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HomeMy WebLinkAbout0107 SHELL LANE�y Town of Barnstable ��t _ C • • \ g Posi This Card So That rt«is-Uis�b;le`From=the Street.A rovedYPlans Must beRetained onJob`and`thisMCard'Must be Ke ... . BBARNS'CABLE, � .a •�. ��, 7'�,� ?��` ., �"''z. `.. . � Pp =�� r�\ �.. � � \ '.:� � pt ��`� M" Permit Posted Until;Final„ins action Has Been Made 4 `°g' ;�, Wh�Ww:ere aert�ficate,of Occu anc;sus Re aired,-such;Builtlm sha114Notbe Occu ied until a,F�nal,lns ectio:nhas been made _... s..� Permit NO. B-18-1219 Applicant Name: Stephen Dickinson Approvals Date Issued: 05/16/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 11/16/2018 Foundation: Location: 107 SHELL LANE,COTUIT Map/Lot 019-099 Zoning District: RF Sheathing: Owner on Record: ROSS,GEORGE E TRCont a 14 ctoName STEPHEN T DICKINSON Framing: 1 Address: PO BOX 466 � e ContractorFLcense CS 081843 2 COTUIT, MA 02635-0466 VE t Project Cost: $3,601.00 � J. Chimney: Description: Replacing 7 Basement Windows-Like for Like replacement-No RermitFee: $35.00 change to header - Insulation: \ Fee Paid $35.00 Project Review Req: x s Final: Date 5/16/2018 Plumbing/Gas Rough Plumbing: w: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzedby this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved applcafion and the approved construction documents,for w h 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 lawsjand,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: 5 s work until the completion of the same. A � Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are p ovi on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: tea _ €F R ' . 1.Foundation or Footing 2.Sheathing Inspection i Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Town of Barnstable Building Post This Card SoT;hat it�is Visible From the S,treet� A roued!:�Plans.Must:le Retained on Job and•thi :;� ` '�` ' '"s Card Must be Kept dAitlytlTilliLG ' Fg,,„� :^�•:-�M �" '.'$a a^:,> '%� ,.,. � �-<;x .� pp '.e � � �r � x c, MASB.- �POSt` n,., :,"�, a •.2,c.' '`s_ -., '>�:.a� \` �'` i$ �s e ,�, r, i ,p v s�.rS ` - Permit ,aed U tlFinal Inspection Has Been Made >� z � r � .. Where a;Certificate of•Occupancy istReq,uired,such Build�n shall;Not be Occu, ied until a,:Finalarts ection has been made. , .;„. .•�.,:.�� _:w. ".� ,a�`,� ..�..:•.;:�: ,..v,�:•.z. ,.�.`" _.3::�r, .:,. h ,.�.�.it!�"C..:g<:�;:�.�.,..�.,r.,>��.a;:;� p. .�: ....... ,., >,.�y.. ,,p..�,.,s.,.._.....z3�:� ;.. .,...:..��• .. w..,�.��, ., , Permit No. B-18-1548 Applicant Name: CAPE COD INSULATION, INC Approvals Date Issued: 06/07/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 12/07/2018 Foundation: Location: 107 SHELL LANE,COTUIT 0. Map/Lot: 019-099 Zoning District: RF Sheathing: Owner on Record: ROSS,GEORGE ETR Contractor Name CAPE COD INSULATION, INC Framing: 1 Address: PO BOX'466 Cor rKactor License 153567 2 COTUIT, MA 02635-0466 �"Est roaect Cost: $2,100.00 Chimney: Description: Weatherization } V Permit Fete: $85.00 Insulation: Project Review Req: Fee Paid $85.00 i y m Final: 6/7/2018 p �/ Plumbing/Gas Y Rough Plumbing: F Building Official Final Plumbing: T This permit shall be deemed abandoned and invalid unless the work authoriA li y th s permit is commenced within six months after�issuance. Rough Gas: All work authorized by this permit shall conform to the approved application andtheapproved construction documentsfor which this permit has been granted. -�� _� � Final Gas: All construction,alterations and changes of use of any building and structuresssnall be in compliance with the local zoning b. g4aws and codes. This permit shall be displayed in a location clearly visible from access street o oad and shall be maintained open for public inspect on for the entire duration of the work until the completion of the same. Electrical =fr Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: L ; O K ;. Rou h: 1.Foundation or Footing , g 2.Sheathing Inspection Final: 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 Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health 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. Final: "Pe ntracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department � Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application#� I(/ ( 5 I" Health Division MAY 7 2 1 e Issued o7Af1/&X rOVVN C',:SA f Application Fee Conservation Division N}LLB.. �l Planning Dept. Permit Fee �J •_0 V Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address /d :. r e/z Village C'v Owner"?,a! ,� s' Address 1r�i Telephone 54 z F :5 �Z2 Z Z Permit Request ,cps ,g �i�S�4� ,/� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation /0 g:!�d Q Construction Type11,1.3 a Q�®� Lot Size Grandfathered:, ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family UY'_ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes al90 On Old King's Highway: ❑Yes U-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 ' l'o�% ,�;1�_��L dl� Telephone Number J Z, 221'44 l am' Address License # 1�Aft 0-),)- Home Improvement Contractor# 46 1.5�� 7 Email/ ,),x1 e,1A 6-4 Worker's Compensation # av��G�4 f f 9O ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 6_� �� 1 . FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER i DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL i FINAL BUILDING i f DATE CLOSED OUT i ASSOCIATION PLAN NO. Permit Authorization mass saves Form 5&mw4s.'1rouvh rncr4Y ctncaa:,sy Site ID: 3383931 Customer: George Ross I, a Po s s ,owner of the property located at: wner's Name,printed) 107 Shell Lane Cotuit, MA 02635 (Property Street Address) (city) 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. �1 I Owner's Signature: X '( ' Date: yaaao4a$aaiaao4aaaaaacaaaoconoaoaaa000aaaaaoaaoaoaoaoa�aaottovoaocfa400a FOR OFFICE USE ONLY We have assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Cf�.PF— CAA tit �c Participating Contractor Date Name: RISE Engineering Phone: 401-784-3700 Email: For Offiice Use Only Rev.102015 The Commonwealth of Massachusetts Department ofrndustrialAccidents I Congress Street, Suite 100 Boston, MA 02114-2017 www,mass,gov/dla Workers' Compensation Insurance AftldavItt Builders/Contractors/Electricians/Plumbers, TO BE FILED WITH THE PERMITTIM At1THORI.T. Almllcant Information �� Please Print Leelbly Name (Buslness/organization/lndividual); Cape Cod Insulation Address; 18 Reardon Circle City/State/Zip; South Yermouth,MA 02664 phone#: 508-775-1214 Are you an employer?Mock the appropriate box$ Type of project(required); I,©I am a employer wlth 48 employees(full and/or part-time), 7. ❑ New construction 2,❑1 am a sole proprietor or partnership and have no employees working for me In 8, [] Remodeling oapaolty,lNo workers'oomp,Imuranoe required,) 3S7 I am a homeowner doing ell work myself,.[No workers'comp,Insuranos required,)t 9. ❑ Demolition 4,❑I am a homeowner and will be hiring contmotors to conduct all work on my property, I will 10 ❑ Building addition ensure that all contractors either have workers'comparaWon insurance or are sole 11,❑ Electrical repairs or additions proprietors with no employees, ® S,❑1 am a general oontrnotor and 1 have hired the sub•oontractora listed on the attavhed shoot, • 12, Plumbing ropairs or additions These sub-contractors have employees and have workers'comp,insurance,$ 13,❑Roof repairs C(I We are a oorporatlon and Its Moors have exercised their right of exemption per MOL o, 14,0 Other Weatherization 152,1)(4),and we have no employees,[No workers'oomp,Insuanoe required,) Any applicant that oheeks box ill must also fill out the section below showing their workers'compensation polio;Information. t Homeowners who eubmlt4Na`Odwit Indloating they are doing all work and then hire outside contactors must submit a now aPRdavit Indicating such, $Contmotors that cheok this box must attavhod an additional sheet showing the name bf the sub•contrsotots and state whether or not those entitles have employees, If the sub•eontseotors have employees,they must provide their workers'oomp,pollvy number, 1 am an employer that is providing workers'eornpensatlon Insurance jar my employees, Below Is the policy andlob site , ' 1r{�'ormatton. Insuranoe Company Name, Atlantic Charter " Polioy#or Self-ins,Llor#; WCE00431902 Expiration Date, 06/30/2018 _ Job Site Address:l, gf5,: 411 City/State/zip: � Attach a copy of the workers' compensation policy declaration page(showing the policy number and explratlon date), Failure to secure coverage as required under MOL o, 152, §25A Is a oriminal violation punishable by a fine up to$1,500.00 and/or one-year Imprisonment, as well as civil penalties in the form of a STOP WORK ORDBR and a fine of up to$250,00 a day against the violator,A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification, 1 do hereby car Hier the and penaltles of perjury that the information provided above is true and correct. He 11III!11 ill MV Date! Phone#: 508.7 -121 Offlclal use only, Do not write In this area, to be completed by city or town q1flclal, City or TOM 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 Persont Phone#) ' Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Ma ��iiusetts 02116 Home Improvems- ractor Registration • _~yam 1�''"�'�'' ••Type; Corporation Cape Cod Insulation InC w Regfsfratblli 153587 18 Reardon Circle Expiration; 12/14/2018 So, Yarmouth, MA 02664 a SCA 1 /5 20M•05/11 ~ � � Update Address and return card, Mark reason for change, _. ....... ._._�P�e ..._....__. � _ •—•----......._—I�.-Ac1�lr�►spa_.�.I ,anruv�•z1._�,r-> t�,�lo�m�nt.�'1.1„nat.r,�xc>_. �691rArt69LLUBa�C�G a C3�aaoac�ccoelZb• Office of ConsumerAffalrs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only el corporation before the expiration date, If foun urn to; %%t^ :" Expiration Office of Consumer Affairs and al sa Regulation 12/14/2018. 10 Park Plaza• e$170 Boston,MA 11 Cape Cod Insu Henry Cassidy ' ;�:` j "1 18 Reardon Circl`�' - '`� So,Yarmouth,MA Undersecretary t ai hout 91 at 1 \ , 1 z' Commonwealth of Massachusetts Division of Professlon'ai Licensure ;Board of Buliding Re ulatlons and Standards • 1 Cons�,t,�v��r��•(t�`rvlsor CS•100988 w :lrar;i. Ia, Upires; 11111/201.9 , , HENRY E CA J4IDi / yl 8 SHED ROW.� , WEST YARMO�,TkJ f, l • •� Commissioner ' �1 CAPECOD-27 D YLE '44CC>R EP4 CERTIFICATE OF LIABILITY INSURANCE FDATE 04103/2018Y) 04/03/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements, PRODUCER C CT Rogers&Gray Insurance Agency,Inc. PHONE FAX 434 Rte 134 A/C No Exc: A/C,No:(877)816-2156 South Dennis,MA 02660 I .mail@rogersgray.com INSURERS AFFORDING COVERAGE NAIC p INSURER A:Peerless Insurance Company 24198 INSURED INSURER B:SafelyInderrinily Insurance Company 33618 Cape Cod Insulation,Inc. INSURER C;Endurance American Specialty Insurance Company 41718 18 Reardon Circle INSURER D:Atlantic Charter Insurance Company44326 South Yarmouth,MA 02664 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP POLICY NUMBER LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 CLAIMS-MADE OCCUR BKW63328281 04/01/2018 04/01/2019 DAP.MAGE TO RENTED 100,000 MED EXP(Any oneperson) 53000 PERSONAL&ADV INJURY 1,000,000 M'OTHER: L AGGREGATE LIMIT APPLIES PER: GENERAL A GREGATE 2,000,000 POLICY 1-1 jpaLOC PROD CTS-COMP/OPAGG 2,000000 B AUTOMOBILE LIABILITY m COMBINED SINGLE LIMIT 1,000,000 ANY AUTO 6232707 04/01/2018 04/01/2019 BODILY INJURY Per person)�US SCHEDULED AUTOS ONLY X AO 1,000 0O IRE pN ftg -BODILY INJURY Per accident 0 X AUTOS ONLY X AUTOS ONLY rP OP cRd nt AMAGE `' UMBRELLA LIAB MX OCCUR EACH OCCURRENCE 2,000,000 X EXCESS LIAB CLAIMS-MADE R/O EXCI0006635002 04/01/2018 04/01/2019 AGGREGATE DED RETENTION$ Aggregate 21000,000 D WORKERS COMPENSATION YIN N PER OTH- AND EMPLOYERS'LIABILITY X ANY PROPRIETOR/PARTNER/EXECUTIVE WCE00431903 06/30/2017 06/30/2018 1000 STAT OFFICER/MEMBER EXCLUDED? �N N/A E.L.EACH ACCIDENT 1,000,000 1 andatory n NH) E.L.DISEASE-EA EMPLOYEE If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If 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 contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD TOWN OF BARNSTABLE BUILDING PERMIT,APPLICATION,- ap d Parcel Application # �® HealthDivision K Date Issued r3 ( -� Id Conservation Division Application F e Planning Dept Permit Fee Date Definitive Plan Approved by Planning Board Historic OKH Preservation/ Hyannis 'et(, Project Street Address Village .Ty t T OwnercpO e& Lc e 55 . Address /0-' JAI L` a COwj-r, AAA' Telephone Permit Request p�A�E�'t�^� l���o klS.�G�J iATF Zx*C_ , 'TQjcM , A)E"3 �L�E � _�fl i EtP.00MS�IZE�r�JSS N FWPiz- , tJ 6W •Lood mr-TOPI Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation �v 006 Construction Type '� Lot Side' Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling TypMe: Single Family Ir Two Family ❑ Multi-Family(# units) Age 4,Existing Structure Historic House: ❑Yes 5rNo On Old King's Highway: ❑Yes WNo Basement Type: A"Full ❑ Crawl ❑Walkout ❑Other a� Basement Finished Area'(sq.ft.) Basement Unfinished Area(sq.ft) Number of,Baths: Full:existing_ new Half: existing new Number of Bedrooms: 3 existing 6 new Total Room Count (not including baths): existing new O First Floor Room Count Heat Type and Fuel: j(Gas ❑ Oil ❑ Electric ❑Other Central Air: ►;(Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing 0 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 jrnIEn Proposed Use "'I� APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 'r Telephone Number Address x- I r�� License# Home Improvement Contractor Worker's Compensation # \4'W c3p0 qq 1_ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE )10 ` r .. FOR OFFICIAL USE ONLY APPLICATION# a " DATE ISSUED ,, MAP/PARCEL NO. a, _ ADDRESS ' _ ' VILLAGE OWNER DATE OF INSPECTION: t t k FOUNDATION FRAME INSULATION +r,. r FIREPLACE r . ELECTRICAL: ROUGH r_ FINAL PLUMBING: ROUGH FINAL iz GAS: ROUGH FINAL FINAL BUILDING r - '{ DATE CLOSED OUT ASSOCIATION PLAN NO. t The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations a 600 Washington Street Boston, MA 02111 4 www.rnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 1 Name(Business/Organization/Individual): ADAIA Address: -D A t-w s,4 S-reFLU' City/State/Zip: &,),GS4 Phone SC AVu an employer?Check he appropriate box: Type of project(required): 1. am a employer with 4. 0 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 g. 0 Demolition workingfor me in an capacity. employees and have workers' Y P tY• x 9. � Building addition [No workers'comp.insurance comp. insurance. . 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 11.[1 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors.must submit a new affidavit indicating such. ?Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for niy'employees. Belowis thepolicy and job site`- information. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address:�a 7 ,Sd& City/State/Zip: 6pTVX71t Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insur ce coverage verification. I do hereby certify under the in and penalties of perjury that the information provided above is true and correct Si ature: Date: D Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 11 6.Other Contact Person: Phone#: 47 :/•94 V/�.�� - DATE(NMi001YY^rY1 :CERTIFICAT'E F LIABILITY.INS URANOE THIS CERTIFICATE IS ISSUED ASXMATTER"OF INFOR MATION ONLY,AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT-AFFIRMATFVELY_OR N86ATlVEI_Y'AMEND f EkTfiND OR:ALTER THE COVERAGE^AFFDRDt:D BY THE POLICIES $II:t..w. THIS:CERTIFICATE OF INSUFiAiNCE DOES NGT COtdSTITIITErA CONTRACT BETMIEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,WNd THE CERTIFICATE HOLDER IMPORTANT: H the certificate holder Is an ADDITIONAL,INSUFtED,the_poliey(les)must lac+endorsed. If^SUBROGATION IS WAIVED,sub)oet to ' the terms and conditions of the;policy,cartaiR policies may require an endorsement. A 6tatement on thls,certltieate does not confer rights to the certfticate.hotder in lieu of such endoraeme a.' PRODUCER N M Maek Sylvia Inuranoe ApenCy p NE FAX T71 Main Street Milk 8••0440 .SAfc K��_5C8�420O 27 _. Caterville,MAO2E55 Rzibucsa`•' • _ _ _..... CU$JStaErt o u Msrk W Syfvia,� INSq"jIAMWVl E NAIC Y rraURt!e A Mantpe4er US Ina Co West Bey Pmpeny Management Truit ----....._ dba Hostetter Hort,es WSUREq e s vMeeco InsursnCt!Co i �1 isaro Hostetter,Trustee Ri8URER c: I '•10A Main Street pleueERo: - 0;tervllle,NA 02655 Mtt-unit C: + AVERAGES CERTIFICATE NUMBER.. REVISION NUMBER:' fTHIS IS TO CERTIFY THAT THE FO:ICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED AdOVt?POR,THE POLICY PERIOD INNCATED. N07IMTHSTANDING ANY REOUIREINENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITM RESPECT TO WMICH THIS i CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE(NSORANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT.TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES..OMITS SHOVIN MAY t44VE BEEN REDUCED BY PAID CLAIMS.' LtR TT^E Or INSURANCE Ih�R I--- ro LNMrra _- A OtAL uA=LrrY 'MP00DW0100513 12/4/2010 112/4/2011 H O 'JIiRBdcE 8 1,000t000 X (GONYERCWL GENERAL LIA81ll'Y' I -. ..emisdS ER1z mlrtael_j R 1D0,000 I _ CIArNS•tlADe OCCUR ! 1 .I MED EXP r are warn) f 5.000 }c - PERSONAL 6 ADV WJURY _I S 1 O0D GOO I ccNNFAL A30MOATE , S< 2 D00 t700 JE7-L AGGREGATE VWTAPPuES PER: I PR i , i . PRODUO 9 CONPf(7P Aqp S v2,Q00,00D r011CY tEr+T LOC I AUTOMOWLS UARIUTY COM91Nf?D l371GLE UNIT . I , ANY AUTO : IFU SMINN) 4 I A.0 DwN¢D AUT08 I + I eoo!Uy,�NJURr cPer pelsa) 3 } y,l r s.•, .:' I t`s .I -;." BODILIV,INJUkTIPerOsilaitt) SCHEAVLEDA1J109 `) f +�. i 1 HIwEDAUT(>3 ti �- ti" PR01E!gTYDmit, _ -- I (Parlkdda i nON•0YAEDAUTOS { UwIMM A UA9 +CCCUR I i g a. 4 t 1 ) �"i t!ACM OCCLIftRENrp :excessuae CLAINS"ADEI I l AGGREt3ATE �_tt CeDUCTIRLP H vroaKsascorlP>�rsATgN - --� w 3009920 X.V21010 i 3123J2011 • a :AND S61PL01'fiR6'UAaiLITY YVC 8 A i .4tit Pi.PRlETQR/PARTNER.CXt'sCUTI4F j` CRY LlhlrrS X n r IP1m!d In NNR EJICLUDEC? i N IA } c _ ! EL&AC�ACCIbENT __I A 5OO OQO a &II tl c be u�p)s e.L Ct�6ASE EA eMPLO'1%3 500 OQ0_I v 3t;RIPtMN OF OvkrtA'l(}N^b�1ow E.L. t EAstc.POLICY LII1�1,r y- i 0911000TION OF OPERATIONS ILDCAT046I VErf"S(Alcoch ACORD 101 Addnto.0 ltw mris lChId4N,M mon J i1lCI a NItuYOd Landscape gardening, painting carp3ntry t v • . r _CEI'TiFiGATL HOLDER `C,ANCELLATIO ' (508)4284974 r - �.ottar Realty CO Inc J D ANY OF THE ABOVE DESCRfBt'_D POUCiE3 et?CANCELLED BEFORE 770A Malr StR3et ° XPRATICW DATE THEREOF, NOTICE W.I.L. BE DELIVERED IN j Oatemitle,MA 02655 ; DANCE VA71H TML POUCY PIeQ1,W10N9.0 tIPIPRESE?0ARVE A 0IM-2009 ACORD CORPORATION. All rights reserved. Ar,ORD 25 f2009l09) The ACORD name and logo are registered marks of ACORD - OpIKETpk Town of Barnstable Regulatory Services aaRNSTABLF- MASS. $ Thomas F. Geiler,Director 1639. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 4-'01 I as Owner of the subject property > J P P Y hereby authorize hkA 14#S MTT'V?- to act on my behalf, .in all matters relative to work authorized by this building permit application for: (Address of Job) /1 o Signature of Owner t rJate rint Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISSION L f`• fwyn• x y. P r ,... t, a i y frce ofCo RC Onsume Affairs&Bus ness HOME IMPROVEMENT CONTRACTORgnI won License or registration Vand{for mdividul use only �Z 'Reg istration- x before the ex irahon date E52124 xA � � ;° P If found return to y ,, ,cs k ,Type 0ltice,of Consumer Affairs and Business Rey ulati Expiration f 8�212042, WE BAY MAN m TM DBA h rx J Yt l0 ParkPlaza Suite 5170" 1 g one p Boston,MA 02116,� J �.z a AD Tars i }" /�;� H�OSTE r 77�A'MAIN ST` 44 r i T• X y t r ti c;: a . OSTERVILL M ''So a _ •c 'k r. rf�}�� rr -„ t`� Ns{? n""g�..� ,� / i a UnUCrS@Greta 'lnp fx. t �7"' 1 - . r4�d '.}�++r �r 4 .++• t,.X,m., "�ti ��.�r'c� '�' f f��t� y,• z� '� 3 s y - '�- ""fiWIt110 r{ w..."�'✓='`+c.x'''e""`�' i: uf:� t.:y rt tt x`si'4 s' '", ''-�?xx. 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L.,.y -'-. - •^..�-• --.a....•+s. -.,..:• :,,.,-+t• '.rf r-•M^ .7"'e.`S- *"�'"'p{ .+ •.,+• •,n',#+ *.-r,r•- t�'r�:. .a- w <7. !'tJ}.: P; : k - .. a �. a F--1 — � J W12 �- ❑❑ ANN: Q o co � w � Wo ►� 3 = EXISTING FRONT ELEVATION EXISTING RIGHT ELEVATION "-1 co 0- SCALE- 114' . P-O" - - - SCALE: 1/4" . V-o" IBM • � Z Oa pN Lj Ov OJ ❑❑ I s ® r aW ®�I � 1 - oa � — SNB!'T 1 DI PCOWAooWTIOW Al FRONT ELE E VATION PROPOSD RIG T ELEVATION SCALE: 1/4' V-O' SCALE: 114" V-p' I JLB. aa_ LDPAWW DY, Kw CV n '-� N Wo TYP ROOF ]r0'° ":r PLYwND SHEATMNG/ ' ASPHALT S INGLES 91nPSd1 In.a. FA5T ENERS T ALL .�• r aS RAFTER/TOP PLATE _ W JUNCTIONS TYP TYP.EAVES - ,.' O -. rS FASCIA/1.A SECO D MEMSER U (2)2.10 BEAM ALUMII l GUTTER D.S. 1.6 BEAM WRAP PI.E COLUT'W g PINE WRAP - who PT ae.a K�o.c. EXI5TING - ^ Q PETAL-4ERS EA END RESIDENCE a rA PT....POST -RESIDENCE ^ lLi IE� IIE-L POST BASE CONNECTOR �+ IY CONCRETE PIER w n W N.'BIG FOOT N'DEEP PORCH SECTION SCALE, I/4" I'—O• LEDGER h RV BOLTED EACN JOIST BAY W/(2)`IS'CARRIAGE BOLTS DOUBLE RIM-V'18T P.T.2.4 B.IL'O.C. V IL•O. ;j �'•� Q W HVNG W METAL CONNECT(R5 of J Q N . EAr-END a.-J- Q 12'DI. Y.ORO TLSE'PIER V Q SIMPSN PO5 °Ut.'ECTOR T BASE CO cy 26'BIG FOOT TYP. -- -- - - - - - r p J ae•-4• d-B° d-B° da° v-e• sw• O d pro a"eer 2 Or 2 FRAME / FOUNDATION PL-Ats' ptAra ar. Rr( L PATE._e/vIo V 4 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION: Map Parcel c.r Application# Health Division Date Issued q cv ,r / Conservation Division�/� t_' f Application Fee Tax Collector Permit Fee Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis ` Project Street Address !' S ( Lk j[, Village Co ' `* Owner G VT Address - s Telephone Permit Request W �dN} SCfe,"J, Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain. N Groundwater Overlay Project Valuation I a'o t D 0 O Construction*Type �' F Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure h S Historic House: ❑Yes A No On Old King's Highway: ❑Yes �No Basement Type: Wull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) �R � Number of Baths: Full:existing new - Half:existing cone_ -v o Number of Bedrooms: existing- 3 new '^ Total Room Count(not including baths):existing new first Floor Room Count 3 cn —t Heat Type and Fuel: ❑Gas ❑Oil 0 Electric ❑Other a v Central Air: ❑Yes 4 No Fireplaces: Existing New Existing wood/coal stove]Yr- 'n JdNo Detached garage:❑existing ❑new size °J J A Pool:❑existing ❑new size N/4 Barn:❑existing ❑new size Attached garage:garage:❑existing ❑new size tjShed:❑existing ❑new size N /f Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes No If yes, site plan review#np Current Use . 1 Proposed Use-* 4s� BUILDER INFORMATION Name �`'� Telephone Number J v�J "l ZT/`Z1#7-1,$ Address d �2•��w �7 License# Home Improvement Contractor# 15I-A 3 1 ` Worker's Compensation# W w ob�l ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE O 3d & i- FOR OFFICIAL USE ONLY t APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER f } DATE OF INSPECTION: FOUNDATION FRAME 9 l att c, ( INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL x GAS: ROUGH FINAL FINAL BUILDING I DATE CLOSED OUT. ASSOCIATION PLAN NO. zw' of r ` 'own of Barnstable VAERe' gulatory Seryices as F. Geilex • ' �,�� Thom , Director 019, �.�� Biding Division' rid Thomas Perry, CB 0, Building Coxuru ionez 200 Maim StYeet, Hyannis,MA 11. E Wwvv.town.barnsta ble.tna.us Fax: 508-790-6230 •Offices 568-862-4038 PLAN WEW S , M' ap/Parcel: 6 O Project Address /O S// e T� Builder' The fallowing items were noted on reviewing: .a. Su-PZ f3 .ems` vu R1R,E-� Revie''wecl by; pate f - Y �J 1 S'- i P '1 1 .} 1 t f- #FM•ih y t 1 t .� � ..< } � 1 f . �(, 1 sr T3�� I(�- { ♦ 1 -� l c.� i if I rr � � t{ � �. i � S i44 r3 * i U:., � F 2 r �. t� 5 c ' The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street Boston,M4 02111' wtvw.mass.gov/dia ' Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information _ .Please Print Legibly Name(Business/Organization/Individual):. Address: MA;7 S� City/State/Zip: l�C mA. Phone.#: ���' y?i� • ��Z 0 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 aiWorPart 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 g• Demolition- �vorldn for me in an capacity. employelis and have workers' g y p ty. 9. ❑Building addition • comp.insurance$' ❑ [No workers comp.insurance 10. 31ectrical repairs or additions required.] 5. We are a corporation and its 3.❑ I am a homeowner doing ell-work . officers have exercised their 11.❑Plumbing repairs or additions ' myself.[No workers'comp. right bf exemption per MGL 12.[]Roof repairs ed, t c• 152, §1(4),and we have no insurance,required.] 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 aff davit 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 on additional sheet showing the name of the Sub-contractors and state whether ornot those entities have employees, If the sub-contractors have employees,theymust provide:their workers'comp.policy number. jam an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site' information. Insurance Company Na)ne: w S t '''t` �'°Ire ' Policy#or Self-ins.Lic.#: W VJ 6 3 0 0 5 ti I D Expiration Date: 3 I�'31 Lo I I 7obSiteAddress• I��'. S "'` i( °"� �'"l City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). ' Failure•to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment;as well as civil penalties in the form of a STOP WORK•ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the.Office of' Investigations s a verification. I do hereby certify and he pains andpenalties of perjury that the information provided above is true and correct. Si afore: Date: Phone# S08�y1�-L�ZB Offtclal 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 Y �°FSHET° Town of Barnstable ' Regulatory Services " saxxsr E Thomas F.Geiler,Director y MASS. � ' �'ArFo;prA�� Building Division Tom Perry,Building Commissioner , 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on mybehalf, in all matters relative to work authorized by this building permit application for: S �( (Address of Job) 05 6//,9: A Sig re of Owner Date pan �C' �d S Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side.- Town of Barnstable YHE Tpk Regulatory Services '* BARNSTABLE, Thomas F.Geiler,Director p MASS. 16.59. A,0 Building Division TfU MA'I Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 __________---------------- ---------------------------------------------------------- HOMEOWNER LICENSE EXEMPTION Please Print- DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state t 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 minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements, • Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by_ several towns. You may care t amend and adopt such a fom>/certifrcation for use in your community. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I A m / �(C�"J LI DATA 5934209227 HARK W S'vL V-,g PAGE" 92 AC_J>DT,, CERTIFICATE O LIABILITY INSURANCE -- � D�cI«ckoic P,,9—IXCEA NFOf2 AA-IO;d I (50%+42J3-rJ•130 � THIS CER T IFICALE IS ISSUED AS A PrL$Ti'R OF ,= ' Mark SyMe Ir�s:ua.iwAgency' ONLY AND •CONFERS NO RIGHTS UPUV THE CERTIFICATE Tit Mah 5t'C'0 HCLOCR. THIS CERT)FiGATC 00E-S f\'CT AMRNZ), EXTEND ^R ALTER THE COVERAGrz AFFORDED 8Y •rF!E POLICIES BELOW. 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ROOF W 2x8's @ 16" O.G. 1/2" PLYWOOD SHEATHING/ —� ASPHALT SHINGLES SIMPSON H2.5 ?x10. FASTENERS AT ALL ,, '' rr s @ 16 ® W 3 RAFTER / TOP PLATE t— O C JUNCTIONS TYP. TYP. EAVES = O ix8 FASCIA / lx4 SECOND MEMBER (2) 2X10 BEAM ALUMINUM GUTTER 4 D.S. Z lx8 BEAM WRAP ` V PT4x4 COLUMN N PINE WRAP w V ^t U Q EXISTING o (� P.T. 2x8s @ 1 PT 2x8 s @ I6 O.G. V METAL HANGERS EA END RESIDENCE PT 4x4 POST METAL POST BASE CONNECTOR F 12" CONCRETE PIER U 1 J 26" BIG FOOT W z 1 48" DEEP TYP. O T o F'ORC�4 SECTION SCALE: 114" 1'-0t1 LEDGER THRU BOLTED EACH JOIST BAY W/ 42) 5/8" CARRIAGE BOLTS O 0 16°o.c. � O DOUBLE RIM JOIST 2x8's P.T. 2x8s @ 16 O.G. p w HUNG N/ METAL CONNECTORS EACH END OL 12" DIA. "SONO TUBE" PIER r 1 SIMPSON POST BASE CONNECTOR 26" BIG FOOT TYP. OF 5'-3" 5'-3° 5'_3" 5'_3" rai_6" TAYL 32'-0" PEET 2 OF 2 FRAME / FOUNDATION -'LAN SCALE- 114" 1°-011 JOB: 1001 DRAWN BY: KW DATE: 514110 L 1 V1 W 0 CA 32'-0" TYP. ROOF j 2x8's @ 16" O.C. LLI 1/2" PLYWOOD SHEATHING/ —J ASPHALT SHINGLES vkVe > SIMPSON H2.5 V- & AT ALL 0 W s @ „ is 3 RA TER /R TOP PLATE w �— 6 O,C JUNCTIONS TYP. V— , n s @ 16" TYP. EAVES = O r ix8 FASCIA / Ix4 SECOND MEMBER (2) 2x10 SEAM ALUMINUM GUTTER 4 D.S. ix8 BEAM WRAP PT4x4 COLUMN N ' PINE WRAP O a N 00, co f�L EXISTING o F� s @ PT 2x8 s @ 16 O.C. _' O METAL HANGERS EA END RESIDENCE �.,..� CD t n PT 4x4 POST L 1 METAL POST BASE CONNECTORt- 12" CONCRETE PIER V 26" BIG FOOT 1 , ` 1 48" DEEP TYP. W T PORCH SECTION SCALE: 114" = 1'-0" I LEDGER THRU BOLTED EACH JOIST SAY W/ (2) 5/8" CARRIAGE BOLTS (Q Itik MG► Q CO O DOUBLE RIM JOIST 2x8's @ 16110. . W w P.T. 2x8s @ 16" D.C. Q HUNG W/ METAL CONNECTORS -- Q EACH END CL ---� �— Lu 12 DIA. "SONO TUBE PIER V SIMPSON POST BASE CONNECTOR 26" BIG FOOT TYP. O Q 32'-0'I SWEET 2 OF 2 FRAME E / FOUNDATION PLAN SCALE: 114" 1'-0'° JOB: 1001 DRAWN BY: KW DATE: 814110 IN5TALLR15ER5 t COVER5 TO PIPES TO BE LAID LEVEL FOR E A I HOLE LOGS WITHIN G" OF FIN15H GRADE 2' OUT OF DISTRIBUTION BOX DEEP OBS RV TON `�r) (5EE PLAN VIEW FOR LOCATIONS) 2" LAYER QF 3/8" PEASTQNE DATE: 09-09-2010 P-13047 O� OVER 3/4" I V2" DOUBLE WASHED TEST BY: D. MEYER, R5 *C5E STONE ALL AROUND WITNESS: D. 5TANTON, HEALTH AGENT W PERC RATE: < 2 MIN./ INCH EL. 26.5 _EL. ?_8.0 DEEP OBSERVATION HOLE#I EL. 28.2 0_ - DEPTH T.O.F. @ '- "� SOIL SOIL SOIL COLOR SOIL ____ ---- L. 2 7.7 4"SCH FROM OTHER Q) EL. 28.5 4"SCH 40 PVC 40 PVC TOP @ EL. 25.2, SURFACE (MUNSELL) MOTTLING 5C 0 PVC 0,r-8,l c .: ..... HORIZON TEXTURE I a 2 500 GAL. PRECAST DRYWELLS A LOAMY SANG I orR4! i3 !� :::...... 8 - 32" 13 LOAMY 5AND I OYRG/8 75 25.5 O Q 25. Q 24.63 BOTTOM @ EL. 22.5D 32"- 144 c MEDIUM 5AND 2.5Y7/4 IN5TALL GA5 BfffLE 24.50 1N OUTLET TEE �I 24, O � 25.25 5 t.. _ „f � DB 5 INSTALL TANK 4 D-BOX Q 6.3' DEEP OBSERVATION 15OO GALLON PRECAST ON G"LAYER OF CRUSHED HOLE#2 EL. 28:2 LQCLIJ (17 SEPTIC TANK STONE DEPTH 501L 501L 501L COLOR 501L W BOTTOM TH @ `FROM It HORIZON TEXTURE (MUNSELL) MOTTLING OTHER L EL. I G.2 O" 13 A LOAMY SAND I OYR4/1 (( 8"-32" B LOAMY 5AND I OYRG/8 28 SEPTIC 5Y5'TEM PROFILE 32"- 144" G MEDIUM SAND 2.5Y7l4 'i\t tf a t lip 1;c.l 2 G 30 \~ � �L 24 \1 DEEP OBSERVATION HOLE#3 EL:28.5 32 \ `,,, , I H 501E 501E SOIL COLOR SOIL 22 FROM HORIZON TEXTURE (MUNSELL) MOTTLING OTHER 5U'' ACE 0" 7" A LOAMY 5AND I OYR4/1 20 7"- 32" B LOAMY SAND l /8 34 � 32' - 126" C MEDIUM 5AND. 2.5Y7.5Y7/4 '/30.0 0 DEEP OBSERVATION HOLE#4 EL. 28.5 '\ DEPTH 501L 501L 501L COLOR 50IL �� FROM HORIZON TEXTURE OTHER SU FACE (MUNSELL) MOTTLING O��_7" A LOAMY 5AND I OYR4/I 7"-32" 13 LOAMY 5AND I OYRGl8 32"- 12G" C MEDIUM 5AND 2.5Y7/4 o , p ' ~ NOTE: NO GROUNDWATER ENCOUNTERED IN ANY OBSERVATION HOLE �w/JZTH#3 / �� / DESIGN DATA '0.0, f'OPQS�D �' .. DAILY FLOW: (3) BEDROOM5 x 110 GPD = 550 GPD RCh o \ ` 5EPTIC TANK: 330 GPD x 200% = GGO GPD / ,// • / 1 I I , U5E, :.1 500 GAL. PRECA5T 5EPTIC TANK /,� k/: DISTRIBUTION BOX: DB-5 /a r / iIt7TH #2 r,N � �/ l r'� �,� `'� `` .,.., 1�Tt1 #I_�. ._.._- = �";;-v,-: � � 501 L AB50RPTLON SYSTEM: / � �( - 7;O / USE. (2) 500 GAL. PRECA5T DRYWELL5 LINED W/4' �' / OF DOUBLE WA5Hf-D 5TONE CAPACITY: 28.S W!S , O r / � � / 51DEWALL AREA: : 76 x 2 x 0.74 = I l 2.5 GPD / ow� DECK / .''i / ,/ 16 BOTTOM AREA- 1 3 x 25 x 0.74 = 240.5 GPD - o ` / / TOTAL CAPACITY: 353.0 GPD 34 .31 GENERAL NOTES ��' / l . SEPTIG.SYSTEM 15 TO BE INSTALLED IN ACCORDANCE WITH 3 10 CMR 1 5.00; TITLE`V. 30 / ..- �� ;' 2. TH15 5EPTIC5Y5TEM 15 NOT DE51GNED FOR THE U5E OF A GARBAGE DISPOSAL. 3. TH15 PLAN I5 NOT TO BE U5ED FOR PROPERTY LINE DETERMINATION. �15.2 4. CONTRACTOR TO PROVIDE 48 HOUR NOTICE TO 28/ DE51GN ENGINEER FOR ANY REQUIRED INSPECTIONS. 5. CONTRACTOR TO BE RESPONSIBLE FOR LOCATION Of ALL'UTILITIE5, ABOVE * UNDERGROUND, PRIOR TO 2G / .� - �� /. ANY EXCAVATION OR CONSTRUCTION. 24 - - j u, .-- 1 SITS -�- SEWAGE PLAN I oo i 14 FOR 22 / / -�' 107 SHELL LANE COTUIT, MA t 20 PREPARED FOR 12 ti� GEORGE E. ROSS REVOCABLE TRUST 2007 1 8 / I DA REN cn 5CALE. DATE: DRAWN BY. MI~YR ` 1:'n^ 1 " 20' 09- 1 5-201 O TMW 6 •� \ �w No. 11407 /`n JOB NUMBER: REVI5IUN: SHEET NUMBER: ��10 o�, N. . 10-038 SP i 4� �' s STD :�,,� s / '4MITAR( ` r WE LLE R * A55 O C I ATES CO , I 1 2 / 1�s i I G45 FALMOUTH RD., SUITE 4C -� P.O, BOX 417 CENTERVILLE, MA 02G32 O EDG= ,-�--°F- - 2 WINDY WAY, #232 NANTUCKET,_MA 02554 TELEPHONE * FAX:' (508) 775-0735 EMAIL: trl5wcIIcr@comca5t.net REGI5TERED LAND 5URVEYOR5 ENVIROMENTAL CON5ULTANT5 I