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0236 OLD TOWN ROAD
d � r -V 3 J* Op 3 x .- p W N � � �o f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel U Sa Application# Health Division Conservation Division Permit# Tax Collector Date Issued Treasurer Application Fee Tf S� Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address U L 0 Village Owner,/ �U�✓ti '1 Address Telephone �y �� — 7 U L) r Permit Request 48 -- NZ Ta Square feet: 1 st floor:existing proposed 2nd floor:existing proposed w Tota' he Zoning District Flood Plain Groundwater Overlay Project Valuation 31 00 dConstruction Type 41,'5. — Lot Size .2®d Grandfathered: ❑Yes o If yes, attach supporting do umentation. Dwelling Type: Single Family Cam( Two Family ❑ Multi Family(#units) Age of Existing Structure Historic House: ❑Yes &110 On Old King's Highway: ❑Yes Basement Type: Ual ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) /,Vs Basement Unfinished Area(sq.ft) y�� Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing_ �I new Total Room Count(not including baths):existing l�' new First Floor Room Count Heat Type and Fue- Gas ❑Oil ❑Electric ❑Other Central Air.-.- , es ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes e<o Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Commeal Board of 0 Yes eals Auto rizafioes oteApan aeview# Recorded❑ yes, p Current Use Proposed Use BUILDER INFORMATION Name , ®1���—� Telephone Numbers Address 2�� ��� �� "' �Pr Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE 7 G I FOR OFFICIAL USE ONLY PERMIT NO. ' DATE ISSUED � MAP/PARCEL NO. I ADDRESS VILLAGE ' g OWNER 5 T s DATE OF INSPECTION: FOUNDATION FRAME INSULATION i FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL } FINAL BUILDING 0(C, i DATE CLOSED OUT ASSOCIATION PLAN NO. �?►+E Town of Barnstable Regulatory Services Thomas F.Geiler,Director `rEn►',��'`� Building Division l�D Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax 508-790-6230 PLAN REVIEW Owner: bd W H S Map/Parcel: (4f ® � Project Address tf builder: The following items were noted on reviewing: CABMN 77S 9 C r -0-k Reviewed by: Date: 6 — �' —O —7 Q:Fomis:Plnrvw -- The Commonwealth of Massachusetts Department of Industrial Accidents W Office of Investigations 600 Washington Street Boston,MA 02111' wtvw.mass.gov/dia ' Workers"Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Orgamzation/Individual): �,.,-9�. •z--7 17 Address: /iJ ,. City/State/Zip: 71�1 CG� Phone.#: S` U �' - �• G y� —� Are you an employer?Check the appropriate box: :Type of pioject(required);, 1.❑ I am a employer with 4. [] I am a general contractor and I employees(full and/or part-time).* , have hired the stab-contractors 6. ❑�emode:gc tion . 2.❑ I am a'sole.iroprie'tor or partner- listed on l ie'attached sheet. 7. ship.andhave no employees These sub-contractors have g, E]Demolition: '�yorking for me in any capacity. employees and have workers' [No rkers' comp,insurance comp.insurance.$' 9. []Buulding addition . r am a ed,] We area corporation and its 10.El•Electrical repairs or additions 3, homeowner'doing ill-work officers have exercised their 11.❑Plumbing repairs or additions myself,[No workers' comp. right bf exemption per MGL 12,E]Roof repairs . . insurance.required.]t c. 152, §1(4),and we have no employees, [No workers' 13.❑ Other_' comp,insurance required.] *Any applicant thatchecks box#1 must also fill out the section below showing their workers'compensation policy information, t Homeowners,who submit this affidavit indicating they are doing all work and then hire outside contractors mutt submit anew affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the gub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their, workers'comp,policy number. I am an employer•that is providing workers'compensation insurance for my employees. Below is.the policy and job site' information. Insurance Company Name: Policy#or Self-ins.Lic,#: 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 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK.ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the-Office of' Investigations of the DMA for insurance coverage verification I do hereby certify under the pains and aloes of perjury that the information provided above is true and correct Si tore: �7 Date: _ 0 f cial 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#: : Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hue, express or implied, oral or written." An employer is defined as "an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a-deceased employer, or the receiver or trustee-of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGrL chapter 152, §25C(6) also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to'operate a business or to construct buildings in the commonwealth for any applicant who has not produced•acceptable evidence of compliance with the insurance coverage required." . AdditionaIly,MGL ehapter:.152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public•.work until acceptable evide=6.-ofcomiiLmice vithtke insurance' requirements of this chapter have been presented'to the contracting authority,." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contiactor(s)name(s),address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability-Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members-or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit.or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law-or if you are required to obtain a workers,' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate'lind. — City or Towtn Officials Please be sure that the affidavit is complete•and printed legibly. The Department has provided a space at the bottom of the-affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill.in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permitAlicense applications 'n any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations in (city'or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (i.e.a dog license or permit to bum leaves-etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance.for.your cooperation and should you have-any questions, please do not hesitate to give us a call. The Depa;trmnt's address,telephone-and fax number:; 4 CQMM0UWW1h of MASSKUR�tts Dqpartment of Indusuial A-coidimts ()f .ee of 1U'Ve 1dgUf1 1kS 600 WaWnato i Stmd $4ston,AAA 02 111 - Fax#617- 7-7749 Revised 11-22-06. www.mamg6v/dia 6v/dia Town-of Rkrnstable Regulatory Services sAxNsrnsr�, Thomas F.Geller,Director 9 MASS• 16;9• IN Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 Fax: 508-790-6230 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: / -y. � / �J% -".,. ated:Cost Address of Work: ��� o/12 12,) /vi� �- Owaer's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): FlWork excluded by law ❑Job Under$1,000 ❑B ,fig'', not owner-occupied [� pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR IDEAI.,IN G WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS T. O THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES.OF PERJURY I hereby apply for a pezmit as the agent of the owner: Date Contractor Name Registration N o. L��ff jam, �G6iodvl? Date Owner's Name Qd'oms:home�dav ' I Town of Barnstable t)F 1HE Tp� Regulatory Services swaxszne , « Thomas F. Geiler,Director 9 MASS. le39• a.0� Building Division TED MA't Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: ' r� JOB LOCATION: C v/0 77-y" /0d/,?-0 number street ^�village "HOMEOWNER � /tom 00111il/ /wf �� �' �� 0 C.-5' name home phone# work phone# CURRENT MAILING ADDRESS: /` ` U B0k 7 cityftown state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. ignature of omeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt �F1HETpk, Town of Barnstable Regulatory Services r r * BARNSTABLE, � MAss. Thomas F.Geiler,Director 039. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 June 11, 2007 Sean M. &Diane L. Downes PO BOX 513 W. Hyannisport,MA 02672 RE: EXIT ORDER 236 Old Town Rd., Hyannis Map : 268 Parcel : 030 Dear Property Owner/Occupant : This letter shall serve as notice that the building department has become aware of a building code violations at the above address. In accordance with 780 CMR 121.0 and 780 CMR 3400.5 you are notified that the basement bedroom is declared dangerous and unsafe and its use must cease immediately. The property must be brought into compliance or be subject to criminal prosecution as provided for by 780 CMR 118.4. A building permit is required to bring the property into compliance and must be applied for by June 25, 2007. You may call this office at (508) 862-4034 with any questions. Thank you for your anticipated cooperation in this matter. By Order, e . Lauzon Local Inspector Q:zoning5 °FI►�� Town of Barnstable Regulatory Services a" MASS. ` Thomas F. Geiler,Director_ 9 .. MASS'-- 0 Building Division Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.ba rnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXIT ORDER DATE: 0002 LOCATION: a2 � O)eI Tow,, R ylGhAi -S Under the provisions of 780 CNIR, the State Building Code, Section 3400.5.1, you are hereby ordered to immediately discontinue the use of ' the cellar/basement area for sleeping purposes. LPVWIJINSPECTOR SIGNATU OF RECI NT TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 268 030 GEOBASE ID 17030 ADDRESS 236 OLD TOWN ROAD PHONE HYANNIS ZIP — M LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 59525 DESCRIPTION NEW RES 40 X 40 RANCH 2/BED 2/BATH PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of ARCHITECTS: Regulatory ator Services TOTAL FEES: $25.00BOND .00 g y CONSTRUCTION COSTS $_00 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE *0 Mass. i6gq. BUILDI G D gVISION BY // DATE ISSUED 01/27/2005 EXPIRATION DATE / , -y TOWN OF BARNSTABLE �. 60 DAY TEMPORARY CERT.OF OCCUPANCY F• PARCEL ID 268 030 GEOBASE ID 1.7030 1� ADDRESS 236 OLD TOWN ROAD PHONE HYANNIS ZIP — LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY u PERMIT 59525 DESCRIPTION 60 DAY TEMP CER .OF OCC_ PERMIT TYPE BTC00 TITLE TEMP. OCCUPANCI PERMIT CONTRACTORS:ARCHITECTS: Department of Health, Safety and EnvironmentalServices TOTAL FEES: BOND $.00 per Tt1E CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE P;, :`�E"' # * BARNSTABLF, # MASS. 1639. ED MIS BUILDING DIVISION B DATE ISSUED 03/08/2002 EXPIRATION DATE 05/08/2001 1,AQne ` �aw1eS . TOWN OF BARNSTABLE cam } BUILDING PERMIT PARCEL'* ID 268 030 GEOBASE ID 17030 ADDRESS - 236 'OLD TOWN ROAD PHONE HYANNIS ZIP - WT BLOCK LOT SIZE DBA - 'DEVELOPMENT DISTRICT HY PERMIT 52136 DESCRIPTION DEMO/REBUILD ,EXISTING HOME SEWPT#2001-06 PERMIT TYPE BUILD TITLE NEW RESIDENTAL BLDG PMT CONTRACTORS: DMF CONSTRUCTION. -Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $481.74 OxIm BOND $.00 CONSTRUCTION COSTS $155,400.00 Q� 101 SINGLE _FAM .HOME DETACHED 1 PRIVATE P ' -� grA BM MASS. 039. A� BUILDING DIVISION BY v 11 DATE ISSUED 03/16/2001 EXPIRATION DATE • ,�'iwa APPROVED�'��-a2 TOWN OF BARNSTABLEo ❑ GAS X WIRING a ❑ PLUMBING ❑ BUILDING �� TOWN OF,, BARNSTABLE BUILDING PMJI`.[' v PARCEL 'ID 268 030 :G90BASE I.D 17030 ADDRES;i -236 OLD TOWN ROAD PH;JUTEq bz HYANNI5 LIP - BA DEVELOPMENT DISTRIt1 Sr �Y PEP-MIT 52136 DESCRIPTION 1)1410/I BUILD 'EXISTING HOME SEWPT<2001.-06 PERMIT. TYPE BUILD 'TITLE NI"W RES I:DENTUAL BLDG PM.T 'CONTRACTORS: IMF CON5TRUCTSON Department of Health, Safety ARCHITECT'S': and Environmental Services I'pTCTAL FEES: : $481.74 INE BOND 911,nQ CONSTRUCTION ' POSTS' $1.55;4 00,v6 g 'SINGLE t y hC..D rh �1 ^ lG�A , A G10 T. i*�. ''e WABI �ti � .n ri less. `��► BUILDING DIVISION BY DATE. ISSUED 03/16/`200I: . EXPIRATION DATE r� THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN— CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF'OCCU ELECTRICAL,PLUMBING AND MECH— ANICAL TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL-NOT BE INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. " �JBUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS l 2 !i S.9 off `(� ;7#Z-Y 2 3 KOTING INSPECTION APPROVALS ENGINEERING DEPARTMENT t 2 �'4 :J� BOARD OF HEALTH OTHER: SITE PLAN REVIEW 0PROVA_L.F r WORK SHALL NO ROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS —THE INSPECTOR HAS APPROVEDTHE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR B, ' , VARIOUS STAGES OF CONSTRUC— MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA d TION. ,' NOTED ABOVE. TION. h III _ f r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �t Parcel 036 ermit# 26 /0� Health Division �' �C � ate Issued Q Conservation Division �� � �(�}� - kc Application Fee Tax Collector ��� O �— — lql -� Permit Fee D Treasurer Planning Dept. Ln X Date Definitive Plan Approved by Planning Board , U) Historic-OKH Preservation/Hyannis Project Street Address b U 1� �UW r o rn Village Owner (�A,(I 7�WN �S Address d� oI Telephone Permit Request CC K Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation '64 f ADD -� Construction Type Lot Size �,ow Grandfathered: ❑Yes UH4o" If yes,attach supporting documentation. Dwelling Type: Single Family @f Two Family 0 Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes alo On Old King's Highway: ❑ 'I o�Yes La Basement Type: &Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing CW F new Half: existing new Number of Bedrooms: existing �® new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel- C-Gas ❑Oil ❑ Electric ❑Other =Central Air: Zes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeal;No ut orization ❑ Appeal# Recorded❑ Commercial ❑Yes If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE, DATE C� P FOR OFFICIAL USE ONLY PERMIT NO DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE. OWNER r DATE OF-INSPECTION: � FOUNDATION t FRAME s INSULATION > FIREPLACE ` ELECTRICAL: ROUGH FINAL _ PLUMBING: ROUGH FINAL r GAS: ROUGH FINAL FINAL BUILDINGS n/ t7 A •} DATE CLOSED OUT • (- ASSOCIATION PLAN-NO. s i Q, G 1 { ` To `( _ \JLid _rr� V,/tom- , - R C)A�� ✓r�i 1 LEY. � _ '`•- � Lr ( AMERICAN SURVEYING COMPANY OF BOSTON, INC. 1 1}�ETAJN j :��� �S',,�� T289 VAIN STREET YfALTHAM. IdASS. 02gS1. lAaDvE a REGISTERED LAND SURVEYOR• PHONE (781) 893-6477 PAX (781) 893-7091 DO HERtUY CERTIFY THAT THE MORTGAGE iN�EcuQN MORTGAGE INSPECTION PLAN `PLAN WAS PREPARED FOR - -- — - , ACIFIC HOME LOANS_ " '� 3Z RECORDED AT. BARNSTABLE COUNTY REGiSiRY OF DEEDS CLIENT nNN fl BOOK: 12B56 Iv CONNECTION WTiri A NEW �CLIENT REF.p:� i4 PLAN REFERENCE: tORTGACF, AND IS NOT INTENDED i.O•y- 4Q016602 -ORAwN PER TOWN OF:- ASSESSORS ROR REPRESENTED TO BE A LAND THE LOCATION OF THE ORIGINALRRQPEfRTY SURVEY. NO DWELLINGSHOWN NER€ON, €THERRNERS WERE SET. AND IT WAS IN COMPLIANCE WITH LOCALANNOT BE USED.FOR APPLICABLE FONINC BYLAWS IN ESTABUSHINC FENCE_HEDGE, EFFECT WHEN CONSTRUCTED OR BUILDING LINES. THE LAND I(WITH RESPECT TO HORIZONTAL - SHOWN HEREON IS BASED ON `04"EN%QNA,L REWREMENTS QN0). t CLIENT FURNISHED OR IS EXEMPT FROM VIOLATION NFORMATIOty AND t AY BE ENFORCEMENT ACTION UNDER MASS THE SUBJECT DWELLING LIES IN FLOOD ZONEX SUBJECT TO FURTHER IGL TITLE Vu. CHAP 40A. SEC 7 AS.SHOWN_ ON THE NATIONAL FLOOD INS RAMC€ PROGRAM TIOUT-SALES. TkKiNCS, E,ASMENTS. UNLESS DTHERWiSE RIOTED OR INSURANCE FL000 RATE MAP DATED: l4N0 RIGHTS OF WAY NO SHOWN HEREON A CONFIRMATORY CQMMIK'PTy r P U #; 2S 1 e I o a • .I? +RESPONSISILTY IS EXTENDED INSTRUMENT SURVEY IS ADVISED Iur 09 im Tel THr l ANn nwNFR, nR WHEN STRUCTURES ARE SHOWN ( _ FI L ED- D A CHECKED N C I ! � l0�'/� All Qr y 14% A ) - � c r)(/f_O gam'p] ,(jf` y . L J. l � 1 a r o •c � j o z; Town of Barnstable �of•cxE rok,� • . • o� Regulatory Servi.des 8 sr�sr� ' Thomas F.Ceder,Director " "� $ Building Division pCty s634 k�� ' '°lFc Mpl Tom Perry,Building Commissioner ' 200 Main.Street, Hyarmis,NIA 02601 , . gal; 508-790-6230 office: 508.862-4038 ' P ermzt nc• DAVIT ROMERSUPpL%jAEx PERMIMNT T APB CATIONACTOR S conversion, GL c.142A rages that the"reconstruction,alterations,renovation,repair,modernization, , M or construction of an addition:to any pre-existing owr�er-accupied improvement,removal,demolition, ellirig units or to containing at one but not more than on actozsvrith ccertain exceptions,along with other n o building be done by registered such residence or building requ ente, hem �Cr Estimated Cost 0 Type of Work: ,p ddzess of Tork: , .1 is Owner's Names Date of Application: 0 I hereby oertify that: Registration is not required for the following reason(s): []Work excluded by law []lob Under$1,000 [IBLu3dk9 not cvmer-occupied }veer pulling own permit Notice is hereby given that: ORMALING WITH UNREGISTERED OWN gS p�,L�G THEIR OWN PERMIT CONTp,.CTORB FOILAPPT�CABEE HOME TtOYEMENT WOI ERMGL c 142A, ACCEUND SS TO THE AMYTRATION pR0 GRAM OR GUARANTX YM SIGNED UNDERMALTIES OF PER7URY I hereby apply foi a permit as the agept of the owger: ' RegistrationhIo. Contractor Name Date ' �. ;:: . _ ; .... :' •• :• •'.The'Coriitnaniveulth oflNlassachusetts� partment of Industriai'Aceidents' . 60a Washington Street - Boston;Mass.. • Workers', rn ensation,anspranceAffidadf'GeneralBusinesses / �. ' � � � . t 5•t'i 1•,,,r. 4 •' , address: , y, ...• . • ' I e# _. . . • . _- ' • stale, • ai IEat at Fstablishmeat . dress estaur 11171 ant/B work site locate ed • $Rness Type: []Retail[]R gel pstae,Antos etc,). am•a sole proprietor and have no on . , , Q Office[�salts('including . . �f capacity. art time: ❑03her O% yvorking to'ees full&' I am 1Cr with•' I • . ////////i'/ %%/ %/ %Gl%%%//%///01 In/ %/jo///e%s worki#g.on,this job`; . 5..;, • .1:..:' r///m/No17J11711' corkers'ebm easatlon f Y, . ; :• ._ e pjoy��rov. . r !.. � t,,i;i 1 5 i ,i-t;4.r ti;w_t+!:• '^��,r .�,M' ':( ':'r•.a 4 i ', r �' .. •+ t i j' t,:S'. t 'r 1' !•'l rlr ,:•. r•;J.`;::' •.3': ' rS tl•,': ''y�y.sj t,Zt. .t''i•�'1, ':;�:. t.; ..t • ,. r'. , y•. tlt:N• � �•". � �.11•+• •{r''.. r. ;fdt 8y Jy�14 1.'¢ .1.4 , , �:N 1 i. .�•a'i• '!mil{;,•• •L t Y, ,,t'' , •�::�•i t b 10! °• 1 C. .:'}; ' :il F'.. .. 1 ti 5 ;r. �,_• t�,; ,;; . k ': COIYI.9A t.l. . •:,r� r�'7C •I:'! 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"r,a.•'xK,v',7e}, t �hOII 1 .. .. , ti , i 't 't,••, t'.4t a 1 yt'1+:.h• 'i''•' '• t r . .r. r'M '' 4 1• f' ,,,i'�./', .'•,,t �,•;1' t t+': f, '^ 'S '''''':i'•.+' •{ •..r?:.. .'. r ai�ti'+ •.+'�:�, ' :• •.�• ,•t .�'. .1,}�• i,^.1',:' .la�'•4±.5 ,,,,,,,,1t' t••a'1„•..w.il`,t..J + ' 'w: j+•�31•• t. , 0�1C . � {' u ` r •,}'ias gr,rz:•,.. , NIF ti,t. ;�,' . . ;, :..1:Sir�ll;��a, ,HJ• :•:• �t}iefnlJowsngiNorkers' su'ra>3ce.do bd6wwhohav .' e��the io:depe>kdent contractors listed• •, ;` r •: i am a sole proprietor and'hav + . ,i •,, r. .-,'� ':' vices; :comp�ation polices: � •, . � . , i .':Eat is;;-,fi;�::�,:t *;..:�' �.,.N ,:;. •�: �� • !. .. •.... 1 A''4 r' ;'h',r i�': . . .•r IJ.�r'i..� :iP.ti.,.1�fPra•� ,•�:.� i.�•1 r ' ', ' ,: ' t:61,'1:1'4iM11�, �.r.:t.,. +••' .yr_ r`aS:.,� :r .. :"•• t"� S {•}. :•t. t' 1 l''i':�•:�'' :4•,. t r CbID SiII ''t18I11 ' tie,t 1.4: ,1?>?11;rl•: rt*' ::7:i•tr, ^?! {. t t••.s,'! ' v. „' 1» r J'r; v ti •,'' ' :r?ra ,.. 1.'• ..• .•. 1 '•t Y.:'.': •i.• y t.( :r,t:. l'.4,P�'••r%.4{I���t• •'•!'•r'r t• .I0.r.. ,.r '�L.11 \ •uit�:. Lr.f , . '1,, r , .1 �•1.:. ..r,.. •!,• ,l, rr+j�rpp' }.' 5...•!•, A '.I.,,,yr}, :ti.:•'i� j et.::ylylo[' :�'r ,i `„�j r ..ra� •.. +• r{�l':f'i 6an7,e' S:rti•+. '' .'rC'.a•:.+ '+.t+i.'•`•;� 1:'.:I.pi•'•:i''a75'.let..�t,•,1! nZS•••}� t' 11daBff:. •i•..:. •.. ••i. •Y,r,l,•�:4.v',,.�r,.• , ,. Z• , Cry{ �: '1q,'rr•, •!� r l,!'t'• s' l ,,,1,.•,' •t t t' •,' ,.yr�; . .. .r •r . •�;;'! i... ,1� r,�a`ti^l1.:1: •',rr•:t{�5•;�' r•i ?' F t i, :�.L' t., 1""•.•.i:`• •. .,•.J.., � y4 I.{, „ ,w•. r; + l,.,lr .;ti,.,j• ,r ;,ri tSy,}.a,Ir:�,a`'GLf1 �•�• t:•' ' 1' ,,, �r r .,,tyg•y''i3�-:-• t f^t7 Cll v'''•i:^ '• • ..HpaF.,';�+�ySAt�ht�YI,�frr t>;i,,.y�r .. I r i• ti ,4.l.Fy i!r^.i:+ !•5:.•' `� •,t::/'OICi t'w,�:,rl}„,^2Y-.r.+{..}ih'•t.t't.�.., ��,•••,, . ������J ��J h^ a i Y Yia '1 WINNER ; ,.,+1.;,, .• t t'r.,,• !•.S,'j.:r' SllYaACe'C0. :X• r. i'r f:' ?!t :,' r +y�ti,'}C J�;ii•' ,y :'}.'�'�:, { !�5.1..+„",r {{. .i+ .;+•:,.a'/.!: r�jy,3:{.flii•:'S1 vt hv ' •.''+j ".N... : -1, r.: ''\ t"•:''•. •dAa �•� t' '" r , q•', \'• ''i7�-'tt'..,: t i rtit t.. i}•;, i1'' w I..li.• ,• }1 ' . l' ;r ,.'�• t,; n K•'+••;•• ;'•:`.t Yw•,._ ♦ + ,, . .• vti,til;t-j tl �`rtt.-�:".p .:t f. .it • ••1+ , 4. ti;. .A; ` 4, ,•' bOm Ham• I1a�A ''•t•:.: '. '' '' '•,•• , '}•; 1 �d:k. ' 't !• '-':• ",;,,j, • 'ti ..-±• . :i ti .. '^ •t1 +• : .J•'` 1.:, rM1'•'3,,f5''.,!�+fiuth ..` •';::}.e, .�' :•i: f;..r �{j2'eS5'. •' .r :~• ' '. ''•� ,a• { :• ,.'�J .ra..', .ri. "i;.11 r"��:,.,i 1.f;.j 1�::+�tlr •"t'~r....':•�•'•..:: 'j .:` a +• •'1 �• .., :t., .,,• l,' :l} •'. ' ',, w.41• �' •�OLE�f.- •• ''._ ,,J,r :� t?•:i�•'.:t�i'� 'i t'•i,• . '•1^ t, ti j:.r.•tr r. ••' 'a., '•r•+. ' +: r.•.. !.'r J.•;yJkr,4• 4,f:•^. 1'::'11�. tr•• a,: a.' rl ! .' + . r , J � •n.t•5�i '•l• tgt'�i:�>f i r ,r.9::' �;il.•.T t_ rtj .�.�."21 ;;,„t•.: .•: : ,�,,� S•'}: a...•;+SL4.�, //f d�1 r '• •y'.+•," ' -i' ,• ?'t 1rt'•�M:'''\ f' ;a4••r • ( • •' n' •.fir h, IP r1 .,•�•• Itt} A. !,'n••1 •'t .�}4. .! rr'! •�4•:. �• I,t 't 1 tjj ++i,.. !r5'ytr 0•L1C.•:ftr £r. ,•' 1'. .1}�Si't:;��;•• :��N. .a,J+::r°ry::t°,..J a tosl,5oomsm or enaYties of a fin Lt}] ositioa of cziminal p a sins,me• I undrxatand that�c Failure to secure coverago as regt�red under Section?�A of MGL 152 can lead to thelmp + + rbonm ent as yell as c Penalties to the fol=of I STOP wORK O�tDFiR and a fine of�100.0o s'day g one yeas imp be folded to the Office of Investigation+of the minor coverage verification. copy o f this statement maY ' airs and enalties bf p erjury that the Worm anIct on provided abo is frua �nrd r/X�e erti under the p p ate `� rdo hereby c fy D 5i�atura hone# Print Lama ' do not write in this area to be completed by city orio=oft'iCia� []Building Department o{fcialL!saonly permitliicense# pLicensing Board city or town: ❑Selectmen's Office (]HealthDepaztmenf chockif inzme to respoaye is requlred []Other phone#; contact pi�3j' (:nvaeascp _ ._� .. r Znfornaa ion and lAstruCtions eral Laws, pter 152 section 25 xequires all employers to provi$c workers' eorrenstioix fir their. missachusetts Geri ' L'` ' loyees; As quoted'fromthe °lsw'', an employee is.defined as every person m the service of an under any contract lied;oral or written. of hire;express or imp , ` •arhoers ' , association, corporation oration or other legal entity, or any two or mare of pZoyer is defined as an individual,p hip the foregoing gaged-in ajoint enferprise,and including the legal representatives of a deceased,employer, or the-receiver or artrsershi association or other legal entity, emplo�sg employees. 'However•the owAer of a trustee of an individual,p • P� . dwelling house having',n0t'inore than three apartments and who resides therein, or the;occupant;of the dwelling house bf another wlio.err lb3�spersbris to clo maintepance,constrption or repair work orr such dwelling house'&on the grounds or 1 thereto shall not Uecause pf such;employment.be deemed to be ail employer, •building .Ppurt errant . • •.. ,:, •;; .. , cha ter 152 sectibn 25 also'states t:hat'every state or Iacal licensing•agenq shal'i withhold the issuance or renewal MGX� P Y PP• , of a license or pe?'�?f to operate a business or to construct buildings in the.comnnonweaIth for an a licanfi who has not xonse o acceptable evidence of coimplianEe with the Insivrance coverage renal a-' A.adidonally;neither'the' ' P of olitical subdivisions shall enter into any cotitract for the performance of public work ug q,' coiraoonwealth nor'.any• its P acceptable MUM' of compliance with the insurance requir ements of this chapter have been presented to the contracting.. authority. A:pFhcants Pleaseewo �s' eoensation a€ddavit completely,by checking thebox that applies to your sitdation•, Please Supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted t•of rndusirial A.caidents•for confurnation of insurance coverage. Also be sure to sign and date flie to the Departmen davit should be returned to the city or town that the application for the perrrmt or license is being affidavit The aft ,rtmeit 6�T dustrial A.ccideuts. Should you have any questions regarding the qw;or if'You ai•e requested, not the Dep • •yrOlkerSr.Compens4tionpQlicy,please call theDgparEment at,the ntur�ber liste�3belov�. required to obtain a• „ , . 1• PAIN City or Towns - , lease b e sure that the affidavit is a lete and rioted legibly. The D artment has rON*d a space at the bottom of the P p Y eP P affidavit for you to fill out in�the event the Office of Investigations has to contact you regardwg the applicant: Please e permitilicense number which wm be used:as a reference number. The.affidavits maybe xetuzned to b e;sure to fi11;m tb gawnts have been made, the D ep arfinent b' or F AX.w4l,ss other;arran . The Office of Iuvestig ations would like to thank y'ou in advance for you cooperation and slioiild you have ally questions, othesitate to give us a-caTL. please do n / artment's address,telephone and fax number, , TheDep The Commonwealth Of Massachusetts Department-of Industrial.Accidents Office>n iiieftaliens 600 Washington Street Boston,MR. 02111 fax#: (617)727-7749 Town of Barnstable Regulatory Services &UMSrrABM : Thomas F.Geiler,Director MASS, �bA 039• ��� Building Division rED MA't a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:.508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 5_1 tf JOB LOCATION: OZ7_S( ��� � ` \V3 � }- number street village "HOMEOWNER': \Rs�C\e. — y V� � 1��CLS Q,a-a-a 3 name v0 home phone# work phone# CURRENT MAII.ING ADDRESS:_. 1 0 K_', S 173, city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner perfoxming.work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." - Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. - To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �u t Map - Parcel Permit# ' l p 7 Health Division t — 60 421103 DE0<_ BARNS TABLE Date Issued .� 0 3 Conservation Division s Ss �� �.a ''ff)71- Y 28 R. j� 2� Application Fee � �� Tax Collector Permit Fee Treasurer — -- STlC SYS'I Planning Dept. VM TITLE& Date Definitive Plan Approved by Planning Board ENMROWAL CODE AM Historic-OKH Preservation/Hyannis TOM REGUL MNS Project Street ddress J `� ! �� TO �i r_ � Village IS Owner MN c AJ b UWO�Idress �J 1a 01 Ib O�A f!\ 'Z-D Telephone Permit Request AJ Square feet: 1st floor: existing 600 proposed 2nd floor: existing proposed Total new Zoning District OD Flood Plain Groundwater Overlay Project Valuation �. Construction Type Lot Size��^�S U Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ® Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ®'Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room.Count(not including baths): existing new First Floor Room Count 4 Heat Type an7FI: �f Gas ❑Oil ❑Electric ❑Other Central Air: ❑ No Fireplaces: Existing 9 New Existing wood/coal stove: ClYes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use ' BUILDER INFORMATION Name O'l-en 226 PAC Telephone Number r Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �� ph��� 1a DATE FOR OFFICIAL USE ONLY PERMIr7NO. --J�-- DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER - DATE OF INSPECTION: TU,�',�� �,/ • FOUNDATION s FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL A„ FINAL BUILDING DATE CLOSED OUT - a � t ASSOCIATION PLAN NO' - xt> V � ��:-._. The Commonwealth of Massachusetts Department o Industrial Accidents .......:: p f .11 _ = Office offnyestfgatfons . 600 Washington Street � Boston,Mass. 02111 WorkersInsurance Co Com ensation Inrance Affidavit name: ) S ` �,V—\-�-- J () �K3 X1 f--S . location: � � ()\ z�) -TU�3�,- ,�-)-) Y)Sc� ` Unn l S hone 5U ci I am a homeowner performing all work myself. ❑ I am a sole r rietor and have no one worki>1 in an ca achy %%%%��%%%%%% %/%%%%%/O��%%/%���/%//%%%%%%/////////%/%/%%%%%%%%%%��%%%%/��%%%%%%%%G/%%%%�%%%�%��%%�%%%%%�/%%%%% Q. I am an employer providing workers'compensation for my employees working,on this job. :: . .................................... . :comnsnv name :::>:::,... ; :::><::<:::«::<>::::::::::::: :::>:<::.>.::::>:: cl r .. .: ..:...:.. ..::.:.... .:':.:::::.;:.:;::g,... . ... ....,:...:'.::..:::'.:.:.:.:.'.:':..:..:.::.::.:.:....:..:.:.:......: ..:':' ;'..:::.;:::. ....................... .:.::..';;..;;:::>: ::>::>:::::>::>':>::;::>::>::::;.:i:5>•<•::>::::::>;::;:.:.....:.:>:::;::;. .. < o11G# :. :: :::::::<>r:<::<:>:::i G>::: :.city ah ...:::.::.::::.::.:...::..:. . insllranad.co..::.: :. ::>:<;: ::;:.:; .; ❑ I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have . . .. the following workers' compensation polices: comaanv name >•::;:> aldk ` i# ; ><?<'>>v>''<3i?z'`:YE> > iE>?:: :':':::%::::EE<<'iy`'^ '?`ii'i ''is g hn ................. :J�:::::::::`.:;;:�::1: j:`:;i::?ij:f;:i;:....sisi......::.....'•:':��:':'^:::::::v:i'' }:!::::{+:v:i'::'iii:':iiiiiii:i:ijy:i'...;:;:yi`ii;:;!i;: i'i::::':::::i'ii:iiiii::i:::;:�:M ......... .11.. .... ;.;i:,�i: :;i:; i:;:;:';; �i;: i'i`i*."...::$i.!;:•;i'Y::; f:.:.:.....:.':;:;::! fir:3'F.�:.V::}j. :yi?.,...:ii: ..:....:..:...:........:':::::.. ..... . .. ........... %''�%%lam%/�i. :c an nI. ...: SldtlrEss:.::..::';".'i.;':::: ...`:::': »::...:.>>:::..:..:: I. I. 1 :...:.:................................................... <'Ibn # ........................................................:.................................:............... _. _:..::.:..:....:........._:......:..._..........:........:. _. ,.. :::... ........... ::..:.:.: ..•:::.,... »:::;rice co': <`` .- >: ':.:::<' :»` <".< < `:< »> ><: :<::; irisnrac Fsflure to secure coverage as required ender Section 25A of MGL 152 can lead to the imposition of crindnal������ 00 and/ord that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature 2i������� Date \ /ZZ3 GS . _ Print name ,�' < � Do A//l/e� Phone i��0 VS.2 V-7 6 U y official use only do not write in this area to be completed by city or town official . city or town: permit/license# ❑Building Department 19, QMI ❑Licensing Board ❑checkff immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (devised 9195 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a . dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying' company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of-lie affidavit for you to fill out in the event the Office-of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits maybe returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of In11estigatlons 600 Washington Street Boston,Ma: 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 I °*1HE Iaf• Town of Barnstable P Regulatory Services ' RMSTABIX ' Thomas F.Geller,Director Mass. 16119..�A � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements.Type.of Work: / r� �/ FU Estimated Cost 1� UyU�UU qV Address of Work: ) 6 U 1 -/-) ) U �c 1 Owner's Name: ( V \ 1 ` )c� ' 0 r� Date of Application: S j z-s o > I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑lob Under$1,000 OB g not owner-occupied LqOwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Own r s Name r Lot 1-1- 7 ll LOT 6 jecK N T� — Lu Q 1`b -T-c�wf- R OA -aasa� r4ti LOU o . 47 44 4 QtBs"zc I. is = `y AMERI�CAN SURVEYING MPANY Off' KSTONt INC. i9 ,r�L a �12 k HAIN STRSB! TIAI.Tu". MA6&• 99401 JDM PHONE (T@I) a@8—Bt7? PAX (7Bi) M-7091 REGI TER€D LAND SURVPYCR. 0 HEREBY EERitFY 1FIAT TI+E ABOVE MORTGAGE�.�SKcrtOR _ MORTGAGE INSPEGTI, PLAN LA#4 WAS PREPARED FOR � �F_. 8� - CvuPiTV rZ€osTRT OF DEEDS PACIFIC HOME LOANS DATE. n r�Nt3if--• COROED AT; BApi1 CLIENT N C0N14 ECT04 WITH A NEW 4teNf REF. g214l PEAPI REFERENCE • � i � ORTO-Act AND is Nor INTENQE T R' DRANQ4 PER vQw F.:' ASSESSORS REPRESENTED,TO HE A LAND ME LOCATION OF THE ORIGINAL P. Eat GATED FROPERTY SLQ.KY- ! A — OnLLgNG StMJtiYN eiEREBk E:tFf€R AUDRE55s �RNERS WERE SET. AND IT WAS IN COUPlIM10E WTH LOCAL BORROWER:Mrlhs� « Ariwoi BE u!90 FOR APPLICABLE ZONING BYLAWS IN ST[e8L15MkNG fEt+GE. H QCEt ¢fFEC? yytfEN Wm$TRUCTED BUILDING LINE$, THE LAND (WiTN RESPECT TO MQMZONTAt_ BASED_ - OOR.INS S.EWxE�uLP TR EWAREMENTS QKY)KOW HERRENFUO FROM VIOLATIONCLIEkT HSD NFORMARON. AND MAY Of ACTSON tHbMR MASS THE_S`ui�,{ECT-{3v�LLm lKS IN FLOW WINE _ 5LIVLJECT T41 fvRTHER CL T17LE V11- CHAP 40A, SEC 7 AS SHUWN ON..THE,NATIONAL FLOOD INS *�n O�T T OUT=Snt ES. TAIftFi65. E'A$kiENTS. UNLESS OTHERmSE NOTED OR INSURANCE FLO66 RATE iAAP File 2: 1 l ANO - Ri tS OF wax NO SHOW ttEAEON n CDpFIRMATQRT' 'CQIiOi(tu�iY/pE�PlE4 9a:—•,—. ..�r.,n..e.oi.,� e c1e7rNnen IN5TRUMENT SURVEY 15 ADVISED r?w--.mVmAr7CK O - ow s fps'fit��ln��115'll�RmMIr liiE40W_� ir Mid'NOW;' F _ $ d.•"I .� @!� ���■�.�..�:.�i arm �,�'�L�.���iY��f�.. 4�irOW"�+r�Yi�kl�eil 1 iC' * 5 rrrn DIY%;�i'1�1�'1���4iX1�11iA.s rl� s � 11 ,�1•.�'`,, '"ems _ ■Y��:Gr�rr'A?�L�I�I4i6' !4_1� �1}� .... *_�'1��,y�- r4 ' 1101 W,�S:T`id='a �iawYt^,S'• f 4 pf ARM IMF r .t tl f. _ t i /• r The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 5 ;� 2,)6 JOB LOCATION: nu( `mbeer street �( village "HOMEOWNER 1"�( �U Vy C� (S \ © V— ?OU q name 2 home phone# •work phone# CURRENTKkTUNGADDRESS: T(li 4i7i1 S,�U/21 U G-? city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the •-' Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and -- other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. /} Sign tore of H meowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed-Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C� /DD. 74 ' I it Of I N CARL �g I H. I®EVILACf?lMt NR.33317 ' �O�cr�F AVI tee„ M� ���'`�r Per • �Z� �� T 36• i S - 13UI L T PL hAl D�Q lJourr7 e s A17ASSOCIA2rZS C46140,10eers c�Surveyors 23� o1dT�� S, Don'moutli, ,fL4 OZ748 O1S1 JCQ e ! - 269 zoo JD /�Iol <3/ 4D1)l TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map t4, Parcel f Permit# r Health Division l ( Date Issued 3 Conservation Division �+ a/d 0/ �L 1N Rgv 2`9/D/� Fee o I E { Tax Collector lz� o � 2 8 2001 GINSTALLED INZOMPLIAN. EC n C cVGTF_r � tT;J% " Treasure 1PlflTH TITLE 5 -; Planning Dept. ; NlVIRONMENTAL CODS Ceti D. Date Definitive Plan Approved by Planning Board W6av— Rpp�p OPENING PERMIT FROM ENGINEERING OR Historic-OKH Preservation/Hyannis i FMOA TO CgNg11UCU0 Project Street Address T Village V1 C C�_ Owner l�iG(,vt i°_ a/�r.J h. Address o2� �� �`� 256 - Telephone -,Permit Request (�C)V( rc�(.,4 16c, O X 0 t^& V Square feet: 1 st floor: existing proposed /Gr00 2nd floor: existing proposed - Total new ,\Valuation / , I-iw Zoning District Flood Plain Groundwater Overlay construction Type 451'Qeyr_Y16 Lot Size 9, f� Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family tom, Two Family ❑ Multi Family(#units) Age of Existing Structure Historic House: ❑Yes 6&No On Old King's Highway: ❑Yes o4% Basement Type: Wull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new�- First Floor Room Count Heat Type and Fuel: ( ..Gas ❑Oil ❑ Electric ❑Other Central Air: **Ies ❑No Fireplaces: Existing New�_ Existing wood/coal stove: ❑Yes ❑No .Detached garage:0 existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# C,,(rent Use Proposed Use BUILDER INFORMATION Name J)rn eoa5 6 4-c fI C)r'_1. Telephone Number Address a9 3 7C7.XrLC- +'Da License# j�.� U '7 1 Home Improvement Contractor# Ic(P3 /t/ Worker's Compensation# C c�2—00J 3r?vim 3®S ' ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE I I FOR OFFICIAL USE ONJ.X 4le _ - PERMIT NO. Y f �� � � i - _ - •� . ,. ^.. , . _ . DATE ISSUED t . MAP/PARCEL NO. ADDRESS, _ VILLAGE.` ' OWNER t a r DATE OF INSPECTION: FOUNDATION FRAME INSULATION / Y FIREPLACE ) t ELECTRICAL: ROUGH. "' FINAL } PLUMBING: ROUGH' <. FINAL. GAS: ROUGH_ FINAL BUILDING /tio-• - _�` 3 7 be2 T M p4�k.e tv 4M cc DATE CLOSED OUT '` � - ASSOCIATION PLAN NO. ' t i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map o� Z9 Parcel - - Permit# p Health Division �� - �� � FEB 2 8 2001 J Date Issued a0 0 L Conservation Division �� o� �� � �; ee Tax Collector �`� VVLwLF-S • ��_s-'LBO •�.'„��9� � �.. . . , . - .. Treasurer - IvTAILLE® IN CCMPLIAN WITH TITLE 5 Planning Dept, ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board �^^� TOWN REGULAv IONS Historic-OKH Preservation/Hyannis Project Street Address 3(a UP _ LU a_ oo_j�) • CJ)' Village t,0 -� l 4�0 Owner ) i01_VlK Dort) VLe5 Address Telephone eZZ &OP -6f�d -3SF Permit Request e It i r r rz_ cd S 'i A%v6y®k Square•f6et: 1st floor: existing proposed 2nd floor: existing proposed Total new Valuation Zoning District Flood Plain Groundwater Overlay Construction Type U)©0 t'� _ Lot Size��T�/� Grandfatfiered: ❑Yes ❑ No If yes, attach supporting documentation. Dwellang Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure a Historic House: ❑Yes W.No On Old King's Highway: ❑Yes Q&ko Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other_a o,&,e, Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing_ new Total Room Count(not including baths): existing _ new First Floor Room Count Heat Type and Fuel: 64 Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes W-No Fireplaces: Existing . J7 0— New Existing wood/coal stove: ❑Yes 4N.o Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION 6,�v f y -3,sLC7, Name [=1 ork, Telephone Number JZ) w'�5 Address z23 1-1 C It z e. rn License# 6 5 0 f 7 1�6j Home Improvement Contractor# Worker's Compensation# T< 0—GBS S- Z —,3c�c5' ALL CONSTRUCTION DEBRIS ESULTI G FROM THIS PRO T WILL BE TAKEN TO SIGNATURE J c DATE o� -0 1 ' FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED �r , MAP/PARCEL NO. T' ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAMES Gtl INSULATION I/ FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL , FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts : — _� Department of Industrial Accidents alikeollMOSM211oos 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: t>m or K 54r CkG li lU location: city 8),a a(4• ❑ I am a homeowner performing all work myself I,am a sole Lumnetor and have no one worldn in anv achy ❑ I am an employer providing workers' compensation for myemployees wonlang on T.MS 'ob. .... tO�QanY name: .........:::s} ;z: ?:r•:x:a:::> . ............}}:;::.•..:.::::.:;::.;.::.. .:................ •..........,:.......-.............:::v.v:•::;•�•:?4;{;;}:}::{{;:�::::x::•• ..........vxv.v..tv:.:{:w::.v:::::tvty::{:titi4}}v:•vhv:•}}::}.i!}: ::i`:tii iiii:v:v...i::i 'i}:ii:>::::.v v.:::...........<}:`.,t. :ivies]isistii}:::ti;:}:}:::•i$}:vii:i}iiiii}:i:}:}':i i•}:;};:.}: :.aJWr tv.L.::::?:};{}:i}:•}?;�:{:};{i:i:}�i�i:•i}:i`v'riii>iii:!?ii is>i'riii:�{:{4�i:i:�Ji:^'' .................................�:v::::..::.v.�:�:v::.:::w:::^i:}}i:•v:•:X::::::......v:...•w:::;;.........•• .. ...........................v.... fv:' ............ .................. ....................................... , x ........... .................... .. testa:.::.:. . . ,.::...: ;;.. ..:::..;.::.:.;::.: .:::...... ...,.....::.:.::•::::::.::.:::......:. :::.._:::::::>. . insuaan :..:::.::.::t...,..::.:.:.. ...:.,:.:. olicv#.: . :<:;:<:;;.:.;•,':.}:.;::<:::;;::::;::,.:.:.:. :::.. :. .:., ,,::.:;;;;,,,..;.<.>::.:;;:.. ❑ I am a sole proprietor,general contractor,or homeowner(c&cle one)and have Hired the contractors listed below who f have the following workers' compensation Polices;- e. ,..: ceui nv 0 .............................. .:.....::.:.:.... ...... ... {.:•.•::'iti�}:::::::::.v;.}}}:;p}:::r.:{.:.•.v.}•:{:;:;.}y`•yv.}:{•iF<�iiTiii:t T:?4'r:i}�::::>}i::is>::; ................................................ .................................;}}:.v:•}rv:w:mn:x•.w::::r..}}:�titi4:•}?ti:i}•..:.;...::.t:•n M:.• v ••-v:.v.v::::...:........-......-.........,�......:.... ,.t4i ,.::•::.:....::::.................. :::w:::::::.v::::w:::::.v::•::.v::n{4'•:.:v:•.:::v r ..........:.. .. .�.{• ...f.V{-0`^i.•.•vvv:{•}}:{::(!•4tv.};:{::::.:...............:i.v:.::y?:;;.. :::•....... .......................r..t......................\}i..w\.:,......a. ,.;{i+,%:t,.}v.,-..:nvy},.t:.•.vv..:.v -,•:}:•:•:::::•.w::::::•.. ......:::......:::.............:.::• .... .f..:..:...... wau.Y• .!S 4:... }. .} ..t i?•°Jk S'�:s++'....t ,;:::ice:+•:;:. .......... ................ { }H....... }x....;#.Qwh„ .k• } :t t:.. �,}::::. �{{:;n{vy xw,vaW.'.:..-w.v<iin;Ji: : :v:............:::hw:::::::::::.:v::::::.v::::.v.::v::::..:;;•}}:;;<;•}:v:::::::::.:v:::v.:::....;.....:.:v:...... :.:.......:..................................................:::v::v:w.v::v.v:w...:v:..:.•.::•...::y::..v,•.v :.,..... .....v...:.. a .t.....::. ..:...... -....:::.:.......:: ........ 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Fame to secure coverage as required tinder Section ZSA of MQ.1S2 cart lead to the tmposido n of czimWd pew of a dne tip to S1.M00 and/or one years'imprisonment as weA as dvfl penalties in the form of a STOP WOGS ORDER and a foe of S100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the OIDce of Investigations of the DIA for coverage veriantlon. I do hereby certify under the p ' p nines of perjury that the information provided above is&zw and correct Si tireG�- Date cg Printna= Auk /✓;9,/eo ri,o— otHcial use only do not write in this area to be completed by city or town omdal city or town: permit/llamse o Mudding Department DLicenung Board ❑checkif immediate response is required ❑Sdeetnen's Office ❑Health Department contact person: phone#; ❑Other_ Vvnua 9/93`P1Ai • • • . . 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Tax Dist. 400 Land Ct# Per.Prop. #SR Life Estate #DL I Notes: VISION #DL 2 GIS ID: Total l 59,9001 59,900 V/41 whe WIN MIXT C ""I LANAGAN,V KILLEEN 6736/085 05/15/1989 U 1 17,150 A Yr. Code Assessed Value Yr. Code Assessed Value Yr. Code Assessed Value DWYER,CLARENCE&CATHERINE 1095/513 Q 0 1999 1010 31,400 1998 1010 31,400 1999 1010 28,500 1.998 1010 28,500 Total: 59,9001 -Toakt, 59,9001 Total: 43,600 Year TypevDescriptio-n Amount Code Description Number Amount Comm.Int. Appraised Bldg.Value(Card) 28,500 Appraised XF(B)Value(Bldg) 0 Appraised OB(L)Value(Bldg) 0 Total: I Appraised Land Value(Bldg) 31,400 Special Land Value *ADJ FOR COND... Total Appraised Card Value 59,900 Total Appraised Parcel Value 59,900 Valuation Method: Cost/Market Valuation �et Total Appraised Parcel Value 59,900 Insp.Date % omp. Date Comp. Comments Date ur os Permit ID Issue Date Type Description mount ID esu t 7/15/91 ML Pur B# Use Code Description Zone D Frontaze Depth Units Unit Price L Factor S.I. C.Factor Nbhd Adj. Notes-Ad jlSpecial Pricing Adj. Unit Price Land Value 1 1010 Single Fain RB 4 0.39 AC 179,000.00 1.00 5 1.00 55BC 0.45 SPCL(.39,U10)Notes:10 1BLD 80,550.00 31,400 Total Card Land Units 0.39 AC Parcel Total Land Area: 0.39 AC Total Land Value 31,400 Property Location: OLD TOWN RD MAP ID: 268/030/// Vision ID:19348 Other ID: Bldg#: 1 Card 1 of 1 Print Date: 02/22/2001 Element Cd. ICh.I Description Commercial Data Elements Style/Type 36 Cottage Element Cd. Ch. Description Model 01 Residential Heat&AC Grade - Frame Type Baths/Plumbing AS 16 Stories 1 1 Story Occupancy 00 Ceiling/Wall ooms/Prtns Exterior Wall 1 14 ood Shingle /o Common Wall 2 Wall Height Roof Structure 3 able/Hip 1 Roof Cover 3 sph/F GIs/Cmp Interior Wall 1 08 Typical Element Code Description Factor 2 Interior Floor 1 9Pine/Soft Wood Complex 2 Floor Adj 1 12 Unit Location eating Fuel 1 None Heating Type H None Number of Units C Type 1 None Number of Levels /o Ownership Bedrooms 2 2 Bedrooms 1 Bathrooms 1 1 Bathroom 10 1 Full Unadj.Base Rate 48.00 Total Rooms 5 Rooms ize Adj.Factor 1.54942 Grade(Q)Index 0.82 ath Type Adj.Base Rate 60.99 Kitchen Style Bldg.Value New 41,961 28 Year Built 1951 ff.Year Built 1965 rml Physcl Dep 2 uncnl Obslnc con Obslnc F7Specl.Cond.Code 'Spec]Cond 1010 Single Fam 100 Percentage Overall%Cond. 8 eprec.Bldg Value 8,500 QUTB lI DPI YG cPc l' RD ITEMS BUILl)INU EX>7RA EAfTURES Code Description LIB Units Unit Price Yr. Dp Rt %Cnd Apr. Value ' BUIL�IDINC�SiIB A�A�SU ,y d SECTTO� �� Code Descri tion Livin Area Gross Area E .Area Unit Cost Unde rec. Value BAS First Floor 688 688 688 60.99 41,961 i 1 Tit. Gross Liv/L ase Area 688 688 688 BW Val: 41,961 Barnstable AT� 47 Old Yarmouth Road R 1 P.O. Box 326 C O M P A N Y Hyannis, Massachusetts 02601-0326 508/775-0063 I FEB RUARY 28 , 2001 TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN HALL +. HYANNIS MA 02601 RE: Water Service #1242 236 Old Tow-n Road, Hyannis Dear Sir: Please be advised that the above water service , #1242 , was shut off at the main and the meter removed at the owner' s request on 2/23/01. We were told that it is- the intnent of the owner to demolish the existing building located there. cerreiy, Jane Morse , Clerk Barnstable Water Company , . 1 d , STAR 2421 Cranberry Highway Wareham,Massachusetts 02571 EL EC TH/C GA S February 27, 2001 Killeen Flanagan 236 Old-Town Road W. Hyannisport, MA 02672 To Whom it May Concern: Please be advised that the service and meter have been removed from 236 Old Town Rd.,W. Hyannisport. This was completed on February 23, 2001. Sincerely, Karen Corriveau Office Administrator f 02/28/2001 10:35 508-646-7111 VIVEIRDS PLYMOUTH AV PAGE 02 D4PLETE APPLICABLE S tlflpN On REVERSE roram.;o use Fidelity --'- v Pubhr'nnciai t .. em Surety Company Individual 0 . 2 Probate Partnership O Court Rnconor, etc. .:`. a A Suhsid,.lary'rrf.CNA Surety Corporation s Corporation 0 License .. .• . G " : Form 10 � Limited Liability Company O Lora Seourme ' APPLICATION. '��,� �(��®.,,,,,A�� ���� Lim lability Partnership❑ tied L Applicant(Ptrr Parini?».hip,give till!nit IQl of rAl'tiWrs and trade nwm(,) typeSpi itil Security IA - Plroase print or # Age D M F CONSTRUCTION G22,56-387 rrl�a , I • _.. .. � 5 3 3 3in?�le Xesidc•nce address 293 t.'(roct and Nun�bcr) TICKLE R D (City) W E S T P 0 R T (5&aw) hl A (Lip)CI _.. 2790 (SvoA and Ntnriircr (city Oc u6ttinr or busiiw.s.s How lory#,r`Su enaa d•) Previn S lre n :.uret fl Yea is Nil r rot, ,}rc tsars;md n7aynn fur c•ha;:g:. C�INSTRUCTION '� y ' � _......---..... _...... 1 YEAR Tyw. !U3cni y1 rrut of icnd- A BOND 52) .00 .. - Effct lei ve I.).tte 2/ 01 ----�I — I :t7rlp ate name and .tddre5s of(lhlic,'ge TOWN OF BARNSTABLE �67 MAIN ST BARNSTABLE MA 02630 FINANCIAJL STATEM.ENT'a3 of _ Check applicable section on the reyerse side to SfLe whether a financial statement is necessary. Check glee: :7 Business Financial Statement ❑Personal Financial Statement ASSETS - �- T_IAB1L1'."IES � ......... _ Cash(List•Banks) ^IAccounts Payable _...., Tuxes due & -ecraed Stocks + Bo,ids — .Desctibct ;_— able to Raze _ , . Pa yable ay ti_......... I -- Notes Payable tat Others(Describe) - - !Notes 110,,eivable-•.Describe Mortgegrt> on Real Estate _... .._ A._—.-... Mortgage on Real Est�-lu_' _ F ._.... Morehandise or Mawrial in Stock...�� � A(i!ounts Rccoivable,--_„_ 0 0iiher Liabilities I sill]✓stile, 1Iorrlestk.sct A Real --- Estate, Inc�estment,., .,u• B TOT1eL LIq,13lLITIEa 1 Furrituro and Fixtut".,,„„--- Capital Stoclt (Paid inj. � ! Other Assets Describe,__ � _,_—]NET wORTR OR ST.iRP1,T-11,;,� TOTAL ASSETS TOTAL Liabilities and Net worth - Gross Sales •Tap Years Ago last Year -Not Income- Two Years Ago _ Last Year INIDEIVANITY.The undersigned applicant and indcmnilors horsily request wcocro Surety Campueiy'(the'•Company")(0 bedtime sbrcty for 111C All h,:lad.The un; igttod hcAl:y certify the truth of all staivrnent in (he"policotion,�aut orizetheCompanytoverifyth!sinforrwi6nantitoobtainaddhionolinfnmationfromaoytlource,includingohtniaingacrvd;trportat,herimeofappii aliao,inunyrcvicwoercttewal. at the limy ttl'my pethmllal al'actual claim,at for' Other ICgitimatC ur>Ja%L'�3S tiCa:Ylninad by the Cnmpapy ill it%reasnnabie ducredrin,anJ jotntly and severally tlb!'Cxa ( 1) To pay the usual pr4mlllms.including renewal premiums,to the omputiy'or:its n0.epr8,wllce due. ( 2) To vlmt,letely YNDEmNtNTT V the Company from and-11%alnnt 04 iiahidtf�last,enrtt attorney's fees and eypl ltc�whatroolver which the Company shall YI anytime muxtaln a4 sloroly'oe 117 rtuvan of hnvllog hoen 9urtty rrn this hand or any other. and tsaurd'Porapt,lknnt,or h,r lh'r ettfarcemeMof Oil agretment,or In obtaining a release or ttvideaee of terrninaliun under such bondH;rof(ardlexs of whither such liability,loss,"SiA,dathalreg;attorriryx'fees and txponsts a,l•t mused,or 4111log4ld to be enured,by flit nc0i' duct or the Cnmpuny. ( 3i TO fulnis(l the Comports with snlisfacrory and cnndus;vC termioatl'dn dvidencr tfiut tharc ig no funflcr liability eni this hi�nJ or ay uthcr bond iszued Mr applicant, ( 4) Upon demand by the Company for any reagoa whatspavar,to deposit carr�ellr funds with the Ctmrciny in tin errloarn.iufficiero to sulinolh any claim a b•ainvt the CDmpi,ll)'by briar of such surcrysltip, ( n) That the Cnmpuny"shod hAvc Bat;right to handle or sclticaany eiuim or suitin goat)faith,An i Wmiad statement of lose and expense incurred by the Cotnpa:,y,sworn to by an offieC+'of the Company. shall be prima tucic cvidctice of the feel anu extent of the{lability of the undersigned it)the Company, ( (j) flat the Company ma�JeClim to bee;ome surety on an a r y bond anetry Coneet or tnnend any bond without eluige;tad'without any tidily which might urine therefrom, ( 7) That the Company slit I,without Hants,have the right do alter who,palt Icy,ie8rms and enndiuoni.of any bond kgac4 for undcreigacJ,and this agreement shun apply la any swh altered I.w7nd. ( g, That i(a,contmcr or Wl'ormuacc bond is lssadd•hereunder,the, m undtrRtgticd:hercby.assign to the Company any munies now dot or hereafter b-icomingduc under the contract,including all Jefcucti payneents and retained percentage,supgliCs,Iooh.plenla,equipment line matelots due or ewcd on the Contract ( 9) AI Inc Cumpuny'xdiseretion,thiVinderenityagreClnenFsllallbegoverntoinalT("rmttFby the lawtel'theStateof$outhDakotaamd the undosiarkedappiecanl and indcmnitnrsco68enitotAdjurisdictiun of the col'etS of the State of South Dakota and the United Statcs D:j eiet Court for the 044rict of South Dakutu in all actlons or Tpceadings aril:ing tram or relating w lh.ia indemnity agrecnicat. t 10) That Ibis indemnity may be cancelled os to subaequcnt hubilky by en indemnity!upon written aurice to;bc Company at Sioux Po(is.South Dakuta 57102,ef(ictiye ten(10)days afterthe tartest eiatc thercatler upon which the Company cuald have cancclicd all bonds in force;for upplicont (11) to the event or any,payment by the Company,:o pay thtComp:u,y inrerem on such amounts at the highest legal rate frin,the Cdtc Well Payments wire made, �I}{I1l'tl Phi,: dFty, of Agency N 5\ro e1. Agent'-, v — Non rial"An}g', g-P.It4rn should n gn their 11n h,12 anll&dd the word"fret nnie�Y ill ty,eir S Code — awn hnndwtitt • r. n, 11 AGENT'S RECOMMENDATION Your recommendation will he.helpfu)and may be thra difference between getting a refusal or having;the bond. written. Tell w; what you know and think of the applicant,_rNSUREO HAS ALL FERSONAL AND COMMERCIAL INSURANCE WITH US AND HE 'S WELL KNOWN TD THE AGENCY - PLEASE LIST LOCATION OF WORK TO BE PERFORMED AT : 236 QL,D TOWiV RC .BA STAB>,E AGENT: Check here if this correspondence woo P evibusly faxed to YSCci.f ! m w m 2 f ErPL+11tiA'ION AMOUNT 53-714-112153 = DMF• CONSTRUCTION CORPORATION 0 Z93TICKLE RD. WESTPORT.MA 02M -- --- J rL 1312 0 .� -- PAY - f i(g o H w DOLLARS AMOUNT TOTl1E0 DER OF L'HEiKN0 H Q0.7� DESCRIPTION cQAMLRy � AND' lI°p01, 3 � 21�° r� � � 1, 37i� 46s: 5630 i963 Sri° ' .�_ 6JF�•_`Sc •-_-�.�._L�k:�.:' -._-., l':L'_7:'::.:n Win..?.�':_ MI ....-r•�4l_ r - n _ __ LO On 0 m m m Q, N a� rr ti m a _ m/ The Commonwealth of Massachusetts Department of Industrial Accidents - � -� '•7 r ==3 r Ofllcr ollayestlgatloos - .- - 600 Washington Street Boston,Mass 02111 Workers' Compensation Insurance Affidavit name: location: J!� city GUL?� /.rb r'Lam- l��� 0-a phone# (k ❑ I am a hotficowner performing all work myselL �I am a sole ro�rietor and have no one workin in aav atdty ❑ I am an �1�������� � �emp over providing workers' compensation for mp.emplovees working on this 'ob. •� n��8ev tO�D ...... :�.�:..::.::.}?;.:}::3:<?v:ii}:�:::•:iii}:?::}:}:}i:•.�:::•:Y:?:�i:{.:r.:{.:::v.v:::::•::::•..::.:•..:.....vv:w::: ....{.:..,...:...r..:.s......v. ........................................................... ......... v. ..............:. w::::::::...................................::.•r::::::.:v.:,...:........:•...:::.v:.v::x,::•:v:.:A::v:.�:v.v?::S:v:•:}.......• ..::::........v: ...v::::::::}:::.....:.:•.�:::::.�{•:}:•:i•>:•:•ii:}.;� :::........................... }.,:nor%•x:::t:•}:•:t••;•;;:.;;:.::??:.:?.;?:?::>}:?;;•}:-»:�:}::>::.}:.;»:.:_•.:-}:?•}:::::.:•}::-:�::•>:<.,. a. a ty- : «ocae<z :. . >hxry ::N UMMI q ❑ I am a sole proprietor, general contractor, or homeowner(drele one)and have hired the contractors listed below who have the following workers' w==s=on oIi= .....................,-.:v.:�:::.v:•.v.•.:.}:.i::{t.}:}::.i::i::S-:t.:.>?;.;^.:::ii''�>.;:;;:;.;:.•:it:!ii:ii;:;:i::}:::'.•}:•:?{??}:•}:.:::....................- .............................,,.?N.}...... ....................... .......::::.. �:.::{ :.:•:}:•:!,4x•.......;}};.}}};{.}'?•Y{???.v{.t}?}:tY:•}}:{:t}:'.:}}}::.;.}•..v::??;:?:}??:}{j':?{{t?::i}::Y???4:}•i:yi ....;.:;,....:..............................:::::::.::.v::..................r.{...(?y::...............::nW?CLt.<?:l::.v::::?.,-:::-:ti4:S::•xAv..�J•.:•.v:,,•::.v:.v::::•::•:{�+:�vv:x.:::::.:vh•;•,•:::v::::::::.�::.�:.:�:::::•.v:._::.. :.:?.}•:::::•:::.�:.�..........:.:....:....;•i?::�?}}:is ii:?-ii.`i•::i:.�ii:..::�.:.��-:is i.'.::.:ii::�..:�:.:'-.i::::?{r;:}}•{.:•.}}•.v:.}:-}i':•:•i}:.xt•:}}::r:{+.••?{:::::r.}?•:.;••}iY•}Y?!-:?.:.:•::.}•:.,•::i:::::•.v::.v-:::::... 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Yh:•:{•}:L:.v::'•}:4:'.�Cti�.. <:v;:{;C:`}:ti}:;:ijiii:ii'i�i:;:tiSi:i�:i addresr.' .. .... ftyr �i�on ...... .............�.:�:: •..�......:-.�:^:v::.�::n�:.:..................................t...n n.,,Y',:T.:.....{...... x.vrw {...:•.:..�.,:.:titJSX'n..#n C. .. amnnce:%�. ::......... ................::.,.......:.......... .::.:,:..?-::....,.. Fsfime to seems coverage as requ ted under Section 25A of MGL 152 can lead to the imposition of afmmai penalties of a fine up to S1,S00.00 and/or one years'imprisonment as well as dva penalties in the form of a STOP WOGS ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the piece of Investigations of the DIA for coverage verification. I do hereby catify under thepairss and en of perlury chat the information provided above it&w and correct Si tuts Date -9 64•-O Print name # :SCR-fin Pr? 3 S"e 9 0oincw use only do not write in this area to be completed by city or town omeial city or to": permit/lleense t# ❑Building Department ❑Licensing Board ❑checkif immediate response is required ❑Seleenne; O}fise ❑Health Department contact person: phone ti; ❑Other. (mvuw 9195 PIA) . • • . .I • .111 1 - 1 • . IIIU - • . . 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' 1 B.•1111• 1 • 1 •11 • 1/ I "I'' 1 .1 . • • 1 YI.1 .I■ •11 AI 1 Y II ' •I111• .11 1 .IBI -� 1 11 Y, .11 1 1 1 •II IIt111 • -1 •II ' ' III Bn.l .11 •w.11' . 11 II .1/•• NI • • • 1 - ' / ./ •11�111 11 1 111 .1 MM 1 till•. •1 •'UI1.1.11✓.11 •11 • 11 11 .11 ••" • �1 '1 1 1 1 At 1 1 1 1 I 1•- •• / ' 1 1 • • • .+111.1 �1 /• 11 MI •1 11 •' 1 1 .1 11 .11 • M:1■ •11 • 1 •�1.1111 • ••.•1 `• �• �•. 11• 1 1 11 - 1 •%1 111�111 •i 11 111 •• IMM • -1111. 11 1 1 1 ' / .11 • ..� • •11 � Y 1111 • 1 •I • • 111 �• 1• • • Y,111 "110.4-1•, Y•I111/-.1 `✓•1•Is,1 rj 1 • • •.; 16 1 IT41 •Y.-• •11-111 .1 •1 IIIIII 1-1 �• • 1 - •/ •1 y t• • ' 1 1+•1/111 -1{ - 1 1 • 111/�• •J • 1 • •11-111 I • • •�• • .1 1/ 1 • 11•I1Iwo) 1 • • • 71 • 11 11 11 -111 •1 1• •' • 11 •-. • •Y.1• .. •II 1 1• V.III•'. • w•Y. • 11 • 1 .1• • •+:111 �: • - • t�.1 11 /1 •�1.1111 ••-11 ill Ito Lill, - -11-1 wI �• IIIIII •-1 1 •• • ' I•. 11 • -1I1I.1�• • •••w1I • 11rh •) 11 w • 1/ -B .• .11 • ••1/•�1.11. 1 •�-11 I/ •• of I ' Y .1 • v 1 /�jjjjjj�jj�jj��jjj�jjj�������������j���/������j����j/�����j��jj��j�j�������jjjjjjjjj�jjjjjj����������� •. •••.1.1 ••1 .•. • 1•1 .0 • Y.Y 11 /•1 •-1 1 1 11 11 1 I 1 ' 1 . off I 1 1 1 1 / — — rT_ _ . � � ,_, �- ; ✓tie �o�ninwozurea,/,C1 a���cteluateCts DEPARTMENT OF PUBLIC SAFETY CONSTRUGTIUM SUPER,IS LICENSE � � Mumber S: hdate: - - { Cs '<CIF 539 p41/25/2001 ll/ 5/1963 Rest ted T" OO MARS 41 _tABEROE W 77 STETSON ST FALL RIVER, MA 12720 F -cTk 6avre6..e d ll_&lv� HOME IMPROVEMENT CONTRACTOR - -Registration 126314 _ a Type - INDIVIDUAL " Expiration 05/13/00 r MARK W. LABERGE 77 STETSON ST 3RD L� �o &yfAi�C RIVER MA 02720 ADMINISTRATOR d I I MAScheck COMPLIANCE REPORT Massachusetts Energy Code I Permit # MAScheck Software Version 2.01 Release 3 I I I I I Checked by/Date I I CITY: Westport STATE: Massachusetts HDD: 5426 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 12-21-2000 DATE OF PLANS: 12/20/00 PROJECT INFORMATION: lot 8 Shand Court COMPANY INFORMATION: DMF Construction Corp. COMPLIANCE: Passes Maximum UA = 504 Your Home = 457 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U�Value UA CEILINGS 1340 30.0 0.0 47 WALLS: Wood Frame, 16" O.C. 2470 13.0 0.0 203 GLAZING: Windows or Doors 365 0.350 128 DOORS 83 0.420 35 FLOORS: Over Unconditioned Space 936 19.0 0.0 44 HVAC EQUIPMENT: Furnace, 82.0 AFUE ---------------------------------=-----------------------=--------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer ' '2� � Date MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 Release 3 DATE: 12-21-2000 Bldg. l Dept. l Use I CEILINGS: [ ] I 1. R-30 I Comments/Location I I WALLS: [ ] I 1. Wood Frame, 16" O.C., R-13 Comments/Location I WINDOWS AND GLASS DOORS: [ j I 1. U-value: 0.35 I For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: [ l I 1. U-value: 0.42 I Comments/Location _ I FLOORS: [ ] I 1. Over Unconditioned Space, R-19 Comments/Location I HVAC EQUIPMENT: [ ] I 1. Furnace, 82.0 AFUE or higher I Make and Model Number [ ] I , 2. Air Conditioner, 10.0 SEER I I AIR LEAKAGE: [ l I Joints, penetrations,. and all other such openings in the building envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1.. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. I 2. Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.0 cfm (0.944 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be .labeled. , I I VAPOR RETARDER; [ ] i Required on the warm-in-winter side of all non-vented framed I ceilings, walls, and floors. I MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can [ be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment. must be provided. Insulation R-values, glazing U-values, and heating 1 equipment efficiency must be clearly marked on the building plans 1 or specifications. I I DUCT INSULATION: [ l I Ducts shall be insulated per Table J4.4.7.1. I DUCT CONSTRUCTION: [ ] I All accessible joints, seams, and connections of supply and return 1 ductwork located outside conditioned space, including stud bays or 1 joist cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be 1 omitted where gaps are less than 1/8 inch. Duct tape is not 1 permitted. The HVAC system must provide a means for balancing 1 air and water systems. I I TEMPERATURE CONTROLS: [ ] I Thermostats are required for each separate HVAC system. A manual 1 or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided.. I ( HVAC EQUIPMENT SIZING: [ ] I Rated output capacity of the heating/cooling system is 1 not greater than 125% of the design load as specified 1 in Sections 780CMR 1310 and J4.4. I SWIMMING POOLS: [ l I All heated swimming pools must have an on/off heater switch and 1 require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. i HVAC PIPING INSULATION: [ ] I HVAC piping conveying fluids above 120 F or chilled fluids 1 below 55 F must be insulated to the following levels (in. ) : I I PIPE SIZES (in. ) HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" I Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 Low temperature 120-200 0.5 1.0 1.0 1.5 1 Steam condensate any 1.0 1.0 1.5 2.0 COOLING SYSTEMS: 1 Chilled water or 40=55 0.5 0.5 0.75 1.0 1 refrigerant below 40 1.0 1.0 1.5 1.5 CIRCULATING HOT WATER SYSTEMS: { ] I Insulate circulating hot water pipes to the following levels (in. ) : I I PIPE SIZES (in. ) i NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F) RUNOUTS 0-1" 1 0-1.25" 1.5-2.0" 2.0+" 170-180 0.5 1 1.0 1.5 2.0 , ! 140-160 0.5 1 0.5 1.0 1.5 100-130 0.5 1 0.5 0.5 1.0 I ----NOTES TO FIELD (Building Department Use Only)------------------------- y EST/MA TED PROJECT COST WORKSHEET LIVING SPACE Value (high end construction) square feet X$115/sq. foot= (above average construction) /i�0 0 . square feet X$96/sq. foot= (average construction) square feet X$57/sq. foot= GARAGE (UNFINISHED) square feet X>$25/sq, foot= PORCH square feet X$20/sq. foot= / 1-0 DECK square feet X$15/sq. foot= OTHER square feet X$??/sq. foot= Total Estimated Project Value f �06 Z6 qua r 4gda I 6® No.�r��J-" lJ�--------------------------—Fee ---Q THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS oiopoof Ootem eongtrurtion Permit Permission is hereby granted to Construct( )Repair( )Upgrade( Abando ( ) �' System located at i and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be c-oompleted within three years of the date of t ' t. Date:___ � -' � 5� Approve a i t � :.cz3s 1C21 l r �r+rFx n r 5 a ole lin r. -, P: .� .. ,.:._ .w•�c�.unnrtaa�ac�5,:—�.-. .. -r-usC :: '.- ..._ g ni �... copy 9ht .200.0': ' _ iG .re for the use OI their customers pn fy'AOy of her use is st rl C tIY proh-bile liminary pf ans�a nC layouts Dv DCD r M. 39 D S a3 i t ll�K,WAU.$ON 1.,r, . . 'TH15 KRVEO 17Tr, 1 1 O i 1 Q P Yu j T 7 t r i. 0 4`j;IMIC CfisNC..51.fti3 0 cp i O i O I _ r i 1 FWNDAT'LON. DtJIN i 5?tll 12fJCa'v� m: , 3 —y �_, h:� �' •IS tT '. T , iD f � '��;rl"SIJEATIJIu{� ! K1, 508 428.6191 ' i. esaa tusut ; \ — USt0111 ".: : - .:. � :; I �'esigns i g coPyngnt©2001 All R,ghrs 1 •; 1_G T '\v�R 9 l uSlk ..... Q es oven S un5 ! R c u.ui . anTu { is i N jor T4::l4 O..C.. _�I O R S 1ki, , ,t t F__7 1 4. , { I. F . a .. r U e .. .. Pr'ellm nay ,plahs by DC D ar.e for i he use Of [heir customers only-:.'Ahy other use is strictly!Prghi D'i l'e r* V tv G SUIF+41b5 au„tGH.. — . ." pi ORfFiti:YxL .: ... If . l 1 . P; ?x.(v Pa slU-�Y/ r{I - , S 1:LL DECA x 1 — , i 3 I L It i . R; ..It I � sca T it 5 8428 1 Trvife ' a r . C3ustom a es igns x i r copyright rDUC'-MUtA Iu t i F. .G-V4ST'4+vET5 .. e f . X., sy - y s SO _ r, 1 , t . . �I Preliminary rohibit plans and layouts by DCD are for the or their nrstomers only Any other use is StrlCTly-pe t� „y � q � s _ VIP 3 CIA, �ikt let _ o � i - A W 11"X l - 1;vaiz ate clod remove all 11u, lmmalable material M th(,ar ill of the absorption syst(,111, (lilt/ (1 111i1111n11111 of .1 , Oil all si&(,, and bacf>'fill Zo 2� zz th approved sand, ( (hpih = 961+), (lilt/ also i11 Ra c'Ive b-al if . 7 ' i ver• ittiliNet/. 2 - l/ef�f' all di11lensiolis in the field pror to (17mmenCi)-ig CZmstriaii(M. 3 - Vritilj, Did; S(lfe at 1-SSb'-DICE,S;-I'F; prior to mnlnlazdiig - -- N lX�lrstrruaio�l. 77te Ictititl� luc•�Itiolls s/toz�ni are apprrlx�lnate and I - .-VI zzywk to twifr)r-n to ( ppli«Iblt slatemid local re-glrlatiolis. Y r� 0 — - o� - � �02 a T�-lay rP-IOZ o 7�(fk' �v) 7 el) Q� �' � ` CS IS d6 3 'may --�—�D- i Floor Plat? - LX/s f�nq f��Use , = „ ���� B4 sated Sale: l l0 r 1 /22 11 es�`erl6i� Gt�a�sh Dafe= 8-3-DD C Public Health Division The ex/s fi1)9 cez)spco/ to 6,e removed 30 CMR /S 3S 4 Town of Bamslable , f)(IT'S PL-�V PO BOX hll.SettS 02601 rni>r DESIGIY_DWA: �� Hyannis, 12"min. mver _ tQpsorY 1 Daily Flow = 2 bedrooms x 110 l pd = ??D ,*d ,�> , FaX Phonnee r:( rT44 bach/ill L)sign Percolation Rate=Z minutes per indt � N 790 790-6265 mininrurn Application Rate= �,740d/sf (Qass ?� S(iil) O. . O O o O 1/8"-1/2"ur"slrxl sto ne L -e Deposal Bad: L =/6r ', W_?�?`, Area =32J sf � °o 0 0° o o°o° o ° co Flow Provided= 32o sfxgpd/sf= 2 3 7 gpd Repair I o' SubsuOaty Sezwge Disposal .S4wton I 6 "min. O O O O O O O O 4"01. 3S perforated pzxpipe - y4 Existing Grade= "9- Maximum Grouitdi¢x1tcr Lkpth �; AFFASSOCIATES' Maximum Groundimter Elevation = 3e. Z. rR • `r �+ �'--+ - ±i4'- 1 112"urzArl cone Bottom Of Disposal Bert Elevation = ��• 3() #��� a a� CARL H. Separation Provided= `�. ' r' ' I / BEv;uCQUA y', Ci(ii/£>'�ii�eers c� Sardefors �> � ' CIVIL y No. 33621 f P 0 got' SW-!!.J nTIG1L SE6770.V- DISPOSAL BED ��. ti Ton/ t`o 65 by /rf�S Cemen>`BGc 4 !o}or a�orov�d cQva/ F��pO�AL E ` .s. 0,71 `1110v (, J1,4 0274Y-W-57 In/ef # Ovf/er Tees fo he e v/e 90 PtiC urifh irJii�iirlvm 3"oir - 4".41t 4r1 k- _-r _ ,. 4"sd,35 perforated pvc pipe I.EGF. �rD ooce of r`�os. Ovf/e/ Tee fa e�viooed ulth qos baf</e - 1 01Qge D04"es t -d 6 atis ing alwour propusslcantour top of{aun lotion 2' -j,j' rrrir� fool u Bland flag ISDO,(sal septic:tank ec�lmtd alder � .............. .......... alge of buffer a .r —i- I ttk OF r'd•� J !/�Q���s.00C� .....— — — — existing utaer line + �`a � �s �cT, ....LL� LL AA��1 v a erns ,, c;,RL 4- QC . '7'013le MR Re�,�/ 5Pa- ^L }t. proposal"tel ine :O B0 r C t H. ' 7�c•�� ® Tp.! soils kst loartion _ ' i BEVILACQUA a bottom U No.33317 y� S�rtl� 1 — �D ' L�lt� Q ^! ✓ jOO inlet � `f�6 srJ,tic r��tk _ � _ !� � — .� a, s. r., ,- ��. �P� r� OrrllcY Z.Q 4 d tributiwn lox --- �, FfSS1�` � ordlet _�� � '-�� -'�vti�`�� Gontad: C-ai 1 Bezvlacgrra, PE int'Crt at house rlil(t intv77 at ends .0 proposerlsanitarystccxr 1 A VAT As.SQ(t�lt(�1 PROFILE - DISPO.�aL BED orttlet distribution box Defa;/ Cxe/, �eptie Tu�� t, '0 r