//%//i/r.'Gl"L/////(///,G��IG%�//.G///%��G �/ ' camnanv name- : ::...:.• :..:..:••::... ..,...: address- Cites ohone#e Insurance co. ..... ......11 ...- ,� Failure to secure coverage as required under Section 15A of MGL 152 can lead to the imposition of criminal penalties of a fine up to s1.S00.00 and/or one years,imprisonment as well as civil penalties in the form of a STOP wORIC ORDER and a Me of 3100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verification. Ida hereby certify the paints d penalties of perjury that the information provided above it ins:mid correct Sizaature Print name U Phone# otncial use only do not write in this area to be completed by city or town otllcial city or town: :permitalcense o Mudding Department QLicensing Board ❑check if imrpediate response is required ❑Selectmen's OMce ❑Health Department contact person: phone#,, QO er64 �� (mevuea 9,95 PIAI Massachusetts General Laws chapter 152 section 25 requires ad employers to provide workers compensationif employees. As quoted from the "law", an employee is defined as every person in the service of another under any conv..Z. 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 c; the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the rece:s•er trustee of as 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 e, construction or repair work on such dwelling house or on the grounds c: 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 renew, 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,neitherthe . commonwealth nor any of its political subdivisions shall eater into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements ofthis chapter have been presented to the cam== 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 numb=along with a certificate of insurance as all affidavits may be submitted to the Deparmneat of Industrial Accidents for confirmation of;nmrmcc 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,pleese call the Departtaeat at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Departmmt 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 permitllicease number which wall be used as a reference number. The affidavits may be rctumed io 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. 101 The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Ofitce of lawaf e.902s 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone #: (617) 7274900 ext. 406, 409 or 375 I fie �anvm:o�uve�z�i o�.a2�aaaa:c�ivaeC>�• ;' HOME IMPROVEMENT CONTRACTORS REGISTRATION 19 , oar`d• of Building Regulations and Standards i One Ashburton Place — Room 1301 i Boston , Massachusetts 02108 j HOME IMPROVEMENT CONTRACTOR Registration 103714 Expiration 07/09/00 1 Type — PARTNERSHIP i HOME IMPROVEMENT CONTRACTOR i Registration 103714 PAUL J . CAZEAULT & SONS ROOFING Type - PARTNERSHIP Paul J . Cazeault i Expiration 07/09/00 22 Giddialt Rd . P .Q. Box 2781 Orleans MA 02653 PAUL J. CAIEAULT 3 SONS ROOFI Paul J. Cazeault $iddialt Rd. P.O. Box 278 ADMINISTRATOR s 653 Orlean MA 02 2 h 1,,:;>�i:li'11.I`ii l)i` Lillrl.):l. , ,•;,I,.; I ...i•, ,'i, 0Ht iil ui. Sold i>I rc 1 , I iI a ;;c i.11i.l',1 .il If' I C(UP`1 ::;lll'i�i;�Ja.•iQi�. l..l.(,4.i`I:-�1. ... .. I'•i I!I I I I):•Y': c �.)1 i U J-.l l..�i�e+.kk? ' .. ... ,- - I d 07 * I Mr''1LI.1 I. e ' KfI`i? .. it/76 -V/n9J14It6/tI/RQCI11 of••((,ild)C7CIIJCIIJ.`� ` c OEPARTMENi Of PUBLIC. SAfFTY , LONSTRUCTIO SUPERVISOR LICENSE ' CS F;N26325 lA/2 j"Q q - Festricl'ed 'To: NN I ij s AL J WEART ti 1555 MAIN ST OSTERVILLE,- MA '0265 I . i C. 6 ZZ Parcel c zol: Permit# � Conservation Office(4th floor)(8:30-9:30Y 1 00 .2:00) Jr26 (v Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) _ 2 1 °y9 Fee Engineering Dept.(3rd floor) House# .,51 iL2Y �1ME Bldg) � ' BARNSPABLE. MAR& d 19 039. ' �f0►M'�� &Proe'eit TOWN OF BARNSTABLEBuildingPermit Application ss Village C".9 71/7 7- Owner 0 hV-7 0 k)-CF-L C r Address 97 oo 8 c:> Telephone Permit Request Gel- First Floor tO square feet Second Floor square feet Estimated Project Cost $ , Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use S yy ; Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure / 4 j r1 Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No. of Bedrooms .3 Total Room Count(not including baths) First Floor Heat Type and Fuel /,fir �44zf Central Air Fireplaces / Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name cou-)Y a—r Telephone Number 4aT- /t 69� Address _9-7 VFA c�,AJ ICn License# t i9 ems, Home Improvement Contractor#.f Worker's Compensation# 7W Lb 6.5 A (4 Y /f` NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO )C SIGNATURE / DATE `-BUILDIN ERMIT DENIED FOR THE FOLLOWING REASON(S) r FOR OFFICIAL USE ONLY r P MIT NO. D'TE ISSUED P/PARCEL NO. _ DRESS VILLAGE O VNER DATE OF INSPECTION: 3 FOUNDATION FRAME: INSULATION t FIREPLACE M - r , ELECTRICAL: ROUGH y FINAL - PLUMBING: ROUGH FINAL GAS: ROUGH FINAL , FINAL BUILDIN\ DATE CLOSED OUT ASSOCIATION PLAN NO. -------8. Asphalt Roof Shingles with 20 Year Limited Warranty ). Aluminum Louvres with Screens � 10. Three Light Window Hinged to Open 11. Window Box &Shutters 12. Solid Pine Doors Diagonally Braced with 2 x 4's wid three b" Hea.vy Duty Zinc-Plated black Hinges See Page 5 for 13. black Bugle Head Screws Available Options, IJ PERMITS ARE THE CUSTOMERS RESPONSIBILITYCustom Design, and WHERE REQUIRED ,?Motet Floor n,Plans. 2 MAY-21-96 TUE 10 :53 AM EAGLE FENCE CO FALMOUTH 50e 540 5182 P. 01 EAGLE FENCE COMCFAn of FALMOUTH 570 East Falmouth Highway ! EA$t Falmovth,IviA 02536 FAX.: (508) 540-5182 ® PHONE: (508)540-3161 FACS54ME COVER SHEET ' DATE: - FAX NO. 7q -6 C7 TO: Ol : Bzl��'h� �L.ns �s C2 FROM: ENCLOSER ARE PAGES LNTCLUDLNG THIS COVER SHEET CONUVIENTS: �? xlo ~ JOG] Qyu r 2=' STANDARD FEATURES AVAILABLE WITH ALL REEDS FERRY SMALL BUILDINGS: 1. 2 x 6 Pressure-Treated Floor Joists, 16" on.Center 2. 3/8"Top-duality Flooring 12 x 4, 16" on Center Framing CLASSIC 4. Tongue&Groove Siding by �bx� °' ROOF 5. Heavy-Doty Trusses 1 Roof 6" c►.�1 Center ��°7�;�;;r'�k��'�,;�',K;:�A:, 6, Roof Sheathed with 1 i 2" Exterior Grade Pljvood. 7. Aluminum Driu Edge J f , THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) Im ^ACC DATA 97 _ y, L L lb CUSTOMER'S NAME D A v 1 o ADDRESS CITY/STATE C�T��-- 3 Industrial Drive:Hudson, HOME P Tel: (603)883-1362•His 6 NH 03051 HONE F ( 03)882-95 WORK PHONE HONE(-) BUILDING STYLE: � C�SIC N COUNTRY OPTIONS: C] CARRIAGE TRADITIONAL A 2 x Custom Hole in Floor for P GAMBREL P•T Floor Pool Filter. S X PlYwood Flo Joist per sq,ft.of flo..........' ...... ine TY Additional Wall per t9 per sq,ft.of floor... . , NO. OF So. FT Cupola Wall Ht.per tin. ft. , •NO. OF SQ. F Additional LIN NO.OFLIN. Custom ndow (s)••" NO. OF To change�ex SWs.�(Indtcate C on ske... •...................QTFTy_ Additional ng Windowtch beto Ad nal Door to Custo w1 • ' " ...Q1Y Arch p (s)X or 5, m. .. Dutch Door 3� 5�(Indicate A on....... k................. QTNY .... etch below)..**... ..... .... Q °change ex-ONLY...................... Ty Black Wrou ht Ong Door to Arch. 07-Y ... . ...... Loft 4�x 9 Iron Hinges. ............................ Loft 4 QTy Loft x10 . _ Rampsx3 X q� . ..Q lY� rY 4,x 5,.... ........ . QTY Standard Windo................. QTy w Custom Wind Screens.. Q �? .................Wind N,Bo sans..... ..Q X&Shutters inc/udBd w��, ' QN Tile Cuntnronwealth of Massachusetts Department of Industrial Accidents ` ; ' •�` 60011 ashitt.,pon Street Boston,Man. 02111 Workers' Compensation Insurance.ARdavit Anniica—nt nformatio'm�• •• Please PRiIVT'le t�ly• - ,�;__„ _� name* C3 /z n /+ c cJ location city i ur i P44,+ nhane 0 1 am a homeowner performing all wort:myself. I am a sole proprietor and have no one working in any capacity 1 am an empiover providing workers' compensation for my employees working on this job. address• .. phone#t inatrnnce co nolin•# 1 am a sole proprietor,general contractor,kr homeowner circle one)and have hired the contractors listed below who have the following workers' compensation polices. mans n•rme �C�Q t =cGZ6� �1/�4/�'ti i ' /✓ 'J E''" w address 3 T Vz2u-r i o7t,,fc- �= : tots l��1'O N l� l phone#. 603 FF-� — / 3 6 a- lnsurnnee co �"t E2GEf/��' -�/i�(''" ytll P, nelicv# 7WC 06226 ) �r:a: :«- -• — .. .s. •.say*�-'Q*�'r"S-1.RP.snrasi*Cr •r•�%�*:t.�S��,r�r�.,t`-"",y - - _ m v city - phone#*insurance co. policy# _ Atiachadditidnd'sheetifaeeessa -'•►:�s- ^.t'w...rr..�+ r'- Failure to secure coverage as required under Section 25A of AIGL is!an lad to the imposition of criminal penalties of a fine up to 51.S00.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a line of S100.00 a day against me. 1 understand that a coin•of this statement may be forwarded to the Ogee of Investigations of the DIA for coverage verittation. I do herebr ccn#yJ •under the pal and penalties of pedurr that the information pro►7ded above is true and come Siertature ...: ate go Print name _ Zh /� u�Z c_ i Phone# 4,;17 - -, official use only do not write in this area to be completed by city or town official eii, or tow". permitAieense# rl Building Department (3Uceruing Board C3 check irimmediate response is required QSelectmen's OBice �. (3I1with Department contact person: phone#;. MOther__ :, :.Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all emplovers to provide workers' compensation for their employees. As quoted from the"law",an empliti ee is defined as every person in the service of another under any contract of hire,express or implied, oral or written. An emplityer is defined as an individual, partnership,association.corporation or other :sgal entity,or any two or more c the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased cmpiover.'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 wito employs persons to do maintenance,construction or repair work on such dwelling house or on the`rounds or building appurtenant thereto shall not because of such employment.be deemed to be an employer. MGL chapter 1.52 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. Additionaliv.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 hay 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 as all affidavits 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. 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. Pleas( be sure to fill in the permittlicense number 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. w._... ...,. ,.�� ... .,. .. _ . . ~"i � _ter.. :J:•�•«..:+i,+�•...ai..r•�if.s'iii:�..:. __ 'w�:�•`: .��.�." •':.25r y;:F•�•.��•' The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of ifnrestlgadons 600 Washington Street - -- Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 ext. 406, 409 or 375 C ,� `ice t1'te 5 : The Town of Barnstable • °"' '" Services t� $ Department of Health Safety and Environmental . Building Division 367 Main Strect,Hyannis MA 02601 Rai Office: 508-790-6227 Commis Building ngg C Commis F= 508 775.3344 For office use only Permit no. Date AFFIDAVIT SOME IMPROVEMENTCONTRACTORLAW SUPPLEMENT TO PERK[T APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repai,modernization,conversion, improvement,.mmo%-4 demolition. or construction of an addition to any pre-adsting owner 0=lpied building containing at least one but not mote than four dwelling units or to saucmres which are adjacent 'o to such residence or building be done by registered omnaacto�.with attain aaceper z� along with other requirern ' rx(v Type of Work: Pc�ec�rcv i av 1'H c o Fst Cost la oc- r\ Address of Work: Owner.Name: D n Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under SI,000 Building not owner-occupied owm pulling own p=4 Notice is hereby given that: CONTRAC.I'ORS OWNERS PULLING THEIR OWN PERMIT OR DEALING WITUPREGISTIED 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. on No. Date Contractor name Registration OR 120 � n^,e Owners name • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE -- / - JOB. LOCATION /Z4z yW RD co w 7- Number Street address Section of town "HOMEOWNER" Ltd f}- 1.c} - (_ I 4G9O Name Home phone Work phone PRESENT MAILING ADDRESS -8'/ � Ly� C) a /VI�4 DEG 33:: 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 such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor DEFINITION OF HOMEOWNER: Person (sy who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one to six 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 buildinci permit. (Section 109. 1. 1) The undersigned "homeowner" assumes responsibility for compliance with the Stat Building Code and other applicable codes, by-laws, 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 sa ' procedures nd requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER' S EXEMPTION ` The code state that: "Any Home Owner 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 a Home Owner engages a person (s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for . licensing Construction Supervisors, Section 2. 15) . This lack of awarenes often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Homel wner actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, man communities require, as part of the permit application, that the Home Owner 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. L `��'"' •e TOWN OF BARNSTABLE Permit No. ----------—.-------__ /h Building Inspector �n q NA"."L Cash oO''tOUP.- OCCUPANCY PERMIT Bond ----—__ "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Gary Tavares Address boX 23t, ;:.,t a-LrlV1li% ,, ,h Wiring Inspector _ - Inspection date Plumbing Inspector t Inspection date Gas Inspector Inspection date Engineering Department 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. ......................................................1 19...... ..............................................................................................................._ Building Inspector Assessor's map and lot numb ......................................... SEPTIC SYSTEM MUST 6*THEtG 7 I NSTALLEI� I Sewage Permit number ................................................ N COMPLI o� 1................................ WITH.ARTICLE If ST AT �/ A"STADLE, House number ...........................................................�� / � �r/ . /7... �Q SAtNITARY CODE AND � Maea � ..� REGULATIONS. a i639 ♦� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..... E.WL.. .:.....c�. �. .4.�Z .. L��:. . TYPE OF CONSTRUCTION ..........:...........M.0 0 ........ ......:. :..... ... ............................................... ................................................19...... :. ° TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Lo f................................................yg/ 1..e. �C c ;...Location AnTao l�n,3s,l .. Proposed Use ....... � rman.cat ............................................................. . ........Zoning District ..��..''...:..............................................................Fire District .............................................................................. Name of Owner S... V. ........Address .. .:... Q ....SO/.....F......7 l? Name of Builder .J\ ��.V. ........6.n...l;..Ca. .Address .c .a.cabd/c !`::C/r. Name of Architect ........Address CCn�. knr......�V' Number of Rooms .................7...........................................Foundation :�1.......... 0C �Q:�.�.......300 .7iff:5� EIn xterior C%. hc��.�cl. .Sl�..�ny .�. Qf3 �Roofing ... ��.r.11...... .�J. .[. �.�. ......�1. . ...... Floors no rpC .�.n.G. 1 I.Q..�.IY CoynoL.Interior or,.-tcac./....... ��.�.�:.�.�.!_%.... Heating ......l.J..L:/.:.....:......................Plumbing .C: :...... . ..Q.S. ��. ......... . .C'� Fireplace /.�.�. 5 O.C . ..11�� .lwt....�J..r�C Approximate Cost .. .... ....j...`�....pQ.... ................ Definitive Plan Approved by Planning Board ________________________________19_______. Area .....J hct...... ................ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 1D -Qa 1�2-z � , v S� I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ' Name 5 F..e....... Ufa ares, Gary A=22-62 ...2:1153.... Permit for ......... ............f mily..dwelung................................... Location .......J,Q.t...2.4.....a.1...Ra].xn..'.RQad........... R r (wotuit........................................... Owner .......Cary„Tavares Type of'Construction ........VQ..Qd..�:r=(� ............. ................................................................................ Plot ............................ Lot .............2.4................ 9 � . Permit Granted ................Mar.ch..3.0......1979 Date of Inspection ........19 Date Completed ... /.. ..... .. .............19 PERMIT REFUSED - ....... ........ .. 19 _ ........� . .... . . ............................................ ......... ..............:A... . ............................................................................... 'Approved' ... ....................................... 19 .... ........ .................................................. Assessor's map and lot number ....... rf................................ �oF THE ro Sewage Permit number .... 7 /................................ d`�Q y°► Z 33AUSTI►DLE. • House number ..( .7............... ....... ...�....... .. ..:�r.�.?....�` L �� so rues p �63q \00 �o YAY Ar• TOWN OF BARNSTABLE �D BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....................................................� I� 1!" , {. `�' .. �t .. .. ............ ... .. TYPE OF CONSTRUCTION ` } .......................................... 4. .......`...................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .... ............).............................../1 �..................................... ................... .�..:... �...��'�.. ProposedUse ......... �I................ ..........?............... �F....:? l��,r.1.) .............................. ................................... ...... ZoningDistrict .................................................:......................Fire District .............................................................................. Name of Owner :/..:r�I„.v. .....'.....t. .r.�... k�.�. .'.........Address ... .0...... 1Qx/...... :.��.....�.........:�: �. ....�.. Name of Builder ........................................................... ..4:-.Address (... ../� ..` .. ..................., ......:....... ..G../...... , ` . !! Name of Architect ..' .��..)l n_1�i .). ( ........Address ,J� i� �. . �. I;..... ( �,1 1 � . r 1 �! 1, . ✓ I �' .:......Number of Rooms ..................................................................Foundation }.� Exterior r 7 !) l r; ,'r '.r l h 1 ...........f I1 J)Roofing ....'.a.I,!�,.�.�.....�..... l�4..�r.�.� !�............................y. ................. ? Floors .. (.�.:.: ...... 1....', �l.�./..... ... �...'...�'..Interior '.f. :: ..t.�.r-, ..^--.............../.'.L.......S...t. .... Heating ........... .............................................................. g .................................................................................... Fireplace .f........./.................... ........!.........!.......... l.. ... .Approximate Cost ........................... .......:............................ L/ / , V C v i Definitive Plan Approved by Planning Board -----------_-------------------19________. Area .....!.................................... Diagram of Lot and Building with Dimensions Fee ....... v7 i ► ��,':................................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH } '1 j • r .� tl- I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..................... ............................................... ..... Tavares, Gary %, A=22-62 ~ ^ ^ ^ ^ ~ � m No Permit for .BuiId.-oicgLe--.. .........;(Mily. ------------ Location IQdt..a4--.$1.. .�oad----'' ' QD134 it. Owner .9-�PY ' Type of Construction W/oa.Frame.................... VMaIrch..30 ' ~~'~ of Inspection^ PERMI REFUSED .................................. ............................. 19 —. ................................. . «�4 .z" � __.___—____.. � '--~^''- '---~^'^^--'~—' —.----. ��..- . .---.—_—..—.----' - » ` .�^ ~ 0 —_------------.-- lg Approved ^ -------'-----'—'—^^^^^^^—~—^---' -------'---'------^^---~^^^^^'' ' ! | NO COW5 .E P, YAT cOW I �v�l�vt � LOT# 1 $ LOT " 17 � 4W.°2ooP B,FAID.-MM-5148 I.P.FND. TOP ML 45.60 LOT 24 76�± rQ GALPN C.A:aT CONCR -K,v5 1^ P620FtLE AREA FOP- CREA 1 2 LOT-* 2 3 RF5I~v_vE I PIT T N# + 9� � CoNc�E t'E I LOT 2 PEACH INS. PI RFQD' 40 -t p SEE DETAIL- , P of E ? 51 .00 N P Ov Q� W.4 12, �t : o CA � ��, .�`r•' � � t ��"G .�i. F� � ��i?�>�"'�I•.,��xr`.°p'i� TMG e 1 r - '-- a! FO L L t 5S LA f 1 ap - .J('.. ...... 4" C5 f DE� , 1 4w�s 51.0 O PARK TOWKI CC eg� low D12tV ,g p hSsuNrLD rMEv.+9o.00 . R.S8' P. FND, no f \ `•.. i�4� .ae ro y fi�6 w ' � ;�a �„ , �•' f>"�, t. Y � ..:, .: S'� 'ant''�-,� a,;,; ,.... .r ,�e ��pr�( T �{ K. ..,ytid" ,-:e� IXI OWNER MR . � MRS, GARS TAVARES B. M. NOTE- -(o9 OLD M F_F_T r V4 Q I-1Ot.j�jE F>D, ------ } EASE' FA�_M O UTH MA. ALL ELEV5, BA5Eu aN TOP OF EXIST-. T L ODIq C , 8, AS SHOV'4W ON F. L ASS U"ED F L_E.v. +5 C7.00 Y ` AREA PLAN: REA . PLAN. PRFP ABED F �"� PLAN Cyr- t. AW o 1: StANTU I77/�C0TUl - C0UWTPy 17A,, � RAYIU.pt�IQ. T �02 ' ;, �,� yY cr�Ayv �,Ap ywROBER7" C. CLot��Y� 96� �Y r� , � , s FQUNDATIO = �t N C E R T I F I C A T i Q N a } . I CERTIFY •INE FOUN UAT'to�t A[^r•� 13EEN IMSTALLEt)...AS SHOWN , ---� 9 SEC P CL LOT t�r . .X' F. F. 5 ' TYPICAL SYSTEM PROFILE FDN TOP FINISH GRADE='4I,.O NOT TO SCALE FINISH GRADE OVER rTANK_` 51'. 00_" � , k" ' GRADE OVER PI'T -98,0o I PVC OR O .; " I �C. I. TEES g7,67' ; • .., • '. .�: ,. d • • ,0. BSMT i 47.50 ti •47,33 • • • • • •. • • FLR'44 oo_ ��„ 00, GAL. • - RE I OFORCED 4 DI 'q 7, 2S • • • , • • • • ' ; '. CONCRETE ST. BOX BEINSTALLED ON • � A LEVEL STABLE BASE • • SEPTIC' ' TANK ` • • . . . , . TO BE INSTALLED ON A • • • • • • • , $ LEVEL STAPLE BASE� ., . .,.,-.,-�.• ` �r .; >, '� .�u �:;� P • ' � SEA REQUIRED TO BRING CO tRTO GRADE AND DUST IN PLACE 24 "C.1 . MANHOLE SAVER a 3/4 "TO 1-1/2 "WASHED CRUSHED LEACHING PIT FRAME - SEE DETAIL STONE ALL AROUND FREE OF BASE TO BE LEVEL IRONS, FINES AND DUST IN PLACE l �1 FOR FIN. GRADE SEE SYSTEM PROFILE SOIL AND PERCOLATION . 4,, - DATA 8' _ J� PERC. RATE: MIN < 2 .�IN. L 4" a� �� FOR INV.ELEV SEE INLET SYSTEM PROFILE ° . TAKEN BY • C. D. SPOHR LINE o =16 WITNESSED BY:raw� HURRAY BARMSrAME BD.OF RFA.s� 0 OPENINGS W/4-1/'8" v I 0 OUTER-DIA. 81 1 -3/4"a DATE . 28 ocr. INSIDE DIA. 0 TEST PIT-GND ELEV. + �19�.90! f 6 ' ._ TOTAL , ° . 0 � : ° 0 0 0 3 VEG. LOAN 0 0 o AREA No RUsr, MIDGif, 0 0 0 0 3595T- o 0 0 5 sue - Spl r` OZ WATIEP- 0 0 0 0 0 0 0 0. COAeS - --- -- BOT. PERC. HOLE 12' 6 '� EFFECTIVE DIA. . DOWN 4S ' 1i LEACHING ' PIT _ SECTIONR�OD) ` qq �� TAB NO SCALE , Y y ` :DES1- N110 P sx ago. oeRcoM` NOTE:•'-DO NOT RUN HEAVY EQUIPMENT 0 VER SYSTE'M 1-0 DISPOSAL �— EST. TOTAL DAILY EFFIUENT�GALS. LEACHING PIT NOTES. SEPTIC TANK I . CONC. TO BE 4000 .P.S.I a 28 DAYS . 2. REINF. W 6 x 6 " �6 GA. W. W. M. 3. 21AND 4 SECTIONS ARE AVAILABLE FOR GENERAL NOTES GREATER DEPTH REQUIREMENTS 1 . ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH TITLE 5 OF THE STATE SANITARY CODE NOTE. EXCAVATE TO ELEV.4_0Q OR LOWER AS DATED DULY 1,1977 B, ANY LOCAL RULES APPLICABLE. REQUIRED TO REMOVE ALL LOAM AND CLAY CONTAINING 2. ANY CHANGE TO THIS PLAN MUST BE APPRD. BY THE MATERIAL BENEATH PIT. REPLACE EXCAVATED MATERIAL BD. OF HEALTH, AND CHARLES D. SPOHR• WITH CLEAN,CLAY FREE GRAVEL, MECHANICALLY 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING, COMPACTED IN PLACE. NOTIFY THE ENGINEER FOR INSPECTION. ;lDE AREA = 2 3 G S•F• S q 7 2 S.F./GAL - -GALS 4. FOUNDATION ELEV, MUST BE CHECKED WHEN COMPLETED. °- , LS. k a ' s ;d ntOUWR ITTEN 90TTOM AREA= I —S•F• 2S•F•IOAL-1-�- �ALS BC : NW ; ,�yTHESE C � EAG TH 9 DSPOHRROqL BY. HARLEO APPGA rOTALAREA = 359 S:F .� q 6.'-FOUNDATION INSPECTION READ. WHEN EXCAVATED. LEGEND + 50.0' EXIST. GROUND ELEV. "A ' � ' FINISH GROUND ELEV.��UNDERLINED MM►� 9 FOUNDATIDPl. (=�{2T1�1 CATi;OI~J. 50'� REV. DATE DESCRIPTION 47 50 PIPE INVERT. ELEV. SEWAGE DISPOSAL SYSTEM 0 TEST PIT LOCATIONFOR SEPTIC TANK MR.4 MRS. GARY S. T AVA R ES ❑ DISTRIBUTION BOX LOT -* 24 RALYN ROAD 4" C. I . PIPE rV' C.QTU 10 IY. S ..K�ti ,3 4' BIT. FIBER PIPE "TIGHT JOINTS ( r.: ' - 1 z - URAWIN� NO. ` DESIGNED: C•O,SPQHR DATE: .- - PROPERTY LINE DRAWN: � C,5 SCALE:AS SHOWN 7 . � L ,` MIN. CODE DISTANCE CHECKED: C. D. S . AREA PLAN SCALE : I "= � f LOT # 24 RALYN ROAD, 2 1 , 8 34 ± S. F .>40 T I t+,! THE 3A R NSTAZLE F LOOD P LA 1 KA No cow S'E Z YAT 10 IQ INVOLVED LOT# 18 LOT » 17 �c,5. FWD, TOP Co R,FND,TOP -39go 1<P,FND, TOP Q 45,60 gQ .4a 'LOT 24 76. _ � AREA. FOB' �.P, (REAR �2- I ,8 3--�I' t S,�'. 15or� QA l , Pa��►Sr eaNcr�TE LOT-� � 3 PIT T H�k , A9.9.4' LOT# 2 5 40,.E r` LEACH Imci Pi 1 MD, . r cl S9 50422 ' -- 6suu IKEAD to h, — T �PC E + G T HousE - o 5IDE) (FULL 5smr) csres�S z 5o.6i +5o.4,` 51.00 PARK Tow m 1, P. FND. Rain.. w TOPS 5.5.9 -44. o' ��.•" gs , ;4p �►5937Ma.leY R� SIB Z, P. F1VD• r•• wry fiq .�, 80 TOP @ 5a b .y OWNER - MR , 4 PARS. (;AR" T-AVARES M. NOTE: (>9 (JL t) MrZET 1 t4Q KOL�E RD, ALL ELEVS. 5A$E�u aN. TOP Or EX I5'r. 5 .48 . 0.14) C , 5, AS 5HOWt4 ON 511S!EET L ' c ASS UPED r=��F-v +S P.coo AREA PLAN AREA . PLAN. PREPARED F ►M PLAN OF LAWD 5AWTUIT.."COTU1T. rDUN"IT,.Y 1'AT " FOF? QAYM.OMO D. 4 GYtEM DOLYM W. CPAVet FojkD SCALE I'' =. -46 ' 14 woy, 19GS gy FOUNDATION CERTIFICATION, 1. CE:RTIFY THE FOUNDA110W HAS 15.EEN IWSTALLEt) Aa SHOWN . As-- E DATE SEC P CL LOT i .ri F. s�s�'°` TYPICAL SYSTEM PROFILE FINISH GRADE=.S1.. -051 NOT TO SCALE / FINISH + TOP+ [yam 507,CDC? 5 I , ,p FINISH GRADE OVER TANK= GRADE OVER PIT- WYK 1.7 PVC OR O O .•.• � :. 47;3 • C. 1. TEES :::;:'s_:•':: • 1 1 0 o • o '/ • • n 9.0 1 0 • • • 0 T f 1�5 0,, GAL. 4 'q7, 25 R` 1 1 . • e • —= SOX DI ST. 1 1 e 1 + REINFORCED CONCRETE 8 , 1 • ,1 • o • • 1 1 • 1 TO BE INSTALLED ON •' •�•-r;.—�'. .. •` 1 1 0 • • • � p e 1 e A LEVEL STABLE BASE = e + SEPTIC TANK 1 • 1 • . TO BE INSTALLED ON A '' 1 • • � , • e • 1 1 1 LEVEL STABLE ;BASE r • 1 1 0 • • • • • • 1 / 1 ►. 2"-1/8`!- 1/2 `WASHED PEASTONE ALL BRICK a .MORTAR COURSES AS AROUND FREE OF IRONS, FINES REQUIRED TO BRING COVER TO GRADE AND DUST IN PLACE LEACHING - PIT 3/4 "TO 1-1/2"WASH ED CRUSHED BASE TO BE LEVEL 24"C.I. MANHOLE' LAVER 13 STONE ALL AROUND FREE OF - FRAME - SEE" DETAIL IRONS, FINES AND DUST IN ( ' PLACE ` IR FIN. GRADE SAIL: AND PERCOLATION ._:E SYSTEM PROFILE • DATA t #T PERC. RATE . { 2 MINJIN.. a FOR INV.ELEV SEE BY • C. D. SPOHR _,4 PROFILE TAKEN SYSTEM ; • 6�� ° FlAU4 MURss�aY aARIJST►+6LE 8I?. H aT� INE o _ WITNESSED BY: - \ 1 �� ° , 2-S OCT. a W 4 /8 - � ` • . o OPENINGS / „o . , , . � DATE. + ' OUTER DIA. 81 1-3/4 0 = ° TEST PIT-GND ELEV. -E �19�� D INSIDE DIA. o ° 0 —. 6 , , a o TOTAL o o ; , ° , , ° AREA o 3 y V>`G. �,d�.t�I NU Rust DQ,1 D D D a . 51 OR SUB 0 0 0 35 `,�. �' D 0 0 - %30�� COAP- 0 ( 0 0 D 0 .� ,o -• -_. .p p.-.p p p -=. D .O .0 O _ .,, - .- -- �',C�_ � ._ - --�--4-ems.- _ _ _ ,_�. _ — HIV D 31 6 6 D.IA', 3 ---- BOT. PERC. HOLE 12-1 60' EFFECTIVE ' DIA. DOWN 4 Ii LEACHING - PIT ' SECTION Cl IZF-QD DATA : ,. NO SCALE DESIGN �- : NOTE: DO NOT RUN HEAVY EQUIPMENT OVER SYSTEM -No. of BEDROOMS Sd_. DISPOSAL NOTES; EST. TOTAL •DAILY EFFLUENTGALS. LEACHING PIT SEPTIC TANK -GAL—___ CONC. TO BE 4000 .P.S.I a 28 DAYS . k 2. REINF. W 6 " x 67,06 GA• W. W. M. ' , } 4 ` SECTIONS ARE AVAILABLE 'FOR GENERAL NOTES 3. 2 AND GREATER DEPTH REQUIREMENTS I . ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH TITLE OF THE STATE SANITARY CODE NOTE: EXCAVATE TO ELEV.A0' OR LOWER AS DATED JULY 11977 B, ANY LOCAL RULES APPLICABLE. EX 1 , REQUIRED To REMOVE ALL LOAM AND CLAY CONTAINING 2. ANY CHANGE TO THIS PLAN MUST BE APPR D. BY THE MATERIAL BENEATH PIT. REPLACE EXCAVATED MATERIAL BD- OF HEALTH, AND CHARLES D. SPOHR• WITH CLEAN,CLAY FREE GRAVEL, MECHANICALLY 3• WHEN CONSTRUCTION 15 COMPLETED, PRIOR TO BACKFILLING, COMPACTED IN PLACE. NOTIFY THE ENGINEER FOR INSPECTION. DE AREA = �S•F•�—S•F./GAL 4 —GALS 4. FOUNDATION ELEV. MUST BE CHECK ED WHEN COMPLETED. )TTOM AREA= 1--- @1—S•F• S.F./GAL— —GALS 5. THESE ELEVS. MUST NOT BE CHANGED WITHOUT WRITTEN 3.59 TOTAL-�'`� GALS APPROVAL BY CHARLES D. SPOHR. )TAL AREA = S. F. _ _ ` 6:FOUNDATION INSPECTION READ. WHEN EXCAVATED. LEGEND • 50.0 EXIST. GROUND ELEV. ELEV. "UNDERLINED" "A" Mn�`'� FUUti►R�ATIC>ta.! �-fI�'1�Ii�"1 'CAT':C�?.► 50.0 FINISH GROUND REV. DATE D E S C R I P T 1 0 N— 47 50` PIPE INVERT. ELEV. SEWAGE DISPOSAL SYSTEM 0 TEST PIT LOCATION FOR, 3 0 o SEPTIC TANK IVifR, IVIR vr`1R 1 . ' t 1 V f"1'R DISTRIBUTION N . BOX .. LOT 24 R�4L:YN ROACH ` . r 4 C I PIPE • 4 I . . GC�`f U 1 MAC 4"BtT. FIBER PIPE 'TIGHT JOINTS WIN NO- r FESGNED: C.D:SPOHR DATE:'' -- PROPERTY LINE y wN: C SCALE:AS SHOWN MIN CODE DISTANCE CKED, C. D• S S . ./ 7 • I�T�'.},' NOTE5 <Atllo...aA:riC�_.r•,�..... - .,','�':: �_a\2GQ-4[Ap_J9_a[.__z_��("A_u�¢-tv1,—_ ' 2Ly4 aee.�_sJ_.aaQ-t'_!�_ 8� _.`R:.1A_.\w w•AT.ro.N._—_�_.__. (�•,":•l,. � _.Aw[J_ AND NAk.aD.—yJ1�CaMr1NM_. - �1 lti '1, .jxM1T\Nlr atRaaa.wA3A._Ar[pSbM6__4\,ID[0. c\.¢Ai asm.1010, �b_.3e7roM_cf M¢YI—Reap, IR AAa1A-AaD_rbAA.� I - - � Te ealh —^.PA.N7.C.�/1l-P.Rvw4L �:: 1DA/tl=R _ts lND3_w14N�._A.e[_,A%av"_. _�H11'Sf�4a__A_lA—a�1R�4i4l�C • - - - —LYPaAc_ _ �K�;�, �'P_D•L�o..l.,To A7�N0-__nact�ACU6ASiX �:•.� � --M+pPuao-THAT.... .._.......__.—. 77- --L-_- EL__ _i\?¢/w�ALL._ _ 1{�_TX S•f♦Ta.1:1. . 0 t '•� - 1 I I�di1.iL-.NP�NI. _ _ 1� _M{W._w�e0__♦f'tPC _391e_-,�?a� .. ..... ....'. . --- - - 2AO.p,,S.►API � � . —Fr"TaW_e:\Aoi +� .l�. �•.,�'.�:� -� :Y]e .c:S:.b�n•.�t:.W:•.r,+. - nl � it , J. \O I - AN,. 1' 1. 'r^{ __ any/,,.i .1V.'+�., rT ',�(Y"'!'(\•,f -','�-lrh 1' �.._J .1.1." � ._. I r - .._Tt6AR VIlW OF 1,Ou}c_w_1 _P_R.47!ocD--.AR-DIr1eN --......_FLooi�t_� -- . •°'9�`�'4=''O+ _ �l�.R�.Q slE1J�l�{3�tY1-1►9�Z4P� �a6y(.nta,+a� _ Y�(4�L�8.6S�tQFti4f — ' >tl►a¢tr 1 er T _ F. F. 52.00' _ TYPICAL SYSTEM PROFILE h - . • AREA PLAN FINISH GRADE= 51._;Q_ NOT TO SCALE FDN TOP } 1,CJC7 ,FINISH SCALE . I 5 FINISH GRADE OVER TANK= 51._00 _St7. 0 GRADE OVER PI`T } , • LOT 24 A ROAD 2 1 8 34 - F. R L Y N 0 S. F I O PVC OR •. g7,67 r ' . 1. TEES 4?,33 S ' + • , • 1500; NO �ON ,: /� t � FLR/-44.40 GAL. 4 • o r r • s • . r �. p• REINFORCED DIST. BOX •97; 25 _ , at CONCRETE ;: 8 TO ,BE INSTALLED ON a • o r , r • • o ' o • 'o r :.-- ..;.'..,....; . A LEVEL STABLE BASE + r r • +.r ..1 , .. 1 SEPTIC TANK LO i # �J LOT17 TO BE INSTALLED ON A • r • r a • s' r LEVEL STABLE :BASE 49.20 r • a • o • • ,r • • r i B,FMD,TOPS 39g0 f,P,FND,TOP.Q 45,60 t ,r „ „ ,. r. 2 -I 8 - 12 WASHED PEASTONE AL BRICK a,MORTAR COURSES AS AROUND FREE" OF IRONS, FINES r • • ► •' a .• •', o `o 0 REQUIRED TO BRING COVER TO GRADE _ , } LOT � 24 l AND DUST IN PLACE 76. _ „ - LEACHING' PIT �RE�R Z � �'�± J, 150AL, p�'_ C,�. ,T C0IJCRL�"� 24 C.I. MANHOLE COVER a 3/4 TO 1-1/2 WASHED CRUSHED 'AREA FOP- rANK-�15M piZ?O' IL.F, FRAME SEE DETAIL STONE ALL AROUND FREE OF BASE TO BE • LEVEL. LOT# 2 RE�aEfYI IRONS, FINES AND DUST IN PLACE ( � PIT LOT# 215 �• Pk�C'•A5"t" :C=�NC•�•�T'"E � FOR FIN. GRADE ` ' SEE SYSTEM PROFILE 40'�. „„�,' o� _ SOIL AND PERCOLATION OEP,� AE + 017 — 4„ �'` DATA { T _ I I « t • 25' � �I.oc91 � :... Sir �— PERC. RATE : 2 . MIN. IN. 51 ,too 5� - --- — — FOR INV.ELEV SEE 50.4q' 2 �.4., RULK'HER f INLET - o SYSTEM PROFILE ° TAKEN BY C. D.' SPOHR �T z ° 6" +50r i qr LINE 0 0 1`. C A* ��' IA th ° F1w l MU p-PA\ 8KR1JSth8 .8D os-..HFAGTYt 5 �o GARAGE. tis� WITNESSED BY: ,,. - 0 OPENINGS W/4-I�B�� „� ;; AT 2B OdT. /;a N-6 -:19 "18 _� — ��+ NC?USE OUTER DIA. a I -3/4 _ ° DATE ' (51DE) a5° (FULL 5SMT) 7, ° , " � , . , �._. , a• .. r,+ all - , 0 INSIDE DIA. ° - -F - ' ` s §fa' _ 3i� — - _ o o TOTAL ' . ° TEST 0 0 00 _ - TE ...PIT GND ELEV. • o ' w I 5©:� +5 .�' 6 AREA o 3 No RUSTD. 0 , T 51,04 jj ° p 0 0 �5 7.�+ SUB 42 WATk' F'ARi< w 'IOV+YF! ° 0 .0 0 0 °. (yq'py�� .`M�¢ , * N .�. 1.,JFf d*v, r I ' Q p O , '! 'i O 'l'•, 1.YA1�.�•S 4 0 0 0 r 0 0 I, P. FIND. - B.>✓t � , w Y1/ + 6 �_ 6 rr D IA 3 SAN D TOP@ 5S.9 :. . � , . 12,E 6 -1 EFFECTIVE DIA. BOT. PERC. HOLE hssvMorv�►' a�' v� ^ 9S, gis - DOWNl q� R_58o � LP. �ful7. LEACHING • PIT SECTION „r `s 7610 ee �� , � � TOP @ 50.b (I R�91�� 144 , � . v NO SCALE '; �4,�:�±� fx; •�-, ` �r�,�j �a��R:�� h��,--� DESIGN . DATA . NOTE. DO NOT RUN HEAVY EQUIPMENT OVER SYSTEM ' a � � .• .,;, ," . • � :,t��•�.t� � �+ 0 �A �� --NO. OF BEDROOMS NO DISPOSAL Ss EST. TOTAL DAILY E F Fl U ..Rr • * � LEACHING PIT NOTES ENT �4��#.#7 GALS. ' I . CONC. TO BE 4000 P.S.I a 28 DAYS'. SEPTIC TANK i GAL.�r 2 . REINF W 6 " x 6 „ *6 GA. W. W. M. 3. 2 'AND-4 ' SECTIONS ARE AVAILABLE FOR GENERAL NOTES GREATER DEPTH REQUIREMENTS. . ��.. OWNER - . ALL SYSTEM .COMPONENTS SHALL BE INSTALLED IN NOTE . ' _ ACCORDANCE WITH TITLE OF THE STATE SANITARY CODE F, .. . .40,OQ - _ ' e EXCAVATE TO ELEV. OR LOWER AS L_� M. NOTE DATED JULY 1,1977 aANY LOCAL RULES APPLICABLE. 11 R . ? M R , (xA v,i I VARES - REQUIRED TO REMOVE ALL LOAM AND CLAY CONTAINING 2. ANY CHANGE TO THIS PLAN MUST BE APPR�D. BY THE MATERIAL BENEATH PIT. REPLACE EXCAVATED MATERIAL BD. OF HEALTH ?. dog OLQ MEET I V4Cj HO " 1�3, AND CHARLES D. SP,OHR.. ` ALL ELEV5, E3Aa51ED O.M. T13P 0F' EXI5`t" WITH CLEAN,CLAY FREE GRAVEL MECHANICALLY EAST' 1~AI-M OL)TA-t, MA., Co B, A5 .�H©W ON ST�FE.T7 p, L r COMPACTED IN PLACE. � 3. WHEN CONSTRUCTION IS COMPLETED,PRIOR-TO BACKFILLING,- YEL ` 5-4S '" OD14 AS L.�I�t I7 E!-F_v . +.5C) 00 ! SIDE AREA = � 6 S.F. 5 S.F./GAL A? - NOTIFY THE ENGINEER FOR 'INSPECTION. GALS 4. FOUNDATION ELEV. MUST BE CHECKED WHEN COMPLETED. L BOTTOM AREA=LDS.F. I � S.F./GAL. i b 2_ ..GALS - 35c� 5. THESE ELEVS. MUST NOT BE CHANGED WITHOUT WRITTEN TOTAL AREA — S. F. TOTAL 57'4 GALS APPROVAL BY CHARLES D. SPOHR. LEGEND 6.`-FOUNDATION INSPECTION READ. WHEN EXCAVATED. AREA PLAN + 50.0' EXIST. GROUND ELEV. AREA . PLAN PRF_P�n?ED F�010A PLAN OV 50.0' FINISH GROUND ELEV.-!'UNDERLINED ''Q" t�AF�� FUUNDATIC�t� CERTIFI CA-1710 I., SAPIT`UtT,'' C3TUii�.I "FS� T� T1, F02, 4750` PIPE INVERT. ELEV. REV. DATE DESCRiPTioN >AyKA.()�� D. QVql" C)0LYW W. cRAw F'cika ,� * O TEST PIT LOCATION SEWAGE DI SP.OSAL SYSTEM -SCALE I 4 G� NOV. 19 S 1 "G CLO�JE`, 2 . L , .S . FOUNDATION C ERT I F I CATION FOR • o o SEPTIC TANK CERTIFY THE FOUNDA`I-t4W HAS MR. ' MRS. GARY S. TAV� R,ES - , ❑ . DISTRIBUTION BOX , f ' . E f LOT 24 RALY RDA 4 " C. I . PIP , � CO TU I T MAS S ttt+t+111-- 4 BIT. FIBER PIPE `TIGHT JOINTS r I U,y:r ate. f s --- F DESIGNED: C.D:SPOHR DATE: 1�I .+ 9 DRA WIN N0. CFI RLE75 D. .SPOH I.F', PROPERTY LINE , DRAWN: C;S. SCALE:AS SHOWN ' MIN. CODE DISTANCE `�..... -: Q SEC P CL LOT -- CHECK ED: C. D, S . r -