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HomeMy WebLinkAbout0182 SKUNKNET ROAD I �WI21 ;Vz A DI wall J VOW N c'ia AAF -xl cot ANK W&O-Mily "Wn Mgt T yu, ""W to TMOR it's, bag MOR Nj post 14YAWAGN&W gh I Ashok WIN qQ!AS QQ WON q K�;nnj�� WINE NN Rau- IN" ,, i" ,`�� — 'W195 I INMR, - I MAW: 1 MOM W,WIN trj 3 ST NAM it'L 'A'i,7941�,� AIN NMI 14 af 1 0 1 Z MUM MIR WWO MON IN. M ., MUM Ito WON! flow WOWITAWPQ l�� �jpw,,p, w%;j non OWNS HOWNWISNA�q aj& ";.4"P.1 'Pik' N J,;� J'AN., KMIW H� Mon.. Fb-`­I�i. Q MAW �j om 106—A -" A- 3400PAX nn PY: mago MOM A Of" mom' �T- , , I, B1111,101 � SWAST IiAi �0 `" "' - ,, `� Ax. 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KFAIT& 0 j., SO xy IRA MMUM", Mona 0,� No i`� low 10121 Nil Stv Vill 1Q.,aff,; e WOWS, ANN QW WON, W I Via MIR- MIS tWhyS, -�77 W WWI—1114 jjIR044MIT l l/ T Cape Save Inc. 7-1) Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 8/10/15 Thomas Perry CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 RE-: Insulation Permit 2015032690 Dear Mr. Perry ZR r This affidavit is to certify that all work completed for 182 Skunknet Rd,Centerville has been inspected by a third party Certified Building Performance Institute(BPI)Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey s TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel o o — Application # C)6 IS c 3QL&� Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street^^Address S 4 A�_n e+ osi c� Village CfA+e,MI I Owner K&r l QT+e_f Son Address anti e Telephone s d 8 3-� 5 - a a 5 3 Permit Request hd� a" r�Ii 1 ln3ulI4�11en +0 t6t a+-ic. h\dd. R- -F I,QtS� +o .,-►V& WOMS. N R- 30 CAP N, OSP *n P 56Lf64 P i t I At . Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation b 10 0 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 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 CD f Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn:r0 existing 0 new; size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: i Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ 4 Commercial ❑Yes 1(No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name v -Im-, JW1,11119'm k c Telephone Number _ �ob 618 )3 9$ Address 4mi-11,notan Ny , License # -a-L to Sovsj-� 1(orincw4 , Mtr O&6 `q Home Improvement Contractor# 3 g Email Worker's Compensation # Ww C ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO rat SIGNATURE DATE '5/ �$ ��5 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Building Permit Authorization I, Karl Peterson , as owner - hereby give my permission to Cape Save, Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Office:508-398-0398 to take all necessary steps to obtain a building permit to perform work at my property located at 182 Skunknet Road Centerville, MA 02632 Signed Date S Z2- -2- r The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 1.00 Boston,MA 02I14-2017 www mass.gov/dia NVorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual):Cape Save Inc Address:7-D Huntington Avenue City/State/Zip:South Yarmouth, MA 02664 Phone#:508-398-0398 Are you an employer?Check the appropriate box: Type of project(required) 1< ✓ :I am a employer with.Zo employees(full and/or *part-time): ` 7. Q New construction 2. I am a sole proprietor or partnership and:have no employees working for in ❑ & Remodeling. any capacity.[No workers'comp.insurance required.] 9. ;.[]Demolition 3.Fl I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 0 4.❑I am.a homeowner and will he hiring contractors to conduct all work on.my property: I will 10 Building addition ensure that all contractors either havewoikers'compensation.insurance.or are sole I Ln Electrical repairs or additions proprietors with no employees. 12.[]Plumbing repairs or additions 5M I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance:I 6:[]We ate a corporation arid its officers have exercised'their right of exemption perMGL:c; 14.[R]Other Insulation 152,§1(4),and we have no employees.[No workers'comp.insurance required.] `Any applicant that checks box 41 must alsor fill out the section below showing their workers'compensation:policy information: t Homeowners who submit this affidavit indicating;theyare.doing all,work and then hire:outside contractors:must submita 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 s providing workers'compensation insurance for my employees. Below is the policy and.job site information: Insurance Company Name;Wesco Insurance Company Policy#or Self-ins.Lic.it.WWC3136274 Expiration.Date:04/09/2016 Job Site Address: 182 Skunknet Road City/State./Zip: Centerville Attach a copy of the workers' compensation policy declaration page(showing the Policy number and:expiration date). Failure to secure coverage as`required under.Mot c,:152.625A is a criminal 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 ORDER.and a fine ofup to$250:00 a day against the violator.A copy of this stateinent may be forwarded to the Office of investigations of.the 01A:for insurance coverage verification. I do.hereby certify under th 'pains and penalties of perjury that the.information provided above is true and correct Signature: Date: 5/28/2015 Phone#:508-398-0398 Official use;only. Do-not write:in this area,to be completed by city or town lofflciaL City or Towns Permit/License;# Issuing Authority(circle:one): .1.Board of Health. L Building Department 3.City/Town Clerk 4.Electrical,;Inspector 5 Plumbing. Inspector 6.Other Contact Personi... Phone.#: OATECMMlDD1YYYY):� - CERTIFICATE �F LI �lL TY INSU�N�E. 3/24/2015 THIS CERTIFICATE'IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE'HOLDER. THIS CERTIFICATE DOES: NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED.BY'THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE i$SUIN NSURERREPRESENTATIVEO S) AUTHORIZED , T LR.. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the paHcy[tes)mtaA be endorssd. It SUBROSsATION IS WAIVED;subject to the terns and conditions of the policy,certaln.policies may-require an endorsement. A statement on this certificate does not confer rights to the certitcate holder in lieu of.such endorsements. _. PRODUCER NAME: .T Colleen Crowley Risk Strategies any Eft, PHONE t781)986:-4400 FA 1'5 Pacella Park Drive IC o.(781)963-4420 CCrowley@risk-strategies.com. Suite 240 INSURENSI AFFORDING COVERAGE NAIC ptaa> oiph M 02358 INSURERa'Se2ective Ins, ..-,oE America INSURED CapeCaape INSURERsAllmzica IAinalaial`Alliance 0212 Save, Vac INsuRERc.Resco, Zusurance. an .: 7 D Huntington Ave INSURER D: INSURERE: Iouth YUMUth !A 82664 INSURERF. - COVERAGES CERTIFICATE NUMBER:CLI532491501 REVISION NUMBER: T#4tS IS TO C€RTlfY FI AT THE-POLICIES QF IldSlli2AidCE LISTED 11ELOWHAVE BEEhI iSSi7EDTo THE-INSUREo-NA'1MIED'A'B�OVE•FO'R`TffE'POLICY"PERIOD 1ND CATi ED. llklll ITH TANDO�ANY REQUIREMENT,TERM OR OWD1TION OF ANY CONTRACT OR ETHER DOWMENL Wti1i:RESPECTTO WHICH TF{(S CERTIFICATE MAY BE ISSUED.OR MAY;PERTAIN,THE-INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH`POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS: ILT R 3 POLICY EFF POLICY EXP ?R TYPEOFINSURANCE.: POLICY NUNBEIR PO MMI LIMITS GENERAL.LIABILITY EACH OCCURRENCE $ 1000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TEN PREMISES Eeoccurrence $ 1QO,OOO A CLAIMS-MADE Q OCCUR 5119944810 O/16/2014 O/15/2015 MED EJ(P(Any ona person) $" 10,000 PERSONAL BAOV I&MY S 1,'QOQ,QQa GENERAL AGGREGATE $ " 2,000,000 GEN'L AGGREGATE LIMIT_APPLIES PER: PRODUCTS-COMP/OF AGG $ 2,Q00,000 POLICY X ZCT PRO. X LOC AurgMos LE L1AWL1TY, MBINED Mr Ea accident 1 000. 000 Y AUTO $ Mt BODILY W JURY(Per person) $ AUTOS ED AUTOSULED 4.6796600- 1/6/2024 1/6/2015 „gODILY1NJt1RY(Peracgdent) $: x HIREDAUTOS x AUTO � ROPERT'(Df6NA6E.:' $ X UMBRELLA LIAR ` X OCCUR EACH OCCURRENCE. OOO A EXCESS:I:IAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION fill 1994480 0/16/aoia o/x57a0i5 Ce WORKIMO 69PEWSATION $ AND EMPLOYERS'LIAITv ffirYS IAClit�ea for X NC STATU TH ANY PROPRIETORIPARTNEROECUTIVE YIN average CCRCERtMEMBER.EXCLUDED? NIA. E;L.EACH AGGDENT $ 500,000 (Mandatory In NMI Z 627.4 79/201'5 f9j 016 ' {f, s.d;Taiba under, E:L.DISEASE-fAEMPLOY yyaa DESCRIPTION OF OPERATIONS below" EL.DISEASE-POLICY.LIMIT $ 506,0110 DESCR)PT10N OF ORERATIONS!LOCATIONS lVEHICLE5(Aflach ACORD 101.Additional Remarks Schedule,)f moro space Is raquitW) Issued as evidence of...ins=ance.. Thielsch Engineering, .Ina. is listed as additional insuredy as respects Gener-al,yialii3zt as,regLty.reti.bar �rsitten ccarstraot. . , t , CERTIFICATE HOLDER CANCELLATION ssongL�capel ght, act CT>� WOULD# OF fliE,itlSDlIE DE&CQ(BED'�OLICIES 8L CANCELLEiI BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL SE DELIVERED IN Cape Light Compact ACCORDANCE WITH THE POLICY PROVISION& Attn: Ma rga/ret Song... 00 wx 421/61CI� AUTHOl i En REPRESENrAnvc 3195: Ma].n Street Barnstablet; 1+9A 02S3Q Chael ChristianfCLC ' - ACORD1 [2010105) 4198&2610 ACOAD COROOt�ATI#Nt. All r gtt#s reserved. INS025(2olaos).aI The ACORD name and 16go arc rosistered marks 6f ACORD e Office of Consumer Affairs and Business Reg ulation s� 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration +FmS..1iF Wnwyn i+n."a.3n+/+.Ayp4+w. Registration: 1713$0 _ ,, Type: Corporation Expiration: 3/14/2016 Tr# 249649 CAPE SAVE INC. WILLIAM McCLUSKEY t M 7-D HUNTINGTON AVENUE ' SOUTH YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. scn 7 zoM-osni 0 Address [] Renewal [] Employment Lost Card O�tr� Ifr,vitriet2cCUU?ltflnfr:l�Ca:IrriFlilrBC/-� - 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: egistration: �171380 Type: Office of Consumer Affairs and Business Regulation ,'Expiration 3/14l2016. Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE SAVE INC. WILLIAM McCLUSKEY as 7-D HUNTINGTON AVENt7E`• SOUTH YARMOUTH,MA 02664 Undersecr� Not vali�Tt signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor Specialty License: CSSL-102776 WILLIAM J MC C-LU �CEk 37 NAUSET ROAD West Yarmouth NIA 0267° Expiration Conunissioner 06/28/2015 OF FRIEDLINE&CARTER ADJUSTMENT, INC.' *; � 436 Main Street, P. O. Box 338 Hyannis,Massachusetts 02601 At i t; p Tel. (508) 771-3232 FAX (508) 790-2344 g 1 �" > TO: (-)/Building Commissioner or Inspector of Buildings o O Board of Health or Board of Selectmen ( ) Fire Department 1 , TOWN OF BARNSTABLE TOWN HALL , HYANNIS, MA' RE: Insured: PETERSON, Karl &Kathie Property Address: 182 Skunknet Rd. Centerville, MA 02632 Policy Number: HOM00358506 Type of Loss: Fire Date of Loss: 3/15/2015 File#: 122328 Claim has been made involving loss, damage or destruction of the above captioned property,which may either exceed $1,000.00 or cause Mass. General Laws, Chapter 143, Section 6 to be applicable. If any notice under MGL, Ch. 139, Sec. 3B is appropriate, please direct it to the attention of this writer and include a reference to the captioned insured, location, policy number, date of loss and file number. On this date, I caused copies of this notice to be sent.to,the persons named above at the addresses indicated above by First Class Mail. D. A. BENTLEY Adjuster 3/16/2015 ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map' P rcel rO T` .a B Permit# 11��. Health Division - q 15 a 5—' F .�TABLE Date Issued Conservation Division - PR 31 Application Fee � Tax Collector Permit Fee. c<::), Treasurer ',� T (;a y{ � SEPTIC SYSTEM MUST BE ' ""NSTALLED IN COMPLIANCE Planning Dept. VATH TITLE 5 ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic OKH Preservation/Hyannise Project Street Address S 2 .5914NXyE7' Ros}D E Village ENTE'R _V lza_� Owner kAgl_ 1' 9,47H/�' �ET�R oiJ Address S,4A4,C_' Telephone 66 g 7 7S— 22 5 3 Permit Request GL, A f F x 3 3 .4 AoUE (SAnun UN )0ooL f Square feet: 1 st floor: existing proposed .!2& 2nd floor: existing proposed Total new i Zoning District Flood Plain Groundwater Overlay Project Valuation O �s Construction Type A A)4 f6>0 Lot Size 0,3 Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 9 YEARS Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: XFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) /VP*r Basement Unfinished Area(sq.ft) tip o Number of Baths: Full: existing new Half: existing l new Number of Bedrooms: existing_ new Total Room Count(not including baths): existing g new First Floor Room Count Jc- Heat Type and Fuel: XGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ANo Fireplaces: Existing _� New Existing wood/coal stove: ❑Yes >4 No Detached garage: ❑existing ❑new size Pool: ❑existing Xnew size/9X33 Barn:❑existing ❑new size Attached garage:9existing Cl 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 PI SPA- Telephone Numb"q3 Address i License# 1 ri Home Improvement Contractor# to Worker's Compensation# AL ONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C - L? /�__N P9, 4' - pigt' AWYL SIGNATURE DATE Ci 110V FOR OFFICIAL USE ONLY d - f PERM-IT NO. ti DATE ISSUED MAP/PARCEL NO. ~ 'r ¢ ADDRESS VILLAGE OWNER - 1 DATE OF INSPECTION: FOUNDATION FRAME �4 INSULATION ; FIREPLACE ELECTRICAL: ROUGH FINAL' r PLUMBING: ROWS FINAL a'P � , GAS: ROt ®0 FINAL FINAL BUILDING Q , { DATE CLOSED OUT N ASSOCIATION PLAN NOm_ c3 The Com�rion ve4ith of,N!assachusetts Department of Zndustrzat Accidents' Olfse ifkMMPffA' ' 600'Washington Street _ ~� Boston;Mass.. b21I Wor�Cers'.C m ensatio L insurance Affidavit-General Businesses /' address: 3 ^. • 11 e • � •. ,�� state, A ablisbment work site location full address �� � tall❑•RestaurantBar/Eatng Fst 7 am,.a sole)propnetor and have no on El Office ales(including REal'F,staje,Autos etc. 1hr �&., L� vrorkiug f capacity. 0 an em 10 er J11, full&' art timed:%/%/% %//yJ%%y%///�/%%/%///�// %s worlan onthisfob.,ozkers'compensation for myth e g „ , am an -ployer p=oviding vt ,3, 3 , :• r: r. : •.27 . 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D'liCs':{7.3• ,� r ^ :' .n.:" ` +•` •ati 11•'i;.`M1.;�.i;':;d::•' •4•..• :*..•:. lei.. fnsiirariG= a + " ositiQa of crimtasl penalties of a tole up to$1,500.00 and/or Failure to secure coverage as required under Section?.5A of MGL 15Z can lead to the imp + r�omnent as well as civff penalties In the foYm of a STOP WORK ORDFrR and s tuio of S180.00 a'day against fine, I understand that one years i nppri e t be forwarded to the Office of Tnvrstigatlow of the DlAfor coverage verification. ; copy of� I Co 'ect, _of perjury that the information provided above is fru a . mac; X do hereby Date (� Sigma A Phone# �� print name official we only do not write in this area to be completed by city or town officw permittUcense# ❑Building Department []Licensing Board city or town: []Selectmen's Office D checkif immediate response is required []HealthDepartiaent , []Other phone#; contact person: (feYised Sept 2M3) t _-.........z-r>:�aRwr,•"�.:,`SrX--'.�Y acsrr"°"""'��s ate- • Inform'atiou and Instructions• 'ezieral Laws'chapter 152 section 25 requires all employers to pxovide• orkers' compensatidix far .thee. Massac,1 isett$G •i . `:,' oted'fromthe `law", an employe is.defined as every person m the service of another tinder any corrfract C4loyees.. As qu Of hire,expreas or irlod oral or written. An emp oy arhiers , association, corporation or other legal entity, 6r any fwo or mgre of 1 er is defined as an individual,P' hip the emp-foregoing gage&in a joint enterprise,and including the legal zepresentatives of a deceased,myloyer, or the-receiver or artnershi association or other legal entity, employing employees. 'Howevei••the owner of a ,trustee of an padividual,p . P� . dwelling house haymg,,not'more than three apartments,and who resides therein, or the,occupant;of t 6A, yelling hour a bf another who MUplYspersbris to do main,,kenance, constriction or repair work on such ctwelling''lionae.Or on the grounds or artbe deemed'tobe ail hall not because of such, Ioym1oY .. building,apPmtenant thereto sP• , ter 152 section 25 also'states fhat'every s.tate'or Ibcal Ucensing•agenoy shall+rlthhold the issuance or renewal Of a chap too operate a business or to construct buildings,in the.corimionwealth for any applicant who has Of a license or permit P .. .. - . not produced.acceptable'evidence'of compliance with the insurance coverage required: A•aditionally,neither'the' coix��v'ealth nor.any•of its political subdivisions'shall enter into any contract for the performance of public work unto acceptable evidence of compliance with t�e insurance requirements of this chaptez have been presented to the contracin tg :,:. authority. ; MMMI A;pPlicants .. Please es°'compensation affidavit completely,by checking the box that applies to your situation•,Please supply company nwork ame, address and phone numbers along with a certificate of insurance as all affidavits maybe submitted to the Dep t'Of Ind trial A 6"dents-for confirmation of insurance coverage. Also'be sure to sign and date the affidavit. The affida•t should be returnedto the city or town that the application for the permit or license is being requested, not the peparbment 6�ludustrial A.ccideats. Should you have any questions regardmj the'"law"or if you are orkers'•compensationpvlicy,please call the Department at the nim-ber listrA bRIOW. Tequired to,obtain IL-W. ., , City or Towns Please be sure that the affidavit complete imprinted 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 xegarding fhe applicant. Please be sure to fi11in the pemnt/hcens a number w1,ich wil be used as a reference nunIxT. The,affidavits maybe returned tQ 4i ,ss othe'r'arrangemsntshavebeenmadg,• the DepartmentbY maid�. ,jFAXu The Office of Investigations would like tc thanit you in advance for you cooperation andb ave sould you h ahy questions, please do nothesitate to give us a'call... w / is address,telephone and r. fax number. , The Depa The Commonwealth Of Massachusetts Department-of Industrial Accidents . Bifke of l�sli�t�etta ' 600 Washington Street Boston,Ma. 02111 fax#, (617)727-7749 er. iitrn nnrr,.tnnn _...t '.lnC • Town of Barnstable of ME ro�,� o� Regul atory Services. Thomas F.Geller,Director L a sTS&at .�' �'0.1�.C�.�DI'ViSIOn pfiFD '�� Tom Perry,Building Commissioner • 200 Main Street, Hyannis, 02601 , • Fax: 508-790-6230 O Ce: 508-862-4038 ' permit no• AFMAVIT _ CTOR LAW SUPPLEMENT TO ERM[T APP CATION alterations,renovation,xepair,modernization, conversion, MGL c.1A7�►r,quires that the"reconstruction, re-existing owr�,er-occupied improvement,removal,demolition,or construction of an elfin units any p tarns along wig other building containsdg 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 excep , requirements, OU Estimated Cost / [ "Type of Work 71 Address of Work' Owner's Name: '• ' Date of Application: j hereby certify that: Regstration is not required for the following reason(s): []Work excluded by law []lob Under S 1,000 , []Building not owner-occupied []Owner pulling own permit , Notice is hereby giVeu that: GISTF OWNS RS PULLING TIIMIR OWN PERMIT O�ROYEMENT WUOMDO NOT� CoNr CTORS FOR A7'P CAJ3�E HOME ACCE SS TO THE ARBI gp kTION pR0 GRAM OR GUARAl`ITX k'�N�UNDER MGL c.142A. SIGNED UNUBRPENALTMS OF PERNRY Ihezeby apply apermit as the agept of the ow4e-r,. 47 Re® istrah I�o. Contractor N e 4Dot OR N) CAI- . Owner's Name • f Town of Barnstable ` hP flp'(HE TOk�O� • Regulatory Services s B,�xrrsrwt.e. Thomas F.GefIer,Director �4p1 16 9, .��� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyanais,MA 02601 Of$ce: 508-862-4038 Fax: 508 794-6230 Property Owner Must Complete and Sign T1-As Section. If Using A Builder / .;as.Owrzet..of the.subjectptopetty- ...._..._.. .: _ p sa all inattets telative to'Work authoLizec�bp.this binding permit applicatiofl for: Is A '5 (Addtess of Job) {ute of Owner Date Ssgr�. PZ 19 Print Narn•e r 7 7 . 18 cq 17, SF 0.40 A RES 172.32• _` �a r LOT 19 :p Scc deader for details. OVAL - With extl'uded lalunilutti l mLL&xtion for a straight sided oval: 15' x 24', 15' x :30', F 1'Y J I Nd �'� ���5'•'Y'_"�. 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'w:,,.s� �,�}*:in"w"'X k'K"'�PH• � y �,�e�+c � t,. .: .. �, �hyp«ru�a«eexam.msK. <a.�m wnwaar �. :w.e M ., ""'-"� .-._. - -- --_."---.. -- .,,,ti,- -�• -----••-- ,.�,�._..�_ ....._._. x t .max___.-•- �tro, l�n �: t,4 tub., wea '�::�o ,ac swS�:'.a�3"W4�. .wwxin � 3��'ei . .. ._..r•.-,._- - -'-'"�"- --_ - �,.r �.-=-..r�-,_,_,_ _ -x_..,,.-:-.. -, Y t .p�,, o.: � - .�+ �js 'Zztl rawrc>w� ;M,s .w ys,,w.u .-H, ," '"",e°'"' ,wr""°�`."",. a, ...-- .va,3.... ....1 ,9y, :: - ..�'m.._. _ M.•.��+A k t x-x- . •---. .- F._ .ti.. ..a-- _�.- �.. ,s.. r,..-. p ti� i \"z.kne t i�vh Sa.Mtt"� jY"nJ �?p {�a�Ya S�h�'��y� k�.:n�F �, + �,It Tt *•t t �;,.1 t i �'M.�I�t' I I.�{ t� ' - �R LV ' >,�a t � )r ti }'t'TM 1�r Wl+q �t Symph.olly Setics pools are. built ill thq WOFk &r ar w.. '.'.:a a b r!r Y USi1 with the Most current entrineet-ing and tl.cllll.iC.ul knowledge. 111C; waJLH, ul)t'I.g11tA t 'r ^t awl lull toll tails ill'fe'IturC: /)u Multi.-Stage ( ort�ilag Sydte,m anll l'Lt.f) Ii0T1+?QOU alant This systent strengthens the lle:avy gal'Lge f ol'rugated steel b encasing it w:itll ul) to eleven protective c.oat5, 111CJ.11Chllt� 1101 /l.;l, ))(',Cl �'itl.Vall.lzlll" It11Ct a i h 1. 1. galvanizing yS Corrosion inhibitor on both th.e. histde and outside of the walls. L3ac�lcel.• Co=1t. You can he assured your Sympliony Series 1. .Pool otfl,rs superior strength combined Chromatic y 3 with the ultimate protective finish that Treatment nuaran.tees you ye, of cale:free swinuniug a►lc asurc,, Clot ruson lnh h:itor l �-- - Hot 'Dipped Galvanized Steel qwd Galvanized s, 8, Corrc)slon � �Il.hil.)Lt.01' t ♦ s Cllro111aLi . rt-catin jit i tr§ Paint Coat t bilk. .oat t n a ,yC ", x i • a J Clear Coat t t.tti(n:5 4t1l)jeai v change:tvilhuut notice „ . 11t.���1RC)V1:C�IiC)l1ND`PO O 5 R��i;�:Nt)1T-� NG Nt)0�.4 7 r r Z h:t E .. ,u, pw�rk'"�' '6iiwnw.AJ.=Are..,.1.wWw':�.w"+ ' aiA�m:+.,— .• •..sVn.wa. •n•..n.a.r.l' •.n ....nr..•.n...p..�• o va WIVn EXTENDED-CYCLE D.E. FILTER SYSTEMS Perflex filters are performance matched ap ` with the Power-FlWm pump series to ensure a system that maximizes its filtration ability.These advanced filtration r, systems are designed to operate with less resistance than conventional units,thus producing more filtered water with less -" pump horsepower.Quality,value,depend- ' ability and sparkling clear pool water are the Perflex system trademarks. System Features •Pump-to-filter union connection provides simple ° installation and winterization •Corrosion-proof,ABS modular platform base accepts fie optional chlorine feeder and AutoTime m timer •All systems are single carton units and UPS shippable C4OC75XES Perflex System. EC5OC75XES Perflex System. - r r +11 Emma= — -------------- odel System Ctn. Ctn. clip art tmber Filter m Pump+2+ H.P. Components Qty. Weight ;301500 Series EC301540ESNV includes: 301540ESNV EC30 Power-Flo 40 GPM 3 • EC30 Filter ®i 50 lbs. •SP15401,40 GPM r � 301540ESNVTL EC30 Power-Flo 40 GPM 13 1 50 lbs. Power Flo Pump . 401500 Series-New Clamp Assembly! • Modular Platform Base •Union Connection 10075ES EC40 Power-Flo LX Y44 23 1 55 lbs. • 1'1i"Hose Package IOC75XES EC40 Power-Flo LX 1 2,3 1 56 lbs. IOC75XESTL EC40 Power-Flo LX 1 1,23 1 56'tbs. EC30154CESNV 501500 Series OC75XES EC50 AC Power-Flo LX 1 23 1 64 lbs. OC75XESTL EC5O AC Power Flo LX 1 EC40C75XES includes: 1,2,3 1 64lbs. • EC40AC Filter 4_ OC8OX5S EC50 AC Power-Flo LX 1 tfz 2,3 1 66 lbs. •SP15801, 1 H.P. OC80X5STL EC50 AC Power Flo LX 1'/z 1;2,3 1 66 lbs. •Power-Flo LX J Modular Platform Base r I filters include SP1022C 1 W drain plug. •Union Connection I pumps have 6'power cord,except system designated with"TL",which incorporates a 3 ft.twist lock cord, • 1 tfz"Hose Package ;tem Components ECMC75XES 'twist lock cord(UL) P0723 deluxe drain valve W hose packages include:two(2)1 16"x 6'lengths of hose,hose adapters and stainless teel hose clamps EC50C75XES includes: • EC50 Filter with Clamp •SP15801,1 H.P. Power-Flo LX Pump •Modular Platform Base • Union Connection • 1 tfz"Hose Package ® t EC50C75XES For replacement parts see pump and filter pages. Perflex° ,aty . EXTENDED-CYCLE D.E. FILTERS— EC40 AND EC50 SERIES Perflex Extended-Cycle D.E.filters IMPROVED DESIGN provide crystal clear,sparkling water at an economical price.Proven over many now years,Perflex has set the standard in swimming pool filtration by incorporating the patented Flex-Tube'design in im combination with D.E.filter powder— Aim the most efficient dirt remover known for pool filtration.The result is superior water , clarity,extended filter cleaning cycles— x and no backwashing required. Applications •Above-ground/on-ground pools •Small in-ground pools Features NSF •Easy access clamp assembly •Cleans pools fast—removes even the smallest EC40AC Perflex filter. EC50AC Perflex filter. particles the first time through , , Extended-Cyclepflex •Uses D.E.(diatomaceous earth)filter powder— D.E. Buying Guide the most efficient dirt remover known for swimming pool filtration Deluxe Built-In Service/ •Patented Flex-Tube system efficiently reuses D.E. Model Pressure 1'h"Drain Check Inspection D.E. Dimensions Ctn. Ctn. powder and dirt mixture to form fresh cleaning �p Number Gauge Valve Valve Port Required Width Height Qty. Weight 00 surfaces ASSI EC40AC — 4lbs. 16" 261h" 1 26lbs. •Exclusive bump handle activates the Flex-Tubes, EC50AC • • • 5 lbs. 13 T 31 3W 1 30 lbs. causing them to instantly purge themselves of dirt NOTE: EC40A Replacement Filter:EC40AC. EC50A replacement filter:EC50AC. and powder •Uniquely designed to expel any air that may be present Modular Select-A-System in the system through the filtered water returning to Customize your own filter program by utilizing three carton systems,beginning with the basic the pool EC40 or 50 filter combined with a base package and the pump of your choice(Power-Flo 1111,Max-Flo,", •Combination diffuser and lower mixing chamber Super®,.or Super II'"'(. specifically designed to produce a uniformed coating Model Ctn. Ctn. of D.E.on the Flex-Tubes Number Description Qty. Weight Performance Data EC1161 LK Elevated mounting base with sweep union,adjustable connecting 1 5 lbs. loop,elbow adapter and hardware Effective Turnover EC1161PAK Modular platform base is re-drilled forthe Power-Flo Series Pump 1 4lbs. Model Filtration Design (in Gallons) P P P Number . Area Flow Rate 8 Hours 10 Hours EC40AC 20 ftZ• 40 GPM 19,200 24,000 EC50AC 25 ft 2 50 GPM 24,000 30,000 -------------------------------------------------------- Clip Art EC40AC EC40AC EC50AC EC1161LK Rpr 10 04 12: 16p 00000000000 uuuuuuuuuuu p. 1 _��__ �-�PJ'�� •�/:/`�y�P/d'h'' g/i�i�I/•4�/C/°Jtf/��� f� ti.i' ��"✓�"<!�i iyjD l!/:/G�'Y��S/•J�i" . r Board oa Building Regulaons and Standarcls One Ashburton Place - Room 1301. Boston. Massachusetts 02108 Home Improvement Contractor Registration Re>7.istr aticin: 310666 Type: DBA Expirafion: 4/6/2006 The Swim Pool Spa Sale & Ser, MaketGrp Steven Senna P.O. Box 3612 _ E. Falmouth. MA 02636 __.... . . ..........._... Update Address and return card.Mark reason for Chang j_ i{ address j� Renewal 1_1 Employment { ( Losi Card ��lc' �:07/!I/lOYtfllp{(�fjl. Of.'llflJ3flC/!f!J[ttJ -\ hoard of ttuitding tte2olarioos and Standards License or registration valid for individul use onh 7�, j HOME IMPROVEMENT CONTRACTOR before the expiration date. 9f found return to: (}' i Board of Building Regulations anti Standards ,VVI f ., ', Registration: 13066n -;i One Ashburton Place Rni 1301 Expiration: 4162005 Boston,i/la.0210$ Type: DBA The SwIrn Poet Spa Sale&Ser,MakelGrp Steven Senna 435 Waouoit Uwy E.Falmouth,,IAA 02536 _.. �.. ...._�._...__...._..._. ._ . .Administrator Not valid without signature i q..Y. c�ar9n�s n.: T 0 L At ' KEVaNF CAVANMiGt1 43O WWAR HGLW EFALMOUFK MA 025W am iA i = Ekmrd i Of �1,{t« UISUOnS _ bur�an F' oe, Km 1301 Bostw . Ma 02108-1618 1. To: 0 3 ICEM F CAVANAUM . 435 WAQUMT s EFAIAVOt= MA 0206 Tr am 7 N LOT 17 O� >71 67. '\ O 89.7..f 'V rr�w "1 56.2• i o U a09 O O k 0 � O LOT 18 c 17,200 SF 172.32, 0.40 ACRES LOT 19 JOB # 94-427 CER TIFIED . PL O T PLAN ET ROAD CENTERVILLE, MA LOCATION : SKUNKN PREPARED FOR. SCALE 1" 30' DATE 2-15-95 REFERENCE : LOT. 18. PB 224 PC 1274 RALPH CHAPLIC I HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE N OF n GROUND .AS SHOWN. HEREON. `� oft 508—�-541 �� AR� y� \ fox 506 0 + down cape engfneerin8• CSYM rMGINEERS = - LAND SURVEYORS DATE REG. uN EYO OF NNE rOkti The Town of Barnstable NWP` O� 6ARMASSA LE. NASS. �' Department of Health Safety and Environmental Services 7 rFOMA'�p Building Division 367 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Z'U v'-r 12# 9///GJJ// Location � '.�� -5! u N Ic Ple7- Permit Number Owner (fir Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: r14-s7 to a,� / o rz F �U�&'Veer e v s/Kc/V 7"s" Please call: 508-862-4038 for re-inspection. Inspected by Date J ///© 7,— t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Mdp ' �l Parcel . ""D' " .- Permit# �o � � 6�P� fir B ; � E Health'Division DL - Date Issued � s- 6Z 4s 112 AV Conservation Division L4 A2 P 23 PM 2' 22 Application Fe Tax Collector D k rQ Permit Fee ` • C� UZTTIC SYSTEM M Treasurer a� — � _. 3 1SlUN INSTALLEDUST BE IN COMPLIANCE Planning Dept. y�TMI S 4: )MRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board / V TOWN REGULA TIONS Historic-OKH Preservation/Hyannis / Project Street Address 1� 2 s, b'rl� 4e Village C:. �'/1 1tR✓y Owner Cq,6 l -e /�/ 0",-Ad fa/7 Address 5i1`/h e Telephone `s—a$ 7 Permit Request "� �� �?oDr-� /�O�Oi f o 7 e00oz/Z_4_i5_. Square feet: 1st floor: existing 6r' proposed 9� 2nd floor: existing �7 proposed Total new 3 9G Zoning District J Flood Plain Groundwater Overlay Project ValuatZ 7-900 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. DwellingTy pe: Single g e Family Two Family Cl Multi-Family(#units) � Age of Existing Structure ' yC' Historic House: ❑Yes r9'N On Old King's Highway: ❑Yes o Basement Type: ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) lY'6 O Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing 3 new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: CWas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes o Fireplaces: Existing New_� Existing wood/coal stove: ❑Yes 511 0� Detached garage:�existingg exi ' ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage: ❑new size Shed:�in ❑new size Other: 9 9 9 Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes C9"No If yes,site plan review# Current Use . _ Proposed Use BUILDER. FORMATION _ Name1� Telephone Number Address z7 l/1e License# C-S'� «' 7�C'�!i'i�!� t Home Improvement Contractor# 1131 lsU10-ro Worker's Compensation# ALL CONSTRUCTIO�QES C�l�/IN ROM THIS PROJECT WILL BE TAKEN TO� PY Dam,?40C , ? SIGNATUR DATE _'4119tlCr FOR OFFICIAL USE ONLY PERMITN0. DATEISSUED f' MAP/PARCEL NO: ADDRESS - , VILLAGE ; t OWNER DATE OF INSPECTION:,- FOUNDATION ` FRAME INSULATION FIREPLACE ELECTRICAL: ROUGIr." t t FINAL PLUMBING: ROUGHS FINAL GAS: ROUdIPP ;' FINAL ' z. r FINAL BUILDING DATE'CLOSED OUT- ASSOCIATION PLAN NO. _ The Commonwealth of Massachusetts Department of Industrial Accidents ' olflce Ofiarestigatiens . 600 Washington Street ^ ,a Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit • name: location city phone# ❑ .I am eowner performing all work myself. ❑ I a sole ro rietor and have no one workin in an ca acl I am an e to er rounding workers' c pensati n for my empl yees working on this job. ::......:::::::::..... a ddre ss � X.K. :: "`` > �r .......................................... ................:..... ..... .... .... ....................................... ply....#. .... ,. ....... :::.>:.: :,::;:,::.;•:;;:.;::<.;:.;..;:,:.;:.:::;.>.;:.;:•:;<.;:.:<:.;:.;>;:<:.;.... ❑ I.am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have n olices: ensaho the following workers com p.................................:::.:::::::::::::::.::.:.::::::::::::::::::.::::::.::.:.;;:.;:...::.;;;:.::;:.;;:.::;.;:;::.;:.> :>:::;:.>;;:.;;;:.;:;.;;::.>::.::.:;.;: .. com ari IIam :::....................X. y a�lre t ci rillifn :, .:. {;> +' .................:.....::•:::::::::::::::::::n�:v::::;,........':f!!ii::::._:::.::::::v:::.........- ............ .... .....•l.:. '�tt�nranc :::::; bli < « > ... c an nam 1:'ri::!Y.t i:::.:,:i:;:i:: :iiii:i::sji:F:iiiiii:'�i::;<:;i:.:;:<;:;:;:;:<:'::isist: :i:!S�:ii;:iiii !i:? i•>::ii:si: : x'F%::i>.:?ii:`ii:<: j:;: i::; ii:::i::tisi,:: ::i�:;::;i::::!:: (i::i:::':i::i:iF`:�ii i:iyi::ii:................. OII Cl h %aa :3 S :•.o.........,.. ........ ......................:::.::::::::::::::.:::::.,.: idle : :;<:<: ::;;:::>:>::»: ;;:;«...:.;:.:;.:;>:,;:;:.;;;:;.:.;•;:;;:<:.;>:.::.;:.;:.;:.::.;:.;;::: Failure to secure coverage as required under Section 25A of MGL 152 can lead to the Imposition of criminal penalties of aline up to$1,500.00 and/or one years'imprisonment as wen as ties in a form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a' copy of this statement ma orw of the DIA for coverage verification I do hereby.c of perjury that the information provided above is true d eorre Signa Date Print name Plione#�6nP o"� official use only do not write in this area to be completed by city or town official city or town: permitI/license# ❑Building Department ❑Licensing Board ❑checkif immediate response 1s required ❑Selectmen's Office _❑Health Department contact person: phone#; ❑Other (devised 9/95 PJA) } } Information and Instructions ' r their er 152 section 25 requires all employers to provide workers compensation fo General Laws chatP Massachusetts Gen pP employees. As quoted from the"law", an employee is.defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the*legal representatives of a deceased employer, or the receiver or individual partnership, association or other legal entity, employing employees. However the owner.of a trustee of an m ,p p, g 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 section 25 also states that every state or local licensing agency shall withhold the issuance or­renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the' commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. _ Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance 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 obtani a workers' compensation policy,please c0`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 o.,Xt ie affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please a . ,...,._w�,..._ - . be sure to fill in the permttllicense number which will be used as a reference number. The affidavits may be'retumed tF+ the Departni 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 estions. . 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 invesggations 600 Washington Street Boston,Ma. 02111 fax#: (617).727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 • Tabla JS=b(enamisa asaw Foaaal Fnsia + . precri t he P:ekagaford""d T"-Famx4 Rsddeasfal8 M1TtiMUM ' MA=M � . Wait Floor H,nameat Fffidesse� Glazing . Glaring Ceiling W&U � F.grsp�as Area'('/&) U-value= R•v,�lud R-Vsl=# r Fates?t mt to 6500 Heatfasl Degre+Ds� ' 6 Nasmsl IZ!'. 0.40 3i 13 19 10 Normal Q 19 19 10 6 g 12% UZ 30 --- 6, iS AFtTE 1] 19 10N==1 g iZ;'. O30 31 ?S ?i/A W T 15% 0.36 . 31 13 6 Normal U 1S'/8 0.46 31 19 19, 10 NIA 95 AFLTE 1] 2S N/A !S AFVE y IS% 0.44 33 19 10 6 W IS% 032 30 19 ENIA Normal IL lE'/. 032 31 13 23 WAN� l9 25 WA WA y IE'J. 0.42 3t 6 90AFVE 40 AFZJE 13 19 30 Z lE•/. 0:42' 3i 19 i9 10 6 AA 18% 0.50 30 ADDRESS OF PROPERTY: � � v *f k1l//cO ------- 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3, SQUARE FOOTAGE OF ALL GLAZING: G� 4, /o o GLAZING AREA(#3 DIVIDED BY#2): • S: SELECT PACKAGE(Q—AA-see chart above): G ENERGY-REQUIREMENTS NOTE: OTHER MORE ASK US FO ODS 0 S INFO ARE AVAILAB.. BUILDING INSPECTOR APPROVAL: YES: NO: q.f0rms-f9803 03 a r Footnotes to Table J5.2.Ib: I Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but exeiudirig opaque doors)to the gross wall area. expressed as a percentage. Up to 1%of the total glazing area may be excluded.f'rom the U-value requirement. For example;3 ft1 of decorative glass may be excluded from a building design with.300 ill of glazing area- = After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National' Fenestration Rating Council (NFRC) test procedure, of taken'from Table 11.5.31. U-values arc for whole units: center-of-glass U-values cannot be used. 3 The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness• over the exterior walls without compression, R 30 insulation may be substituted for R-38 insulation and R-.2 insulation may be substituted'for R=49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if.used). For.ventilated ceilings,.insulating slleathiag must be placed between the conditioned space and the ventilated portion of the roof. Wall R-values represent the sum of the wall cavity.inmulatfoa plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall.For example,an R-19 mequirement could be met EITHER by R-19 cavity insulation OR R-13*cavity insulation plus 1-6 insulating Sheathitg. Wall requirements apply to wood=frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal'frame construction. The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).FIoors over outside air must meet the ceiling requirements• ' Tl:e entire opaque portion of any individual basement wall with an average depth less than 30%below grade must mcrt the same R-value requirement.as above-grade walls. Windows and sliding glass.doors of conditioned b_-,cments must be included vrith the other glazing. Basement doors must meet the door U-value requirement d_scribed in Note b. The R-value requirements are for unheated slabs,Add an additional R-Z for heated slabs. If the building utilizes electric resistance heating use compliance approach 3;4, or S. if you plan to install more than one piece-of heating equipment or-mom than one piece of eooHng equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. For Keating Degree Day requirements of the closest city or town see.Table J52.la NOTES: a) Glazing areas and U-values are maximum acceptable.levels.Insulation R-values are minimum acceptable levels. R value requirements are for insulation only and do not include structural eampaaeats. b) Opaque doors in the building envelope must have.a U-value no greater.than 0.3-5.Door U-values must be tested and documented by the manufacturer is.accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requiremeat•(i.e.,may have a U-value greaser than 035). c) if a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation Ievels,the rea .component complies if the a -weighted average R va]ue is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors).. _ 43 RESIDENTIAL 13UMDING PERMIT FEES ' APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING'SPACE r D (r s feet x$96/sq.foot= t 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.f� >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) 9 of v x$30.00= Deck ` (der) Fireplace/Chimney ( x$25.00= Inground Swimming Pool $60.00 ` Above Ground Swimming Pool $25.00 Relocation/Moving 5150.00 (plus above if applicable) permit Fee 6 Z --7 pmjcost THE T ' Town of Barnstable Regulatory Services * s s MASS. �+ Thomas F.Geiler,Director 639�p`m Building Division v Ma. g Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 -2, Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: I�Wol,A!D/7 / 7.,q i /X0qVb y"1 Estimated Cost Address of Work: �2 5K�/!'1!� i7C° ��f /f�/jIje Owner's Name:_ Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job 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 ply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date 'Owner s Name Q:forms 1omeaffidav 1-43C^''GC3N ®F )RERTVALUNES Aaw ® STANDARD LEGEND NOTE:not all symbols will appear on a map / (Zt � GOLF COURSE FAIRWAY F / ' MAP 171 EDGE OF DECIDUOUS TREES / EDGE OF BRUSH / T- / ORCHARD OR NURSERY V-V-Y-v EDGE OF CONIFEROUS TREES ` 1 MARSH AREA i s I —•-•— EDGE OF WATER DIRT ROAD DRIVEWAY PARKING LOT PAVED ROAD - •. DRAINAGE DITCH OI PATH/TRAIL / ♦ \ / 1 PARCEL LINE** MnPlio E----MAP# 21 EPARCEL NUMBER Ieso—HOUSE NUMBER 2 FOOT CONTOUR LINE _ _ /' --_, , ^ -- •. --iB— 10 FOOT CONTOUR LINE / //� j `•` Elevation based on NGVD29 / Y : / ' -� ;•<a.a SPOT ELEVATION \ �� ♦ r STONE WALL -X—X— FENCE RETAINING WALL T T I RAIL ROAD TRACK SiONEJETTY ' ' A Pon SWIMMING POOL M MAP 17 �_!_ � PORCH/DECK i] BUILDING/STRUCTURE ' \ / 12 � � ��J DOCK/PIER 7 / / n ! / \ � �--�1`❑ �-C- - r � HYDRANT 6 VALVE O NMHOIf ' ! - O POST Opp FLAG POLE T O -W N O F B A R N S T A B L E 6 E O 6 R A P N I C i N F O R M A T 1 O N S Y S T E M S U N I T a SIGN S STORMDRAIN N PRINTED SCAN^IN FEET *NOTE:This map is an enlargement of a **NOTE:The pmad Its are only graphic representations DATA SOURCES:Planimetda(man-made features)were interpreted from 1995 aerial photographs by The James "' 1"=100 scale map and may NOT meet of property boundarlm They are not tore location and W.Sewall Compooy.Topogmphy and vegetation were interpreted from 1989 aerial pbotographs by GEOD 0 U11U1y POLE n TOWER "' e 0 ZO 4O National flap Auuracy Standards at this do not represent actual relationships to physical obleds Corporation. Planimefriq topography,and vegetation were mapped to meet National Map Accamcy Standards ¢ LIGHT POLE o ELECTRIC BOIL :. 1 INCH=40 FEET* enlorped stole. on the map. at a scale of 1'=10D'.Parcel lines were digitized from FY2002 Town of Bamstable Assessor's tax maps fAdgMconservation.dgn 04/23/02 02:12:05 PM f,� -74 y �s✓fee `ID y�iin"'.�,,',`..�1�i��j " �� BOARD OFxi BUILDING l�EGUTATIOWS ' License&C�O�NSTRUCTION SUPERVISOR \,: Number CS 076536,, sty $i Birthdate OS/27/1956,` `� �t � '/� � .s , E xpires 08127/2003 a Tr no -�76536�� t Restricted To � it TEPHEN W GRESINELL� ? ' ,r� �#s19�5 R;NE STREET _ �+ � CENTERVILLE�MA 02632 �' fill, �$# _ r �xdmlmgtrator r,w.ya g�y . �5yj��• 7� f '�,✓�g f�pp�JLpga���gjQ �L[/dP�� - HOHEIHPROVEHE�ITOHjRACTQR� xpiratioo' 04/�6�?OU2k r> q r.rr , n ifi � StEPHEH;61CbP,ESH�ILU ,�#, ESNE IHE P a The Town of Barnstable .n BA MA LE.SS. Department of Health Safety and,Environmental Services - 9 MASS. 0a . 03q• �0 �pfFDMA�a, Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 -PLAN-REVIEW Owner: TC0 S 6 Map/Parcel: f 7�/o Project Address: 0- Builder: .. The following items were noted on reviewing: i T% ©/z /k C y /I,ld 7'4'5- " /&G �. t fi 7 �T/ r.�. f��✓y zh•. ,w Reviewed by: Date: 31d 2- q:building:forms:review i BOISE CASCADE -BC CALCI 2001a DESIGN REPORT - US Monday,April29,2002 09:28 File Double - 1 3/4" x 16" V-L SP 2900 Name: Job Name - Peterson Untitled Customer - Creswell Cons. Address - 182 Skunknet Rd. Specifier - Rick Lowe Designer - BOTELLO City,State,Zip - Centerville,Ma. 02632 Company: - Botello Lumber co.inc. Code Reports - ICBO 5512, BOCA 98-52,SBCCI 9852 Misc: - Ridge beam 22'span,18'wide room. �0 12 , y Standard Load-25 PSF 115 PSF Tributary 09-00-00 „F BO 2475 Ibs LL B1 16 8 Ibs DL 2475 Ibs LL Total Horizontal Length 22 00 00 1658 Ibs DL General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Live Dead Trib. Dur. S Standard Unf.Area Load Left 00-00-00 22-00-00 . 25 PSF 15 PSF 09-00 115 Member Type: -Roof Beam Number of Spans - 1 Controls Summary Left Cantilever - No Control Type Value YP /o Allowable Duration Loadcase Span Location Right Cantilever - No Moment 22733 ft-Ibs 56.6% @ 115% 2 1 -Internal End Shear 3632 Ibs 29.2% @ 115% 2 1-Left Slope 0/12 Total Deflection U318(0.829") 56.5% 2 1 Tributary 09-00-00 Live Deflection U531 (0.496") 45.1% 2 1 Repetitive n/a Max.Defl. 0.829"(Limit:1") 82.9% 2 1 Construction Type n/a Span/Depth 16.5 1 Live Load 25 PSF Dead Load 15 PSF Bearing Supports Part Load 0 PSF Name Type Dim.(L x W) Value %Allowed Case Material i Duration 115 BO Wall/Plate 3-1/2"x 3-1/2" 4133 Ibs 79.4% 2 Spruce-Pine-Fir B1 Wall/Plate 3-1/2"x 3-1/2" 4133 Ibs 79.4% 2 Spruce-Pine-Fir Disclosure The completeness and accuracy of the input must be verified by anyone NOTES: who would rely on the output as Design meets Code minimum(U180)Total load deflection criteria. evidence of suitability for a Design meets Code minimum(U240)Live load deflection criteria. particular application. The output Design meets arbitrary(1")Maximum load deflection criteria. above is based upon building Member Slope=0,consider drainage. code-accepted design properties and analysis methods. Installation of Boise Cascade engineered wood products must be in accordance with the current Installation Guide and the applicable building codes.. / To obtain Installation Guide or if you have any questions,please call � i (800)232-0788 before beginning product installation. �-- '0/0 J G � BOISE CASCADE -BC CALCTm 2001a DESIGN REPORT - US Monday,April 29,2002 09:28 Double - 1 314" x 16" V-L SP 2900 File Job Name - Peterson Name: Untitled Address - 182 Skunknet Rd: Customer - Creswell Cons. Specifier - Rick Lowe City,State,Zia.p Designer - BOTELLO Code Reports- CBO 5512, BOCA 98-52,SBCCI 9852 M sc632 pany - Botello Lumber co. inc. a - Ridge beam 22'span,18'wide room. �o 12 Standard Load - - � �PSF Triou[ary p9 00 00 BO I 24 5 Ibs LL 3-112, ,6P 6 8 Ibs DL B1 Total Horizontal Length-22-00-00 2475 Ibs LL 1658 Ibs DL General Data Load Summary Version: US Imperial ID Description P Load Type Ref. Start End Live Dead Trib. Dur. Member Type: -Roof Beam S Standard Unf.Area Load Left 00-00-00 22-00-00 25 PSF 115 PSF 9-00;.00 1115 Number of Spans - 1 Controls Summary Left Cantilever - No Control Type Value Right Cantilever - No Moment 22733 ft-lbs "/o Allowable Duration Loadcase Span Location End Shear 3632 Ibs 29.2%u @ 1150% 2 1 -Internal Slope 0/12 Total Deflection U318(0.829') 56.5/o e° 115/0 2 1 -Left Tributary 09-00-00 Live Deflection U531 (0.496') 45.1/0 2 1 Repetitive n/a. Max.Defl. 0.829"(Limit: 1") 82.9% 2 1 Construction Type n/a Span/Depth 16.5 2 1 1 Live Load 25 PSF Dead Load 15 PSF BearinSl Supports Part Load 0 PSF Duration 115 Name Type Dim.(L x W) Value %Allowed Case Material Wall/Plate 3-1/2"x 3-1/2" 4133 Ibs 79.4% 2 B1 Wall/Plate 3-1/2"x 3-1/2" 4133 Ibs 79.4% 2 Spruce-Pine-Fir Disclosure Spruce-Pine-Fir The completeness and accuracy of the input must be verified by anyone NOTES: who would rely on the output as Design meets Code minimum.(U180)Total load deflection criteria. evidence of suitability fora particular application. The output Design meets Code minimum(U240)Live load deflection criteria.above is based upon building Design meets arbitrary(1")Maximum load deflection criteria. code-accepted design properties Member Slope=0,'consider drainage. and analysis methods. Installation of Boise'Cascade engineered wood products must be in accordance with the current Installation Guide and the applicable building codes., To obtain anInstallation Guide if you have any c y questions,please call (800)232-0788 before beginning product installation. C� elf 51, � G Assessi3r's Office 1st floor Ma IeDE s� Permit# Conservation Office 4th floor,_ -�i- �'"} � Date Issued s f Board of Health 3rd floor Engineering Dept.`(3rd floor) House# 6Zr4, y � � � Plannin Dept.-:-1st floor/School Admin.Bldg.): � &r UA _ .sues. Definitive Plan Approved-by Planning Board �" `lam �� 19 (Appli6iti6ns processed 8:30-9:30 a.m.& 1:00-2:00 D.M. lop*. TOWN .OF BARNSTABLE .f ;. Building Permit Application Pro'ect Street Address �_c Il..C.L.I I It ne �Lt 1 ' Village Q gy. h1 C� Fire District ���,�, Owncr ,M r, k M CS, kcd N� f� Address YQ 11e O 1 1tGrl1 Telephone ( F2-��y�``` L �� -i Permit Request: d Y. nn ./�C'Zoning District G �C Flood Plain Water Protection `r Lot Size � 1 Grandfathered (es Zoning Board of Appeals Authorization Recorded Current Use 11 Prop2sed Use Construction Type Existing Information DwellingI e: Single Family Two family Mufti-family Age of stricture /V.Q.1/1� Basement;;=L! (.�,/e Historic House �� Finished Old Kings Highway 0 Unfinished Number of Baths �- /d- No.of Bedrooms Total Room Count(not including baths) C First Floor A Heat Type and Fuel r,d ti Central Air d Fireplaces Garage: Detached Other Detached Structures: Pool Attached �' rc, Barn None Sheds Other Builder Information Name Telephone number ,_, Address License# Home Improvement Contractor# Worker's Compensation # 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 Proiect Cost '�S zfaO n' K-) Fee 0 0 l C SIGNATURE 112 DATE 7 _0 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T FOR OFFICE USE ONLY ADDRESS I slow VMJ AGE2 GG �l1 OWNER DATE OF INSPECTION:• < FOUNDATION FRAMM J , INSULATION -- V FIREPLACE ELECTRICAL: ROUGH FINAL PLUMB€ ' ,ROUGH FINAL GASH+ 1~IGH FINAL FINAL B&D (r DATE CLOSED O .. , ' ; ASSOCIATE PLAN NO. 11/02/94 17:02 V6177277122 DEPT IND ACCID Z 001 CotrunonweaCtli o f Maljac{z.u�etb aU�artmenE o�J'r.�ic�trial,.�`�lcciden� 600 !/V uLl&-St,�f James J.Campbell 0.3olton, ///c a." 02f f f Commissioner Worke ' Com ensation Insurance Affidavit 1, with a principal place of business at: (eay/stwizip) do hereby certify under the pains and penalties of perjury, that: () 1 am an employer provid'mg workers' compensation coverage for my employees working on this job. Insurance Company ,t Pokey Number () I am a sole proprietor and have no one working for me in any capacity. 0/ 1 am a sole proprietor, general contractor or om n (circle'one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor �n=suraanMce Company/Po " Ti ber Contractor Ins rice Company/Pots ber -2IZ vntractor Insurance Company/Po icy Number ,Polick1 t(nSWG(RQ 00 vF �. vICc� O I am a homeowner performing all the work myself. Gcir1 f 1 Clb ll l'N - w o $d 3q qw 14F3 I understand that a copy of d,is statement will be fomzrded to the Office of Investigadons of the DTA for coverzge verification and that failure to secure coverage as req-,,ired under Secvon 25A of MGI. 152 can lead.to the imposition of criminal penalties consisdnz of a fine of up to S 1,500.00 ano/or one years' imprisonment u well as civil penalties in the form of a STOP WORK ORDER and a fine of S 100.00 a day against me. n is day of 19 Lice see/ erm Building Department �� C Licensing Board Vn Seiectmens Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 TOWN OF BARNSTABLE BUILDING PERMIT # � I TOWN OF BARNSTABLE BUILDING Please print. DATE F JOB LOCATION )-ot' / y Yt fthC V. 1 j�' Number Street address Section of tiown"- ' "HOMEOWNER" ( 5 11 E 66 A Name Home phone Work phone PRESENT MAILING ADDRESS �� Se�r� 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: Persons) who owns a parcel of land on which he/she resides or intends to re- siue, 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 building 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 un 'erstands the Town of Barnstable Building De p t mi 'mum in ection pr cedures and requirements and that he/she will 1 th s 'd pro r an requirements. HOMEOWNER'S SIGNATURE ` r �d4b,(L APPROV7-_T• O? BUILDING OFFICIAL Note: Three is 111t' Gwell�r.Cs 35 , G00 cubic feet, or larger, will be recurred to corply with State ; �lcinc Coco section 12- . 0, Construction Control. T.:e cccc s work for which a bui lci;- i ;>rovi lions of this section (Section 109 . 1 . 1 - Liccr,si-n, of Ccns',ruc-ion Supervisors) ; provided that if 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. Home"&iier-actin as supervisor is ultimately responsible. :r To ensure that the Home Owner is fully aware of his/her. responsibilities,'. man communities-require, as part of the permit application, that the tome -oviher 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. T l� J N LOT 17 ,r O� 1 o o , 89• . 6-2- 0 J U,'O 00 � O � O LOT >8 N 17,200 SF 1;�2 32, 0.40 ACRES LOT 19 I JOB # 94-427 CERTIFIED PLOT PLAN LOCATION : SKUNKNET ROAD CENTERVILLE, MA SCALE : 1" = 30' DATE : 2-15-95 PREPARED FOR: REFERENCE LOT 18 PB 224 PC 127 RALPH CHAPLIC I HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN !S LOCATED ON THE GROUND AS SHOWN HEREON. OF M! 508-M' *41 rox 508 362-sIneen ARNE yJ ` J 3 own cape engineering, c. _ CIVIL ENGINEERS I LAND SURVEYORS ---- i9 io main at. parmouth, me DATE REG. DuN EYO I y ATTORNEY AT LAW P.O. BOX 941 TELEPHONE 149 MAIN STREET (508)771-4313 HYANNIS, MASSACHUSETTS 02601 26 Jan 94 Mr. Ralph Crossen, Building Commissioner Town of Barnstable Town Hall Hyannis Ma. 02601 RE: Land known as Lot 18, Assessors. map 171 parcel 008 Skunknet Rd. Centerville Ma. Dear Mr. Crossen, I represent Mr, and Mrs. Ralph Chaplic of Dennis Ma. F , who have purchased the above lot of land in Centerville with the express . - intention of building a single family home thereon. The locus is located within an RC-1 Zoning District of the town which allows the construction of single family dwellings. Prior to Feb. 28, 1985 the Locus conformed to -the then existing zoning by-law relating to area, frontage,width,yard and depth. At a special 'town meeting on Feb. 28, 1985, the town voted to increase the lot size requiremento to ONE ACRE. The locus lying within a RC-1 zoning district was thereby affected.Prior to. this adoption lotsize in the locus was . 15, 000 sq. feet. Ma. General Laws CH 40A Sec. 6 as amended provides in pertinent part" . . .Any increase in area, footage,width , yard. or depth re- quirements shall not apply to a lot . for single , or two family use which at the time- of the zoning. . .by-law. . , shall not apply to a lot for single or two family residential use which at the time of the recording.: : was not held in common ownership with any adjoining land; conforms to the then existing requirements and had less than the proposed requirement but at least five thousand square, feet of area and fifty feet of frontage. " (2 ) On February 28, 1985, . the time of the adoption of the zoning amendment from 15,000sq. ft. to one acre the locus was owned by John E. Barnard Jr. who did not own land adjacent thereto. Accordingly, it would appear, based on the facts herein noted, that the locus is grandfathered from the increase in the lot and area requirements of the Zoning by-law ( 15000 sq ft to one acre) pursuant to MGL Ch 40 A Sec 6 and the corresponding provisions of the Town of Barnstable Zoning b -law Sec. 4-4, 5 ( 1 ) . Sincerely, Mark J Huse MJH/jmj �;ngineering,Dept.(3rd floor) Map Parcel it# f �/ House# Date Issued !0 6 Board of Health(3rd.door)(8:15 9:30/1:00-4:30) 9543 C ,s ,Q�E /—Fee Conservation Office (4th floor)(8:30- 9:30/1:00 2:00) tA 19 SEPTIC V. wexNsreEE TOWN OF BARNSTABL Building Permit Application E QYC1TROTH %3bN59 2WAL `;a Project Street Address , g .Z S Kv�') Village cc,, Owner Z\ '�;\\;G 1/�;.o\,'�- Address Telephone Z 6-\ 7'7 1- Permit Request S i d sw,;A-I- First Floor b square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units ) Age of Existing Structure Z Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: Full ❑Crawl ❑Walkout Ll Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No. 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 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# , Current Use Proposed Use Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# 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 SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY 3 PERMIT NO. s e., DATE ISSUED F� % F MAP/PARCEI NO!' t ADDRESS i k VILLAGE M OWNER N DATE OF INSPECTION: FOUNDATION FRAME F ' INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. v The Town of Barnstable MAN6rnBM Department of Health Safety and Environmental Services Argo" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date (/✓(0 1 4( AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION I 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 of er req ' ements. Type of Work: Est.Cost Address of Work: Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job 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 agent of the owner: a Date tontractor Name Registration No. OR Date Owner's Name r. The Commonwealth of Afassachusetts k A-w _.,1 =-i;_ Department of Industrial Accidents t" l _ oficeoJ/nvestigations 6011 {i ashin�ton Street Boston,Alas. 02111 `-' Workers' Compensation Insurance Affidavit hc in-t mform—at ron• Please PRINT leglb�� t 7— name: locition• J1L phone# I am a homeowner performing all work myself. I am a sole proprietor and have no one working to any capacity 7T, ,.RtET'� '+`T..:,...r"t1^"'? XT ^u+VM'�'•'.;p� :f^'r'A',q?^r ».m:*. ,., .I am an employer providing workers' compensation for my employees working on this job. company name: address: city: phone#• insurance co police# �. ., ,..,<.„. ' .......,t•r.. .,rr,y-...�.^'Mr .!w._�Im-+r+++...,.+rew,s;cno.,•,',�f-s'a+. ,..,,�., ,..,'m.a���"�_`."ts.z 1:y. -'r."'+- I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name: address: cih•• phone#• insurance co policy# j' 'h. -a. - i?a:Ftz:: :T�`"ab`=•."'�'•y;•: , .. '+^'TSes•�F^* u' '�,`.' nr •''!kcrf*,7L' {' .''�O. ++I +.,..r <w,.. -Mc---•,^•—; ' _....1_,...._.�r.:. -•____.-.:..uc• ...:.. r..r:ar' .i <s�i.s. �""'�, -' - •+=:uao�.'.a�it�.:►:a.i..ix.us company name: address: city: phone#: insurance co policy# Atiac_h addi_tionaI'shcet if neiessary:=„ "r }' * =Rc "�F=r.^rt',r°` �,.y. r am• "' `"'.',.�., _..r/�..� .aii.YY�m ����1l�aAC����iR��i. •��Glfll�iGmili��-earo_'}7�' .i�1Y3CJX�I�f Failure to secure coverage as required under Section 25A of 11IGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand that a cope of this statement may be forwarded to the OMcc of Investigations of the DIA for coverage verification. 1 do hereht certify under the pains and penalties of perjun'that the information provided above is true c ud corre�et. Si-nature Date Print name Phone# a...0 +official use only do not write in this area to be completed by city or town official city or town: permitAicense# r'IBuilding Department oLicensing Board C]check if immediate response is required OSdcctmen's offic C]licalth Department., contact person: phone#; mother ' f u'Y f '::7+^ .r.�.»,^.-•.:.tzwzyr`.°e'� � ems,.s�•.a+• �". .;..•x•sr�s.�" Irevised 3195 PIA) 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 e►►►pinree is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An e►npl(tver is defined as an individual, partnership, association. corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the . dwcllin(, house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the (Yrounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance'of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. .... '. '. �' - -' :p7,"."''"`:` '} •'....��'^Ty_. S'— s- ar 'C59.� tp�.- .i:^`:—,:. 7.... J!: 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. 7777; o- 77 Citv or Tos►,ns Please be sure that the affidavit is complete and printed legibly. Tile 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. Tile affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. Tile 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. tr'ray vr,,.... .._•,.,,>„�. ._..-�.,.rc•�^'r....r .r...ee*.> .avr,ne�+�t!�r•7.7 �R+n vim... ..e�+...+ -�a►w a^w. xa". r.e- ..w•�mw•+w:+.rw...- ..rw The Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 _ � ", �/� ���c� ..f �.t} Y,+a r erp.�l � 5 SY+,�'rw''iJi✓� i+ ��eria�wr}�� �i:i:�;} " +i�''� �: :1� ^�a$�Y 75 r .:ht';r,"t i�U. �d rJ f 't �'� a' .i"i °. 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'4rwtJt?•'P,,.�, a /i'd,�{t lti �, .; + h ! 4 'ip.,; • .v+ JI("+yt�•?a^ }tA) r rd t.'�.� lt, �•trv<. ` ,+} Y t(` dra r r +. l"••'7 ^, " r� r�r ,., ki s-�4 S t: .�:r r<� t '�' 1 Y s tt, t, i .t^. s ,. _, , ,� f � ...., `t, y ' o6��ti TOWN OF BARNSTABLE - U PermitNo. ......:......... BUILDING DEPARTMENT I ""n TOWN OFFICE BUILDING Cash D .6J0 X HYANNIS.MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to Mr. and Mrs. Ra]_Dh ChaDlir Address 182 Skunknet Road Centerville, MA 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. I � �fI . ....May. .. ... ..... . .... 19................. . ..... i 95 . ' -. Building inspector 1 o*TWE TOWN OF BARNSTABLE Permit No. ................ ` BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ML .679• X >te,T► HYANNIS.MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Mr. and Mrs. Ralph. ChaDlic Address 182 Skunknet Road Centerville, MA 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 TQWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. .. ....Mgy. .. .. ..... . . .. .. 19.....g5........ ...... .k,w .�M... .' w .... Building Inspector I TOWN OF BARNSTABLE,.MASSACHUSETTS BUILDING E'ER MIT L DATE ? 19 PERMIT NO N° 37410 APPLICANT'((//��v1)9p lc , V ADDRESS (CONTR'S LICENSE) NUMBER OF PERMIT TO STORY DWELLING UNITS (TYPE OF PROVEMENT) - NO. (PROPOSED USE) a} b ZONING Alk T (LOCATION) 7 G 4 {��ICT - 74 (NO.) - - (STREET). t { °3."cTWEEH' AND— C.. T) (CR_SS STREET)..:,,. LOT SUBDIVISION LOT-BLOCK-SIZE ' r; ,.BUILDING IS-TO BEt pT. WIDE BY,' FT. LONG.BY, FT. IN-HEIGHT,AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) I - y S3 r ,E.• 'Td•G 4f�� ( r r�•.*•r<7i r y•ai t'i ..Ar. {qq M 'r� AREA OR t fa PER VOLUME " ^Y ESTIMATED COST - (CUBIC/SQUARE FEET lj AdDRESS� x y ' r Z. y. -I WCM THt UL PARTMENT OF PUBLIC WORKS THE ISSUANCE OF THIS PERMIT ACES NOT RELEASE THE APPLICANT'FROM^THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLESEPARATE INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MACE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED.SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL - MEMBERS(READY. To LATH 3. FINAL INSPECTION BEFOREE FINAL INSPEGTION HAS BEEN MADE. . OCCUPANCY. - POST THIS CARD SO IT IS VISIBLE FROM STREET _- BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVA.IS ELECTRICAL INSPECTION•:PPRGVALS - �1;lflzll 2 � ,�a l � z ' HEATING INSPECTION APPROVALS ENGINEERING CE=ARTMEN-, • 1. I ICJ . -`IS OTHER - _- BOARD OF HEALTH - J ul-1, e':0? SHALL NUT PROCEED UNTIL THE INSPEC. 'ERmIT '.J!LL BECOME NULL AND VOID IF CONSTRUCTION I I INSP'tCTIO.JS INGIC=- ED ON Trr'�C:.3D Ci:R i,L TOR HAS APPROVEO.THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION .PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION- - MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (print or Type) irli 0 TOWN OF BARNSTABLE Date 3 19� Hyannis, Massachusetts permit 11 WOMEN Building Owner's AT: Location (f L 7- A-2:2, Name if G�l�i�LlC G,m�7X�'/dU/LLB _ Type of occupancy: NOW Renovation ❑ Replacement❑ GPlans Submitted Yes ❑ No ( � e w W w w w u = a d a 0- a is w a o e e = �.w ,wt w W F u s i s al W s O W l' a a � O = to e W t W F w L at W a o s z o > W W W w J s v x a a WW t = at 1C 15 .< O 0 a t C i O t9 $ O f! J V i > 12 O sus—SSMT. BASEMENT 1sT FLOOR !NO FLOOR $80 FLOOR ITN FLOOR sTN FLOOR GTN FLOOR 7TIl FLOOR aTN FLOOR (Print or Type) Check One: Certificate Installing Company Name AWZ�W ��j� ❑Corp. Address l0/0 Q(,/�/ ���1' �`, ❑partnership Ante A7y-pe Lif`�rm/Company Business Telephone Name of Licensed Plumber or Gasfitter 1 herebY eartifr dot all of IM debut and Information 1 have wbmilted(of entered)in ateva applleellon era free areal aamate to the ball of MY knowledge and dal all plombind work and b+atalladom performed ender hrmlt k+wod for WY app0adan wW be in a mpau m Wilk a prtdsaat provisions of the Nassubs alts State Gas Oode and ampler 143 of the Cenral Low. I have Informed the owner or his agent that I :do not have liability Insurance including completed operations coverage. Signature of Owner/Agent 1 have a current liability Insurance policy to include completed operations coverage. By TYPE LICENSE: a u mber 4 Title fitter Signatyre of Licensed City/Town: Fter plumber��asfitter ` rneyman APPROVED wFfica USE ONLY) License Number lid BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE N0. APPLICATION FOR PERMIT TO DO GASFITTING NAME i TYPE OF BUILDING A/2f1.✓ C/z� LOCATION OF BUILDING PLUMBER OR GASFITTER G/- -- LIC. NO. PERMIT GRANTED DATE 19 9 S GAS INSPECTOR I . ., . ,__.:I. . �_ ; . - 11 .. t ... . . .. I :.% , :,.ff t � ­ I � . . . I,. .. : �_ . �: t;.. , �t ':t - � it :,,Ii� I �.: , , - .1 I _'Iil­n4.�Tt:A�.;n. .� ­.. I.:n�`::,"i�%I n... �:," il , . %-.-,", ; .. I .1 _� �,�.r .1 : Z., . , ; . , ., ., . - I . 4,� ; .� � � , .". I I . ;-,if. . . I - �,. 7 � e..;.��,--. .�!`_`�,_ tn:2rc'.-�,,,'-�.�', .-If,:�,f�;:.,,- , . � . . � �, . . ,11 , ,��'h�:.".1st I I�.I I . � . 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SEPTIC r'- 1, a / \ Ti , /4 rb3/-1 SEPTIC DESIGN_ (NO GARBAGE DISPOSER ALLOWED) O t j 4 O r"/ TANK ! 7 49 �>\` ` DESIGN FLOW: 3 BEDROOMS (' 10 GPD) = 330 GPD SEPTIC TANK: 330 GPD (1 .5) = 495 GPD f c; USE A 1500 GALLON SEPTIC TANK EAC_ HING: �` t 3¢8.: -- (.92 ) (2.5) = 212.8 GPD ?° TEST MOLE LOGS SIDES: 2 37.25+ �._ -- --- GPD _------ BOTTOM: 37 25*7 1 .0 = 335 3 -._.52._-ate '_`"_ �_ I_ , -- "�� ' (5) PROPOSED-- TOTAL 42.0.4 S.F. 548.1 GPD --- L--cam_ INFILTRATORS ENGINEER: DAMES C. JOD!CE WITH 3' OF WITNESS: EDWARD BARRY (BCH) USE (5) PROP. INFILTRATORS ''WITH 3' OF STONE / 1Q r, _ _` ' STONE DATE: JAN. 10, 1995 ALL AROUN`1. 1�2 3 4-._ _. - y'� �V �e' DFt AGE PERC. RATE _ < 2 MIN/INCH ! I 2 - pA�,CEC wq�SING 1�`�- 0' -, EL. 47.7 0' EL. 47.5 I 954 TOP AND' `TOP AND SUBSOIL SUBSOIL 55 2- -- EL 46.2 2-1---- EL. 45.5 z CLEAN i CLEAN I ! NOTES: + `y I MEDIU SEADINDM ADJUSTED MSANLM WATER 1 . DATUM IS ASSUMED FROM HYANNIS QUAD. MAP. v EL 43.1 EL 42.8 2. MUNICIPAL WATER IS AVAILABLE a 3. MINIMUM PIPE PITCH TO BE 1 /8" PER FOOT. BEY BREAKOUTS ; 4. DESIGN LOAD'NG FOR PRECAST UNIT:S �- To BE AAsHo H 10. EXIST. CONTOUR _----___._..__.50_...__ ._.. 51.0 = 48.0 (150%) _ 13' FROM EL 48.6 r 5. PIPE JOINTS TO BE MADE -WATERTIGHT. PROP. CONTOUR - - -50- - -- - �34' OBSERVED OBSERVED 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. ! PROP. GAS LINE --c-- - - - - WATER 9 5' WATER ENVIRONMENTAL CODE TITLE V. PROP. `WATER. LIME ----W ---W-- SYSTEM !S 25' FROM EL. 48.6 / 9.4' EL. 38.3 I EL. 38.0 ;. THIS PLAN FOR PROPOSED WORK ONLY AND NOT TO BE USE 12 ! FOR LOT LINE STAKING. EXIST. ELEV. .)8tELL_-DATA ! 8. SCHEDULE 40-4" PVC PIPE TO BE USED FOR SEPTIC SYSTEM. ZONE SOW-252 --J EL. 35.7 11' EL. 36.5 g D'gOX TO BE WATER TESTED FOR LEVELNESS. ZONE D DATUM = 47.8' ADJUSTMENT = 4.75' SEPTIC _P_ R0F_IL_E__ _ off 508-362-4541 (NOT TO SCALE) -- VENTVC SITE PLAN OF LAND fax 508 362-9880 __-----WITHIN BRING FRAME AND COVER T) T.O.F. AT EL. 53.5 \ __-- 1' OF FINISH GRADE ----� q11 FOR PROPOSED DWELLING ON LOT 18 SKUNKNET ROAD IN: ' � PROPOSED , tHYANNIS BARNSTABLE MA down cape englneering, Inc. INVERT AT ,- 2'(EL. 51.0) MINIMUM 1' OF COVER OVEF PRECAST EL. 49.37 --- _ 1 (EL. 51.5)CIVIL ENGINEERS --_-- PREPARED FOR: I __ _ INFILTRATOR UNIT 2' OF PEASTONE -- 49.37 (6.25'x3'x1.5') OVER WASHED ;�STONE RALP H C HAP LI C LAND SURVEYORS `� - Tl � ►L� (Hto;�PROPOSED 1500 ! - _ �� i 1i (1% SLOPE) \\ I ---- ----------------._-__ -=--_--==_--=---_ 939 main st. yarmouth, ma �• % EL 48.60 _ f I GALLON SEPTIC I 48.40 - I�E --- - --- ---`-- - 48.65 I � _ 0 00p 20 0 20 40 60 Feet L --- TANK (H10) oo L I! 48.35 '° O oa r\� 48.18- 0 0 0 0 0, EL 4,_1 0- - -- r- ------ ~f.'°n"� __48.0� 3'�._5 O 6.25_ 31.25.0�3' -1 f SCALE: 1"=20' DATE: JAN. 20, 1995 DEPTH OF FLOW = 4' .. -- (2% SLOPE) (1% LOPE) TEE SIZES: S 1 37.25' INLET DEPTH = 10" MIN. 6" CRUSHED I OUTLET DEPTH = 19' ----STONE UNDER D' BOX Z 3/4" TO 1-1/2" ADJUSTED GROUNDWATER AT EL_43.1 i- WASHED STONE BOARD OF EWTB LEACHIrJG r --�` -y" FOUNDATION---- 36� ----- SEPTIC TANK --__ - g' _ -- - D' B 1 g' 0h -- --- --- --- FACILITY . - _ _ BARNSTABLE MA APPROVED DATE TOWN ARNF' H. OJALA, P.E., P.L.S. DATE -' 94-427 t i� i / ~ 1 i 1 I I 1 i 101 1 T it FTAI F ' 4 ET + I 1 i i t- � -- SCALE DRAWN B ,� f�V i )-50P7 REVISED i • DATE APPROVED By DRAWING NUMBER 1 r ' w MADE IN U.S.A ALBANENE T 10 5455 , ARCHITECTS STANDARD FORM s I , N r i i i • i 1 ' I Al t-'-' I ' �j i f 1.4 K` Err I I � I t I t -Lo , i .. /..��':.vL�•),L L-Y SCALE DRAWN BY REVISED '^f.�,k� �'r� Yam• �t'�K t � � � � ¢r�.,"r.,�iyl'� T•'_-7{y'! DATE APPROVED BY OR*WING NUMBER ALBANENE(uJ 10 5455 ,. ., i MADE IN U.S.A ARCHITECTS' STANDARD FORM 410 o s i - -fir-------- —�---------' i —,�' CL!: i j _ ... I i I � , r i 4 0 ° f b .... .._.. ..._. ..--._ ».._.. .. .._ SCALE DR AWN BY REVISED t D A``T1rrE}� f APPROVED BY DRAWING NUMBER,, .ALBANENE 10 5455 WEAR STANDARD FORM MADE IN U 5 A. 3 1 M a �f 04 r r E 41 . l Nampa— n w (4) 9 < ios c.t Ly t f 2 1 4 S t I J7 1 , i 1 fi Ei i d i g { i i F 1} , t 1 --.—.__mac-------- ------�-�. t -_= `�� �'� ( l� X w. 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