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HomeMy WebLinkAbout0002 GENERAL PATTON DRIVE a � p�aic�, CO B ENNET T ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (508)896-1906 Brewster,MA 02631 fax(508)896-5109 X4 L� _y LETTER OF TRANSMITTAL ,a.g TO: DATE: JOB NUAIBER: Mr.Robert Murphy,Case Officer 8/15/17 BEA17-11006 MA DEP,Southeast Regional Office(SERO) Emergency Response Section/Bureau of Waste Site Cleanup 20 Riverside Drive REGARDING: Lakeville,MA 02347 IMMEDIATE RESPONSE ACTION STATUS I w/SUPPORTING DOCUMENTATION RTN 4-26544 SHIPPING METHOD: Ennes Residence: Regular Mail ❑ Pick Up ❑ 2 General Patton Drive Hyannis,MA 02601 Priority Mail ❑ Hand Deliver ❑ [Assessors Map 292,Parcel 096] Express Mail ❑ Other upload ❑X Certified Mail ❑ Green Card/RR ❑ COPIES DATE DESCRIPTION 1 8/2/17 NAP with Supporting Documentation(Appendices A-F) For review and comment: ❑ For approval: ❑ As requested: ❑ For your use: ❑ REA AIM: CC,full report via CD:Rosemarie and Warren Ennes,Homeowner Amanda Moody,Liberty Mutual Insurance and Brian D.Kisiel,GeoInsight,Inc.—Representative to Insurer (via email link to eDEP for report retrieval) CC,*Abbreviated copies: Thomas McKean,Director,Barnstable Public Health Division Mark S.Ells,Barnstable Town Manager Chief,Harold Brunelle—Hyannis Fire Department *As part of Public Notice requirements,the report Title Page,Narrative,Index,Transmittal forms and Site Plan are included,pursuant to paperwork reduction policy. The full report is available as public record on the MA DEP website database at http://public.dep.state.ma.us/SearchableSites/Search.asp or, upon written request to BEA,full copy(electronic or paper)will be provided. FROM: David C.Bennett,LSP/John D. Tadema-Wielandt,ES,Senior PM/Lezli Rowell,Administrative Assistant If enclosures are not as noted,kindly notify us at once IMMEDIATE RESPONSE ACTION STRUTS I WITH SUPPORTING DOCUMENTATI®N TN 4-26544 Ennes Residence 2 General Patton Drive Hyannis,MA 02631 [Assessor's Map/Parcel ID: 292-096] BEA17-11006 AUGUST 29 2017 BE* NNETTENVIRONMENTALAsSOCIATES, INCO LICENSED SITE PROFESSIONALS 6 ENVIRONMENTAL SCIENTISTS 6 GEOLOGISTS 6 ENGINEERS 1573 Main Street-P.O. Box 1743, Brewster, MA 02631 6 508-896-1706 6 Fax 508-896-5109 6 www.bennett-ea.com BEA17-11006 August 2, 2017 Robert Murphy, Case Officer MA DEPARTMENT OF ENVIRONMENTAL PROTECTION (MA DEP) Southeast Regional Office (SERO) Bureau of Waste Site Cleanup (BWSC) 20 Riverside Drive Lakeville, MA 02347 RE: IMMEDIATE RESPONSE ACTION STATUS REPORT I AND SUPPORTING DOCUMENTATION RTN4-26544 2 General Patton Drive [Assessor's Map/Parcel ID: 292-096] Hyannis, MA 02631 Dear Mr. Murphy, BENNETT ENVIRONMENTAL ASSOCIATES INC. (BEA)has prepared the following Immediate Response Action Status (IRAS) Report and Supporting Documentation, as a summary of remedial response actions and the environmental assessment activities conducted in the past 60 days since the IRA Plan filing, on June 12, 2017. This information is being used to evaluate Y g g potential exposure risk to identified human and environmental receptors, following the sudden release of a reported 250 gallons of No. 2 heating fuel from an exterior above ground storage tank(AST), located adjacent to the dwelling. Over the reporting period, environmental assessment and monitoring activities have included the performance of test borings and the installation of additional groundwater monitoring wells, with the collection and laboratory analysis of soil and groundwater samples. These additional assessment activities were performed to more accurately define the extent and magnitude of soil and groundwater impact. Results of soil analysis have confirmed the proposed area of excavation in a 16' x 10' area to approximately 15' deep. Results of groundwater analysis indicate no impact to down-gradient monitoring wells, confirming localized impact only, in the immediate area of release. In addition, proposals were requested from qualified contractors to perform soil removal activities in the release area, using a shoring plan drafted by a structural engineer. Frank Corp. of New Bedford, MA was chosen as the contractor, and work is scheduled to begin the week of August 7, 2017. Subsequent to soil removal activities, soil samples will be collected at the extent of the excavation for extractable petroleum hydrocarbons (EPH) with polycyclic aromatic hydrocarbons (PAHs) and volatile petroleum hydrocarbons (VPH) with target benzene, toluene, ethylbenzene 1 EMERGENCY SPILL RESPONSE 6 WASTE SITE CLEANUP 6 SITE ASSESSMENT 6 PERMITTING 6 SEPTIC DESIGN&INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE 6 WASTEWATER TREATMENT,OPERATION&MAINTENANCE f AUGUST 2,2017 ENNES:2 GENERAL PATTON DR.BEA17-11006 PAGE 2 OF 12 IMMEDIATE RESPONSE ACTION STATUS I,RTN 4-26544 and xylenes (BTEX) compounds. Prior to backfilling, 400 lbs. of Regenesis RegenOx® part A will be mixed into bottom of hole soils, as a contingency to treat any residual petroleum impact. A remedial additive infiltration system will then be installed within the excavation. The infiltration system will be constructed of 4" perforated PVC piping set in double washed stone aggregate. The system will be installed for the application of 240 lbs. of RegenOx® part B, if laboratory analytical results indicate additional treatment is required. Future environmental monitoring activities proposed includes two quarterly rounds of groundwater sampling, to monitor for the migration of any dissolved phase petroleum impact to down-gradient monitoring wells MW-3 and MW-4. In addition, indoor air within the living space and the infiltration system vent will be screened with a photoionization detector (PID) for organic vapors or odors. The indoor air and soil vapor screening will serve as part of the multiple lines of evidence to evaluate potential vapor intrusion and inhalation exposure risks. The results of environmental response actions proposed, will dictate the need for any additional remedial measures to be represented in future IRA Status reports, filed within six months of this IRA Status Report. Remedial response activities performed, and potentially to follow, are intended to mitigate any Critical Exposure Pathways and Significant Risk to identified human and environmental receptors, in support of a Permanent Solution Statement (PSS). It is the objective of this IRA to offer a PSS in advance of the one-year Tier Classification deadline, based on the technical rational and scientific justification from the field testing and analytical results presented herein. This work has and will continue to proceed under direct LSP oversight in a manner consistent with the MCP Response Action Performance Standards (RAPS) pursuant to 310 CMR 40.0191 and the QA/QC policies of BENNETT ENVIRONMENTAL ASSOCIATES, INC. The facts and statements herein are, to the best of our knowledge, a true and accurate representation of the Site activities, remedial response actions and environmental conditions associated with the project and LSP Opinions acknowledged by the certification on the attached BWSC-105 Transmittal Form. RESPONSE ACTIONS/PRELIMINARY ASSESSMENT On February 25, 2017 the homeowner found the 275-gallon fuel oil AST actively leaking. Subsequent to release discovery the Hyannis Fire Department responded and applied granular absorbents to the concrete pad beneath the tank. The absorbents were later collected and taken off-site for disposal by emergency response contractor NRC/ENPRO. EnviroTrac, Ltd. was later contracted to investigate the release by the homeowner's ` Insurer (Liberty Mutual). On March 22, 2017, EnviroTrac personnel performed a single test boring approximately 4' outside the area of soil staining and installed a single groundwater monitoring well. Continuous soil sampling and PID screening was conducted from the surface to the groundwater with a maximum PID reading of 160 ppmv reported in the 8-10' interval and 54.3 ppmv at the groundwater interface at 23' below grade. A single soil sample (MW-1 24') was submitted to SGS Accutest Lab for EPH/4PAHs and VPHBTEX analysis. Groundwater from AUGUST 2,2017 ENNES:2 GENERAL PATTON DRJBEAI7-11006 PAGE 3 OF 12 IMMEDIATE RESPONSE ACTION STATUS I,RTN 4-26544 monitoring well (MW-1) was also collected and submitted to Accutest for EPH/4PAHs and VPHBTEX analysis. 0,>VYJi i j 4 'fir 111VV � -� P II d `4•.ip 4 t { � a � 4 .Stir Photo 1:View of subject AST with monitoring well MW-1 in foreground. Results of soil analysis reported low concentrations of fractional EPH and VPH below the most stringent S-1/GW-1 Method 1 Risk Characterization Standards. Results of groundwater analysis reported low concentrations of target PAHs below the GW-1 Method 1 Risk Characterization Standards. Upon review of the data, BEA responded directly to Liberty Mutual regarding the testing performed. BEA believed that the testing was flawed, based on the location of the test boring and monitoring well (MW-1) installed outside of the release area and in a location up-gradient of regional groundwater flow. In addition, it was noted that the only soil sample submitted (MW-1 24') was collected from below the groundwater interface, and did not correspond with the elevated PID readings observed. BEA, acting outside the role of LSP, believed these results clearly indicated soil impact to the groundwater interface impacting groundwater. However, the sample selection for soil and groundwater did not consider the spatial locations of soil impacts as outside the area of soil staining, or the solute fate of groundwater, and did not give a clear picture of environmental conditions as the basis of Insurer's denial of Coverage. On behalf of the property owners, BEA then requested they reconsider insurance coverage based on the flawed assessment performed by their consultant. The Insurer declined to reconsider coverage and took the position that no coverage would be afforded to the Insured unless groundwater impact was documented above GW-1 Standards. AUGUST 2,2017 ENNES:2 GENERAL PATTON DR.BEA17-11006 PAGE 4 OF 12 IMMEDIATE RESPONSE ACTION STATUS I,RTN 4-26544 Upon consultation with the property owner, additional assessment activities were scheduled to qualify previous testing results. BEA arranged for the AST to be removed for clear access to the area of release for subsequent testing, and on April 28, 2017, BEA personnel performed soil borings and monitoring well installation activities at the property. Two soil borings were performed at the site to determine the general nature and extent of impacted soils. Test boring TB-2 was performed within the release area, directly below the former AST. Test boring TB-3 was performed in the driveway of the subject dwelling on the opposite side of the house in a down-gradient location. Field screening of soil samples collected from TB-2 reported organic vapor concentrations ranging from 157 to 199 ppmv increasing with depth up to and including the 12-16' interval. Soil samples collected from below 16' exhibited decreased PID readings from 8-15 ppmv, with slight increase at groundwater interface. Soil samples collected from TB-3,reported no concentrations of organic vapors above background. r. F, I �' a ^✓'�` I y l i r F R a1 a Photo 2: Location of BEA test boring (TB-2) and the monitoring well (MW-2) as within release area under former above ground oil tank. A single soil sample from the area of impact (TB-2:12-16) was prepared and submitted to R.I. Analytical laboratory for EPH/4 target PAHs and VPH/BTEX analysis. Analytical results, received May 5, 2017, reported EPH/PAH and VPHBTEX concentrations greater than the applicable Method 1 Risk Characterization standards. The analytical results are summarized below in Table 1. AUGUST 2,2017 ENNES:2 GENERAL PATTON DR.BEA17-11006 PAGE 5 OF 12 IIAMEDIATE RESPONSE ACTION STATUS I,RTN 4-26544 Table 1: Results of Soil Analysis Compared to Method 1 Standards 2 General Patton Dr. -Hyannis, MA(RTN 4-26544) Sample Number: 1 .. Sample Identification: TB-2:12-16', . Method 1 Risk Characterization Standards, Sample Date 4/28/2017 14:45 S-1/GW-1 S-1/GW-3 S-2/GWA S-2/GW-3 S-3/GW1 S-3/GW-3 Extractable Petroleum Hydrocarbons C9-C18 Aliphatics 2700 1000 1000 3000 3000 5000 5000 C19-C36 Aliphatics 780 3000 3000 5000 5000 5000 5000 C11-C22 Aromatics,Adjusted 2600 1000 1000 1000 3000 1000 5000 Naphthalene 0.98 4 500 4 1000 4 3000 2-Methylnaphthalene 16 0.7 300 1 500 1 500 Acenaphthene 2 5 4 1000 4 3000 4 5000 Phenanthrene 2.3 10 500 20 1000 20 3000 Volatile Petroleum Hydrocarbons C9-C10 Aromatics 800 100 100 300 500 300 500 C5-C8 Aliphatics,Adjusted 190 100 100 500 500 500 500 C9-C12 Aliphatics,Adjusted 1300 1000 1000 3000 3000 5000 5000 Benzene <2.2 2 40 2 _ 200 2 1000 Toluene 5 30 500 30 1000 30 3000 Ethy]benzene 9.6 40 500 40 1000 40 3000 p/m-Xy0e, 25 400 500 400 1000 400 3000 0-Xylene 15 400 500 400 1000 400 3000 Methyl tert butyl ether. <0.44 _ _ 0.1 _ 100 0.1 500 0.1 500 ,Naphthalene 30 4 500 4 1000 4 3000 Red numbers indicate concentrations exceeding Method 1 Standards Bold numbers indicate Standard exceeded BEA personnel returned to the site on May 4, 2017 to sample the newly installed monitoring wells. Samples were collected from MW-2 and MW-3 and submitted to a MA Certified lab for EPH/PAHs and VPH/BTEX analyses. Laboratory analytical results, received May 11, 2017, reported concentrations of EPH/PAHs and VPH/BTEX in MW-2, including fractional C9-C10 Aromatics, C11-C22 Aromatics and 2-Methylnaphthalene above the applicable GW-1 Method 1 Risk Characterization Standards. No concentrations of EPH/PAHs or VPH/BTEX were reported in down-gradient monitoring well MW-3. The analytical results for the groundwater samples are summarized below in Table 2. i AUGUST 2,2017 ENNES:2 GENERAL PATTON DR.BEA17-11006 PAGE 6 OF 12 IMMEDIATE RESPONSE ACTION STATUS I,RTN 4-26544 Table 2: Results of Groundwater Analysis Compared to Method 1 Standards 2 General Patton Dr.-Hyannis, MA(RTN 4-26544) Sample Number:. 1 2 Method 1 Sample Identification: MW-3 MW-2 Risk Characterization Standards Sample Date: 5/4/2017 @ 13:00 5/4/2017 @ 13:30 GW-1 GW-2 GW-3 VPH(ug/1) Adj C5-C8 Aliphatics(FID) <100 <100 300 3000 50000 Adj C9-C12 Aliphatics(FID) <100 270 700 5000 50000 C9-C10 Aro matics(PI D) <100 250 200 4000 50000 Target Aromatic Ana lytes Methyl-tert-butylether <5 <5 70 50000 50000 Benzene <5 <5 5 1000 10000 Toluene <5 <5 1000 50000 40000 Ethylbenzene <5 <5 700 20000 5000 m,p-Xylene <5 <5 10000 3000 5000 o-Xylene <5 5.5 10000 3000 5000 Naphthalene <5 11 140 700 20000 EPH/PAH(ug/1) C9-C18 Aliphatics <100 640 700 5000 50000 C19-C36 Aliphatics <100 220 14000 50000 Adj.C11-C22 Aromatics <100 310 200 50000 5000 Target PAH Ana lytes Naphthalene <5 <5 140 700 20000 2-Methylnaphthalene <5 10 10 2000 20000 Acenaphthene <5 <5 20 10000 Phenanthrene <5 <5 40 10000 Red numbers indicate concentrations exceeding Method 1 Standards Bold numbers indicate Standard exceeded The Insurer was subsequently contacted and provided with the field reports and analytical results for the soil and groundwater testing conducted, regarding the concentrations of soil and groundwater impact reported, in reconsideration of coverage under the homeowner policy. The property owner later contacted BEA to notify them that the Insurer had changed their position and was now offering coverage of the release, as a covered loss. BEA subsequently received full engagement to provide LSP Oversight and professional services toward development and implementation of an IRA Plan. On May 30, 2017, BEA personnel returned to the site to collect additional data on the lateral extent of soil impact. BEA personnel performed three hand borings in the vicinity of the release area in an attempt to determine the limits of significant impact. Hand boring HB-1 was advanced northeast of the release area, HB-2 was advanced southwest of the release area, and HB-3 was advanced northwest of the release area. Refusal was met at 10' below grade in HB-1, and 6'below grade in HB-2 and HB-3, due to rocks. Low PID readings (<3 ppmv) were reported in HB-1. Elevated PID readings from 40.3 ppmv to 20.4 ppmv were reported in HB-2, decreasing with depth. No PID readings were reported in HB-3 above the instrument detection limit (Non-Detect). Based on the limited amount of data collected from relatively shallow depths, no samples were submitted to the laboratory from these assessment activities. Nevertheless, this information was used to re-define the area of soil impact for the proposed soil AUGUST 2,2017 ENNES:2 GENERAL PATTON DR.BEA17-11006 PAGE 7 OF 12 IMMEDIATE RESPONSE ACTION STATUS I,RTN 4-26544 removal activities. Based on the refusals encountered during the hand borings, additional test borings were proposed in order to collect soil samples at greater depths. The IRA Plan was filed on June 12, 2017. The IRAP called for the mechanical removal of up to 100 cubic yards of impacted soils in a 16' x 10' area to 15' deep. As a contingency against residual impact, Part A of the two-part Regenesis RegenOx ® in-situ chemical oxidant (ISCO) would be applied to soils in the bottom of hole area, with an infiltration system installed prior to backfilling, for the potential application of Part B. Soil samples collected at the extent of the excavation would be collected for laboratory analysis. Groundwater sampling with laboratory analysis would continue quarterly to monitor groundwater conditions at the site. SUPPLEMENTAL ASSESSMENT On June 22, 2017, BEA returned to the site with Bronson Drilling of Winchester, MA, to install two additional groundwater monitoring wells and to perform additional soil assessment in the release area. Test boring TB-4 was advanced in the front of the house, in a down-gradient location, and was completed as monitoring well MW-4. Test borings TB-5 and TB-6 were advanced to the north and south of the release area, respectively. Test boring TB-7 was advanced west of the release area and was completed in an up-gradient location, as monitoring well MW-5. The test borings were performed using a direct-push-type drilling rig. Four-foot composite soil samples were collected in Shelby tubes and then placed in an 8-ounce glass jar, sealed with an aluminum septum, then agitated to develop organic vapors. Each sample was subsequently screened with a PID by "jar headspace method" consistent with the Interim Soils Policy (WSC- 94-400). Field screening of a soil sample collected from TB-4 at the groundwater interface reported no concentrations of organic vapors above the instrument detection limit (Non-Detect). Field screening from Test boring TB-5 reported organic vapor concentrations ranging from 22.8 to 23.3 from 6-12' below grade, 154 in the 12-16' interval, 0.3 ppmv in the 16-20' interval, and ND in the 20-24' interval at the groundwater interface. Soil samples collected from TB-6 and TB-7 reported no concentrations of organic vapors above background [Refer to Borehole Logs— Appendix B]. Based on its location within the release area, monitoring well MW-2 was also checked for the accumulation of light non-aqueous phase liquid (LNAPL) during this site visit. A sample of water was collected with a dedicated bailer and emptied into a glass jar. Small globules of LNAPL were observed in the water sample after emptying the in the jar. Three soil samples from TB-5 (TB-5: 6-12', TB-5: 12-16' and TB-5: 16-20') and a single soil sample from TB-6 (TB-6: 6-16') were submitted to a MA certified laboratory for EPH/PAH and VPHBTEX analysis. The results, received on July 3, 2017 reported trace concentration of fractional VPH and EPH, below the most stringent S-1/GW-1 Method 1 Standards, in the TB-5: 12-16' sample. The remaining soil samples reported all concentrations of EPH/PAHs and VPHBTEX as Non-Detect. These results confirmed the proposed extent of soil removal in a 16' x 10' area. The results are summarized below in Table 3. f AUGUST 2,2017 ENNES:2 GENERAL PATTON DR.BEA17-11006 PAGE 8 OF 12 IMIVIEDIATE RESPONSE ACTION STATUS I,RTN 4-26544 Table 3: Results of Supplemental Soil Analysis Compared to Method 1 Standards 2 General Patton Dr.-H annis,MA(RTN 4-26544 CLIENT SAMPLE ID TB-5:6-12' TB-5:12-16' TB-5:16-20' TB-6:6-16' .. SAMPLING DATE_ 22-JUN-17 22-JUN-17 22-JUN-17 22-JUN-17 LAB SAMPLE ID S-1/GW-1 Units L1721413-01 L1721413-02 L1721413-03 L1721413-04 Volatile`�'etroleuiri: ydrocartrons Benzene 2 mg/kg ND(<O.113) ,ND(<0.1.11) ND(<O.11) ND(<O.112) C5-C8 Aliphatics mg/kg ND(<2.82) ND(<2.78) ND(<2.74) ND(<2.8) C5-C8 Aliphatics,Adjusted 100 mg/kg ND(<2.82) ND(<2.78) ND(<2.74) ND(<2.8) C9-Cl0 Aromatics 100 mg/kg ND(<2.82) ND(<2,78) ND(<2.74) ND(<2.8) C9-C12 Aliphatics mg1O ND(<2.82) 2.92 ND(<2.74) ND(<2.8) C9-C12 Aliphatics,Adjusted 1000 mg/kg ND(<2.82) 2.92 ND(<2.74) ND(<2.8) Ethylbenzene 40 mg/kg ND(<0.113) ND(<O.111) ND(<O.11) ND(<O.112) Methyl tert butyl ether 0.1 mg/O ND(<0.057) ND(<0.056) ND(<0.055) ND(<0.056) Naphthalene 4 mg/kg ND(<0.226) ND(<0.222) ND(<0.219) ND(<0.224) o-Xylene 400 mg/kg ND(<O.113) ND(<0.111) ND(<O.11) ND(<O.112) p/m-Xylene 400 mg/kg ND(<O.113) ND(<O.111) ND(<O.11) ND(<O.1.12) Toluene 30 m k ND <O.113 ND <0.111 ND <O.11 ND <O.112 Extractable+ etf6 eum Hydi<ocarbons. 2-Methylnaphthalene 0.7 mg/O ND(<0.344) ND(<0.342) ND(<0.33) ND(<0.33) Acenaphthene 4 mg/kg ND(<0.344) ND(<0.342) „ ND(<0.33) ND(<0.33) Acenaphthylene 1 mg/O ND(<0.344) ND(<0.342) ND(<0.33) ND(<0.33) Anthracene 1000_ mg/O _ ND(<0.344) ND(<0.342) ND(<0.33) ND(<0.33) Benzo(a)anthracene 7 mg/kg ND(<0.344) ND(<0 342) ND(<0.33) ND(<0.33) _. Benzo(a)pyrene 2_ mg/kg ND(<0.344) ND(<0.342) ND(<0.33) ND(<0.33) Benzo(b)fluoranthene 7 mg/kg. ND.(<0.344) ND(<0.342) ND(<0.33) ND(<0.33) Benzo(ghi)perylene 1000 mg/kg ND(<0.344). ND.(<0.342) ND(<0.33) ND(<033) Benzo(k)fluoranthene 70 TWO ND_(<0.344) ND(<0342) ND(<0.33) ND(<0.33) CII-C22 Aromatics _ _ . mg/O ND(<6.89)_ 11.7_ ND(<6.61) ND(<6.61) C11-C22 Aromatics,Adjusted 1000 mg/kg ND_(<6.89) 113.. ND(<6.61) _ ND(<6.61) - -.. C19-C36 Aliphatics 3.000 mg/O ND(<6.89) ND(<6.84) ND(<6.61) ND(<6.61) C9-C18Aliphatics, 1000 mWO ND(<6.89) 17.3 ND(<6.61) ND(<6.61) Chrysene 70, mg/kg ND.(<0.344) ND(<0.342) ND(<0.33) ND(<0.33)_ Dibenzo(a,h)antIracene 0.7 rn 0 ND(<0 344) ND(<0.342) ND(<0.33) ND(<0 33) __... Fluoranthene 1000 rn 0.. ND(<0,344) ._ND(<0,342) ND(<0.33) ND(<0.33) Fluorene 1000 mg/O ND(<0.344) ND_(<0.342) ND(<0.33) ND(<0.33) Indeno(1,2,3 cd)Pyrene. 7_ LZ ND(<0.344) _ND.(<0.342) ND(<0.33) ND(<033) Naphthalene 4 ND(<O.344) ND(<0.342) ND(<0.33) ND(<0.33) Phenanthrene 10 ND(<0.344.) ND(<0.342) ND(<0.33) ND(<0.33) P rene 1600ND <0.344 ND <0.342 ND <0.33 ND <0.33 Red numbers indicate concentations exceeding Method 1 Standards On June 30, 2017 BEA personnel returned to the site to collect groundwater samples from the newly installed groundwater monitoring wells MW-4 and MW-5. During the sampling event, the wells were purged and sampled via low-flow methodology, wherein the samples were collected for EPHNPH and target analyte concentrations upon meeting purge requirements and the stabilization of field parameters (pH, Dissolved Oxygen, Conductivity,.Temperature). The samples were collected in appropriately preserved laboratory containers and placed on ice in a cooler. The top-of-casing elevations of all monitoring wells were then surveyed to a common vertical datum, towards the qualification of local groundwater flow direction. Static water level measurements demonstrated a site-specific groundwater flow to the southeast, consistent with regional flow. Based on the groundwater flow direction calculated, monitoring well MW-4 (and most likely MW-3) is in a down-gradient location. Monitoring well MW-2 was again checked for the accumulation of LNAPL. An interface probe was used to check for accumulated product thickness. No measurable product thickness was noted. A sample of water was again collected for a visual check with a heavy petroleum sheen observed on the sample collected. Prior to departing the site, an absorbent sock was installed in monitoring well MW-2 for the passive collection of product i AUGUST 2,2017 ENNES:2 GENERAL PATTON DR.BEA17-11006 PAGE 9 OF 12 IMMEDIATE RESPONSE ACTION STATUS I,RTN 4-26544 Laboratory analytical results were received on July 11, 2017. The results reported all EPH/PAH and VPH/BTEX concentrations in monitoring wells MW-4 and MW-5 as ND, wherein the reporting limits were less than the applicable GW-1 and GW-3 Method 1 Risk Characterization standards. RISK CHARACTERIZATI®N/IMMINENT HAZARDS [Refer to Appendix E] As presented, the S-1, S-2 and S-3 (GW-1/GW-3) soil categories are applicable in consideration of Method 1 Risk Characterization, as consistent with the provisions of 310 CMR 40.0933. These standards were developed to evaluate potential ingestion, particulate inhalation, dermal contact and in consideration of potential leaching of contaminants to groundwater as based on accessibility, frequency and intensity of use of the soils. Likewise, groundwater is divided into the GW-1 (ingestion), GW-2 (inhalation) and GW-3 (dermal contact and environmental impacts). Soil Laboratory analysis has reported fractional EPH and VPH compounds and target analytes naphthalene and 2-methylnaphthalene above applicable Method 1 Risk Characterization standards in soils at the Site. These soils represent a potential exposure threat to identified human and environmental receptors. As such, remedial response actions are prescribed under the TRAP to absolve potential exposure risks and to meet regulatory closure objective, without limitation of activities or use of the property. As previously reported, the fuel oil contaminated soils are currently isolated from human receptors by the way of the plastic sheeting covering the area of release. Furthermore, the plastic sheeting restricts the leaching of soil impacts, though impacts in the worst-case area at TB- 2/MW-2 have infiltrated to groundwater already. Regardless, based on the engineering controls, the restricted access to significant impacts, and the laboratory data reported under Method 1 Risk Characterization, no Imminent or Substantial Hazards are apparent nor is any Critical Exposure Pathway complete under current soil conditions as will continue to be evaluated. Groundwater Based on the PDWSA designation and proximity to groundwater, the GW-1 and GW-3 groundwater categories are considered applicable in consideration of Method 1 - Risk Characterization standards, as consistent with the provisions of 310 CMR 40.0932. The initial groundwater sampling event at the MW-2 location, within the release area reported fractional EPH/VPH and target PAH impact exceeding the applicable and most restrictive GW-1, Method 1 Risk Characterization standard. The initial groundwater sampling event at the MW-1 location reported trace concentrations of PAHs below the GW-1 Standards. Groundwater sampling at MW-3, MW-4 and MW-5 have reported all concentrations of petroleum hydrocarbons as ND. As such, groundwater data indicates impact is localized to the area directly below the former tank adjacent to the house, and that such impact is less than the I AUGUST 2,2017 ENNES:2 GENERAL PATTON DR./BEA17-11006 PAGE 10 OF 12 DANIEDIATE RESPONSE ACTION STATUS I,RTN 4-26544 applicable GW-2 and GW-3, Method 1 standards. Based on municipal water supply provided to the subject property and surrounding area and the relatively low concentrations of the reported groundwater impact, no Imminent or Substantial Hazards are reported under existing conditions, with respect to the significant groundwater impact. Indoor Air Indoor air quality in the basement and first floor living space was screened with a calibrated PID during the initial assessment. During the screening, no concentrations of organic vapors were reported above the detection limits of the instrument. No fuel oil odor has been reported in the living space or basement of the dwelling. Based on the indoor air quality screening and olfactory observations, no apparent Imminent or Substantial Hazards are reported under existing Site conditions. The need for soil vapor testing or indoor air testing will be evaluated based on the concentrations of volatile organic compounds (VOC) reported in end- point soil samples and representative groundwater samples, collected following the completion of contaminated soil removal. Such evaluation criteria are consistent with the provisions of 310 CMR 40.0942(1) (d) and the MA DEP Vapor Intrusion Guidance document (Policy WSC-16- 435). PROPOSED RESPONSE ACTIONS As previously indicated in the IRA Plan, up to 100 yards of impacted soils will be mechanically removed from the release area. The excavation will be facilitated by shoring the building with resistance piers and/or steel beams and a shoring box to advance the excavation vertically up to 15' below grade. During soil removal, field PID screening and Dexsil testing will be used by BEA to provide technical guidance and assist contaminated soil removal. When field testing indicates effective removal of significant impacts to the stated objective depth or as limited by safety concerns, soil samples will be collected from the extent of excavation for VPH/BTEX and EPH/PAH analyses. Prior to backfilling, 400 lbs. of RegenOx Part A will be mixed into the bottom of hole soils and an infiltration system, constructed of 4" perforated PVC pipe, will be set in washed stone in the bottom-of-hole area and installed concurrent with backfill [Refer to Site Plan]. A 4" solid piece of PVC riser will be plumbed to the lateral components and completed above ground with a Y fitting. The infiltration system will be capped with filter fabric to maintain the porosity and permeability of the stone aggregate. The infiltration system will provide the infrastructure to deliver 240 lbs. of RegenOx, Part B if desired, subject to submittal of IRA Modification and/or receipt of written approval by the Department. PROPOSED FUTURE MONITORING Subsequent to soil removal activities, BEA will continue to monitor groundwater at the site quarterly for EPH/VPH and target analytes, as appropriate. The further treatment of soils and/or groundwater will be evaluated from the results of future quarterly groundwater monitoring and indoor air screening and testing of the infiltration system. Monitoring wells MW-3, MW-4 AUGUST 2,2017 ENNES:2 GENERAL PATTON DR./BEA17-11006 PAGE 11 OF 12 MAEDIATE RESPONSE ACTION STATUS I,RTN 4-26544 and MW-5 will be sampled for baseline wet chemistry analyses, in consideration of remedial additive application (RegenOx Part B). This testing includes laboratory analysis of iron, sodium, sulfate, calcium, magnesium and hardness, consistent with the chemical properties of the RegenOx product. Field measurements of groundwater elevations, olfactory and visual observations and the field-testing of pH, dissolved oxygen, conductivity and temperature will be reported on Monitoring Well Sampling Logs. PID screening of indoor air will continue in consideration of vapor entry, wherein all impacted soils are intended to be excavated from the prescribed vertical and horizontal distance associated with potential vapor entry. The need for sub-slab soil vapor or indoor air sampling in consideration of vapor entry will be made based on results of soil analyses, PID screening results and observations made following soil removal and quarterly groundwater sampling, under "lines of evidence" considerations. Field inspections will be conducted and documented on"Inspector's Daily Record of Work Progress" reports and remedial response and environmental assessment work will proceed as consistent with the QA/QC Policies of BEA. Future environmental assessment/monitoring activities will dictate the need for any additional remedial measures to be represented in future IRA Status reports as will be filed every six months until an IRA Completion Report is filed. Remedial response activities considered herein, and potentially to follow in subsequent IRA Status reports, are intended to mitigate all Critical Exposure Pathways (CEPS) and to facilitate a Permanent Solution in order to avert all potential risks to identified human and environmental receptors, in support of project closure. CONCLUSIONS The IRA Status I, represented by this filing, confirms the proposed IRA Plan will rely on mechanical removal of up to 100 cubic yards of impacted soils from within the release area. At the completion of soil removal activities, 400 lbs. of Regenesis © RegenOx Part A will be mixed with bottom of hole soils. This work is intended to eliminate the contaminant source in all accessible and potentially accessible areas, and facilitate the construction of appurtenances that can be utilized for treatment of residual hydrocarbons. Laboratory analysis of end-point soil samples will be used to qualify exposure risks in consideration of a permanent solution without restriction to activities or use of the property. If laboratory analysis indicates that significant soil impacts remain within the excavation, 240 lbs. of RegenOx part B will be applied to activate the Part A,mixed in to bottom of hole soils. Quarterly groundwater monitoring will continue to qualify potential impacts to the shallow aquifer associated with the subject release. Based on the analytical results of end-point soil samples, soil vapor testing and/or indoor air testing may be conducted to qualify the potential for vapor intrusion and associated exposures. At the time of this report, temporary structural shoring has been installed and contaminated soil is scheduled to begin within days. The next IRA Status Report (IRAS II) or IRA Completion with a Permanent Solution Statement (PSS) will be submitted within 6 months of this filing to document soil removal and environmental monitoring activities. If necessary, f AUGUST 2,2017 ENNES:2 GENERAL PATTON DR.BEA17-11006 PAGE 12 OF 12 IMMEDIATE RESPONSE ACTION STATUS I,WIN 4-26544 subsequent IRA Status Reports will be filed every six months thereafter, until a preponderance of physical evidence supports a condition of "No Significant Risk" as the basis of a Permanent Solution Statement without restrictions, in support of an IRA Completion. The findings of this investigation, as represented herein, set forth the rationale and technical justification for the LSP Opinions offered, as established by the certifications made on the attached Immediate Response Action Transmittal Form (BWSC-105). The LSP Opinions are based on available data and regulations in effect at the time of this reporting specific to the subject Site. Should the Department have any questions regarding this project, please contact our office at your earliest convenience. Sincerely,. BENNETT ENV RONMENTAL ASSOCIATES, INC ir"�W, ,02 avid C. Wett,,LSP I'D. Tad -Wielan ,Por Project Manager Encl: - Supporting Documentation [Appendices A-F] Cc: Rosemarie and Warren Ennes, Homeowner(CD) Amanda Moody—Liberty Mutual Insurance Brian D. Kisiel, GeoInsight, Inc. —Representative to Insurer (Via email link to eDEP for report retrieval) Thomas McKean, Director,Barnstable Public Health Divisions Mark S. Ells, Barnstable Town Managers Chief,Harold Brunelle—Hyannis Fire Departments ' As part of Public Notice requirements,the report Title Page,Narrative, Index, Transmittal forms and Site Plan are included, pursuant to paperwork reduction policy. The full report is available as public record on the MA DEP website database at hq://public.dep.state.ma.us/SearchableSites2/Search.as_px or, upon written request to BEA, full copy(electronic or paper)will be provided. IMMEDIATE RESPONSE ACTION STATUS I WITH SUPPORTING DOCUMENTATION R TN 4-26544 Ennes Residence 2 General Patton Drive [Assessor's Map/Parcel ID: 292-096] Hyannis,MA 02631 BEA17-11006 AUGUST 2,2017 Prepared For: MA DEPARTMENT OF ENVIRONMENTAL PROTECTION Southeast Regional Offices: Bureau of Waste Site Cleanup/Emergency Response Section 20 Riverside Drive-Lakeville,MA 02347 Robert Murphy, Case Officer Prepared By_ BENNETT ENVIRONMENTAL ASSOCIATES, INC. 1573 Main Street-Brewster,MA 02631 David C. Bennett, LSP On Behalf Of- Warner and Rosemarie Ennes, Homeowners 2 General Patton Drive Hyannis,MA 02631 APPENDIX A: Reference Plans -Figure 1: Site Locus Plan[USGS Topographic Quad.,Hyannis,MA. 1998](excerpt) -Figure 2: Ground-Water Resources of the Cape Cod,MA... [LeBlanc et A 1986](excerpt) -Figure 3:MA DEP BWSC GIS Map [2017] -Site Plan entitled,"Immediate Response Action Status..."Prepared by BENNETT ENVIRONMENTAL ASSOCIATES, INC.,Dated August 1,2017 APPENDIX B: Field Reports -Inspectors Daily Record of Work Progress[(#1 (6/22/17)through#3 (7/6/17)] -Geologic Borehole Logs[TB-4/MW-4,TB-5,TB-6,TB-7/MW-5] -Monitoring Well Sampling Logs(6/22/17, 6/30/17) APPENDIX C: Environmental Records/Permits/Correspondence -BWSC-105: Immediate Response Action Transmittal Form w/eDEP Submittal Summary and Receipt -BWSC-112:Bill of Lading -Aggregate Industries Soil Recycling Submittal -BWSC-120: Transmittal Form for Recording the Receipt and/or Issuance of BWSC Documents(3/21/17) APPENDIX D:Laboratory Analysis -Assessment—Soil[Alpha Analytical—Lab#L1721413 (7/3/17)] -Assessment-Groundwater[Alpha Analytical—Lab#L1722772(7/11/17)] APPENDIX E: Regenesis REGENOX Product Literature -Remedial Cost Proposal -RegenOx Application Design Summary -Technical Description Sheets APPENDIX F: Quality Assurance/Quality Control Plan Massachusetts Department of Environmental Protection f eDEP Transaction Copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: JTWIELANDT Transaction ID: 944837 Document: 13WSC105 Immediate Response Action Transmittal Form Size of File: 186.62K Status of Transaction: In Process Date and Time Created: 8/14/2017:11:23:56 AM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. __..__.__..-......__. Massachusetts Department of Environmental Protection BWSC 105 Bureau of Waste Site Cleanup ' Immediate Response Action (IRA)Transmittal Form Release Tracking Number ' Pursuant to 310 CMR 40.0424-40.0427(Subpart D) ] - 26544 A.SITE LOCATION: 1.Release Name/Location Aid: RESIDENCE 2.Street Address: 2 GENERAL PATTON DRIVE 3.City/Town: HYANNIS 4.Zip Code: r 5.Check here if this location is Adequately Regulated,pursuant to 310 CMR 40.0110-0114. r a.CERCLA r-b.HSWA Corrective Action c.Solid Waste Management r1 d.RCRA State Program(21 C Facilities) B.THIS FORM IS BEING USED TO:(check all that apply) 1.List Submittal Date of Initial IRA Written Plan(if previously submitted): r 2.Submit an Initial IRA Plan. r 3.Submit a Modified IRA Plan of a previously submitted written IRA Plan. r 4.Submit an Imminent Hazard Evaluation.(check one) r a.An Imminent Hazard exists in connection with this Release or Threat of Release. r b.An Imminent Hazard does not exist in connection with this Release or Threat of Release. r c.It is unknown whether an Imminent Hazard exists in connection with this Release or Threat of Release,and further assessment activities will be undertaken. r d.It is unknown whether an Imminent Hazard exists in connection with this Release or Threat of Release.However,response actions will address those conditions that could pose an Imminent Hazard. r 5.Submit a request to Terminate an Active Remedial System or Response Action(s)Taken to Address an Imminent Hazard. ry 6.Submit an IRA Status Report r 7.Submit a Remedial Monitoring Report.(This report can only be submitted through eDEP.) a.Type of Report:(check one) r i.Initial Report r ii.Interim Report r iii.Final Report b.Frequency of Submittal:(check all that apply) r i.A Remedial Monitoring Report(s)submitted monthly to address an Imminent Hazard. r ii.A Remedial Monitoring Report(s)submitted monthly to address a Condition of Substantial Release Migration. r iii.A Remedial Monitoring Report(s)submitted every six months,concurrent with an IRA Status Report. r iv.A Remedial Monitoring Report(s)submitted annually,concurrent with an IRA Status Report. c.Number of Remedial Systems and/or Monitoring Programs: A separate BWSC105A,IRA Remedial Monitoring Report,must be filled out for each Remedial System and/or Monitoring Program addressed by this transmittal form. Revised: 11/14/2013 Page 1 of 6 Massachusetts Department of Environmental Protection BWSC 105 Bureau of Waste Site Cleanup Release Tracking Number ' Immediate Response Action(IRA) Transmittal Form '. Pursuant to 310 CNM 40.0424-40.0427 (Subpart D) r - 26544 8.Submit an IRA Completion Statement. I—a.Check here if future response actions addressing this Release or Threat of Release notification condition will be conducted as part of the Response Actions planned or ongoing at a Site that has already been Tier Classified under a different Release Tracking Number (RTN) b.Provide Release Tracking Number of Tier Classified Site(Primary RTN): These additional response actions must occur according to the deadlines applicable to the Primary RTN.Use the Primary RTN when making all future submittals for the site unless specifically relating to this Immediate Response Action. r 9.Submit a Revised IRA Completion Statement. r 10.Submit a Plan for the Application of Remedial Additives near a sensitive receptor,pursuant to 310 CMR 40.0046(3). (All sections of this transmittal form must be filled out unless otherwise noted above) C.RELEASE OR THREAT OF RELEASE CONDITIONS THAT WARRANT IRA: 1.Media Impacted and Receptors Affected:(check all that apply) ir.a.Paved Surface r b.Basement r c.School r d.Public Water Supply r e.Surface Water r f.Zone 2 r g.Private Well r h.Residence V i.Soil r7 j.Groundwater r k.Sediments r I.Wetland r m.Storm Drain r n.Indoor Air r o.Air r p.Soil Gas r q.Sub-Slab Soil Gas r r.Critical Exposure Pathway r s.NAPL r t.Unknown r r.Others Specify: 2.Sources of the Release or TOR:(check all that apply) r a.Transformer r b.Fuel Tank r c.Pipe r d.OHM Delivery ry e.AST r f.Drums r g.Tanker Truck r h.Hose r i.Line r j.UST Describe: r k.Vehicle r 1.Boat/Vessel r m.Unknown r n. Other: 3.Type of Release or TOR:(check all that apply) Fa.Dumping r b.Fire r c.AST Removal r d.Overfill I—e.Rupture r:f.Vehicle Accident W g.Leak r h.Spill 1 i.Test failure r j.TOR Only r k.UST Removal Describe: r 1.Unknown r m Other: 4.Identify Oils and Hazardous Materials Released:(check all that apply) N-0 a.Oils r b.Chlorinated Solvents I—c.Heavy Metals r d. Others Specify: D.DESCRIPTION OF RESPONSE ACTIONS:(check all that apply,for volumes list cumulative amounts) r 1.Assessment and/or Monitoring Only 57 2.Temporary Covers or Caps W 3.Deployment of Absorbent or Containment Materials r 4.Temporary Water Supplies r 5.Structure Venting System/HVAC Modification System r 6.Temporary Evacuation or Relocation of Residents lr 7.Product or NAPL Recovery 1—8.Fencing and Sign Posting r 9.Groundwater Treatment Systems r 10.Soil Vapor Extraction Mr 11.Remedial Additives r 12.Air Sparging r 13.Active Exposure Pathway Mitigation System r 14.Passive Exposure Pathway Mitigation System Revised: 11/14/2013 Page 2 of 6 Massachusetts Department of Environmental Protection BwSC 105 Ll Bureau of Waste Site Cleanup Immediate Response Action (IRA) Transmittal form 4 - 26544Release Tracking NumberPursuant to 310 CMR 40.0424-40.0427(Subpart D) D.DESCRIPTION OF RESPONSE ACTIONS:(cont.) r 15.Excavation of Contaminated Soils. r a.Re-use,Recycling or Treatment r i.On Site Estimated volume in cubic yards r ii.Off Site Estimated volume in cubic yards iia.Receiving Facility: Town: State: iib.Receiving Facility: Town: State: iii.Describe: r b.Store T" i.On Site Estimated volume in cubic yards r ii.Off Site Estimated volume in cubic yards iia.Receiving Facility: Town: State: iib.Receiving Facility: Town: State: c.Landfill r i.Cover Estimated volume in cubic yards Receiving Facility: Town: State: r ii.Disposal Estimated volume in cubic yards Receiving Facility: Town: State: r- 16.Removal of Drums,Tanks,or Containers: a.Describe Quantity and Amount: b.Receiving Facility: Town: State: c.Receiving Facility: Town: State: 170 17.Removal of Other Contaminated Media: a.Specify Type and Volume: DRUMMING AND REMOVAL OF ABSORBENTS BY EMERGENCY RESPONSE CONTRACTOR 18.Other Response Actions: Describe: r 19.Use of Innovative Technologies: Describe: Revised: 11/14/2013 Page 3 of 6 Massachusetts Department of Environmental Protection gWSC 105 Bureau of Waste Site Cleanup Release Tracking Number y Immediate Response Action (IRA) Transmittal Form 1� Pursuant to 310 CMR 40.0424-40.0427(Subpart D) 4 26544 E.LSP SIGNATURE AND STAMP: I attest under the pains and penalties of perjury that I have personally examined and am familiar with this transmittal form,including any and all documents accompanying this submittal.In my professional opinion and judgment based upon application of(i)the standard of care in 309 CMR 4.02(1),(ii)the applicable provisionsof 309 CMR 4.02(2)and(3),and 309 CMR 4.03(2),and(iii)the provisions of 309 CMR 4.03(3), to the best of my knowledge,information and belief, >if Section B of this form indicates that an Immediate Response Action Plan is being submitted,the response action(s)that is(are)the subject of this submittal(i)has(have)been developed in accordance with the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000, (ii)is(are)appropriate and reasonable to accomplish thepurposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000 and(iii)complies(y)with the identified provisions of all orders,permits,and approvals identified in this submittal; >if Section B of this form indicates that an Imminent Hazard Evaluation is being submitted,this Imminent Hazard Evaluation was developed in accordance with the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000,and the assessment activity(ies)undertaken to support this Imminent Hazard Evaluation comply(ies)with the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000; >if Section B of this form indicates that an Immediate Response Action Status Report and/or a Remedial Monitoring Report is(are)being submitted,the response action(s)that is(are)the subject of this submittal(i)is(are)being implemented in accordance with the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000,(ii)is(are)appropriate and reasonable to accomplish the purposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000 and(iii)comply(ies)with the identified provisions of all orders,permits,and approvals identified in this submittal; >if Section B of this form indicates that an Immediate Response Action Completion Statement or a request to Terminate an Active Remedial System or Response Action(s)Taken to Address an Imminent Hazard is being submitted,the response action(s)that is(are)the subject of this submittal(i)has(have)been developed and implemented in accordance with the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000,(ii)is(are)appropriate and reasonable to accomplish the purposes of such response action(s)as set forth in the applicable provisions of M.G.L.c.21E and 310 CMR 40.0000 and(iii)comply(ies)with the identified provisions of all orders,permits,and approvals identified in this submittal. I am aware that significant penalties may result,including,but not limited to,possible fines and imprisonment,if I submit information which I know to be false,inaccurate or materially incomplete. 1.LSP#: 4303 2.First Name: DAMD C 3.Last Name: BENNETT 4.Telephone: 508-896-1706 5.Ext 6.Email: 7.Signature: DMAD C BENNETT 8.Date: 8/14/2017 (mm/dd/yyyy) 9.LSP Stamp: &fav Etta d+ Seal Revised: 11/14/2013 Page 4 of 6 Massachusetts Department of Environmental Protection BWSC 105 Bureau of Waste Site Cleanup F Immediate Response Action (IRA) Transmittal Norm Release Tracking Number 9 Pursuant to 310 CMR.40.0424-40.0427(Subpart D) R J - 26544 F.PERSON UNDERTAK NG IRA: 1.Check all that apply: r-a.change in contact name r-b.change of address 'c.change in the person undertaking response actions 2.Name of Organization: 3.Contact First Name: WARNER 4.Last Name: ENNES 5.Street: 2 GENERAL PATTON DR 6.Title: 7.City/Town: HYANNIS 8.State: MA 9.Zip Code: 026010000 10.Telephone: 508-7754607 11.Ext 12.Email: G.RELATIONSHIP TO RELEASE OR THREAT OF RELEASE OF PERSON UNDERTAIHNG IRA: r- Check here to change relationship rv-1.RP or PRP rV a.Owner r.b.Operator r c.Generator r-d.Transporter r-e.Other RP or PRP Specify Relationship: r 2.Fiduciary,Secured Lender or Municipality with Exempt Status(as defined by M.G.L.c.21E,s.2) -1 Agency or Public-Udhty•on a Right of-Way(as defined by M.G.L:-c.21E,s 50)) 4.Any Other Person Undertaking Response Actions: Specify Relationship: H.REQUIRED ATTACHMENT AND SUBMITTALS: r 1.Check here if any Remediation Waste,generated as a result of this IRA,will be stored,treated,managed,recycled or reused at the site following submission of the IRA Completion Statement.If this box is checked,you must submit one of the following plans,along with the appropriate transmittal form. r a.A Release Abatement Measure(RAM)Plan(BWSC106) b.Phase IV Remedy Implementation Plan(BWSC108) r 2.Check here if the Response Action(s)on which this opinion is based,if any,are(were)subject to any order(s),permit(s)and/or approval(s)issued by MassDEP or EPA.If the box is checked,you MUST attach a statement identifying the applicable provisions thereof. r 3.Check here to certify that the Chief Municipal Officer and the Local Boardof Health were notified of the implementation of an Immediate Response Action taken to control,prevent,abate or eliminate an Imminent Hazard. r 4.Check here to certifythat the Chief Municipal Officer and the Local Boardof Health were notified of the submittal of a Completion p P Statement for an Immediate Response Action taken to control,prevent,abate or eliminate an Imminent Hazard. 5.Check here if any non-updatable information provided on this form is incorrect,e.g.Release Address/Location Aid.Send corrections to BWSC.eDEP@state.ma.us. r 6.Check here to certify that the LSP Opinion containing the material facts,data,and other information is attached. Revised: 11/14/2013 Page 5 of 6 Massachusetts Department of Environmental Protection BWSC 105 '�. Bureau of Waste Site Cleanup Immediate Response Action (IRA) Transmittal Form Release Tracking Number Pursuant to 310 CMR 40.0424-40.0427(Subpart D) - 26544 I.CERTIFICATION OF PERSON UNDERTAIUNG IRA: 1.I, WARNERENNES ,attest under the pains and penalties of perjury(i)that I have personally examined and am familiar with the information contained in this submittal,including any and all documents accompanying this transmittal form;(ii) that,based on my inquiry of the/those individual(s)immediately responsible for obtaining the information,the material information contained herein is,to the best of my knowledge,information and belief,true,accurate and complete;(iii) that,to the best of my knowledge,information and belief,I/the person(s)or entity(ies)on whose behalf this submittal is made satisfy(ies)the criteria in 310 CMR 40.0183(2);(iv)that I/the person(s)or entity(ies)on whose behalf this submittal is made have provided notice in accordance with 310 CMR 40.0183(5); and(v)that I am fully authorized to make this attestation on behalf of the person(s)or entity(ies)legally responsible for this submittal. I/the person(s)or entity(ies)on whose behalf this submittal is made is/are aware that there are significant penalties,including,but not limited to,possible fines and imprisonment,for willfully submitting false,inaccurate,or incomplete information. 2.By: WARNER ENNES 3.Title: 4.For: WARNER ENNES 5.Date: 8/14/2017 (mm/dd/yyyy) )" 6.Check here if the address of the person providing certification is different from address recorded in Section F. 7.Street: 8.City/Town: 9.State: 10.Zip Code: 11.Telephone: 12.Ext 13.Email: YOU ARE SUBJECT TO AN ANNUAL COMPLIANCE ASSURANCE FEE OF UP TO$10,000 PER BILLABLE YEAR FOR THIS DISPOSAL SITE.YOU MUST LEGIBLY COMPLETE ALL RELEVANT SECTIONS OF THIS FORM OR DEP MAY RETURN THE DOCUMENT AS INCOMPLETE.IF YOU SUBMIT AN INCOMPLETE FORM,YOU MAY BE PENALIZED FOR MISSING A REQUIRED DEADLINE. Date Stamp(DEP USE ONLY:) Received by DEP on 8/14/2017 11:13:50 AM Revised: 11/14/2013 Page 6 of 6 8/14/2017 eDEP-MassDEP's OnlineFiling System MassDEP Home I Contact Privacy Policy MassDEP's Online Filing System D E PH, Usemame:DAVIDBENNETT Nickname:BENNETTDAVID Receipt Forms Attach Files Signature Receipt Summary/Receipt print receipt Exit Your submission is complete. Thank you for using DEP's online reporting system.You can select "My eDEP" to see a list of your transactions. i DEP Transaction ID: 944837 Date and Time Submitted: 8/14/2017 11:13:50 AM. Other Email Form Name: BWSC105 Immediate Response Action Transmittal Form j RTN: 4-26544 Location: RESIDENCE Address: 2 GENERAL PATTON DRIVE, HYANNIS, Person Making Submittal , WARNER ENNES 2 GENERAL PATTON DR HYANNIS, MA 026010000 LSP LSP #: 4303 LSP Name: DAVID C BENNETT Person Making Certification WARNER ENNES , Warner Ennes j Ancillary Document Uploaded/Mailed BWSC-105 Q.1306 - IRA Status Report- Uploaded (BEA17-11006 IRAS I 8.2.17.pdf) My eDEP:, ii MassDEP Home Contact Privacy Policy MassDEP's Online Filing System ver.14.0.2.0©2017 MassDEP https://edep.dep.mass.gov/Pages/PrintReceipt.aspx 1/1 j . Town of Barnstable *Permit 1 � � X- ERMIT Regulatory Services �e 6 mon hom issr�d * switxsresi,E, +' 2(�'Z Thomas F.Geiler,Director Building Division TOWN OF BARNSTABLE Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 EXPRUS PERMIT APPLICATION — RESIDENTIAL ONLY qa/0 q Not Valid without Red X-Press Imprint Map/parcel Number Property.Address �' OZE: /::&G A'I S Residential Value of Work 1/,044kr 7 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name _ LV�'.S Telephone Number �SU�S J �F ' go"C- Sr•Apf-0%e"Co E- Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 751 -9 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Jli�14125 Workman's Comp.Policy#- WC b l`j �j(oFS(O_5 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will betaken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors_ ® Replacement Windows/doors/sliders.U-Value AUa=L _(maximum.35)#of windows 1c?t�©p 7Vo C-r coss Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and 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 I ent Contractors License&Construction Supervisors License is required. SIGNATURE: Of Q MPFILESTORMS\building permit formslEXPRESS.doc Revised 053012 s BARNSTABLE, 1639.MA SS. of Barnstable �ArEO MA'l a Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder T, rie,r , as Owner of the subject er pro 1 p n' hereby authorize t,)eS Cut e✓S ,,, to act on my behalf, in all matters relative to work authorized by this building permit application for: a � I �a r '7Ynnh�S /VI� 0261 (Address of Job) Ce Signature of Owner Date W e r LM28A i . r— _ Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\[,Dea]\Microsotl\Windows\Femporary Internet Files\Content.Outlook\DDV87AAZ\EYPRESS.doc Revised 072I10 - - 1 .. . . .. .. . . . ... . . . .... . . . . . . .. .. . .. .. 0. 14 C� pa zs . ors ;�. '� : �° �:.�" .h �, l+ Wr�+ ',� �, i�•�. o�+. 'gad �: M r� fJ ' .'g.1Ajpjy�l �:�� yq � H 0 .,_� . . V•.; . : �.'.� er]. itii .,.may � � .::C ry th-r� .� i^e rp�: ��'+ .N � � � '` :� . rt I .� . ��:'w� � .i� '`ppia? � .�•.,, +� .� � .: '1 �: - � a� � :$51 � "'S.� �. �'� C4''f-Q�*� �7 ..�.A F�. Y/Yl��p� �..� L: .� �_ �p� f�p \ /. i •y� ,y�q. ypY .Pe,_. �acy� .,.,1.' .�'4 .�. �� Cse i]'1,�. �!+ ��F`7 ':�-C'e l4ai � a��.� �. �n1s L" `/�\ �• yam", yam'. w.:"�..�'� (��,�G� - '� � v"iA � �'. � _� .. SA tn .rd ,,,, •. i�, as .� ,�`� �. � .' ` ua .'tea A . ❑ 0 ❑ 0 ❑.0 ❑ 0 " v wm p9 . . . >: I :1 • The Corflm On Wealth,of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston;AM 02111 www-mas Workers'Compensation Insurance A£ day t,Buil t g/Cotatrae4ors/ leciricians/P�um =TaM !�!� bers Please Prinf T 'bl snesslorga,iization,7ndividual): ` v 71 Address:& CitY/State/ j -J Zl�. ".i"P YL'i 'hone g:tS' 0 �,2�-e�7 Are you an ezn to er • I p Y Check the appropriate box_:❑ I am a enployer with_ 4. f� = i t Type of project(required): employees(full and/or pa $ gave aired the ub-contrac ors ntractorandT ! ' i 5. ❑New construction 2• I am a sole proprietor or partner- listed on the attached sheet.} 1' 7- ❑Remodeling ship and have no employees i working r These sub-contractors have � 8. ❑Demolition for me 111 any capacity. workers'comp.insurance. !!! [No workers'comp,insu ante 5. ; i 9. ❑Building addition required] ❑ We are a corporation and its 1 officers have exercised their I0❑Electrical repairs or additions 3.❑ I am a homeowner doing ail work right of exemption per MGL I i.�plumbing repairs or additions nyself.[No workers'comp. C.152 :; insurance required.]t § ,4),and we have no I2, goof repairs ern ees. ' Y [No workers' comp.insurance required.] 13•❑Other `Any applicant That checks box i l mustatso fil!cut 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. Contra that c.'izck this box must attached an additional sheet showing the name ofihe subcontractors and their workezn comp.affidavit indicating such I am¢fz employer that is prov:dirrg worlrers'compensation insurance information for my emo,o},ees �y }p Below as the o ' and'oh site Insurance Company Name: Policy#or Self-ins.Lic. Y: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25 A of MC-L c.152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 ardor one-year irnprisonnert,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 statemeat gay be forwarded to the Office of or insurance coverage verification. Investigations of the DIA f I do hereby certi under the pal-xe and penalties jperj✓ry tr f Siena { at the informatioiz provided above is it a and correct ture:' � Z�< ✓ Date Phone 7h t��, ,P -1 7, / Of ficial use only. Do not write in this area,to.be completed by city or Town offci¢L City or Town: ?ermit/I,icense Issuing Authority!circle one): L Board of Health 2.Building Department 3.Cif/Town Clerk ' Electrical 6.Other t a. , _fnsaector 5.Plumbing Inspector Contact Person: Phone µ: ✓le :1 _ Office of Consumer Affairs&Business Regulation i License or registration valid for individul use only h(`�OF, r�IiOME IMPROVEMFi�T CONTRACTOR before the expiration date. If found return to: _Mt Sk Office of Consumer Affairs and Business Regulation Registration 1 gggg Type, 10 Park Plaza-Suite 5170 Expiration 101-.872r0.1.3 Supplement Cord Boston,MA 02116 LOWE'S HOMES CEN i ERS INC AMBER DRAHT ,,, t t 136 TURNPIKE RD:.S6ITE;=100 SOUTH BOROUGH,V.6-1-112 — -- l)ndersecretary of slid without signature _- e , €t�cnsumerfairx` �!'rc w7 �. —r�� r .a 114E IhgPROV $ $ads toss` e; ,s - _� x 3 , gistration EMEN r COyTPx Yicrataon valid for aar 4CTOF� a 4 c ; d�vadul use only a Jy �OggI I tlon date If found return,#o srpiration 12/7/201 Nct�INETF, DBA KEND 2 �� "�, � .r VA, and Busmesc Regul Ilion 9 ALL tta' jT � tte5170 Ga V'ELD KEh� LLQ. r `)' EN:pL n rr ter AIRJ;f1�EN MA 02 i vx 719 I s LRnder • � i SA �_ {, y t � aims� '; �1 � '� h�:tictt. i3a I�as fioaent (if Ptjl)lac s of of 13a.61Clua C t*aal:ations,tall} S;txrttlu— �a ljDEr'Yi�C3r c rr•.Gt:: Gg 75153 ;,,eLL fin: atEhNETH.D KENDAII K 5 WEEDEN PLACE FAIRHAVEN,.MA;02719 ONE Exiaiaata©n M-2001,3� - Lowe*-2376-W&4b 09kc U21 Cenbary Hwy.Wic 100 Wes,Ma 02571 STORE NUMB£-: 2376 LOWE'S HOME CENTERS, INC. PAGE: 1 BUSINESS DATE: 09/11/12 WMA 2376 DATE RUN: 09/11/12 REPORT NUMBER: ISZRO02A - _ - INSTALLER INSURANCE INFORMATION RPT TIME RUN: 13:13:09 , INSTALLER VENDOR # LIABILITY AUTOMOBILE WORKMAN COMP 4 SEASONS CARPET WORKSHOP` 27654 05/09/2013 06/08/2013 12/09/2012 A-LINE HOME IMPROVEMENTS 30777 05/18/2013 03/05/2013 - - 06/12/2013 AB 63:*ONS FENCE _ 89121 03/21/2010 EXPIRED 06/10/2010 EXPIRED, 01/28/2010 CANCELLED ABOVE & BEYOND HOME IMPRO 66077 10/30/2011 EXPIRED 03/13/2021 EXPIRED O1/OS/2012 EXPIRED ADDARIO PLMBG MTG & DRAIN 69895 09/12/2009 EXPIRED. 09/12/2009 EXPIRED 09/12/2009 EXPIRED - ADDITIONS PLUS 61663 02/18/2011 EXPIRED 01/14/2012 EXPIRED 04/21/2011 EXPIRED AMARR COMPANY 56870 01/01/2020 01/01/2020 01/01/2020 BARROS COMPANIES 'INC 87674 12/31/2012 12/31/2012 03/20/2012 EXPIRED BASCO MANUFACTURING CO 41921 07/01/2013 07/01/2013 02/28/2013 BAY STATE FENCE CONTRACT'0 655S1 01/28/2012 .EXPIRED 12/01/2011 EXPIRED 08/25/2012 CANCELLED BAY.STATE LUXURY BATH INC 51339 12/13/2010 EXPIRED 63/22/2011 EXPIRED 12/31/9999 BBL HOME IMPROVEMENT LLC 20647 04/07/2013 04/10/2013 , 04/25/2013 BEST FLOORING LLC 66894 Od/19/2009 EXPIRED 04/19/2009 EXPIRED 12/31/9999 INACTIVE BLINDS OF CAPE COD 21759 04/11/2013 06/15/2013 Od/01/2013 ,30YD PLUMBING & HEATING 32780 01/02/2013 03/05/2013 12/31/9999 BUILDERS INSTALLED PRODUC 22612 10/01/2012 "WARNING- 10/01/2012 ''WARNING' 10/01/2012 *WARNING' C AND C NORTH AMORICA INC 85564 01/01/2020 01/01/2020 01/01/2020 CARPET MAN, INC, 41710 05/01/2013 08/15/2013 05/16/2013 CASCO CONSTRUCTION INC 86718 11/09/2009 EXPIRED 12/19/2009 EXPIRED 12/13/2009 2XP;R2O CASTLE CARPET CO 28732, 11/04/2012 05/03/2013 10/25/2012. - *CLASSIC MANOR BUILDERS, I 53669 01/01/2020 01/01/2020 01/01/2020 CLEARVIEW HOME IMPRovEMEN 19095 02/04/2013 - - 02/08/2013 12/31/9999 COLONIAL FINISH 58419 08/23/2010 EXPIRED 05/11/2011 EXPIRED 12/31/9999 COMARY, ZOLTAN - 57149 10/18/2012 02/15/2013 12/31/9999 COMPLETE INSTALL SERVICII'S 28846 05/15/2013 _ 09/30/2012 *WARNING' 07/27/2013 CORRAO ELECTRIC CO XNC 43436 12/30/2012 12/30/2012 10-/10/2012- -WARNING* CORREIA CUSTOM PENCE 31607 03/11/2013 03/16/2013 03/16/2013 CUDMORE, ROBERT N 94539 01/22/2013 08/15/2013 12/31/9999 D LEVESQUE BUILDERS 38233 02/03/2013 09/09/2013 06/24/2013 D'ITALIA & SONS 32567 Od/20/2012 EXPIRED 12/28/2011 EXPIRED 05/03/2012 EXPIRED DISCOVER MARBLE & GRANITE 49528 09/17/2012 .-WARNING* 09/17/2012 'WARNING- 09/17/2012 'WARNING' DOYLE WOOD FLOORING LLC 66397 12/27/2012 03/14/2013 02/07/2013 DURO SLItD, INC.. 55905 01/01/2020 01/01/2020 01/01/2020 DYLAN CLARK PLUMBING INC 21937 05/10/2011 EXPIRED OL/.16/2011 EXPIRR.D 05/22/2011 EXPIRED E-1. DUPONT CO- INC 52177 01/01/2020 01/01/2020 01/01/2020 ELITE FENCE INC 93947 06/od/2010 EXPIRED 04/14/2010 EXPIRED 04/01/2010 EXPIRED FAMILY FLOORING CENTER IN 37500 03/04/2013 11/19/2012 11/14/2012 FARIA PLUMBING& HEATING 89475 01/24/2011: EXPIRED 06/24/2010 EXPIRED 11/21/2010 EXPIRED FD JOHNS ELECTRIC INC 42793 10/01/2012 ''WARNING- 10/01/2012 'WARNING- 08/24/2013 FORMICA CORPORATION 95189 01/01/2020 01/01/2020 01/01/2020 GCI BUILDERS XNC 38295 05/28/2012 EXPIRED 06/03/2012 EXPIRED 05/28/2012 EXPIRED GREAT IN COUNTERS INC 87341 08/24/2013 08/24/2013 08/24/2013 HEARTLAND INDUSTRIES 57673 01/01/2020 01/01/2020 01/01/2020 REARTLAND INDUSTRIES INC 73706.. 01/01/2020 0.1/01/2020 01/01/2020 H ARTLAND PLAY SETS 25772 01/01/2020 01/01/2020 01/01/2020 HEARTLAND/BACKYARD PLAY S 64138 01/01/2020 01/01/2020 01/01/2020 HULME FENCE AND DECK IN 54585 04/15/2011 EXPIRED 03/14/2011 EXPIRED 04/11/2011 EXPIRED JMT CARPENTRY .56400 11/15/2012 09/08/2013 11/19/2012 JOHNS MANVILLE . - 89923. 07/01/2013 07101/2013 07/01/2013 JT PLUMBING .AND BEATING 3124E 03/15/2012 EXPIRED 03/09/2012 EXPIRED 12/31/9999, XEL KOR INC 42453 01/19/2013 03/17/2013 02/21/2013.. LAMINA:'E FLOORING SPECIAL 43S39 10/10/2012 ` *WARNING" 08/12/2013 07/07/2013 t_ - Town of Barnstable y � Regulatory Services Thomas F.Geiler,Director E `' '^ ` MASS. 'g Building Division ►`e Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 .,n www.town.barnstable.ma.us 1 Office: 508-862-4038 Fax: 508-790-6230 PERMIT# at 0c�- FEE: $ SHED REGISTRATION 200 square feet or less Location of shed(address) vill ge Property owner's name Telephone number Size of Shed Map/Parcel# Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30 &3:304:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A . PLOT PLAN i -orms-shedreg REV:05201 i Man Page 1 of 1 Town of Barnstable Geographic Information System New Search Home Help Parcel Viewer Custom Map Abutters Map size ® Zoom Out ,In tp el (9§_7PG Map: 292 Parcel: 096 - Full rR ry Property Location: 2 GENERAL PATTON DRIVE Info 292021 4` a 355 292020 ' Owner: ENNES,WARNER a343 2941 8 a 1 Location Information ' 29209 as Map&Parcel 292096 C Location 2 GENERAL PATTON DRIVE Y 29N n Acreage 0.19 acres �w Current Owner _ � . Mailing Address ENNES,WARNER ROSEMARIE ENNES ' 2 GEN PATTON DR 202098- HYANNIS,MA 02601 k Q y a2 292121 k4 p40 Appraised Value(FY 2011) Lull I Extra Features $3,100 �Q I ' 4 t� Out Buildings $1,100 k4 ' Land $38,400 �'�• Buildings $127,900 292124 292120 Total Appraised $170,500 a lS a 39 r�1' Assessed Value(FY 2011) '492125 - g et 209 3g Extra Features $3,100 �s4{ 3 202135 4 Out Buildings $1,100 _ '�`•5. a3a_ � Land $38,400 ^ Buildings $127,900 k 5 Set Scale 1"= 54 ._ I �Aenal Photos I '. I MAP DISCLAIMER Total Assessed $170,500 (� Copyright 2005-2010 Town of Barnstable,MA All rights reserved.Send questions or comments to GIS BarnstableMA v1.2.4238[Production] http://66.203.95.236/arcims/appgeoapp/map.aspx?propertyID=292096 10/12/2011 TOWN OF BARNSTABLE BUILDING•PERMIT APPLICATION- Map Parcel 0l c Rd Permit# ,3 7 (,o /� /�L �Z� a Health Division d � � � � Date Issued /�2 •Conservation Division �qm" 1,9 Q Fee Tax Collect �i Treasure %a SEPTIC SYSTEM MUST BE Planning Dept. INST�'tM PU, CE NI Date Definitive Plan Approved by Planning Board E OMAND 1j@ EG ONS Historic-OKH Preservation/Hyannis Project Street Address Village_ � 1//�/)/U I S Owner LQ-f ENN�.�_Address ls�/�i 2 �i P�j Pc /i 'Pk (/ Telephone S�Oc� WY �460 7 Permit Request -3 Se6Uoo0 oA)&om QA), t jZ(!n 9 C-nA) Gic �n �le/4T atif/i�6iN C� Cte6T—A c/9 c t t y Square feet: 1st floor:existing proposed/ -2nd floor:existing proposed Total new Estimated Project Cost 10,ro 0 Zoning District Flood Plain Groundwater Overlay C� Construction Type a Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. i Dwelling Type: Single Family @� Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes d-No On Old King's Highway: ❑Yes 0' 0 Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area q.ft.) Basement Unfinished Area(sq.ft) Number of Baths. ull: existing new Half:etFloor new Number of Bedr ms: isting new Total Room Count(not including baths): existing new om Count Heat Type and Fuel: ❑ s ❑Oil ❑Electric ❑Other Central Air: ❑ No Fireplaces: Existing New isting w d/coal stove: ❑Yes ❑No Detached garage: e ' ting ❑new size Pool:❑existing ❑new size rn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes S<01 If yes, site plan review# Current Use R C-S 10<NT14 / Proposed Use e-S f (A)1 tag BUILDER INFORMATION Name /) Oy 1216161V Telephone Number / - , ( 3%J —6 / 0 Address �_���OrM( ��� License# 6 17 U 7 M 4& `(3a Home Improvement Contractor# f d f �a� Worker's Compensation# T— 6609 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO /00 07-a ST' SIGNATURE d /: ter, G;- DATE — / z7/ �700F N FOR OFFICIAL USE ONLY F PERMIT NO. n DATE ISSUED MAP/PARCEL NO ., ` �' j "`ter �• ,� ' "� 4 ` 4 f,} ,,, t t ADDRESS � u' 'VILLAGE OWNER Iry _7 DATE OF INSPECTION:- FOUNDATION FRAME INSULATION FIREPLACE ', , �' f � � `• , r -� - F- --' - T ELECTRICAL: - ROUGH FINAL PLUMBING: ROUGHn Rb FINAL GAS: ROUG FINAL FINAL BUILDING DATE CLOSED OUTca ASSOCIATION-PLAN NO. WQ -? cl t of IME A The Town of Barnstable • anaxsrAEM • 9� H019. ASS. �0 Department of Health Safety and Environmental Services jOTEo ram" l: f Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only i 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: .c - $_QA SZ'�D SOA)A 0aQJ_Est.Cost Address of Work: (TCAI CK 4 7-2/v d)A l V nn Owner's Name UJe/./Vl)s- 4 se IM4iz1e A)eJ _.- Date of Permit Application: d `,/ 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: 12 Z�, a,:=� .5-1 �. D to Contractor Name Registration No. OR Date Owner's Name 8E:5E:L L 666 L'LZ'AeW u6P'96da6Zwkq!Ignd�sdeweysV-- meaam0rwmlmn6wwrim at .lwmanwrm9 # d�1W Y66156aN5aDMM91lmwAal—.l xNM=nreIDwa Z 6 Z am-.l Nan Nmr'ms—a wm no ml MEN 0 s6 TMN6961IMEoIaNnwrN.�=dwuxraromw mtw6 maw 6961 Now armaM 1mm mxra,o6W tar aamM Y64`rou SNOx17a13nam Or AHN S90MN i lllkmad �� 40 9wllwNdSlb9171NdrB ANd Ar Sallf l HRw 91m'alw -��" Z6 Z dV M x� N .# 9 # . 1333 06=H)NI l- 06 Ol 0 U��3ims W Z6 dlxn swauas xou ara rwaodxl 7lx9oa9•a o�d _ dvw ills �--- )mgpay o 1x911 am m w 0 sNNmnwamis f Z CO Glom „0 dSmd o 910 m ® dawn e I aarmxnmm dtlr6 smossassa war/maw/room �awmus/s9xxnlne =d 6Z 'd r W roam,xDaoa Z dV ' 100d 9xWAM t§ '�� ��.• , SronLLOYma lwa � _ / /� . 7wMSNINwdaa r —� DN 7wM3N 01s __ ____ /! # xMHO dmds •'x unanctim mmJol `-- / Mn anonmD mod a 6 aaewnxasnox I L \ aamwllN 13)ard� saxn � arw \ `` U Z ddW i / mza T / wmt/rovata r avoa Nm3nClarr.�-- 1m19d---'� SltlMamam >" mr0a aanm OI doa9md 5 # rnn xsarw 7j 6 Z d W P aaasanx ao mar m xsnmmdoa9m o 7/Z d YH WSaaaasnmlwnao co tfJ� atlmarvd MOM 11o9 dm o w Reft musspqusk mN INN NN:N ON3931 MONd1S >rfktul �i}yPt`'r t: ��Cj`ylk�A�f ay���sPYj•"!,7r" - _ . :Y TTT the Cointnotrive( /l/t 11/ ll'itl.ssltch its tilts than 'Triiyl ' /, /fit ttrltrrilrtl t�/'/tldli.srrinl Accidents f`. —_ yt, 01t1ce ofInvest1galtons /00 fl" , rtshin•aro►r Srriv_r .r gat Y «isli?M° � ' Bosrott, Mass. 02111 Workers Compensation insurance ,\ffidavit � t t, P{t t s ,ri� }'�.ltttf �'+)� "�t��•�yl�ytli,GF nil a /�' �` tw k Ftir yp aA ..: 3t �t �{ t t' � '• -hone� .Sam-39'3-6ca/Ga n,I m 3 homeowner performing all •work myself. : r"I'.•f`srtt a sole proprietor and have no one working in any capacir/ - �'( am an employer providing•workers' compensation for my employees 'working on -his job. a�nanO..name: f 4 /06 • y`'��.e_..� _ old.�Lj �i��c� f'YJ Q � $Fa�',.� `,�'Y ' ,honey• '57�-.,��- oYG� " �� P{ � a{'_, s t rT��{;ify11, h.: :. ,/ / >:.�. y.+.a.�. .ti ...•,...�.a„':. r 10 rence to. T/i� r�1�'��,v�U 2olicv - y}° '} {1art1 a sole proprietor.general contractor,or homeowner(circle ones and'nave hired he contrarors listed below who hav following workers' compensation oolices: f, f { { ' is P s�dr•ss' � ne nsurJnce eo policy 4 �f4t t — t'1 { 7 t 1 [offio....v n1me• r ER1 " ', ''tit w h ar .� P``. ��;� =is." phone�• 5♦ y Sa 1Co. L.ry ;J s y�'F 1,Iurt;to Ileure coverite is required under Section:Sa or.%IGL 13:can lead to the impotillon of criminal penalties of it not up to S1300.00 and/or '„ �'Annt/?�P1i Imprisonment ss N'tll ss civil ptnalties in the form of s STOP WORK ORDER sods fine of S100.00 a dsv s�aitus me. I uadenned teat� { ,L 'j �'Ur cnMi-if this ttalt+"tief ma. he forwarded to the Orrice of Invesrit!suons of the OL►for coverait•tnncsdon. 4f s�rJrjO , l Id ittrfby cerri/'i•under(ht point and penabiet of perfury that the information provided above is true and correct a , d t}.spytr _ 3 SAS l � t�4R7 i t ' • ., a Co•T..�_ Phone i '� u(icHl dsr ttnl� do mn wirier in this sets ro be completed by city or►ovn.)MCul { lt.... Itrmlvlictnst a ^9uJdin�Department a GLicennnt;130 ` y; �l )eleelmen't 0f11ce nte of rmmrdrtle rr�pnme r�required <t QileNth Otvorrment Y . �. Other .fine jet perinn: phont 0: _-_ rl • 3nJ•�°fie 4` Y 2 ✓ , a _ t - r ` l: W .a *'5?L+'z,41t In accordance with the provisions of MUL c 40, S 54, a condition of building Per Number is that debris resulting from this project will be disposed of in a properly licensed solid waste disposal facility as defined by MUL e,111, 8150 A. .. t 1�$�5,1' ��1.y Ul 4�u�° -4sYhseVaA,µ/ - e The debris will be disposed of in: t z:z 3 }N�Ir (Name and location of facility) a< , (Signature of permit applicant) f Date :, . 7 R , t• t Y JllM1�t�NSY*'r ePity.r it _, Wj i�rk7n j ss� r f rt ,r Z R uf�xrJ�s =[w���xs�"J� ;'r'. .. • ! :.R A �� qq�j t�{4£ ;. ter" srs{•�rr� ,�t�}'R�N x, r `'}'__ _ - z- Yt r l a�,ri��r j�,p �+, --., '- �•t. _ _ 'Y �xy`�E n Al j R - •<T s 1q f., .. -: -,. .a 'f ,? •;` .t ,vt i at ;.,r a,a'£ 1...F?. .f t.. er. '' •ax C 1- co p p m m in m r cn -� D _ - r x m D U) y•'•D r yam. rn �., ;r n �. Z O Z,. m.. O 1 Z' SPAN rn mZ0 Z O O « '9 O O . O v m 3" HC PANEL WITH ALUMINUM H-STIFFENERS OR O N O C L7 m\O C) _ 3' EPS PANEL WITH ALUMINUM H-STIFFENERS (SEE NOTE 4) N0O � -mO� O rz o Dv . O0Z coil ' O Z coO m �� O p0 Z orr `{ n O O SEE NOTE 3 Z O TTI mm n� n Ul o V) O rn O cn Z. N �O. 0 rZ ` I 6'-a ';rYaicA� o F D D � ow Z Z x >o� D r N N ' i• O , 71 C) Y 1O m C) r O 713 j m Oc T m� D e 0 i N Z {. r n O r i m Dn z N x Z m LA O m H C—. --I m c _O C Z O 0 V) m i =m ox r1 Z n s k �" m ... .. .... a .r. .. w e • w.%'•k:'!.F-S.z '':. ..i*.^ ra ' : ,.r" .- : :: ^y, ,. .tom., .. -�t� ,•a> '� sr � r e .f 's- .x `.�- ,� y.... "p. ;.. .Y' lh.. - x, .. M.: .�... w�.r-e..+.., v...R.i .;,;.,`.. , ,.i. p5'-'.4+ :�. ., .'1' M. .,•-� '"-_ 4.- '.: Ar'F d` i:�%MNk W`S�."# .Y,:� �6: � .. � t x-.. .;"•i.. ;:. ...,, '4:y r a `m a x { "A' `` �s t,r + ,�x yM y!�(r �. . 5.0.2" ALUM. ROOF MOUNTING RAIL CONNECT TO RAFTERS a, RAIN CUTTER } - ALUM. SLIDING DOOR TEMPERED GLASS .1/4" EXTERIOR PLYWOOD 1O 2.10' JOISTS AT 16' " I • SLIDING DOOR ON SILL °1 �Y BLOCKING PIECES AS . SECTION W/ DOOR FLOOR I EOUIRED FOR ATTACHMENT EXPANDER FIXED TO DECK /-- F ROOM TO DECK AS pcR - MANUFACTURE'S SPECIFti :aONS FLOOR S) 2.10' GIRDER TYPICAL 2r1L1 IEDCER W JOIST HANGERS At MID O I�SECURE TO HOUSE-WILL - ., 4'd' PRESSURE TREATED POST I AT MID`.:PAN _POST ANCHOR BASE 1WO MAX. CONC. FOOTING BOTTOM OF FOOTING 10 RF.Sf ON '?' UNDISTURBED SOIL BELOW FROST LINE STUDIO ROOM SECTION A-A(WOOL)FLOOR) NOTE5 FOR FIGURE 50-1 AND 50-2 1) 5TRUCTURAL MEMBERS SHALL COM PRISE 6065T6 ALUM INUMEXTRU51ON5 SUPPLIED BYCPAFT-BILT MANUFACTURING COMPANY 2) ROOF PANELS SHALL CON515TOF CARDBOARD HONEYCOMB(HC)OR EXPANDED POLYSTYRENE(EPS.)PANELS 5UPPLIED BYCRAFT-BILTMANUFACTURING COMPANY. 3) MAXIMUM 5PAN5 OVER DOORS SHALL BE 87'. 4) ROOF PANELS SHALL HAVE A MINIMUM FACTOR OF SAFETY OF 2.5 AND SHALL _ DEFLECT LE55 THAN 5PAN/120 ATTHE DESIGN LOAD. 5) ALL 5TRUCTURE5 SHALL BE INSTALLED ACCORDING TO THE MANUFACTURE'S COMPANY RECOMMENDATIONS. 6) LOADINGS: ' ROOF: SNOW LOAD 35a'SF~ r WIND LOAD 20 P5F P DEAD LOAD 2 P5F WALL: WIND LOAD 20 P5F DECK: LIVE LOAD 40 P5F ESTIMATED DEAD LOAD 10 P5F 7) TIMBERD.E51G�_SSES ' SPECIES SOUTHERN PINE NO.2 BENDING 5TRE55 Fb 140O P51 (REPETITIVE) COMPRESSION PERPENDICULAR TO GRAIN Fc 565 P51 SHEAR PARALLEL TO GRAINFv 901,151 §_ COMPRESSION PARALLEL TO GRAIN Fc 975 P51 MODULUS OF ELASTICITY E 1,600,000 P51 ALL TIM13ER5HALL13EPRE55URETREATED 8) -5aLB_EARIN.G_.CAEA_Qa- FOOTINGS SHOULD REST ON SOIL HAVING A MINIMUM BEARING CAPACITY OF 2000 P5F. 9) F_ODM.G_5 FOOTINGS 5HALL BE LOCATED BELOW FPOST LINE.FOOTINGS 5HALL BE SIZED ACCORDING TO THE APPLIED LOAD AND LOCAL 501L BEARING CAPACITY.CON ETE" 15TOHAVEAMINIM THOF3000P51AT28DAY5. etterliving` v A T 1 0 R o o M s sludlo4c.dwg eng1em50sty-1 7 tt.. RONlip lawo Al ' a TYPICAL OPENING EXISTING' as > p HOUSE WALL �z . p a - 0 i... N Z _ 7 p yf ` W e v j /,. 174 a W 4 n X ILI 3" SEE NOTE 3 SEE NOTE 3 }' 4 ' 5TUD10 ROOM FLOOR PLAN ,. r f S 1' t � 4 i RAIN .GUTTER ALUM. PANEL HANGER CONNECTS TO WALL STUDS - EXISTING HOUSE aR ALUM. SLIDING DOOR 2 TEMPERED GLASS ao } SLIDING DOOR ON SILL SECTION W/ DOOR FLOOR 4.. CONC. SLAB W/ 6x6xW2.9xW2.9 TYPICAL EXP. JOINT EXPANDER FIXED TO CONC. f FLOOR APPROX. GRADE jY." sYr . L f ! 4 8 +.=THICK POURED CONC. FTC. � dec- BOTTOM.OF FOOTING TO REST ON UNDISTURBED SOIL BELOW FROST LINE 5TUDIO ROOM SECTION A-A(CONCRETE FLOOR) 5EE NOTES ON P AGE 5.0.2 apt :t 4 t3etterlivin� L}t PATIO ROOMS �sludio4a-12.dwgsIudI4b.dwgjen 1 ,2 EV 70-51\11� y� , 2. = 5.0.2 I OEM _ - ALUM ROOF MOUNTING RAILI - - CONNECT TO RAFTERS RAIN CUTTER ALUM. SLIDING DOOR .1/4" EXTERIOR PLYWOOD TEMPERED GLASS - '� 2.10' JOISTS AT 16' - SLIDING DOOR ON SILL 12+ BLOCKING PIECES AS . SECTION W/ DOOR FLOOR I EOUIRED FOR ATTACHMENT - EXPANDER FIXED TO UECK �— F ROOM TO DECK AS f?sR ANUFACTURE'S SPECIFIL�.;IONS FLOOR—_._...... 2■10 II� (J) 2+10" GIRDER IVPII:AL / 7.10 LEDGER W JOIST NANCERS 1 BRIOC.INf, SECURE 10 NOUSE•WALL IYPIfiAL 4"w4" PRESSURE TREAFED POST4I AT MIDST,N O—POST ANCHOR BASE - IB'0 MAX. CONC. FOOfIFIf, BOTTOM OF FOOTING TO REST ON y UNDISTURBED SOIL BELOW FROST LINE - 5TUDIO ROOM SECTION A-A(WOOD FLOOR) NOTES FOR FIGURE 50-1 AND 50-2 1) 5TRUCTURAL MEMBER5 SHALL COMPRISE 6063 T6ALUMIN1JM EXTRU51ON5 SUPPLIED 13YCRAFT-F3ILT MANUFACTURING COMPANY. 2) ROOF PANEL5 5HALL CON515TOF CARDBOARD HONEYCOMB(HC)OR EXPANDED POLY5TYKENE(EP5)PANEL5 5UPPLIED BYCRAFT GILT MANUFACTURING COMPANY, 3) MAXIMUM 5PAN5OVER DOOR5 5HALL BE 87'. 4) ROOF PANEL5 5HALL HAVE A MINIMUM FACTOR OF 5AFETYOF 2.5 AND 5HALL DEFLECT LE55 THAN 5PAN/120 ATTHE DE51GN LOAD. 5) ALL5TRUCTURE5 5HALL 13EIN5TALLEDACCORDINGTOTHEMANUFACTURE'5 COMPANY RECOMMENDATIONS. 6) LOAD_INO-5. ROOF: SNOW LOAD 35 P5F WIND LOAD 20 P5F DEAD LOAD 2P5F WALL: WIND LOAD 20 P5F DECK: LIVE LOAD 40 P5F ESTIMATED DEAD LOAD 10 P5F 7 TA&DER 2E5_IG..N_HE55E5:. 5PECIE5 SOUTHERN PINE NO.2 BENDING 5TRE55 Fb 1400 P51 (REPETITIVE) COMPRE55ION PERPENDICULAR 1 TO GRAIN Fc 565 1`51 u a SHEAR PARALLEL TO GRAIN Fv 90 P51 n 9 COMPRE5510N PARALLEL TO GRAIN Fc 975 P51 MODULUS OF ELA5TICITY E 1,600,000 P51 ALL TIMBER 5HALL BE PRE55URE TREATED 8) -5 ILB-EARIN.G_CAPA_CTTY- . FOOTING5 5HOULD RE5TON 501L HAVING A MINIMUM BEARING CAPACITY OF ' 2000 P5F. 9) FOOTIN 5: , FOOTINGS 5HALL BE LOCATED BELOW FROST LINE.FOOTINGS 5HALL BE SIZED ACCORDING TO THE APPLIED LOAD AND LOCAL 501L BEARING CAPACITY.CON ETE 15 TO HAVE A MINIM TH OF 3000 P51 AT28 DAYS. BP P A T 1 0 R 0 0 M s studlo4c.dwg eng1em50sty-1 7 1 = i .C.- c G C 42, \ a a--s .+ � • - � cam.) _ G � � m O�� �} i CR 0 Town of Barnstable *Permit Expires 6 months from issue date - O3u SS5 R; +BRA- B e� .. _..,. y� T Regulatory Services Fee Cos Thomas F.Geiler,Director 0 r T 2 7 2009 I� Building Division 1 OW�i OF gA1I�STAELE Tom Perry,CB®, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDEI TEAL ONLY Not Yalid without Red X-Press Imprint Map/parcel Number n Property Address �t p 0 . Wesidential Value of Work 51�' Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address W ClA N,-t {YL tq- 0 9601 Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) C S G 69 �&Workman's Compensation Insurance Ched one: ❑ I am a sole proprietor ❑ I am the Homeowner L�I have Worker's Compensation Insurance Insurance Company Name T k2- a aj ca. Workman's Comp.Policy# _ (. — 03 Ll t rY!,5Sb ^d y_ Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ERe-roof(stripping old shingles) All construction debris will be taken to Z ` ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission, A copy of the Home Improvement Contractors License is required. SIGNATURE: Q:Forms:expmtrg Revisc061306 The Commonwealth of Massachusetts - Department of Industrial Accidents f Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): _F A o-�L L LG Address: Q 90)( It-D City/State/Zip: C�b_U-lMA - OX3s Phone #: 549_YO-g — o2o12_ V9\ Are you an employer? Check the appropriate box: Type of project(required): 1;,2F,I am a employer with $_ 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' comp. insurance.1 9. ❑ Building addition [No workers' comp. insurance p• 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 required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 'contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. `V Insurance Company Name: Policy#or Self-ins. Lic. #:U a y 3 L/ R1. -- . , Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi 7h ;dptIties of perjury that the information provided above is true and correct. Si ature: Date: /a -� �' Phone#: �� 0 ' o2 Official use only. Do not write-in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: RightFax C2-2 9/29/2009 5 : 35 : 22 AM PAGE 2/002 Fax Server ACORD. CERTWICATE OF INSURANCE DATE(MMWD\YY) 09-29-09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE WISE&QUINN INS AGCY IN HOLDER- THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 449 PLEASANT ST ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE BROCKTON,MA 02301 COMPANY 24WCB A WMTFORD GROUP INSURED COMPANY B FRASER CONSTRUCTION LLC COMPANY P.O.BOY 1845 C COTUIT,MA 02635 COMPANY D COVERAGE 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. CO POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER DATE(MMIDDIYY) DATE LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL PRODUCTS-COMP/OP AGO. $ CLAIMS MADE OCCUR. PERSONAL&&ADV.INJURY $ OWNER'S&&CONTRACTOR'S PROT. EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ MED.EXPENSE(Any one person) $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY(Per Person) $ SCHEDULE AUTOS BODILY INJURY(Per Accident) $ HIRED AUTOS PROPERTY DAMAGE $ NON-OWNED AUTOS GARAGE LIABILITY ANY AUTOS AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGREGATE $ EXCESS LIABILITY UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ WORKER'S COMPENSATION AND A EMPOLYER'S LIABILITY UB-0341M556-09 09-26-09 09-26-10 STATUTORY LIMITS X THE PROPRIETOR/ EACH ACCIDENT $ 500,000 PARTNERS/EXECUTIVE INCL DISEASE-POLICY LIMIT $ 500,000 OFFICERS ARE: X EXCL DISEASE-EACH EMPLOYEE $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/RESTRICTIONS/SPECIAL ITEMS TIES REPLACES ANY PRIOR CP.RMFICATE ISSUED TO THE CERTIFICATE HOLDER AFPECTQVG WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE FRASER CONSTRUCTION LLC EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT PO BOX 1845 FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES COT=,MA 02635 AUTHORIZED REPRESENTATIVE ACORD 25-5(3/93) Ramani Ayer I Board o B ild➢n��o sand Standards - License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. fffound return to: Regist�'at�orl.; 112536 Board of Building Regulations and Standards r, E'pntt10a' 128/2011 Tr# 281021 One Ashburton Place Rrn 1301 Types D Boston,Ma.02108 FRASER CONSTRUCTION CO. DEAN FRASER 104 TWINN VIEW ANE % E FALMOUTH,MA 02536 Administrator Not re oar o ufllg egula ons -4 rtanYaYrs One Ashburton Place - Room 1301 Boston. Massachusetts 02108 � Home Im-provement-Contractor Registration Registration: 112536 Type: DBA FRASER CONSTRUCTION CO. Expiration: 3/23/2011 Tr# 281021 DEAN FRASER P.O. BOX 1845 COTUIT, MA 02635 Update Address and return card.Mark reason for change. 1 0 40M-o8/o8-Dl3SLIFOFiMC,9108212008 E] Address El Renewal [j Employment I] Lost Card .- a S:anaiwas 6 =. -*QM ' man I. TO Wass 1.0411�Fi�1l�,�1�'I L�' '�'��"--ter.._� .•• , EMT KA MDUTH.:1PV4 96 �??•mmSe�innr I Fraser Construction, LLC 4q>CONSTRUCTION P.O. Box 1845, Cotuit MA. 02635 ROOFING SPECIALISTS' SIDING Email: fraser constructiongverizon.net www.fraserroofin com FAX 1-508-428-0123 508-428-2292 HICL#112536 CS#97668 RE-ROOFING PROPOSAL 2 OPTIONS COMPLETE OR PARTIAL DATE: July 24, 2009 PHONE: 508-775-4607 XAME: darner Ennes MAIL ADDRESS: same JOB ADDRESS: 2 General Patton Dr. Hyannis, MA 02601 FRASER CONSTRUCTION hereby proposes to perform the following services in a neat and professional like manner and in accordance with the manufacturer's specifications and local building code. -Remove and Haul away all of the old roofing material -Re-nail all plywood sheathing as needed. Supply and Install- CERTAINTEED XT AR-25: 25 - Year Warranty, 5 Year Sure Start Protection, CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self- Sealing, 3-Tab, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 10 Year Warranty against ALGAE Containment. Color: PRICE for complete roof $5,695 Initial PRICE for partial roof- all areas except far left side small section $5,075 Initial Supply and Install - CERTAINTEED XT AR- 30: 30 Year Warranty, 5 year sure start protection, CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, 3 -Tab, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 10-year Warranty against ALGAE Containment. Color: PRICE for complete roof $5,795 Initial PRICE for partial roof- all areas except far left side small section $5,175 Initial R 30: 30 -Year wOODSCAPE A E gesistant, L" DYLAR� / RATED, ALGAE lass D S le, Fiberglass _�. Su 1 and Install - CERTAp otE won, CL4�SS A FitecturalCMYC Stones w� DD exed, COPPER/ Warranty,5 Year Sure Start ,Mulan Exclusive 11p mph wind. Sealing ction Extra Heavy Weight, Self New Eng d Ccrltaijarnent. 5 -year Constru arty Based Asphalt Shinglety guest AbG n comma n bond area, cost. actual See warn a Full 10 Year Warr with sin nails Mp additional resistance warranty on bond area at includes six nails in cosnn' ons for specific details and hr� ®cx;01 color: 610 %itial ' • roof $5, aU section PRICE for complete t far left side r 4,950 Initial �- PRICE for partial roof- all areas excep $ SCAPE pgE1VIIUM U LANDMARK /WOO CLASS A FIRE RATED, CERTAYNTEE rotection, Bred, Laminated .10 ear sure staff P My l�lNe Flag Exclusive Su 1 and Instal " ht, Self Sealing, Limited Lifetime WarraHeavY Weig t Shingl LG�AE rage lass ear W arr Wind warranty upgrade ALGAE Resistant, EF berg Based lOy aunty�nst are used. See Architectural StyleIC Stones with wind_resistance w eedhip 8ti ridge includes six COPPER/CE ear 110 mph starter & Certain eraser construction Containment. 3.0 ye d limitations to 130 mph when s ecific details ditional cost. actual warr fo bond area at Np ad nails in common Color: initial of $6,910 all section PRICE for completero left side sin tial PRICE for partial roof_ all areas encept far $6,150 Ini water shield Guard: (ice 8v on eves and CertainTeed winter - ent System ot• hts) tall- roof Underla) , d kylig Su 1 &Ins W aterp 18" on rakes Wall,, ended valleys t Paper (as recomm 9 elect Underlaymen Su 1 B6 Install-b°CertainTeed) Drip Edge y ' ated Drip Edge °r $97 Aluminum $y Install-Itiews ventil Su 1 8ti Neoprene Soil Pipe Flashing & Install- Aluminum recommended by CertainTeed) Su 1 le vent II (as Install-Shing Su 1 s from ea daily. ge�nove -Debn Work ar signed and Clean lied if proposal is upgrade will be apP x Star warranty , bin l� days,(see enclosed brochure 4 returned within i N' WHITE CEDAR SIDE WALL Price is to remove existing siding above far left section and replace with white cedar side wall shingles PRICE- $495 Initial "" 2% Discount if paid by check immediately upon completion NO MONEY DOWN- NO Payment at the start or part way thru Payments accepted are: CASH- CHECK- MASTERCARD-VISA-AMERICAN EXPRESS Any payments not made within 30 days of completion will be charged 1.5%for every 30 days the payment is late. Possible Extra-After the shingles are removed from the roof, we will lift one sheet of plywood to make sure that the insulation is not up against the plywood sheathing preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$6.00 per panel including Materials & Labor. There are 6 Panels per sheet of plywood. Possible Extra-Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$60.00 per hour, plus 15% mark-up materials FRASER CONSTRUCTION Warranties the labor for 12 years FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years. CERTAINTEED Warranties the shingles and labor 100% through the Sure Start Warranty duration. CERTAINTEED Warranties the shingles to be ALGAE resistant for the duration of the Sure Start Warranty depending on the shingle that was purchased. Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: Homeowner Fraser 9wstruction, LLC Assessor's map and lot number .1. ...7�6............ / SEPTIC SYSTEM _ ( .14• INSTALLED IN MUSS` Sewage Permit number ..:�..G.../ -............................... WITH 11 STATE •r g ARTICLE II STATE �Fp�I SANITARY THE Co�T®� N OF RAIV r Q� 8AHB9TOHLE, i �. opya,•�� �ry BUILDING INSPECTOR APPLICATION FOR PERMIT TO . . ✓1 . ........L ........................ TYPE OF CONSTRUCTION .... .. . ......` ... .................................................. ................................................19........ TO THE INSPECTOR OF BUILDINGS:- The undersigned ereby applies for a permit according to the following information: Locationd.:...../7. #d.bq/......................................................... ProposedUse ............................................................................................................................................................................. ZoningDistrict ........................................................................Fire District ............................................................................... Wfiexo,��aQaSeyy� p.i n �� �,�, . � nr�� ,Name of Owner ........ .......ngiF .....I.l. .Address ...... . ....... ........ ..4 �`fed/ �..�l�s ...�!. r� Rye f...MCAr 11 Name of Builder .... ..� Address ................ � �1............................ 0 q/ ?�+Name of Architect � ae "nu�... .............Address3$/....SNwl.. ... ;,��, 4 al.,('/1 l'...il1 Number of Rooms .................................Foundation ......... ................................. . . . . . . ... . .................. Exterior ..... ..... .. ...:..... ....c ... ... . ..................11.(........Roofing ........... .. . .... .. .. ......... ......... .............................. .. Floors .... . 7.... . .. 7� lU erior �. .. /.. ........... . ... O Heating �J ...... ..............................................Plumbing ........ !1..................................................................... Fireplace ..Ao-% Z6 ...............................Approximate Cost J.. B _ Definitive Plan Approved b Planning Board ______________________________19________. Area Diagram of Lot and Building with Dimensions Fee /-5 SUBJECT TO APPROVAL OF BOARD OF HEALTH 13 O (3auAli) S� i I hereby agree to conform to all the Rules and Regulations of t e Town of Barnstable regarding the Bove construction. Name ........... ..................................................................... Ennes, Warner & Rosemarie 16605 add to singl No .................. Permit for ................................ ... family dwelling .............................................................. ...... ........ 2, General Patton e Location ................................................................ Hyannis ................................................. Warner Rosemarie Ernes Owner Type of Construction .....................frame..................... ................................................................................ Plot ............................ Lot ................................ A Permit Granted �PPg .....ig 73 Date of Inspection ............./ 73 .........19 C . ........... Date Completed ......... .........197V 5.1,0� PERMIT REFUSED LA) ..................................................................19 90 .en ............................................................................... ................................................................................ rq ............................................................................... ............................................................................... Approved ................................................. 19 ................................................................................ ............... ......... .................................................. REFERENCE �oy��a BARNSTABLE, MA - PLAN TITLED "SUBDIVISION PLAN OF LAND IN BARNSTABLE MA55", PREPARED BY CHARLES N. 5AVERY, INC., DATED MAR. 28, 1 %8 LOCUS - PLAN TITLED "SITE SKETCH ", PREPARED BY ENVIROTRAC, DATED 3/1/201 7 o - TOWN OF BARNSTABLE ASSESSOR'S MAP 292 PARCEL 09G 3m NOTE: TH15 SITE PLAN WAS NOT PREPARED FROM ANY INSTRUMENT SURVEY AND UNDER NO CIRCUMSTANCES SHOULD THE DISTANCES, BEARING AND/OR OTHER FEATURES SHOWN BE USED TO ESTABLISH PROPERTY LINES. �e KEY MAP e AREA OF STAINING 'fy� s LEGEND HB 3 H -1 �O �°� O pG S S F SEE DETAIL ® CATCH BASIN O���v' pj�'�i) QS SEPTIC TANK COVER TB-7 � / MW-5 FORMER AST TB-5 �' �` �'p *TB TEST BORING *HB HAND BORING --- FULL Q / BASEMENT — MW MONITORING WELL . \ O W-5 ATTIC •• • M W-I �: FURNACE TB-I MW-2 / M W-I TB-2 . �. KITCHEN M W- HB-2 / FURNACE G — 0 M W-4 Q� TB-G / SLAB LOCUS O OL / 2 GENERAL PATTON DRIVE ShOTsbF PROPOSED AREA OF EXCAVATION I G' (L) x 10' (W) x 1 5' (D) — 89 YARDS �z DETAIL F� SCALE 1 "=4' NORTH 6� WEST EAST PASSIVE WIND TURBINE DOUBLE WASHED STONE AGGREGATE _.. �O �O EXTERIOR FOUNDATION CLEANOUT WALL (Y FITTING) VENT SYSTEM RISER FIRST FLOOR FULL/ BASEMENT — ---- VENT TO ROOF „p,• MW-2 WIND TURBINE 2 [RTN# 4-26544 FLOWABLE FILL OR COMPACTED SAND c Project: PLASTIC SHEETING RO S EMARIE ENNE S VAPOR BARRIER (G mil) 2 GENERAL PATTON DRIVE-HYANNIS, MA 02601 0G PERFORATED PVC Title: WASHED AGGREGATE S150 SLAB LATERALS (5CH 40) IMMEDIATE RESPONSE ACTION STATUS I 2 GENERAL PATTON DRIVE-HYANNIS,MA 02601 lo BENNETT ENVIRONMENTAL 5 SITE PLAN , ASSOCIATES, INC. SOUTH LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS, PA551 VE VENTING / PASSIVE VENTING / 0 20 40 GO GEOLOGISTS, ENGINEERS mmmm 1573 MAIN STREET,P.O. BOX 1743,BREWSTER,MA 02631 I N F I LT RATION 5Y5T E M 5 C H E M AT I C I N F I LT RATION 5Y5T E M OVERHEAD 5 C H E M AT I C SCALE 1 "=20' PHONE:(508)896-1706 www.bennett-ea.com FAX:(508)896-5109 DATE SCALE BY CHECK JOB NUMBER NOT TO SCALE NOT TO SCALE 8/1/17 As Noted SRF I DCB IBEA17-11006