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0070 WATERFIELD ROAD
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Permit Fee 3 5 Date Definitive Plan Approved by Planning Board S Historic - OKH _ Preservation/ Hyannis / L Project Street Address ( WA f n�lr� R00J, Village os ier Y l t�e, Owner M*.r c,L6 e C-OL(a, Address -5;ata e Telephone 3r Permit Request d 1� 8` ` e o S 1 r Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family EllTwo Family ElMulti-Family.(# units) ro Q 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) =u :2-" Number of Baths: Full: existing new Half: existing new? � rn Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes )R(No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) i Name 1 . Telephone Number Rf 3?fi 0 3 9 Address ��► Ave, License # 1-- C 6 S. 1 � cl4 e,�� i Home Improvement Contractor# t h 3?h Email Worker's Compensation # IJkLC ,313 I I`Lq ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO G r�►o w�I, SIGNATURE DATE ! 6 FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO, r f , ' ADDRESS VILLAGE _ OWNER , DATE OF INSPECTION: FOUNDATION - i - h J FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL r GAS: ROUGH FINAL FINAL BUILDING DATE'CLOSED OUT ASSOCIATION PLAN NO. p To .of Ba rxistable Reg�iYat0 Se ces KAMr )2ichard -Scali;birector �,. Builda g DIVAsioil. Tom Perry,Building Comminioner 200 Main Sheet;Hyun,MA 02601 iiww tovvn.barnstable.ia ns Office: 508-862-4038 Fax;. 508 790-623a PropextY Owner Must Complete sand 5 gU TNS Section ZtUsxng;ABder I, xMrIVs l?He(lht asC?aner0tlie,s liJe0pmpe hez'eby authorize C P L S 14 d L w.act:on,my bebalf,. in-A.matters relative to work authorized by this building Permit aj�plication for 70 (-Mdiis.s-of : **Pool. and alarms ai+e:tli� m' 6ns rpf tie-a licanl::P60Is - P � PP� are notto be filler oruul zed hefore4ta(� e s i slall d and all Iiva1, . in ect ons are p-erfr d and accepted, S' of Owner S• 6f.-Apphcaax Print Name Print Name • ,4a , 6 Daze Q;F0nIS:o%\W-FEQJ-=I0NPOOLs .�coRv� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODIYYYY) 10/14/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements. PRODUCER CONTACT NAME: Colleen Crowley Risk Strategies Company PHONE E (781)986-4400 FAC No):(781)963-4420 15 Pacella Park Drive no�ESS:ccrowley@risk-strategies.com Suite 240 INSURER(S)AFFORDING COVERAGE NAIC* Randolph MA 02368 INSURERA:Selective Ins. of America INSURED INsuRERs Allmerica Financial Alliance Ins Co 10212 Cape Save, Inc INsuRERC.Wesco Insurance Company 7 D Huntington Ave INSURER D INSURER E South Yarmouth MA 02664 INSURERF: COVERAGES CERTIFICATE NUMBER:CL15101402127 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. LTRR TYPE OF INSURANCE POLICY NUMBER MMIM EFF MM,�EXP LIMITS X COMMERCIAL GENERAL LIABILRY EACH OCCURRENCE $ 1,000,000 A CLAJMS-MADE Fx-1 OCCUR PREMISES(Ea occurrence $ 100,000 81994480 10/16/2015 10/16/2016 MEDEXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,0 00,000 POLICY a ACT Fx-1 LOC PRODUCTS-COMPIOP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea ac_adentI $ 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED AWNA46796600 11/6/2015 11/6/2016 BODILY INJURY(Per accident) $ AUTOS AUTOS X HIREDAUTOS X AUTOS a accidT�AMAGE P $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED I I RETENTION Nil S1994480 10/16/2015 10/16/2016 $ WORKERS COMPENSATION OPPicera Included Po= X PER OTH- AND EMPLOYERS'LIABILITY YIN N STATUTE ER ANY PROPRIETORIPARTNERIF�CUTIVE NIA C Coverage E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? N❑ (Mandatory In NH) VWC3136274 4/9/2015 4/9/2016, E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,desaibe under DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ 500 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Addidonal Remarks Schedule,maybe attached If more apace Is required) National Grid Corporate Services LLC d/b/a National Grid, Action Inc, Colonial Gas Company and NStar Electric are all included as Additional Insureds with respects.to the General Liability coverage of Named Insured as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Housing Assistance Corporation ' THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 460 West Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE Michael Christian/CLC < AOE O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) + The Commonwealth of Massachusetts Department of IndustrialAccidents 1 Congress Stree4 Suite 100 " Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO-BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual):Cape Save Inc Address:7-D Huntington Avenue City/State/Zip:South Yarmouth, MA 02664 'Phone#:508-398-0398 Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 2!] employees(full and/or❑ • -7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $. Remodeling any capacity.[No workers'comp.insurance required.] ❑3.�I am a homeowner doing all work myself. No workers'comp.insurance required.]t 9. Demolition - 4:❑I am a homeowner and will be hiring contractor to conduct all work on my prope'rry. I will 10.0 Building addition ensure that all contractors either have workers'compensation.insurance or are sole 11.0 Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions t 5.❑1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.[]Roof repairs These sub-contractors have employees and have workers'comp.insurance.' 6. We are a corporation and its officers have exercised their right of exemption per MGL c. �✓ Other 14. Insulation 152,§1(4),and we have no employees.[No workers'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 tharis providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Wesco Insurance Company Policy#or Self-ins.Lic.#:WWC3136274 Expiration Date:04/09/2016 ,Job Site Address: 70 Waterfield Road City/State/Zip: Osterville Attach a copy of the workers'compensation policy declaration page(showing the,policy number and expiration date).. Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punisbable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under th pains and penalties of perjury that the information provided above is true and correct Si mature: Date: 2/9/16 Phone#:508-398 0398 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 I Building Department 3.City/Town.Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Office of Consumer Affairs and Business Regulation _ 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 171380 = Type: Corporation Expiration: 3/14/2016 Tr# 249649 CAPE SAVE INC. WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 ---- - - -- Update Address and return card.Mark reason for change. scA 1 r, 20M-05111 ❑ Address Renewal Employment Lost Card �T v�rttuiun.tueall�t�f�l�ii.1>rr�tue//1 Office of Consumer Affairs&Business Regulation License or registration valid for individul use only WExpiration:-,-- OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: '171380 Type: Office of Consumer Affairs and Business Regulation 3f-14/201,6 Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE SAVE INC. WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH,MA 02664 Undersecretary Not vali rthout signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards Comistrur .iOn Surieiv iir,r Sr,ecialov - -F License: CSSL-102776 WII.LIAM J MC 'tUS1QChL- - 37 NAUSET ROAD I West Yarmouth NIA Expiration Commissioner 06/28/2017 c. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map e q Parcel a 6 Application # Health Division Date Issued iConservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board ��-- Historic - OKH _ Preservation/ Hyannis Project Street Address Village os-beryl I G Owner NW a Ca arinP Address _23�4.M6 Telephone aO Permit Request "11410 e, and rA&A, Aa_ ked �, .e R l l B - 4 c ewe CG l l ill 0C +5 "6C IA I L- {1._ :0 D r,�,IU L�c IL I A;w An '69 AC -�.,C"A+. m r seal -tie l b -s Square feet:l st floor: existing proposed 2nd floor: existing propos(�d; Taal new U) 011 •� - Zoning District Flood Plain Groundwater Overlay c:%. .,o Project Valuation Jr'0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach s . porting�dpcurn4ntation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) � , Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing . ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes JXNo If yes, site plan review# Current Use_ Proposed Use. APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name US'NoA RCC Wkey IC& 5me, T - Telephone Number 508 -318 03 9U Address lv1 4_ S L(°� License# TC 10 A 4-} 6 S. k Ytirn►6w'1 h . OIL 11 Home Improvement Contractor# Worker's Compensation # �VUI� I ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO \arn►olA SIGNATURE DATE r. FOR OFFICIAL USE ONLY APPLICATION# ' DATE ISSUED Y•� MAP/PARCEL NO. tj Fy ADDRESS VILLAGE OWNER t`w DATE OF INSPECTION: - F' N • ' is ufF0.QNDAT.ION uA-rfup1_ ram• ..: .- FRAME SINSULATION- H :. FIREPLACE ELECTRICAL, ROUGH FINAL r PLUMBING: ROUGH FINAL i GAS: -ROUGH FINAL FINAL BUILDING r DATE CLOSED OUT ' ASSOCIATION PLAN NO. r Building Permit Authorization I, - 'Marcus.&Cafherine Gher ' di as owner hereby give my permission to o :. Cape Save, Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Office:508-398-0398 to take all necessary steps to obtain a building permit to perform work at my property located at 70 Waterfield Road Osterville, MA 02655 Signed Date The Commonwealth of Massachusetts A - Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/did Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibiv Name (Business/Organization/Individual): Cape Save Inc. - Address: 7D Huntington Ave City/State/Zip: South Yarmouth, MA 02664 Phone#: 508-398-0398 Are you an employer?Check the appropriate box: Type of project(required): 1. ✓� 1 am a em loyer with 4. I am a general contractor and I P 6. ❑New construction employees(full and/or part-time).' have hired the sub-contractors listed on the attached sheet. 7. Remodeling 2.❑ 1 am a sole proprietor or partner- ship and have no employees These sub-contractors have 8• Demolition workingfor me in an capacity. employees and have workers' Y P tY• 9. [] Building addition [No workers' comp.insurance comp. insurance.* required.] 5. We are a corporation and its ME] Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their I LEI Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.Q Roof repairs insurance required.]t c. 152, §1(4),and we have no e 13.�✓ Other Insulation employees. [No workers' comp.insurance required.] "Any applicant that checks box#1 must also fill out the section below shoving their workers'compensation policy utformation. 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.pot icy number. I am an employer that is providing ivorkers'compensation insurance for my employees. Below is the policy and job site. information. Insurance Company Name: Wesco Insurance Company Policy#or Self-ins.Lic.#: WWC3085633 Q ,, Expiration-Date: 04/09/2015 Job Site Address: 70 Wa,-I-edt e I 1 octd City/State/Zip: Q. '±er V 1 I e 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 S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification: 1 do hereby certi under the pains and penalties ofper1m6 that the in orination provided above is true and correct. S ienature: bate Phone#: 50$-39$-039$ Official nse.only. Do not write in lists 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#: AC40� CERTIFICATE OF LIABILITY INSURANCE 4ii4i2o14 THIS CERTIFICATE IS ISSUED AS A MATTER.OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE.DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE.AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER NAME:NTACT Colleen Crowley Risk Strategies Company PHONE . (781)986-4400 AAC No:(781)963-4420 1S PaCella Park Drive E.MAILAppgrss. Suite 240 INSURERS)AFFORDING COVERAGE NAIC# Randolph MA 02368 INSURERA:SSelective. Ins. of America INSURED INSURERB:Safety Insurance Ccmpany 33618 Cape Save, Inc. INSURERc Wesco Insurance Company 7 D Huntington Ave INSURER D: INSURER E: South Yarmouth MA 02664 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1441475243 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR 'MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES..LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER MMIDD EFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY- DAMAGE TO RENTEU- PREMISES Ea occur-once $- 100,000 A CLAIMS-MADE ❑X OCCUR S1994480 0/16/2013 0/16/2014 MED EXp(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $ 2,000,000. POLICY X JECTPRO- X- LOC - $ AUTOMOBILE LIABILITY COMBINED SINGLE,LIMIT (Eaa M 1,000,000 B ANY AUTO 130DILY INJURY(Per person) $ � AUTOS OOSSVNEO X SCHEDULED208200 1/6/2013 1/6/2014 BODILY INJURY(Per accident) $ X HIREDAUTOS X NON-OAUTOSMED PROPERTY c t DAMAGE $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED I I RETENTION 1 HI 1994480 0/16/2013 0/16/2014 C WORKERS COMPENSATION - fficers Included For C STATU- OTH- ANDEMPLOYERS'LIABILITY YIN .X Vo RYr ANY PROPRIETORIPARTNER/EXECUTIVE overage OFFICEPJMEMBER EXCLUDED? N❑ NIA. E.L.EACH ACCIDENT $ 500 000 (MandatorylnNH) 3085633 /9/2014 /9/2015 E.L.DISEASE-EA EMPLOYEE $ 500,000 II as,describe under r DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCA71ONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Isrequired) Issued as evidence of insurance. Issued as evidence of insurance. Thielsch Engineering, Inc. is listed as additional insured as respects General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION msong@capelightcompact.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cape Light Compact ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Margaret Song PO BOX 427/SCH AUTHORIZED REPRESENTATIVE 3195 Main Street Barnstable, MR 02636 chael Christian/CLC ACORD 25(2010105) @ 1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005)01 The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 —Home Improvement Contractor Registration Registration: 171380 Type: Corporation Expiration: 3/14/2016 Tr# 249649 CAPE SAVE INC. �� WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 - Update Address and return card.Mark reason for change. sCA r 0 20M-W11 Address Renewal Employment Lost Card Vlre�a»znzozicaeal!/z o!'�aaaac/zrcaelti Office of Consumer Atfairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: �71380 Type: Office of Consumer Affairs and Business Regulation WExpiration: 3/14/2016 Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE SAVE INC. WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH,MA 02664 Undersecretary Not vali rthout signature -- Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction Supervisor Specialty License: CSSL-102776 WILLIAM J MC C-LUS 37 NAUSET ROAD West Yarmouth MA 0 73, r r ` 'I W Expiration Commissioner 06/28/2015 t' �tiW�� , Town of Barnstable *Permit# Teti Expires 6 months from issue date. Building Department Se �°� Fee �xxst,�sI,E : Brian lorence,CBO "1 I BuildingCommissioner16396 iOrEo�► 200 Main Street,Hyannis', 41 nko; www.town.barnstable.ma.iis �/j/ 1('?® / Office: 508-862-4038 ��� ,tFax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL Not Valid without Red X-Press Imprint Map/parcel Number —7 W/ n Property Address / (/ P-Lb VIL el-esidential Value of Work$ G. i1 10 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address/y(I�/Z�i(/�� �9� b l .Contractor's Name • s2 1 (11 4l (�%`G0 Telephone Number lj 10 y 7�7� Home Improvement Contractor License#(if applicable) I a3 I I ' _ Email: ►J V E C R L LL r {yJ�i 1' C-y i1 Construction Supervisor's License#(if applicable) CS FA yQ©a(o ❑Worlmian's Compensation Insurance Check one: Iam a sole proprietor am the Homeowner ❑ I have Worker's Compensation Insurance - Insurance Company Name Workman'.s Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request check box) �. L'Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to. M 4; &+"6 L(, ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: .JO On�Ad� Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 08/16/17. i �VE Town of Barnstable Building Department Services AseS Brian Florence,CBO 163 ►�� Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.maxs Office: 508-862-4038 Fax 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I- U 4 h ` t 5 14"F t1h I ,as Owner of the subject property hereby, authorize ! to act on my behalf, in all matters relative to work authorized by this building permit application for. yiW-t, (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final in ection e pe rm d and accepted. Sign e of Owner Signature of Applicant , 1419,L) (�Fl E a"I r�I l Print Name Print Name t4� yrM b �(Q1� Date Q:FORMS:OWNERPE U&SSIONPOOLS Rev:08/16/17 Tc C..- ., r The CommoniveafYh u,f Massachusetts Depart5ne7it o,f'Irrdustriaf Accidents Office of Investigations 600 Washington Street _ Boston,MA 02111 fvrv��mass.�v�din 'Workers' Compensation Insurance Affidavit:BuildersrContractursMectr cians/Ph mbers Allp]icant Infwmatron Please Brent Le Name(Husineets DrganII3fimAudMdua1Y���(�l o j d 0om'Y i Address: fr2�p rl G k 8 Ciyrtttl l l9=D Phazle�. y 7� Are you an employer?Checkthe appropriate box: ' Type of project(required): 1.❑ I am a em to with 4. ❑I am a general contractor and I P 5`� 6_ ❑New construction employees(Ml andforpart-timer* have hired.the sub-contractors 2�am a sole proprietor or partner- listed on the attached sheet. �- ❑Remodeling VV ship and have no.employees These sub-contractors have 8.-❑Demolition w g for me in a employees and have workers' odd any��� 9. ❑Building addition [No u7xkars,comp.issurarire comp- nv-1 5. ❑ We are a corporation and its 10,❑Electrical repairs or additions 3_❑ F m.a homeowner doing all work officers have exzrcised their 1L❑Plumbsagrepairs or additions. mys,,Z[No walkers'camp. right of exempfion per MGL. 12.[1 Roof repairs insurance required.]F c.152, §I(4),andwe haven employees.[No workers' 1-3-El Other camp-insurance required-] 'Any WHcmtdmtchecksbux#1mustalsoMoultheswdonbelowshmmgdi&woikerecmmpeusatioapolicyiufo=zd0 - Hmmem nemwhosubmitdvsaf5dmvititeratingthF_yaredoingallwaaicsadthenhueoutsidecDn=Corsamstsubmitanewaffidx7kimdlC=gssuiL fCanitsctm 1hxt check this bmr moot xMiched sa additi mil sheet showing the name of the sub-caa=Axs—and state whether or amt tbmse eatideshn e ernplayees.IMP sub-c==ctnrs hive mnpIoFee%&eynmstpmvidetlwk workEWs mmp.pmlicyn»her. lam an employer Mat is prouiducg workers'compensation insurance for mS•errp£ogees. $e£ocv is the po£icy and job sde information Insurance Company Nrame: Policy 41,cc self--in:s.I.ic. Rxpird&n.Date: Job site Address: le-7 0 UJftTM[-t t(i-b AD, City(State z7 p: Attach a copy of the workers'compensationp.olicy'declaration page(showing the policy number and expiration,date). Failure to secure,coverage as requiredundes Section 25A.of MGL c 15,72 can lead to the imposition of criminal penalties of a fine up to$1,50a.00 andlor one-yearimprisonnzeut,as we11 as civil penalties in the form of a STOP WORK ORDERand a fine of up to MO-00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Iavest gatinms of the DIA,€or insurance coverage veriftcation- 1 d'a frerelry G 12, life tiLeper and r ' s 0.F9UuxY thatthe informatfon pros-i&d above is.barearid correct �it>flature_ Bate IJ 1Y / Phone i�- gieY / 06,a O,ocia£use-only. Do not tvrke in t is area;to be competed by city ortoum afficza£. City or Town: PernritUcense 4 Issuing AuthDrity(curie one): 1.Board of$eaItli 2.Building Department 3.City T.own Clerk 4.Electrical Fuspector S.Plumbing Inspector 6.Other Contact Person: Phone#� -- --- ---- - - -- - - 6 1;9w, Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CSFA-060265 Construction Supervisor 1 & 2 Family ;1 DAVID A CARROLL 12 FEDERICK B DOUGLAS RD N FALMOUTH MA 02666 7��(i ��1��lrr•• -• Expiration: Commissioher 03/08/2019 ,cti• ����• T�ariaiJ[Oi�u�Cu�/�O�G7�lrilJr'u•�ri.u•/%J Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Z ( Registration valid for Individual use only 4J _ •' TYPE:Individual a before the expiration date. If found return to: =: Registration Expiration j1 Office of Consumer Affairs and Business Regulation 5 I r 10 Park Plaza-Suite 5170 1231f1:, .; 12/09/2016 Boston,MA 02116 DAVID A.CARROLL D/B/A Cape Cod'Remodeling dnd Design DAVID CARROLL',. `.. 12 Frederick B Douglas Rd. 61 N.Falmouth,MA 02556 Undersecretary i Not valid without signature 1 o Cape Save Inc. 7-1) Huntington Avenue South Yarmouth, MA,02664 Tel: 508-398-0398 Fax: 508-398-0399 3/2/16 Thomas Perry CB O Town of Barnstable Building Division 200 Main St. L �� 0' Hyannis,MA 02601 N q" csa RE: Insulation Permit 16-196 Dear Mr. Perry This affidavit is to certify that all work completed for 70 Waterfield Road, Osterville has been inspected by a third party Certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey i f Cape Save Inc. UU 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-03W- ''• 'C 6 9/29/14 -, Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permits Dear Mr. Perry, d5T This affidavit is to certify that all work completed for 70 Waterfield Road has been inspected by a certified Building Performance Institute (BPI) Inspector. Ceiling: R-25 cellulose in main attic; R-49 cellulose in knee wall attics Exterior Walls: R-13 dense pack cellulose; Knee walls R-7 FSK Crawl Space: R-10 Thermax on foundation walls All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey i WORK SHap • �x4 DW SDA��F S6 P ,o 1 1 r ` 5 CQA�L 1 i SPA`'\ 1 yq r • ,� � uGRouN9 FAll Dot I I 9MRI�80. '1 AD fFp 1 i P 6xB i C.uRC.� w DATE May 21, 2014 TO Building File FROM R Anderson, ZEO RE 70 Waterfield Rd, Ost Martin MacNeely(COMMFD) called to check status of detached 2 story accessory structure in rear yard of this property. He reported that subject structure has separate gas meter, kitchen set up (minus kitchen sink and stove). Current owner says it is a play space. Property is to convey on 5/29/2014. The pre-sale inspection on this date failed. Our file contains evidence of a rental history in the form of a classified ad from March 1998. I advised of rental history in file. He replied that unit is not set up on this date as an apartment. 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AM- :iy:3Y':y'`{:t;.;:;i}i}iinnSit?}}j,•:ii}j,>.}'.. ........ ..,nv.,v n..v..n:.:.:::::::::v.:«xw:.w.,vv::.w.v„x,v:::::.x::•.v.v:•.vxxw.i•:.xy:.}:•::.v:.;.:::•.«:vi:xixw:nw::ny:::::::::v:::w:• it:>...:::.v.:::vn:.......:..... .... ;:..:.....•....AN NY— W t>:s? `Q O SEE NEWSPAPER 'tYY'tY'•}} ...m nv.a,aaaxx.xxx:xx , ,»v,,,,,nvvv.vaa:xx:•mxxvvvaxxvv»,»»„x„a,a,aaaaavx::.•.vva:axvv,:,x,x,xxxvx,a,,,,.vvvxvvvvv:v:xvxv:xvvvv„•n,,,,»,»ni}}.}..:; .;»,...,:;;.:>:::,:,..,..;::a,::•:i, ::}}}}i}ii}}Y}Y}}}}:;x•}}i}i„+,+„Yiaii:•is•>irY}}>::}>}}}::>}>::•}>:}>:•:;>:•;.:••:}};}}:::}:•}•: :u•:a;oca:•:ta,;;t;:uuttttt;atuttt ..1rC.:. .....,,...,.., .............. ..,:....:..::::..:..:.•.:::::•:..,.,,,,.,,v:::::.,»,.:a:::x:x::x::.x,.,,:x,,,,,,,,,,:x•:.,..,,aaa.,:...vxx:xxxa„xxxii ii•.i:i•.i,•.�.;,:,,;M,•:, '`i'aAPT. FOR RENT.- i I T E R VI l ST L LE•- . St udi 0 apt, ti Wa lk to vil lage. a e. 0 N 9 pets. r .................................. r N on sm ok r e.Av ' } ryY2 y` : :::.#`{#'�?�' %>;:####�:<<:2t`•�3#:'t all 4 ..<.. / SeP t _ 1. 33$ 00" all 50 8-42 -0 75 ~:�YttY }•`•.•'•.`' `•}}Y}Y} i:}}::;YY::z}Y }„ <€:REFER TO R. STEVENS ............ -to....... 5ASl� 1 Pc x> 0 V�L 5 W gal p� „} " ?t•:;;t;•:;?}.iii:;.:::;;t;.::ta:.:t}}}}}}};}}}}}Y}}}}:;}:;Y}::YYYY}}}}}::::::::::YY::}}}•'.YYY::}:.:o^}Y},.:..:.:.. :;::::.:,.:.: t � � t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �•s— Map _Parcel Permit# 'Soo �P Health Division �,��/S ����� Date Issued Conservation Division �, ! B '. Fee � � • � d d�o QEfd`� —�f tl Q®`S Tax Collector SEPTIC SYSTEM MUST BE Treasurer - _ INSTAL.EpINEOMPLIANCE iNA'N> fLE 5 Planning Dept. ENWRONkg"L CODE AND Date Definitive Plan Approved by Planning Board - GVLATIONS Historic-OKH Preservation/Hyannis li Project Street Address r7n (Ala, 'f P� If�9 Q 'Village �-Jecyl Owner / Address `7e) fit �, ,\Al d at Telephone w Permit Requestn�D �2YV1P�Z �� �� dP /i9S/�rr2 Z r Square feet: 1 st floor• exist'_gam proposed PZlEav 2nd floor: existing /3G0 proposed Total new l . .Valuation Zoning District Flood Plain Groundwater Overlay Construction Type !M Lot Size ' IA/ wit Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family (ff/ Two Family ❑ Multi-Family(#units) Age of Existing Structure y2 Historic House: Cl Yes &No On Old King's Highway: ❑Yes ❑ No Basement Type: Bfull Q10rawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) P OO Basement Unfinished Area(sq.ft) /_ky) 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: C9"Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing 6an Q New Existing wood/coal stove: ❑Yes C<o\ Detached garage:CR/existing O new size 2©X Pool: ❑existing ❑new size rL6AP 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 If r Telephone Number Address �/1 ��ll`� � � I �PXr License# 7� Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESUL G FROM THIS PROJECT WILL BE TAKEN TO 1"I/�CO!'✓I 13t�'YZ t S �04 ?-o—s7 � 6 SIGNATURE V, DATE FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL'NO. ADDRESS VILLAGE ; OWNER r DATE OF INSPECTION.'. FOUNDATION' FRAME INSULATION g 3 en FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH s FINAL GAS: RO.UGlI4 Im" FINAL 0 _ FINAL BUILDING Nat ; DATE CLOSED OUT -r ASSOCIATION PLAN NO. Inc Affordable H011MI r Fes Residential Commercial** Property Owner's Name Project Location Project Value 7, J. �� Permit Number 9�� **E.Yisting Sq. Ft. _ **Proposed New Sq.Ft Fee S �- g O - ,, - [AHFOR..N1 11 00 %nclusionary Affordable Housing Fee C t Residential Commercial** Property Owner's Name Project Location 778 ' Value � C2 D�-fl . ProjectPe=it Numb. **Existing Sq. Ft. _ **Proposed New Sq. Ft A-e Fee S �- g O r IAHFORM 1.12:00 MCZMApp.,,t j •- PresQiptbe Psdca�e for aaa aad TwFFsmi'iy Rnfd�Balldia�geamd with Food Fosb • MAMIUM mom Will now a-- U-valor Rrval� &vaL�' &value Will Pfdt Padm�ecolingma:ing uafoe R.yalad. S10I b6dD0 Ressl�Oe�Dam' Q 12% aao n 13 19 1 10 6 Nowt f[ 12% as2 30 19 19 A0 6 Now s im am n 13 1! 10 6 UAETJE T 15% 936 n 0 25 WA -WA Na and U Is% I am. n 19 19 10 6 No mal V7 ifs Qli� JI a 23 WA Y ice. ft3 AFIM ' W 13X asz 30 19 19 10• 6 M AFUE x ls'/. 0-42 3f 1? Zt WA WA Na�at TIVA a42 31t 19 25 WA WA Nom d i><'b aA2 1: 13 19 10 6 W ACE M 1a'/. 050 30 0 19 10 6 9OZ7m 1. ADDRESS OF PROPERTY: 70 Z SQUARE FOOTAGE OF ALL MERIOR WALLS: 1 300 3. SQUARE FOOTAGE OF ALL GLAZING. 4. %GLAZING AREA(#3 DIVIDED BY#2): ' S. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUnUlffNM ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-f980303a 780 CMR Appendix J Footnotes to Table MUM doors, skylights. and Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass basement windows if located in walls that enclose conditioned space, but excluding opaque doors)to the gross wall area, expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 W of decorative glass may be excluded from a building design with 300&of glazing aria- 2 After January 1, 1999,glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRQ test procedure, or taken from Table J1.5.3a. U-values are for whole units.center-of-glass U-values cannot be used The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness-over the exterior walls without compression, R-30 insulation may be substituted for It 38 insulation and R-38 insulation maybe substituted for R-49 insulation. Ceiling R values represent the sum of cavity insulation plus insulating sheathing(if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space nuts the vawflmd pff on Oft th•'mssulation plus insn�ng sheathing (if used). Do not include Wall R-values represent the sum of the wall sty P exterior siding,structural sheathing- and interior drywau.For example,an R-19*mquirement could be met FITUR by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wail requirements apply to wood-flame or mass(concrete,masonry,109)wall suctions,but do not apply to metal-flame construction. 'The floor requirements apply to floors over un (suchas unconditioned crawispaces,basements, or garages).Floors over outside,*must meet the ceiling requirements. ,The entire opaque portion of any individual basement wall with an average depth less than 50%be o grade must meet the same R value requirement as above-grade walls Windows and sliding glass doors ed basements must be included with the other glazing. 132-tenent doors must meet the door U-value requirement ` described in Note b.. The R-value requirements-art for unheated stabs Add an additional R Z for heated slabs. If the building utilizes electric ice heating use compliance approach 3, 4, or S. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the e$cienry requited by the selected Pie. - For Heating Degree Day requirements of the closest city or gown see Tab1e J52Lla NOTES: levels.' a)Glazing arras and U-values are maximum ac eeptable levels Insulation R-values are minimum acceptable R-value requirements are for insulation only and do not include stuctInal components. b)Opaque doors in the building envelope must have a U-value no greater than 035.Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.53b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(Le.,may have a U-value greater than 0.35). c)If a ceiling,wail,floor,basement wall,slab-edge,or crawl space wall component includes two or more arras with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or dd or components comply35 for dooms-weighted average U- value of all windows or doors is less than equal requirem erit i I NOW., R W.0 F F I FF MIMI 71TED-11. ---- -- P171 -------------- ------------- li 11111!NMigaign W/MMMI/0"MON/1 Bill 1 II 5:1 NO _V7TV, 14 1_711 711...... ........ 4 A 44011AID v I I. a 1. 77,1,i.M. 1.) .77 1) ... ............. ...... .. ..... .... .... ..................... offirial use only do not write in this area to be completed by city or town oMUW D■ epartnteut PMW*UCM city or town, C3LIcensing Board ( OSelectmens Ofte 3 chwk ifimmediste rwponse is required C3Hex1&Dep2r1=9ut ct person: phone#, ............ ■ sit - . a r • • • • • - . . •11 r - • III :1/IU • • . false I 1 . , , . fall i. . . 1 11 1 - - . 1 . 1 1 . / •Illfa Na 1 - A. . 1111. 4• • . . III - . 11 . 11 :III . 1 1 1 . 1 • 1 r . it l l . . . . - . i OT4 . • I 11 • • • •1�1 1 11 •M . •II • • / 'Y. �111■ L1/11. • 1! �1111. • �� • ` 1 . • 1 �1 • .1. fan�111 1 • 1 • • 1 - :ill • 1 - • Ir I • 1 1 ` 11 • 1 • • • . 1 • 1 • 1 11 ` 1 • 11 • 1 .11 1 - - 1• 1�1 ` 1 • :1111• • .�I •II • I • II III .11 1 Y' •II • . fall • . I • /. •II I • • II • I• • •11 II L . II . • • . 11 Ifitse.hol all 1 �I11.)(Oki 11;I 11 1 I��111 �• • • I :Illlr • is • Y.1 / .1 1 1 1 1 ' 1 1 1 1 1 1 : I •' 1 1 ' • 1 1 1 11 I 1 1 1 rll rqrq7,40 - I Y 1 1 11 !JI1 I I I 1 1 I - 1 1 1 • • • 1 I�1I I�I 1 •mle *If I • 1 • 11. •• 1• w. . • Y .11 1 M11 �1 111 • 1 •11. • 1 .' • 1 1 see • •:11 • •11111 1 1 1 11 1/ 11 .11 �• �111�111 • 1 1 . 1' 1 .��11 r �.�11 . • 1 .111. fall s I • • y • •. �1 •Ills.�11 .11 •I/ •/ / • 1 •Ills. 1 ` 1 .�1/ • 11 •• 1 .1 . 1 • • 1 Y1.1 .111011 .11 1 I. ill III . 11 ` •Ills. fall 1 .111� . •1 w .11 • ##I• � •II fall�111 •1 1 111 . M 1 -1111. • Y•11 /1.11 .1• fall • 11 11 .11 Y' . it 1 1 1 JI 1 1 1 .111 11 �• 1• 1 I • - . 1 11 • 1 .. • ` i 1 • • • alll.l �• 1• 11 - MI 11 • " 1 11 .1 II • . .1. •II • 1 •�1.11 1 • �-• I 1 111�I I I • 1 111 •r M 1 �1111, 1 • • `• 1 .1 I 1 1 . •I 1 v: • 11 • 1 • • 1 .;.111 • W. 1 .� 1-• 1 I 11 - �• III �• 11 • • 1'.111 •1/.•�1 111111-11 W,1• •II • • 1 �•: •': I 1 I • 111 till .1 1 - II 1/1 •:1 1�• • • • :MEjj/��j�j��jj • 1 1 /1 1 .1 1•1� /• 1 1 •I1111 .11- .11 1 • 111 -• •I 1 1 I • 111-111 1 . • .�• . •1 1 1 • 1 falls fa 1 •I • • III • 11 11 11 :ti 11 11 � r/ •' • 1 -� . `Y.1. fall 1 /. falls Y. • y • 11 ` 1 r • •r;lll • ''i 11 11 •.Irllll .,1 11111/ • a • 1 / I 1 1 -I �1 �1 �11 11 I11 I.I 1 ■/ • of . • •11.1�• So - I • 111-1/1 1 11 • 111 • 1/ -1 kip •11 _-111 �111♦ 1 •�-.1 11 i/ • 1 ^ . 'yi• fall • • • 1 1 • 11 . .11 • • •• 1 .1. •II 1 1 1• . • 1 1 1 w . . 1 .. sea.11 •• . 114111, 1 e r.fa' 11 111 I.1 11 11 11 1 1 1 1 1 11 1 1 I I 1 1 I . . 1111 1 ' Il II I ' 1 °F ve r� The Town of Barnstable btAS&-pg - Regulatory Services QED MAC 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 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•ownet-occupied i building containing at least one but not more than four dwelling units or fo structures�which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along'with other requirements. n r- Type of Work: Fug Cl2_' RdVi+_y Estimated Cost `Y Q Address of Work: Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR -Al .P. Date Owner's e q:forms:Affidav EST/MA TED PROJECT COST WORKSHEET LIVING SPACE Value (high end construction) square feet X$115/sq. foot= (above average construction) ,�X 2�Z q square feet X$96/sq. foot= Is (average construction) square feet X$57/sq. foot= GARAGE (UNFINISHED) square feet X.$25/sq. foot= PORCH -square feet X$20/sq. foot= square feet X$15/s foot= 2,Z DECK j o`Z � �a �a 5 )�0 q q' OTHER I-Cl¢,,� square feet X$??/sq. foot= ,U Total Estimated Project Value o 1 °Ft►+e rqy, The Town of Barnstable s anRrtsTnat. . • 9 MASS. g Regulatory Services 'i639 39 °' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print /,7 /0-0 DATE: JOB LOCATION: number n street /�--� �f village/ T HOMEOWNER": �(91'' ��Y l'P�l� �f 6 �cO I / Z�^O�'L�/� V name /home phone# work phone# CURRENT MAILING ADDRESS: Sx 114 �" 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 i 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 De p ent minim ' pe.ction procedures and requirements and that he/she will comply with said proc ur s and req ents. gn re w of Homeone val 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:EXEMPTN 1 Distinctive Home Designs PO Box 192, Osterville, Ma 02655 508-428-9398 WINDOW SCHEDULE: John Peacock, 70 Waterfield Rd. Osterville,MA Andersen, clad, color white. All windows; with screens, grilles. Verify if no screens required,2-CW145 First Floor windows. Header heights per. Existing. Code Ouantit�style Window# Location 2 dbl hung TW3046 Bedrooms 1 & 2 2 dbl hung TW2046 Bedrooms 1 & 2 1 casement C24 Kitchen sink DOOR SCHEDULE: Code Quantity, Style Size Location Live Andersen, with grilles 1 Patio Dining Lie Verify_if no screen required. kct Nirt-1 1 Patio, single lM WH2968AL Kitchen L/H t . Engineering Dept.(3rd floor) Map t c( Parcel Z�. Permit# 30 / House# `7 0 pig Date ssued 1— 14 9—T Board of Health(3rd floor)(8:15'-9:30/1:00-4:30) 9` �I!,� F% e� ��C Conservation Office (4th floor)(8:30- 9:30/1:00:2:00) -� 1 �`®/� Planning Dept. (1st floor/School Admin. Bldg.) V100Jtff �9A 4 F •+,r�, Definitive Plan by Planning Board 19 � BARN STABLE. MASS. 9. 63 TOWN OF BARNSTABLE 6 Buildin Permit Applicatio Project Street Address 90 64 Lq�&A�,U Village ' Owner � Address Telephone — Permit Request alclai First Floor l d oo square feet Second Floor goo square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family I Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes @4o On Old King's Highway ❑Yes EtlO Basement Type: Kull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) >> Basement Unfinished Area(sq.ft) Too Number of Baths: Full: Existing New Half: Existing �_ New No. of Bedrooms: Existing L_New a Total Room Count(not including baths): Existing_ New Q First Floor Room Count Heat Type and Fuel: Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes � Fireplaces: Existing New Existing wood/coal stove ❑Yes Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ` ❑Barn(size) ❑None hed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial. ❑Yes CEO If yes, site plan review# Current Use4' " Proposed Use i1der Information Name Telephone Number TV17_ 0 Address /fat License# ` Home Improvement Contractor# /0 35-7d— Worker's Compensation# TO q`/ _10 1� g� NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PE MIT DENIED FOR THE FOLLOWING REASON(S) ,e C �0r �, Sc- FOR OFFICIAL USE ONLY r _ PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER a DATE OF INSPECTION: a FOUNDATION FRAME INSULATION .lO `oC - FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ' GAS: _, r, ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. y s PROPERTY ADDRESS I I ZONING IDISTRICT CODE SP-DISTS.IDATE PRINTEDI CSTATE I PCS I NBHD KEY NO. 0070 WATERFIELD ROAD 11 RC 300 11C0' 01/04/96 1011 00 30AC R119 026. 61319 LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS `, UNIT ADJ'D.UNIT ACRES/UNITS VALUE Description L.ntl By/Data S�z.Daman lion LOC./YR.SPEC.CLASS ADJ. COND. P PRICE PRICE PEACOCK, AMY L MAP— CD. FFDeIh/Acres #LAND 1 43,500 CARDS IN ACCOUNT — L 10 18LDG.SIT.1 x .34 '=10C 197 64999.9S 128049.9 .34 43500 #BLDG(S)—CARD-1 1 68,200 01 OF 02 A #SLDG(S)—CARD-2 1 21,600 N BATHS 2.0 U X C= 100 7000.10C 7000.0 . 1.00 7000 8 #PL 70 WATERFIELD RD MARKET 162100 D — 1/2 8SMT. S X C= 100 3.210 3.20 1218 3900-8 #RR 1789 0135 INCOME #DL LOT 15 USE A APPRAISED VALUE D i A 133,300 A U PARCEL SUMMARY T S LAND 43500 A T BLDGS 89800 0—IMPS M TOTAL 133300 F E N 'CNST E N DEED REFERENCN Type DATE R,�rOeO PRIOR YEAR VALUE A T Book Page I^sl' MO. Yr.D Sala.price LAND 43500 T S 9252/0891 1.06/94 A 1 BLDGS 89800 U 8596/13VTE1:05/93 135000 TOTAL 133300 839/55 :00/00 i R I E BUILDING PERMIT S Number Date Type Amount LAND LAND—ADJ INC ME SE SP—BLDS FEATURE SLD—ADJS UNITS j 43500 1 3100 614422 10/71 Consl. Total Year Built Norm. Obsv. Class Units Unlls Base Rate Adj.Rate A 1 Age Depr. GOntl. CND. I Loc. %R.G. Rapt.Cost New Adj.Real.Value Sltrie.. Height I Rooms Rms Batha I It Fia. I Pruty.all Fat. 01C 000 100 100 56.05 56.05 50 60 34. 56 100 56 121735 68200 1.5 8 4 2.0 7.0 Description Role Square Feet Rapt.Cost MKT.INDEX: 1-00 IMP.BY/DATE: / SCALE: 1/00.66 ELEMENTS CODE CONSTRUCTION DETAIL S SAS 100 56.05 1218 68269 FAMILY'DWELLING : LING CNST GP FSF . 90 50.45 430 21694 IN *---14---: B15 42 23.54 1218 28672 *__—_—_—__ STYLE 04CAPE COD 0. T � R 32---------*4—* FIN ! " DE�rGN-ADJMT. -00 -------------------Q: *----18----* ! ! EXTER-W-kCCS-- -01 60D-_F1fA ME—-------0. U ! RE_ T/At--TYPE- -04 -fL----------------0: 25 INTER:FTNISIf -00 -------------------0: T ! 20 ! INTER:LAlf0UT_ -01 -------------------0: U ! BASE ! ! ' TER:dUACTY -02 kME-A�-EX-r5`9 --O. R IN 25 FLWIJR--STROLT -00 -------------------0. ! ' ! A W'• ! ` ! EFLa6R-COVER-- -00 -------------------U. L E Total Area. Aux_ Base_ 1648 ! *----16---X4=*---14---* RDOF-TY_FFIE - -00 -_-_-_-- _---- _-_-0. BUILDING DIMENSIONS ! 8 ELYC-T RI EAC 00 __ __ 0. T BAS W16 S08 W34 N25 E18 NO3 E32 ! F DIN 0ATI-OR--- -00 -- -----------V4: A FSF E04 N04 E14 S25 W14 N01 W04 *----------34---------* --------------' --- ---------------------- LN20 f Sf. .. SAS S20 .. -----NEI-GH8D72 6OD .30AL-6STE72VILLF--- LAND TOTAL MARKET PARCEL 43500 133300 AREA 4508 VARIANCE +0 +2856 STANDARD 25 yr PROPERTY ADDRESS I I ZONING I DISTRICT CODE 'SP-DISTS.I DATE PRINTED I CSTATE LASS I PCS I NBHD KEY NO. 0070 WATERFIELD ROAD 11 RC 300 11CO 01/04/96 1011 00 30AC R119 026. 61319 LAND/OTHER FEATURESDESCRIPTION ADJUSTMENT FACTORS y UNIT ADJ'D.UNIT PEAC0CK• -AMY L MAP— L-0 By/Da,o Size Drmons,on LOC./Y R.SPEC.CLASS ADJ. COND. P PRICE PRICE ACRES/UNITS VALUE Description CD. FF"De Ib/Acres — L BATHS 1 .0 U " X C=. 100 3500.0 3500.0 CARDS IN ACCOUNT 1.00 350D B 02 of 02 A — NO BSMT S X' C= 100 7.8 7.85 576 4500-B N MARKET 162100 D INCOME A USE APPRAISED'VALUE D i A 133.300 A U PARCEL SUMMARY T S LAND 43500 A T BLDGS 89800 0-IMPS M TOTAL '133300 F E N CNST E T DEED REFERENCE osp. DATE R—, PRIOR YEAR VALUE A Beck Page Mo. Yr.D LAND 43500 T S BLDGS 89800 U TOTAL 133300 R I 1 E ESTIMATED-83 BUILDING PERMIT S Number Dale Type Amount LAND LAND-ADJ INC ME ' f, SE SP-BLDS FEATURES OLD-ADJS UNITS 1000 Consl. Total year Built Norm. ,Obsv. Class Units Units Base Rate' Adj.Rate A 1 Age Depr. Conti. CNO. I I—. ab A.G. Real.Co.,New Adj.Repl.Value Stories I Haigh Rooms Rma Bethel ♦Fia. Pertywell F.c. 01C 000 100 100 62.90 62.90 50 50 44'38 100 38 56968 21600. 2.0 4. 2 %0 4.0 Description Rate Square Feel Real.Cost MKT.INDEX: 1-00 IMP.BY/DATE: / SCALE: 11 D1.00 ELEMENTS CODE CONSTRUCTION DETAIL S OAS 100 62.90 576 36230. Y.. W LLING CNST GP:00 T 820 60 37.74 576 21738" *=----------24----------*. STYLE 10O -------------------STYLER ! EXTER.NALLS _01 OOD FRAME _____ C 0.0 U ! H_EATIAG TYPE _03E_L_E_C_T__R_I_C___________6. ! NYER.FINISH 00 . 6:0 T INT 7LAYOUT- -01 ------------------6.0 U ! ! INT-E9aWkLTY -02 SWKE AS EXTER= Q.0 R 24 BASE. 24 FL 00 R STR _ UCT 00---------------- ---11 A W ! EfL_T69 ZOVER-- -00 -------------------6. L D R8a F-TYi�E---- -00 -------- ---------6.0 E Total Areas 3UI Be. 576 . ! T yI-00 (BUILDING DIMENSIONS ! 1 E L C-T R 1 C M L (/.0 A BAS N24 E24 S24 W24 .. ! FBLK15AT76N--- -00 -----------------V4.9 --------------- --- ---------------------- X------ 24----------* LAND TOTAL MARKET PARCEL AREA VARIANCE f0 +0 STANDARD FOUNDATION BSMT. & ATTIC PLUMBING ^PRICING LAND COST )onc.Wells Fin. Bsmt.Area Bath Room Base 3 j 0tj BANG. COST :one. lablk.Wells Bsmt.Rec.Room St. Shower Bat Bsmt. _ '170 PURCH. DATE :onc. Slab Bsmt.Garage St. Shower Ext. Wells +. PURCH. PRICE. 9riek Walls Attie FI.3 Stairs Toilet Room Roof RENT v ;tone Wells Fin.Attie L L• Two Fixt. Bath Floors t* 'iers INTERIOR FINISH lavatory Extra Ismt. F '1' 1 2 1 3 Sink y70 /� Attie i- y y / r Plaster Water Clo. Extra EXTERIOR WA LS Knotty Pine Water Only D F / a rouble Siding Plywood No Plumbing Bsmt.Fin. ingle Siding Plasterboard Int.Fin. �. )OOYShingles [. Q TILING . — — — — 3 one. Blk. G F P Bath FI. Heat 1 8 ace Brk.On Int.Layout Bath y.&Wains. Auto Ht.Unit / a/� •'2� �S Veneer Int.Cond. Bath FI.h Walls 6 Fireplace om. Brk.On HEATING Toilet Rm.FI, t 8yG /b• /� olid Cam. Brk. Hot Air Toilet Rm.Fl.3 Wain$. Plumbing u' 3 ff. 3 7 8 _ Steam Toilet Rm.FI.&Walla Tiling ` _ lanket Ins. Hot Water St. Shower oof Ins. Air Cond. Tub Area Total Floor Furn. ROOFING COMPUTATIONS sph.Shingle Pipeless Furn. S.F. 5 food Shingle No Heat S.F. �O sbs. Shingle Oil Burner S.F. late Coal Stoker 'S.F. its Gas S. F. OUTBUILDINGS ROOf TYPE Electric able Flat S.F. 1 2 3 4 5 6 7 8 9 10 1 2 3 1411 6 7 8 9 10 MEASURED ip Mansard FIREPLACES S.F. Pier Found. Floor ambrel Fireplace Stack Well Found. 0.H.Door LISTED FLO RS Fireplace Sgle.Sdg. Roll Roofing T J one._ LIGHTING V J Dble.Sdg. Shingle Roof arth No Elect. DATE ins Shingle Walls Plumbing ardwood ROOMS Cement Blk. Electric 9 r sph.Tile Bsmt. Ilst5-t-,6 TOTAL Brick T Int.Finish PRICED Ingle 2nd ,A 3rd FACTOR .� \ N G REPLACEMENT •j..?�. OCCUPANCY CONSTRUCTION 9 SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy—D7ep• PHYS. VALUE Funct.Dep ACTUAL VAL. r�( )WLG. /-- �j� IJQ C7C�<).a y� 3O /L 2 3 4 5 6 7 8 9 10 33/So TOTAL RESIDENTIAL PROPERTY MAPeA6. LOT NO. FIRE DISTRICT SUMMARY O3terville 119 26 STREET Waterfield Rd. LAND BLDGS. OWNER S`JC� TOTAL ^� i RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: 7 LAND 33/S0 BLDGS. Leonard Philip & Leona L. 4 13 53 839 55 B TOTAL So LAND 01 BLDGS. Leoov.4� G le/ TOTAL LAND 01 BLDGS. TOTAL i • LAND O1 BLDGS. TOTAL LAND O1 BLDGS. TOTAL LAND BLDGS. TOTAL LAND �� •r !� (i INTERIOR INSPECTED: , � •,f �J r� C.;_F.art f�,� BLDGS. • }, 01 �-' (�I TOTAL DATE: ��� a LAND ACREAGE COMPUTATIONS BLDGS. LAND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL HOUSE LOT s8 R . 2 v c7 8 2 0 R .0 LAND CLEARED FRONT BLDGS. REAR TOTAL WOODS&SPROUT FRONT LAND REAR BLDGS. WASTE FRONT TOTAL REAR LAND BLDGS. TOTAL LAND BLDGS. LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH% FRONT FT. PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ROUGH TOWN WATER BLDGS. HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND SWAMPY NO RD. ell BLDGS. WORK 4' K 1 cEs6 P / i, SPACE' 1, i so Ft.dfca tit ' P ` r . r _.._..._._... ... ... ... -Ro A L I l• I h'♦" y y' �!e �ammzoncuealU o�✓�aaoadcuaella I •-- ---.. Restricted To: 00 p DBPARIKRNT OF PUBLIC SAFETY H 31 O 8 CONSTRUCTION. SUPERVISOR LICENSE 00 - None Au®berg-;= __; Expires: 1G - 1 & 2 Family Homes Restricted fo ='. 00 Failure to possess a current edition of the F Massachusetts State Building Code f_ SCOTT B CROSBY is cause for revocation of.this license;, 61 CROSBY CIR OSTBRVILLB, MA 02655 Y � ' .. .«. i i:..•....a. �i ....,.._._ ._ _.. ...:1.,vMf!++ 't aEY�6"f2`re�e._ '�'9i_. ._.�_�....._..__.... .�..�. ._._.�is...:i?..♦....__�.. The Town of ]Barnstable • s~ _ '•4' BARNSTABLL ' Department of Health Safety and Environmental Services rY, �► Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax::;- 508 775-3344 Building Commissioner 3 •nh t For office use only f Permit no. Date ' AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied .`:;building containing at least one but not more than four dwelling units or to structures which are adjacent r1>;: to such residence or building be done by registered contractors,with certain exceptions, along with other MF ., requirements. Type of Work: (.t�^� 1� C Est. Cost D00" (70 rJ Address of Work: Ovmer Name: Ta"", P `! Date of Permit Application: I hereln•'cc tify that: .. Registration is not required for the following reason(s): Work excluded by law Job under$1,000 Building not owner-occupied ` Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN-PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY ` I her by apply for a permit as the agent of the owner: Date ontractor name Registration No. OR NJ �- �-g� Date Owner's name ` The Conittiottit'Cultlt of itas.achusctty •ri4 '� Department of Industrial Accidents ' ` V.. :1 oficeollaveS119s affs 61JO Ii'asllington Street Boston.Alas. OZlll Workers' Compensation Insurance Affidavit nnmF-:, JW"n Inc tion. p�O c t`i/v ••i `� �`? - v 02G S�S'� nhone it I am a homeowner performing all work myself. 1 am a sole proprietor and have no one working in any capacity I am an employer providing woe ers' compe sation or my employees working on this job. n v 1 add ess: city nhnne#• incur•tnceco `�t��/Vi`la�l1a policy# �1 am a sole proprietor. general contractor,or homeowner(circle one)and have hired the contractors listed below who h; the following workers compensation polices: cmm�anv name: atldress• phone#: insurance co. nolicv# �• -y•� .• �^ - - _• urns:. •tr ey-::�.•,-s•::�+t�r«c�-+�T.:: ar�••-.na�-sl�.\;- J= f•nn!! .,.•!Zc�s�a.:v.•••Ta..-�,w..�:.-ems:�•.� cmmi2anv nnmc• iddress' city: phone#• insurnnce co. policy# 'Attach addi_tionafshcetiftiecessar ;� y ,_v--�1'?^1re:afrt r.t.t. n•v.+.;:�! ;w •►.�• .w iSC'�•+•Y s:� failure to secure cuvcraFc as required under Section 25A of AIGL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 andi( une rears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that copy of this statement may be funrarded to the Olfice of Investigations of the DIA for coverage verification. ' I do hereby cc if}•under the pains and penalties of perjun•that the information provided above is true and correct. ` ? Sinnature Date 9 Print name :&E5 SCt 0#_ f'c adOL k Phone# y� 6905� oRicial use only do not grate in this area to be compacted by city or town official city or town: permitllicense# nlluildinr.Department C3Ucensing hoard check if immediate response is required 13Sclectmen's Office C311calth Department contact person: phone#. nOther j f Ire•ued14)1 P1Al °FTHE T°�♦ TOWN OF BARNSTABLE •33AHB9TODLS, i a pY•��e� BUILDING INSPECTOR APPLICATION FOR PERMIT TO Fri. �1 �¢4. '.�4r....... ` TYPE OF CONSTRUCTION ...Z01,4111.i=.....................:....................................................................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby. applies for a permit according to the following information: Location .. ......... - 7� /tT. Qe.{��Fl ...f�oA ..........l�Sf, �cl �....-....,���. s.................................................. Proposed Use ... ...... /YCt�..... �'i Cvlf/..c.......Y.., JY/f9`.................0...................... Zoning District .............. ...............................................Fire District . --W.lFce..v�il= — �f�vi�/.......�D 4 OyA6e !J ANI/, Name of Owner ............................AddressaS ��tll�f �f�s. ... ... .. ... �. ... Name of Builder .-4f o.!!F....... .....................Address Name of Architect .......... !v...........................................Address .................................................................................... Number of Rooms .........f ..,P.....0.......................................Foundation ....... o.c. .............................. Exierior ......................... ................. ....fxery �.............................................. Floors ....�G!i.�...............�.�.....................................................Interior ...O.l. �x ....r%�/f llllr............................................... Heating ... ...... ................................................Plumbing ........Yd.4v1Ic�....................................................... ... Fireplace ........mow.............6...............................................................Approximate Cost ...l.:L..r�..�................................................ . Difinitive Plan Approved by Planning Board —----------- . 00 S Diagram of Lot and Building with Dimensions h• D Zo � �GC G�O E FC! SAO 1?,q I hereby agree to conform to all the Rules and Regulations of the Tow Bar able regarding the above construction. Name . ......... .. .. j.�.�. ... . .. ... ...... .. ..��..... Leonard, Philip.& Leona L. storage shed No .... Permit for ..................................... .......................................................... r->r A�"AV 04/4.v- -x i� Location ....... .?0 Waterfield Road . ....................................................... Osterville 11 ............................................................................... Owner .....Pjqjip & Leona L. Leonard ................................................. Type of Construction frame ................... ................ ................................. .............................. ............... Plot ............................ Lot ................................ October 8 ?l Permit Granted ........... .........19 Date of Inspection . ........19 ........................... Date Completed ... y.7.g=............9 PERMIT REFUSED .................................... ........................... 19 ................................................................................ ................................... ............................................. . ............................................................................... ............................................................................... Approved .......................................... 19 ............................................................................... ............................................................................... 6 THE r TOWN OF B.AR.NSTABLE BARNST'A"6 9 BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...construct an auxilliar-v,outbuilding TYPE OF CONSTRUCTION ..........,wood frame ..................................................................................................................... .......Sept............26..............19A§.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according t&'.the following information: Location .................70 Waterfield Road, Osterville, Mass. ...................................................................................................................................................................... Proposed Use .......Storage of lawn mower, garden toolsp and workshop use appertaining to.................................................................. .............................I.. .. ............... the occupancy of the premises as a dwg. Zoning District Residence B .Fire the Centerville-0sterville Fire Dist. Name of Owner ...Philip Leonard Address 70.Waterfield Rd., Osterville.„Mass. Name of Builder „above owner Address ....... .................................................................................... Name of Architect .,.,none ,,,,,,,,,,,,,,,,Address Number of Rooms .........one,...... ....Foundation .......concrete block... ith concrete„footing Exterior ........wood„shingles. ........... ............. ......................Roofing ..asphalt„shingle................................................. cement floor on ground floor Floors wood„on„second....flo or. „.s... „attic .Interior ....unfinished -„rough stud Heating .........Stove..............................................................Plumbing .......none.....................................:............................ Fireplace none................................................................Approximate Cost $1 000 Difinitive Plan Approved by Planning Board ____________________< _______ , X c ® = 1Q f Diagram of Lot and Building with Dimensions-," /� a� id - Q: �w�osEc� IS K ZD� Fzo �� to -k 0wr ci S16walm /S IICI(41lvg REd •. .r.�� �� 8 a:o a ll SCA/H - l = *O I hereby agree to conform to all the Rules and Regulations of the Town o arnstable,,reg dr nia g the. ove construction. / Name . .... ...... ....... ............................................ Leonard, Philip Cc No ...4275... Permit for .... Private Outbuilding .................................. Location Road ............................................. Osterville .................................... Mass............................. Owner ......Philip Leonard ..........I................................................ Type of Construction Wood frame .......................................... ................................................................................ Plot ............................ Lot ................................ Permit Granted .....September...30....*.....19 68 ...........• ... Date of Inspection ... ............19 67 Date Completed ......................................19 PERMIT REFUSED ................................................................. 19 ............................................................................... ................................................................................ ............................................................................... ............................................................................... Approved ................................................... 19 ............................................................................... ..................I.........I................................................... U J 1- o 0s c WALL 5 oC L 6" O.C. -ram s �o►tN t�ERcoc� � W axe �� o.c, _�_ wt,!- - ovs'rs p to 0 c kx, PLY. x Co�C• ��oo R a x b P.T. Do House 6 /T b Ib" 0, C,T 3y \b. I Kf eF MALL 65 SY'i 2X I D a oSTs 1 6,� D.C. v - aJ(I O c.p,x, . - PLY. x X 6 P.T. -sk 14, All- (/.AV- 71 K1 y r L'k w r SECOND FLOOR DORMER FRAMING" 7 cl ts) C) VA 4n- - V.h F r -A - f 43 LEFT ELEVArrl ON FRONT ELEVATION rt T—i:-7 _L;'I 7A 1'4(.3 PORCH, LEFT ELEVATION r 5 x �z 4- — t 4 Ilk _c co 0 __'B4TH .2-4 kn BEDROO < CC) NO kl) 6) OPEN DECK �vsA'L",r CID Im 9 C-4 Lu It VIA-lk-h C6$tl.+ 47� CLOSET >< CA C) >1 SCREENED PORCH F T.p Lo �A"C.-V-4e s v - cr z LI X 2 j BEDROON 41 131,A)ROON � C I� I DINING ROOM X 37 I-A4 rx _�5m 6 �J_ JA_p,4 CC_ ztt� rV._(.1 Nr 1 ------ Hk(5�k- ' /.Q "a SECOND FLOOR KITCHEN PLAN 11 - C' Illy ON DETAIL: LATTICE SKIRT PORCH, REAR ELEVATION DINING RM & SCREENED POkCH PLAN