HomeMy WebLinkAbout0009 HYDE PARK ROAD q 'aCr
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Town of Barnstable *Permit# o?D0 70(y3a
�-® � PERMITSS Expires 6months�rom issue date
i' Regulatory Services Fee
MAR 1 3 2007 Thomas F.Geiler,Director
TOWN �e Building Division
'Z,"�TABLE Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA.02601
www.town.batnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number 12.3 Q 6 11
Property'Residential Value of Work Address
76 lf�'
c�y� Minimum fee of$25.00 for work under$6000.00
�
Owner's Name&Address
Contractor's Name �� ' �',/��
,�°��� /�' Telephone Number'
-�
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check.one:
❑ I am a sole proprietor
❑ I am the Homeowner � y//
have Worker's Compensation Insurance / /�v.0 Tell0 6 C 6
Insurance Company Name 7��
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must be on file.
_Permit Request(check box)
Re-roof(stripping oId shingles) All construction debris will be taken to 6*�eeL,4
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
r
❑.Replacement Windows/doors/sliders. U-Value (maximum.44) .
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Hislonc,Conservation,etc`'
***Note: Property 0 must sign Property Owner Letter of Permission.
f e Home Improvement Contractors License is required. ,
n
SIGNATURE:
Q:Forms:expmtrg
Revise061306
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,per ✓!e �anvrrLauuec o�✓�aooacluaella
'\ 136ard nf>37777
Regulations anc ,$t�ntiai ds .
> l:vMk or registration valid for individul use only
H6ME IM0.116YEMENT'C6NTRACTOR ' �`l ogre the expiration date. If found return to:
Reaislraboii 134tl94 art ut l3iliiding Regulations and Standards '
xpiratign 2Gg7 ' O shbur'i"on Place Rill1301
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Type IBA + , 08
,
LePA E a SON$ %FING
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�• Administ atm -NotA•alid without signature
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Town of Barnstable.
Regulatory Services
AW KA33
11YI , �,e�
rFp39., 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
I, ,as Owner of the subject property
hereby authorize /� % to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job)
Signature of Owner Dat
Print Name
Q:FORMS:OWNERPERMIS SION
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
d 600 Washington Street
Boston,MA 02111
,4 J,W www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): .
Address:
S C
City/State/Zip: Phone.#:
Are you an employer? Check the appropriate box: Type of project(required):.
4. I am a general contractor and I
1.k7employees
I am a employer with_ 6. []New construction .
(full and/or part-time).* have hired the stab-contractors
2.❑ I am a'sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have g• Demolition
workingfor me in an capacity. employees and have workers'
Y P tY• 9. 0 Building addition
[No workers' comp.insurance comp.insurance.$
required.] 5. We are a corporation and its 10.❑Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their I l.❑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 infomiation.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
*Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is-the policy and job site
information.
Insurance Company Name: 57-
Policy#or Self-ins.Lic.#: U d7 766 7 Z3 �o E pffati A ate:
Job Site Address: q1tay/kate/Zip: C
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 ma arded to the Office of
Investigations of the DIA for• urance coverage verification.
I do hereby certify e pains and penalties of e ' :at the information provided above is true and rrect.
Si ature: Date:
Phone#: O
Official use only. a in this area, to be completed by city or town officiaL
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver o trustee of an mdmdual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for.the performance of public work until-acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit(license number which will be used as a reference number. In addition, an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture _
(i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions
please do not hesitate to give us a call.
The Department's address,telephone-and fax number;
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA€12111
Tel.#617-727-4900.ext 406 or 1-877-MASSAFE
Fax##617-727-7749
Revised 11-22-06
www.mass.gov/dia
LePage_ & Sons Roofing Lic. 134094
508-295-6483
Job namepBarbara Finnigan Bob Marshall Job# bob marshall07-32
address de Park
Town nterville State RI Zip
home Date 30-Jan
cape toolman11560-)aol.com extended
cell
strip install mat'l/sq total/sq #squares total
20 year _ $ _
25 year _ $ _
30 year ART 31.00
40 year $ _
special $ - additional layers
CEDAR $: - $ 6,045
STAINED $ _
rubber $ _
extended
additional char es: cost per q ; cost
Dormer $ 70.00 dormer
Hip roof $ 10.00 sq
Pitch 7-10 $ 15.00 sq
Pitch >10 $ 25.00 sq
Valley $ 60.00 valley
Solar Col $ 300.00 system
Tar paper $ 88.00 roll optional
Ridge Vent $ 5.50 ft optional
Dumpster per quote job
Vent Boots $ 30.00 ea
gutter $ 3.50 job optional
Ice&Water Barrier $ 2.50 ft optional
$ 1,795
Description of work to be performed:
Stog existing roof and replace with 30 year arch shingle. Ice and water barrier the
first 6 feet of heated area and tarpaper the balance of the roof.
Replace the(2)pipevents with new and seal the chimney flashing with adhesive
membrane to insure water tightness. Haul awayall debris.
All workmanship guaranteed for 1 year all materials car manufactures 30 ear
warranty.
color: Gaf Pweter Grey
Total $ 7,840
Deposit(50% req'd before material delivery) paid #1243 $ 3,600
Balance due upon.completion
requested start date paid $ 4,240
Special instructions
i
:00 AM PAUL UU%/UU% r ax 7CL vG -
�ltY�a
Air
OAT it(MM D6\YY)
PRODUCER THIS ERTlFICATE IS SU ISED AS A MA TT E OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
A DAMES LYNCH INS HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR
297 B.OALWAY ALTER THE COVERAGE AFFORDED BY THE POLICIEd.BELOW.
COMPANIES AFFORDING COVERAGE
LYNN MA 01904 OOMoANY
29SY T A TRAVELERS PROPERTY CASUALTY COMPANY OF A1dIE11ICA
INSURED OOMDANY
LEPAGE, HERBERT DBA B
LEPAGE & SONS RCOTING OOMDANY
32 PIERCE ST C
ROCHESTER MA Dn2770
OOMDANY
D
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 HAVEBEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LT DATE(MMNDDIYY) DATE(MM\DD\YY)
GENERAL LIABILITY
j GENERAL AGGREGATE $
COMM-=FCIAL G"cNERAL LABILITY I PRODUCTS-COMPICP AGG. $
CLAIMS AIDE OCCUR I PERSONAL&ADV INJURY
OWNER'S&CONTRAOTOR'S PROT. EACH OCCURRENCE
RRE DAMAGE(Any one tire) $
MED.EXPENSE(Any one perscn) $
AUTOMOBILE LIABILITY COMBINED SINGLE $
ANY ALTO I 1.1117
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per Person) $
HIRED AUTOS BODILY INJURY
NON-OWNED AUTOS (Per Accident) $
PFOPERTY DAMAGE $
GARAGE LIABILITY AUT:ONLY-EAAOCIDENT $
ANYAU70 O-HER THAN AUTO ONLY:
ACH ACCIDENT $;::f
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
UMBRELLA FORM AGGREGATE $
0-WER THAN UMBRELLA FORM
WORKER'S COMPENSATION AND STATUTC'R LIM TSA .-
A EMPLOYER'S LIABILITv (UB-,664810-�-061 CQ-13-06 i
08=:3-0?
THEPROPRIETOW EACH ACODENT $ inn nnn
PARTNERSIEXECUTIVE NCL i DISEASE-POLICY LMIT $
OF=ICERSARE EXCL DISEASE-EACH EMPLOYEE $
- OTHER
I
DESCRIPTION OF OPERATIONS/LOCATIONS YEHICLESIRESTRICTIONSISPEOIAL ITEMS
THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS CON.P COVERAGE.
TWICAT C�4 1GE.�.ATtQN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE.
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
BARBARA FINNIGAN LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
9 HYDE PARK LIABILITY OF ANY KUNO UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES
CENTERVILIE MA 02632
AUTHORIZED REPRESENTATIVE '�'- "'C-
As ssor'""s map'and lot number THE
g ...�..�.�..D..I............. SEPTIC SYSTE pMPL�►NC �PyoF Sewage Permit number
IN C
9 LW TITLE 5 = 33AUSTAnLE,
INSTALLED
Ho4 number ..........................:......:..:.................................... ENTAL CODE
" 3a
v9
MENVIRONM IONS
a•e
TOWN OF BARNS `
BUILDING INSPECTOR
APPLICATION FOR'PERMIT TO ......<,W.1 �.1.. ... ....... .. .. N.^.-�. ..................
''' _ pp. �.. dtW,.L..............................................................................• TYPE OF CONSTRUCTION ......:4:K� ,...... ►'1..
.............1.2V-5--.... .l9. .
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies ,for a permit according to the-fo'lllowing information:
Location ............. 1 ii D. l`F Lam.... `�'.C�I... ............. yyQ�� ..................
...... �. ... ' '. .. ........
ProposedUse ....... . .................... ..........................................................................I.........................
ZoningDistrict .......�...4...................................... ........Fire District ........ .......... ..............................
Nameof Owner .......... :5-4 .` ................................Address ...............c ....................................................
Name of Builder ......... ....................................Address ...............C94" .......
Name of Architect .........�...a...��.e.................Address .............. .... .. .. .. .......................................................
Number of Rooms ...........7...................................................Foundation ........PI�..... ............
Exierior ............ .. . .. ... ........ ....l. .� . .....................Roofing ............ . ^ ...........................................
Floors 494- ........... . OL.)-n-. ........V1 .... ... .:.......Interior .............P.I..4ff........ ........................
Heating .........&AS........P ... .............................Plumbing ..................v:.....-..........
Fireplace .......... �. .-...�1. V.�.....................Approximate. Cost ............ 5,�. ...................
Definitive Plan Approved by Planning Board J� - - -19 5 -. Area 1.4P.�a4.... : ..:.....!�V
Diagram of Lot and Building with Dimensions Fee 7
SUBJECT TO APPROVAL OF BOARD OF HEALTH
/A �
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction:
Name ............... ..�......L ""'.... .... ........
Construction Supervisor's License ..j ,!;7Z. ..eS...........
BAYSIDE BUILDING O. A=173-16
. x •
2.9.14.9Permit for ?, storX single '
o . .. ...
`family dwelling -
.......................................... .....................
Location .I'�.t.... 10......9 H1 d Park..........
Centerville
Owner ...Bayside...Buildg...Co.............
f ;
....
j
Type of Construction .............frame.............................
{� .....................
s
tisPlot ..'.....................14 Lot ....,................:..........
r,. _
Permit Granted ........... .....AL........ 4 .....1986
Date of Inspectio ... ................... 19P4
' Date Comple - -
t� Y~ .ram .. •r� • �• ^ .r - T
SZ
P"
Cif � v t< ' • "� - _
i.7
ti
a r
TOWN OF BARNSTABLE Permit No. ...:.291.49
° BUILDING DEPARTMENT
TOWN OFFICE BUILDING Cash
HYANNIS,MASS.02601 Bond ........
CERTIFICATE OF USE AND OCCUPANCY
FF .
Issued to ' BAYSIDE BUILDING COMPANY
Address lot #10 9 Hyde Park; Centerville
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL-NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
Building Inspector
f
TOWN OF BARNSTABLE
BUILDING DEPARTMENT
ssaaSTAU TOWN OFFICE BUILDING
rua
�g 'i639• HYANNIS, MASS. 02601
OIUY M.
MEMO TO: Town Clerk
FROM: Building Department
DATE:
An Occupancy Permit has been issued for the building authorized by
BuildingPermit $k.... °2.. 71 ..".......".........................................................................".".."..........................._........".".... .. ........" .
issued to Aec/genle- .. CL,4...." .." ......."1,r "/ .."...." Y�CY�
Please release the performance bond.
TOWN OF ...""..
w -. , 6ER CARD (�
PERMIT NO. 29149
APPLICANT ADI;,
ti JJU.) (STREET) - (CONTR'S LICENSE)
i, I I ,NUMBER OF
PERMIT TO J�1.,1( �'W '?.L�!7l. (=) STORY •). J,r; .i!1 L J JI'n'' :::DWELLING UNITS i
(TYPE OF IMPROVEMENT) NO. } (PROPOSED USE)
!!-I a t• } 14, 1'. r-• 1 ZONING
AT (LOCATION) DISTRICT
IN0.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS:
AREA OR PER- -�•!�.'. z,�J. _I: '_
VOI_UME ESTIMATED COST $ ~ FEE
MIT
.(CUBIC/SQUARE FEET)
OWNER
r « BUILDING DEPT. f.
ADDRESS BY
,
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR
® PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP-
PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED
FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
INSP, C OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR
ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND
I. FOUNDATIONSOR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
2. PRIOR TO COVERING STRUCTURAL QUIREO,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
MINAL INSPECTION
TI TO LATHE FINAL INSPECTION HAS BEEN MADE,
3. FINAL INSPECTION BEFORE
OCCUPANCY.
') POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
�4�APPRDVED��e � -
WN OF BARNSU
{ U LDING I a r
ECTOR;
2 2 2
r
3 HEATING 'NSPECTING APPROVALS REFRIGERATION INSPECTION APPROVALS
TO
STABLE
fi cvl LgBG , EN TV s o
12
Apk
P=tCr7EED JNTIL THE PERMIT,WILL BECOME NULL ANU VOIU'IF CONSTRUCTIlDN iNSPECTiONS INDICATED ON THIS CAR(
WORK IS 1:O f STARTED WITHIN SPX MONTHS OF DATE THE CAN BE ARRAftiiO FOR BY TELEPHON'.
STAGS =" :�'�S'.9',:=T:ON• I OR WRITTEN NOTIFICATION. a
I PF'40T IS ISSUED AS NOTED ABOVE.
Rd30.00 (,
P*47.12
d0
90
co m�°o
FovNVATto 22
CURVE RAOIU$ ARC
1 - 1335.98 14.49
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•
JOB # 84-198
CERTIFIED PLOT PLAN
PREPARED FOR:
LOCATION. LOT-10 HYDE PARK
SCALE: 1=40 DATE: 4/2/86
REFERENCE:
PB., 383 PG 39 BAYSIDE CONSTRUCTION
I HEREBY CERTIFY THAT -THE BUILDING
SHOWN ON THIS PLAN IS LOCATED ON THE OF
GROUND AS SHOWN HEREON A�gJ fy
o ARNE
a`
OJAIA .,
down :cape engineering #M48
CIVIL ENGINEERS ��f 9 S;T..�O
LAND .SURVEYORS
II` ROUTE 6A YARMOUTH MA DATE REG. AND SURVEYOR
1 \ \ `p►��t'� ems' '
v-
L10`1" 1�
�2G-�}.�I i�C� �fSTE I�� �f✓ �V t O F� �
I F-I�D P,`r
I o , SITE PLAN
�I`7
Locus:
bafZtL STD I,lam-
I oZ. REF:
mown Cape enlineefOg JA
F1 PREPARED FOR:
CIVIL ENGINEERS _
LAND SURVEYORS
LAO
DATE ail ccv-- .
r
I
� .MON - SEWAGE I
SEPTIC TANK- y ' _"D"BOX - ��' t%I�01.j pi rpU�U
TOP OF FON
Cola (MSL:)e "2"OF r/8TO 1h"
WASHEO STONE I
� !C)
TF
IN-
OUT-
IN-
0
COI•3J
UT-
G
ELEV. 7_4" TiE .
y
ELEV.
ELEV
ufD
- -------- EL'iV. ELL V.
ALAS LIS-rM I✓'I�JT-�.C�' WASHED STONE
�: �n1�7ErPS,FV2
- ELEV 54.y
TEST HOLE LOG 4�}
TEST BY grl
WITNESS 3 BEDROOM HOUSE
TEST DATE DESIGN
T.H: • 1 T.H. 2
ELEV.(0,_5-D ELEV. NO
LOQ� LZ DISPOSER DISPOSER
ri 1J15 PERC RATE MIN/IN.
FLOW RATE 6�)(GAL./DAY)
GL �( SEPTIC TANK : !_
ME Iv0 REQ'DSEPTIC TANK SIZE
LEACH FACILITY
SIDE WALL(2F�^�3�2 L 72,0l �.' ) .G/D.
BOTTOM %.�; .Y `, 2 2� �.v} . 'c 2-y, o G/D.
'�� A��TClJ TOTAL 'Ji.r oSF NC�N,OG/D
�I-OW D r-lUSORS- J) EI=F.
USE:
_WATER ENCOUNTERED t^j ;T I 2' C:DI- j770 E- /5,LL-
NOTES: (UNLESS OTHERWISE NOTED)
1.DATUM(MSL):TAKEN FROM ' Is QUADRANGLE MAP
2.MUNICIPAL WATER I -AVAILABLE
3.PIPE PITCH:%-PER FOOT N 4.DESIGN LGAOINQ FOR ALL PRE-CAST UNITS:AASHO- 44 1N Of
S.MIN..GROUNOCOVER OVER ALL SEWAGE FACILITIES:(1)FT.
6.PIPE JOINTS SHALL BE MADE WATERTIGHT
7:CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. �� AR E H, t
STATE ENVIRONMENTAL CODE TITLE S
Ate. T�-?a�5 Pt�lv_J Fo'G 7YA7ryk:.� tJ.O'CIC 4�i�Y a•.�d 7+-Y�J�.�
REG. EER
KAl E
BOARD OF HEALTH j
(EXISTINU', ..._..•.__.... - =a�/:5 ✓ MA
` CJNTOURS (PROPOSED)-O-O-O-o-• APPROVED DATE_
Assessor's mapJ nd lot number v/,.�' : . ....: 1 .../�
bY-
Sewage Permit number .......... ......-... I.............
Z BABBSTABLE, i
House number 'S
y; r Op 3639. \00
�t 0 MPY a'
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ... <1.....,.�.1 i 1.�� � . �� ��:.-�.��!!+ .y ..... ;.....�w: .... ..r...:... �....................
TYPE OF CONSTRUCTION ...... Z � ...... C�..� ka!t k.............................................................................
�. ..._�...............19 .5.
f.. TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ........ & ......... ...�.� ?............t.t..I-
......I.......0
.
Proposed Use ........ ...........................................................................................
Zoning District .......�f ...4......................:..............................Fire District ........ : C...........�.,!. .:.j:............. .............
Nameof Owner .......... .c . .............................Address ...............C.xc,.A t ......................................................
Nameof Builder .......... r ... ...................................Address ...............l.,. v..l ..................................................
Name of Architect ......... b,-I v .` j............... ...... ...................Address .................,. . .a::.....:...... ........................
Number of Rooms ............?....................................................Foundation � .�.c.�
Exterior ............ lil c�r�r!�lZ....... ....!...�.a: ....................Roofing. ...........::/ v�.! ........ .......
,� �r IS '
f
Floors ..........Cl..✓Q . \,...:..t..�c :U R ......... .......Interior ............. .1.:?,.................. `,aR�yt .........
Heating 1,�.1.. }. ' ..( i.. �,, is a % Y
.... .. .................. ...Plumbing ...................� ................ . �. ... �......r? .. fi::.
Fireplace ..........� n, ...`.... t...4�. a:�........................Approximate. Cost
�. . . ........................................
Definitive Plan Approved by Planning Board `F_-fC�_r?'•_11195___ . Area ..........................................
Diagram of Lot and Building with Dimensions Fee
. .............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
i
r
1
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ....... y .. . . ..... .....................
Construction Supervisor's License ..�?t�_ "l. ...........
Ix
T-
BAYSIDE BUILDING CO. A=173-16
k-
06
No Permit for .1h.-at.Qry...Sing-le
..f am.i l.y...dw.el.l.i.n.9.... ......................................
... .... .. ..... .... .. . ..
Location Ji0t...#.I.Q........9...Hy. .de:..Park......
Centerville
. .............. ...............................................................
BaXsi
Owner ... B u.i l.d.i n.g...��Q...... ..........
.. .. ..... .... .. ....
Type of Construction ...........................................
................
................................................................................
Plot ............................ Lot ................................
Permit Granted ............Aptil.....4...........1,9 86
.........
Date of Inspection ....................................19
Date Completed ................... .................19
C �-
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