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I , ,��I',; "i", �,.�.. - -%L�! _�,,.,., -�4"�i`,�,`,,�i,:".­.�- ", ���� �R i,,_ RINAUR'S �! � � , A", ]]]]]]]]]]]]]] ,,I 'I" .. �,,� � M , , , to�,",�-,�,!,:,�";"",�,�,L�,.,��.,�---,:-,,, ,,�, i :;,_ !�; ,;�"" .,�� U0741 �) Ir , IF 0; I � " :"�',', �',�,,,?7 :�.,- ,, �� i i .. . , . ik�,�' " I 3*0 XV ,_",_,'L',�, �`:""��,� __IS, � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 6 Parcel ��32 Permit# Health Division I12 f— Date Issued �� I Conservation Division e Sy �;_ 1 `off Fee— `02_!;�Ld0 Tax Collector .2 �� ,�,i 0 Treasurer 711 2 LEV SEPTIC SYSTEM MUST SE T Planning Dept. INS 1IN COMPLIANCE TITLE S Date Definitive Plan Approved by Planning Board EWRONMENTAL,CODE AMZ; Historic-OKH Preservation/Hyannis TOWN REGULATIONS Project Street Address Z4nR S 6.Alrq Village A 71 Al,4 Owner Zr_ AAA 6*;g a2� 101- alZS/E Address /S'P _C bg?AE!�� GL..I Aim Telephone Permit Request Z2=4e rer T Square feet: 1 st floor: existing /3-40 proposed 2nd floor:existing Z proposed Total new AM aD Valuation 7 2 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 0' Two Family ❑ Multi-Family(#units) Age of Existing Structure _ C� Historic House: ❑Yes 0No On Old King's Highway: ❑Yes ❑No Basement Type: Wfull ❑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: M Gas '' ❑Oil ❑Electric ❑Other Central Air: ❑Yes ®'No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:Cl existing ❑new size Attached garage:❑existing ❑new size Shed:5rexisting ❑new size is it r6 Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name /, 6&4ZA s- ,� jZ ,� Telephone Number Address /ST-7 S1M E CG LEI l/ License# Home Improvement Contractor# D 2-e<312— Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY I. 1 PERMIT NO. LATE ISSUED' MAP/PARCEL NO. ADDRESS VILLAGE tR• , � OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE 1 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH " FINAL GAS: ROUGH FINAL I FINAL BUILDING ,. r 1 co 0 DATE:CLOSED OUT ASSOCIATION PLAN NO. `I `) " I t { " RESIDENTIAL BUILDING PERNIIT FEES .' i APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovatioris $25.00 �Z Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$961sq.foot= 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>12.0 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 t x$30.00= (number) Deck _x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool .$60.00 Above Ground Swimming Pool $25.00 - Relocation/Moving $150.00 (plus above if applicable) t®� Permit Fee - projcost G`- ��\ _ The Commonwealth of Massachusetts . _= _' Department of Industrial Accidents ` = oi/ice of/nsestigations . -_. . - y�' 600 Washington Street ,. <;1 Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: Zc z�A 6 n� ��iZ location: f g� C niga if G4/Fib ci Z hone# — — 3 I am a homeowner performing all work myself. . ❑ I am a sole r rietor and have no one worldn ' an ca achy %%%/%% / ❑ I am an employer providing workers',compensation for my employees working on this job. com n .: .,x:.-.i.:�,::,.,:.,-..,-..:.,.-,:.�.,..�....:.—...,.�....;:..:....-,.:.....-,...*....,:-..::..:..:-.:.:.;:.i.-....-.i,.-:..-::..*-,"...11.,..1.--*".-.1....,--1.I*"..1.-11..'.--....�11.-."..-11..-I11..I-1.....11.."...--....11....11...1."..-..-,.11.,-.1...1.=,...1I....-..,,-..11....11.*-"..11..,..1"...*.-I1.,..1.,-,.`1.,,-I1.*-*,---I1.-. city, phone# :.;;:.: :::. instlt n . .:.:..:::...:..:.::::...:.::::.:.......::.:.:.:... i `- %/ I am a sole proprietor, general contractor, omeowner ' cle one)and have hired the contractors listed below who have . .. .. the following workers...compensation polices: :...:::..:::::::.:::/ 0....t:.:!.::.::.::::::::::::::;.:.:::.::..::...:.:.:::.:::::::::::.:::..:::..::...::::.:.:.:::::.:.:::::_.::::::::.: :::?<::a:::'`e:;i> <' :: ' '2 s r ';?::: sy:>: s :r :as si> ':'%:%:% ....I ......?`!<'::::s 2f>':'<:s::>f ::5> .S ! ?!>' ;? ?5 ' : _:::: ::'?: : :counan�'n m >< :�5'::?:::% :?i 2 �`:: : 2: ::y:y 3 (f": jy c:: <.± k> :::> :is!:::::' :::::':J:I:: :: :: : ::::'s:y <`%t::a::2>: ::y: s j<::2< :i;iy; ':::a:;.::::•:«• adores . .................:::....:;::::...;;«;.;::.;:::.::::::::;;::::.;:.: #t.. ::.:.-I...::..:........... ci#y:. ...: ..........::::..,:X.::.:::.:::::,%,:;............:...:...:..:::: ::>:;::>:::>::;::..... n :: ..:::;::::. :...... .. yy_� .:.......::>::,:.:::::::::... :ib$taace.ca......... :::.:::::.::.:.....................................................:..:::::.::::.::::::::::::::::::::...............................................................................................................................................::.::.:::::::::::::. :............:.....:..:.....:.......................................................................:..:...........:.:...:.....:....:......................:......::::..:..:...:.:......:....:::::::.:.:.:............... :.:::::::::.:.:::::::::::.:::::::::::..........................................:::::::::::::::::::::::::.:::::::::::::::::::::.. ::.::.::..::.::..::::.:::::::::::::.:.::::.::::::...::.:::.::.:.::.:::.:::.......................:::.;.:: *.."..-.....*,I......E*1......*-.-.""'-�....*..-......'l......,"l.I.."....."..�"l.........'.....*..I*......'*..."-... adelress. ::: ......::::.::..:::::.:..::........ ... .. . :. . ..-""".....m,,........-.-.....*...,.',�.-...�.".....".-,.'."1.....-*".....!::1.......'-�-"..'I..::,"*.......,-::....::,'1......:*'......-".....-:-,,...:-'"I..-...i*....:,.-....-.'-....,........*,.-.I i, ' :I1011e:#< < ?3:? :r? <` : :::�:t'<'2' ??{' '<'?>` ::'Y?:<7:''? ` »:»> inSnraitce.co....:.................... ... %/ Failure to secure coverage as required under Section 25A of MGL 152 can lead to the Imposition of crbnhud penalties of a fine up to$1,500.00 and/or one years'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that s copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. .I do hereby certi u th e penalties of perjury that the information provided above is true and correct Signature �"� Date �,��--4�. . f=Q—z _ Print name Phone#.�2 l `�> , official use only do not write in this area to be completed by city or town official . city or town permit/license# ❑Building Department . ❑Licensing Board ❑checkif immediate response is required [:]Selectmen's Office ClHealth Department contact person: phone#; ❑Other (revised 9195 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of 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 trustee of ani individual:,partnership, association or other legal entity,,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants 1' 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 obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permitllicense number which will be used as a reference number. The affidavits may be retauued b_ the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigatlons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 °FINE A Town of Barnstable Regulatory Services 9BMA . Thomas F.Geiler,Director �'OIFOMA�a�e Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no._ � Date l 0 Z 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 f �c Estimated Cost �© Address of Work: l � Owner's Name: Date of Application:_(. 3 b�L 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: Date Contractor Name Registration No. OR Date Owner's Name Q:forms:homeaffidav Town of Barnstable THE Tp� yP "� Regulatory Services sAxxszAs Thomas F.Geiler,Director 9 MASS. g �A 1639. �0 Building Division rBn �a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: S-/ / Q 2 JOB LOCATION: /LP S MA191cf! C4 Irozz- number ��// p� street S� village "HOMEOWNER": l.�lLfl�iQ�� K C01'ear oc ��1�JOX�.�I� ,76��2 J'/ S name home phone# work phone# CURRENT MAILING ADDRESS:_ �.C'VrPa/•�� CG iFi� city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as su eervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in.a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirement . ignature of meowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger.will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt - i4 E�I57y �:JLMCR _ n�. _ ZSs RAFT - � 'All- y N ors ; , y �-r� I _ � ._1..IV Se�s..0[{ . . ...._.( — Q you soGctvnNl -L?n �s tS�iv�f�' csC 3: r dl lii Gt 1 `^' lY,l�y gEAc ...._. -._. krteAD Z - `Nh '. At7o , w�vrw y Nl.l�"c r„c P� Z� �_' I , i . u i — --- ' - - - I t � I � TZ 3 2 S : Ar Ll k .,It t pQ�l � I QP¢ S i f ..-.. « _ .-�--- -.. . . -- . F - y - -- ,�p(� 1 NIAU.� I ._ � T{tW Wb. ..II ���` 9a' G 7i-1 Lo , — U f : ot-�-r5rtrb, - I _ -_. . -. ....... 1 iM w of ;._ ...- . -- -- 1 . - : . . . t J —• - - I + -+ -'---- '-- -'---- - ' —- - -' -- a.. : : , —— ! L. . _ - "! '- -- - - - - - - --- 71'ICt -- r '!'-- 1 � ' N Y... ! �Y JOB YY1e a,. . j - - - g I �Remodelin �2 I i _ SHEET NO. OF -i- — _ ... - _ i_... $ 1&� CALCULATED BV DATE ... . ... t.__. _,.. .,....._... - -,. - - _ .-'- -__ Horseshoe end Way Mashpee,MA 02649',00 p�e z . ( , 59-7033CHECKED - ! � DATE i 508 7BY SCALE 1114 NFt lHbt It'fOf>Ef pPWILiS641,/tALE IT®Gq®�Is.6oGl Wa N111.is PW/IIW6 i0LL{Pe 1dpG}EOl4 � - 777. 1, ... :........... .. . 9Q .�. - ,... � E -.... �. i ff L v _ aq Z, — �s - -- ..... q �X! — K . _ - - _.. r l .. G ,s7)� NRu � Y : _ f Remodeling joa SHEET NO. OF Plus �& MCUI TEO 9Y OnTE (508)746 pee,MA02649 ryc^Vc^eV �/ y . ` 1�ID ns Ti 1�{ 000 S Ba b ��TB�E Ppy� Town Of rta 1 I k Permit# a��b 0 Expires 6 thonths from issue date Regulatory Serr<vIlces Fee sAsxsras , MASS.1639 Thomas F.Geiler,Director Building Division Ok Tom Perry, g CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 1 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-190-6230 EXPRESS PERMIT APPLICATION ASIDE T' IAL ONLY Not.Valid without Red X-Press Imprint Map/parcel Number i"l O 0.-_�'2 Property Address - V'S';�r j i-b W Ll-1 F'r 2 0 A- TL—�V I l�l 941esidential Value of Work$ �2�� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 556a2c ,���-� t P F3�v`o crH c.c-{ems l= N► '��I Contractor's Name Pkl l,L. 5 C�.Z�^7X�t�� -� S ue�:S Telephone Number7z�— 27- (F Q o Home Improvement Contractor License#(if applicable) Email: �����•� -2�— v�T C.c)ti Construction Supervisor's License#(if applicable) S G 26 a ❑Workman's Compensation Insurance' ® e Check one: PR ❑ I am a sole proprietor ❑ I am the Homeowner NOV 17 2014 . I have Worker's Compensation Insurance Insurance Company Name LM COOP .. .TOWN OF BARNSIABLE ' Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Reques (check box) . e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to y�12 Ali tij)} ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red Sand inspections required., Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e..Historic,Conservation,etc. *,*Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: C:\Users\decollik\AppData\L alWicrosoft\Windows\TemporaryInt et Files\Content.Outlook\8R76BDVA\EXPRESS.doc Revised 061313 ry The Corr morzwealth of Massachusetts DepartrrientoflndustrialAceldents Of rce of InvestigationE -:: f 600 fffashington �`ireet Boston, 14 02111 www.mass.gov/dia Workers' Compensation llasurance Affidavit: B-adders/Conil,-ractors/EIect-ricians/]Plumbers Applicant Information Please Print Leeibly Name(Business/Orgaaization/Individual): PAV L.J— 6A Z1L Al.)L J 'l O M--S Address: ( 0 :S 1' h,1^ i ri i City/State/Zip: Phone T: Are you an employer? Check the appropriate bog: Type of project(required): 1.❑ I am a employer with 4. ❑'I am a general contractor aad I employees(fpart-time).*ull and/or have hired the sub contractors 6. ❑New construction 2.❑ -I am a sole proprietor or partner- listed on the attached sheep 7. 0 Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in an capacity. employees and have workers' g Y P tY _ 9. ❑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 11.❑Plumbing repairs or additions myself.-[No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance re uired.]r c. 152,§1(4), and we have no _ 13:.,2-0ther �F employees.. [No workers comp.insurance required_] =Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy informa`ion. T Homeowners who submit this affidavit indicating they are doing all work and then hue outside contractor must submit a new affidavit indicating such. ?Contractors that check this box must attached an additional sheet showing the game 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 arrc an employer that isproviding workers'compensation insurance for my employees. Below is the policy and job site infarrnation. Insurance Company Name: Z-ki w s• Policy�L'or Self ins.Lic. (VC •- S l 9-;�iG 6 �M-" U 2 d Expiration Date: 1 y Job Site Address: /fig �9'1��' G(1 F �7 City/Slate/Zip: CC`N1 1//LLB 0 0263, Attach a copy of the workers' compensation policy declaration page.(showing the policy number and expiration date). Failure to secure-coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil'penalties in the form of a STOP WORK ORDER.and a fine Of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification.. I do hereby certify under the pains and penalties of perjury that the ircf orrrc ion provided above is trJue�apnd correct Simatare `I-'�iC C.C�K �,f%' sk�z.e.e�f Date Phone t 5)0 official lase only. Do not write in this area to be completed by city or town officiaL City or Town: Permit/Lieense Issuing Authority(circle one): 1.Board of Realth 2.BuildingDepartaent 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other Contact person: Phone r: 7 ® DATE(MM/DDIYYYY) AC"® CERTIFICATE OF LIABILITY INSURANCE 8/7/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER DOWLING &O'NEIL INSURANCE AGENCY INC NAME, 973 IYANNOUGH RD PHONE FAX MA PO'BOX 1990 E- IL Ext: AIC No): HYANNIS, MA 02601 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A: LM Insurance Corporation 33600 INSURED INSURER B: PAUL J CAZEAULT&SONS ROOFING INC 1031 MAIN STREET INSURERC: OSTERVILLE MA 02655 -INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 21146142 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLISUBRTYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD�YY MMILDDY� LIMITS LTR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ —1 DAMAGE TO CLAIMS-MADE OCCUR PREMISES(Ea occu RENTED nce) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑JET LOC PRODUCTS•COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS ii NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ TIDED I I RETENTION$ $ A WORKERS COMPENSATION WC5-31 S-386670-013 8/10/2013 8/10/2014 �/ STATUTE OERH AND EMPLOYERS'LIABILITY Y/N WC5-31 S-386670-024 8/10/2014 8/10/2015 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1000000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1000000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers'compensation coverage CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE LM Insurance Corporation ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD CERT NO.: 21146142 CLIENT CODE: 1614182 Lucy Garfield 8/7/2014 2:44:49 PM (EDT) Page 1 of 1 Property Owner Must Complete & Sign This Form If Using a Roofer 1 Builder. ffidnr) � -'^' E pP t- `1 , as Owner / Agent of the subject property hereby authorizes Paul J. Cazeault & Sons Roofing Inc. to act.on my behalf, in all matters relative to work authorized by this building permit application for. Address of Job �rbN`�( �-�-+ r� P—c��4 D CL������� Signature of Owner Mailing Address of Owner D L V/D Telephone # '�' �2� — l b Date I tot I � Please return this form to Paul J. Cazeault Roofing along with your signed contract. It is needed for us to obtain the building permit required by your town to complete your roofing project fax#508-420-4555 office@cazeault.com r r , a� Massachusetts -Department of Public Safety Board of Building Regulations and Standards ConstrnCtinll Superi-kor _ - License: CS-026325 PAUL J CAZEAUI-,`T 1031 MAIN ST - OSTERVILLE h1A- 02555 FF • - Expiration Commissioner 10/2012015 r ; �,�/ Office of Consumer Affairs and Business Regulation .% 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 103714 Type: Private Corporation Expiration: 7/9/2016 Tr# 254237 PAUL J. CAZEAULT & SONS, INC. Paul Cazeault 1031 MAIN ST OSTERVILLE, MA 02658 Update Address and return card:Mark reason for change. 3CA 1 Address Renewal Employment Lost Card L} 20M-OS/11 ( �r. ,r.�irrirc=irorrrr�l�c�C llri.;rrr�rr�e/Li `C'-\ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only DME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: �� Office of Consumer Affairs and Business Regulation �' �tegistration: 103714 Type: g ' E 10 Park Plaza-Suite 5170 1=xpiration: 7/9/2016 Private Corporation Boston,MA 02116 AUL J.CAZEAULT&SONS,INC. .ul Cazeault 31 MAIN ST ( 1 TERVILLE,MA 02658 Undersecretar Y Not valid withou gnature TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION V63 cl �-b MaP Parcot pp Health Division Date Issued 3b Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address �S�' f obey C/i(— - Village CeA¢es-Vfdl. Owner, 941ce tk-if heY'1he. 6'ep ell7, Address I SY Jfa✓! ey C144 �1 Telephone Sod'- W-'001 a Permit Request a✓F f tfn/ Q41-/6 eg o tg h mil, . ".�.J rll 2''(/�-/7)7-� �� r `�s_ //��=�/'` � '►� l�(G", Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total-new .. Zoning District Flood Plain Groundwater Overlay Project Valuation �i ®S L' Construction Type .Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Ur"" 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 Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name V cl,,r Ci" Telephone Number 7P47/4212- Address 2(Q 7 Q�fhc�f h License /4 T:2 02-31/ Home Improvement Contractor# ` /9 w Email V1cr�­r Worker's Compensation #Ktf t1b 662 6 K35-2141 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO r-,17c�,-7/1le-1' �lrY SIGNATUR i DATE (0�L��` FOR OFFICIAL USE ONLY APPLICATION# -DATE-ISSUED r 1 MAPS/PARCEL NO. r ADDRESS VILLAGE OWNER 4 DATE OF INSPECTION: FOUNDATION FRAME . 1 I t INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL k PLUMBING: ROUGH FINAL- GAS: ROUGH FINAL FINAL DUILDING_ DATE;CLOSED OUT ASSOCIATION PLAN NO. f I z a Federal ID .65-MM29 RISE Engineering RI Contractor Reglstratton No 8196 MA Contractor Reglstrabon No 120979 A division of Tbielseh Engineering. CT Contractor Registration No'.620120 25 Mid-Tech Drive,West Xarmouth,MA 62673 CONTRACT 508-568-1926 X-6613 FAX 508-�68-1933 Page 1 I. S- .I?ROGRAM. THIS CONTRACT I9 ENTERED INTO'9ETWEEN,RI9E: CLC-RCS ENGINEERING AND.TNECUSTOMER FOR WORK AS- N IlN1ElE1i:Itd OESCMED MOW CUSTOMER' f4iohe DATE CLIENT/ WDRK ORDER Bruce.Epperly: (508)827.-4901 05101120:14 15.7953 00002 SERVICE STREET - ... .. .. . . eILUNO STREET 158 Stoney Cliff Road 1`58 Stoney Cliff Road SERviCE crry,9TATE;ZIP. f 01a.J NO.CITYSTATE:Li Centerville,MA 02632 Centerville,MA102:632 JOB DESCRIPTI.ON Provide labor and materials to seal areas of your home against wasteful excess airleakage: This wort:::well iie`perforrned in concert withahe use of special tools and diagnostic tests:to assure that!your home be left with a healthful16 of air exchange and indoor air quality.Materials to be used to seal youraiome can include caulks foams;wcatheistnppmg.and other.products'..Primary; areas for sealing include.air leakage to.;attic,basements,attached garages and other unheated areas.(windows are not.generally addressed.) (20)working hours. At the completion of the weatherization`Work.,and'at'no additional cost to:the homeowner;a"final bloWer door and/or combustion safety analysis will be conducted by thesub contracfoito ensure the safety ofttie indoor air;quality. $1 540.00' STORAGE BARRIER:Homeowner Is responsible'for the removal of the stored items blocking the'installation of weatherization work in the kneewall areas Removal must.occur prior to thc;scheduled work start. $0;00 ATTIC FLAT:.Provide labor:and:materials to install a.9"layer of R-3I Class I Cellulose added to(708)square feet of opea:attic space, $93456 KNEEWALL,FLOOR Provide labor and materials to install an 8"layerofdense.packed R-30:Class.I Cellulose,added to 068i. Square feet of kneewall floor: $336:00 Provide labor:and materials to...insulate.the;back,of(t):attic'hatch with.2"rigid`Thermax,board.,.Weatherstrip the:perimeter., $42.50 Provide.laborand materials t6.insulate(3).back of the kneewallr hatch:with 2"rigid`Thermax board;and,seal,the edge of the hatch with weatherstripping. $21. Provide labor and materials to install 2" FSK faced semi,-rigid fiberglass:board insulation to(152)square.feet of.kneewall;area $50312 Provide labor and materials to instalL(2)insulated exhaust hose wlth.roof;mounted.flappervent to exhaust existing:bathroom:fan(s),. $232:20 WALLS.Furnish and install blown in Class'1 Cellulose to(277).square feet of vinyl-sided exterior walls:Invoicing will occur upon completion of:installation. S.ubsequent.toyour payment as an added service.RISEIngineering wll.l<return when;.weather permits to .check.for:any voids:withaminfraredscanner. Any major voids.that:may be:.found.will bet,Iledatno.:additional;cost. $484.75 WALLS:Furnish and install blown in Class l Cellulose to.(489)square:feet of shingle andlo,.r:Clapboard;exterior_walls. Touch-up painting if:needed,will.be the customer's respons16 lity. Invoicing will,occur upon completion of installaton. Subsequent to your payment,as.anadded..servke,RISE Engineering will`retum when weather permits to check:for any:voids with an infrared scanner. Any major voids that may be found will be filled:at no additional cost. � $850:86 BARRIER;Homeowner is responsible for the removal.of any Ceiling tiles blocking access to the sills. 1 I S0:00 I l r federal ID#06-0406629 RISE Engineering Al Contractor Registration No8186_. ' MA Contractor Registration No 120979: A division of Thielsch:Engineeriog CT Coat actor Registration No 620120 2-4 Mid-Tech Drive,West Yarmouth,MA:02673 CONTRAG`T 508-568-1926 X-6613 FAX'508-568=1933 _ Page $ Z IS lG PROGRAM: THIS CONTRACT:19 ENTERED INTO BETWEEN RISE CI.G;[tCS: ENGINEERING AND n+E CUSTOMER FOR WORK AS, ENCINIEIE1 ING oncRIBEOenow .CUSTOMER PHONE.. _ DATE' CLIFATv: WORK ORDER.. :Bruce Epperly (508)827-4901 05/.01/2014 157953 00002 SERVICE-:STREET ._ .. .. _ .BILLING STREET: . 158 Stoney Cliff Road 158 Stoney Cliff Road SERVICE:CTTY.STATE,.ZIIP BILLNO CTTY,'STATE.ZIP- . Centerville,MA02632 Centerville-MA 02632.. T� . I JOB DESCRIPTION RISE Engineering will apply all applicable;eligible igoefitives to this contract You will be billedonly'the Net.amount. Currently, for eligible measures,alie Cape.Light Compact offers.75%incentive,not:-to exceed:$4,000 per calendai.year:and'an incentive of` 100"/o for theAir.Sealing measures.. $Oi00 Total: $51051.49 Program Incentive: $4,173.62 CustomerTotai: $877.97 WE AGREE AEREBY TO FURNISH SERVICES-COAAPLETE iN ACCORDANCE.WITH ABOVE SPECIFICATIONS FOR THE SUM OF. ***Eight.HUndred_soventy-Seven.,&871100 Dollars $877.87 . CUSTOMER`AGREESTO REMr,T AMOUNT'OUE IN:FULL.INTEREST OF 1%MALL BE CHARGED.MONTHLY ON ANY . UNPAWAALANCE AFTER M:DAY8 SEE REVERSE FOR YM.PORRT,A47AFORMATION OWGUARANTEES..RIGHTS OF RECISION.SCHEDULING.AND,CONTRACTOR RECUSTRATION. DO NOT SIGN THIS CONTRACT IF THERE,ARE ANY BLANK SPACES AUTHORIZED S_ TURE--RISE ENGINEERING: CUSTOM. ACCEPTANCE NOTE:THIS CONTRACT MAY BE-WITHDRAWN 8Y:US IF NOT EXECUTED WITHIN DATE OF.ACCEPTANCE AxACCEPTANCE OF CONTRACT-THE Aal CES,SPECIFICATIONS AND CONDITIONS ARE I SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE.AUTHORIZED TONDO THE WORK AS SPECIFIED.PAYMENT WRI BE MADE AS OUTLINED Aa01/E . - . i OWNER AUTHORIZATION FORM I, (Owner's Name) owner of the.property located at (Property A dress) cell�eevdl'Ile (Property Address) hereby authorize (Subcontractor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. Owner's Signature Date I he(;ommonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organizationdndividual): Address: City/State/Zip: A2I1, .�--19 /fZ S 0)-)S1 Phone#: 7-1 J-252- Are`. u an employer?Check the appropriate box: Type of project(required): 1.L9 I am a employ er«ith 1J `l ❑ I am a general contractor and I emplo}ees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. [] Remodeling ship and ha-,-e no employees These sub-contractors have 8. ❑Demolition working for me in any ca acih-. employees and have workers o P 9. ❑Building addition [No workers'comp.insuraace comp. insurance.+ re uired. 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions ❑ q ] officers have exercised their 11. Plumbing repairs or additions J. I am a homeowner doing all work ❑ myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §l(4),and we have no employees. [No workers 13.[ 'Other/n f1411 -� comp.insurance required.] •Any applicant that checks box 91 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is thepolicy and job site information. Insurance Company Name: Tr,�i V e t elf (qJ(" l Ly S v r-L 1-�Z 1'O Policy#or Self-ins.Lic. #: )< 4 V/3 G 6 Z (9 Y 3 S L Expiration Date: S/ 6z` � Job Site Address: 1513 Ct4.LZ Gi ty/State/Zi fthrcl�l!le� 1� G1 6 1 L Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations�of the DIA for insurance coverage verification. I do lrerebt certifi under the gains and enaltic o er'ury that the in ormation provided above is true and correct Signature: _ - Date: ---- Phone#: Official use only. Do not write in this area, to be completed by cih,or town official Cih 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#: Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS—M969 VICTOR CINIINO 267 N.QUINCY S f ABINGTON MA�"12351 Expiration Commissioner 05/11/2016 Office ofa �Affairs��eul//r.o ME IMPROVEMENT &Business Regulation License or registration valid for indi ' _ gistration: CONTRACTOR v�dul use only 149123 before the expiration date. If fo P radon 11/28/2015 Type' office of Consuund return to: mer Affairs and Business Regulation INSUL-PRO,INC Private Corpo�tior2 10 Park Plaza_Suite 5170 Boston,MA.02116 VICTOR CIMINO r - 267 N.QUINCY STREET MA 02351 Undersecretary F Not valid without signature r `'cam CERTIFICATE OF LIABILITY INSURANCE ° °°"""'' 5/6/26/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such en dorsement(s. ) PRODUCER CONTACT NAME: Denise Butcher Strategic Insurance Solutions, Inc. PHONE (617)558-7100 X122 aX o.(781)459-8292 2000 Commonwealth Avenue E-MAIL .db@strategicinsure.com INSURERS AFFORDING COVERAGE NAIC# Newton MA 02466 INSURERA:Scottsdale Insurance Company INSURED INSURER Commerce Insurance Company 4754 Insul-Pro Insulation Co. , Inc. INSURERC:Torus National Insurance Cc 267 N. Quincy St INSURERD:Travelers Casualty & Surety Co INSURER E: Abington MA 02351 INSURERF: COVERAGES CERTIFICATE NUMBERCL145602872 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMID MM/D LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE To RE ED PREMISES Ea occu en $ 50,000 A CLAIMS-MADE a OCCUR CPS1914781 /13/2014 /13/2015 MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO- LOC $ AUTOMOBILE LIABILITY Ea COMBI SINGLE LIMIT 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED FILS563 /5/2014 /5/2015 AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ $ UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 5,000,000 C X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED I X RETENTION$ C 79425F141AL1 /5/2014 /5/2015 $ D WORKERS COMPENSATION WC S7ATU- DTH- ANDEMPLOYERS'LIABILITY YIN X ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1 000 000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) US6626Y35214 /6/2014 /6/2015 E.L.DISEASE-EA EMPLOYE $ 1 000 000 If yes,describe under , IDESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule_If mare cnnee Is reoulredl CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE r Denise Butcher/DMB ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 r7mnnsi m Thn At npn noma 2nr1 Inn^2m raniefamel m2rka^f Aflnpn �PIh1:ORlE C,�1►LL -I FOR �[7m DATE// L .TIME P.M. M � � PFfONEQ :. OF R�74}F�NEO P HiJ N E -7 1 3. Y41 lA CALL AREA COOE NUMBER EXTENSION ' PLElz51=CALL' MESSAGE UV1LL CALL CAME,TO SSE YOU ::: U�tANT5 TO _ SEE YOU SIGNED niverSah 48003 1}T } 6P7/?�O, a 1 Engineering Dep .(3rd floor) Map Parcel n 32 it# 0 / �2 d House#. 4 Date Issued 11 —12, Board of Health(3rd floor)(8:15 9:30/1:00-4:30) Conservation Office(4th floor)(8:30-9:30/ 1:00-2:00) mak M,,,. PTIC SYSTEM T BE Pl ill st flnnr hnnl Ad >3 INEXALLED IN C E WITH TI De by 19II�OI`��JIENT/� .TOWN OF BARNSTABL ' ' � U Building ermit App 'cation Project Address EJ Village Owner ¢ Addresses Telephone — �3 Permit Request f 0 First Floor squ cond Floor square feet Construction Type Estimated Project Cost $ (O Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family VzTwo Family ❑ Multi-Family units) Age of Existing Structure -3 Historic House ❑Yes o On Old King's Highway ❑Yes eo Basement Type: ul ❑Crawl ❑Walkout ❑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 5d o Fireplaces: Existing New Existing wood/coal stove ❑Yes Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ® V, ❑Barn(size) ❑None ❑Shed(size) a ❑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 C' SIGNATURE s` DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) �l FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED ' MAP/PARCEL;NO. - ADDRESS VILLAGE ' OWNER �; I DATE OF INSPECTION: t + FOUNDATION FRAME INSULATION c _ 1 FIREPL•ACE 1 ELECTRICAL: ROUGH FINAL - PLUMBING-- ROUGH FINAL GAS: w. 4 TROUGH ~r FINAL FINAL BUILDING ' DATE CLOSED OUT : y ASSOCIATION PLAN NO. ,' 1 . 1 i i 1 I i I l i - � i =-qN !S�"- -4- _ -- -- -- - --- I �� -1- ---�- I 4- 1 1 I _ 1 � I y I � 1 I i - i I _ _ - - � I I I � + + I II , -- i- i --4--�-- 1 L I I _ , l n� i Mi. r I IIt � i i r -- _ - I ' I � I c i T I ILL --r-�'- --�_ _j -� -�- --r - i i''�I I 1 t � - - - - � 1 I I -T+ r + I t - - - - ........... T--4-[ - I I T I -r- - - --i �- - - I I I i -- I � I I I � r °F VE The Town of Barnstable BAMSTABM 9q, 1`16A3399.. ,0�' Department of Health Safety and Environmental Services " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only f 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: r Est.Cost 6 eer_ Address of Work: /2:5 G if'— ,a /_ G Owner's Name /2/C�4� vZn `22�5� Date of Permit Application: //I'— 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 i 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: Date Contractor Name Registration No. OR __zoe_- 4 Da �/ Owner's Name r The Commonwealth of fassachusetts De artnlent o f Indiinrial Accidents Office Of 111yestl9afivils `` 'i iF3 '-jY-� 600 11 Qshington Street V '�,�' Boston. A1uss. 0 111 ' Workers' Compensation Insurance Affidavit �ppltcant mformation• • Please PRINT lebtbly !,_ - name r�/GGt//d� S- Jli/725� locations cln, Z77 phone# I�Kl am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity .. ..w.... ...,,--*�-.-r.�-^ 7'!.--agAKvrrn�.v,V?;1•--L.¢+'R1i'P�.',�!�.'�'V'+!'. .9--•---.wry...-�-_'.--r-j�•s�..��;^_^.:•�,�,�__r-''.�.+..-.�- •� I am an employer providing workers' compensation for my employees working on this job. company name: address: -- cih•• phone#• insurance co polio # 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: comp•tm• name: address: cih• phone#- cv# msurinccco _ Po _ __._.___•_ � ... .-..-._...• Jw ._...-. .T T"';'��Y'i'— � ��a. -_._ .LLB—� Y'tit r com any name• address- city phone#• insurance co policy# Attach additional shct t if necessary,• Failure to secure coverage as required under Section 25A of NIGL 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 NVORK ORDER and a fine of S100.00 a day against me. 1 understand that a cop% of this statement may be forkvirded to the Office of Investigations of the DIA for coverage verification. I do hereht certif tinder the pains an per !ties o erjun•that the information provided above is true and correct. Signature ez= Date Print name ,�///� n J ,2,C Phone#�L 29�L—.G'2: � .:' official use unh• do not write in this area to be completed by cih•or toN•n official - � city or town: permitAicense# Mudding Department [3Liccnsing Board check if immediate response is required [3Sclectmen's Office (]llealth Department contact person: phone rIOther ve.,sed 3!'r;I'1.A) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an enrploree is defined as every person in the service of an()ther 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 c the foregoin�- enLa�, 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 dwelling house of another who employs persons to do maintenance , construction or repair work on such dwelling hous or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section '_5 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 Nvho 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 Ila been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The city or town that the a lication for the permit or license is being requested. affidavit should be returned to the ci - pp not the Department of Industrial Accidents. Should you have any questions regarding the "law" or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Toivils Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of ti�ations has to contact you regarding the applicant. Plea_ event the Office of Inves the affidavit for you to fill out to the e b be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned tc the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questionE 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. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 TOWN OF BARNSTABLE .BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE % -' JOB LOCATION j.. > ��Y�,�/ i L` c',c/T05-_ rGG Number Street address Section of town "HOMEOWNER" / u g n Name Home phone Work phone - - PRESENT MAILING ADDRESS City town State Zip code The current exemption for "homeowners" was extended to include owner-occupied dwellings of six units or less and to allow 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- side, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"- shall submit to the Building Official on a form acQaptable 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 understands ..the Town of Barnstable Building Department, minimum inspection procedures and requirements and that he/she will comply. with sa'-d`p ocedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which a building permit is required shall be exempt from the provisions of this section (Section 109.1. 1 - Licensing of Construction Supervisors) ; provided that if Home Owner engages a persons) 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 "dwner, actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, man communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. .2 — �� 34.1 161 }/52.6 k i j I i }�52.3 54. /48 8 �, / 162 i X C 51.0 r .2 ------ t 7 t ii c 163 ( }�52.8 / 4 5 0.3 I %/5 >/53. r�32.9 i }� 51.7 / I,8 . 64 ; 49.6 1.0 - - , 3 X 49.8 � �5 .9 ;? ` 34 425 �24 23 , , �/29. 8 'i I d >/29.0 ' . 49.2 i/ 7.0 3 , Z Thomas D. and Land In ..BARNSTABLE..�.Centervillegelonging to.Marcia B VanderVoort Deed in Book,3075.. , page.192' ..............................................B. ... .... . ..... . in Book - Barnstable of Deeds Land Court Certificate No. ............... .......:..... g ....... Registry Recorded Plan ....Land„in,Barbstable„b.v..Charles,N:...Saverv..Co............ Date of Plan .APril...15t...0 ...........I in Barnstable, Registry of„Deeds,„in„Plan, gok,204,.........No. ....1.» Filed Plan No. ..................................... MORTGAGE INSPECTION PLAN THE BOSTON FIVE CENTS SAVINGS BANK FSB Loan No. 158 Stoney Cliff Road, Barnstable (Centerville) Louis V. Sorgi, Jr., Esq. /00 Lor 17 o� 16 t 2! a! �----3a. r1w� �o SWpo� N �, eQ M - /0O' 'A July 12, 1985 STON EY C LEI FF ROAD JN 44619 + Seale I" I CERTIFY THAT THIS PLAN WAS PREPARED IN ACCORDANCE WITH THE COMMONWEALTH k. r 4 y OF MASSACHUSETTS PROCEDURAL AND TECHNICAL STANDARDS FOR THE PRACTICE y� OF LAND SURVEYING 250 CMR 6.0s AND WITH THE SPECIFICATION SHEET ATTACHED HERETO, t OF At Q^ V . I ' al T �' �o�� KENNETH cyG� B. j; B ANDERSON o No. 31288 0 c1s1E��`� Assessor's map and lot`number _ — J - 7 SEPTIC SYSTEM MUST BE .,a j INSTALLED IN COMPLIANCE Sewa a Permit number g . � � • � �° WlTI-I AZTICLE II STATE r SANITARY CODE AND TOWN fTNETO F BARN TA hE �Q TOWN. W � BARNSTADLE. Lc oPASS.aY BUILDING, INSPECTOR 00 039.. `00 a• r, rAPPLICATION FOR, PERMIT TO '`T................ , ...........................:.................................. " TYPE OF CONSTRUCTION ...................... ............� .......:............................................................. ta ............!�...... .........19...?? TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... �/�/U� (� ii�. / h ......................................... ProposedUse ... T .... ...... OIQf'r�.....:........................................................................................ ZoningDistrict ............ ............................................:..............Fire District .............................................................................. Nameof Owner . ................................. ..t...............................Address .....................5 .......�'.. ....... e.........Address .. ......................................................... ✓�' �!u' ,J/. 7" T.. ... ���-� Name of Builder ........ .... .... " Name of Architect .........•.............................: -.....Address ............................................. ...................... ....................................... Numberof Rooms ..................................................................Foundation .......................:...................................................... Exierior ... N...�..� ..... ..............:............Roofing .........0 ..re.' ... /..:............................................. Floors .....................................................:................................Interior ................................:....:.............................................. Heating ..................................................................................Plumbing .................................................................................. Fireplace ........................................................-........................Approximate Cost ....../...,����.... .......................... Definitive Plan Approved by Planning Board --------------------------------19--------. Area 4. . /i....��1�7`�.,.. / d Diagram of Lot and Building with Dimensions Fee ........... !.. ............... w ...... .. ........ SUBJECT TO APPROVAL-OF BOARD OF HEALTH I hereby agree to conform to all the Rules:and Regulations of the Town of Barnstable regarding the above construction: Name ............................................ .�. ... ' o uzmmnm^ Alipzn H. ' ' . ' . . �u��� dormer y�v z -Permitrp, �----. - � 158 Stoney Cliff . ^ Location --._--.—�����--.--' — .......... . V . . Centerville .............. ---------..—.--.—.----.— ' r ' ' �ll�im 8. S _ Owner ----________..^����_...___.._ �ra�a Typo of Construction -------------- ` ^ ' ................. .............................................................. . ^ Plot ---------. Lot ------_---..` l 77 ry Permit Granted ............---� '�---'']A �- " L~�' � ' ^ ' Date of | ' l9 ' ` - , �~r~^^~' ~"" —' 'f'—'' . '' ' Dote Comu|ata6 . .77--._.]g / , PERMIT REFUSED . . . ` .—._—_~—^—...--.---.---.— 19 - . . . ^ --.~.----....----.—.----.----- . . .`,_.~.—.,,./ .............. . ' . . . . r—~'—^^^'----'^------~—'----'',^ - ' .—.—.—.—..--.—..---.......--.—.......... ' ' Approved _— ......................................' l9 ' ' , ' /-------.---.-------.—....,..--. . . . ----.---..----------- ................... ' ' | - 'ate-•-:w�..�..�.+.... _ _ �...,.y ..,.�,yy.y..«i+.�e�+�-r.f. -=: .n!- __•S�ti, eCr i:�j'.r- - � i�Y.,.'tii_ v .....w.,r.�.� � �._�....Y+ f..�q�~_".M.M1i Assessor's map and lot-number ...... ..... 0 ��. �' G 1 Y 1 7 Sewage Permit numberx?! ��?..: �i-,.a��? . 2`. %T"E�°�� TOWN OF BARNSTAB•LE Z BAUSTADLE, i 9' BUILDING INSPECTOR iOTE'p MPY h• .✓' APPLICATION FOR PERMIT TO ... � T........ i l?......................................................................... pTYPE OF CONSTRUCTION .......... ; .:•.............................................................................................. ....../.........19...7, TO THE INSPECTOR OF. BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........................................... .`................................... d............................................................................................ el .....X/... zoo s ProposedUse ........................ ............................................................................................................................................. ZoningDistrict ........................................................................Fire District .............................................................................. %.Address ......:.. ..—�C, /.ram Nameof Owner .:.... ................................ ��./.../..'�....................... Name of Builder Address .. /.� ."..". © :../%y �- ........... Nameof Architect ..................................................................Address .................................................:.................................. Number of Rooms ......................Foundation ......................................... Exterior ............... ..................................................Roofing .....,........ ............................ Floors ......................................................................................Interior .................................................................................... Heating .................................................................................Plumbing ...,................:......p...................................................... Fireplace ..................................................................................Approximate Cost ...... ./•• ...r.......... ............................ Definitive Plan Approved by Planning Board ________________________________19________. Area . .° .... .. d Diagram of Lot and Building with Dimensions Fee .......... �. ............... ......... . SUBJECT TO APPROVAL OF BOARD OF HEALTH r I hereby agree to conform to .all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ................................................�C ��........,// ..... Simons, Alipio H. A=190-32 18924 dormer, No ................. Permit for .................................... ............................................................................... Location 1.58; . ..S.toney Cliff Road .. .. .. .............................................. Centerville ............................................................................... Owner Alip.io. ..H.....Simons. ............................ . .. .. . ........ .... Type of Construction frame .............................................a ............................... Plot ......................... . Lot ................................ t Permit Granted ..........................Febrny 1. 19 77 ......... Date of Inspection ................ .............19 Date Completed ... PERMIT REFUSED ............ . ............. ............. 19 . .. ............... .... ................. .... .... ................. ..................... ...................... Approved ............................�.................. 19 - ............................................................................... TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB LOCATION Number Street Address Section Of Town "HOMEOWNER" - - -Name Home Phone Work Phone PRESENT MAILING ADDRESSCit 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 individual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a ,one 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 verformed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 c is feet, or larger, will be required to comply with State Buildin Code Section 127.0, Construction Control. .p HOME OWNER'S EXEMPTION The code states that: "Any Home Owner performing work for which a building permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that if 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 awareness often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the unlicensed person as it would with licensed supervisor. The Home Owner acting as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, many communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Assessor's office(1st Floor): }, Assessor's map and lot number Q s 3v�i o�TNT>o Conservation -- SEPTIC SYSTEM MUST E ,�`R `•a Board of Health(3rd floor): _ INSTALLED IN COMPLIANC D Sewage Permit number AJU ADLZ WITH TITLE 5 . .... Engineering Department(3rd floor): Ju > r ENVIRONMENTAL CODE AN®�°•�to Y1ir►���' House number % � TON REGULATIONS Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF , BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO 7_!�,///� TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to.the following information: Location z Proposed UseJ�f,—ir n Zoning District Fire District �— �lG�i4-/ZG� S . ��7?S./Z Name of Owner Address e Name of Builder Z224i 7"t'�Address Name of Architect Address Number of Rooms Foundation/Pl_ Exterior 2221! Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost Area Diagram of Lot and Building with Dimensions Fee ��V to �2' / t L -..� ' 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 con ction. Name Construction Supervisor's License MORSE, RICHARD S. �gO �075 Now Permit For BUILD SHED Accessory to Dwelling Location 158 Stoney Cliff. Road " ` Centerville Owner Richard S . Morse Type of Construction ' F r aine f Plot Lot ! Permit Granted February 26 , 19 93 Date of Inspection 19 ; Date Completed S 19 �5 *" s,+" 0. 4 . STANQARD LEGEND note:not alfsymbols will appear an o map 55 3 ❑ \ GOLF COURSE FAIRWAY . L n A� 51 . 7 DECIDUOUS TREES 0jTI / EDGE OF BRUSH ♦ \ / ORCHARD OR NURSERY (ON I FEROU S TRE ES 1164 MARSH AREA ° 194 EDGE OF WATER _ DIRT ROAD �\/ / i_ �\;� - \ ,� /'��\ f`\ai4 _ ..,,^M1�-,�� RIVEWAYS f j` __....__....._ _.._._.—`... _._ -,= ---_-- .—...� -----_.._._...-- _ _\ 2-AC- ._..__.—_. __ __. __.— _.....___.. _......__._ ._.__—._—.._—_____ _— —.._._._.. .._... _..._.._. _------.-- -----.,_��—___..._._._ �_—.---- .._._ _..._..... _. _ PARKING LOT -- VED ROAD DITCHES PATH TRAIL !\ ; ` ._\ I/ d,' PROPERTY LINES 168 it 1 ee¢ LOT ACREAGE / \ 1 ❑ 0 \ / 2t RCELNUMBER \ \ .. ` fJ j. L.—.. - \ \ ciea OUSE NUMBER \ \_ 49 . 0.3 4 ,r / \ 2 FOOT CONTOUR LINE 10 FOOT CONTOUR LINE �.... �� x.., SPOT ELEVATION 0.34 AC - STONEWALL FENCE , RETAINING WALL r f• \ <;` -- `., RAIL ROAD TRACKS 33 TELEPHONE POLE I ' ri < 3 r / �� i 11�.1 #14 8 STONE JETTY 0.3 5 AC l°'' SWIMMING POOL PORCH/DECK BUILDINGS/STRU(TURES 4" DOCK/PIER/JETTY \�' / / 'ASSESSOR'S MAP BOUNDARY 0.39 AC 1.40 .22 - \ l i #60 0 _ \ SIT'E MAP 4 .cY, ;.........\ ;r f `f ,♦t��L�u� - •.� i T.O.B.GEOGRAPHIC INFORMATION SYSTEMS UNIT E l J` _ 13 SCALE:in feet / J/ \ 0 20 40 \ y \ ; \ 1 inch = 40 feet .. ,•; �< �` �`' ♦ ♦ ' FILE:hose'.dgn gis 1996 / 2 ♦� r _ \{ NOTE:THE PARCEL LINES ARE ONLY GRAPHIC REPRESENTATIONS OF `•, ` `` ,' `// ,/ i/ \ _ „- /- \S /� PROPERTY BOUNDARIES;THEY ARENOT TRUE LOCATIONS cmh 8-3-94 - '0.34C r j- "t VEGETATION,TOPOGRAPHY ANDPIANIMETRICDATAINTERPRETED ' \ ♦ / ,-_;�\ / / `\ ?< -�`.`� _ FROM 1989 AERIAL OVERFLIGHTS,PHOTOGRAPHY AT 1 800' MAPPED AT I"=100',PARCEL DATA DIGITIZED FROM 1"=100' •- ENGINEERING ASSESSORS MAPS 1989 1' / ♦ P; • . r r T C. y — _ -- ...- I• f -- ! -- -- - ---- -- � 5 ref ;• -- — _ I 1 I. 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