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HomeMy WebLinkAbout0024 ALDER BROOK LANE � y _ ���� 1-OWN OF BARNSTULti- Z�Jl2 T Tf6fl a�r>lls to b e erm i Re ulato Services g ry ate:�ofTHWE Thomas F. Geiler, Director D.TVygTBuilding Division ee: ' Tom Perry, Building Commissioner 1679' 200 Main Street, Hyannis, MA 02601 www.town.ba rnsta ble.ma.us Office: 508-862AO38 TOWN OF 13ARNSTABLE Fax: 508-790-6230 SOLID FUEL STOVE PERMIT Owner: V'P*uL..- Install at:�Lk_ %-- •.Village; ` wa Map/Parcel: �3 lFz,a, Date: ®�ti Stove A.G�/ Used B. Type: adi t Circulating l o C: Manufacturer: \Lab. N D. Model No.: b o.—MPS ChimneyA. New/Existing jYexisting, please note date of last cleaning l�,p B. B. F1ue.Size } k to C. Are other appliances attached to Flue? �� D. P - ab Type and Manufacturer -- Jzk Maso me -Xj mined Hearth .A. Materials: Gp_x B. Sub Floor Construction: ��� Installer Phone: P S � � Address: 3_t Location of Installation: H.I.0 Registration# Construction Supervisor# <z < h L S NP OR check Homeowner Installing, no license required. APPLICANTS SIGNA FURE APPROVED BY: -Please make checks payable to the Town o Barnst,ihle *This constilutes an.official stove permit after inspection,photographed, and approved by the Building Inspector. The Cominonwealth.ofMassachuseds . Department oflndustriaZXccidents Office ofb"estigations - ' 600 Washington,Street Boston,MA 02111' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/•Contractors/Electricians/Plumbers Applicant Information Please Print I,egifil-p Name(Business/OrganizatimVhdividuat): . •,kddrf,-SS: City/State/Zip: 'ins,� �'.N` t !'U4� Phone w.- !S 4$`-'la�Q�Z — a�o � Are you an employer? Check the appropriate.b or. :Type of proj:,reqeduired): 1,❑-I am a employer with 4. ❑ I am a general contractor and I 6, ❑New cion .employees (full and/or parttime)•* , have hired the stlb-contractors2,❑ Iama'soleproprietororpartner- listed•on the'attached sheet 7. ❑Remoship and have no.employees These sub-contractors have 8. ❑Demol'-.Forking for me in any capacity. employees and have workers' 9. Bu>7dmon[No workers' comp, i,,.sma ce comp. msurance•t' ❑req•ai ] 5. ❑ We are a corporation and its 10,❑Electrirs or additions 3. I am a homeowner doing a'll•work , officers have exercised their 11. Ph�bi ❑ s or additions myself [No workers'comp, right df exemption per MGL 12,❑Roof reinsurance required.]t c. 152, §1(4), and we have noemployees. [No workers' 13`�Other �/`� comp. insurance required.] *Any applicant that checks box#1 must also 0 out the section below showing their workm,compensation poEcyinfrn tioo. t Homeowoets,who submit this affidavit indicating they are domg'all work and tliea hire outside contractors must submit anew affidavit i ndiratmg such - tCvatractors that check this box must attached an additional sheet showing the name of the gubtontmtors and state whether ornotthosc entities have employees. Ifthe sub-contractons have employers,They must providt:their workers,comp,policy number. , I am an employer that is providing workers' compensatiDn insurance for my employees. Below is.the policy and jab sife' information. Ins=ance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: - City/State/Zip: . Attach a copy of the Workers'compensation p4cy declarafinn page'(showing the policy number and expiration date). Failure•to secure coverage a4 required tmder Section 25A of MOL c, 152 can lead to the imposition of mimmal penalties of a fine up to$1,500.00 and/or one-year imprisoinnent, as well as civil penalties in the form of a-STOP WORg;ORDER and a fine of-up to$250.D0 a day against the violator. Be advised that a copy-of this statement may be forwarded to tie Office of Investi tions of the DIA for i,;c mnce coverage verification.. Ido hereby certify under thepains•andpenaides ofperjury that the information provided above is true and correct Si tore: Date: Phone# Official-use only, Do not write in this area, fo be completed by cr[y.or torn 0fj7cial City or Town ' Yermit/Iacense# Issuing Authority(circle one): .-I,Board of Health 2.BuildmeDeoartment 3. n-tvl'T'nvm rl.,-i, d w►a.+, ,r _ t_ .c ,,,__t._ r IKE r, Town of Barnstable -� Regulatory Services f � s�grtsrABLK Thomas F.Geiler,Director Mass. 1639 ••� Building Division ADD MA't A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: --t-F- L,� ��(Z � rL.{� c� number street village J "HOMEOWNER"TA*4asa�V-X name home phone# work phone# CURRENT MAILING ADDRESS: ��.0♦ 3��—� city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be,a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,ruffles and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner 7 Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." " Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt .I. a �IHE Town of Barnstable t,r . Regulatory Services y�MASS.I'E � Tbomas F.Geiler,Director 16gp �Fo �a Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 . a Property Owner Must Complete and Sign This Section }' If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work,authorized by this building permit. (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 inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORM&OWNERPERMISSIONPOOLS 6/20.12 l V � Sx �t i ��g; .0 } ri 4 2 c.�e�e.. $ieoo�e Lfy�� wB ii as iz ' Town of BarnstablePermit: 5,g:v oFt ro,,, Regulatory Services ate: /G/a J6/0 2- Thomas F.Geiler,Director ee: BA STABLE, = Building Division MASS" 039• ��� Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 ,�o - ' Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: AFL P���s Phone: Install at: Village: W%a C!5V Map/Parcel: 133 O Date: Stove A. New/ se B. Type: a i /Circulating C. Manufacturer:-1 tj C--S Lab. No. D. Model No.: v t c--< <-,o-o j l :k-7 -7 Chimney V A. New/ xistln (If existing,please note date of last cleaning) -►— �� v S 2-a� B. Flue Size Ott C. Are other appliances attached to Flue? C> D. Pre-fab Type and Manufacturer c� e •�L l��N` � E. aso ine nlined Hearth A. Materials: 132��-K l+a �L K��� �� �--� S \H� VIGL� B. Sub Floor Construction: Installer Name: P A.v t_ g , C�o�AS\� Address: Phone: ,o� Location of Installation: ��ff�oJDI�JC� CC�I�IN N��� C-- APPROVED BY: Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Q:forms:stove Rev 122801 t � - . n _ qt - •' �tC ✓, .., `,. .• r�s � / � � .t. f .y,•,v +. •� .r ,i.•3,t(y�., N'� •k,r.-��F is?t � h1 - 2`i �. � .!r' z _•..� ~ .� �' '` ••f :�- ��_. { R `,r;:YFf.�„ _` „ ••fit. y?', ��:r,.t. 1 �•� s J•.:� .y,ti b' t � t'►� l.'�'..' �.r t i" pro ;t•1' i 1 f y � �.�RiM �.t •.1. - '•i lei yaw ki ��°,r;4 5= � y-• ' t � Y5.` "'� `. �O� ��`"�►� �"'� ~t y� '' �' �5 •r i .lE3S�ylIC3���C(rl. ��� •.Y: �ti�:W ,�tC �}-;Y. 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Y i. � �� t„, ssessv�'s offioe Ust floor): _ At Assessor's map and lot number © K' c�?NE>o Board of Health Ord floor): Sewage Permit number ........................................................ S _ Z BABE9'ISDLE. Engineering Department Ord floor): o raea 9 _ p 1639. 0 Housenumber ........................................................................ o Mal d� APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILID- INSPE TOR APPLICATION FOR PERMIT TO .........,.......... ........ .. ..... .......... .. . .... ...................................... TYPE OF CONSTRUCTION M o 4-'......... .a............ ......19.$ . v TO THE INSPECTOR OF BUILDINGS: The undersigned Mere/by a lies fo ape mit actor ng to th allowing informa on: Location . !`. .�^".... ............. .. ........... ..... . ....... ..., ........ .... ................................................... Proposed Use .... .. .......... ................ ..�..... . ..... .............. ................... ................. . . Zoning District ..... .......Fire District .......'. Name of Owner ....�A`.V L .......................Address Nameof Builder ...........t .. .. ............... ............................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ...........�..............................................Foundation ............................................................................... S( 01W(r Exterior ......................C►��i..(Z �C�V�QpOiOCZ��.......Roofing .................................................................................... N VI Floors K...C3oT'C'O@{....�...P . .......T'0�..��'02 Interior Heating ..................................................................................Plumbing ......Q�... . ......................................... Fireplace ��Cie p :.............`................................................Approximate Cost ....... ....................../..................................... Definitive Plan Approved by Planning Board _______________________________19________ . Area ...`. ..... .. Diagram of Lot and Building with Dimensions Fee ... V` SUBJECT TO APPROVAL OF BOARD OF HEALTH I i r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. . P� Pam-- Name .................................................................................. Construction Supervisor's License .................................... POTASH, PAUL 14c, .,•30.792 Permit for _P:tAild Deck ............................ .......... F AIA:L 1 Y...awg!Xiag Location .....4 R A..A Q.Q X..Lane............ . .................... .................... Owner ......Paul...P.o t.a.s.h................................... .. .. .. .... .. . .. Type of Construction ......F.rAMQ....................... ................................................................... ........... Plot ............................ Lot ................................ 8 Permit Granted ........... .............19 7' Date of Inspection ........7.. .. .. .........19 Date Completed ...... ... ............19 / ;Lvr . 3 I I t 'C I 0 I I IV U 2 1` ----------------------- 4 0 Q 93 I � I IR• - W I � I 607- oe4- q >� �E.risrivL � � I I I I 1 I I G 0 7- ", , f ' CERTIFIED PLOT PLAN © F-v LOCATIONBOX .!!s(rsr B.oiz.vrrgpL,E �!l,�Trr 77 SCALE DATE •4,n.e�c .�o i�B.� FAST DENNI& ij ASM. 02641 r PLAN REFERENCE . fv'¢. .. . . y ?a; PG. 8.r Z 7� .PL•.S'! .PEGatQ,W.-9T.. � XJT/NL �i .4T/o I CERTIFY THAT THE ../... . . ...... .. ...... SHOWN ON THIS ,PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF . . /3�.ervlr-tdc�. . . . . . . WHEN CONSTRUCTED. DATE PETITIONER: r REGISTERED LAND SU YOR 7 Application to eOVj�ZP tNOV\P SD'pttS+DP ty\S EP GP ` 6D OE ENS\„DP EDP Old Kings Highway Regional Historic District Committee ✓c�S in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: Z New Building ❑ Addition ❑ Alteration Indicate type of building: ❑ House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3. Signs or Billboards:' ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other _ (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY DATES ADDRESS OF PROPOSED WORK LQ 1 �4 aPOOK L9A/ZA7- SSESSORS MAP NO. wes,i 13ACI✓S71-7,3(- OWNER R� r o t Pv�,1-1 ASSESSORS LOT NO. HOME ADDRESS L'So co i' C- t.--,' I, <, t l l L_L ,� TEL. NO. -E7 l O C. i ti L tz-v t t_L G\ 4-t P,:;`� u�--G- 3<�-- FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). AGENT OR CONTRACTOR D2P)NF- S_�&FAQ2 Cn, TEL. NO. ��� - 8(28 ADDRESS _/06Y0 R/F 442 , / lie&/ -, i DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8, other side), including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). L Uri g Q 0GZ o1 E X - I � Ida ,-�t`.� C�P� GS PLti P1Ro5 3V8I-T-7 � TGD, Signed RECEIVED Owner-Contractor-Agent `•� c �—G'�-- sPAHM USTrCommittee use. ReUUMARD.C. Q Q Date The Certificate is hereby Da,�e ` a �� 92 By Approved IMPORTANT: If Certificate is approved, approvai is subject to the 10 day appeal period provided in the Act. Disapproved ❑ r ADDITIONAL INFORMATION FOR MAKING AND FILING AN APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS The four categories for which a Certificate of Appropriateness is required are: (application for demolition or removal is a separate form). 1. EXTERIOR BUILDING CONSTRUCTION (new or existing buildings): An application is required for any exterior of a building to be erected or altered including windows, doors, siding, roof, light etc., that will be visible from any public street, way or public place. The following scale drawings are required in duplicate with application: plot plan (if addition — show existing buildings in outline), floor plan and elevations. Also required are snap shots of existing buildings, where additions or alterations are to be made. No plot plan is required for addition or alteration which does not touch the ground. 2. EXTERIOR PAINTING: An application is required for portion of a building, structure or sign to be painted that is visible from a public street, way or public place. Color samples must be attached to these applications. An application is not required when refiointi^g existinn colors, changing to white, or using colors approved by the Town Historic District Committee. 3. SIGNS OR BILLBOARDS: An application is required for any sign or billboard to be erected within the District, with the following exceptions: a. Existing signs.or billboards on November 27, 1974 shall have until November 27, 1977 to secure an,approved Certificate of Appropriateness. . b. Temporary signs.for use in connection with any official celebration or parade or any charitable drive as long as they are removed within three days of the event. Certain other temporary signs that the Committee feels does not detract from the Act may allowed with the prior permission of the Committee. c. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they are erected or displayed. d. A single sign of not more than 1 square foot in area showing the name, occupation or address of the occupant of the premises on which they are erected or displayed in a residential zone. 4. STRUCTURE: An application is required to build or alter any structure within the District which is defined by the Act as a combination of materials other than a building, sign or billboard, but including stone walls, flagpoles, hedges, gates, fences, etc. GENERAL REQUIREMENTS 5. Work on projects requiring approval shall not be started until the Certificate of Appropriateness has been filed with the Town. Clerk by the Committee. Approval is subject to the 10 day appeal period provided in the Act. f the Commission on an 5., No changes shall be made from the original approved specifications without advance approval o amended application filed with the Committee. 7. A separate application must be filed with each project requiring a Certificate of Appropriateness. 8. Under heading of "Detailed Description of Proposed Work" give detailed data on such architectural features as: foundation, chimney, siding, roofing, roof pitch, sash and doors, window and door frames, trim, gutters —leaders, roofing and paint color. 9. Unless application is complete and legible and all material required is supplied, application will not be accepted or acted upon. Copies of the Act establishing the Regional Historic District may be obtained at the Town Hall. Assetsor's map and lot number ......!.>-?.3..- 01V lolriv- '��� X11i 2 THE t0 Sewage Permit number ..B.a� 6 a.. SEPTIC SYSTEM MU o� j........................ �� INSTALLED C �/ �� C® � AXLE, House number .?`•.y,�7`. ..............................................:.....� ' /�G WITH TITLE 5 *, "b a � ENVIRONMENTAL COD � �'�•e TOWN OF 'BARNSTA °� PLATI01 � BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...CA! !`��2`�c'� NFL.► �w t�ZL L vet C� .. ........................................................................................................ TYPE OF CONSTRUCTION ...[Zt, S t� eJ� 1A ...................................................................................................................... ................................ .........19. ?a' a � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: l.,d� t-k- A�—OT��ZfSbZoOK LAIv� 4N �ACZtJSQAt3��3 ►-LASS' . Location ...................................................................................................................................................... ................................ Proposed Use ..17—,L�S i4Lshc'�l A`1--, Duds L_L l hl Cs .......:................................................................................. ............................................................. Zoning District ...................:.1.... ..............................................Fire District ........ .......1..... JL. .................................. I Name of Owner .. O'�t�St�>..............................................Mia(ZSl- Address Qb ...�! ?-.•w, tk`t RaN�S�osZ`C .trtAS3 na-6"1 ....... Name of Builder- 1.AN4N.W... .............Address Q.01.-. ..... T....E?� Wry BPc S�'AS31 �NtaSS ........... ................ Name of Architect ............ ............................................Address N 1 .... .................................................................................... u Number of Rooms . ................................Foundation W.................I...................................................... Exierior .c. ....GLQt3oltC ..............................Roofing ..PSQuiI :!- ....................................................... IT Floors ................................................Interior L Heating �r�L STcv�- � LffL�tZ g ?- MKT-N ........Plumbin Fireplace � ...Approximate Cost A..Sc)-,,d�C) ...........................................n...... Definitive Plan Approved by Planning Board -------------___-__-_ / - -------19------- . Area .......U.. ............................ Diagram of Lot and Building with Dimensions Fee ...5........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH —T3o ND i j OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. P Name ......\.. ....................... .............. POTASH, PAUL & MARSHA 0 ...2-4 017 Permit for ... ............ Single -amily Dwell ' ......... ...... ............... ............... .. ....................... Location ....Lot...#.4.......2.4...Al.de.r.6r.o.ok....Ln. .. . . .. ..... .... .. .... .. .... West Barnstable Owner ... P.a.u.1....&...Marsha. ...Potash. a s.h............ .. .... ....... ..... ....... .. Type of Construction ...Frame ............................ .... .. .. .................................................. ............................. Plot ............................ Lot .................. ............. May 6, 82 Permit Grant d .........................................s e -19 Date of s ................ Date Competed ...... 9'7/= --,19 "A.... ... ......... . e-I ` • !� TOWN OF $AR,NSTABLE.L. Permit No. �- inn-�----- Building Inspector sair,;.n 1 Cash ---------- ,=M, owl OCCUPANCY PERMIT Bond _ Issued to Paul & Marsha Potash Address i lot #4 24 Alderbrook Lane.West Barnstable 'Wiring Inspector / /t>��`.:r Inspection date _ � r Plumbing Inspector Inspection date 'Gas Inspector / /2 Inspection date Inspection datey�7� Engineering Department �l � �d � Inspection date/0 Board of health THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. AF. ............................... ...................., is..... _ _..........._......_...........___..._ ._._�.. /. Budding, et •,,r,. �.r„r.r f 1 Application to yzi +Et�O`EP�`�S v✓ BPE�~EP``'E��� , Old Kos Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: ❑ New Building ❑ Addition ❑ Alteration Indicate type of building: ❑ HoA ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: X 3. Signs or Billboards:] New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY DATE b„ ADDRESS OF PROPOSED WORK ASSESSORS MAP No. J toot 4 AA(Lermom ACL. OWNER ASSESSORS LOT NO. 5� HOME ADDRESS TEL. NO. 6 u �e e• ris u e PAWS.* — FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). . W 11iAm H. iainrs0lo Alciertzmok Lane- W. `Barnstalale, bil%na. Hold L. WiYne%aiuen, iu. iaain 6t.a R. s'ta6ble. VASS. 1 3J19UIGC� �UNn: R -t4,!164ir AGENT OR CONTRACTOR TEL. NO. ADDRESS DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8, other side), including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). builder to erect a Gape style duelling with white cedar shingles on th0 sides and rear elevation and clapboard (4" to weather) on front elevation. The pitch of the roof to be 14/120 \, Signed Owner-Contractor-Agent I - Space below line for Committee use. Received by H.D.C. ? i� Date The Certificate is hereby Date Time 1 Approved IMPORTANT: If Certificate is approved,approval is subject to the 10 day appeal period provided in the Act. Disapproved ❑ t;` ADDITIONAL INFORMATION FOR MAKING AND FILING AN APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS The four categories for which a Certificate of Appropriateness is required are: (application for demolition or removal is a separate form).. 1. EXTERIOR BUILDING CONSTRUCTION (new or existing buildings): An application is required for any exterior of a' building to be erected or altered including windows, doors, siding, roof, light etc., that will be visible from any public street, way or public place. The following scale drawings are required in duplicate with application: plot plan (if addition — show existing buildings in outline), floor plan and elevations. Also required are snap shots of existing buildings, where additions or alterations are to be made. No plot plan is required for addition or alteration which does not touch the ground. 2. EXTERIOR PAINTING: An application is required for any portion .of a building, structure or sign to be painted that is visible from a public street, way or public place. Color samples must be attached to these applications. An application is not required when repainting existing colors, changing to white, or using colors approved by the Town Historic District Committee. 3. SIGNS OR BILLBOARDS: An application is required for any sign or billboard to be erected within the District, with the following exceptions: a. Existing signs or billboards on November 27, 1974 shall have until November 27, 1977 to secure an.approved Certificate of Appropriateness. b. Temporary signs for use in connection with any official celebration or parade or any charitable drive as long as they are removed within three days of the event. Certain other temporary signs that the Committee feels does not detract from the Act may be allowed with the prior permission of the Committee. c. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they are erected or displayed. s_ d. A single sign of not more than 1 square foot in area showing the name, occupation or address of the occupant of the premises on which they are erected or displayed in a residential zone. 4. STRUCTURE: An application is required to build or alter any structure within the District which is defined by the Act as a combination of materials other than a building, sign or billboard, but including stone walls, flagpoles, hedges, gates, fences, etc. GENERAL REQUIREMENTS 5. Work on projects requiring approval shall not be started until the Certificate of Appropriateness has been filed with the Town Clerk by the Committee. Approval is subject to the 10 day appeal period provided in the Act. 6. No changes shall be made from the original approved specifications without advance approval of the Commission on an amended application filed with the Committee. 7. A separate application must be filed with each project requiring a Certificate of Appropriateness. 8. Under heading of "Detailed Description of Proposed Work" give detailed data on such architectural features as: foundation, chimney, siding, roofing, roof pitch, sash and doors, window and door frames, trim, gutters —leaders, roofing and paint color. 9. Unless application is complete and legible and all material required is supplied, application will not be accepted or acted upon. Copies of the Act establishing the Regional Historic District may be obtained at the Town Hall. i A/4rZr- 444 Eai9" P( SyB-so.G C'E- / E. / i/ !!! GNa4•�. Ab lY�r.:' A Pam,, 1 . � G_ ' �' ' i^�.- ��•v-c 7'��/'r7l..r 34 y i ...+.rJ I , 74' u_ f.r:� -mow -0.6 i I 3 .:rK7i l� 7?t�i� WAtTE'T4 O�i4'�7— a3�VClnr�•?_';� GDt � � _ �',•=.� ` F!�'Cat�fT IV11t�IM�M (3t11LDI�6a 5� R , O Q PS WN PA l /TAN O►- To FR D f+N►sµ Gr to►ol� Aw.. 2°!o L Y. ._/�� �` rn4lk ONF- <=oOT or- FIr+ SH 43PWP- OVER LEACH AREA /o f —�-p! / �1 �*- �'c�� f ..r�. z of ?GA iiTo14E FC ' :a (ICf`AAItJ� vw. Cows^ i ��9viX,•. IMPFZVIDu 5 Ca1 � ,'14"/Poor -• - - � if CAw•t 1Ka41 -m:-1 2'' 11J. IN, P C1� T 1 , � 1 13 ,�w.�. _ 0 5d'.p,Ao4 � �4V-71 4-tt�G qqT / ` I NUN, IMI FDOT Tfl. 11N. 47.7.Sc� 1 .7.or t f L.SAGH 51'ONE� it RT \--li GALLON 4, rtiALL za I Gp,P G17Y nti� �r.C. 4 t1A. �/.C. �� ARC�J�P E G TArI K INvERT PIP>~. / u> ,� -,,, ., c% II �NATtrRT��113'2 Z � mot.G.�a ��, , ��'E� _ rib J ( Ofi STT•v,"_ -----'`rC_--�ARBac,E GRI�1c�R --- - 2o'MI,�. IN y� ,'-���� ' ,.,,, r; ��� ' .,L•G 5EPTI G 5Y5TEM CoN 5TRvc-T)oN U" - I 5NALL CONFORM TO THE MASS. v NUM of F, �I RONMeNTAL CODE -TITLE y IZV-v I S e 0 7- 1-7-7 THE 'rcA/1-4 OOAIZO Or- IAEA►LT--•t IMCAL I L-AT►OIJS i L lEA CN I N C RAT - - 73.• ,� nw_ nJN�, �EPTi G'fAN{C, Dc 5TF2► BoTioN 00g '`*r:"` .__ •�< REQ'p, I.EACI-+. CAcPA G 1T 336 AND l->GAGN IriCy �T TO [3E of "=� -'* ! R1 I N FoRG1E.17 GoN GRATE :_.�'�� {!{ MsN(. .foNuR6�E NTH � PRovo!5av 1 e)kr'H CA PAC I1Y — f 'm iz C�.C.9 4� ?�./ ij 10 L oA D I N S vRt,/EvA)/ Nor -ro DE �oc�iso I.OoA�`���� ovelL WS'rEM UWLE�aS I'}- 2.0 9I5cv,I CAN LOAPIWca U P � v' rV / VV�../"', L./ • ���� LJ.�1a=sal�7�!�.�,.1L,+� /�'�i�}�`� AU. PI P5* To tie WATi� ZT Ci HT REFER0ARN65. Mx. OF Vas9sp NC�• � =- � = Dptt FiL6* —;-3 s — �. C ENGINEERING C. R. DESIGNING BUILUINU INC. i I �A LTI-1 /�Ca�.I Ji APPXOVAL- �"� �T INC. 0, MASS. a 385m2831 ,,