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HomeMy WebLinkAbout0042 BURNING TREE LANE 1 I i i I { I' I t NO, 152 1/3 ORA ' L rl-L — ) ,,��//�� Application number..... ..........................4..*. Fee .....................:.`H.......1. !.. ..................... 'q• a.. • n X'.. 1 ` &�'�' 9 ���NV Building Inspectors Initials..... . ............................ 16 �. ` �a Date Issued.......�{..��I.�.................................... ,. Map/Parcel.................. ....S.J...a..................... TOWN OF BARNSTABLE EXPEDITED PERNHT APPLICATION: ROOF/SIDING/WINDOW S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: (9 �'l� U��� t -TREE E L-ME 1�&57 ,64 NUMBER STREET VILLACE Owner's Name: �aSEjPJ4 (FD7/L..�_ Phone Numbe - C 0/o cOM(�-- AST= h1E Email Address:�'USC-1pf 41 Cell Phone Number _ I of C) Project cost$ 'D000 Check one Residential Vz, Commercial OWNER'S AUTHORIZATION As owner of the abo property I hereby thorize to make applicati for buildin ermit ' a rdance with 780 CMR } Owner Signature: Date: 4 TYPE OF WORK Siding ED Windows (no header change) # ED Insulation/Weatherization ED Doors (no header change)# Commercial Doors require an inspector's review ED Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor name Home Improvemen ontractors Reg ati applicable)# (a ch copy) Construction Supervisor's Li se F' (attach c ) ®CC T. NC T- Email of Contractors Mz Phone number _b2d ALL PROPERTIES THAT VE STRUCTURE VER 75 YEARS OR IF THE SUBJECT PROPE')HY IS IN A HISTORIC DISTRICT OU MUST OBTAIN HI RIC APPROVA RE A PERMIT CAN BE ISSUED. r' The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations IF 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly Name(Businees�sjjs/Organi ation/Individual)• — Address: `-t' aog,Mwec . EL c City/State/Zip: `]-A 8 t-C= 'A Phone#: - 6� Are you an employer?Check the appropriate box: Type of project(requires: 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for mein any capacity.acitY• employees and have workers' _ 9. ❑Building addition [N ur workers'comp.insurance comp.insance. ] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sbeet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their worker;'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine 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. Ida hereby certify under the p ' dpenaMes of perjury that the information provided ab a is true correct. Signature: Date: r�_ Phone#: U�_ Ojj`ieial use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 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 iri 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,constriction 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 local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to constrict 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-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLQ or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate 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 perm /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 firture permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related 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: The Commonwealth of Massachusetts Department of In&mft al Accidents 4ffiEce of Investigations 600 Washin&rt Sheet Boston,MA 02111 - Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 WWWw maw.gov/dia 1 .: APPLICATION NUMB ............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent / If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: 2 Telephone Number s�- 3 J _ (D/ Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE G Signature Date O areAll ermitaPPlCationt s iject to a building official's approvalprior to issuance. (; ow►10LlglN� W� s� 4t 7, I Message Page 1 of 1 Mckechnie, Robert From: Perry, Tom Sent: Wednesday, May 14, 2014 2:09 PM To: Mckechnie, Robert Subject: FW: 22 Burning Tree Lane, West Barnstable Get a bucket! -----Original Message----- From: Joseph Gill [mailto:josephgill@comcast.net] Sent: Wednesday, May 14, 2014 12:41 PM To: Perry, Tom Subject: 22 Burning Tree Lane, West Barnstable Mr Perry: I left a call for you 2 days ago and understand you are out of town so I'm putting my questions in this email. 22 Burning Tree is under construction. Our property is at 42 Burning Tree adjacent to J`e #22 and to the east. Most importantly our property is downhill from #22 and thus we receive considerable water runoff. The owner of#22 has told me he will run his gutters from his new home to dry wells which will help. He also is considering a trench and pipe system along our common property line that would collect the surface water running towards our property. That water would then be run to the street— I would prefer it be run to a dry well. Does code permit running water to the street? This water would hit the street just uphill from our driveway and worsen an icing problem we have along the street and in front of our driveway. While the construction is underway silt runoff to our property is another issue and the owner has a silt fence in place and has promised to add hay bales. What are the regulations regarding hours of operation for the construction work? We would appreciate your response to these questions and your suggestions. Regards, Joe & Nancy Gill 508-733-1010 5/21/2014 F� ro Town of Barnstable *Permit# H Expires 6 ntontbs r iss da PERMIT Regulatory Services Fee BARN Thomas F. Geiler, Director 9�pr6a,� 4 200$ Building Division F BARRlSTABLE Tom Perry, CBO, Building Commissioner( 200 Main Street, Hyannis, MA 02601 www.town.bamstable:ma.us Office: 508-862-4038 Fax: 5087790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL'ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property.Address l__. j Residential Value of Work 2 COO�— Minimum fee of 325.00 for work under$6000.00 Owner's Name &Address � � �-�- 41 C� 1�- �Contractor's Name `C Telephone Number ] ,2 (/. Home Improvement Contractor License# (if applicable ❑Workman's Compensation Insurance Che one: Kr I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name ` Workman's Comp. Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) [?(Re-roof(stripping old'shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. 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: Prope, caner must sign Property Owner Letter of Permission. A c y the Home Improvement Contractors License is required. SIGNATURE: Q:\WPFILESTOR.MMudding permit forms\EXPRESS.doc Revise020108 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 ' www.mass.gov/dia Workers' Compeation Xnsurance Affldavit: Builders/Contractors/ElectriciansMumbers ns Applicant Information Please Print Le 'bl Name (Business/Organizshon/Individuan: City/State/Zip:��l���G► L'2 employer? Check the appropriate bor: Type of proj ect(required): employer with 4. I am a gencral contractor and I 6 New constriction yeesulland/orpart-time). eve hired the sbb-confiactorsa'sole proprietor or partner- listed on the attached sbeet 7. ❑Remodeling nd have no empployers Thesesub-confiactors havo 8. [�Demolitionemployees and have workers'ng for me in any capa�ty. 9. �Building additionorkers' .•mrrranr_C COIDp.incTrrance.5. [] We are a corporation and its 10.❑Electrical repairs or additions re officers have exercised tbcir 11.[]Plumbing repairs or additions a homeowner doing all worklf: [No workers' comp_ right of exemption per MGL12 0 Roof repairs ancc L t c_ 152, §1(4), and we have no � � 13. Other employee workers' s. [No cow,insurance required.] "Any applicant that cbcclx box#1 raLut also fill out the section bclorw sbowing their wmi=r'c rnpaiszfian policy information. t Hamcownas who submit this affidavit Mciting lbay an doing all work and thin hiM outside contractors must submit anew affidavit indimting such. tcont mebrs 93at ebccic this box nmst attached an additional shoot showing the name of the sub-amft zton and dFoz whether or not those entities have arployees. If the sub-contractors have employxs,they must pruvi&their workus'annp.policy number. I am art employer that is providing workers'compensa-won insurance for my employees. Berow is the policy and job site information. I' Lncttrance CompanyN?Tn Policy#or Self-ins.Lie.#: Expiration Date- lob Site Address: —Nu' '� �- City/swriZip- Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine iip to $1,500.00 and/ nc-year inaorisonmtnt, as well 2-s civil penalties in the form of a STOP WORK ORDER and a fi of up to$250.00 a da a t the violator. Be advised Gnat a copy of this statcmtrit may be forwarded to the OTacc of Investi tiara of the IA e Vera e verification. I do hereby certify the ins•and aloes of perjury that the infvrmmYon provided above is true and correrl Si c: Date: — Phone Offirid use only. Do not write in this area, Ib be completed by city or town officLL City or Town: Perrn!Mcense# Tssv7.ng Authority(circle one): 1.Board of He2lth 2.Building Departmeat 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other i r• .a vo Phone#: °FZHE, ti Town of ]Barnstable w Regulatory Services �BAR'NUSS. $` Thomas F. Geiler, Director plEo �a Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 Property Owner Must Complete and Sigh This Section If Using A Builder r �— � ' 0 as Owner of the subject property authorize C to act on m hereby u Y behalf, in all.matters relative to work authorized by this building permit application for: (Address of Job) S1 a e of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of Barnstable �Of THE Regulatory Services swttrtsixsc> Thomas F.Geiler,Director MASS q,P 0,19. A,0 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 R,vny.town.barnstabl e.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOl%1±OWN'ER 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'oivner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on'which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the. State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Ueensing 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 w m is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that hdshe 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 formlcertification for use in your community. Licensee Details Page 1 of 1 The Official Website of the Executive Office of Public Safety and Security (EOPS) Public Safety Mass.Gov Home DPS Home EOPSS Home Mass.Gov Home State Agencies State Online Services Department of Public Safety Licensee Complaints License Type Home Improvement Contractor License # 104514 Restriction Company George W. Blakely Name George Blakely Address P.O. Box 206 City, State, Zip Barnstable, MA, 02630 Expiration Date 7/14/2010 Status Current No complaints found for this Licensee. Back To Search r , http://db.state.ma.us/dps/iicdetaiIs.asp?txtSearchLN=HIC 104514 9/24/2008 Application to `N Old King's Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying,this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction:. ❑ New Building ❑ Addition Q' 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 L � '�'��L.tgu`�,,'. DA E c; 3 v ADDRESS OF PROPOSED,WORK 16 T�� + �6 �uccC� 11La Q ASSESSORS MAP NO. L3 OWNER d 77 eaXe 6f::Lt 'L ASSESSORS LOT NO. �4-:z7—co- HOME GiG[� v/C:4 O�S37 e ,P ADDRESS �fa,P� � idekl�o .�1��4t,�- /l�h! C32& TEL. NO. ,Fff--g.s;1s"- FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if nec ssary). e,(4 5- C CZ�rL 'J• Z 77 ` Jed 0•i Gcr�l" yyGaa �'� c�-f L, cvi -4 'r��. C,/is"Q elA to CC 0,6Y/ AGENT OR CONTRACTOR TEL. NO. rF's�` -22'e 6 ADDRESS f� ct�rG� XL C• DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done(see No. 8,other side), including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). .,�� ,q _ , ��� �I.UJ �L Signed va C'" Z� (Zcy� C�O�-OBI-o O or-Contractor-Agent Space below line for Committee use. H.D.C. rsr. ►'� cod '� I �/ ate r�:T e Certifica is hereby Date f j Time By A Nd 3 •� IMPORTANT: If Certificate Is approved,approval Is subject to the 10 day appeal period provided-in-the.Act.. - Disapproved ❑ I Assessor's office and floor): _ b a� ►S� � GY M TMET0` Assessor's ma and lot number ....... tm ®E WQ o Board of Health (3rd floor): p� ;;-0 ,� gS •r ,+rn� e Sewage Permit number ......... .. �1 _ �k 4&L E Z B6HD9TGDLE, i Engineering Department (3rd floor): Ei, "j a• �o raen n �L CODE I :cf� O 1639. \00� House number ........................ . ..........., ........... ���iU ''gyp�pY a Definitive Plan Approved by Planning Board -----------------_-----------____19________ ��0�� APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-'2:00 P.M. only TOWN ,OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ......A_tel. .......... ..............�... .. .0 ,pn&++ TYPE OF CONSTRUCTION ....... Ck�C�..:. .O.f4.M.E.Lt. ........................................................................................ ,.�..�.....i"5...............19.88.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........ .R!'!.�1.9..... C'.� .....L.*n! ... (rV /� LOT // ` r .............. Proposed Use .........4���. G/�i'' Shr;�-L Zoning District ...........................................................Fire District ..................Zl...J.. .. .... .................................... Name of Owner `.kk.Y...... ................................Address .....Z........�e. . TQa6 �aNf - ....... ..................................................... Name of- Builder. A .20.vN..................Address ......R. .4 ..... . . . . ......c..I ........................ NbP0r9C-f• S� CgNrorV Name of Architect ..".%is....AA. L(`At:0............................Address 3.�........................................................... Mfl Numberof Rooms ..................................................................Foundation .............................................................................. Exterior .... .. ..D...o.41-)....s/t.//10.6.kLF.......................Roofing .......... .....v.U.y..o....51.7..�N. L..4 ............ Floors Interior ............. ... .�1../.... /.. .................................... ................................................................................ Heating ..................................................................................Plumbing ...... ................... �� c)b Fireplace ...................................................................................Approximate Cost ....... . ..... v�•• ll,........ ................. Area Diagram of Lot and Building with Dimensions Fee Q s .................................... 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 ........,° 1-�. . ...../.I / Construction Supervisor's License ..Q �. J7................. FALLEN, BETTY ?�No Perr�nit for ....B.ui.l.d...Dormer. .. .... .. .. .. .... .... .. Dwelling ............ ..... ................................... Location .'...4.2...B,u.rn.i.n5..Tree... La.n.e......... .. .. .. .... .. .. .... .. .. West BArnstable (Lot #11) ............................................................................... Owner .....BettX Allen ..................................... .. . .. Type of Construction ........Frame....................... .. .... .. ............................................................................... Plot ...... ................... Lot ................................ Permit Granted August 16, 88 ........... .................. ........19 Date of Inspectioh ......... .......19 D te Completed ......... ...... .....19 W, yo�THETo�` TOWN OF BARNSTABLE 33ARESTLELE. M MA 1039. BUILDING . INSPECTOR APPLICATION FOR PERMIT TO .........6 ................................................................ TYPE OF CONSTRUCTION ...............410.0d...zzz .A.01..a............................................................................. ...... M.r /4.................19.4 TO THE INSPECTOR OF BUILDINGS,:., The undersigned hereby applies for a permit according to the following information: Location ......... . ........ ...................... . ...../....2. ........ .................... Proposed. Use ........../n/a.'e./o ............................................................................................................................................ Zoning District ............ F..............................................Fire District ... -&-70713AAWSIWZLE. ....... Name of Owner ..... 0.....Ct. .....Address ...... .......................... Name of Builder' .--R-40*4 .2r.....8P"..OAtCS.......Address .......i E.S.M.# .......OY ....................................... Nameof Architect ...................................................................Address .................................................................................... Number of Rooms ............. ..........................................;........Foundation ......Cs.P.Al.e.&K.77�C..................................... Exlerior ........4�!?Pd..... .........................Roofing .........1l1!V..&.,0.e, A. ........................ Floors .......*..C*,&Re.?...................................................Interior ......1P ...... !K Heating ...... ................................Plumbing ......... kllk�...... ................ Fireplace ..........X AFF$........................................................Approximate Cost ..........tlo-, s:po ......lop.............. .... Definitive Plan Approved by Planning Board -------------------------------19_____ - Diagram of Lot and Building with Dimensions 49 15-7� SUBJECT TO APPROVAL OF BOARD OF HEALTH X Lij LLI 0 LL_ 00 P Ld o go z LU cr- 1, > Ld >0 (D < < LL M LL� L-Li 0 0 0 Ir LL4 Q? Uj D _j < Uj Lo Cn -Z 0 < 0 Fes- C� U ,.7 < < rp <14:4 c7 I hereby agree to. conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...6 ...................... Grimm, Richard �09 two story No ... ....... Permit for .................................... single family dwelling ............................................................................... Burning Tree Lane LocationL.............................................................. West Barnstable ............................................................................... Richard Grimm Owner ................................................................... frame Type of Construction .......................................... ........................................ ......................................... . Plot ............................ Lot ................................... Permit Granted ......Or-t.9ber..,19...4A72 Date of InspectionA/ 19 Date Completed ..... ) fj�j -1- 7 ..... PERMIT REFUSED ...............................................................*. 19 ............................................................................... ................................................................................ ► ............................................................................... ................................................................................ 00,0 Approved ................................................ 19 Approved ............................................................................... ........... .......................................................... Assessor's map and lot number An.... S wage Permit number .........................:................................. "E.T TOWN OF BARNSTABLE - i SARNSTADLE, i "6 q BUILDINGINSPECTOR �a M p'' s ` APPLICATION FOR^PERMIT TO ....'•. .... r' '�G--� TYPE OF CONSTRUCTION ............................... 1'm�' �.. .......7........./................................................ ...............................' .................19 4 ` TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: r Location Proposed Use r� r;,7�c ,•...................................................................................................... M zId. ZoningDistrict .....-.-........ .. ..............................................F re District•......................................�.................................... r 1 (vt� �Ir.!.. ?..�'� ?..........Address ?d/ e2 �-GL/ ' �' r�'Ln Name of Owner ...................................... ......................./. ................................................. Name of Builder= 0-........................5.I...........................Address <h g Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ........................................:.........................Foundation ./o..............,...................................................... Exterior I `-..... ....-' !`:`:'.!"! ............:.1.n.....................................Roofing ...................1T1.................... Floors ......................................................................................Interior• .................................................................................... Heating ..................................................................................Plumbing .......... ........,............................................................ Fireplace .......... ..':..................................:........Approximate Cost ...........��!v....................................I...... .................... Definitive Plan Approved by Planning Board -----------_------_-----------19________. Area ........ ?� .j.....'S: `......... . 0 . Diagram of Lot. and Building with Dimensions Fee ............... ........5...... ............... SUBJECT TO APPROVAL OF BOARD OF HEALTH U \Nf- .y • N. ,,• yf o - I hereby agree to conform to all the Rulesa and Regulations of the Town of Barnstable regarding the above construction. Name .................................................................................. . 'y` S• Grimm, -Richard A=136- 2 ' 8620 g g " ..... Permit for ara e ....... .... ............................. - < Point Hill ° Location West Barnstable ........................................ Owner .......... Richard Grimm ............. ................................... e . Type -of Construction frame ............ .................... t .............................. Plot ............................ Lo ............................. J August 76 tPermit Granted .........: ..........19 Date of Inspection ....................................19 Date Completed 19 PERMIT REFUSED .................................. . ................... A .. ...... .......... .................. ....... .............. :......t. 1. �..... � .............................. [ ..................................... . ...................... } r. Approved ....................•. .......................... 19 .......................................................................... ............................................................................... r Assessor's map and lot 'number ...1..1..I.. A3V.... �. -� . ' `� '.•�'°'�..�, 4� SEPTIC SYSTEM-MUST BE INSTALLED IN COMPLIANCE r- `. Spwage Permit number ....... ..�. � a Z,ITH ARTICLE 11 STATE �. 1 �kr-II.TWRY CODE' D TOWN �ofTNE TOWN OF B AR I 115 �L- ew O ' BASBSTAMLE, . 169. = BUILDING INSPECTOR a YPY d �' APPLICATION FOR PERMIT TO, .. .... c C'Q�l TYPE OF CONSTRUCTION ..................................../". ............................................................ ............................... .................19.�� . TO THE INSPECTOR OF BUILDINGS: The undersigned jbeby applies for a permit according to the folio ingin�fo�rmation: �` Location ................. ''..... .r........................................ .............................................................................. Proposed Use .............. " . .. " -� ti�Zoning District ............��.�....F............... .................. ...........Fire District ........ ..:. ...... .................................... ... Name of Owner .J4..! .� fit.......... .1..�!�!..r?'� Address ......... .d.�.�/.. �C/ y ............ ....... ..... ....................................... ` =s. . , - .... - ... S Name of Builder Address .......................... Nameof Architect ..................................................................Address .................................................................................... .0, Numberof Rooms ..................................................................Foundation ./d.......... .:(. . .................................... 7� 7 e �y Exterior .A. �!.!�?. ...............................Roofing ...........We a �...........................:. `........ ................ '- Floors Interior Heating ........................................Plumbing Fireplace '�—...........................................................:......................Approximate Cost ............�09............... ........ .......... . ...... Definitive Plan Approved by Planning Board ___--------_------_-----------19_______. Area ........ b .......... ............ 0 Diagram of Lot and Building with Dimensions Fee /� .` ................. .......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH � 4 513 T �c 0 � 3, ?oo L o X ' 00 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. ......................................................................... Grimm, Richard 18620 garage • - , No ................. Permif„fort. .................................. ` Location ....................................... - ........ e West Barnstable .-......................................................'. ..r............. �'d + Richard Grimm • J r v< r .� Owner .................................................... • � frame .. ........... �^ � f» � .l i` � � i � • t +. Type of ,Construction ..................................... �► r" ` ' > 1 Plot ....`.'. Lot ................................. _ R ,•' ; - 'fit t , �- c� :'7 � Au ust 27L� y Permit Granted �........ 19 76 Date of Inspection ..........:........ ... .. ....19 Date Completed A �< 7r .19 ,n '...... .. / � _. ,., Jam. �• •�-' C• .� !. 1 • ' y�••� - PERMIT REFUSED �... ................................................ .............. y...........................................................•r .................... Io- ........................................................................... +a.......'.................................................�.............. / r , Approved ............................................... 19 • � .. it � - ' ye. ............... ......................................................... �•..� Y 1 (Assessor's office '(1st floor): - � r Assessor's map and lot number .......�.. .b ...6..a.'��U-9 F THE .. Qyo Board of Health (3rd floor): o Sewage Permit number ........ .':..+ �1........................... '� w Z BAUSTODLE, Engineering Department (3rd-floor)_ i �o rb o House 'number } `e Defiritiv,e Plan Approved by Planning Board --------------------------------19_______- APPLIdATIONS PROCESSED 8:30-9:30 A.M. 'and 1:00-2:00 P.M. only' TOWN OF BARNSTABLE BUILDING -MS�PECTOR s-. �� fi� FA� t� APPLICATION FOR PERMIT TO ...,.... .. -..........:......... .1................................y........./.�!(.4� Q..........!!�/�'/ /�. TYPE OF CONSTRUCTION ....... rJ.C.M.t,.. ? ....................................................................................... ,. 0 fi TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the follow ing information: 'location .......` ....:'��-? R�"1 .N . ...�5'.� L,�tl�+ � W..... .� ................ uf // ,.�.. ............................................. �. M ,[i Proposed Use ..........ate.!s'... .. 1 I/ ZoningDistrict ........................................................................Fire District ...................1 �.. �.. . ......................................... -Name of Owner .... .. ... L-� N Address 2-� Sae-�1, Q T bF L�Nt .Y................�............. d......... ..... ......... .................................................... Name ofAvtD w 2 ' rt 5 w Builders...:................�..... ....A....R.�.N........ .....Address .. ,.........! .F A.....t-`.:....!ta"p l L . ,.i .............. �x> N b%rv9 E.t S:r Cq N ro n� Names of Architect .. - .ut.S....lb. .(. �At41............a................'Ad'd�ess 3.rT?Z.............................................................r...M .... Numberof Rooms ..................................................................Foundation .............................................................................. G0,d....s./. ./.i..,�,. // - ES Exterior .... Qo: .... i .6.X........................Roofing /� /V, l.. ....... Floors .Interior Heating ..................................................................................Plumbing ............../............. ................................................... 6b Fireplace ..................................................................................Approximate Cost ........ ..... `--? ., v............................. 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 the above construction. { Name /..�k e""�/ L�....... ...r e ............... Construction Supervisor's License ..Q.o.43.$................ y ALLEN, BETTY A= 36-026 C �d r mer No Permit for ..............1...d.....D...o..r......... w 1 J:L wellin in.g.I.e P�M-i 1-Y...... ............ ....... Location ..4.2...B.ijr.njrj.g..Tree . Lane .......... West Barnstable ........................................................................... Owner ......Betty Allen ............................................ Frame Type of Construction ..............Fra............................ ...................................................................... Plot ............................ Lot ..........#.1.1............... Permit Granted ... ............19 88 Date of Inspection ....................................19 Date Completed ............ .........................19 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3 Parcel 0 016 Permit# Health' ivision 7 3 // �� 4 Date I ued Conservation Division AJOV fz R9lC 'F3 Fe Tax Collector—, Treasurer r 1— SEPTIC SYSTEM MUST BE INSTALLS®IN COMPLIANCE Planning Dept. — WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENS iRONMENTAL CODE AND J TCertf N RE0UL1: 13 1 S Historic-OKH Preservation/Hyannis Project Street Address Village 2.7 b Owner - Address av2 a ' S-f ISO4 4Z . Telephone 7(92 — ` 02 Permit Request i l ids 6— Square feet: 1 st floor: exis ing 10 7 proposed n 2nd floor: existing proposed Total new ��a Estimated Project Cost) Q�Zoning District !` Flood Plain y C— Groundwater Overlay r Construction Type 5-21 k Lot Size �''Z L ��� Sq Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family R Two Family 0 Multi-Family(#units) Age of Existing Structure d Historic House: ❑Yes W'No On Old King's Highway: 44s ❑No Basement Type: 0 Full lB'rawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) ---® Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new ` O`— Number of Bedrooms: existing�3 new _ Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas CWKI ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing C2 New--O = Existing wood/coal stove: ❑Yes FIND Detached garage:e existing 0 new size Pool:❑existing 0 new size Barn:O existing ❑new size Attached garage:❑existing 0 new size Shed:Vexisting 0 new size Other: Zoning Board of AppealZto orization ❑ Appeal# Recorded El Commercial ❑Yes If yes,si plan review# Current Use , o� F- gsaa Proposed Use i BUILDER INFORMATION Name ( • `�� ( Telephone Number jc��C'— �(o — ��T Address `C f oC C90G 2 U License# 0 S D l g 3 4'i Ox—S 0 Home Improvement Contractor# lO q S( Worker's Compensation# (� — 6?& G 30`F�' B RESULT F� ll L ALL CONSTRUCTION EING FROM THIS PROJECT WILL BE TAKEN TO Noy c(. 1 S SIGNATURE /r DATE //—9 FOR OFFICIAL USE ONLY PERMIT NO. 3 , DATE ISSUED y MAP/PARCEL NO. € ' ADDRESS VILLAGE j OWNER wi DATE OF INSPECTION FOUNDATION FRAME ✓f�'� 1 ~ INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL - PLUMBING: ROUGH FINAL ' GAS: ,,ROUGH, FINAL ; , FINAL BUILDING,.' s ' r � � Irr . � • . ^ t DATE CLOSED OUT ASSOCIATION PLAN NO... y ' t.I � nl i f f,'_4 i n.i I. W 1 LJ!4"1 r-1JOVt_ r Lim 310 CMR t0.99 } Form 5 DECE=decio SE3-3357 ` + —• v iYNs T` :To oe orowaeo by DEOE1 Commonwealth C:ty Town Barnstable I ofMassaChuSet,S = DasiyTAM Gill v _ x"M APDlicani p A`f i. Order of Conditions Massachusetts Wetlands Protection Act G.L. c. 131, §4:0 TOWN OF BARNSTABLE ORDINANCES, ARTICLE XXvij l From Barnstable Conserva "on i i To Joseph Gill same (Name of Applicant) (Name of property owner) a i x t. I :.f i.; , ,.,,. gin•. �- . dress` ,'Fiddres` i ,. y i a. P� ,.t Ti'is 0(dt?i°rs issued°an'd'efe,liv.ered'as`.3oifows O` ',tiy hand'delivery to applicant or,re Ores entative:on (date) i C by certified mail. return receipt requested on Orr,.27 1g9B (date) This project is located at 26 Burnijig Tree Ln. , West' Barnstable The.property is recorded'at the Registry of Deeds in•Barnstable:' 111ao 70 Book ' page CertitiC'ete.(if re.gis'iered.) i ilfie`h.otice:of lnteri�t for•this project ivas filed on - June• 3, 1998 (date)' Tfie piibljc hearin;g;was cfose.d:on July :21'„ 199s3 { (date) m' r�0 "i Th 'sr. rnstal5l e 'CO21se_tpg.''°'nn`•:l�nri.e,: ''. •,� I ?' ..�.Y.a�s� has rev�ewediahe above ceterencetlNotic' of et,t`aricf.o s:and.has held a p:ublfc:haarki on the r' n .'.:�,.�:,.:,.•, . .: : . . 9 R.oject. 6as®;do. fhe�lnforrratipn avai;ab!e to the ecttmu,s'sion. tthis t(me•the 'Cotnttu ss: on.i. .i. ,. �, has:.Cetermined(hat , n,wiiipjj'therp`rb pose d work i0o be done i&significahtto.the followingintere§ls h accoid'ance .`t ' ,Pieaurnptions of .pi,ficance set forth in fhe regulations for each Area Subject to Protection Under the Ac't;(Checls as apprope•iat'e); L7 :•:Public wa�errsupply Flood control © .Land containing shellfish 0. .Private'watei;supp(y Q��torm..damage prevention �. Fisheries [1.: Ground,water supply tom''Prevention'of pollution Q�Proteotion of wildlife habitat. i To a�Fiiing,Fee Stitiinitted $275 $f $40 " $125 State Share j C'{tj�I`i`owrt Share•. : 0 & 0 (�i:fee in excess of g25) Total;Refuh� Due s City/Town Portion S: � State Portian S' I or ARTILI.E 27 Only: (/x totaY) (�h iot8lj 0 Public• trust. fights Q. Agriculttaze [erosion control' ©'.Aquaculture Q Recreational Hi8toriC' ( AeSthetilC Effe-live 11 ill 0189 I LV GJ LJJV LL -tlllll I I\VII fl. . WILJVI'1 1--IJ�IUL. IV -_��_�_ f IJJ 1 SE3-3357 - Gill Approved Plan.=Oct. 6, 1998 Revised Site Plan by Paul Merithew, RPLS Special Conditions of Approval: L.• General Conditions 1-12 on the proceeding page are binding, and demand both your attention and compliance. Within'.one month of receipt of this Order of Conditions and prior to the commencement of any.work-approved'herein,. General Condition:num ber 8'(preceding page)shall be con1plied with ; 3.• ' Lhe<applicant shall pay for their legal advertisement as invoiced: 1 '{4r:;• 'Vr..k.'?; ;� •ti`���.'• <;;�h�5�eiYii•�t.is.valid:for�3:• eair 1�.y - _,. ..,.;;I::...,... ..,... •,• ':: •• ,. f :.r.: d'ate p UahCe, -$ r o1?the�$: Gan �,t F :a f e'• steal s - ° r� ide• .,. pP. .,p• projeeE contractors witli copies�of�tl�e.Order of Conditions -an. approved plans prior to the start of their work. 6• The work-l'amit shown on the approved plan shall be strictly observed, J. The work:linfit line shown on the approved plan shall be staked ld :in the fie ;ny the project purveyor/engineer:pribr:to the start of work. °.'$,• Prig j to th-�st<1rt of work, staked hay bales.backed'by trenched4ii s. iltatioiii•fenciir shall ' s`be.seyt•a10 die: ,. . ,f g' .;. 1 �:. .. ...: g;.- appravPd work tiinit'line. E ffeoti,ve.sediment controls.steal remain'until afie'site:is sita> ilized=witili vegetation.; �. i `. :i• �stu•,. da f; ce. - of'. s a4 i •�nc1•••d'�u �cuttin�'� . �. g � .g tafion b�e.`.oiid:�th�•. work;lzn it.i i its restr'�cuon tshall Coritinue:over time: ' Y 1:0:.• U' i coni 'letiori:of :.e:fou Po . .. 1? tl nclat3on(s)1or tFie itclditions,the project surveyor or engmeer.,• `shall provide in writing(6 the Coroiin`ia:ion verificatiort of the a}proved siting.of'the. foun±datiort s aon de-of a tth°teh approved.l.o..cation and cv ' fineritadition:of thesed �introTs:. ; „',. r?- _y; ,ep. ! , Oce:the foundiition(s).are l.'ai iio.£�rther wort oii the< prgyect shall occur unti i e veritiCatibri`is si ed o#f i�'writ�n' ; .. , gbytle. onservation . ? ' ;Commission. ' All ai+eas 'disturbed during construction .shall be .revegetated.immediatdly following comp etiori; of work a't{.tlie site. No areas shall be left-•'unvegetated or uzimulched'for . f•-rnoz'e j han 30 days. ; eILs•ori{Y}�yelled trench I .#P.^. es al6pg thi �drip.lirie 'sha11 be installed ro aceornmodate D�o�: T'h� .w .s�iall�:l�e�c o''strutt . .. ed .p. u§;material. •• .. .�:•" .. „• ;14,,::::-'.�l l ro osed kw,n areas:sh 1'be , P . a1 �tAijerTaiu with a iiniztimtim'of 6:..iiiches=of or gamic'lctain, . ' ' III •Ij 1 .. I ...... ": .. <'•...,�. 15• The septic system upgrade-shall be completed, 16. . Vista pinning may be conducted under this Order of Conditions where conducted in consultation with and with the advance approval of the Conservation Agent. 17. It is the responsibility of th.e. applicant, owner and/or sticcessor(s) to .ensure that all conditions of this.Order are cotrtplied with. The project engineer and contractors are-*to be ,provided with a copy of.this Order and referenced documents ,•before the. commencement of construction. T1te foregoing condition shall not be construed to exempt project contractors from responsibility for any work performed in deviation with provisions of the Order of Conditions or with the detail of the plans of record. 1�• The:Gonseivation Commission, its employees, and its agents shall have a right of entry'. to inspect'for compliance with the provisions of this Order of Conditions. :.<. I. 19 • . om le ton o 1.k.'. p i vvorlC' oi b, tlYe t' _ . Y expiration or the present.: eriit='the:' f V .: equest:in-;wrr g''.�::Cert'if cat8::of p ,;, apphcat�it she ' fiii onipl;iance for'the Work hereui peimitted, Where a. :. : . :. ..... ...:... t..: .. project lies 'been .colnp•leted' in accordance with plans stamped : by a regl tered professional:en gineer, architect; landscape architect or land surveyor, a written•staterraent i by such. a profession I person certifying substantial compliance with the plan and setting forth what deviation, if any; exists with the record plans approved in the.Order shall accompany the request for a Ce'rti.ticate of C'ornpliance. •..r.. .,: :. j.. following Coz1a„£ 1• v228necee8arpq J= With the Tee-�= Staadards not fz3rth is the z;egalations fo protect two int="" chocked above. The Commission arde= that all work shall be pesfo=ud iz accordance with said canditiazzs and with the Sotics of =tent referenced above. To the =tazzt that the foilowinq caadit,i. modify or differ fr- the' plans, spec ,ficati.4= or other pre13s233als submitted with ttze.fet e of intent, the eo��,s shall coatz'oi. � .• Gez:eras Caaditicas: i. Failure to ==ply with all conditions stated herein r and with all related statues and other requlat=7 measures, shall to deemed Cause to revoke = =dify this =der. Z- This Order does 4et grant any property rights or any exciusive 'privilgs�s; ' does . Uut authorize. any i.ajur7 to private prcpe=- ' , or levee inz: of P=;Vats rigtta :1 3:h. :This 0 ,.+. tier does`'sot relieve the as cr any other: a=oA.`o : ;; t? :of complying With all other applicable 4derzaf s state or Locsl statutes;, vzdiaancss, by-laws ar regzttations: 4 The Irk authorized hereunder She ba Isted wa:thia t}t-ee years a the date of this Order .un, be either of the foilowiac i apply: i a) The work is a ,tQaizttertauce . dredgi ►q o=ject az p#cvicL6` fa= i in th8 ar i :b) Th:9. .for Cr=pleon. has. bests extsncd .ta.:a• sP>°c:;.fied: . dat8`. cre thou three years, bst';le9s thanfve E e: c eta of. ssuaaFs:.:and ..both: t"t dam and. the, 9p>+cial :• c:...c• stances �arraizt aq t3is :exrenced ^e peril :are: set . EoriYfh is •this .ozdar t :0n'8r day be° extended by the is u atttor;'.. one. or � ;zaore per:;ads;l.:of; to;thsiee are 4ach�. u onr csr_o�a to the. � QQf.• t M/ Y.'•. / g: .aioz at'.' r : tihe ixatoi;'.da tY` : 1 Ieaat�'.3fl'`r3sYq:;pr � - } t3ze otder. j ;,• :} 'Used coanac.. .ot with .ttla 8ct. sha3:I. .be ',c�saa f31:.;r =i Cti g. nc ttagh'; z>Bfuse,: rtish at. d�ia, #ac::udAg; but .Ao� 13m tea to luzaber,. br .PCs, piaster; wire IAtw r . papas; ,css3Yz Fi B. tire$;"ashsg., ,rafrigsratars, motor v+e iic:.es or 8 '-s of., air ;Ghe :f 7. }• o Work shall >bs 'uadsz+..aken until :a1T: e ,aPpsaL. try . :. �':"�`°••!'` •�b�: . . are :,if has• ... t'h� :' eea. file t:;Z 'orrFer ':have 'fps®d . t. .an appeal, • . d+° �ud at7 pxaceediuge �bef••ors' the Dep hake been xo work.. sha.Ll..:bs :.�zd4rtakcen uats.I :tine'. Fr.nal' Order. has: 'bEea ;r>3 arc d ii '`fie :sec ��ada: br ttis.;: - for:thB I - -•• ,.a+i�a uiv xa as iaaaraa, Wlt213.22 the ChMn of titles of the affected PaopertY- Za the case of recorded land, the Plnal T Order ehail also be noted is the R®gistry,s GraAtar index wades - the name of the owner of the Iand upon which the proposed work is to be done. The recording info: ►tion shall be submitted to the Commi88ion on the form at the end of this prdELr prior to ca�eacement of the work. � 9. A sign shall be diaplayed at the site not less than two square feet or more than three square feet in size bearing the words, i "14a88achu8etts Departaent of mwirbAzantnj Protection, Pile Nu=ber i SE3-3357 + i • 110. Where the Department of F.nvironMental Protect;:on is requested to Make a dats=d=ation and to issue a SuPerseding order, the Conservation Caamtission' shall be a•.party to all agent,, prcceedi.Zgs and hearings before the Department. iI. DPon completion :of the work.'deac-ibi fAzthwi,' requestin writing thatv','a`::Ce� fcat® of Campiiance b,e 48sued sta t j +. I t�nq that the wcrk 'has beeax satis�fac..orlly co:pletad. 1 The work shall aanf o= to the followi.nq plaina and special co:tditf,ons. i 1 i I i• f ' I r r r. ,I�?( I ; ' , � ,•` f I '•' .ten I •}• j I I - •i.. .'. 'r 1 I 1) •A f I I • i Issued By{` Barnstable ICiOusffvaQDII C0MML5510A 61 i 1' Thisl oridii iaust.be'signed by'a majority of the Conservation Commissi= 0.1 .•22nd o f October 98 Y 19 bezore me Pen}naily peattd' AUDREY.- A. OI,MSTEAD to me known to be the }aa11 viuA`W�YO`8 1L8d:i: TB`+fir@ lII.9U l: _g :arid; MO.. , j' Naia ,y i a My coas*oiz.expires E S The.epp}i .,:t� orari ::aaype"oa.a riavad by this Order.nay owster of Iaad abutting the tend upon wbkh'the;prepoaed avoiic 9.ta.b °.ucmii:or aay ieh reiWie ts,of the city or town in which such Iaad i9'Iocated are hereby-nodged•of theirfnght io request:tDep8#%b s4:0f Enviroameatai QuaL#y-Engineering to issue.a•3aperisedingOrdar. ptuv iing•the reque§c is afade;+by;certi'fied iasil.or nand delivery o the Department within tea days&o=athe-date of issuaiace of this Crder. N copy of th iegzie9 slisil ayi}ies�ine bras be seat bq certified iasil or hand delivery to:the Cons rvatioin Commis�+aad-the applicarst. Deta h;'ou. oi><ed'•I;in �tid;Sotittiit to the issuer•of this Order'i-i" .to Corii�ienrec�isnc oE'Worit.' {.:.: , 1I'e Cods iKat{c .'Coiivaiaaioa::(1$s�iiag Mit on ' v„F•t ::i:..c�:_,:r '- :, G!D�,YS`fZaY, l;:F: ?«mil,. eQ�4r-- A;DYi == `26;;,?$i ` n3': =;Tree Ln.} $]~D.THe�,T THE 013DER,OF.. O;�I..n_ITIONS.FOR P ..fig , THE It03ECI'°'�,T` ..... . .... ... :t. s .B ar s;i~ab:�e E3=33'.7 .' 5 3I:E YUitiTBE E;r•' BEEY�RECORDED':�T•TH : . .., D"ee'.,REG. ©F: dsa l 1 BdritxSia.d! If` vrde#: re`.' ei3i be%' Wi; ideaLfiea t�Ia:iransaciion'�, :•= i Wit. anli.•t31 1: . ocua3s t: k identifies•.thii'trsiisactfo . . TOTAL P 07 The Town of Barnstable • uaNEMABIZ • Department of Health Safety and Environmental Services Building Division r 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 _ Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires tl at 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. s Type of Work: "I l OO V� �s— yP / —/ _Estim/ated Cost ��� � {�J Address of Work: b lti% l .Y Owner's Name: GQ 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 PENAL OF PERJURY I hereby apply for a permit as the agent of t e owner: /r- .-qr �� e-L- o /�3N Date I C ntractor 14ame Registration No. OR Date Owner's Name q:fortns:Affidav The Commonwealth of Massachusetts Department of Industrial Accidents x _ _ Office ollnlyesiigatiow 600 Washington Street ov Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name: V location: city phone CL (7/ ❑ I am a homeowner performing all work myself. ❑ I am a sole ro rietor and have no one working in anv ca acity ❑ I am an employer providing workers' compensation for my employees working on this job. compnnv name: address: city: phone#• insur a co. policv# i I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who have _. the following workers' compensation polices: company name: :;. address_ 'gt �G� dtv: - phone `e insurnnce co. `::1. . :: olicv comnanv name: address: city: phone#: .........: _ . insurance'c0. 261itV# •... ...;...:.,;:.>::.>:>.;:;>::>::::::.::::::::.»:.;r::<::: :>:::»»:;:>::::>�::'<:::>:.>:<'::<:::.. . Fagure to secure coverage as requited under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to s1s00.00 and/or one years'imprisonment is well as civil penalties in the form of a STOP WORK ORDER and a tine of$100.00 a day against me. I understand that a copy of this statement be forwarded to the Office of Investigations of the DIA for coverage veriacation. I do hereby certify he pains a aft of p ju that the information provided above is trru,-and eon�e / Signature Date G ` I-,i Print name Aj Phone# �O� official use.only do not write in this area to be completed by city or town offidai city or town: permit/license q ❑Building Depatiment ❑Licensing Board ❑check if irnmediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other .........................: ,....... ...,.. ... . . (cvam 9l95 PJA) Information and Instructions « Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contr 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 o: the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receive:c: 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 cr building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renews: of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. • I Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit- The affidavit should be returned to the city or town that the application'for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to.obtain a workers`' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and pri>rted 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/Iicense number which will be used as a reference number. The affidavits may be returned io j the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number- The Commonwealth Of Massachusetts . Department of Industrial Accidents amce of IWettl8allons 600 Washington Street Boston;Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 i:! 1. i�anvnzovzcuea i a�� to/uveCCo � I i ? DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Expires:Nulber, s Res.tricteQIV�K ' .0 00 GORGE MvBLEL'Y 130'REOMING LN BOX 206 BARNSTABLE, MA 02630 x �r,:.:a��parnmea�xu�ea���'�d6�uaede k HOME IMPROVEMENT CONTRACTOR 1" Registration 104514 10; . Type INDIVIDUAL 14/00 Expiration . GEORGE W. BLAKELY _ 130 RRedw' Ln/P.O. Box 206 asuaatj styl }o uoil4aonai ao} amo s apo3 6utplInO WIS sllas0yaess4u '+ j a I }o uotl?pa Iuaaana 4 ssassod oI a�nTi43�; 1 y saaoH dit®eI l i ;T Aluo AWS4 tlT 1 (109'S 2TT'� Uki , aaeds pasolaua 10 :01pa '' , a3 > I a 7 117 � �• I1 u0aso6` r 1 8olZo :oz ui►uai� ja�e�d uoliudxa a °�O ��o a�n'� 11 pu o}; u a1Ep uen oi� �s►�az to asua 1 �Enpin!pu! • i ' I i MAScheck COMPLIANCE REPORT I Massachusetts Energy Code I Permit # I MAScheck Software Version 2.01 I I I I Checked by/Date I. CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 10-26-1998 DATE OF PLANS: OCT. 23, 1998 TITLE: GILL RESIDENCE PROJECT INFORMATION: PROPOSED ADDITIONS TO THE GILL RESIDENCE COMPANY INFORMATION: FENUCCIO & RICHMOND ARCHITECTS, INC. COMPLIANCE: PASSES Required UA = 606 Your Home = 591 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 1156 19.0 0.0 59 CEILINGS 1049 30.0 0.0 37 WALLS: Wood Frame, 16" O.C. 1569 11.0 0.0 140 WALLS: Wood Frame, 16" O.C. 1017 21.0 0.0 58 GLAZING: Windows or Doors 276 0.470 130 GLAZING: Windows or Doors 246 0.320 79 DOORS 36 0.310 11 DOORS 20 0.300 6 FLOORS: Over Unconditioned Space 1156 30.0 0.0 38 FLOORS: Over Unconditioned Space 1049 30.0 0.0 34 HVAC EQUIPMENT: Furnace, .84.0 AFUE ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements' of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has -been determined using the applicable Standard Design Conditions found in the Code. The 'HVAC equipment selected to heat or cool the building shall be no greater than 125% of the-design load as specified in Sections 780CMR 1310 and J4.4. I Buil er n - ner Date 1a/lf Air �EPED AgCyj c,A)V N, L FE,y�c 1_0 0 n U �- Q No.7M :a W NARMOUTHPOiTT, y °y MASS. TN OF MPSyP i MAScheck INSPECTION 'CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 GILL RESIDENCE DATE: 10-26-1998 Bldg. 1 Dept. ) Use i i i CEILINGS: [ l I 1. R-19 I Comments/Location [ ) 1 2. R-30 I Comments/Location I WALLS: [ ) i 1. Wood Frame, 16" O.C., R-11 I Comments/Location _ [ ] 1 2. Wood Frame, 16" O.C., R-21 I Comments/Location I i WINDOWS AND GLASS DOORS: [ ] I 1. U-value: 0.47 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? ( ] Yes [ ] No Comments/Location [ ] I 2. U-value: 0.32 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments/Location I I DOORS: [ ] i 1. U-value: 0.31 I Comments/Location [ ] i 2. U-value: 0.3 I Comments/Location I I FLOORS: [ ] I 1. Over Unconditioned Space, R-30 I Comments/Location [ ] I 2. Over Unconditioned Space, R-30 I Comments/Location I HVAC EQUIPMENT: [ ] I 1. Furnace, 84.0 AFUE or higher i Make and Model Number I AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of: the following requirements: I 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or i gasketed to prevent air leakage into the unconditioned space. I 2. Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.O. cfm (0.944 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I . shall have been tested at 75 PA or 1.57 lbs/ft2 pressure r I difference and shall be labeled. I - I VAPOR RETARDER: [ ) I Required on the warm-in-winter side of all non-vented framed ( ceilings, walls, and floors: i MATERIALS IDENTIFICATION: [ ) I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be I provided. Insulation R-values, glazing U-values, and heating I equipment efficiency must be clearly marked on the building plans I or specifications. I DUCT INSULATION: ( ] I Ducts shall be insulated per Table J4.4.7.1. I I DUCT CONSTRUCTION: ( ] i All accessible joints, seams, and connections of supply and return I ductwork located outside conditioned space, including stud bays or i joist cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. I i TEMPERATURE CONTROLS: ( ] ( Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating ( and/or cooling input to each zone or floor shall be provided. I I HVAC EQUIPMENT SIZING: [ ] ► Rated output capacity of the heating/cooling system is I not greater than 125% of the design load as specified I in Sections 780CMR 1310 and J4.4. I [ ] I SWIMMING POOLS: i All heated swimming pools must have an on/off heater switch and i require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require a time clock. I ( ] I HVAC PIPING INSULATION: I HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in. ) : I I PIPE SIZES (in. ) I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-l" 1.25-2" 2.5-4" I Low pressure/temp. 201-250 1:0 1.5 1.5 2.0 I Low temperature 120-200 0.5 1.0. 1.0 1.5 I Steam condensate any 1.0 1.0 1.5 2.0 I COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 I refrigerant below 40 1.0 1.0. 1.5 1.5 I [ ) I CIRCULATING HOT WATER SYSTEMS: I Insulate circulating hot water pipes to the following levels (in. ) : I I PIPE SIZES (in. ) ( NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS I HEATED WATER TEMP (F) : RUNOUTS 0-l" I 0-1.25" 1.5-2.0" 2.0+" I 170-180 0.5 I 1.0 1.5 2.0 I 140-160 0.5 I 0.5 1.0 1.5 I 100-130 0.5 I 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only)----------------------.--- Application to Old Kings Highway Regional Historic District Committe) in the Town of Barnstable fora CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: ❑ New Building ■Addition ❑Alteration Indicate type of building: ■ 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 DATE March 25. 1998 ADDRESS OF PROPOSED WORKturnin-g Tree Ln W. Barnstable MA ASSESSORS MAP NO. 136 OWNER Joseph and Nancy Gill ASSESSORS LOT NO. 026 MAILING ADDRESS 22 ffigh Street, Southboro, MA 01772 TEL. NO. 508-481-0572 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners.across any public street or way. (Attach additional sheet if necessary). SEE ATTACHED LIST AGENT OR CONTRACTOR Fenuccio &Richmond Architects TEL. NO. 508-362-8382 ADDRESS 923 Main Street, Yarmouthport, MA. 02675 DETAILED DESCRIPTION OF PROPOSED WORK. Give all particulars of work to be done(se No.8,.other side), including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary) Two proposed single story additions at left (Northwest) and at rear(Northeast) with deck per attached dr wings. Signed__ Owner-Contractor-Agent Space below line for Committee use. Ei'lTff atle T he Certificate is hereb Date d"Ti R 2 61998 040 F s �444 T I h HIGHlll�AY Approved ❑ IMPORTANT: If Certificate is approve , approval is subject o'the day appeal period provided in the Act. Disapproved 0 Town of Barnstable Old King's Highway Historic District Committee SPEC SHEET FOUNDATION Concrete +/- 8" Red Cedar Clapboards (Front) Natural SIDING TYPE White Cedar Shingles COLOR Natural CHIMNEY TYPE NA COLOR ROOF MATERIAL Red Cedar Shingles COLOR Natural PITCH 10 : 12 WINDOW 1212 Wood Double Hung SIZE TRIM COLOR White 1 2'-8"x 6'-811 Green DOORS 3 2'-6" x 6'-8" COLOR White SHUTTERS COLOR GUTTERS NA DECK 1 X 4 Mahogany (no railings) -Natural GARAGE DOORS NA COLOR SIGNS NA COLORS FENCE NA COLOR `i�` U & NOTES: Fill out completely,including measurements and materials/colors to be used. Three copies of this form are required for submittal of an application,along with three copies each of the plot plan,landscape plan and elevation plans,when applicable. Plot plan need not be "Certified"except for new homes,but should show all structures on the lot to scale. SPECSHT r _ _ ABUTTER'S LIST for Joseph and Nancy Gill 26 Burning Tree Lane West Barnstable,MA 02668 Map No. 136 - Parcel No. 026 Map No. 136, Parcel No. 025 Audrey M. Loughtiane 26 Point Hill Road West Barnstable, MA 02668 Map No. 136, Parcel No. 027 Carey and Mary Margaret Congdon 570 Park Avenue New York,NY 10021 Map 136, Parcel No. 028 Anne H. Bates 25 Burning Tree Lane West Barnstable, MA. 02668 Map 136, Parcel No. 052 Robert E. and Dorothy Sansonetti 48 Vista Terrace Cheshire, CT 06410 Map 136, Parcel No. 14-2 Robert W. and Grace L. Russell P.O. Box 215 West Barnstable, MA 02668 f avelersPropertyCasualty�I - s Am—cvaTravelerrGroup J .•i„' ^;,. WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY POLICY NUMBER: (6NUB-696G630-8-98) BLAKELY, GEORGE W P 0 BOX 206 BARNSTABLE MA 02630 MASSACHUSETTS CONSTRUCTION CLASSIFICATION PREMIUM ADJUSTMENT PROGRAM WORKERS' COMPENSATION PREMIUM CREDIT APPLICATION The Massachusetts Construction Classification Premium Adjustment Program has been proposed for employers engaged in construction operations and is applicable to policies eligible for experience rating. - A_special_premium calculation.-which,-may.result-in a premium credit for you, will be based on average hourly pay rates for each classification of construction operations. In order that your premium may be correctly estab- lished, please return the completed premium credit application, as shown on the reverse side of this letter,to: The Workers' Compensation Rating and Inspection Bureau of Massachusetts P.O. Box 9005 - Boston MA 02205 t ` f Attention: Underwriting Department 'The will advise us of an premium - : c:,. •.z, :a ;.�%, tt Y y premium credit applicable.".' ' IMPORTANT: Initial written notice of possible credit under this program Is given to you at policy Inception:or during the policy term. If you have not already submitted an application for credit prior•to policy audit, you will be•requested to sign a form acknowledging receipt of notice and, at the'same ;..._+...,`'.> time, requested to indicate whether you will apply for a credit. If you apply for a credit, you must submit a 'completed and signed application to the Bureau before the completion of the audit of the affected policy. In any event, the completed and signed application must be received by the Bureau within six months of the expiration date of the affected policy, or within one month of the time you receive written notice of the Program, whichever Is later. For each applicable classification (both construction and non-construction) covering your company's opera- tions in the state of Massachusetts, report the total Massachusetts payroll (excluding overtime premium pay) a and-the corresponding total number of hours worked, for the third calendar quarter (July, August, September) as reported to taxing authorities. ., �{wNote,.#.1: _If you did not engage In construction operations during the most recent third calendar quarter, the requested information to be provided should then be for the-last complete calendar quarter prior to the effective date of your workers compensation policy. Note #2: If you are a new business (no prior operations), or an existing business engaged in construction operations for the first time, submit the requested information for the first complete calendar quarter ^ following the effecive date of your workers' compensation policy when available. Note #3: In the absence of specific records for salaried employees, you should assume that each individual worked forty (40) hours per week. Please preserve your payroll records which formed the basis for this declaration as we will.be required to verify the reported information in order for any premium credit to be applied. . Thank you for your cooperation. Turn Page Over for Premium Credit Application ' DATE OF ISSUE: 101 698 t` W20M1D97 003083. I . i P:RQ.FOSED ADDITIONS - TO ME GILL RESIDENCE . 2.6 BURNING TREE LANE, WEST BARNSTABLE;MA. w '. ARCI�ITECTS F.ENUCCIO.&RICHMOND ARCI&ECTS 9 :NIN S'I'RBET Y�tMOIJTHI'oRT,MA. 02675 508-362-83:82 SFpFD ARCh. / 0 8 a Romm $ � �t = 0 BviYG,.wYsB k ;py PORI'4jJ c � 1 < ; P OCT.8 5 1998 `c g .. WVJi"IW TFEE I,uJE c or{uatfon on this;plan was taken from a Certified Plot'.Plpn,dated 1214/97 by Yankee Survey Consultaots, lvlar'stYins Mills,MA I I • Y7d IF',d i•d' I''-a' �•.I N I+.i �� -- -- -----. ----=—i.. I-I I'I - I o•or I a .�W ' � I,t-tlON"id wo r� N . � w? oM.•V I o I I I I• I � /YeNrV'NM M. � � I srrr• I1 IL b yi•�w.wo ova- °o' ALAII}1 S3 'r wru.deoty. ' H t.�n.7�.ri aP,gN.uw tdOKn�N.ld M;a.r++wiea . t xl•• scwo.NwL dos KC io ii«xD ewe./sF- . IiDWO fo><w taK Ker'Iww- N,e.+m+r o/ NFN F,N.fL ro exrrl• Z :>a If rosT q+�t� - RRo.a8f0w>+8 •WM ro Barren a• � ' . I+�1iIN��TDre aiV'/Y'VI wY N4bl Wnlp � � - ' PKKII"N, orl—WF-P �w�' P�QpULF�,",A C m ITIONS TQ FEFSfICCIO 8c RICHIvtbr7D.hRC#i142('1S:IN 3 N Nw77� 3O ARAI �q •r•o�.f�� � 9Z3-I>kAIN STREE]' MASS. YA � �, r RjvLOUTMPORT.'MA 07b15 F P° 9 56&361-8382 OF MP , R ' �EpED AQCtii _ ¢ps QpULF TFC� . - So ARtdOUT11PORI. 2h h1AS$. `rJ P P 1EFr SIDE ELEVATION PROPOSFD•ADDTIIONS TO'THE . - FENUCCIO&ItICHMOND ARC/HI,-CbC,TS,INC. J.OSEPH&NANCY'ILL 923 MAIN EFT RESIDENCE yABMOVSTR ORT,MA 9267.5. '26 BURNING TREE LANE .598-162-8382 :Y✓-.BARNSTABLE,MA. K4 EF El 0 .L-=� 9. ' 4 MX P^ _ • w,µ xnr�xn recariea i,00rroN tibr easriun m+rJn ao ' 58' ' raua�ao .�iiT�?N . ly. ou ZEPED Aft, c"G�QpOLF rFo PROPOSED ADDITIONS TO TM RLCHTIIJE ELBAT�Ol�f" 1/ ' 1 9° S ¢ °A� L1is�CC�i�.gt RICH�vIOM3 ARCHIT ECTS,MC. Jotl . 8cNANCYCrJ_L.RESIDENCE i ,•APodAUiNPORT w 'Mt11�YSTREBf' 26btM1046 TREE LANE MWASS .. .. 33� P 4DLE;NIA: s t> aP o ;NLA: az�5 j i rf.�.w-W wr. ow..w rnw� Fror LONafNL'nalJ IY4 f.4•uy Ow:ry Fae�C�_ pp MWL�f o•N . mwi•RL�i V.YT 1!y AI4a'14� � %O wf ftYW � 2K14 hwW A0. `p 4t I0sG ILf4 . pyG LH JeT4 G'IiiTi. -}C/ fit!��^G lyoG• F p F.I•KMT1ew . _ ` wNMGN wnK. QU Q w I✓i0 NL.W,Nw.C�•Vry•1 ful>a 1:w we .W;pO,f/v�aJ.fywlpM1 9GTu�N...(hr � (Y f/Y AYwo.`owrw. tY/ w(M INIO JSTf C�] w Hy wNw o..ln rrr wwmw+•fx+rw hr . �.4y„4 qG� (FZ'owwM•✓9'h^�e`T I4•GTBI• ._.... H.Ee�fae!•I �E o/ h. ' }9f l'Y W.J.,nT NYN NwY{ Y wvnµ To Tvdtw Q+�Mf. .. (T'iof,f0 I1YMaeT' RF.u•NweTMT of R'I•/10. lo•FM1T--ITA��pf eN 4�YwRvaY.bici LWiAYC h NfwN,w4WM✓ 4 L.+ NM. On/PeoA+w•1YP. . a .TY w a- 9...T A GRfa3SSECfiION.' ._...::. '. ; .1/4" = V-0" c w . g¢ No.Mg :: .ADD1`Ffl3N$TO I'FI'� .EEt CC�Q&RICHMOND ARCHfTECTS,INC. i. JZJ,) TNPOAf, a 9B3 STREET °24 MASS, a� OSU'T OG T,MA_ 02675OF j. 7. v f , 1 FN{tNwL • ex.at+� ex. epwwrrw�nnWo rsr. eu:wmH . a,t eem�wn a,� a 17•a �J pc:a(1aN g�fflX MA ' ;s n ia7orri 5iis o VD 4 ^'AAMOUMPORf.y - t'I4F&,{ CHMOIID ARCEa'S`ECTS,INC: °s MASS. �r� ET.. . IRBE'LANE gay H ssP �,t {)R�"MA 02675 r ,1�. I ) lS i7�Or 1 � 1 i I r 7 1 i N _ _ ED all ---------------- 4- CD / c(VL.Y ou, 1 , r FAllL � gl I n wrn•r I 1 I I #il '11 II p m - ��.vr�r� lr�cL w��.rw�) �I Ii II 4u�d oil s FxwnW 4mj&TLr . aw .. tEpED wq�ti �WSpt�oQpUL F� r'� PROPOSED,ADDM-G21STO'iI3E'.. C1CIO�RxGi{1�40Np1+HCMTECL�.INC. �a APoaOuiHaORt. �« I: ►As& �r 6 BLLFRN1NfY fRE$LANE GH � t W' •MA. U267$ aq F MPSSP W.BARNS'T'A.BLE MA. :3q". , WINDOW SCHEDULE Gill Residence All Andersen Units to be White Vinyl Clad unless noted otherwise Symbol Mfr. Unit Rough Opening Qy_, Comments A Exist. Brosco True Divided Light +/- 2' - 6" x 4' - 9" 4 Relocate exist. 12/12 Light 6" x 8" (Field Verify) per plans B Brosco 4 Lite Square Sash 1'-11 3/8 X 2'-5 3/8" 1 Customize hardware 10" X 13" Glass Size (Unit Size) for awning setup w/ interior screen C Andersen TW2446-2 4'=l 1 13/16" X 4 -9 1/4" 2 12/12 maple wood grilles twin narrow mullion D And. DHP4246 4'-3 7/8" X 4'-9 1/4" 2 E And. CW25 4'-9" X 5'-0 3/8" 1 F And. CXW15 T-0 1/2" X 5'-0 3/8" 4 2 LH Units/2 RH Units G And. C135 T-05/8" X T-5 3/8" 1 LH Unit H And. CW235 4'-9" X 3'- 5 3/8" 3 J And. TW2446 2'-6 1/8" X 4'-9 1/4" 5 12/12 maple wood grilles K And. DHT4210 4'-3 7/8" X P-01/2" 1 6 lite fixed transom L And. TW 24310-2 4'-11 13/16" X 4'-1 1/4" 1 M And. C245 4'-�0 1/2" X 4'-5 3/8" 2 Remove exist window-adjust \ RO as required for new unit Symbol Mfr. Unit Rough Opening Qtv- Comments N' And. C14 TO 5/8" X 4' -01/2" 1 LH Unit -Remove exist window adjust RO as required for new unit P Brosco True Divided 2'-6" X 3'-5" 1 6/6 light 8"x 8" Q Velux VS 1 31-5/8" X 39-1/2" 2 Venting Skylight Exterior Door Schedule Gill Residence All Andersen Units to be White Vinyl Clad unless noted otherwise Symbol Mfr. Unit Rouah Opening 0tv. Comments 1 Morgan Wood Door M-3984 3'-0" X 6-8" (Unit Size) 1 Provide full lite storm door Spectrum Series by Harvey 2 Andersen FWG10068-4 9'-9 3/4" X 6'-8" 1 3 Andersen FWH2968AL 2'-9"x 6'-8" 1 4 Andersen FWH 5468 5'-4" X 6'-8" 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# Health Divisloi 9S-'7 (Or�1 Or Date Issued 7 — If r�' BAARNSTABLE Conservation Division, 0� �, Fee 5� �� `t Tax Collector oS /' 1115 JUL 18 PH 1: 34 �'p Application Fee � Treasurer �> Planning Dept. Q1 11S10 ---""rhecked in By Date Definitive Plan Approved by Planning Board Apprca SEPTIC SYSTEM Historic-OKH Preservation/Hyannis UMM1110, OF BEDROOMS Project Street Address C 13cn-- Village Owner 1 7 LL Address Telephone jcZ ►.--. -rl Permit Request Square f QeW st floor: existing proposed 2nd floor: existing proposed Total new Valuation—� O Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 81*1 Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes 'lo On Old King's Highway: a;r<es ❑ No Basement Type: f�Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing I'S new Half: existing new Number of Bedrooms: existing_ new Total Room Count(not including baths): existing L 0 new First Floor Room Count y Heat Type and Fuel: ❑Gas C`Oil ❑ Electric ❑Other Central Air: l'Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes M No Detached garage:&rexisting ❑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 ff*-No If yes, site plan review# Current Use Proposed Use O Gt�fj v BUILDER INFORMATION ® KOr _ IJJVV Name — e ephone Number Addre s c E. lJ License# s Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO E72— SIGNATURE DATE - —o FOR OFFICIAL USE ONLY d - ' PERMIT NO. DATE IAONEI�, = MAP/PARCEL NO. ADDRESS VILLAGE V OWNER DATE OF INSPECTION: i FOUNDATION FRAME INSULATION a ` FIREPLACE a ELECTRICAL: ROUGH FINAL a PLUMBING: ROUGH _FINAL 64 GAS: ROUGH �_ ® FINAL FINAL BUILDINGir a t 4p 0 o DATE CLOSED OUT ra P m 0 ASSOCIATION PLAN NO. • Application to ®Lb Ring,,# 3bIgbjURy.3PLegijonaj 3�L#taric �BlS3triLt Committee In the Town of Barnstable R Vvpq CLERK BARNSTQBLE, fob ,,SS. CERTIFICATE OF APPROPRIATENESS pis Jb _9 AGM t0 4 9 �lication is hereby made,with four complete sets,for the issuance of a Certificate of Approprlateness under Section f Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, wings, or photographs accompanying this application for. IECK CATEGORIES THAT APPLY: Exterior building construction: ❑ New ❑ Addition ❑ Alteration Indicate type of building: ❑ House ❑'Garage ❑ Commercial 11 Other Exterior Painting: Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Re ai ting Existing Sign �� Structure: ❑ Fence ❑ Wall ❑ Flagpole Other rpE OR PRINT LEGIBLY: DATE )DRESS OF PROPOSED WORK ,tom ��Ri�(16C3 (EC ASSESSOR'S MAP NO. 3� NNER C--L— ASSESSOR'S LOT NO. )ME ADDRESSEa(a T�C)P did INC I�K�E C�- — TELEPHONE NO. 9� JLL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any Vic street or way. (Attach additional sheet if necessary.) A1_L_ LZ C_ e = I�1 E Js t.._.�•- o v16 - .� o T ,O.i`' TI ` �Ck SENT OR CONTRACTOR W�L'L' ��� � EPHONE 1�0.$_ DDREss -Mai" A 4J2�z�: ESCRIPTION OF PROPOSED WORK: Give particulars of work tp be done, including materials to be used. Please ,clude locations of proposed signs. Signed • T:N7- o6l tra tor--Agent -or Committee;Use Only U Ii MAY 0 5 Z005This Certificate is heAPPB Date L' ;T. Approved/DenieTO!'IN OFCom s Signatures i PE, RG0LA STRUCTURES A. FRFFsrANDiNG � -----� = PERGOLA This 13'x I V pergol struc- 4 ture(16 x 13'8" cluding am csvl r ang)stands on s h four,5'rS"square posts 12' long(for a 3 foot burial),and topped with Colonial Post Caps.The four 2"x 8"carry- ;;; ing beams are 16'long and hold the ten 2"x 6"x 13' 8° long cross members,all of which have curved end cuts- "" Ten."x 2%"laths with angle ^'- end cuts sit atop the cross mem bers.Stained white.Shipped kit t' Motor freight BE #140260 $5,950 . if this design does not fit your r'1 ' needs consult your Walpole Representative for the many sin - and architectural possibilities- r B. GALLERY ARBOR „ Choose the width,length and decide how enclosed you'd like your arbor to be.Start with an Anchoring Bay of 4 posts and curved spindle i top,then add Extending Bays to desired length.Lattice side panels are x ? I unnecessary for a formal grape arbor or patio cover-Otherwise,fully �-� enclose with lattice nels to create a gracious walkway.All stained white 1"" \ Shipped kit.M r freight ME . . ' - - if t - _ c it !r+ } t ANCH NG BAY .-V sq.arches with spindles and four 4h"sq.posts - -'.' — ith collars.43"D. 4i5'W, #294290 $995 I ` ""°• ., i T # 'W, #294291 $1,395 " MAY p 5 200 I 1IIrl NI ' �I t ITA� �11 F ING BAY _I��, � One 3%" h with spindle`s and two 4%"posts with collars'38%i'D W, #29 2 $649 it ' yam 6'W, #294293 789 Illjl, s t ■ "�Jt I tl Y LATTICE PANELS 5'H,34"W.HorizontaUv cal lattice with 5°openings. #294294 $169 EXAMPLE: ;. 4'A"Wide Gallery Arbor as pictured: - 1 Anchoring Bay= $995 1= $995 4 Extending Bays= $649 x $2,596 7 Lattice Panels= $169 x 7= $1,183 TOTAL$= $4,774 �. �-�- � �� . �- ��.J. . . . . f���--� _. . o ��, ����� . - � � ��, � � �.a� ��, . � � ��; �� �- ..._.__..�M.._: ... ... ._ . . . .. .. .. . ..._.-- i . . - .. i. I ''. F �.�. �. I i . _ ... i .. . ` .i .. i . . •__ � i ,; � 1. .. . .. � j .. . - i . --�---L , .._....; �� . -. ._._.. 1 , .. ... +1 � �,. _ . �.. i WALPOLE WOODWORKERS, INC. !M hl LEN MAKE ALL INQUIRIES TO ADDRESS CHECKED D E.Falmouth,MA 02536 Walpole,MA 02081 Farmington,CT 06032 Greenvale,NY 11548 Morris Plains,NJ 07950 508-640-0300 508-668-2800 860-677-9690 800-599-6682 973-539-3555 Framingham,MA 01701 Wilmington,MA 01887 Ridgefield,CT 06877 Water Mill,NY 11976 Warwick,RI 02886 508-875-6668 978-658-3373 203-438-3134 631-726-2859 866-866-5765 or Nwell,MA 02061 Westport,CT 06NO Great Fails,VA 22066 781-681-9099 203-255-9010 888-880-4411 CUSTOMER NO. DATF� ORDER NO. BRANCH CLASS OTHER YES NUMBERS S J G J Q G ORDERS NO BILL TO NAME SHIP TO STREET STREET/P.O.BOX CITY STATE ZIP CODE CITY STATE ZIP CODE THIS AGREEMENT DELIVERED TO WALPOLE WOODWORKERS AT(ADDRESS) Contact Home Phone Daytime Phone Sal Sales A LT N SG 161?- \115N7-c QUANTITY DESCRIPTION t .. .. . . .... ... ... ``t !t�� 7 t `• r i LAYOUT—IN LAYOUT,LAYOUT;FINISH SIDE FACING ON EACH LINE.OF FENCE GHEGK LIST ADD'L DRAWINGS �l STAINED ti CLEAR FENCE TAEES/STUM S IN r I _ FENCE LINE P IV n� MA]L r I FENCE ON WALL CORE DRILLING OF HlS �i EX)OZJ BRING COMPRESSOR _ _ .. -: - s ✓Attf. TAKE DOWN J DISPOSE OF FENCE STEP SECTIONS EXTRA LONG PO .. _....._. .. ........ - ___ F-. 1/ STS RACK SECTIONS TOP OF FENCELINE STRAIGHT t T<tk t e(Q CURVED SECTIONS PAVED AREAS .a.l Y WIRE /-.'.. .. ON FENCE /� � k INSIDE OR OUTSIDE UNDERGROUND `. C_ + L - t l< j c< PIPE OR CABLES �y Z , SITE AVAILABLE: `c.\< v l •��G.r �. V ob DIG SAFE X ■I�I�I�I■I NI■I�I�I■I_ d 36ul+%wdddc#dK L"!i IL .� Iltf,,v .� .. ca �► =*4a Vp .. _ I _ a&CIP) —dakbt p in wow 41 _ - - lij fro U-71r■ ■ rar ■ ■ii■ � -� G • LL G�Ei!➢ v i� iii ■ irG � • ■•• � ii� i I ,aG iiii� ■ �iGG�4lia� -,-il��. 4!���1��- i�.- _ � � i•� _iiSG.i ! �•ii•;ii�� � iGii�. SF�aii'SiiGii`i� �i ` �r •iiEi._ ■ iii-:i�i ��■ i�•iir. �fi• i0 iii iii . i•ii�i*i.a ri• -i." �i� aii �GG�i, ■ ■ i iGi�■ r►� ' i ;iii•iii.:➢ iii � ■'aiG -sii■ y3 "��iyiGi i 1• �:i� i�iiiS iii• ;■ � �� �� � ■•�i'' iii " i ■aii" - si e,iG G-s•G •Gii.i -i G i- i r G'i ■ ■�• ••.G,i ;,t--- --- - �� -- s- � 5- -i -�- Eii �•ii � � �••• ■■ i � i � ii-'sir. iG• i�?iGie�i! E • Gi•�i�� IaGGiG �i! iG•i-i i, ■■ Q.§��� �. •- �i _ --- - ; - - - - .. t f -- - The Commonwealth of Massachusetts • Department of Industrial Accidents - - Office of Investigations 600 Washington Street, 7th Floor Boston,Mass. 02111 Workers' Compensation Insurance Affidavit:Buildin lumbin /Electrical Contractors name: O ��— address: J �c _� cityW tate: zip: ne# w ocation full address): a homeowner performing all work myself. Project Type: ❑N onstruction[]Remodel ❑ I am a sole proprietor and have no one workin in any capacity. uildin Addition ❑ I am an employer providing workers' compensation for my employees working on this job. Ps'_s�T. ?'id' •" + - r •da v'e�{...i:y'•z.?:°::£'i-'Y p Cw,air 's••(:s: p T';�_,L'°'t:" 'p.:.:,. 7 ;'.r u, • '< ��`b .. ,.,r.:- :.fPd14 <ta.,•+y-. _..ya'. >_� Mi s4-.rt 1»�'•J, .n -3�F.'23'J iitt •Y,..,. 'J .� } - v: fit, ... -:Ll•='h' .,qa.g': ea,PS'L i F1:r'. -{ Jtl.. __ _ .. )'�:y?.,J:'L.::'.�,..:z': :•�� %`;y.. �s r M•�M '7."s.. ;nr•i:',,,. �. t'•tt:.. 6:':.;r.. ,k a• 'L,,::a:r.:Mz:��, �,�•<:� :J•!.mot':. _ .k° `6 .� -...rr.• .rf:.... ,�"•". . ..:Sy�*y.;Ws.<'ti ._J�?e ":t• �r•S+-. >t.iii". .w' ..rr R:•:.n 'rk `t .: ;•rd ..i=`, 1:`�::"q:$'e.•t>r<'.. i�t.� _ .1 'Pr n •'Y*i P• i{ :CI- k .s�rr•�,. _K; :;n�i'...t>:...:1.4 ...'�..1�.`�' •�e:Xl'�� ffl'K �';`^-:c'f:':,J::!. {, ,y 'r' rop��?F ��'"y4s:° y.l� ��`� �c�'-� ��'��'- +'�,'7` + �t x��3, a;�:;;..;.'��r'�,r��^r at�{-��•r rn Tr � :,.,J�f. - �>v'.�ri. r. -�:.,`�� sh: `.�.43 " }�'rt'�' ��.:�-"r.}��; _�5 ��c'" �T•x,y."'<s�a`f`'L,a�'a r r...'u��..{,�r�t���r +lt��.•�ix� t -� � � -'tri0�'.i - - . ;1nS11E C :GO��.:�t,v���da'sx�'"'°'.�•.J.i.7r_;:r� ::'6� ' �, - -.-m+.:� �_.,e.a's>'�Jsr:Ec.+^wd?> 011l• .Jf,,,.-}4.:y, t ..'sJ r:v.: �:J:�S?S.%.,' - - I am a sole proprietor,general contractor,or homeowner(c cle one) and have hired the contractors listed below who have • worker in ensation polices: the following s' co .s#fi,rla.�5 -*dry-• s'?rr„d•�y,:_�'i+�l''•i�t'e,-'v:'r °����p'11_'9•'.; g;.�. �s;.f _. _ , .r, a., d;�'J..S • "WO d )COm an ame""to'�r t m� k S R ';`` 't.',,V , , ...•�: •a'� J"'si:,�,°•� -�� �d' f-� n �3 •,, 5r�x'�r ,tr .uY'''��°>''?r+.':F�'l?;�'.^',v�r-y 4tS� ?S �' # rt 1n•�� fires iE rs v�- a ,L?ti.s � _ .r arcl_ :,a i y'' y '.�G%!-.'�?::{J �".i�{ - ht., •. !•r .. � sr Ott: u � rk> 1'��'�'i. , 'nc.P;;.y. c `kc � 4 ,�� 7 J- r ' -� - �- •� a J• �J�i�a� t} r ;fie. k _ � >� j ' done r .'371511 7a'IC�+'4_ P�- S'.5 .I "�'!• �kG7il ' `'`"✓•��,. a ir. -•4'.'L. kv.� }:.�F`.•rt$•N:, Vlr(ti !r}f :.wr�. ..-9..Ai'':tis.�, - 'a �ti(.`� '.:7°��ri7:y..:'^• » -."z.f f .�:•.... E :-L..'�.rye.:' �-,:; 6T`ra`6.:. :• 3r..L;;''., i�.fir:.. r.-t ..S•. - s:J�rr..'• ^1=.: r.rt�'t•';� .Jn ,,N ry S: '•0�711-al{'. "aR1C3�.��e.rx�'wr�ah� .,u.. .".-..a >;...� e@e+ M1�, •_ar -:e?s? ._a: 'si'r:r v:3-- �,,s�C vi+z- .�y..r .Y• :nv.�. O.,i - ew. e` '{} j S:�r--•r qI��{ `1.:j'r�'s p::'E`d:� ,.i �',�. 4'- ..A rJ?i �:� �¢�.q M�• � I�::t.. ,MJ',:Y '�'.��"�:.�l L::•:rylr:;.��'.1�,4. ':A.•���.� —.l_ 'a�Q �SS:.. ..irr.. �Y. m ard� -t.,'fs..."2 '�..� J a: .s,."3: .,....�:r�y..�'b s,.eua' , '� :::>�3•.,..,.,�r �t r r -'�_..j�p,xy'Aa; �' ���.. .�? -Ci\'_ _�'}p• w. 1+.•f+�"`.�.!'"Yc h i".Y?Sa if ,��,� ::lr;q�.0•.',_:.VY .:.K.{:,. 4�•h`l�}� ;j ;y:�.fi?.r;�: '+ -y ''� o;"' X4-%s ,,,,�•�0t s arr,txy, rdaVt�'ri t '.'...' �d' F•� v,�� lnsaran '�`O'.'"•'� ..il'�N�vX''be��4�.�.'S�s.•, n.i,-t?x yPA.��n; �t.,�`"sy.1` g�` } ���L.t i,d.m d •'f w w +. w�L�'.">L� &-,.t'�"r..asf':o.,'rrl,..S °,.a iJ.�J-,7w .OIIrCo �TFF�can;.>�£'t:,•r.��'Ar .x.ox }: �Y,.-�'-t;.e �'�_ .5.�-,..M.a_: Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify a in a pena ties of erj that the information provided above is true and correct. Signature / ( Date Print name --�°--- Phone k official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑ ❑Licensing Board check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (revised Sept.2003) I Information and Instructions Massachusetts General Laws chapter 1,52 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law",an employee is definedas every person in the service of another under any contract of hire, express or implied,oral or written. An employer is defined as an individual,partnership, association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not.produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work-until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking.the box that applies to your ktuation. Please supply company name,address and phone numbers along with,a certificate of insurance as all affidavits.may be submitted to the Department of Industrial Accidents,for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the.Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom.of 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. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street,?h Floor Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900.ext. 406 I1 p*1HE tOk, Town of Barnstable Regulatory Services : BAMSCABLE. v HAss. Thomas F.Geiler,Director 1639. IN 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 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: Estimated Cost Address of Work,=,4a Owner's Name: -1, a - 0 ( —`,_ Date of Application: — I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law []Job Under$1,000 QBi Ading not owner-occupied er pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date �__Zjr s Name Q:fomis:homeaffidav oFtHE,� Town of Barnstable Regulatory Services BARNWABLZ ; Thomas F.Geiler,Director MASS. 1639• .0�A Building Division ArFD A�A'I Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION q — ti — a Please Print DATE: JOB LOCATION:,O(o B VR A I(V& 7Pt"27_ C 66• FE—L-OP P- `vTNP�� number street L village "HOMEOWNER":�� �'�^f .�— \\ Z� 21 ` a/ name home phone# a work phone# CURRENT MAILING ADDRESS: StS 8�11A C" 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 W requirements and that he/she will comply with said procedures and requireme Signature of r eo� er Approval of Bu'Hding Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt f •-� .� ) Map �. //Parcel � �ermit# House# `f Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00- ?. I r' Fee_ 9 0 Conservation Office(4th floor)(8:30- 9:30/1:00-.2:00) Planning Dept. (1st floor/School Admin. Bldg.) SEPTIC MUST BE Definitive Plan Approved by Planning Board 19 INSTAL PLIANCE 5 ENVIRO CODE AND TOWN OF BARNSTABLE 'OVY B-uiilld-ing Permit Application i Project Street Address c i �ti 4 e Village kri Owner Address a14 4x 54 6yo a. On Telephone 1 r Permit Request �;& UzW !gA� 'Nky-(-. 1f1,Psj �o} �rN.2y- AO C&2k5& —a First Floor square feet Second Floor 247 square feet Construction Type Wc� Vq.2CWt_ CaL.SVV('a;o ff Estimated Project Cost $ Ck,Oco Zoning District Flood Plain Water Protection Lot Size -__1.25 Acen Grandfathered ffYes ❑No Dwelling Type: Single Family Cff/ Two Family p Multi-Family(#units) Age of Existing Structure Iq Vk- Historic House ❑Yes C No , On Old King's Highway es ❑No Basement Type: ❑Full ❑Crawl ❑Walkout 1`6* ther Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No. of Bedrooms: Existing �0^ New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil p Electric ❑Other e)okk Central Air ❑Yes id N0 Fireplaces: Existing '"t>" New Existing wood/coal stove ❑Yes <0 Garage: f�Detached(size) <?n<tXJ 24(17(0 Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Au orization El Appeal# Recorded❑ Commercial Yes o If yes, site plan review# Current Use i Proposed Use Z ` ii 11 Builder Information �I Name Glen e Telephone Number Skc- 30- 'T 7 Address nn�0 License# Q j y l y 4 \`dint.. (3, G Home Improvement Contractor# B' lq 5-1q Worker's Compensation# 6 n -Q(" 1pq 6G 06-&"12 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TOtv SIGNATURE DATE 1 BUILDING PERMIT DE IED FOR THE>a� LLOWING REASON(S) A. Y ti FOR OFFICIAL USE ONLY 41 PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE ' OWNER v DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL- PLUMBING: ROUGH FINAL GAS: ROUGH- FINAL FINAL BUILDIN -2 �` D DATE CLOSED ASSOCIATION PLAA NO.'' 1998 089 Application to Old King's Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: ❑New Building ■Addition ❑Alteration Indicate type of building: ❑ 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 DATE March 25, 1998 ADDRESS OF PROPOSED WORK 26 Burning Tree Ln, W. Barnstable, MA ASSESSORS MAP NO. 136 OWNER Joseph and Nancy Gill ASSESSORS LOT NO. 026 MAILING ADDRESS 22 High Street, Southboro, MA 01772 TEL. No. 508-481-0572 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). SEE ATTACHED LIST AGENT OR CONTRACTOR Fenuccio &Richmond.Architects TEL. No. 508-362-8382 ADDRESS 923 Main Street, Yarmouthport, MA. 02675 DETAILED DESCRIPTION OF PROPOSED WORK. Give all particulars of work to be done(se No.8, other side), including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). Construct new 28' - 0" long shed dormer at rear of exisitng barn Ep n Signed �� i "pktl�-�•" Owner-Contractor-Agent U �! s u I Space below line for Committee use Receive "�by`tH:D70. 2 Date ThenCertificate is hereby Date �L Tim a MAR 2 6 Igo; � � e �� � ByDWN OF RAC-- . 4 40�v,*a4&"y,0, i-U ING'S MIG W_ 'y! Approved ❑ IMPORTANT: Certificate is appro ed, approval is subject to the 10 day appeal period provided in the Act. Disapproved 13 i Town of Barnstable Old King's Highway Historic District Committee SPEC SHEET FOUNDATION NA SIDING TYPE White Cedar Shingles COLOR Natural CHIMNEY TYPE NA COLOR ROOF MATERIAL Red Cedar Shingles COLOR Natural PITCH 4 : 12 WINDOW Wood Double Hung 12 over 12. SIZE Varies TRIM COLOR. .White DOORS NA COLOR SHUTTERS NA COLOR GUTTERS NA DECK_... NA' GARAGE DOORS NA COLOR, SIGNSff r FENCE NOTES: Fill out completely,including measurements and materials/colors to be used. Three copies of this form are required for submittal of an application,along with three copies each of the plot plan,landscape plan and elevation plans,when applicable. Plot plan need not be "Certified"except for new homes;but should show all structures on the lot to scale. SPECSHT f ABUTTER'S LIST for Joseph and Nancy Gill 26 Burning Tree Lane West Barnstable, MA 02668 . Map No. 136 - Parcel No. 026 Map No. 136, Parcel No. 025 Audrey M. Loughnane 26 Point Hill Road West Barnstable, MA 02668 Map No. 136, Parcel No. 027 Carey and Mary Margaret Congdon 570 Park Avenue New York,NY 10021 Map 136,Parcel No. 028 Anne H. Bates 25 Burning Tree Lane West Barnstable, MA. 02668 Map 136, Parcel No. 052 Robert E. and Dorothy Sansonetti 48 Vista Terrace Cheshire, CT 06410 Map 136, Parcel No. 14-2 Robert W. and Grace L. Russell P.O. Box 215 West Barnstable,MA 02668 of st+e T The Town of Barnstable • Matra A11M • Department of Health Safety and Environmental Services BuiIding Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commission: For office use only 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: —Est. Cost •ow Address of Work: Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following renson(s): Work excluded by law Job under S1,000. 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 pw er. Dale Contractor'Nam Registration No. OR Date Owners Name i _ The Commonwealth of Massachusetts Department of Industrial Accidents Olfice ol/alrestig Vos _ 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: e:3Gz�V-:3e__ U location: �19 Q city JU Q . ZJ�9 phone# M\;24," ❑Xam a homeowner performing all work myself. [y7`I am a sole proprietor and have no one working in any capacity ❑ I am an emplover providing workers' compensation for my employees working on this fob. tom anv name: address: city phone#: insurance co. olicv# ❑ I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: ::.....:........ company name: address: phone#: city ....::.:....: . . Ifisurnnce ca. cam anv name: address: city- insurance co.. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties a fine up to 51,500.00 and/or one yeah'Unpritonment as well n dull penalties in the form of a STOP WORK ORDER and a tlne of 3100.00 a day against me. I understand that a copy of this statement y be forwarded to the Offfce of Investigations of the DIA for coverage verification. 1 do hereby certify.: and penalties of perjury that the information provided above is tru,and correct Signature Date Print name Q.�"' . 1'Z Phone# �d�' oinciA use only do not write in this area to be completed by city or town olIIciai illy or town: permit/license it ❑Building DeQsrvttent ❑Licensing Board Dose is required ❑Selectmen's OMce ❑check if immediate response q ❑Health Department contact person: phone M, ❑Oef�� .......... ...:.... (trnsca 9i95 P1A) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a . dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the _ commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain'a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of 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 penmit/license number which will be used as a reference number. The affidavits may be retunned ie the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents -t Me of Invesugadons T, .R:.... 600 Washington Street Boston,.Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 y, I _ I ECTS l oii /11 \ � I I i \ / 1 / 1 PVO,fIUN = o r l� � S � I' J � R 'S I GG — — i f c � Site Plan 1" =20' -U" I- ' Information on this plan was taken from a Ce•titied rows ov enr Plot Plan dated 12/4/97 by Yankee Survey Coisultants. Marstons Mills. MA l.orTimonweafin OT massacnusetts .......- Department of Public Safety/ Board of Building Regulations and Standards , LICENSE RENEWAL APPLICATION ❑ Check Box if you have a change of address- prini new address/corrections below. li � i. GEORGE W BLAKELY 21 130 REDWING LN BOX 206 _ BARNSTABLE, MA 02630 i I Construction-CS and Hoisting-HE must have 1" X 1 1/4" Photo. 03/20/1998 RESTRICTIONS DESCRIPTION: 00 00-None I-Masonry only 1 G- 1 &2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. 'LICENSES NOT RENEWED BY THE EXPIRATION DATE SHALL BECOME VOID,AND SHALL AFTER ONE YEAR BE REINSTATED ONLY BY RE-EXAMINATION OF THE LICENSEE.' (Authority C.43,C.146,C.148,MGL) ENCLOSE CHECK OR MONEY ORDER FOR THE REQUIRED RENEWAL FEE(PLEASE SUBMIT A SEPARATE CHECK FOR EACH LICENSE RENEWAL WITH THE THE LICENSE NUMBER WRITTEN ON THE FRONT OF THE CHECK.DO NOT MAIL CASH). MAKE PAYABLE THE 'COMMONWEALTH OF MASSACHUSETTS°. MAIL THE ENTIRE RENEWAL FORM WITH PAYMENT TO THE ABOVE ADDRESS.ALL CHANGE OF ADDRESS REQUEST MUST BE SUBMITTED IN WRITING. I certify under penalties of perjury that to the best of my knowledge and belief the license information above is correct and I have filed all state tax returns and paid all.state taxes required by law. (Authority: C. 62C, S. 49A, MGL, as amended by C. 233 Acts of 1983) Sign lure of Applicant Re uired Date THE,CONSTRUCTION SUPERVISOR LICENSE MUST INCLUDE A PICTURE OF THE LICENSEE MEASURING 1" BY 1 & 1/4" PLEASE WRITE THP LICENSEE NAME AND NUMBER ON THE BACK OF THE PICTURE. p f fad' .✓/2e�VdlXryJ20lt[!/CCUA/(• O/�✓.'GQ.aQQ�C�llIdE -r V`'O }' A �;. :8 Restricted'To': 00 ° DEPARTMENT OF PUBLIC SAFETY w 519 CONSTRUCTIOtftSUPERVISOR fICENJE OB - None .. A m CA ., F Number„F • Expires: i 16 - 1 6 2 Family 4eme's' 3 c0 4. m Restrftct'ed.To 80 a r e s Failure to*possess a curqnt edition of the I. ' , ' N-0.r vco -r F Massachusetts Slate Buii?.ding Code v, • a p ".;:.6EORGE W BIAKEIY is cause for revocation of this license. 130 REDWING LN BOX 206 0'' CO x a BARNSTABLE, MA 02630 { r N —1 THIS IS A QUOTE; NOT A POLICY TravelersPropertyCasualty� WORKERS COMPENSATION n Mao h—f TravelersGroup AND, The Travelers Insurance Companies EMPLOYERS LIABILITY POLICY (Each A Stock Insurance Company) Hartford, CT 06183-4040 QUOTE PROFILE VERSION 001 INSURED'S NAME AND ADDRESS: ;'R OLICY NUMBER (6N-UB-696G630-8-97) BLAKELY, GEORGE W RENEWAL OF (6N-UB-696G630-8-96) P 0 BOX 206 ;.,. BARNSTABLE MA 02630 f``' WORKERS COMPENSATION INSURANCE PLAN s A/R (WC I P) # MA POLICY PERIOD FROM 12-12-97 TO 12-12-98 TOTAL ESTIMATED ANNUAL STANDARD PREMIUM $ 405 PREMIUM DISCOUNT NONE 0900-20 EXPENSE CONSTANT 95 TOTAL ESTIMATED PREMIUM 500 DEPOSiT AMOUNT DUE 516MP Etc EMPLOYERS LIABILITY BI LIMI0-: $ 100000 EACH ACCIDENT 500000 POLICY LIMIT x 100000 EACH EMPLOYEE ADJUSTMENTS OF PREMIUM SHALL'� BE MADE ANNUALLY �c�csc4c�c�c�'c:c:c�4:c c:c�;9c DEPOSIT AMOUNT DUE $ 516 �c�:�c�c�cuu:c9cu�;�c�cxu -----------------=------------ POLICY NUMBER 1't (6N-UB-696G630-8-97) '1 r r DATE OF ISSUE: 10-23-97 RA ST ASSIGN: MA OFFICE: ORIND 161 DISTRICT:-C-09 PRODUCER: RIDER RISK SPECIALISTS 28XXD y,t TravelersPro ert Casual P Y t3'J n MC WORKERS COMPENSATION mn«or TravclenrGmup AND. The Travelers Insurance Companies EMPLOYERS LIABILITY POLICY (Each A Stock. Insurance Company) Hartford, CT 06183-4040 j QUOTE PROFILE - VERSION 001 :'yfi,POL I CY NUMBER. (6N-UB-696G630-8-97) INSURER: THE PHOENIX INSURANCE COMPANY , 'INSURED'S NAME: BLAKELY, GEORGE W 12610-MA ", PREMIUM BASIS ESTIMATED RATES ESTIMATED . TOTAL ANNUAL PER $100 OF ANNUAL CLASSIFICATIONS CODE REMUNERATION REMUNERATION PREMIUM LOCATION 001 01 FEIN 032385288 ENTITY CD 001 BLAKELY, GEORGE W P 0 BOX 206 BARNSTABLE MA 02630 CARPENTRY-DETACHED DWELLINGS 5645 ,; IF ANY 15.25 ADD FOR MINIMUM 355 ------------------------------------ -------------------------------------- EXPERIENCE MODIFICATION NONE MODIFIED. PREMIUM $ NONE�r OTHER PREMIUM :CHARGES LOSS CONSTANT 50 TOTAL ESTIMATED ANNUAL STANDARD PREMIUM 405 PREMIUM -OISCOUNT NONE EXPENSE CONSTANT 95 TOTAL ,ESTIMATF11 PREMIUM 50 4.00% MA WC SPECIAL FUND AND...'TRUST FUND 16 DEPOSIT' AMOUNT DUE 516 DATE OF ISSUE: 10-23-97 RA ST ASSI.GN: MA SCHEDULE NO: 1 OF LAST 4 y 7 ! V 1 i ��� . `. xY.. w , ie-C, d •. i' if � �n� r 'r. d i' a..::. �` - t i�t 7'c,� s�- �'`(`LE.7` �T.a �y r 1 �,2 !^'?•�{.� .�r'�'`4' +" g$k'h h �'�' y t i is 4, 9 �l• :'` . 17 Qj y T yrj rir 1 � � �r � I. JI. � !` 1 •f.l�`a. •; „x���'� ` :` :i x s# 1 :c c,f.: 1 / I �T ,� I � a ,x -�- v,a,oi�,�,?!•-ram�.:' y � F' r r• J a4, Ara),-, pa r T n i 3L� FOstan o IN a3ius` r-�L V -2 . .29 '. view �ovtur�e•'Mz'tc�„ asc �X �0 Q�,p-�pz1 SSA 4law r-) 2A 5 zv a I r !g2 A6 A.M. 136/14-2 a 8 2 � M N P/P6 A.M. 136/52 I'(0m'9J w t lbg,93 i r � 1 �I i a'gb E I� A,N63 q i I � I -=GARAGE I-i A � SLABI= ��. I f J, ca q1.q J.:=_� `°• .o o' 0 ��� bpi E1�N/? to 10 .E.YIST%NC O Po -:-HOUSE• ( YIN/4 �? -_-_•SIL4£[d'N __ ! 62.5' ^�y LOT 10 u"DAnON A.M. 136/25 N /' so MOO 0 (EOM16 (n (VACANT o _►a�uvc, ,0 \ <s�" 11, 1 ova � 44 LOT 11 AREA=62,916t S.F.,,.••••••• i qll = ti/r \�� •.,` AINAG IpE) UAUTias° ( DR 20 '8 EON/s �., • MMIJO ---•------ lave ° s VACANT BURNING TREE LANE LOT 12� A.M. r3s/z; WWI FLOOD ZONE "c"_ FO UNDA TION CERTIFICATION RES ZONE.- "RF" TOWNBARNSTABLE SCALE.-1 "=50' PL. REF.'249 107 ELEV N/A I CERTIFY THAT THE ABOVE YANKEE SURVEY CONSULTANTS FOUNDATION IS LOCATED ON a Of P. 0. BOX 265 THE GROUND AS SHOWN, AND p y�J UNIT 1, 403 INDUSTRY ROAD ITS POSITION �Q=___ __ a CONFORM TO THE ZONING LA ME MEW " MARSTON,S MILLS, MASS. 02648 SETBACK REQUIREMENTS OF TEL: 428—0055 say FAX 420—5553 _ BARNSTABE,ez �L�� ____ p� �aosg PA U� ERI�THE DATE' 12 2 //98 N�oB 1 L_ UMBER51481FND ______ NOTE. THERE WERE NO SEDIMENT CONTROLS AT THE SITE ON 1112100 WHEN THE FIELD WORK C`gP�' COD BA Y FOR•THIS PLAN WAS PERFORMED. THERE WERE, HOWEVER SEDIMENT CONTROLS AT THE TIME OF CONSTRUCTION A9 SANDY ONECK ♦g BEACH Locus AM. 136/14-2 � 4— P� o IRON P/PB A M. 136/52 GREAT e s Ilk p MARSHES 6 9 !� 1 t ,L I 08 s AL Llt Ita _ t a t m =5p0 ;;_ AL LOCUS MAP -GARAGE.---_ 5z 9' (ON SLAB-_- v:h �� '`,� ASSESSORS MAP 136 _- _- =_-__= ' o cRass t RES. ZONE. RF" m <\ - `� ___=________ � t, 1 t a PLAN REF. 2491107 =-- Y 'blvvrs -___-__=�B_-= —50.2 b EXISTING CONDITIONS PLAN -- ------------ OF LAND AT LOT 10 ; ____•a� i w� AM. 136/25 N — r =_ �H 5o.e t x 26 BURNING TREE' LANE' "° (VACANT) c ,1 " BARNSTABLE; MA. o p4 it •� ,d. 3� cis^� c ,�,�/7 k� PREPARED FOR: LOT 11 -- J.OE GILL i i 1 -$ A.M. 136126 I i ��~� E IA=62,918_t S.F. ~� RE -,-- EOi, \ A JANUARY 1.3, 2000 Pal�l `� ur/crr/�s °vi OF If �1 0 = ~ ; '�.`` ---'.-Dg2oADE) GRAPHIC SCALE ,� o Leo SIIAL� rom//o ao o zo ao s NO. 32M BURNING TREE LANE — � c IN FEET ebv/// d2 1 inch = 40 ft. LOT 12 7 CERTIFY THAT THIS SURVEY AND PLAN WERE MADE D i AM. 136/27 \ ��p IN ACCORDANCE WITH THE PROCEDURAL AND TECHNICAL L YANKEE SURVEY CONSULTANTS STANDARDS FOR THE PRACTICE OF LAND SURVEYING IN SAY E UNIT 1, 40 INDUSTRY ROAD TH MMONWEALTH OF MASSACHUSETTS. 0 5 2005 P. 0. BOX 265 MARSTONS MILLS, MASS. 02648 I zo 8o T p WN pF g k TEL 428—0055 FAx 420—5553 PAUL A. MERITHEW, P.L S. A HISToR,C PA S VAgtE REERVAlipN , J.# 51481A GGM .i