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0090 ALDER BROOK LANE
90 UPC 12543 No. 53LOR Ha CT-NG¢ MN Town of Barnstable of Regulatory Services c Richard V. Scali,Director STAB � Building Division RAMIX MAS& Paul Roma,Building Commissioner s63q. �0 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: O �� Name: TtW 1J f� W)L'" t'J Phone#: g � 20 Address: '1 d 12ffPlr__ Lim' - Village: Ul Name of Business: �'� t�TD/J CuL 6U•�TLS =1�L ` Type of Business: IP—AA ( t1c Map/Lot: t 6 t 7 INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration, smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or-other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials, in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. 1,the undersi ve read and agree with the above restrictions for my home occupation I am registering. • i J Applicant: Date: s - / 72 &- Homeoc.doc Rev.06/2 /16 YOU WISH TO OPEN"A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY-REGISTERS YOUR NAME in town (which you must do by'M.G.L. -it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis_ Take th.e completed form-to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis: MA 02601. (Town Hall) and get the Business Certificate that is required-by law. DATE: ��` I IO Fill in please: No: ;x•.,T " i YOUR NAME/S: �s. l w� ti ' APPLICANT'S (s' Nrs i lJ l e tii2L4 p• . �U�. ` BUSINESS / YOUR HOME ADDRESS: h�'�L15 l t�G 6TiL <o 1 ,1 ;li�l5 w'Y6�• l4li''w':.i�J�Jlifi _1 v 2- TELEPHONE # Home Telephone Number �b�'ri 3` v iyiJ�s;Ld EI.N #: E—MAIL: NAME OF CORPORATION: ' NAME OFNEW BUSINESS �'J TYPE OF BUSINESS IS THIS A HOME OCCUPATION? . YES NO ,ADDRESS OF BUSINESSl't o �4-�A+rsTL6��lC �-� MAP/PARCEL NUMBER 3� D y� (Assessing) P/US r Zi bl�� 01'�{{�M L� C l (/J X LE: IPi he When starting a new business these are several things you must do in order to be in compliance.with the rules and regulations of the Town of Barnstable. This form is intended to,assist you in obtaining the information you may need. You MUST GO TO 200 Main St. (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. '1. BUILDING COMMISSIONER' OFFICE This individual has been fo 'd ofany pe It requirements that pertain to this type of businessMUST COMPLY WITH HOME OCCUPATION .RULES AND REGULATIONS.. FAILURE TO Author" ed Sign ure** OMP1=Y MA.Y RE;$QU IN.FINE: COMMENTS: . 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: TOWN OF RARN:4TABLE License #: . 14-1 16J9•�. . Aqudcultuxq License to pl r t, grow and.take shellfish fr6th the water4 of Barnstable rbor, as indleated on a plan of fire in the offices of tht Town Clerk, the..Toivn Manager, and the 1Vtaririe and EnvirOnrnental Affairs Division. This lieerise issued i'rn accordance with Massachusetts Genial Lbws, Chapter 130 Vic. 57 through 68, .and the Town of Bartistable Shellfish Rules &id Regulations. Issded to: Sett D. PViyllia, 90 Alderliiook Labe, west Barnstable, Iv1A 0266$, subject tp suchg sttfctios amay bp e n established by the Town Manet aYid federal and state regulatory agencies, This license does not grant any property rights. Any use of this license for other than digging and taking of 5liellfish upon privately owned property may not proceed oyer the objection of the property owner. Pursuant to Gen@.r_•al Laws Chapter 130, Sectidn 57, the lipensee may not impair the private rights of any person. This license does iiot authorise any injury t6 private property pr invasion of private rights. The issnarici of this licenses ript a determirlatiori of title tSr owrirrrship. The licefisee acknowledges, it is the r6p6hsibility of the ligensee to obtain peiiiiission, if required, from a private property owner before exercising the rights conferred by this license tither than for digging and taking of sfiol.lfish. The license holder is on k9tice that owners of the property described above may bring an actiofi for trespass in a coprt of competent jurisdiction: A license bolder may not r'dly on this license as a defense to an action.in t1espass. Any shellfish licensed area bounded by a navigational channel, as decried by the Harbortnasr, that has migrttteti by natural or man made causes into or hough a permitted shellftsli licensed area and has ir, — l a portion of the permitted land within the licensed area to a navigational depth of at least thf`ee (3) feet at mean 1Rw water, said cliarinel shall become the natural boori0dy,of the licensed area and supersede any previous agreed boiiiidaries of the licensed area, The license holder shall sacrifice any and all rights of His/her licensed area within this defined navigational chahhel. Said licensed area ng003 in the waters of Barnstable Harbor bounded by th& following four coordinates (Lat, Lori, d m:s, Datum: WGSl;4), as identified on the Town of Barnstable Geogfiaphic Itiformation System maps. 1.,.41:43 21.000"N, 10:20:33.011" VV 3. -41:43:15.816"N, 70:20:32.615''.W 2.-n-41:43:19.904"N, 10:20:31N7" W 4..- 41:43:15..220" N, 70:20:35.237" W License issuccl.: June 30, 2014 License expires: JllIlE 30, 2019 Thomas �. Lynch, To` 1Vlanae , Tovbn of Barnstable Town of Barnstable ermitc9d ��j oFTMf' Richard V.Scali,Interim Director c re te: Building,Division :. eaehAM Tom Pe r B ildh g(-bmmissioner. 2D0.Main Strut,: 14yannisg 11M1 01260] / www.town.lbarnstable.Ula.Us � V Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Toilirr-we Owner: .S�`r /�'�C.c Phone: k stal;l gig: m : /2J, die l ST94� � Map/Parcel: �j.� `��� / L-�� Date:—11 15 Stov &Oe' 'Used B. Tyke: Radiant Circulating C: 2Ulaxnxfacti r: Z— . -La`b--Xo. Chimney ,I A. Ne xistin (If existing,please note date of last cleaning) B. Flue::Size C..:Are•.other..appliances,attached to F1ue2 —...-- D. Pre-fab Type and Manufacturer E. Mas'em-y: Line `lamed A. Materials: :3r24 UL ALU S f 3oa r n B. Sub Floor Construction: Ui =, ® Installer ' Name: Address: i .-Phone: er H.I.0 Registration# r+ - Construction Supervisor# OR-check_Homeowner Installing,no li,cen�e required LICENSED INSTALLERS SIGNATURE: A,PPI I,CANTS SI4GNrATI-JIBE: Please make checks payable to the Town of Barnstable t 5S- *7hcs:constitutes:anrofficial.stove�permit after i`nspectconr.photographed;.and'approved.,by ttxe- Buldang ln�p-e°ctor I Q:forms:stove Rev 11/4/13 the Comrnomveahh oaf Massadjusetts Depart rmerrt of frud—ustrid Accidents QJfWe Of rnVVZ6g.Gfi07U. 600 WashhWorz Street y Baston,MA.02111 t ymn7ar=gov1dia Wur•leers' .Cumpensaiian.Insurance Affidavit.B•ceders/C—antractnrsJEIectri;cians/Phunhers Applicant Infw m,afian "' Please Fri-atFe�lIy -Name3usiIIressAOanizatianfludivitlnal Address: city/s$3j 9 tE YM WC�(Ge P}3QIIe J UY� �rO�'bl 7�/ Are you an empIoyer?C heckthe appropriate box: Type of project(regnured}: I.❑ I am a employer with. 4 ❑I am a general contractor and I 6- ❑New cons ruction employees(fall andforpart--time)-* Itavehired.the sub-coabmrtors 2.❑ I am a sole prDprietcKr 6rs.er- listed on the attached sheet 7. ❑Remode-ag These sub-condractors have sleep and have Eta employees. $. ❑Demolition urorkin r for un in any capacity employees andhare wod:ers' 9_ El Building additiozc [No vrorbers.'comp.insuurance comp-insurance) . regnired_] 5. ❑ File are a corporation and its 14❑Electrical repairs or add,Ttf•[XI4 3.f&ama homeou%merdoing all v mk ofI"acen have exercised their 1L❑Plumbingrepairs or additions ' red£ o ivoirkers' tight of exempfion per MGL � cO°1F- 13_0 Roofrepairs insurance required-]Y c.152,§IM andwe have no employees_[No workers' 13- ''Other W 0 f coop-imRrance regUired-] I PU 'Any gpticsutthatchedaTUox#1mw-t also fill out the section beiow showing die vioaeerecompensatiaaporkyinfnomaoab Hameownett who*submit r11ir.xiMz%ii t5czt+gthr_yare doing zUwcAand dim hatautddeamtracters-rrm suhmit anew affidavitbdiC9*ngsuch IQ rsffixt checicthis box must attached sa addidoml sheet showing diensme of the sub-cant wtars and state whether or not those eatitieshav employees.Ifthesuh-conttmdwshave employees;theymnsCpmvi&thek workers'comp.poncy number. I atit au etripin�rr that is prauidiiug tvark¢ts'cotrrpertstr{iart insurance far�}*e�rrptoyees $etasv is tlteFa"��'ruzd job site ircforeurlma Insurance Company Nrame: 'Policy�or Self-ins_I_ic.O Expiratioa Rafe: Job Site Address CityfStatet2�p. Attach z copy of the workers'compensationpolicy declaration page(showing the policy number and•expiration date). Failure to secure coverage as required under Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up f6$U.OD oG im&6r 6�e year imprison,as well as civil penalties is the farm of a STOP WORK ORDER and a Erne of up to$250-00 a day agaiast the violator. Be advised'fimt a copy of this statement maybe forwarded to the Office of Inrvestigatinns of the MA for insurance covera&5 verific a iom Ida herrby carte cite penis med perms ofget�[ur}�flrattJie inf arezatiar�prot�d agars i i/g tr�rg and tarred tmat,.rP Date f 3/15— Phone iF '?' �22— '6i 11 r OjyEdd ere may. Do not eriite in this area,&be cmrT&ad by city artomn oJok&L CRY or Ta ww PermftUcense# Issuing Auffiority(drde one): L Board*Mwlth y Builaing Department 3.City1rawn(3fz- k 4.Electrical Inspector 5.Phimbing Inspector 6.Other Contact Ferson: Phonr=9: :lbaformation and Instructions ' Mjacea� ft G—neaalLaws chapter M requires all empIoyess'[n Providewor5�eomPmsation fCr$lea=PIayees. . putt:)this s&t3t,-,an mnpIay w is defined as.`�.every person in the service of another under auy contract of hire, express or implibc%oral or wrh =." Air eznpky�is deimed as`air i ada7idnA pmctzmL�,associahan;cooeoration or other Iegal etiy,or any two or more of the foregoi ag engaged m a joint enterprise,and including the Iegal representatives of a.deceased employer,or the receiver or trustee of an individual,parbamsh p,association or other Ie:gal entity,employing employers. However the owner of a,dweIlinghouse,having not more than If ree apartments and who resides therein,or the occupant oftim - - dwelling house of another who employs persons to do mafi fiance,construction or repair worm an such dwelling house or on the grounds or building appurtEn�tiiereto shallnotbecanse of such employment be deemed to be an employer_ MGL cba-pte r 152,§25C(6)also s dcs that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the comet on:wealth for any appli a.n.6who has not produced acceptable evidence of compliance Widx the iTsur�ance.coverage,regai red•" Additionally,MCI-chapter 152,§25C(7)states"Neither the commonwealth nor day of its political subdivisions shall eninr mt) any contract for the pe Em mance ofpnblic wow uni�I acceptable evidm=of compliance with the insiaa ace-_ req=M nts of this chapter have been presented.to the confracting ar�dhodty." Applicants Please fill out the workers'compensation affidavit completely,by checI®g ihebo5ces that apply to your situation and,if necessary,supply sub-contractor(s)names), addresses)andphone,mmnber(s) alongwiththeir cm1ificate(s)of „m„ra„ce. LimitedLiabiiI4 Companies(LLC)orLmnt-:ed.Liabi7ity-Partnersbips(LLP)withno employees other than the members or paxtaer,are,not rbquimd to carry workers' compensation insoTancce If an LLC or LLp does have employees,apolicyisrequired. Be advised.that this a$dayh maybe enhmTtb:�;dto the Department ofIndustrial . Accidents for conffimation ofinsurznce coverage. Also be sure to sign and datethe afndayiL The affidavit should be reinmed to!he city or town that the application for the-permit or license is being regaested,not the D eparfruent of Indnsb3al Accidents_ Shouldyou have any questions regarding the law or ifyon ate requ>ed to obtain a workers' compensation policy,please call the Department at the number listed below_ Self-in%aed camPanies sb-onId inter their self_i sui-,3j,cd license nuaber on the appropriate Ime. City or Town Officials Please be sore that the affidavit is complete andpriated.legiibly. The Department has provided a space at tfic bottom of the affidavit for you to till out in.the event the Office oflnvestigatior a has to c�OBfact you regarding the applicant_ Please be snreto fill in the pen�iVIiceasenurnber which will be used as arefe=cenumber- In.-addition,an.aPPHcant that must submit multiple p=WHcense applications is any given year,need only submit one affidavit indicatmg cun-ent olicy information(if necessary)and under`Job She Address"the applica t should write"aII locatiL ns in (�`or p Town)-"A copy of the affidavit that has b eev_officially stamped or madred by the city or town maybe provided to the ' applicant as proof that a valid affidavit is oa file for fntore permits or licenses. A new affidavitmust be filled oi.±each year.�i liecre a home owner or citizen is obtaining a License or permit not related ire any busincss or commercial venteuo Ci-e. a dog license orpermit to burn leaves etc.)saidperson.is NOTreq��complete this affidavit The;Office oflnye-stigatiorswouldamto ffiankyoum adv-mce foryour cooperation and shouldyouhave mayques6ons, please do not hesitate to givers a calL The Department's address,telephone and fax nnM.ba: �o -W a -ft of I1 . ' Depadmmt oflu�a AMOL-nts ( BI=of Trre&titati0= -Wash oGil Sit $ostans MA Q111 Te,-L#617-' -490Q Mt 406 Qr 1-477-MASRAFE Fat 617 727 7749 xevisea4--24-07 � �gf� �o N v ()o o d Town of Barnstable Regulatory Services pfr rofyy Richard V.Scali,Director Building Division r + R LANSTARM Tom Perry,BuHding Commissioner MAas 200 Main Street Hyannis,MA 02601 www town.barnstable.maus Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER UCENM EXEI<'>P'ITON Please Print DATE: 1��1j I\�i� JOB number StE=t villap �roMEowl : SL`11'f�£� Iefn1"� {'u.0 t," �b(06:)-A VSg name bomc phone# wotk /lone¥r CURB=MAILING ADDRESS: cityltown ski up code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor_ DEFT MON OF HONMOwNER P erson(s)who owns a parcel of land on which he/she resides or intends to reside,oh which there is,or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the buildinz permit (Section 109.1.1) The undersigned`.`homeowner"assomes responsibility for compliance with the Staff Building Code and other applicable codes, bylaws,rules and regulations. - The undersigned`homeowner"certifies that he/she understands the Town ofBamstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. ign offiomcownc _ Approval ofBm7dingO$cial • 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 HOMEowrt RIS EXFMPTION 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 109.11-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:\WPFII-ES\FORMS\bmZdmg permit£o=.s\EX??MS.doc Revised 061313 � Tqy Town of Barnstable Regulatory Services � ASS. Richard V.Scali,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstablema.us office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder ' as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized bytbis building permit application for. (Address of Job) j 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 Dare . QFORMS:OWNE RPERMLSSIONFOOLS 4 TOWN OF BARNSTABLE BUILDINGaPERMIT APPLICATION Map Parcel o'7f � � OF- Br,RNSTABI.E . Application p Health Division ''ff i N j 4: 144.i Date Issued Z 3 Conservation Division JK' Application Fee UL_42� Planning Dept. r ,.. � '- Permit Fee �) Date Definitive Plan Approved by Planning Board aVI SIC►W Historic - OKH _ Preservation/ Hyannis Q Project Street Address O ,, Village G�1,CrJ� /5we 0V�) Owner }=& y�L Address 1040 Telephone ® "s/ Permit Request X" 6V;7✓oe001y /W Square feet: 1st floor: existing proposed 2nd floor: existing ZC�roposed 45 Total new Zoning District Flood Plain Groundwater Overlay Project Valuation dv0 Construction Type 1/�)0 Lot Size X 3 41 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family J& Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes Q No On Old King's Highway: W Yes ❑ No Basement Type: bull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) 6 Basement Unfinished Area (sq.ft) f Number of Baths: Full: existing new / Half: existing new Number of Bedrooms: 3 existing Ohew Total Room Count (not including baths): existing 7new 4n First Floor Room Count Heat Type and Fuel: ❑ Gas 13 Oil ❑ Electric ❑ Other Central Air: ❑Yes Flo Fireplaces: Existing New Existing wood/coal stove: Q Yes d 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 V No If yes, site plan review # L Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number��(?_ Address License #141 Home Improvement Contractor# ZZf A Email LOt> i�-err �" �1�L' Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO DATE SIGNATURE /d 7y FOR OFFICIAL USE ONLY APPLICATION# DATE.ISSUED MAP/PARCELNO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL '- PLUMBING: ROUGH FINAL GAS: ROUGH- FINAL FINAL BUILDING DATE*CLOSED_OUT ASSOCIATION PLAN NO: e The Cam momveaUh afMassadhusetts Depuronent of IndosaialAccidents Offwe ofImvesdgations 600 Washington Street Boston,MA 02111E wmnv.inasmgavldia ' 'Workers' Campensafian Insurance Affidavit:Builders/Contractors/Eiectricians/Plumbers Applicant Infarmation Please Print Legibly Name(RttsmesslOanizatiot>lfndividwl): Gz� Ad&ess. City/State/zip: Aw—� �i/J1s f W one 4-7 sG,Fioo, -/-/ De3--1 5 Aire you an employer?Check the appropriate box: T of project (r 4. I ate a contractor and I 3� � J ����� k�am a employer with ❑ t� 6- ❑New consErirction employees(full and/or part-time)* have hued the vib-conbractom 2.❑ I am a sole proprietor or partner- listed on the attached sheet; 7- ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demralifiou and have workers' working for me in any capacity. � emP to�' x Q. ❑Building addition [No workers' comp.insurance comp.insurance -I 5-❑ We area corporation and its 10-0 Electrical repairs or additions 3.❑ I am a homeawner doing all work officers have exercised their 11-0 Plumbing repairs or additions myself, [No workers'comp. tight of exvmption per MGL 12-0 Roof s insurance require&]t c.152,§1(4�and we have,no 13_❑Other employees-INC,workers' comp.insurance required.] *Any appUmn that checks boa#1 mmst also fill out the section below showing 8teir trousers'caugeusatiou policy u f nmatiaav fi Snmeoamets who submit this affdavif indicstiag they ace doing aIl vacs sad&�hoe outside coatxacton tmmst snbmi2 s nave s�davii inthcsting mdi tCannactots that rllxk this bar mint sttarhed sn additional sheet showiad the t»e of the sub-cam tsoft"sad state whether or IlDt these eves have employees- If the sub_tactots hoe employees,they tmrst provide their workers'comp policy number I am an employer that is providing n�orkers'compensrrlion insuraace for fity empinyaras Beloty is thepo4cy and job site infotmration. Insurance Company Name: 4v/.ea/ t✓ r " Policy 9 cr Self-ins.Lic-# ��^ � c3o2o�(5 ZJJ Expiration Date: — o Job Site Address:�� 6P�040 Citylst wzip: Attach a copy of the workers'compensation policy decbratiotn page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A o€MGL c. 152 can lead to the imposition ofrrirninal penalties of a fine up to S1,500.00 and/or one-'year imprisonment as well as civil penalties inn the form of a STOP WORK ORDER and a fie of up to$250-00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIAL for insurance coverage verification I do hereby c,erh;fy under the t . allies fgetyury that the information prmdded above is true and correct Date: Phone# L 0,,kial use only. Do not mite in this area,to be completed by city or town gffi'ciaL City or Town-. PermiVUcense Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CitFlrown Cleric 4.Electrical Inspector 5.Pliumbmg Inpector 6.Other Contact Person: Phone ff: 6 Information and Instructions - Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more' of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or IocaI licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.-coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certi:ficate(s)of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required_ Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit Z7ie affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-ias -ance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition;an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a homeowner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit- The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. ne Commanwealth of Massachusetts Department of Industrial Accidents Office of Juvestigations 600 Washin„taa Street Boston,MA 02111 Tel.#617-727-4900 ext 446 or 1-$77-MASS.AFE Revised 4-24-07 Fax# 617 727-7-149 www.mass-govldia License or re, bre a of a exPirahon,On valid por Bo Parkpalas4mer..4 fai s or d edul.useonl_.. °n,Jfq Suite 517p and$usiness r°to. 02116< Regula�ian f w� NOt valid, � • f. wlth0utsignatur e Massachusetts -Departme.nt of Public Safety siwwo ;%OVVZ/SO Jauois �'r 'Boartl of.BuiIding.ReguIa4o0s and Standards ';-uollejldx3 �s �.�� Construction"Supeni'so6r., MIXIM ON License: CS-039868•' . 8.•ZO '�'IAi S'I� w SNO.LS2i�'7Ai ! _ V �. IG OER - � COL XC3g Od ROBERT J. � _ PO BOX 703` � V�w �Amf r.LHI3 H0?I MARSTdNS8`. . 8996£O-W :8sua3i_1 ..� sp4equelS put suoF;ejn6aa`6u;ipllRg;o pjeo`g, ` "{?�i -�- Commis Expiration sioner 05/24/2016: F;a;eS o!Ignd 1o;uawpedaa- s}}asng3esseW ! Uela�aas�apap 649i;0 '01• J=:Nu�o;ei;�el's�W 6Sxa N I_O I W2.VVq,S S12(awCOL 08 Od b3nOlJ L'0E0d ; lJI4 118 2i3AO t94 460Z161 suo :adAi 1dWAoWO B010"J.N001N 41XZ ' _ _. n�a ssagisng s►�e t..ptuns`uoj lcogel au �amuouueuodd a�� - arn��vcai� � - __-- 4� Tarti Town of Barnstable Regulatory Services IIAMSTAMMASS,LE'g Richard V.Scali,Director i639 �0 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 Property Owner Must Complete and Sign This Section If Using A Builder I, T�-tiJ f Iq0-(L-c- J , as Omer of the subject property hereby authorize � 94-0V to act on my behalf, ^` in all matters relative to work authorized by this building permit application for. a A-n9j42�6r2a�,1,-- L (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. S* atom of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:O WNERPERMISSIONPOOLS Town of Barnstable Regulatory Services Prof TOiryy Richard V.Scali,Director Building Division rSM4.13 Tom Perry,Building Commissioner unss. 200 Main Street, Hyannis,MA 02601 CEO A www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner" shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned`.`homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection ' procedures and requirements and that he/she will.complyy tH said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner 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:\WPFU-ES\FORMS\building permit fomZs\EXPRESS.doc Revised 061313 Generated by REScheck-Web Software Compliance Certificate Project Energy Code: 2012 IECC Location: Barnstable, Massachusetts Construction Type: Single-family Project Type: Alteration Climate Zone: 5 (6137 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: Compliance: Compliance: 0.0%Better Than Code Maximum UA: 0 Your UA: 0 The%Better or Worse Than Code Index reflects how dose to compliance the house Is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Envelope Assemblies Gross Area Cavity Cont. Glazing Assembly or R-Value R-Value or Door UA Perimeter U-Factor Ceiling: Flat or Scissor Truss --- --- --- --- --- Exemption:Framing cavity filled with insulation Wall:Wood Frame,16in.D.C. --- --- --- --- Exemption: Framing cavity filled with insulation Floor:All-Wood joist/Truss Over Uncond.Space --- --- --- --- Exemption: Framing cavity not exposed. Compliance Statement: The proposed building design described here is consistent with the building plans,specifications, and other calculations submitted with the permit application.The proposed building has b n designed to meet the 2012 IECC requirements in REScheck Version 5.5.0 and to comply with the mandatory requirements(is R �tion Checklist. Name-Title Signature Date Project Title: Report date: 11/17/14 Data filename: Pagel of 7 J' G r I-+�T� Ol wx :� o TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3 Parcel A pp n 'licatio ® �L16 �✓ Health Division Date Issued a� Conservation Division Application Fee Planning Dept. Permit Fee vZ�'� Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address �� ,'� Village GUs10�, Owner S � � U�/(//�/f � Address Telephoned Permit Request Square feet: 1 st floor: existing�Ydproposed Q 2nd floor: existing proposed Total new 0 Zoning District & E Flood Plain Groundwater Overlay Project Valuation'0O by Construction Type W4no � Lot Size_ �� Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family $A Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes Ad No On Old King's Highway: M Yes ❑ No Basement Type: -..Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) P'Z 6)� Number of Baths: Full: existing v new Half: existing new w- Number of Bedrooms: existingonew TotaMoom Count (not including baths): existing new CD First Floor m COA Heat Type and Fuel: ❑ Gas d dDil ❑ Electric ❑ Other Central Air: ❑Yes zRLNo Fireplaces: Existing New _� Existing woo /coal stove: 4s 0 No c� aF Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing Cl neg size_ CA rr+ 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--r,2 J%4y_A) /r 7� Proposed Use I APPLICANT INFORMATION (BUILDER OR HOMEOWNER) _ -�Name �SC�iF�1/ Telephone Number Address License# C"S-- Home Improvement Contractor# Worker's Compensation ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED_ MAP/PARCEL NO. ADDRESS VILLAGE s. OWNER t DATE OF INSPECTION: oPFOUNDA-T:IONK, a)UA► FRAME -" W Ok- . /o -vQ INSULATION.,'l la-, FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL • . GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT j ASSOCIATION PLAN NO. i . The Commomvenith off-gassachuseft Deparftnent ofhuhrsb al Accidents - CWwe of Inveshkadons 60013Washingfoa S`fteet Boston,MA 02HI mov.Ynassgovldia Workexs' Campensafion Insurance Affidavit:Bii-lders/Contractors/F:Iectricians/Numbers Applicant Infarmation Please Print Legibly Name gks ness/Orpni2a onffixi idnao: ��-C� / — /y-,Ol V1 Ad ress:& City/stat&Zip- e;0)0/t)6 HIL16 R4 Phone 476 D 44�-25 Are you an employer?Check the appropriate box: Type of project(required): �-�/ 4_ I eta a contractor and I � �' 3 1.r 1 am a employer with�_ ❑ 6- ❑New consfcuc#oa employees(full and/or part-time).* have hired the sub-contractors. 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7_ 0 Remodeling ship and haze no employees These sub-contractors have g- ❑Demolition wo6cing for me in any capacity employees and have workers' 4- ❑Building addition [No workers'comp.insurance comp.msuraoc t repaired] 5-❑ 'We area corporation and its 10-0 Electt ical repairs or additions 3.F1 I am a homeowner doing all work officers have eiercised their I I..❑Plumbing repairs or additions myself [No workers'comp right of e-xc tioa per MGL 12..0 Roof repairs insurance -]T c. 152,§1(4),and we have no employees-[Na workers' 13_❑Other comp.insurance required.] *Any soplicxat that checks boa#1 most also fill out the section below shooting their workers'rntmpensstioa polity infcnnadam_ T Homeowners who submit this afEdsvd iuudzcstag they ere doing aR track sad then bee outside contrecturs mast submit a mew afdavit indicating sash_ tCont mcmrs that shed this box must attuiched an additional sheet shoring the name of the sots-axub—A om and sts whether or not those e3ities have Employees. If the sub-cant nctots bare employees,they most provide their workers'comp.policy number- lam an employer Thatisprmidkg tt�orkers'compensa on insurauce for?rty e-mpinyeeu: Belau is the policy artd,}ob site infor maholt. Insurance Company Name: r Policy 9 or Self-ins.Lic-#: NC-k1 / �c2D SVfi-mil Fxpiiatio:nDate: l Job Site Address: �Q 4ZC V-2- City/StateMp: " Attach a copy of the workers'compensation policy dedaration 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 ofcri inai penalties of a fine up to S1,500.00 and/or one-yearimprisonment,as well as civil penalties in the form of a STOP WORK ORDERand a fine of up to S250.00 a day against the violator- Be advised that a copy of this statement may be forwarded bo the Office of Im-estigations of the DIA far insurance coverage verification- I do hereby certify under i ena ' s thatthe information prin ided above is hwo and correct Siena Date: Phone# OBIcial use only. Da not write fn this,area,to be completed by city or town officiaL City or Town:. PermitlLicense It Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cit frGwn Clerk 4.EIectrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: 6 i Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also sus that"every state or Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for ally applicant who has not produced acceptable evidence of compliance with the insurance.coverage required.- Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth'nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contacting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required_ Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of ias uanee coverage. Also be sure to sign and date the affidavit. T1ie affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple pennit/l.imnse applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a homeowner or citizen is obtaining a license or permit not related to any business or commercial venture (Le.a dog license or permit to bum leaves etc.)said person is NOT required to complete this aihdaAt. The Office of Investigations would Ile to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Depari went of Industrial Accidents Office of kvestigafions 600 Washington Street Boston,MA 02111 Tel. 9 617-727-4940 W 406 or 1-977 MASW. E Revised 4-24-07 Fax#617-727-7749 www.mass.govldia CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY) 4/3/2014 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 endorsement(s). PRODUCER DOWLING& O'NEIL INSURANCE AGENCY INC NAMEACT 973 IYANNOUGH RD PHONE FAX PO BOX 1990 IC No A/C,No): \ E-MAIL — - HYANNIS, MA 02601 ADDRESS: INSURERS AFFORDING COVERAGE _ _ NAIC g _ INSURER A: LM Insurance Corporation _ 33600 INSURED INSURER B ROBERT GLOVER --- — — ---- DBA ROBERT GLOVER BUILDING INSURER C: _ — -- — PO BOX 703 INSURERD: MARSTON MILLS MA 02648 INSURERE: INSURER F: —� COVERAGES CERTIFICATE NUMBER: 19744223 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. INSR TYPE OF INSURANCE A L BR POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDDIYYYY MM/DDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ _ CLAIMS-MADE OCCUR DAMAGE T5REN ED PREMISES Ea occurrence $ MED EXP(Any one person) $— __ _ PERSONAL 8 ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ POLICY 0 PRO-JET LOC PRODUCTS-COMP/OP AGG $ _ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS I AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIREOAUTOS AUTOS Per accident S g UM13REL A LIAB OCCUR I I EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE ' I ( AGGREGATE DED RETENTIONS S A WORKERS COMPENSATION WC5-31 S-320856-014 4/19/2014 4/19/2015 �/ STATUTE ERH AND EMPLOYERS'LIABILITY YIN I WC5-31 S-320856-013 4/11/2013 4/19/2014 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $ 50000( OFFICERIMEMBER EXCLUDED? a N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE S 50000( It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 50000( DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101.Additional Remarks Schedule,may be attached If more space is required) THE WORKERS COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR ROBERT GLOVER Workers compensation insurance coverage applies only to the workers compensation laws of the state MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers'compensation coverage. CERTIFICATE HOLDER CANCELLATION O SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF BARNSTABLE SOUTH STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 230 HYANNIS MA 02601 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Liberty Mutual Insurance Co VV ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD CERT NO.: 19744223 CLIENT CODE: 136417E Anne Chandler 4/3;2014 3:30:08 PM Page 1 of 1 iIM Massachusetts - Department of Public S3$ef'i %W f3oard of Building Regulations and Star.:dards (..instruction sups-1-N i"(1Y• License: CS-0398" t ROBERT J GL0V)9R PO BOX 703 = t MARSTONS Wag, OO48 u� s �,,(,..,.� n ;,+�•' Expiration. Commissioner 05/24/2016 Office of Consumer Affairs&Busibess Regulation k . #TOME IMPROVEMENT CONTRACTOR egistration: 111157 Type: iration: 12/9/2014 DBA R.GLOVER BUILDING CO. ROBERT GLOVER PO BOX 703/13 CURTIS BOG RD �4s M, 2STONS MILLS,MA 02648 Undersecretary 1 ' �TNE Tp�� Town of Barnstable Regulatory Services s - �BAM' `&I E�, Richard V.Scali,Director 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 Property Owner Must Complete and Sign This Section If Using A Builder J' W' LU/J as Owner of the subject J property hereby authorize ��� � �'.�fd��o act on my behalf, in all matters relative to work authorized by this building permit application for. (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. 40fOwner Signature o£App cant Print Name Print Name Date Q:FO RMS:OYNERPERMIS SIONTPOOLS Town of Barnstable Regulatory Services �oF rosy Richard V.Scali,Director ]Building Division s�xMAS& > Tom Perry,Building Commissioner 16 � 200 Main Street, Hyannis,MA 02601 prED �a www.town.barnstable.ma.us Office: 508=862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: -.. JOB LOCATION: number street village "HOMMOFJNHR": name home phone# work phone# CURRENT MAILING ADDRESS: cityhown state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. _ The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homcowner 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 persons)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,RuIes &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:\WPFILES\FORMS\building permit fonns\ERPRESS.doc Revised 061313 ` Barnstable Old cgs Highway Historic District Committee . B11WMABM . 200 Main Street,Hyannis,MA 02601,TEL: 508-862-4787 Fax 508-862-4784 s639. - . APPUCATtON9 CERTMCATE OF APPROPRIATENESS Application is.hereby made,with five(5)complete sets,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 all categories that apply 7�7 1. B141d1II _ _ ,N..J{ - 9 constInIction: ❑ New ="a f-1 ❑ Addition" Alteration �L-� it.� � �T.-1 r: 2. Type of Building: House ❑ Garage/bam ❑ Shed ❑ Commercial ❑ Other 3. Exterior Painting roof ❑ new roof color/material change,of trim,siding,window,door 4: Sign : ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 5. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Retaining wall ❑ Tennis court ❑ Other 6. Pool ❑ Swimming ❑ Other man-made pool . ❑ Solar panels ❑ Other Type or Print Legibly: Date NOTE i1Q applicauoru must be signed by the aQre�u awnal • Owners �V�"' (print)' Telephone#: 5b G 1)L g l to Address of Proposed Work O Village W. • Map Lot# Mailing Address(if differe t) Owner's Signature �-- Description of Proposed Work- Give particulars of rk to be one: Agent or Contractor(print): -4 ✓ Telephone Address: Y Contractor/Agent'signatur . For committee use only. This Certificate is hereby APPROVED/DENIED Date /3 Members signatures R,ECEWE'D JUL 112014 . E GROWTH AGEME. APPROVED I F ' I Town of Barnstable Q Old King's Highway 1 :IBoardsandCommissronr101dKmgsHighwaylOKH,IppJiaationslOKH2O11 Cert.4ppropriawness.doc Committee i Town of Barnstable ,K Regulatory Services Thomas F.Geiler,Director snxxsr,�sns. Building Division Perry, g TOl N OF E�.`' STABLE 1639. `0�' Tom Per Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us r"11 SEA' 13 ASS H: 38 Office: 508-862-4038 Fax: 508-790-6230 Approved Fee: Permit#: HOME OCCUPATION REGISTRATION Date: Name: �PWg l�f ��/`I Phone#: Address: 7 D fT16f9A P— 0 e C-/U Village: 1.)LJ. &AfM,7*A96C_ Name of Business: leS Type of Busuiess: t -4 UA' Ptre-7-w-E, Map/Lot: /3,,?O `V INTENT: It is the uitent of this section to allow the residents of the Tomi of Barnstable to operate a home occupation vvztlinn single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling. there shall be no increase iu noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase ui traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located«athi n that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary ui residential bu ildnngs,and there is no outside evidence of such use. • No traffic will be generated un excess of normal residential volumes. • The use does not.involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,un excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,aid not within the required fi-ont yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned aver d and agree vvit n tl above restrictions for my home occupation I an registering. Applicant: Date: L Homeoc.doc Re%•.01/3/ YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: q la-III Fill in please: APPLICANT'S YOUR NAME/S: CA 41- A exu.i An tr BUSINESS YOUR HOME ADDRESS: Iq 0 Sag 36Y 5lalot4 We 41 TELEPHONE # Home Telephone Number 1 !'f�;- NAME OF'CORPORATION: %/Sl o 5 S D` 0. NAME OF,NEW BUSINESS e 0 TYPE'OF BUSINESS IS THIS A HOME 000UPAT N?. YES. OF BUSINESS �QD �Q,12P�B�'a�L�1' , _ _ ADDRESS, �'f tl 1. t�lK'774R/ff1AAP%PARCEL NUMBER 1 (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. J1. BUILDING COM R'S OFF E This individ uthap be ipfor e o n er t requirem nts that pertain to this type of business. MUST COMPLY WITH HOME OCCUPATION Au i ature* RULES AND REGULATIONS. FAILURE TO COMMENT 1 p �w Q -COMPLY MAY MESftf !I! FINES. 2. BOARD OF HEALTH j This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature* I\ COMMENTS: It-IQ- 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual h(as been informed of the licensing requirements that pertain to this type of business. WAuthorized Signature** COMMENTS: S I , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application# Health Division Conservation Division Permit# Tax Collector Date Issued 9 a 7 Treasurer Application Fee Planning Dept. Permit Fee 1331 I S 3 Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address (Q Village Owner 54�;V � Address �� ��� �l✓� Telephone SO P— 621 1/1!x� Permit Request / " L<� Xe. �W h� 6e Square feet: 1 st floor:existing /O proposed /C, 2nd floor:existing proposed to Total new-2/6 Zoning District Flood Plain Groundwater Overlay Project Valuation a� Construction Type 1AA00 ° Lot Size ® 19Z- e-tom Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. r Dwelling Type: Single Family 4Q Two Family ❑ Multi-Family(#units) r Age of Existing Structure S/ XA91 Historic House: Cl Yes WLNo On Old King's Highway: AQYes ❑No Basement Type: &Full ❑Crawl ❑Walkout ❑Other ti 7 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 3 First Floor Room Tount / Heat Type and Fuel: ❑Gas Q9 Oil ❑Electric ❑Other Central Air: ❑Yes M No Fireplaces: Existing _� New_ Existing wood/coal stove: ❑Yes (A No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing Cl new size Shed:❑existing O new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use. %%/r1�1%h /)i��)ly �� Proposed Use BUILDER INFORMATION �J Name oo6,eG-'e-!Z_7_ Telephone Number � �� Address / 0 License# J U /W -16 / "/N Home Improvement Contractor# Worker's Compensation# PV ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE " Q� I e FOR OFFICIAL USE ONLY ' -PERMIT NO. DATE ISSUED MAP/PARCEL NO. - ADDRESS, VILLAGE A / OWNER t DATE OF INSPECTION: FOUNDATION f FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ' The Commonwealth of Massachusetts Department oflndustrial Accidents Office of Investigations 600 Washington Street ` Boston, MA 02111 ' www mas&gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information l Please Print Legibly Name (Busiaess/organizatimludividu4: Address: 000 -26 City/State/Zip: •/ �xdr-;*�i k5 Phone#: Are you an employer? Check the appropriate bps; Type of project(required): 1.❑ I am a employer with 4. p�' I am a general contractor and I 6 employees(fall and/or part-time).* have hired the sub-contractors El New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet t ?.,M Remodeling ship and have no employees These sub-contractors have 8 ❑ Demolition working for mein any capacity. workers' comp.insurance. g. ❑ Building addition [No workers' =V.insurance 5. ❑ We are a corporation and its officers have exercised their 10.❑ Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL I.❑ Plumbing repass or additions myself.[No workers' comp. c. 152,§1(4),and we have no 12.❑Roof repairs insm•ance required.] t . employees.[No workers' 13.0 Other camp.insurance required.] ' *Any applicant fhat checks box#1 asset also fill out the section below showing tiles workers'compensation policyinfaTmatiou: ' t Homeowners who submit This affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit iadi=ti g such tCoatracbm that check this ben must attached an additional sheat showing the name of the sub-contractors and their workers'comp.policy won. lam an employer that Is providing workers'compensation 1nRsurance for my employees. Below is the policy and job site formadox InInsmrance Company Name: Policy#or Self-ins.Lie. #:U,,G p� iJo� 4 Expiration Date: Job Site Address: 7-U ,41� �� l-��r City/State zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and W.1ration date). Failure to secure-coverage as required under Section 25A of MGL e. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and p aloes of perjury that the information provided above is true and correct Signstore: Date: Phone#: /26— / r11-11tnr Of cW use only. Do not write in this area.to be completed by city or town of fciaL � 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 1 Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. . pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,.oial or written." An employer is defined as-"an individual,partnership,association,corporation dr other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the . receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house haying not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance;construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be urn employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of con:�pliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractgr(s)name(s),address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partaerships(UP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The-affidavit should be returned to the city or town that The application for the permit or license is being requested,-not the Department of . Industrial Accidents: Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the member listed below. Self-insured companies ftM enter Their. self-insurance license number on-the appropriate line. City or Town Officials . Please be sure that the affidavit is complete and printed legibly.- The Department has provided a space at the bottom. �€ of The affidavit for you to fill out in the event the Office of Investigations has to contact you regarding'the applicant Please be sure to fill in The pmm it/license number which will.be used as a reference camber. In addition,an applicant that racist submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job.Site Address"the applicant should write"all locations in—_(city or town)."A copy of the affidavit that has been off cially stamped or marked by the city or town may be provided to the applicant as proof thata valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year.Where a&me owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give ins a call. The Department's address,telephone and fax mmber: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1 a77-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia r LMG . 6/15/2006 3 : 41 PAGE 002/002 LMG Liberty Mutual Group ]Liberty PO Box 7202 Mutual. Portsmouth,NH 03802-7202 Telephone(800)653-7893 Fax(603)431-5693 June 15, 2006 TOWN OF BARNSTABLE ATTN: BLDG DEPT 230 SOUTH ST HYANNIS,MA 02601- RE: Certificate of Workers Compensation Insurance Insured: ROBERT GLOVER DBA ROBERT GLOVER BUILDING PO BOX 703 MARSTON MILLS, MA 02648 Policy Number: WC2-31S-320856-016 Effective: 4/192006 Expiration: 4/192007 Coverage afforded under Workers Compensation Law of the following state(s): MA Employers Liability. Bodily Injury By Accident: $ 100,000 Each Accident Bodily Injury by Disease: $ . 100,000 Each Person Bodily Injury by Disease: $ 500,000 Policy Limits As of this date, the above-referenced policyholder is insured:by Liberty Mutual Fire Insurance Co under the policy listed above. The insurance afforded by the listed policy is subject to all the terms, exclusions and conditions, and is not altered by any requirement, term or condition of any or other documents with respect to which this certificate may be issued. __This.certif Bate is issued as a•matter of information only and confers no right upon you,the certificate holder. This certificate is not an insurance policy and does not amend,.extend, or alter the coverage.afforded by the policy listed above. If this policy is cancelled before the stated expiration date,Liberty Mutual will endeavor to notify you of such cancellation. AUTHORISED REPRESENTATIVE. LIBERTY MUTUAL INSURANCE GROUP This CerGBcate is executed byLIBERTYMUI'UAL INSURANCE GROUP as respects such insurance as is.afforded by those companies. cc: Insured:.. Producer.of Record: ROBERT GLOVER SANDPIPER INSURANCE AGCY INC DBA ROBERT GLOVER BUILDING 12 ENTERPRISE RD PO BOX 703 HYANNIS, MA 02601 MARSTON MILLSi MA 02048 r °*IHE,, Town of Barnstable Regulatory Services va I'E'g Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-8624038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: /� // � GL�y� Estimated Cost�O 4g Address of Work: /�'Z�a� Owner's Name: (5<��67r / V022-44 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: ate Contractor Name Registration No. OR Date Owner's Name QAmislomeaffidav l vaFTr+e,oyy Town of ]Barnstable Regulatory Services v�a�ss. Thomas F.Geller,Director Building]Division. Tom Perry, Building Commissioner 200 Main Street, I3yannis,MA 02601 www.town.barnstable.ma.us " Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, l l 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. (Address of Job) ignature of Owner Date' Print Name i Q TORM&O WNERPERMISSION I I MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code I Permit # I MAScheck Software Version 2.01 Release 3 I I I I Checked by/Date I I I CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 6-9-2006 COMPLIANCE: Passes Maximum UA = 185 Your Home = 177 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 840 30.0 0.0 29 WALLS: Wood Frame, 16" O.C. 870 13.0 0.0 71 GLAZING: Windows or Doors 56 0.340 19 DOORS 56 0.340 19 FLOORS: Over Unconditioned Space 840 19.0 0.0 39 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to he or cool the building shall be no greater than 125% of the d gn as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date r RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $ 50.00 Alterations/Renovations $ 50.00 Change of Contractor/Builder $ 25.00 FEE VALUE WORKSHEET NEW LIVING SPACE, F=0161 square feet x$96/sq.foot= gkox.0041= � a plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE i i square feet x$64/sq.foot= x.0041= plus from below(if applicable) GARAGES(attached& detached) square feet x$32/sq.ft.= x.0041= ACCESSORY STRUCTURE>120 sq. ft. >120 sf-500 sf $ 35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq,foot= x.0041= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee Projcost Rev:063004 i Application to itt '� �t����p �,Q�[Ot'CSI �L�t01LiC �t�ttt (�,ptt[I1T111tEC . In the Town of Barnstable CERTIFICATE OF APPROPRIATENESS complete sets,for the issuance of a Certificate of Appropriateness under Section �ppiication is hereby made,with fourP proposed work as described belove don plans, f Chapter 470. Acts and Resolves of M acttus 973, far prop -.-100 jrewingspor photographs accompanying thisapplicationo g M CHECK CATEGORIES THAT APPLY: cn �� ❑ New El Addition Alteration rn construction: ❑ Garage [I commercial ❑ Other r- 1_ Exterior building � House Indicate type ofbuild❑ing: 2, Extenor-Fainting: ❑ ng Sign ❑ Re ainting Existing Sign p 3. Signs or Billboards. [I New Sign ❑ Flagpole Other ❑ Fence ❑ Wall 4• Structure: DATE TypE OR PRINT LEGIBLY: ,�Q�� ASSESSOR'S MAP NO. J ADDRESS OF PROPOSED WORK �� ©�� y , ASSESSOR'S LOT NO. OWNERS v& /) �' TELEPHONE NO 6cw- bQ HOME ADDRESS �� ES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any FULL NAM additional.sheet if necessary•) public street or way. (Attach ad — © o,2fl� Ica '— CO U 4 'P'A �,F TELEPHONE NO. AGENT OR CONTRACTOR _ 'I4'1 7� �� �� � ADDRESS OF PROPOSED WORK: Give particulars of work to be done, includ��eri������lease DESCRIPTION 'eaLa include locations of proposed signs. A5 /8T1•� � Signed Tyner-Contractor-Agent �4M1� •1 9'. Nai e s . Date F This Certificate is hereby Approved/D ied JUN 2 2 2006 Co e M mbers' Sign to ' HI OWN OF BARNSTABLE STORK PRESERVATION Town of Barnstable do Building Department - 200 Main Street BARNST"LE. Hyannis, MA 02601 9� M"� �' (508) 862-4038 i6g9. Certificate of Occupancy Application Number: 20062821 CO Number: 20080085 Parcel ID: 132045 CO Issue Date: 05121/08 Location: 90 ALDER BROOK LANE Zoning Classification: RESIDENCE F DISTRICT Village: WEST BARNSTABLE f Gen Contractor: GLOVER, ROBERT J. Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: FAMILY APARTMENT ISSUED TO SCOTT MULLIN FOR JOAN CROSS, MOTHER. Building Department Signature Date Signed Q File Edit Tools Help Action ............. ! ' Deti3� _ ...........—..............._..... Application 2t}062821 j +s Applicant GC-GENERAL CONTRA Collect Status R �,+ ACTIVE Qvrner 28$34�� r Department fi300-8UILDING DEPARTMENT Close/Derry CROSS,JOAN _ Project/Activity 500 FA:MI'LY APT W_/CONSTRUCTION___ tContractor IGLOVER.ROBERTJ. f Workflow Description 1 FAMILY APARTMENT-MOTHER JOAN CROSS 3GX27 ADDITION - �1 Business Description 2 � Parking/h4isc •- ---_----�-•--�-- — -- - Property/Us Property e Non-Conforming Dates/Mist l Permits �— Reactivate Property Property Use Location 90 �� Unit 6dsting use 1010 SINGI Adjust FeesT Street AID ER BROOK LANE �IF. zoning RF-- SID 1 Escrow �G Parcel 132015 _ _ }� memo y Municipality VJBAR-WEST BAR NSTABLE (! —__ tvlisc Chgs f ► SubdivisionAot Paymt History Between - - �- Proposed use 1014 SINGE and zoning RF-RESIDI Audit'History r - - Location desc LOT 8 memo Summ Permit ; COPY App Plan Review --- - �� Prerequisrles � Hazrd/Res]r ! ( Names bonds J Sub Addis Teed Prior History i� Inspections !� Violations fc3 Reviews Open hems Warnings Find Related ' 4�� jfET]C� ,r Maintain project/activity detail for the current application, r - �� + (��.'.I,Main C ,1iifS Mirrnc is��,Tnhnw _) I���1 Amnpc— In.A.mn-o~c��lll 1 FBM �1 in,M�AinM._f Re. ilv_ll t'R ., r ' �♦ � yr„ .Y:?'. � File Edit Tools Help — - _ . a Uri Schedule Type Requested Scheduled Time Inspector Performed Results 'Galan Field Sheet JLEB 01�26/2007 PASS y EFINAL H1 J WAMA O1/25/2007 PASS App Profile EROUGH 1 WAMA 11/09/2006 PASS ESRVC INSP WAMA 12/e1.f7m PASS TRENCH WAMA 10/122006 PASS i h { FOUND 1 I i JLEB 11109/2006 r PASS FRAME 1 JLEB 11/09/2005 PASS INS INSP 1 JLEB 11/14/2006 PASS • i • � � Viev Schedule �� ,. 1 i 1 -- i Y • f �r�• , i i .. - @� � �• .. �, y f } '� _ _... _. >::F+ ., Town of Barnstable OF tHE 1p� o• Building Department Services Brian Florence, CBO &UWSxns�.e, 9 MAM 1639• •� Building Commissioner °rFn nnr•+" 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit : I, being on oath, depose and state as Afollows: My name is _� �� 1 r`�" rI3 I am the owner/resident of the property located at: 6 PItc W, The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner:�Ar,� GP456, W , Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately note the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building tas —Commissioner listing-the names and relationship of occupants in said Family Apartment. I also m r"�tndersta d that I am required to comply with all conditions imposed by the ZBA Special Permit —•and/or t Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree z Ito note e Building Commissioner immediately in the event of the sale of this property. a 40therz4s no to a Family Apartment at this location, please explain: the ap t has been dismantled. �he apa -ht has been transferred to the Amnesty Program(Appeal No. ) ther C Sworn to under the pains and penalties of perjury this e_ft day of 019. q' 6zo(o q Signature Phone Number Print Name (S C0v- b 4W u-I r-J q:forms/famaffid.do c rev 11/08/13 Town of Barnstable oFTME Building Department Brian Florence, CBO MSTT SC (VINE® Building Commissioner 1639 200 Main Street, Hyannis,MA 02601 l RFD MA'S www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 own of Barnstable Family Apaftment AffiMmit 0 I, being on oath, depose and state as follows: My name is — I am the owner/resident f the 77a CD q �property located at: ( 0 A c( ,r2yry `e—C.V m The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: 11 Name & relationship to owner: y/9�l ce o S S~ Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notes the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of`J�Jv 2018. Signat4e Phone Number Print Name q:forms/famaffid.doc rev 11/22/2017 Town of Barnstable Regulatory Services �TME Richard V. Scali,Director v_ Building Division = o "BI ` Paul Roma,Building CommissionerMAM , ° .�� 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us P Office: 508-862-4038 Fax. 508-79&23q; Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows:po My name is v C0 MU L c-e_ I am the owner/resident of the property located at: 43 LA WA The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: �'t1� C-1�'�O S s, M 0_7tfF7e_ Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If`here is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to der the pains and penalties of perjury this day of V i1 J 2017. Signature Phone Number Print Name SCei�—JT q:forms/famaffid.doc rev 11/08/12 Town of Barnstable Regulatory Services of Richard V. Scali,Director r °* Building Division RAMSTABM MAM ' Thomas Perry, CBO,Building Commissioner Ari639 200 Main Street� Y �H annis MA 02601 Ep�l www.town.ba rnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: t My name is S LO?T- A'LY L4--l'I1 I am the owner/resident 6 the ,j =' C property located at: © rn The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: '�JaAfj Name &relationship to owner: The Family Apartment will be the primary year=round residence for the above-ident f ed family members. In the event that the listed relatives vacate said apartment, I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this 2--day of YW2016. Signature I Phone Number Print Name S Ali �J q:forms/famaf d.doc rev 11/08/12 i Town of Barnstable oFE r Regulatory Services ti Richard V. Scali,Director `s ,STABIE » Building Division MAn 039. 0. Thomas Perry, CBO, Building Commissioner ED MA'S 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: f My name is /t I am the owner/resident of the property located at: 10 f�Lt L- g e'Z(�b-Z r� The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: �ytA-7-j '0 Se3. ,,V1 G`r�-.'� Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately --a notes the Building Commissioner in writing. I understand that no subletting oZlibleasing of sai_ Family Apartment is permitted. _ I understand that I am required to file an Affidavit annually with the BuYlding Commissioner listing the names and relationship of occupants in said Family rtment. .Ualso e-j understand that I am required to comply with all conditions imposed by the ZBA pecial Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. E4greeLA to notify the Building Commissioner immediately in the event of the sale of this prrerty. If there is no longer a Family Apartment at this location,please explain: ~3 The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this 1-3 day of 2015. Signature Phone Mumbei Print Name -- - 11bu f ej q:forms/famaff.d.doc rev 11/08/11 Town of Barnstable Regulatory Services Richard V. Scali,Interim.Director Building DivilffiM OF BARN STAB E 9 S& Thomas Perry, CBO,Building Commissioner &639. 1% 200 Main Street, Hyanni?s!1R4As�627601 P11 50 www.town.barnstable.ma.us Office: 508-862-4038 ..... Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is !2L( c AW b'" I am the owner/resident of the property located at: -I 0 A-�eFP-6 PLC ►,J , INN S i j L� l/Vl/4, C) The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this (o 4� day of 2014. Signature Phone Number Print Name 6t 7 7 AW b r�J q:forms/faniaffid.do c rev 11/08/11 .. ;. �, SI ;r �� :, .. . . 7 ,t } :� � � . . ._ � � } 1 .. ., i _ � , , . �� ..- �� � - �,. e - io!i - -' �\A"a � � I �� _ .. �. . . w. a f �� I - � 2. F I Town of Barnstable Regulatory Services Toys Thomas F. Geiler,Director °* Building Division . TOWN OF $ARP�STA$LE &ARN,►ssBL ' Thomas Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 7013 MAR —5 Ali §1: 3 3 iOlEp MA'S www.town.barnstable.ma.us Office: 508-862-4038 DiVISIO Fa-:5T8-"79T-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is Cb`11 °�' I am the owner/resident of the property located-at: A a Z.,0 t t I I. The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: 14ri (�gySS A t�-k—cj� Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately note the Building Commissioner in writing. 1 understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of fi,6Y1kaAL4 2013. g 3k y SAC`/ Signature Phone Number Print Name q:forms/famaffid.do c rev 11/08/11 Town of Barnstable Regulatory Services oFTME Thomas F. Geder,DirecW77,tor Building Division anxivsr" is, ' ommisseionert• I2 3M"ss Thomas Perry> CBO Buildin C 200 Main Street, Hyannis, MA 02601 eo� www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is 6�77�' L I am the owner/resident of the property located at: q o A-t d"r+y The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: Jo xk� C'leU S S WLO nf-c�_ Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately note the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) ' Other Sworn to under the pains and penalties of perjury this_ _ day of Qxct 2012. Signature Phone Number Print Name S U 7r- M.0 i,t ,^J q:forms/famaffid.doc rev 11/08/11 Town of Barnstable Regulatory Services 4 Toys Thomas F. Geiler, Director Building Division IARNSPABLE. Thomas Perry, CBO, Building Commissioner-, � } {+ Mass 1639. 6. 200 Main Street, Hyannis, MA 02601 Eo Mnr www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 i Town of Barnstable- Family Apartment Affidavit I, being on oath, depose and state as follows: My name is . 6CC'7T— N y tr"�. I am the owner/resident of the property located at: a A-L,6 ER,01e0-b e LI J MA oa&&? The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: Jt A-,, CKP d s S {NI b Tit Ei�! Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, 1 will immediately notify the Building Commissioner in writing. 1 understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also understand that 1 am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. 1 agree to notify the Building Commissioner immediately in the event of the sale of this property•. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn.to under the pains and penalties of perjury this 5 day of 'sec 2011. 5bg 3 I s �� Signature Phone Number Print Name L 4/1 Town of Barnstable Regulatory.Services pFTNe toh, Thomas F.Geiler,Director Building D vi_sion -nr- &UNSTABLE BARNSTABLE, ► Tom Perry, Building Commissioner MAW� • �� 200 Main Street,Hyan{ri s,-MIA 02R6011'11 8: 3 5 ArEn Mai° www.town.barnstable.ma.us Office: 508-862-4038 DIVISION Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is S '1 4 I am the owner/ esident of the property located at: (2 S � 6 LIP MA r4 The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: TO W n� S 5-- WW Name & relationship to owner: i i The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. 1 understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit' and/6r the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the wilding Commissioner,immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of �L U 2010. Signature a Phone Number Print Name J Q/b l d g/fo rm s/fa m a ffi d Rev:12/08 Town of Barnstable Regulatory Services �IHE tqy, Thomas.-'F.-Geiler,Director , , tag BARNSTABLE Building Division 9BARNSTABLE, 0 Tom Perry, Building Commissiar JAS 1639•� ♦0 200 Main Street,Hyannis, MA 02601 ArEo �A www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My.name'is IIILU I.LI I am the owner/resident of the property located at: G(D Aut�'-Z,6 t2 co IC ( r). The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: SOA 7,3 C 6� , 14-'Le Name & relationship to owner: The FamilyApartmentwill be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. 1 understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that 1 am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. !agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of 2009. �zg 5Q ai4;� v c Signature I Phone Number Print Name L_�_Aoy J) (NFU L�..J Q/bldg/forms/famaffid Rev:12/08 Town of Barnstable Regulatory Services Thomas F.Geiler,Director MAM + Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-8624038 Fax: 508-790-6230 AGREEMENT FOR FAMILY APARTMENT I(We), the undersigned, being the owner(s) of property situated at 90 ALDERBROOK LANE in WEST BARNSTABLE, MA, holding title under a deed recorded with the Barnstable County Registry of Deeds or Barnstable County District Registry of the Land Court in Book 1(71X(5-, Page �S� , or as Document No. , being shown on Assessors' Map 132 as Parcel 045, hereby agree, certify, warrant and represent to the Town of Barnstable that the accessory attached apartment,which contains living quarters, is intended for use as.a family apartment,for year-round occupancy. The intended and authorized use is for JOAN CROSS, MOTHER OF OWNER SCOTT MULLIN associated with the residential use on the same premises. This unit shall be used for a "Family Apartment" (as defined.in Zoning Ordinances) which would require compliance with the Family Apartment Rules and Regulations. This unit shall not be rented as an apartment or as a single roorp,or in any fashion,which rental would be a violation of the Town of Barnstable's rules, regulations, and zoning ordinances. Prior to occupancy of this unit, affidavits reciting the names of occupants.are to be recorded with the building department. This agreement shall be updated whenever a change occurs or every calendar year. This Agreement shall be duly recorded or filed at the Barnstable County Registry of Deeds/Land Court for the purpose of alerting future owners of the property of this binding Agreement concerning the use of the property as herein stated. The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. WITNESS our hands and seals this day of 200�. TOWN OF BARNSTABLE OWNER(S) By: ril mg Commissioner q THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY,SS Date 1 a Then personally appeared the above-named (owner), lk 1 Cfland made oath as to the truth of the foregoing instrument,before 117aA IwAio, No Public My orrimission Expires: i Alderbrookln90 Town of Barnstable Regulatory Services BAWMABL% ; Thomas F.Geiler,Director —1659. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 AGREEMENT FOR FAMILY APARTMENT I(We), the undersigned, being the owner(s) of property situated at 90 ALDERBROOK LANE in WEST BARNSTABLE, MA, holding title under a deed recorded with the Barnstable County Registry of Deeds or Barnstable County District Registry of the Land Court in Book 11 Za�,', Page / or as Document No. , being shown on Assessors' Map 132 as Parcel 045, hereby agree, certify, warrant and represent to the Town of Barnstable that the accessory attached apartment,which contains living quarters, is intended for use as.a family apartment,for year-round occupancy. The intended and authorized, use is for JOAN CROSS, MOTHER OF OWNER SCOTT MULLIN associated with the residential use on the same premises:. 'Phis unit shall be used for a "Family Apartment" (as defined in Zoning Ordinances) which would require compliance with the Family Apartment Rules and Regulations. This unit shall not be rented as an apgrtment or as a single room,or in any fashion,which rental would be a violation of the Town of Barnstable's rules, regulations, and zoning ordinances. Prior to occupancy of this unit, affidavits reciting the names of occupants are to be recorded with the bgjlding department. This agreement shall be updated whenever a change occurs or every calendar year. o Q This Agreement shall be duly recorded or filed at the Barnstable County Registry of Deeds/Land Court for the purpose of alerting future owners of the property of this binding Agreement concerning the use of the property as herein stated. The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. WITNESS our hands and seals this _day of 200_jj�p. TOWN OF BARNSTABLE OWNER(S) By: it mg Commissioner",q THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY, SS Date 4 of Then personally appeared the above-named (owner), (�1Cfl and made oath as to the truth of the foregoing instrument,before �. Not Public J _ My t6trimission Expires: _ Alderbrookln90 Town of Barnstable *Permit 0 ✓T�� Expires 6 months from issue date r7 "' s�xrrsrnsre. : Regulatory Services Fee 9� MAW. Thomas F.Geller Director AIEo 39. 6 Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 X®Pt"SS - -- Office: 508-862-4038 Fax: 508-790-6230 Uhl; 1 0 1UU3 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red%Press Imprint TOWN OF 13ARNS Map/parcel Number ;,? Property Address 9.0 A16b,5el-6400 K 'L 4-10 G gesidential Value of Work Owner's Name& Address -31d t?.� Contractor's Name Telephone Number Home Improvement Contractor License#(if.applicable) Construction Supervisor's License#(if applicable) e ❑workman's Compensation Insurance Check one: ❑ I AM a sole proprietor M-fam.the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman,s Comp.Policy# Permit Request(check box) []'Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) I 2'fe-side' ❑ Replacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home rovement Contractors License is required. Signature—?&L Q:Forms:expmtrg I 2, Revise053003 Application to: 8P ePEN`'NPR tY.r ,. f• .� ... . Old King s HighwayegionalHisoric District Committee in the Town of Barnstable for a CERTIFICATION.OF EXEMPTION Application is hereby made, in triplicate,for the issuance of a certificate of exemption under Section 6 and 7 of Chapter 470, Acts and Resolves of Massachusetts, 1973, as amended for proposed work as described below and on plans, drawings,or photo- graphs accompanying this application. TYPE OR PRINT LEGIBLY DATE /-2 ADDRESS OF PROPOSED WORK�� ` � �� ��� ASSESSORS MAP NO. OWNER � � �� s ASSESSORS LOT NO. .._rJ.__6/s HOME ADDRESS �� � ���� Yam— `� '& �6' TEL. NO��� AGENT OR CONTRACTOR ADDRESS TEL. NO. I This application is for exemption of proposed exterior construction on the ground that: Ef (1) It will not be visible from any way or public place. ❑ (2) It is within a category declared entitled to exemption by Old King's Highway Regional Historic District Commission: (Check applicable box) PROPOSED WORK: Describe and furnish plan of proposed work, showing location on lot,and, if an addition is involved, show,, ing location of existing building. SIGNE Space below line for Committee use. . Own ar•Contractor-Agent Received by H. C. The Certificate is hereby Date Time ByZ�j� Date Approved ❑ The categories of work entitled to exemption are listed on Disapproved ❑ the back of this form. yam. SEPTIC SYSTEM musT sE Assessor's office(1st Floor): I6��i�LL��IN C®It��� t Assessor's map and lot umb r ��� y /J��. _ ; WITH TITLE 5 va Consertion .WIRONMENTAL CO Board of Health(3rd floor): was .$swage Permit number . G� �� ���I�9 � �� �°I s r:i�n6 Engineering Department(3rd floor): House number Definitive Plan Approved by Planning Board .1g APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2-00 P.M.only, + TOWN OF . BARNSTABLE BUILDING INSPECTOR . r APPLICATION FOR PERMIT TO G0• TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 10 �li06(& IV-d ol-r G, l u1 Z41,. 6AI,2 A-�5 TAB Lr- �7�r Proposed Use I S` Zoning District Fire District L V Name of Owner 142 f&AM 1& 1l w Address Name of Builder �/r/ /f �`h /!�/(�(�//^' ✓ Address Name of Architect - Address Number of Rooms Foundation Exterior �/ '` Aj,�- Roofing Floors �`J Interiors Heating Plumbing � J � Fireplace Approximate Cost Area Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding✓t a above nstruction. `• Name Construction.Supervisor's License ���7 MULLIN, WILLIAM JR. J No Permit For 35516 BUILD SHED Accessory to Dwelling Location 90 Alder Brook Lane W. Barnstable Owner. William Mullin Jr. Type of Construction Frame Plot Lot d Permit Granted November 17 , 19 92 Date of Inspection 19 Date Completed�s �_,�1'3 19 _ -Ali. � - • � e LOT g �I 1 V� -co � °p � IV A SHED j Q Jpo�� b 1 CERTIFIED PLOT PLAN LOCATION !�s7`A44 �.. SCALE . ./ ��.So�. .... DATE NoV./7 PLAN REFERENCE . .. . . .7"la"47 '`t8 Q��� ofQss `� + . s s/ o o-v L 'A No.No 231Q:� �d L 1 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. .WHEN CONSTRUCTED. DATE /1/cY. /7 /11Z WiGG i A,,� n. P47: REGISTERED LAND SURVEYOVI � �. Application to - . P�O� •E..Jt� r { �' V 0PP OENN tE p.V1�5 OPEC OE�t�� _ Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, id 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: 0 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 ) p DATE i0 2 ADDRESS OF PROPOSED WORK 90 �L-1-26L �j9-eJL `• /L)- &U1 ASSESSORS MAP NO. `J OWNER Lam'/ ���� �'^,� VyIU�Lcw .) ASSESSORS LOT NO. HOME ADDRESS CID �Lt��l���1�t�L;�fy• Lv1 •I7f�'�1U• 1lk)4 - TEL. N0. 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 (-JI ���� L IJ TEL. N0. C Zj' —¢�r C� ADDRESS 1 Lr�f 7Lj7/�TD ��� � . f���/1 • 414. 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 Iocations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). i 0 D Signed Owner-Contractor-Agent Space below line for Committee use. Rec D ) e Certificate is hereby Date DC �Z Approved - IMPORTANT: If Certificate is approved, approval is subject to the 10 day appeal period provided in the Act. Disapproved ❑ Assessor's map and lot number .. ..............�...7`.............. IHEro� WQ o Sevyage Permit' number .-At2°. r'I Ic S`YS I twi INSTALLED IN COMP t BaENAGILST&BLE, : House number �IA� soo 1639 ........................................................................ E . M-1,11 TITLE 5 '�p YPY a� T�'CODE AAA -..� �TTOWN OF - BARNS �AIS SUBJECT TO APB. . BUILDING INSPECTORARRf5TABL ��� �, ,°� APPLICATION FOR.PERMIT TO .... !�.P!�?. I.tfl.�:....................................... ......: ................................ TYPE OF CONSTRUCTION .......1.:'f �1�..'' - —m..........................................: .............do'.. ...................19. TO THE INSPECTOR OF BUILDINGS: The undersigned. hereby applies for a permit according to the!,following information: Proposed Use ...:. .!Il ""....:.�: ....[C(. .... Q�IC S � ...........................:.:.:... .................:.:........... Zoning District ...............:.......................................................Fire District �/��! �./:... : � �r,.:............. Name of Owner ... �.�:�`:! ...: .:... 4e 4/. � o Rldress ....;/10A Rg� d Name of Builder ...... ...... "..4 ..........................Address. .—............................................ ....... Name of Architect ....................................Address :..:.......................... 1 Number of Rooms ..............................Foundation ...... .�.�.� ��� .......Js/ �r � 1................... ....... Exterior Yam' ..............RoofingU� . .y5..�............ . ...................... ..... !�.................................................. Floors .................Interior 7P." . Heating ..................................................................................Plumbing .................................................................................. Fireplace pp..................................................................................Approximate Cost .......�.�..���.�............................ .. Definitive.Plan Approved by Planning Board ___________________-_-_______19_______ .- Area ....fit./.,�................... ... .. Diagram of Lot and Building with Dimensions Fee 5 ..... . .. SUBJECT TO APPROVAL OF BOARD 'OF •HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnsta regarding the above construction. / Name .Il. . . ....... . MULLIN, WILLIAM D. JR. - ... Permit for ...AMIT.1.011........... S.ing.J.Q F AMily...D.W.elling................ Location .....9.0..Alderbxook Lane .................................................... West Barnstable ................................................................................ William D. Mullin, Jr. Owner .................................................................. Type of Construction Frame...... ...................... .. ..... ................................................................................. Plot ............................ Lot ................................ November 3, 31 Permit Granted .........................................19 Date of lnspectiorv-4A07��...*--*:.-.--19 Date* Completed ....... '43.2 .........19 • 1 {. .ti. /` ���� ', •f A, LZ_ - - F-7". JUO_OU_I-O�iM• y 'r VO 1p - - "• • _ � �, a�� � � • . � n Q a T6,��a .•�h9lll� `�`:. , . iw If 76 t �c- -✓-_____fTA�o�� QD 00 P RL API07 A IV L O CA T-/O/V �'C � SQ,►�4 -� SG.gL�..11�=�QI^DAT��r1'��S�� ' � ' - � .. � � PLAN 2�F��2�NC�: ... '' .� � :�•; Lac-►i .5C. \--C) _- �. :I�1?D Gam►., F+'t c. T,e+.�kJ Fob �_ ' �,�,-�• 3 0 _ ' �: y �_c�s Fey:.CY.ov� �.�-: TWYy orr- j v-,c.ctL►tay \T } gEC.. � �N, \".E�y."�r'.�E •�� �,vE //I.Ei� I NE,i?E8Y cERrIFY TNT T / 51 ... N-o�l�gsf yttes FOUNDATION GOC9TiO�y/-502- C NFO,�iy iY/TN c' WILFHED ' , qS SHO/YN AND_-t• of0f ' P F. Tit/E SU/LD/NG 5ETd�4C'eR6PUIEL TAYIQit �`� OF TN6 7p`✓A/ OF V3,�-g =SS1.S' �---• S B N//GLOW—5r yi42M0 U7l/Y��T W. � r nil .N.U. ..- .- ;.. � .. ,".: -:,r., �. - c•. :_ _ -• .-_-.. ".:'��`� �3Z S 4 11131a/ Assessor's'map and lot`number .................... .. THE Tp�` Sewgge Permit number .:.. ............. Z DMOSTADLE, i Housenumber .............'....................................................... q MASH �p 1639. J ON a' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO `.7}= �0-4 n w..;.; ' ......................................... ..... .. .. .. .. .... TYPE OF CONSTRUCTION ....... .;5:° .. r' ...................................................................... ............ . ......... ...................19. ..!; TO THE INSPECTOR OF 'BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location �.1 C?...:4`�;^Jr�.�� �°...... �l°.... ^.�............ ��/.....� :?.���-��f.!� � ?'?�5�ft ...•;�.'�!'�- ProposedUse .......... j.:: ...... .. .. .... ............ ............:.................................................................... Zoning District ........................................................................Fire District ............... . ... .......................................... Name of Ownert "►....f Address ?:.... ...... Nameof Builder" .fa.„ "",.`.. :........�....................................Address ...............:.................................................................... Nameof Architect Address.................................................................. .................................................................................... Number of Rooms Foundation 4.� I!_ ..•�:c`!..„.a . .ie ............ . v 0-7, ... ........................ Exterior °-` /��+ ............. .... .. ........................................................Roofing .....�s.4 ....2............................................................. Floors i ...Interior ....... ....1..� .. ......................................................... Heating ..............................................................1.........,...........Plumbing ..:.:;:............................................................................ 101, Fireplace "`' " ..` .....Approximate Cost ......................................................... Definitive Plan Approved by Planning Board -----------___________ ....;;:.:,':! , ------19-------. Area ........................... Diagram of Lot and Building with Dimensions Fee ..�. ............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH b P S I' 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. Name r .? . ......... t.. .. ..,�...... ��'`�`..... M D. JR MULLIN, WILLIA A-132-45 - 23606 ADDITION No .......i .......... Permit for .................................... Single Family Dwelling ............................................................................... 90 Alderbrook Lane Location ................................................................ West Barnstable ............................................................................... William D. Mullin, Jr. Owner .................................................................. Frame Type of Construction .......................................... .............................................. ....................... Plot ........................... LOT ................................ 81 Permit Granted ....................................... .19 Date of Inspection ....................................19 Date Completed ............... Z/.........19 _ . . . Assessor s ma' and lot n ' be ....L. .z....4.................... 7J IPd�TALl..'SEPTIC Sys7ft 1'"! C^UP.IA Sewage Permit number ....... MCE ...................................................: r "' �� ^r. L ?"Er°�o TOWN OF BARN5TLABLE e Z EAHBSTABLE, i "6 9 o war BUILDING INSPECTOR � °'• APPLICATION' FOR PERMIT TO ...... ............................. TYPEOF CONSTRUCTION ..... .. 1Nv. ............................................................................................................ ...4'.-......!/.........................19./ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... .S .....'A.L<.......le.-AN 6;�....... .a..r: .4........................................... Proposed Use .... Zoning District ...................................Fire District :........................................... .../..,............................... .................................. Name of Owner hi...TR...Address 6 v 4)...... bT S 1�j� Nameof Builder ......�..r�.'�!.�?'"..........................:.............Address .................................................................................... Nameof Architect .... .W�.....................................Address ................ ............................................... �( r t� � Number of Rooms .........1........................................................Foundation ... .....0.......�.....�.��...........:....�SYs..l..t..�N Exterior C �...�.!��.'C.�.�.:S�P�a`?.1i�,Roofing ..��!4:,�a....e41..�.�..p,T�...�...............�1......... . . a Floors �� �"� r? �aC�..... E�` 1 Uay7................... 1.N: .......l.y 4 n............. ..... ....�:.......�k -A,Interior ..... .� / .. . .�.:� Heating 447-0.'T... ►- .S5 .. .......................................Plumbing .....1.:.�..1/,.�r.�......................................................... Fireplace ... ............................................................Approximate Cost Definitive Plan Approved by Planning Board -----_-----------19 7. Area 1..Z.vv.. ..... Diagram of Lot and Building with Dimensions Fee �l �� SUBJECT TO APPROVAL OF BOARD OF HEALTH gz 79V J � I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name//e � ............................. �`'. ��,. .... . 1 Mullin, William D. � < --� ` single family d�all1�o � ~ } -----.------------------- ��/� -�wAldar Brwnk Laoe Location .."-------------------- . | / West Birna±abla .' --------------------------. ' Owner William D. Mullin --- . _________________.__ . . ' frame ' Type of Construction .......................................... _./ ! � .................................................... / �------' ' ' P|ct ---------. Lot ..'---------' � ` . . � Parm ' A75 ' Dote Date Completed ----..lg ^ ' ' ' � / 'PERMIT REFUSED . . � ' | _____-_-_----......................... 19 . { ` ' ! ---------------------..----.. ( —.------------------------- ^ ' . ....................................................... � ----.----------..---------. ` , � � lA | . `''.~'~~ ---------------' - . ---------------.----------- , , ' ------',------------------.~ . | i ' / map and lot number ..... � Sewage Permit number ........................................................... � r�������77l�T �-��� �� Jk ��^ 7�T�� r�� � l0� l� �� ! TOWN�� |� ��]� BARNS TABLE �������� BUILDING � N0 N N �� N ���� INSPECTOR 11639- �� N0 0 0-0N N ���� �� �� � ���� � �� �� � APPLICATION FOR PERMIT T�� '�-.----'^-----_.----------.---...L.'------------. TYPE OF CONSTRUCTION -._^-----'------------------------------------. -' ........................................... ........ TO THE INSPECTOR OF BUILDINGS: The- undersigned hereby applies for o permit according to the following information: ^ Location ','----��,'.-----------i-- ~-�.''.----.--------.�-`-'-_-------------. Proposed Use ................. �-....................... ...................................................................................................... ......................... Zoning District ------.-----------------..Rve District -------------------------- / ^ Nameof Owner ................... ...............................................Address ............................... .............................,...................... ' / Nome of Builder -----i'.....---------------A6Jroo -------.--------------------- Nome of Architect -_---'----------------.A66,eo ---------------------------- Num6er of Rooms ----------------------Foundohon ............................................--.--------~. Ex/e,io, ---------------'------------Roofing .....................I.................................................................. /- � � Floors -----------_----_-.-----.----in���r ----^-------------'—__-_____ Heating ..........................................-------------'F1um6ing ..............---------------------_ Fireplace --_------------------------ApproximoteCou ............................................................ Definitive Plan Approved by Planning Board lg----' ' Area .......................................... Diagram of Lot and Building with Dimensions Fee _______________ SUBJECT TO APPROVAL OF BOARD Of HEALTH � ` | ^ . � ~ ' . - ' | , | � ' � � | hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Noma -.-..--.-.-...-.---.---.---.--.,.-. ' Mullin, William D. , Jr. A=132-45 No ..17731 . Permit for 1 1/2 story, . ` sin le famil dwellin Location .q4L.der. ...Brook. ..Lane. .... .............. ........ .... . ........ .. ...... .. ... West Barnstable ............................................................................... Owner .........Wil„ am D. Mullin; Jr. Type of Construction frame Plot ......................... L t .......0 ..................... Jun' fl 75 Permit Grante .... ...................................19 Date of Inspection ........ ...... ....................19 Date Completed ......................................19 PERMy1T REFUSED ................................. 19 ............................................................................... .................................... .......... ......................... ...... Approved ................................................. 19 ............................................................................... ............................................................................... f y t 0�0 r t 40 z , 1 s 4 } ar � • " o 4° � • S/LL 4(-.6 ___ _ FEAT 4e30✓E PGD.dD PL. O r PL A Al b L 0CA T/ON SCA4EI�1=�n-�--ZOAT,& �: PLAN 26FL12ENCE: I1462E$y CEQT/FY7-14A7- T/-/E E X/ST- WILFRED '/N6 FOUNDA7'/ON LOCA7-iOw-IS Gr7leQ4, ,n• F. .45 sNoh/N q�va 56�5:_:cO�vFoey I�YirN 7AYLflft �1 � �TNE 8U/LD/NG SETQAG`4'PF�JUiPEMF�t/T 9� sttfi£�1 OF TMS TOWN Or- 0 Gv/GGow v'' " y.A2tilO /rs/ Q7.i�l.4. I i , I ! , r Er- M AI r-A N:NS� ? i ! ' Ell '�"n�- N (0 `J S C� Cll� Coll �v ._ ._ _ � - _ - • . _- off, - ..- . - - �- - _ � _ ._ _- „_.-. i I ' MO�FO . , ST�4ce>✓i S RF o O . _ ...._..---. -• 'r. '� I s� � 1 _ es<s-o a�:,�..) AFR�cOv�R� _'°�•p� I ...... 'OSPueLT:OC.Cu='4Jrt[[lt5_.:.. __ __ _-_ __ ♦ . i ._qur�c� ._.._. ............. .. _..__........ -- ....:..:... . I El G II r :EI::EVAT:OI'I ` .�P�/C'�C-42L-L'lt-�EC"R72Z�'.L—I3ESE�� ey l� 3'H 9Ye' .m0. — : : : .. .. iJ :.�I7F!✓ ",� •-?•..wry.. I .o r� I o r I I ... rnZ •2c� c I Cy.1ST:TR"4YLTt61.Et.1 I4 aT nl i'•. , ' D I - 2 _ • i V I - RGCT - - - �. I - I I I J•: L _ _ I I I I - -PI.RS.I...FLOO�Ot111J _C,�E�S'::p�GLIITEC"rOVJSC.DEST�,^� .. .i . . uwo.oLmo 1 i -• .:_IZ� / Tu'r.BN1iPFTCT ..._•.: .: �.�'+ �Qnl1�"'CKIC�—._�_:.:.. �!� __ !.� •-gig•--,�-Y=�=-.... + I Y ��� 2-A'u"N6:.'':a�2a1D WSJI. iJ ,! d •, -e r���4e .L i a, : , : 9771 = . 1U9V' ... ..._. aa r YY g) I i a : -........ ....... C� O 0.T.AZS 1 i -='D0l':.ac5s_u�36FX.3!-i�!li?r..reays_•_er_cu..eo:i - __.. � �2QV6�:`peCU�TEC7UP.dL'OESi�^1 a-jA0bddV WEST BARNSZWM 98 / C8 I / locus .L1 O C US MA P R = 25.00 ; \ ASSESSORS DATA: \ L = 35.21 - - _ --� ss " �_-•- MAP 132 PARCEL 45 \ LOCUS ADDRESS. 94 Z-snoDRD 04 #90 ALDER BROOK LANE LOT AREA = 58,200.tsq.ft. yy _ _ �- - ss• �` REFERENCE PLAN.- 273-51 ZONING DISTRICT RP i92 , \ OVERLAY DISTRICT AP & RPOD SE CKS. FRONT 30' AWE �` �� 8z56/ �,/ es SIDE AND REAR 15' LA W SEE WETLAND DELINEATION BY OTHERS 80 SEPNC PER TITLE V INSPEC?YON REPORT / �/� o ns° f/i FEW DAM ZONE "C" PANEL 250001 0011 D �• �' �` / / / MAP REV DULY 2, 1992 jL 92' ap M"oax / GRAPHIC SCALE so 0 15 Jo so 120 I FOSS `j Pasr 1 inch = 30 ft 4LO MAFZ9 Si t o .PI a T2 Of La rz d Jwrm �� Prepared For s�T�r 1�• ���� ,�� 9O ALDER BROOK LANE z_vwzm/-7 �.j/ �JK In �', ��. West Barnstable, Afassa ch use t is so ti ' M Scale. 1" = 30' Date. June 20, 2006 Prepared By-- Stephen J. Doyle and Associates 8 ��' . 42 Canterbury Lane, E Falmouth, MA 02536 � ��' O �� ►► � Telephone: 508/540-2534 0 �T- ss-<0 �Dg STEPHEN J. n POST DOYLE ti � 6 ,..,off nt�! qu CEO `v��-D L I M O NO. DATE DESCRIPTION B _ CS.,:3 t z ,