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0256 TOWER HILL ROAD
/U C042�4 �11 r F A w..r. ■r rr� AU I V 1= ------------- ...... a TOWN OF BARNSTABLE BUILDING,PERMIT APPLICATION. �1 Map Parcel t7 Application# � 0r Health Division + Date Issued CO Conservation Division y✓ .' . Application Fee Tax Collector ._L Permit Fee 4, Treasurer Planning Dept. �;t Date Definitive Plan Approved by Planning Board ,i Historic-OKH Preservation/Hyannis Project Street Address 94�L Village Owner M A 4 IUb6rL :R(lte-4 Address _6U tA&&A. Telephone /l Permit Request E1y)019155L l L (A,,0 Q Square feet: 1st floor:existing gtiO proposed 2nd floor:existing Lt00 proposed Total new_(Z Zoning District Flood Plain Groundwater Overlay Project Valuation S; 0 00,bo Construction Type C."a FPAM,19: Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑' Two Family ❑ Multi-Family(#units Age of Existing Structure Historic House: ❑Yes No On Old King's Highway: ❑Yes No Basement Type: la/Full Zrawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) (4aT Number of Baths: Full:existing new O Half:existing D new d Number of Bedrooms: existing_3 new_[ Total Room Count(not including baths):existing _new O First Floor Roo Count o ' Heat Type and Fuel: 2/Gas ❑Oil ❑Electric ❑Other C? _ J S Central Air: ❑Yes No Fireplaces: Existing New U Existing wood/'aal stove: ❑Yes 3 VNo Detached garage:❑existing ❑new size Pool:0 existing 0 new size Barn:0 e isting ❑dew Vze Attached garage:❑existing ❑new size Shed:U'existing ❑new size Other: Q m Zoning Board of Appeals A thorization ❑ Appeal# Recorded❑ Commercial' ❑Yes No If yes, site plan review# Current Use Proposed Use Al BUILDER INFORMATION Nan�.e atV Telephone Number — � Addresskuv�. ALicense# 5� Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO � 1A0 I SIGNATURE DATE 1-744,73 K n FOR OFFICIAL USE ONLY S ' APPLICATION# ' DATE ISSUED MAP/PARCEL NO. . i . ADDRESS VILLAGE OWNER DATE OF INSPECTION: ► i .f'` FOUNDATION FRAME G !1 ay INSULATION O 09 FIREPLACE 1 ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL = FINAL BUILDING s DATE CLOSED OUTi. ASSOCIATION PLAN NO. ; The Commonwealth of Massachusetts Department of Industrial Accidents ' Office of Investigations ' 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bl Name(Business/Organization/Individual): G(,O-f- Address: I Ili ST. GIP 1 City/S /Zip: Phone#: ' Are y an employer?Check the appropria a box: Type of project(required): 1. 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. ❑N construction 2.El am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g. ❑Demolition workingfor me in an capacity. employees and have workers' Y P h'• 9. ❑Building addition [No workers'comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑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' 13.0 Other comp.insurance required.] *Any applicant that checks 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 must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 1�� Policy#or Self-ins.Lie.#: -I r� "`l�'�' Expiration Date:(DTd'/ D� n Job Site Address: b (6wg 4i i %t U>✓ 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 c under the p nd penalties of perjury that the information provided a ove is tru and correct Si mature: Date: D Phone#: 1- —SS 9 q a-D Official use only. Do not write in this area,to be completed by city or town official I 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 M Nlassachusetts- Department of Public Safetc Board of Building Regulations and Standards Construction Supervisor License License: CS 43556 Restricted.to: 00 i SCOTT E CROSBY 62 CROSBY CIR OSTERVILLE, MA 02655 Expiration: 12/13/2010 \ (lnnmissioncr Tr#: 7475 --J 4 t3oAfA`8f I3?r1 ( `f`bf �lt8�'t7S License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: � Board of Building Regulations and Standards Registration: 151882 One Ashburton Place Rm 1301 Expiration:�_7/13/2010 Tr# 0 EE� __ Boston,Ma.02108 �..�: Type: Pnvatre Corporation SCOTT E CROSBY BUILDER;INC.,l SCOTT CROSBY•" 1 t � u 1112 MAIN ST UNIT;#.7 . �` Not valid without signature OSTERVILLE,MA 026S5` Administrator g tRfO 0/14/2008 10:11 FAX 5084283068 GERMANI INSURANCE Z 001 I ; I ,. I 1 PIN 1. II,:; AGO ITN I ' H { DATE(MMrDDIYY) I f t f� .,Y I tkl; 10/14/2008 ar.�m; L 1 :;tl11L; Uljl�l�j�I�i�� (1 Ifli.ftffl 11 I ! h! DUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE GERMANI INSURANCE AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 908 MAIN STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. OSTERVILLE, MA 02655 COMPANIES AFFORDING COVERAGE COM A SAFETY INSURANCE INSURED COMPANY SCOTT E.CROSBY BUILDER, INC. B AIG-AMERICAN INTERNACIONAL GROUP 1112 MAIN ST. UNIT 7 -- --•---•-•••--- ••••_. . _ .. ... COMPANY OSTERVILLE, MA 02655 C COMPANY D II pg L 31,Jc U i.��' t"f 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 B Y 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 TYPE OF INSURANCE POLICY NUMBER POLICY 2FFPCTIVE POLICY EXPIRATION LIMITS TR DATE(MM/DD/YY) DATE(MMIDOIYY) A GENERAL LIABILITY GENERAL 07/05/OB 07/05/09 GENERAL AGGREGATE $ 2,000.000 X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGO 9 CLAIMS MADE "OCCUR PERSONAL&ADV INJURY $ OWNER'S a CONTRACTOR'S PROT EACH OCCURRENCE $ 110001000 FIRE DAMAGE (Any one rve) $ MED EXP (Any one person) $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S ANY AUTO ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) — PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE S EXCESS LIABILITY EACH OCCURRENCE. $ UMBRELLA FORM AGGREGATE Is OTHER THAN UMBRELLA FORM $ WC STATII• OTH• B WORKER'SCOMPENSATIONAND WC 292-99-85 06I22I08 06I22/09 TORYI�A(IT'<,, ,, ,,• eR,.._..__�_......,.�. .-- EMPLOYERS LIABILITY EL EACH ACCIDENT $ 1 OO OOO THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT S 500,000 PARTNEWEXECUTIVE OFFICERS ARE. HEXCL EL DISEASE•EA EMPLOYEE $ 100,000 OTHER I DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESISPECIAL ITEMS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 110 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KING UPON THE COMPANY ITS AOENTS OR REPRESENTATIVES. AUTIHOPW TATI1/r • i�"���!��`. I ,�;�P�►�i�:.����iP�lif�li�!�i!1!�iH 1N�IRNl1 . .��"' "co"I �'�i��YiKi�` ( r Town of Barnstable �SAM Regulatory Services� � xY 'hogs F.Geiler,Director Bulldbg WvL*i1 Toss:1'aq,cw l wjftg comtlues uaw 200 Mren Stteek Nyaanb,MA 02601 A"►vw.sorvu.barurtael�a.vs Office: 50"624038 ' Fax: 508490-6230 a Property Owner Must Complete and Sign This Section If Using A Ruildet I I I 4f, x, .�.. as Genet of the subject property hereby aut110.&e _ _44� �—to act an my behalf, I is all ma-cts zelaiiye to work authot4td b7 this huildmg petiait application for: KA Signature of Cara a f'zint-Name ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- AND TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00), Applicant Name: Crc>5 Site Address: grin! Town: Applicant Phone: p Applicant Signature: Date of Application: NEW CONSTRUCTION: choose ONE of the followin two-options) 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE- AND TWO-FAMILY BUILDINGS MAXIMUM MINIMUM Ceiling or Slab QOption 1: Basement P Fenestration exposed Wall Floor Perimeter U-factor floors R-Value R-Value Wall R-Value AFUE HSPF SEER R-Value R-Value and Depth National Appliance Energy R-10, Conservation Act(NAECA)of .35 R-3 8 R-19 R-19 R-10 4 ft. 1987 as amended,minimums or eater as applicable Note: This form is not required if you choose either of the two versions of REScheck as listed below. ❑ Option 2: REScheck Version 4.1.2 or later variant software analysis must be completed 780 CMR 6107.3.2) REScheck—Web which can be accessed at http://www.energycodes.gov/rescheck/ ADDITIONSOkALTERATIONS.TO EXISTING BUILDINGS.OVER 5 YEARS OLD* *Buildings under 5 years old must use option#1 or#2 in New Construction section above. Complete the following formula to determine the %o of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b -a) SF 100 x — _ % of glazing (b) Glazing area equals SF b a If glazing is<40%.use the chart below. If glazing is> 40.% proceed to "SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM Fenestration .Ceiling and Wall Floor Basement Wall Slab Perimeter U-factor Exposed floors R-Value R-value R-Value R-Value R-Value and Depth 39. R-37 a R-13 R-19 R-10 R-10, 4 feet a R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area(i.e.not compressed over exterior walls, and including any access openings). SUNROOM—An addition or alteration to an existing building/dwelling unit where the total ❑ glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fill out Consumer Information Form (found in Appendix 120.P) Barnstable Assessing Search Results Page 1 of 2 Town of t• a+ •it 2009 Property Lookup Home:Departments:Assessors Division:Property Assessment Search Results New Search _- ,� ; New Interactive Maps» c�l Owner: 2009 Assessed Values: PRIEST,ELVIN H&NORA TRS ELVIN PRIEST&NORA PRIEST TRUSTS 256 TOWER HILL ROAD Appraised Value Assessed Value Map/Parcel/Parcel Extension Building Value: $173,100 $173,100 142 /047/ Extra Features: $0 $0 Outbuildings: $300 $300 Mailing Address Land Value: $201,600 $201,600 PRIEST,ELVIN H&NORA TRS ELVIN PRIEST&NORA PRIEST TRUSTS Totals $375,000 $375,000 11 SURF RD BOYNTON BEACH,FL.33435 2009 REAL ESTATE Tax Information: Tax Rates:(per$1,000 of valuation) Community Preservation Act Tax $77.63 Fire District Rates Town Residential Barnstable FD-All Classes $2.37 $6.90 C.O.M.M.-All Classes $1.08 Town Commercial C.O.M.M.FD Tax(Residential) $405 Cotuit FD-All Classes $1.43 $6.12 Hyannis-Residential $1.78 Town Tax(Residential) $2,587.50 Hyannis-Commercial $2.77 W Barnstable-All Classes $2.11 Community Preservation Act 3%of Town Tax Total: $3,070.13 Construction Details Building Property Sketch &ASBUILT Cards Building value $173.100 Interior Floors Carpet Property Sketch Legend Style Conventional Interior Walls DrywallUPM MT[256J Model Residential Heat Fuel Gas - Grade Average Heat Type Hot Water i Stories 1 Story F A AC Type None - RAS.9MT24 Exterior Walls Wood Shingle Bedrooms 3 Bedrooms 1>#s_ Roof Structure Gable/Hip Bathrooms 2 Full Roof Cover Asph/F GIs/Cmp living area 1300 Replacement Cost $192321 Year Built 1890 Depreciation 10 Total Rooms 6 Rooms Land CODE 1010 AsBuilt Card N/A Lot Size(Acres) 0.66 Appraised Value $201,600 h4://www.town.bamstable.ma.us/assessing/2009/displayparcelO9map.asp?mappar=142047 4/21/2009 Barnstable Assessing Search Results Page 2 of 2 Assessed Value $201,600 View Interactive Maas Sales History: Owner: Sale Date Book/Page: Sale Price: PRIEST,ELVIN H&NORA TRS Oct 3 2001 12:OOAM 14301/054 $0 PRIEST,ELVIN H&NORA J& Jul 15 1989 12:OOAM 6810/171 $1 PRIEST,ELVIN H&NORA J May 8 1954 12:OOAM 874/187 $0 Extra Building Features Code Description Units/SO ft Appraised Value Assessed Value SHED Shed 80 $300 $300 Property Sketch Legend BAS First Floor,Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRIN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) I http://www.town.bamstable.ma.us/assessing/2009/displayparcelO9map.asp?mappar=142047 4/21/2009 ZME, Town of Barnstable *Permit it -70 `'T�� Expires 6month from Issue date BA Regulatory Services Fee 7 00 ;y MAW. ' ' Thomas F. Geiler,Director Pxr rFDMAt CT 'akft/), Building Division TO ZQ Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 �7,18k Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not MaIid without Red X-Press Imprint Map/parcel Number 1 Prope Address v, Vid e- YA 7Residential Value of Work Owner's Name&Addressa , ��ro f c cuur gal, cil Contractor's Name Telephone Number, Lqn—1 fj Home Improvement Contractor License#(if applicable)_. Construction Supervisor's License#(if applicable) morlonan's Compensation Insurance Check one: FIa sole proprietor the Homeowner e Worker's Compensation Insurance .Insurance Company Name Workman's Comp.Policy# 14) log I " A — S. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof] ❑ Re-side YReplacement Windows. U-Value (maximum.44) ❑ Other(specify) *Where required: Issuance of this permit does not exempt compliance 'th other town department regulations,i.e.Historic,Conservation,etc. Signature, Q:Forrrs:expmtrg Revised121901 r FROM :PO,TTEIGER, PRIEST 8 POTTEIGER FAX NO. :6722977 Oct. 18 2007 03:24PM P1 OCT-19-2007 02:22 AM SCOTT-CROSBY 5084289-O&C P. c" i f Town of Barnstable Regulatory Services Thamas F.CeDer,DhvWar Duvfts INr►don As Puny,Ceo BRIW,g Cammiadonar Zoo Main sues% 11ymde.MA 02601 a.rw,fewabarf�rtablsaa.as 4ffice: 308-862-4038 Fax: 508•1,90-6230 . Property Owner Must Complete and Sign This Section If Using A Builder as Owner of ttic subject PwPeM hereby a ftme 9rl�fil W,0 r---to am on my behalf, 9,U moan n&twe to cvoric=ftn=d by this WAq permit Vpk aiion for 'e c *(rob) &W atwe of Ows r' Print Name AcvWW14N r 08/0+8/2007 16:54 FAX 5084283068 GERMANI INSURANCE fool Alt 0 `KTM w9l u I t DATE(IIINUQDIYY) I r qC�m•'i ', )t,. If ! .t •t' ;a moo [PRODUCER THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE GERMANI INSURANCE AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 908 MAIN STREET ALTER THE M—VERAOE AFF DED BY THE POLICIES OSTERVILLE,MA 02656 —_• .._ COMPANIES AFFORDING COVERAGE _ co A SAFETY INSURANCE INISURED•-r.. .. _ .. - —.tB MPANY SCOT?E.CROSBY BUILDER, INC. AIG-AMERICAN INTERNACIONAL GROUP 1112 MAIN ST.UNIT 7 OSTERVILLE,MA 02655 COMPANY COMPANY 0 �;!T•:, ''t ' *' I t!'. t l�ht'�I�'. !zal:?YmII6;:�:4:d'.I;:,.':.,::��ua.AWN ;aF�i'r",5r.�:,.o:ifi���JI- ,..L.�l..a...:��"„��i'�41nii';III ka THIS 13 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED AHLOW 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 B Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMIT'S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Do TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION LTR POLICY NUMBER DATE(MMIDDIYY) DATE(MUMD" LRi1IT$ GENERAL LIAHWTY GENERAL AGGREGATE $ 2,000 000 A X'COMMERCIAL GENERAL LUWLffY CP00001183 07/05J07 07105/08 PRODUCTS-COMPIOPAGO f JCLAIMS MADE U OCCUR PERSONAL a ADV INJURY f — OWNER'S$CONTRACTOR'S PROT EACH OCCURRENCE f 1,000,000 FIRE DAMAGE(My am fim) $ MED EXP one person) 11 AUTOMOBILE LIABILITY COMBINED SINGLE LOW ANY AUTO ALL OWNED AUTOS INJURY �pPLY SCHEDULED AUTOS tPe P—) 5 HIRED AUTOS BODILY INJURY NON-"EDAUTOS IPerereldw4 S _... ... _.. . PROPERTY DAMAGE' $ CARAC,.ELIABILITY AUTO ONLY-EA ACCIDENT f ANY AUTO OTHER THAN Aviv ONLr. --•--_ EACH ACCIDENT •.$. AGGREGATE f EXCESS LIABILITYEACH OCCURRENCE IllUMBRELLA FORM AGGREGATE 3 _.._..._. OTHER THAN UMBRELLA FORM f B W IRKER30OM/ENSATIONAND WC 687-7$$8 00raM7 06/22= - _ EMPLayowLWBRITY EL EACH ACCIDENT f 100,00O INCL EL DISEASE-POLICY LIMIT f 500,000 OFTIPARTNER6110MCLITIVE �EXCL EL DISEASE-EA EMPLOYEE f 100,000 OTHER DESCRIPTION OF OPERATIONSILOCATM)NS/VENICLEBISPECIAL ITEMS Emiliffil mm"HwAmnal SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ORATIDN DATE THEREOP, THE ISSIRNG COMPANY WILL ENDEAVOR TO MAIL DAYS WRITYEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL LMPOSS NO OBLIGATION OR LIABILITY OF ITS AGMTS OR REPRESENTATW& g� AUTTiO �I�r A .i Ifl +dka �,. A�iyGl:'tal� " I 'h „i i ' �'!ie TDomvnwmurea�i o��/�aaaacluea�,tta i•�' � oard of Building Regu`tations andStandar-ft t x Construction Supervisor Lice"rise Llcen�e CS 43556 ` 1 r;'rr BlPFUhdate� 1 3`/1,962 M Y � EXpir�ati^�c�n1312008� �Ti* 6886 E/ t i "" SCOTT E CROSBY ' - A i,; OSTERUILLE MA'Q'2655 'Commissioner (\ Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before.the expiration date. If found return to: Board of Building Regulations and Standards k1piReg istrati07 4:n,:-„\51882 One Ashburton Place Rm 1301. Expiration=7/_13/2008 Boston,Ma.02108 r- _-� -� r,Ty.peRPrate Corporation. SCOTT E CROSBY--BUI:LERIN_C SCOTT CROSBY _ = 1112 MAIN ST UNIT'#7 -- Not valid without OSTERVILLE, MA 02655 Deputy Administrator signatur i r The Commonwealth of Massachusetts Department of Industrial Accidents 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 ,5 0 oName(Business/Organization/Individual): ! K I'd�. Address: 911 cd uI/I1� City/State/Zip: !�5Phone#: —4�)-Z—qM Are y an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. ❑ I am a general contractor and I 6. ❑ ew construction employees(full and/or part-time).# have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. gRemodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance.: required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.0 Other comp.insurance required.] 'My applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowner who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: (� Policy#or Self-ins.Lic.#: IQ l9 D " Expiration Date: Job Site Address: R22 -Fbwby 1-11 A City/State/Zip: e A Oa(oSS 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 cerd r the pains a penalties of perjury that the information provided above is true and correct Si mature: Date: 10 Phone##: 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#: M TOWN OF BARNSTABLEBUILDING PERMIT APPLICATION Ir Map , Parcel Permit# . Health Division A a Z — ,0;W Ar �Op1 ��--- A Date Issued 1 Conservation Division ' 2� - -Fee Tax Collector - SEPTIC SYSTEM PAUST vP INSTALLED IN GOPd.sl. �% Treasurer•- WITH TITLE 5 Planning Dept. ENVIRONMENTAL COPE AND Date Definitive Plan Approved by Planning Board TOM REGULATIONS L+ Historic-OKH Preservation/Hyannis Project Street Address --as Village V Owner �u/ � � QJ �S� " -� Address Telephone \\_D S 9 9 Permit Request zip1? ,� Lgz/ ��� ��" ��))J� QDI)m D DII' P Square feet: 1 st floor: existing L490 proposed SW 2nd floor: existing 360 proposed 0 Total new � Valuation .�~ �� +.00R Zoning District Flood Plain Groundwater Overlay —��- Construction Type Wapf2 FIZOM I'-- Lot Size , b b Grandfathered: &4s ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure t)0 4 R,S Historic House: ❑Yes �No On Old King's Highway: ❑Yes �6/No Basement Type: ❑Full ❑Crawl dWalkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) D 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 0 Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes 5(No Fireplaces: Existing CD New 0 Existing wood/coal stove: ❑Yes No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Ahorization ❑ Appeal# Recorded El Commercial ❑Yes la No If es•site plan review# yes; Current Use , �,6,1 467- YCA 10 1 Proposed Use BUILDER INFORMATION Name��p r 4, r-rd S ���, Telephone Number S7D 9 Address License# n �L 5-J_6 v I Lz�T ;A Home Improvement Contractor# Z 7 `% Worker's Compensation# Tj�,b r $ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE `� ' z - FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED r MAP/PARCEL NO. ' ADDRESS% czk� ' " I VILLAGE , ' OWNER A ' ' i DATE OF INSPECTION:° FOUNDATION' - e FRAME '✓� -2� - INSULATION to i FIREPLACE r ELECTRICAL: ROUGH �_ . : ' FINAL , PLUMBING: ROUGH-_ - - . ,y FINAL GAS: ROUGH - FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ' i ESTIMA TED PROJECT COST WORKSHEET Value LIVING SPACE (high end construction) square feet X$115Isq. foot= (above average construction) square feet X$96/sq. foot= (average construction) square feet X$57Isq. foot= GARAGE (UNFINISHED) square feet X'$25Isq. foot= PORCH square feet X$20/sq. foot= DECK square feet X$15/sq. foot= OTHER square feet X$??/sq. foot Total Estimated Project Value oFt�r� The Ton f„,a,,STABL, . w_ o Barnstable ,m$ Regulatory Services Thomas F. Geiler, Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date c 7 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: A Dy 1///�W Estimated Cost ,ov Address of Work:_a� Owner's Name:_ iS--Lu 1 NrKj — Date of Application:_ 3 /0 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law QJob Under$1,000 ❑Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor N e Registration No. OR Date Owner's Name q:forms:Affidav The Commonwealth of Massachusetts . r" Department of Industrial Accidents • .s ,� _=• � ; •:_ Olflce ol/m�est/palloos 600 Washington Street Boston,Mass 02111 Workers' Com ensad Insurance Affidavit name• L L.V I A/ �2 l� ' location / �„� /✓UGC �P- ' city OA-� U) phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working in anv capacity %%%% %%%/%%/// %l/%�01 X91////%%=0=0//O// ///////O/%%%%%////0%///O�/�/�//O//O//��/,. I am an employer providing workers' compensation for my employees_working on this job. ::.:: m aav ,. one ll icv. 'fisnura 0 ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed belcev ow who have the following workers' compensation polices: com'an :na ::.:.. gig ;mares � .. �. /:;t<.?:is ::is•.'•3: : ... .... ... ::..,:::::.................. -D t1II ::::.................................................................................................... ii;Y:??•:?•W..�..:.. .........???-:_:i4:i'-is6:..;v:n}ii:•:i::•:::::::.�:::.�:::....................... :::..:. :::?'j;i:?i:Ti:;':i::'i�:i ii:;:j}�:;ii:iiF^i::ii iii: <::?:::::T?ii:Lit:L:::'tilt:i:::::::::.....:ii::>..... :r.....: i::X. ?:iJ:r::i:v:ii:!:'ii:S!i:ii:�>i::ii?i::i:i::�i:ii::i:vi2v:i?•: ,...:>name:>::>::::::>::::;ii::::::::::>:::::>:::<:>:::: :L::i:::: ::::>:.i:::::<:: :::::::::::<:::»::<:::..:.:::..,.:., .::.... ... ....... ........ ... address.......,..:..: .. ... :.... :.. ::.....:::::.;;::;::...... < :<? t:ii:?i::i {:$^tilt}};isijiii:i:iiiii?;i:::i:?5.:: ;`:<i:;iii ii:':+:<:?L$i"iii:Li:i:i}iiiiiiiii -ii:{±•:i-i:??Sit:::;.};L:i::w:??•:}-i::::?•:�:?:;;i JY.};iii':iJ:{}!i:??•ii?:]:•iiii:.ti;�:' t;:>}:?::{:;":'yi. ni:::;:j.i:•::::.:.i';! :;{.'i�.�ii ?;'.};ii::�i:j:,:i:�{.:::.�::::.�::::v::. w: :•vi:?4i::3i:3: :.:..C�sii:.-:�:'�'-'.'.:::':-:?ii:.:-iii:•:?•:vii:?tiC:?-iii::.^:?:!::iii:��':5:::•::::'i:::•i:•i:.?.:^:?•i.d::?^}}i:?•::::ii:Li:S::L:•t::'?:'i'::::':i4;;:;:: :nmrance FallrQe to secure coverage as required under Section 25A of MGL 152 can lead to the tmposidm of crbnh d Penalties of a 9me up to$1,500.00 and/or am years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that it copy of this statement may be forwarded to the Once of Investigations of the DIA for coverage verification I do hereby c under the pairu and penalties ofperlury that the information provided above is tru,.and correct co.'z�Si�at , Date t� Print name r Phone s-<- 6 CID 3 ------------ official use only do not write in this area to be completed by city or town ofScial city or town: pemdt/llcense# C3Bnilding Department ❑Licensing Board ❑checkitimmedlate response is required (:)Selectmen's OIDce ❑Health Department contact person: phone#; - ❑Other ---------------------- (awed 9193 PLAN 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 0- 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 renewa 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 eater 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 fin in the workers' compensation affidavit completely,by checking the box that applies to your situation and .. Y;1, N ;;..;., supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be V S snbmitted to the Department of Industrial Accidents for confimmatioa of insurance coverage. Also be sure to sign and r date the affidavit. The affidavit should be retuned to the city or town that the application for the permit or license is . 5F being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or ify . are required to obtain a worim' compensation policy,please call the Department at the member listed below. Y: j ' I r City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the p6iiA license member which will be used as a reference member. The affidavits may be returned ie the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would hle 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 OfflCe of Invesd 8tlons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 1 . a�!e �a7xnxancueal!/ .F.,/��aazc/u�kM �4 { BOARD OF BUILDING REGULATIONS cerise: CONSTRUCTION SUPERVISOR Numba9CS\ 043556 ti B� date 2/13/1 6 wires:,1W13/2002 Tr.no: 4782 . Restricted To',:;�001* ' y SCOTT E CROSB-F 62 CROSBY CIR OSTERVILLE, MA,02655 Administrator ✓fie ZDanzrrwouuea� a�✓vGd4oac�utdeQ2 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR _ Registration:'131378 Expiration: 07/13/2002 Type: PEACOCK&CROSBY BUILDERS, SCOTT CROSBY 1112 MAIN STREET UNIT 7 OSTERVILLE,MA 02655 Administrator Jun-29-01 02:54P C.C. Insulation Inc. 508 778 5735 P.02 MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 New Addition DATE: 6-29-2001 Bldg- 1 Dept.1 Use I I i { CEILINGS: ( I I 1. R-30 I Comments/Location I WALLS: [ j { 1. Wood Frame, 161, O.C., R-19 I Comments/Location I I WINDOWS AND GLASS DOORS: ( ] I 1. U-value: 0.33 For windows without labeled U-values, describe features: ( # Panes Frame Type Thermal Break? I ] Yes [ ] No Comments/Location I { DOORS: l ] I 1. U-value: 0.31 I Comments/Location [ ] I 2. U-value: 0.27 Comments/Location I { FLOORS: [ ] I 1. Over Unconditioned Space, R-19 I Comments/Location [ 1 I 2. Over Outside Air, R-30 { Comments/Location I I HVAC EQUIPMENT: [ ] I 1. Furnace, 91.4 AFUE or higher Make and Model Number i 1 AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When ] installed in the building envelope, recessed lighting fixtures i shall meet one of the following requirements: I 1. Type IC rated, manufactured with no penetrations between the 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 { conditioned space to the ceiling cavity. The lighting fixture ] shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. I VAPOR RETARDER: ( ] { Requir.ed on the warm-in-winter side of all non-vented framed Jun-29-01 02 : 54P C . C . Insulation Inc . 508 778 5735 P . 03 I ceilings, walls, and floors. I 1 MATERIALS IDENTIFICATION: ( j I Materials and equipment must be identified so that compliance can I be dete.cmined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be provided. ' Insulation R-values, glazing U-values, and heating I equipment efficiency must be clearly marked on the building plans I or specifications. I I DUCT INSULATION: I ) I Ducts shall be insulated per Table J4.4.7.1. I I DUCT CONSTRUCTION: [ ] { All accessible joints, seams, and connections of supply and return I ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be 1 omitted where yaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. i I I TEMPERATURE CONTROLS: ( ) I Thermostats are required for each separate HVAC system. A manual I or automatic means tc partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. 1 . I HVAC EQUIPMENT SIZING: J I Rated output capacity of the heating/cooling system is I not greater than 1251 of the design load as specified I in Sections 780CMR 1310 and J4.4. I ( J I SWIMMING POOLS: I All heated swimming pools must have an on/off heater switch and I require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require a time clock. I ( J I HVAC PIPING INSULATION: I HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in.) : I I PIPE SIZES (in.) I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" 1 Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 1 Low temperature 120-200 0.5 1.0 1.0 1.5 1 Steam condensate any 1.0 1.0 1.5 2.0 1 COOLING SYSTEMS: 1 Chilled water or 40-55 0.5 0.5 0.75 1.0 refrigeranL below 40 1.0 1.0 1.5 1.5 I [ J I CIRCULATING HOT WATER SYSTEMS: I Insulate circulating hot water pipes to the following levels (in.) : I I PIPE SIZES (in.) I • Jun-29-01 02: 54P C .C. Insulation Inc. 508 778 5735 P.04 5 NON-CIRCULATING I CIRCULATING MAINS 6 RUNOUTS I 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)------------------------- .7 I ti Corr.cT � W4l ra..,aaA ej,n / / L oil jt1 y /// p LOCUS PLAN O`" ,,- ► e"'a ✓ /j / .• �" n a Apescees Z 142 Porw147 "'Xio,,,i \ \ /'"\v` •.,�� // dt// ;' � `b. ,a Zo".Rc t.awp, \ • ti / / //o l vP,.t`' �. — S«becln•Fan 20' •02'! J / / / / / �L Sid. 10' / _ Lot Arta 0.GGAc S LAwN i 1 o s73'2e00,. -- W1T}N♦„L COM.C.•K �+✓•e+MV OHO PLAN VIEW .�o_o SECTION A—A �_ vk, Notb le lRlrc.pl7fiTlb ldk WYd.oI Me1s. O •.o >T lwrla••tlEain eN»»llkrb h•A�..y o Opc"alc MwT4RNL FETM At NO.0M 7L Nwr.MwbSuILLmn IM ti•Qw,yNp-cye"'ty��"p»»�r.7�� a BRM.OOAVB\a.Mn ' -IMNblbooke•hlFnoo-]Qrµ{) ,!' to v.a/j Cy. qYl F.G se.a iITM..•tk�R,a"0'�,. be.°,s °. vw° .rvww/i ,y�• •b.ral.l».» w. au.o lorillf'n" ..1i ,.Wtv MMO IMaG� C Is000.tb, r»nss: n"nsn.el....:,t.aw:.r..l>III°.osr}a' Iw S..Ncr•M D.El.ll. bMlbMrT.•t/io bl•NtOI.•.bp TesT�w u•e. 6Ci . a a a . bw b'b.'•i..cym.e o./oo/ol euno.,otnn kek0 ct. m.tw tr.,i�mwnr..nl n.,.r to caoa,.•.,,,..o,w»•awao Dlrectlorta: from Hyannis take �•'• rat•IeN1 Gs.M Mdl• p.TNke Route 28 towards Oetervllle• left 2 All rbfp hae.a W vvt onto Five Comes Road and OELVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM tal continue W-Ight onto Bumps RWer bs»r Read and then atreight on Pond Street; Take a left onto Tower HIII ast0n DATARoad and house is on the latt e256 .x.»o°..n'4...''op INr u�.7•...•TTEopD rm aeo ao a�ik� - Mpne T». LPn...AREA SITE PLAN " Qe'"^''° PROPOSED ADDITION 81 y ew.rl.eaY: :.Nee.E SEPTIC SYSTEM UPGRADE eallwln.•IYYEe•.00 iF. _ «e v.euwo,kw LUlcwne aureE.o®br AT "1iv`iib6'e ''�•'e•"'• 2%TOWER HILL ROAD _QnS SSEMON OFCHAMBER 2-S006o1lt•dYq oo.e.nke ¢'.a'wa.e saN n.b»s•.» OSTERVILLE.MASS. FOR ELVIN H.PRIEST SCALE,AS SHOWN DATE:OEC.29,2000 ' Rc b.•• Aad een b•k i•fer••:loo o.k:«MllWt SULLIVAN ENGINEERING INC. 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