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0054 CARLSON LANE
V L/�"_'�'"G� ',i 1 '�_ .. �a :i# �f i i U rS �. i r kk�� f ', a; .f �' � �i ., �' ��� ;� 't t j �� ,� '� K _,. IM, S' �- 1,-e,,�T C� r`-' U�6 �� �2., -i/►-�C�,,� .... w G �i �77 1 i r IM .: ` ' .�: Town of Barnstable-• ;,�ABiB, .:, Post This,C-�ard M,'r', '�' •. ��aa"x���,^�ad'�5�Mu'ss`sm't�'b���seR:Kept Building ? tV m ssbe eeApdPn a .S y� ••�:. � . �a ¢, Posted UntiliFlnal�Inspection�Has BeenMade.;' °•• `�e���,r��, ��. rz�s �� x ���,���,,< �� Q »& ". ::� _ ,> Permit . � Wherea�Certifcate�ofOOccupan�cy>�sRequir�eci�,:such�Building�shall�Not� be�Occup�ed�puntin�I�yF�a Inks-pecton�has evade. Permit No. B-17-4180 Applicant Name: SASSONE, LOUIS P&KARA L Approvals Date Issued: 12/04/2017 Current Use: Structure Permit Type: 'Building=Siding/Windows/Roof/Doors Expiration Date: 06/04/2018 Foundation: Location: .54 CARLSON LANE,WEST BARNSTABLE Map/Lot: 133-063 Zoning District: .RF Sheathing: Owner on Record: SASSONE,LOUIS.P&KARA L _ "5Contr Names Framing: 1 s- tC',,y Address:• 54 CARLSON LANE Y' �. � 4 ., nt ctor Lices?� a 2 WEST BARNSTABLE, MA 02668 Project Cost: '..$500.00 u �r Chimney: - Permit $35.00 Description: reroof(stripping old shingles) '- t Bf'. Insulation: *Fee Paid:f $35.00 -Project Review Req: 12/4/2017 Final: q Plumbing/Gas � nw Rough Plumbing: it Building Official Vt Final Plumbing: g. This permit shall.be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas:' All work authorized by this permit shall conform to the approved application,and theapproved construction documents for which:this permit has been granted. ! s All construction,alte ratio ns•and,changes of use of any building and structuresis�ha be in compliance with the local zoning bylaws;,d codes. Final Gas: PA This permit shall be displayed,,in a location clearly visible.from access street or road and shall be maintained open for,,public inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until'all applicable sign atures,-bythe Buildmg,and=;Fire Officials are-provided on this permit. Service: - Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing > .- 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy , Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until-the Inspector has approved.the various stages of construction,, final: "Persons contra cti ng_with unregistered contractors do not have access to the guaranty fund" (as set forth-in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT J Q U*O ) co, � y Z Z) .�.,c Ada , a v 1HE r Town of Barnstable *Permit# p E�r�res 6 months from issue date Building Department Fee EnaNSTAB Bri an Florence, CB0 6 039�- elm' , I �i uilding Commissioner S25, AIFo A �in Street,Hyannis,MA 02601 DEC (�4 Z017 www.town.barnstable.ma.us Office: 508-8�' ��� Ok Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 1� /_ Not Valid without Red X-Press Imprint Map/parcel Number n Property Address �y Canso^ Lo•..R vJec V �c.S"QS"k.e a t(,(,$ [Residential Value of Work$ 500.00 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Lou _] 5) c nq_ S4 Cr..r\5on C,, V42S� cc�c��( Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: VIam a sole proprietor am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Req st(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to TO_& ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is quired. SIGNATURE: QAWPHILESTORMMEXPRESS2017 y � T7ie Comm-omveakh of A&Fsachusetfs Deprartineut o,f rndmstriat Accideu& - - Office ofrntestigataons 600 Washington Street Braston,MA 02M --- w►vtu mas�gflv�dia Wa}rkers' CompensaffanIusurance davit B.nilderslContmdursMec kianslPl=bers Applicant Infarmaion nsnessl0 // Please Print Ey Na=�3jg x Lou i 5 SCA1S50 Ne Addrt✓ss SL\ Crs\SOn Lo..rt� WQ�� Prlz-/\5 .�6 Citylstatezig Phone Areyau an employer?Checkthe appropriate bom ' T f project 4. am a general contractor and I �o P ]ect(required)- I.El I am a employer with I❑ g 6. ❑New contraction employees(f d andfor pact time)-* Nave lured fie sdbr comhr-act= 2.❑I am a sale proprietor orpartaw- listed oathe attached sheet 7- ❑Remodeling ship and have no-employees These sob-conl actas have 8.,❑Demol(tiou waiting for nu-in any capacity. emplo3r m and bare wodaTs' 9. ❑Building addition. [No n-adaecs' comp.Aname comp-insurance I • �required] 5. ❑ We are a corporation and its 10❑Electrical repairs or additions 3_R I am a homeo-mmer doing all work officers have exercised uteri 1 L❑Plumbing repair or additions myself[No woklmrs'COMP_ right of exemption per MGL 11 2 Roofrepairs immranceregmire&]i c.152,§1(4�andwe have no �,/ employees.[No wodcess' 13_ ,' Other coop-iammmnce required.] '$ayaWNczr2thatcbedmboar1roost also ffiootthesectivabe7Aarshatdagrheirwarkea'compensariaapaTieyi Qoa Somevwmn who submit d m sf5dmrd iadkzhn&they are doing Owa l sad dumhi m out d&cm bxct= rest submit a nesysfadaidd mdicotino such TCauhsctaa riot cbecY this box mhst attached ffi additional sheet sbou�g thename of the sob-coahscbo-s�d statE wheths ar mttbose enfitiesbat� employees.Ifthesvb-contactmshareempleyeas,t5eymnLstprwidetheir worke&wmp.policynmabm I ant art erltpIr r flint is prauidirig markers'catrrpertsrdiatr insrirarzca for rrty�entplvgees Ref-w is f ie pa8ry ar:d f ob site information. Insurance Company Name: 'Policy 4,or Self-ice.Uc_ piEatiaaDale: Job Re Address_ CitylStatelzap: Affach a copy of the workers'compensationpoUcydecIaration page(sha ving the policy number and expiration date). Failure to secure coverage as req*edtander Section 25A of MGL a 1P—can lead to the imposition of crimimal penalties of a fine up to$1,50U o0 andfor one-gearinprisonment as well as civR peualties.in the fang of a STOP WORK ORDMand a time of up to$250-DO a day against the violator. Be adtdsed that a copy of this statement maybe forwarded to the Office of Investigations ofthe DIA for insurance coverage verffication- I rIa lreraby calm tkspains mtdpsrialires of f.pedwy'dud infonuatknprmi&d abmv fs h=acid correct Si�ature_ Date: Phone ik " Ogi al use arty. Da not twee in flds area,to be carnpLetesd by city or town official City or Town-. PermifiLicense: +' "5 Amffiority(circle one).: 1-Board of Health 2.lBuilifing Department 3.QVFowu Clerk 4.Electrical Fnspector S.Phrmbing Ea pe for 6.Other Coufact Person: Phone 9: Mf ormation and .untrue ions Massach asvtts General Laws amps 152=I==all empIoyeam b provide worms comopensation fur their emphoyees. Pnisaaot-t-o this state,as employee is defined as.= everypersonin&e service ofanad=under any contract ofhire, espsress or hnphied,oral or wtiften." Air.MTIvyer is defined as"an indxv�partaer314,association.corporation or other legal mdity,or any two or more of the bregoing=gaged m a Joint Vie,and in lu ding the legal representatives of a.deceased employer,or the receiver or t m st=of an individual,per,association or other legal entity,employing employees. However the owner of a dweIIing house having not more than three apadments and.who resides therein,or the occupant ofthe- dwaIlmg house of another who employs pemans to do maintmance,r=truid►on or repair work on such dwelling house or on the grounds or building appa¢teuaotthereto shall not becanse of sarh employment be deemed to be an employer." M- GL chapter 152,§25C(6)also staffs that"every sfatm or local licensnag agency shall withhold the issuance or renewal of a Ticem e.or permit to operate a business or to construct buildings in the commonwealth for any. applicant�vlio has not Produced acceptable evidence of cdmpn=c:e With the insurance covexagerequired_" Ad ionally,M(sL cbapi�152,§25dM states"New the commonwealth nor any ofits political snbdivisians shall elm tiro any contact for the perbxonaace ofpubho work until acceptable evidence of compliancewith the msm-aace._ requ�ea3ts of this chaptca.have been pr =ti-,d to the contracting anfhority." Applicants ' Please fill obt the worto'as'compensation affidavit completely;by checking the boxes that apply to your situation and,if necessary,supply tor(s)name(s), addresses)andphonerammber(s) alongwratheir certificate(s)of i mnmance Limited LiabiiIity Companies(LLC)or LimitedLiabflityPazi hips(LLP)wihno employees other.than the members or partners,are not required to rally workers'compensafian insurance" If an LLC or LLP does have e?mployees,apolicyisregma-ed. B a advised 7ffiat this affida-Vit maybe sabmitted tx)the Department of Industrial Accidents for conf¢mafon ofmsui-.mce coverage. Also be sure to sign and date the affidavit The affidavit should beret medtzofecityOrtownthattheapplicadonfxthepermtforlicenseisbeingmgaestAnottheDeparfmmtof . Lnaasb al A cam- Shouldyou have any questions regardmg the law or ifyou are repaired to obtain a woil=' campensation policy,please calL the Dcpartment at the nam'ber lisfzd below. Self-insUICdcompaniesshonldentrrtheir self-in r=ce Iicrose mnmbm an the appropriate Ime. City or Town Officials Please be mare that the affidavit is complete and prm[nd.legibly- The Department has provided a space of the bottom of the affidavit for you is fill out in the eves the Office of Investigations has to comfact you regarding the applicant Please be sure to fill in the perm>i'lliccose mLnber which will be used as a reference number. In addition,an applicant that must submit multiple p ennit'llicensa applications m any given year,need only sabmit one affidavit indicating dent policy inbrmation(if nccessaiy)and under`Job Ste A ddrm&'the applicant Ehorld w]ita"aU lacati<.ns n (G'tS'or town)- own)"A copy of the•affidavtt that has been officially stamped or maticed by the city or tows maybe provided to the . applicant as proof that a valid affidavit is on file for fatore 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 I@zb�A to any bush=s or commercial venture (Le. a dog license or permit to bum leaves etc.)said person is NOT regai ce d to colaplete this affidavit The Of of Investigations would SMto thank you in advance for your cooperation and should you have any questions, please do not hesitate to give Us a call The Df--RFtnenfs addmss,telephone and fax rtamber. 1 CGo� ttlr of I ch s - ent cif Iudak Accidents f Iff ce of 7ut�e�g��au� Tf,-L 4 6177727-49W Qirt 4-06 or 1--977 ICI SSAFF- Fax9 617'27 7749 Revised4-24-07 WW ��� f ' 1 PoFlHE, � Town of.Barnstable Building Department BARNSMABM • Brian Florence,CBO ��pIEDMAS& Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This.Section If Using AA Builder I ,as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) ** r onsibili of the applicant. Pools Pool fences and alarms are the esp ty pp are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS Rev:10/17 1 V TV u VA ""A SAO L""XI �OFZHE r, Building Departinent c� Brian Florence CBO Building Commissioner v MASS. g 200 Main Street, Hyannis,MA 02601 s6;9- �0 ArED MP'I" www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: SCE Cc�\Son L �QS� `�nS �L4 number street village "HOMEOWNER": Lo,i,j �.SSo� C "88y7 name home phone# work phone# CURRENT MAILING ADDRESS: S 4 Cc-1 city/town state up code The current exemption for"homeowners"was extended to include owner-occnpied.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 T pection.procedures and requirements and that be/she will comply with said procedures and .meowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors),, provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require, as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. .y fr `� Application to f Old Kings Highway Regional Historic District Commime in the Town of Barnstable for a _ CERTIFICATE OF APPROPRIATENESS .ter Application Is hereby made, iri triplicate, for the issuance of a Certificate of Appropriateness under Section 6 oft-hepter470. 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 .29 Addition 14 Alteration Indicate type of building: (M 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 54- CL'i --FC t-1 L-k)-LE DATE 3 177 L 0 0 ADDRESS OF PROPOSED WORK W - tQ s"T-�4,12> ASSESSORS MAP NO. OWNER 1=# tZ�4 W 1 L�©*J ASSESSORS LOT N0. HOME ADDRESS 43©'L 26o&IftL NO. 3(0�:Z• FULL.NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). AGENT OR CONTRACTOR d 1:JBTEL NO.'B *;;L •4-0� ADDRESS �2 4-0 14400 �o"L(oJ 5 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). 10' � 1 O' OIr µ - >z� A P d 1 TI ON I b' J--- (41� x 3$J O is E-.51 OI'ty1 A>Ob t 10►1 p)'11".+Lu{ 1�-to^ 3 2'-0") W 111+ 0'. C A-ppieox)&eea; esA—o �-T-& 'Erlk Ld-.,"j'- eot n � Sign [ � OwnN tractor-Ager►t w line for Committee use. 5&, C �� c e y 'J a (j Certific is hereby D Ti e 720 _ TbWN OF BARN STABLE '. Approved 13 IMPORTANT: If Certlflcate Is approved, approval Is subject to the 10 day appeal perlod 11 D 3 "7 I C44A EL Or . $2rouJ.l 1� Air,L.S ON LAt4 E W . g O --n Cos (0s) vi b 0=60 4(v ai I LEA, mplOr-4144. t 3 7y • tp d- Fj�rb� L- �- Sv�p �-}�t L� t�prp�,QS �- J vtiti\p ez, Town of Barnstable ' Old King's Highway Historic District Committee SPEC SHEET FOUNDATION COt.I� �'�► � ' �- �' r SIDING TYPE G COLORC CHIMNEY TYPEl •COLOR ROOF MATERIsu+�rs � COLOR PITCH Yd©oil .6,Ii nl V I D NGt-Lk�S SIZE Sk i WINDOWS ' L—Ry"T1 ©h t TRIM COLOR G S COLORS DOORS1��—i�I —T COLORS SHUTTERS l 1 � . . COLORS Yl�•�-T�� ��-� �`'7 GUTTERS DECKS 51 W I �4T � � S MATERIALS WA 1-+0 2rA 1`1 - DOORS �� COLORS GARAGE -- U COLORS S...IGNS COLOR T'QI `M •01 n FENCE P NOT89i Fill out cam�pletely, including aeasuzemauto and materials/colors to be wed. Three copies of this three copies of the plot pan. form -are required -for submittal of 'an application' along with landscape plan and elevation plans, when applicable. SPECSHT i LOT 14 � '� 000 � 5 54 �T N s-7 �-rE ,e�%? p,~ AN p ru k,50.5' O AeC rladX4 3Lo ` 4 25 ` l +243 l .5 9.09 6;.54 211 M PLE- �� '\ � Z II co I6 4 v 3 l 60 ' 61 2 MAPLE 2° PLE �' -006 49 086.9 y 171 6" THE l .20 20 23. of .09,� h� 33 4 9 57.38 52. I GARAGE 13 �o°ao �2 2 e,a 8, 916 1 . 2 5 �57. 5 55. q �1 9 S .57 Mb i 5 N 203 5 a . / O N 0 202 . ,30 yq ISTIN�G . • •�o• � .. LOT 11 .,`` 53 0 SE TFa51.76 2 40 Feet '` ` y9 �� , FF=52.54' 49 i7 201 :p �. 48 • as ai / —47 NOTES; 00 - 4 59 ELEVATION ASSUMED ® 50' { 1 Biz IL JO it"' ,j 9 fir• , '}' �5�."�44 .M�' ,��N'.,rs,'+�' y5,� • Y cap it- t• R` FM!*�v ��s!I!.�kI.Slogo �w�+�e' r \ ESTIMA TED PROJECT COST WORKSHEET Value LIVING SPACE (high end construction) square feet X $115/sq. foot= (above average construction) square feet X$96/sq. foot= (average construction) square feet X$57/sq. foot= GARAGE (UNFINISHED) 6 O square feet X.$25/sq:foot= 0 . -- PORCH square feet X.$20/sq. foot= �, �0• DECK 00 square feet X $15/sq. foot OTHER e square feet X$??/sq. foot— ld•���• Total Estimated Project Cost IAHFORM 1/3/00 f WilsonGaragePlan12-00.doc Bodfish Farms MEMORANDUM Z)ate: 12/27/2000 Richard Stevens, Inspector, Barnstable Building Department �n4�ft: Richard Marshall, President, /&/ Bodfish Farms Communi Association Saab : Garage Foundation at 54 Carlson Lane ,geed: Partial Copy, Site Plan of#54 Carlson Lane (West Barnstable), PE/PLS Stamped 5110100 This is to thank you for your prompt follow-up to our telephone conversation on Friday 12/22/00 regarding the relocation of the garage foundation at 54 Carlson Lane, West Barnstable. We appreciate your checking of the garage foundation relative to the site plan dated 5110100 on file in your office. We especially appreciate your discretion in this matter so as to avoid any unpleasantness amongst the residents in this friendly neighborhood. At your suggestion I checked the site plan in question on file in your office, and also the elevation views. They seem to be the same as were reviewed on 6/21/00 by the Old Kings Highway Commission The actual garage location appears to be substantially different from the position shown on the approved plan. Referring to the enclosed copy of the approved plan, I have highlighted in green the designed location of the garage. The red markup shows the approximate location of the actual garage foundation now in the ground. The measurements were taken informally after the contractor personnel had departed for the afternoon. This location change from the approved plan has produced a significant modification to the overall appearance of the historic Bodfish Farms house relative to what was expected by the Old Kings Highway reviewers for this property. I suppose now it is too late to correct the foundation location problem. At least, however, the contractor should be required to correct the plans and submit them to the Town of Barnstable for board review. Bo"Farms CommumiyAssodation • P.O.Box511 • West Barnstable,MA 02668 O 2 ER LINE TO LEACH PIT. RE-ROUTE AS {f �A\\ PROVIDE GRAVITY FLOW TD LEACH PIT 2" M PLE ,\\ 7 61 2" MAPLE do 6 2" PLE ,/P 59 Kip EXIST. 6" TREE EXIST. GARAGE � ��, BE RE—LOCATE {f�l RE- OCATMEE GA AGE \ h� {f �J \ 36'1- PROP. BRE AY •�'�� W E ST t S r \\ N(RET IN) ` /5 PROP. ORCH PS OP. D N PROP. PORCHj. EXI S Il N U i LOT 11 d HOUSE 1 TF=51.75 n FF=52.54' 4 —47 , 1 D FROM QUAD MAP RCELS 63 SIDE, 15') ROM AS—BUILT CARD ON FILE WITH HEALTH, INSTALLED 7/85 c'' rTE FLAN OF #54 CARLSON LANE IN THE TOWN OF: (WEST) BARNSTABLE PREPARED FOR: JEF,FREY WILSON 30 0 30 60 - 90 Feet PLS 6ATE SCALE 1' = 30' DATE: APRIL 13. 2000 off. 508-362-4541 fax 508-362-9880 down• cape engineering, inc. CIVIL ENGINEERS sr Roijy.sq LAND SURVEYORS 939 main st. yarmouth, ma 02675 LOCATION MAP (NO SCALE) LOT 14 rn \ �v r„ CID; `\7�\ �CI� \\ O P. Z EXIST. SEINER LINE TO LEACH PIT. RE—ROUTE AS NECESSARY. PROVIDE GRAVITY FLOW TO LEACH PIT FROM D'BOX 2" M PLE LOT 15 61 2" MAPLE I D%% 43,940 SFf {co 6 v 2" l PLE LA EXIST. GARAGE 6" TREE (TO BE RE—LOCATE RE- OCATE[ GARAGE `� \ 6ZT' N 36" \� c � PROP. EIR AY W`` ES ST ' (RET IN) PROP. ORCH \0 IO -o PH OP. D N 1 I PROP. �',`!•+ {.`., �.` ,� PORCH EXISTING/ LOT 11 e HbIJSV . rye. TF=51.75 a e FF=52. 48 54 4 NOTES: K / ` 1. ELEVATION APPROXIMATED FROM QUAD MAP 2. ASSESSORS MAP 133 PARCELS 63 3. FLOODZONE C 4. ZONING: RF (FRONT: 30'. SIDE, 15') 5. SEPTIC SYSTEM SHOWN FROM AS—BUILT CARD ON FILE WITH BARNSTABLE BOARD OF HEALTH, INSTALLED 7/85 SITE PLANT OF OF Mq,, #54 CARLSON- LANE P ARNE H, IN THE TOWN OF: °J^L" z;; (WEST) BARNSTABLE 4 No.26348 x 9��Fss�oFCIS ��o�Q,��o PREPARED FOR: JEFFREY WILSON Al IANO 30 0 30 60 • 90 Feet ARNE H. OJALA, PE, PLS 6ATE SCALE: 1' - 30' DATE. APRIL 13. 2000 99-369 „• Application to �,.�,•►' Old Kin 's 000 , 128 g Highway Regional Historic District Committee in the Town of Barnstable for a 0 CERTIFICATE OF APPROPRIATENESS J'' = Application Is hereby made, id triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Choterr�� Acts and Resolves of Massachusetts. 1.973, for proposed work as describe4 below and on plans, drawings or -47A'� accompanying this application for: 9s �iliotograptu) CHECK CATEGORIES THAT APPLY: I. Exterior Building Construction: Indicate ❑ New Building• � Addition � Alteration type of building: (Z House ❑ Garage ❑ Corhmercial ❑ Other 2 Exterior Painting: Co 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Fla 9pole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY G 4- �-r4L'�'O t� Lh 11E DATE S ADDRESS OF PROPOSED WORK W • i�,A y-to S ,4--, T .�--- ASSESSORS MAP NO. 33 OWNER W 1=�T 0*3 I L ASSESSORS LOT NO. HOME ADDRESS -}--Ap3LE- $TEL NO. 3 fob a, 1 2 FULL NAMES AND ADDRESSES OF ABUTTING'OWNERS. Include name of adjacent property owners across an street or way, (Attach additional sheet if necessary). Y public AGENT OR CQNTRACTOR !Z?dV!::pA =561 1�r14 1 Q �--r- T EL NO.�(— Q ADDRESS �2 4•Ur Z-I�°�i►J �tT' � �; 1-},P C�-1T(••-}�.�-�.(o-J S DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8, other side), includin matirials to be used, if specifications do not accompany plans. In the case of signs, g locations of new signs, (Attach additional sheet,if necessary). 9rve locations of existing signs and proposed 10' -”- O' ol�F- A P D 1 T1 ON APPROVED ��•�x p�. C 4�P1Rcx)��Mj,�.� . . Signed Spa Owner Agent - _ htee.use. - Rec M Da The Cate is by -� Dat , Ti e OF BY y4 ��E f✓C �'1� �. Approved ' ❑ IMPORTANT: If Certificate is approved,approval Is subject to the 10 day aonpal nari-i r =_ ? Town of Barnstable ' Old King's Highway Historic District Committee SPEC SHEET FOUNDATION OY17 r—A C.A:!'1 n �.L.0 SIDING TYPE }A iMF Gl COLOR 2:0 CHIMNEY TYPE �C.r— COLOR A� ROOF MATERIAIr �,Gt�O 4X�- COLOR PITCH I ` L1 WINDOWS SIZE Ste, IJk�J� TRIM COLOR . DOORS COLORS �"C.}-} r7-- X �T SHUTTERS COLORS GUTTERS W p(Y 0 COLORS r2EC--�j Z'jf-,1 I--1 DECKS 1�5 W'►Olt �4T ���S' MATERIALS WA 140 GARAGE DOORS 1 ?Q COLORS SIGNS COLORS 6 . FENCE_ ` -O'� �-} #� 1 LK �T COLOR NOTLSa rill out completely, including measurements and materials/colors to be used. Tbra• copies of L*{s Lora 'ate required fbr submittal of an. application, along 'with three copies of the plot plsn, landscape plan and elevation plans, when appliceble. SPECSH? • �' � ��jo t`1 � �3 - �3 t L-AtlX_bO�-4 (oG) VJ e7 4z(o 4�, a l a� •� M��1 n/��e.p g 1�oNu 1 �.�, YYIf���X, . l 33 • co d• �j1�✓1 t- �- soap }}� q C��1`e,RS ,IDGVwW- »riq o -.�--o 3 0 i ' 206 • 14 26 00 �.t206 6 in MAP 133 LOT \t �� 205 O 50.54 +6423 N��, In I\\ l '8 4 0 25 +2434 6 +� .5 9.09 2" PLE 61 `�64 l W5 0.61 \\�I 60 24 16 5 2 MAPLE 2" PLE 2 50.06 49. ^ \I 7 1.63 Cr 6" TREE204 44.11 I 9 12 233 3 / \150.84 A 38 ' .. I �^ Lf2 \\ 52. GARAGE 1 . 0 1 �8 _916 _ _. . e 2 5 56.f3 SS:Ei� / C �, 4 .9 ; % 7. .3: G�1 IP 203 \ 15 4:.?_ \� 6 'C N 0 17 Q 2 202` .2c 4 .J 53 EXISTING \a LOT 11 HOUSE TF=51.75' 2 et FF=52.54' 49 7 �L201 48 .-4 7 TES: 00. "^3py 43.59 :VATION ASSUMED @ 50' 54- C�i��tJ �A►•� � � . � : » M � . � � � . . . � .. .� . . . � � \ � � . . r>= \ \ !C . \ I � v7� < .'40� _I.LL.aVs�viwDaHa'e w.nx'� n+l.w Teui+'+v:OeO u wT,.a bow•+o•-' n Y . - " ..�.-nw_•.w eroa vs re Nw7cer:ax eTrwis __ _ ' • . .e�w.+.eKaC:w�.au+�...soex�en.,d wwa�.u- � 0 yjl N f- —_ waste- _ I�— I z N pp - • -�. - .,...ef mac-f.fwr.. '� / .� �. �._ _ m sa - Mr lu r — S N : • m I. rw - n , to w� - — I 2 I I.iQ�-ry i �we o.ravc — �"Wtf �Y-rim-.^ --D[.I / - ` TP.w••RN ` — � ' Lew Nq}�p,Y R.N�IL'... _...._ ® R!+a•rTnMuc * '.IFld-8d_..—. P � I ,` �1 ��J O Y ,L jl.Jl jl,■' ... 1 .IlIDa.4W�: � ' K' �a.•„v[yeaYT[.•N� r . y i u — :; �'eb°n ' -- ---—�'ETx cot fwv 1E—.. grsw-wr.ra.TaM [ .. ___ F•iiw Y - :tL''a':__..__ aD•r.rw•.a .r'n"iome.Ta--' aulz a � - e..SR.D�¢Mq 'ariaT•+e v}eNe itN+D. 'O.y la 0M •'! Pau- MEW nw �'-'�" °' '. ? �_.`- ._ __..__...__ - _ ,�o�J[.oar.or - a.,e ,� - .• I- '.�EGi'f0]T_�_:ffl.aaceii:•ry_cea"ip �A.e �------....- SEGrLOF>l'A-A. ,aTes•eTsawa-: w I`-' � w[-aw' e � —._aS4l.E_I v.�•o. r,.°>. .. ....,.. I i J � . r•>f/� NCI� r•pATCMmI /n.aN mn+amt.<. - new.t.. •I� . ♦+„ � aaa m �rrr Te w IT.r ' f� \ _.,� . ' �... s.H'frz��N_nli renl.ue c n•ra'+aer�lu m exl.n?w L°ruc �rr/ae•waa ., I ' �. \\ \ c�[avm[m••�cw...rcna m; a *n.e!♦wa'o7T.«e+'f: '_- ...<'m<ma>..•<ear. _ v • / �- awns ,..a'cm.`;ray '.;. � •/ _ >o''d' "` �.� � p ' \�-' � ]CB{pr4 •-'��� _.•..� //•/� .Jl ._ _ ___ _- tnc'.[M s..♦ u.nwf.. 4 Y � c.•„e D f � 4 g ......... '. _ _ 4.3 •. .. .�� B ,' .. ..��.. ..��T �_rar+ree e�w+ ■✓xs a.m nl _y-]]] - a v,N o.rwas Q - - ✓L -Rt 'jy{_PNvlae r'NIR'�.. 1�N • V.. r .. ..-.. teDae ar aae-aTa� **"'111eee w<IN✓(wroa.l 9 S� ' - b" .OI NIe K.�MfGI: n"sawr S • ° •. —_ _..—.—'.-.. -.— —.—Tw.oP. :yr.*•l@M-II"1•aa os�isN:AauCir 2 9 N — � ��, �''7• n♦.ID.e�<a iaG_y�<y1��Yf 2 .fli�'aflKLA{.♦6AS' _ . � N[M Raal Wi•.e 1a�/<I+R+,wTti4�aL..t � aNR T wnaa f[<a a A _-_- t gayfoi 2)£S.C9n c—AiOCLQf£i, JnC. 28-Ba-untaffE a\oad 07yannii,�VI�T 02601 DfionE (508) 790-4686 July 20, 2000 Sara Jane Porter, Architect 240 Main Street Route 6A Yarmouthport, MA 02675 RE: Wilson Residence Addition and Alteration West Barnstable, MA Dear Ms. Porter: I have reviewed the roof framing of the subject residence. The roof framing member that spans I T-0" can be either: W8x18, A-36 steel beam Or 2-1 3/4"xl4" gang lam or LVL beams, fb=2400 psi Or 3-1/3/4"xl 1 1/4" gang lam or LVL beams. The end posts should be either: 3 1/2" dia. concrete filled lally columns Or 6"x6" wood posts. If you have any questions, please do not hesitate to contact me. AY Sincerely, �o R.GREGOF YLOR CTUFAL TTI /� a R. Grego or, P. Fs N SON -� CCI Cape Cod Insulation, Inc. 18 Reardon Circle South Yarmouth, Ma 02664 508-775-1214 hankcassidygcapecodinsulation.com Town of Barnstable RE: Wright Residence 54 Carlson Lane , West Barnstable, Ma ,3 r 3 1 To Whom It May Concern: Can we please get an extension on building permit # B 20+442q*6 as the homeowner does not want the work done until November of 2014. Ti k ou, C;/) nlc o ape Cod insulation, Inc. ' - ;n lJ7 �' i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map' ' Parcel ll� 'Porpolical'ion #p 71,11 Lt Health Division Date Issued Conservation Division Application Fee `r Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis I Project Street Address 5o Village Owner USG Address Telephone :Permit Request �f` W ►" Square feet: 1 st floor: existing proposed 2nd floor: existing proposed: T619 new+ .Zoning District Flood Plain Groundwater Overlay Project Valuation �iQvs Construction Type-�� .(!� -, M Lot Size Grandfathered: ❑Yes ❑ No If yes, attach su porting�cur�ntation. cn Dwelling Type: Single Family � Two Family ❑ Multi-Family (# units) ry coo Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway=❑Y@9 ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑'No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION / (BUILDER OR HOMEOWNER) {. Name (1#4t Telephone Number �5 I2f Address � � r� License # /d0 Avuett IYfr Home Improvement Contractor# �����7 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO VwGm SIGNATURE DATE FOR OFFICIAL USE ONLY 4. =APPLICATION# _ DATE ISSUED 4 MAP/PARCEL NO. r ADDRESS VILLAGE OWNER ` t _ y; s' 'DATE OF INSPECTION: .";FOUNDATI©NUPFiUU—�IL). E'°tea z - .FRAME - - - - - - -. INSULATIOWLA3- 2 FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH. FINAL GAS: ROUGH FINAL f FINAL.BUILDING r :. DATE CLOSED OUT ASSOCIATION PLAN NO: = Massachusetts -Department of Public Safety { . Board of Building Regulations and Standards Construction Supervisor License: CS-100988 ` 1I\ HENRY E CASS110 -- ' 8 SHED BOW f k s WEST YARMOUrrH 2' 7 0 Expiration Commissioner 11/11/2015 0 L0��l./l.-(ill .�`L, C�I�'!�'L:CI::J:1C�=Gfl•I�JC:'��) C)I:�l i�� �1 C C orlsurne.r AtFairs and 13usuless l�e.g l.11illi`(�ll. 10 Park P1a211 - Sl1'lte 5170 Boston, WSLrChUSettS 02116 l- ome lrriprovemenr Comractor l\eg istration Reg i.s lra Noll: 15356 Type: Private (:orpal'alioll - Expiration.* 12/15/"'�1.114 'frll J;lull INSI_JL...A-f-ION, INC CASSIDY II'i I\'I�:AhD0N CIRCLE _ 0 YARNIOU-I-H, MA 02664 - . . ................... UpdateAddress it lid relIlr'u card. 111litrk rcatiuu fordiantie. L.1 A(Idress IZCrIUIVIII I!:ullrlu}ntcnl I I I.u,l l:;nll�...I .. � •.. '(, I'N/,rtrrrrrv�i rrf�%t ry`i'?�!r.r,rnrErrr_u?l!� .. 111)I�, ,.I t „Inunutr:�lluirs Itusincss ►tel;ulaliult License or registration valitl for indivitlul Ilse.wily •.:1:� �b{ulvlr IPA HN0VE.ME.N'I ( ON1 RAC I Oh hcrurc the c.Xpiratiun dale. U fuunrl rcltu'u lw; ?.di: .. z.y�T p �'•p:,tr uurl I ti3 iri% Type: Ofke Uf Canstlnwr Affikirs antl Uttsiucss kegululivn •i��l:4µ I{'nllll,llll)I I. I•;i I J/)G 14{. �' 10 I':irk Plaza-Suilc 5170 y F I rvate- Corporaac-n liustun,MA 02116 l.y l'If)IV. INC, ,i'I ylPl I,.rtO.:l l tllrticl'SI'CrL'litI.)• Of%'it� 1YI1110 l IIIII 1'l The Commonwealth ofMassachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' CoMpensation Insurance Affidavit: Builders/Co ntractors/Electricians/pIumbers 1k0l)UCa"t information please Print lLeeibly Natnc (Bwinesslorbaniiabodindividual): Cily/Slate/Zi Phone #: 6� 17'�% Z %Z/- :U-c You in employer? Check the appropriate box: l.al min a Ctnployer with,_ 4, ❑ I am a general contractor and I Type of project (required): cmpluyccs (full and,{or part-time). have hired the sub-contractors 6 ❑ New construction proprietor p listed on the attached sheet. 7. ❑ Remodeling ' l am a sole ro rietor or partner- and have no employees These sub-contractors have g• ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.t 9. ❑ Building addition required.) 5. ❑ We are a corporation and its 10,❑ Electrical repairs or additions }.❑ I am a homeowner doingall work officers have exercised their ;;1 1.❑ Plumbing repairs or additions myself. LNo workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4), and we have no 3a.Cl 1 am a homeowner acting as a employees. [No workers' 13.Mther f,& general contractor(refer to #4) comp,insurance required-] Kay apphc:aut that chccks box#•1 must also fill out the section below showing their workers'cotnpensatioif policy informndon. t Houicowacn who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such. Cuutn aom that check this box must attached an additional sheet showing the nama of the sub-conmrctors and state whether or not those cnories have cutployccy. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that it providing workers'compensation insurance for my employees. $'elow is the policy and job site informatiun. . Insurance Company Name:_ j���,l/ L Policy#or Self-ins,. Lic. #: vG� , / Expiration Date: Job Site Address: /�� �' City/State/Zip: b gj.jz .�ItaCtl a CO Of Il ' ���— py the workers compensation policy declaration page(showing the policy number and expiration date). Failure to sccurc�covcrage 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 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of lnvestigatioas of the DIA for insurance coverage verification. I du hereby terrify nder the nd penalties of perjury that the information provided above is true and correct. 'r Date: Phut ;Offk'ial rue only, Do not write in this area, to be completed by city or town o�cia( City ur'rowu: 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#: i CAPECOD-27 MYOUNG DATt`IMMIDDNYYYI CERTIFICATE OF LIABILITY INSURANCE 71812013 fI-IIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE: AFFORDED BY THE POLICIES iJL'LOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTtIORIZEO REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. .._.... -------------- —___�.. ---- ----------- ._._... ..._......_ ... --- u:1F OItTAN'h: If the Certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subjectlo I III,; luring and Conditions of the policy,certain policies may require an endorsement. A statement on this col-fificate does not confer rights to Ihu Ck;llikatU holder in lieu (if such andorsament s . I''"•""'�Llt Lit:un5t: 'M PC-514062 CONTACT Margaret Young —.--- - — lHDyun X Glay Insurance Agency, Inc. PtIONE ___...._-----�FA ....._..__ _... 1434 lRtu 134 JAIL ° _._..__.____.-...(AIC,NqL:..-_.._ ^. :+uuUl Ur:nnls,NIA 02000 ADOREss:nl OU11g t rOflL'rS]fa .COII'1 INSURERS AFFORDING COVERAGE NAIC0 _...._.... _-- INSURER A;PEERLESS INSURANCE COMPANY INSURER B,COMMERCE INSURANCE COMPANY CdIJU GULI Insulation, InC. INSURER C:Eva nston Insurance Cornpany '18 Reardon CirCIV INSURER D:ATLANTIC CHARTER INSURANCE GROUP Soulh Yarmouth, MA 0266,4 INSURER E: INSURERF: '-�._....__...-_.__..-.. CUVLI,1AGLS CERTIFICATE NUMBER: REVISION NUMBER: Um. 15 10 CERTIFY THAT THE' POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME.0 ABOVE FOR THE POLICY PERIOD 11401 A1LU NOIVVITI-ISTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VVITHRESPECI'ToWHICHTHIS rcR'In ICAIE' MAY GE 13SLIED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS'SUBJECT TOALL'IHETERMS, I nt:LUaIDNti AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Ip:Sk - ----'- AbO-SDBR P�C1�� PODGY ESfP i fH I'YPE OF I_NSURA_NCF_ _ hY$t. POLICY NUMBER AID DIY _.YJ_ A MID Y LIMIT'S �_�•_•__�____-__-_..._._..._...._.._._._—.. titr+t14tL LIAUIU TY-^^ — EACH OCCURRENCE b _1,O00,U0 i A X CUhlMthla4L CkNEkAL LIABILI'ry CBP8263063 411/2013 4111-,0'1A �AMACE TO'RGNTED-- __ 100,00 PREMISES lk:a ocuur°nra1 Ct AIM5-MADE X.) Ol,.(.Uht _ ME;D EXP(Airy una UOfwn)......f_..._ 5,00 PERSONAL x ADV INJURYb 1,000,00 GENERAL AGGREGATE _ b 1,000,00 2,000 00 LIMIT'APPLIES PER: — I'RODUCII-COMP/OP AGG- b—' -`— I'UUt:Y�_._-�,.1LS�T..__L—_l-��?� _ OMBINtfJ SII�GCE LlMlr— b '1,000,00 AUIUAIutJ%Lc I.JAUILITY Ea acodul 1 3 U AN1AUlLl 13MMBCKVMK 41112013 41112014 BODILY INJURY(Par patson) b 1 +Ilt LANMA) SCHEDULED BODILY INJURY(Pa(accident) s ' AI)Ios x AUTOS .._. A InhbLl AU r(15 x NON-OWNE-O f' OPA�C L)NMAGE b---...----._..-- ALITOS }' ---�1- X UMMItcLLA I.IAt3 OCCUR EACH OCCURRENCE _—_^-b........ ( I ca,:cs:,LIAu — CL.AIMS-NtADE XONJ453512 4/112013 411/20'14 AG0jziCGATc-_ - — Y — 1,000,00 b ( u�.0 l X, IiE'rENTION —.._— 10,000^ V47✓STATIJ- OfII• _._._.._ I'+JItItlH�L:UMPtN SA TION AND E6IPLOYERs'LIABILITY It111' _._ i - •----> U YIN ANT PKUI'KINIOKIPAHTNER/EXECU'r1VE WCA00525904 613012013 6130120.14 E.L.EACH ACCIDENT b 1,000,OOU rlrtlt:LK:NtEMOrlt EXCLUDED? l� NIA OOO,OO (hlwdaluty In NHI E.L.DISEASC-EA EMPLOYEE-b,__. _._ _,. n,00,dax:nUa under EhDISEASE.-POLICY LIMIT $ 11000-00U IlEiCKIP'1'ION OF OPkHAT'ILONS Ualaw FF_ u,1,l141t'IION 0I-UPEHA)'IONS I LOCATIONS I VEHICLES (Attach ACORD 101,Agdllional Ral11arl,a S°hadula,II mara space Is raqulrod) . !WmI,dts Compensation includos Officers or Proprietors. jAdduunal Im urud status is providucl under the General Liability when required by written contract or agreement with the Certificate I•Ioldur. CEN VIFICA FE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE:DESCRIOEO POLICIES CIE CANCELLED OEFORE d LOCI InStllatl011, h1c THE EXPIRATION DATE THEREOF, NOTICE= WILL BE DELIVERED IN L:a N ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 11 // 0 1988-2010 ACORD CORPORATION. All rights reserved. ACORU 25(21010/05) The ACORD name and logo are registered marks of ACORD OWNER AUTHORIZATION FORM I, Wr er'(Ow s Name) ' owner of the property located at S-4 cav Sc � D ,/,(Property A dress) (� / ". G 66 (Property Address) ' hereby authorize �>n� 'a� (Subcont tor) ' an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. Owner's Signature Date TOMN OF BARNSTAF -E CAPE COD INSULA LOf, tl" 2; lftod F-7z�y ®® F.—p-3S 3lAM!!33 SPpAT iC'LMFi]YSIlNOLp PARS ou r.S WSYIA T J�fII OL 1-800-696-VV66'1�1Qf� Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 If Date: Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BP•1) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village e se + 7����t� i,��i� h Sal 1ztY e. :ire s ✓�S !�1-e� _ y Insulation Instal.led: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) (x ) ( ) ( ) r(�C) Slopes C36) �, Slo P ( ) ( ) ( ) ( ) ( ) Floors Clos{d Oil( ( ) ( ) ( ) ( ) ( ) Walls ( ) ( ) ( ) ) ( ) Y Sincerely He y E Cas y Jr, President C e Cod I ulation, Inc. • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division Date Issued < Conservation Division Application Fee ram, J6 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board p Historic - OKH Preservation/Hyannis Project Street Address ��/I lxd tof Village , gj,00'4�, iL3, /G Owner T,1�fi Address Telephone Permit Request 6,f��Ji Aioiv/ Zr7d4;i!�:ig,4r-u gwwl/ Z&;I Z ;rz-a " t�Lee0.1 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation A700, eP Construction Type %Dd Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting do,cume lation. c� Dwelling Type: Single Family Er"*' Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes 2 No On Old King's`Highway: 0~Yes%11Qo s�,{ Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) `a Number of Baths: Full: existing new Half: existing 1. new wi t, u Number of Bedrooms: existing _new Total Room Count (not including bath,;): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size-_ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name , ���� �«��.�� Telephone Number /�- Address ,/� �dlsd ,(vim License # /DD -Fo 0 4!�M *dd!J Home Improvement Contractor 47 Worker's Compensation A�O�✓ D ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE G .� ' FOR OFFICIAL USE ONLY 4 .E JAPPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: ' 2�FOUNDATION ' r FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH -.FINAL- PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN.NO. Ile OWNERAUTHORIZATION FORM I &4� Wr (Ow er's Name) owner of the property located at S-4 Car so � 0 (Property A dress) l� G 66 (Property Address) '20hereby authorize (SubcoVtt an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. Owner's Signature Date l h \'lussachusctts - Ucluu'[nu'nt of Pulllic 1afc1� Board of Re,ulaliuns and "talidards construption Supervisor License a W Licen Cs 100988 ft HENRY CASSIDY 8 SHED ROW WEStT 1fARMOUTH, MA 02673 Expiration: 11/11/2013 _ ( .,n lilt issiurrrr Tro: 7620 U Lice of Consumer Affairs and Business Regulation F 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 153567 TVpe: Private Corporation Expiration: 12/15/2b14 TO 233831 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE ._ SO. YARMOUTH, MA 02664 ------..._..__.._._.______...._...__..._..... . Update Address and return card. Marl(rcuson for change. Address LI Renewal auploynleut I.. I Lust Card A+ t; of Consumer Affairs & Businessltegulatio„ License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: ` egistration: 153567 Type: office of Consumer Affairs and Business Regulation ;Expiration: 12/15/2014 Private Corporation 10 Park Plaz -Suite 5170 Boston,MA 02116 (:APF C01)INSULATION,.'-INC.. HENRY CASSIDY 18 REARDON CIRCLE r 5O YARMOUTH, MA 02664 --- A0 'i4'o — —---t ❑AI I-e- Die Commonwealth oj'Massachusetts Print-Norm Department of Industrial Accidents Office ofltivestigations I Congress Street, Suite 100 Boston, MA 02114-2017 w ww.nutss.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A .> tlicattt Information Please Print Le(,i�b!y Naln�' (15usincss/Or�anizatiun/�ndividuaal): (A ( a V MA' Phone #: �OO- --- Arc you au employer? Check toe appropriate box: --- Type of project(require(l): -- I.( 1 ant a employer with 90 4I. ❑ 1 am a general contractor and l l have hired the sub-contractors 6, [] New construi;tion 011ployces (Cull and/or part-time). ant it sole proprietor or partner- listed on the attached sheet. 7. ❑ Reu-todeling ship and have; no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Quilting addition INo workers' comp: insuratice comp. insurance.$ reeluired.1 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions U I and it homeowner doing all work officers have exercised their 1 I.❑ Plumbing repairs or additions myself. INo workers' comp. right of exemption per MGL 12.❑ .Root ie airs insurance reduired.J t c. 152, §1(4), and we have no �j V���� at I employees. [No workers' 13.� Other r _— h o, comp. insurance required.] ".All applicant that chcckti box #I must also till out the section below showing their workers'compensation policy information. I lonic'Milers who submit this affidavit indicating they a,•e doing all work iuW then hire outside contractors must submit a new affidavit indicating such. ,Couu'actors that chuck this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those cutiti45 have empluyucs. 11'I11c;sub-contractors have employees,they must provide their workers'comp.policy number. I tat an employer that is providing workers'compensation insurance for my employees. Below is the policy and joh site lujrrrttuttion. lii,nratt�c:.cuntpatty Natrte:_ A4&Ac, CkAvh�- I�l�yGtVGtUt G �i Policy fi or ticll=ins. Lic. #: WGA o6)z5 2&5 0i Expiration Date: v - •Ioh site Address:_--_ City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). FailurC to Ceure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a line ill)to$1,500.00 it one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine ol'up to.$25t1.00 a clay against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investii�ations of the DIA for insurance coverage verification. /do hereby cegt&.itnVer the pains.atyl penallies o/perituy that tine irrlortnation provided above is true and correct. � 7 tii;ti:uure: Date: UJIi hil ave only. Do not write in this area, to be completed by city or town official. fait} or'l'owu: _ Permit/License# Issuiul;Authority (circle one): 1, fivard of Health 2. Building Department 3. City/Town Clerk 4. electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: CAPECOD-27 SPURDY .ACORO" CERTIFICATE OF LIABILITY INSURANCE I DATD/YYYY) 4124122412013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). _ PRODUCER CONTACT NAME: Cape Cod Commercial Ro ers 8r Gray Ins.-Dennis Branch PHONE — FAX 434 Rte 134 (ac,No.EE )_(508)398-7980 (ac,No): (877)816-2156 South Dennis,MA 02660 E-MAIL - ADDRESS;_ _- j INSURER(S)AFFORDING COVERAGE NA_IC# INSURER A:PEERLESS INSURANCE COMPANY INSURED INSURER B:COMMERCE INSURANCE COMPANY Cape Cod Insulation Inc I-INSURERC:Evanston Insurance Company 18 Reardon Circle INSURER D:Atlantic Charter Insurance Company South Yarmouth,MA 02664 �- --__ _ _.. . _ ._ INSURER E: _ I INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 'INSR' JADDLJSUBAF_ POLICYEFF POLICYEXPLTR TYPE OF INSURANCE N R,WVD POLICY NUMBER LIMITS _ .__.-- ._ ... _- - ._ .{(.MM/DD/YYYY), WWDD/YYYY)3 _ _ GENERAL LIABILITY EACH OCCURRENCE I$ 1,000,000 ICBP8263063 4/1/2013 4/1/2014 DAMAGES(RENTED I 100,000, A X :COMMERCIAL GENERAL LIABILITY � I PREMISES(Ea occurrence) $ . CLAIMS-MADE ! X i OCCUR I I I MED EXP(Any one person) i$ 5,000 PERSONAL&ADV INJURY $ 1,000,000 I i l GENERAL AGGREGATE $ 2,0000001 GEN'L AGGREGATE LIMIT APPLIES PER: I I PRODUCTS-COMPIOP AGG $ 2,000,000' POLICY i PRO-JECT I_LOC i .. _ ;$ LJ AUTOMOBILE LIABILITY I 1 - rCOMBINED SINGLE LIMIT I (Eaaccdent) _ $ 11000100Q B ANY AUTO 112MMBCKVMK 411/2013 j 41112014 f BODILY INJURY(Per person) t�$ ALL OWNED X SCHEDULED i I BODILY INJURY(Per accidenl)I$ AUTOS I i PROPERTY DAMAGE I$ N D I-X HIRED AUTOS � X 1AUTOS AUTOS (PERACCIDENT)I �_—_ 18 , X UMBRELLA LIAB I X I OCCUR I ( EACH OCCURRENCE 8 1,000,000; C EXCESS LIAB i CLAIMS-MADE ; XONJ453512 j 4/1/2013 I 4/1/2014 AGGREGATE I$ 1,000,000; DED ??X RETENTION$ 1 0,0 00 ( _ 8 _.... ... . .. ...._ I_......------------ -- --, .... _.--_ WC STATIJ OTH- WORKERS COMPENSATION i _ TQC LIMITS _ ER_ _ _ AND EMPLOYERS'LIABILITY Y/N 1 4_ 1,000,000; D ANY PROPRIETOR/PARTNER/EXECUTIVE`--.I N 1 A IWCA00525903 1 6/30/2012 6/30/2013 E.L.EACH ACCIDENT I$ _ OFFICER/MEMBER EXCLUDED? l NJ (Mandatory In NH) I E.L DISEASE-EA EMPLOYEE$ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below _ _ _i E.L.DISEASE-POLICY LIMIT I$ 1,000,00Q � I I DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Certificate Holder is an additional insured under General Liability when required by written Contracts or agreements. CERTIFICATE HOLDER -- ___- CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE EVIDENCE OF INSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. i i AUTHO�RIIIZE•�/Dr REPRESENTATIVE i - ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Q PHONE CALL FOR ^� DATE ^9 TIME -P.M. M PHONED OF '77 /_�� RETURNED PHONE ( ! YOUR CALL AREA CODE NUMBER EXTENSION PLEASE CALL MESSAGE � WILL CALL AGAIN CAME TO p SEE YOU WANTS 0 SEE YOUO SIGNED niversal 48003 r NOTES t y J_ � MA R. M.Marshall Pm 4" 26 Carlson Lane a. y� W. Barnstable,MA 02668 za r,Fc o, Q(cmth.c 2OO �vG-7 r3 „111iII1111I'i1r„f III IIIIIIIfIf„IIIIII1II III 1111111111111 .'.^'' ,/ _,.�. �/ � i .... �. .�.«. ....... 1 .. .�v. � .«..... � ....• � ¢{, 1, 1 ' R 1 i FIKE r Town of Barnstable Expires 6 torith $sue date Regulatory Services Fee •tr Thomas F. Geiler,Director BARNSTABLE�Q - . 7 MASS 0 _ t639• Building ]division � ATFp��a 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 1/alid without Red X-Press Imprint Map/parcel Number ` 1/3 O .Property Address —� Residential Value of Worl Minimum fee of$25.00 for work under $6000.00 Owner's Name&Address I L.S o Contractor's Name &0q, p `Z Telephone Number�pS 3� Home Improvement Contractor License# (if applicable) f D 6,5?j ❑Workman's Compensation Insurance ]eck one: I am a sole proprietor X-PRESS PERMIT ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance AUG _ 6 2��8 Insurance Company Name A TOWN OF BARNSTABLE 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 / U� ❑ 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 depaYtme lati� } .��i Iipric,Conservation,etc. *''Note: Property Owner must sign.Property.Owner Letter of Permission. - A copy of the Home Improvement Contractors Licens i�re uired.- M 4V 9 c'r� ��l l l 8 U� SIGNATURE: I Q:\WPFTLES\FORMS\building permit forms EXPRESS.doc r r The Commonwealth of Massachusetts Department of Industrial Accidents Office of In 600 Washington Street Boston, M14 02111 www.mass.gov/dia Workers' Compensation lnsu.rance Affidavit: Builders/Contractors/Electricia-as/Plumbers AppUcant Information Please Print Le 'bI Nainc (BusincssJOrgauizaiiowgndividual): • Address �� � S • City/State/Zip: �1CZIQt�)g �Z — Phone.#: 3 Are you au employer? Check the appropriate bar: Type of project(required): 1.❑ I am a eroploycr with 4. ❑ 1 am a general contractor and 1 6. ❑New construction employees (fill andlor part-time).* have hired the stab-contractors 2_ I am a sole proprietor or paztncr- lusted on the attached sheet 7. ❑Remodeling 2f I am a-sole proprietor or paxtatr- sb p and have no employees These sub-contractors have g, ❑ Demolition warring far me in any capacity. employees and have workers' 9. ❑Building srrr addition [No workers' camp.inanrC camp-tnsurance.t 5. ❑ We are a corporation and its 10.❑-Electrical repairs or addition required] officers have exercised their I LEJ Plumbing repairs or additior 3.❑ I am a homeowner doing all work myself: [No workers' comp. right of exemption per MGL 12_0Roof repairs insurance required-]t c. 152, §1(4), and we have no employees. [No workers' 13.❑Other comp,bin ancc required.] `Any applicant that ehccla box#1 must also fiA out the section below sbowirlg their wmi=%'compi;on policy information. f Hmrsowncrs who submit this of davit indicating tbey arc doing all work and thrn hire outside cantraetom must cubrnit a new affidavit indicating such. tcantxactors that check this box mart a-tachcd an additional cbcct showing the name of the sub-cantractmrs and statr whether or not those entities have employees. If the sub-contractors have cnmployccs,they must provi&they anrkcrr'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. In_nirance 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. fins tip to$1,SO0.00 and/or one-year imprisonment, as well as civil penalties is the form of a STOP WORK ORDER and a i of up to$250.00 a day against the violator. Be advised that a copy of this stattmcrit may be forwarded to the Office of Investigations of the DIA fo e v verification.. I do hereby certify under a pa' d rt. of e " that the information provided above is true correct cs Si c: Date: d - Phone# 6 Z O fichd use only. Do not write in this area, to be completed by city or town offrciaL City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2.Building Department 3. City/Town Clerk 4.EIectrical Inspector S.Plumbing Inspector 6. Other °FIHET°�y Town of Barnstable Regulatory Services r aARNsmBm Thomas F. Geiler,Director MAn O rE1 ,9. Building Division Tom Perry, Building Commissioner 200 Main Street; Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize (, to act on my behalf, in all.matters relative to work authorized by this building permit application for: (Address of Job) S gnature of Owner Date , ` ki Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on .the reverse side. Town of Barnstable pF'ME ray o Regulatory Services >. Thomas F."Geiler,Director BAartsrwer MASS, Building Division g Tom Perry,Building Commissioner . 200 Main Street; Hyannis, MA 02601 www.town.barnstable.ma:us Office: 508-862-4038 Fax: 5.08-790-6230 HON EOWNTER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAFLING ADDRESS: city/town state zip code The current"exemption for"homeowners"was extended to:include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts M supervisor. DEFfNrrION OF HOMEOWNER Persons) 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) ibility for compliance with the State Building Code and other The undersigned"homeowner"assumes respons 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. HOMED"ER'S EXEMPTION The Code states that: "Any homeowner perfomvng work for which a building permit is required shall be exempt from the provisions of this section(Section lom.1-Licensing of construction Supervisors);provided that if the homcowner,cngagcs a person(s)for hire to do such work,that such Homeown shall act as supervisor." Many er homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(ice 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 pari of the permit application, sbilitics of a Supervisor. On the last page of this issue is a.form currently us that the homeowner certify that hdshe understands the rrspon ed by several towns. You may care t amend and adopt such a form/certification for use in your community. Board of Building Reguobs any% Standards HOME IMPROVEMENT CONTRACTOR License or registration valid for individul use only ,y � before the expiration date. If found return to: ;Registratiori:N 100390 Board of Building Regulations and Standards E r tio .--6716/2010 Tr# 269584 One Ashburton Place Rm 1301 �— Boston,,Ma.02108 �,,..�--•---..r� STURGIS ST:PE~ Sturgis St. Peter\j" ;''f t-�'i.}•yam..././ _ '``� 65 Cindy Lane/P.O. Boz-372 • �_ Barnstable, MA 02630 a- Administrator Not Y without signature HOME IM PRUvtmenI HVR 4-vLP I wl% Regi t _ io ' 100390 ID S 1612006 Uai bwn of Barnstable *Permit# �l 7 Expires 6 months from issue d fURMS ST.P - o urgis'st.Peter regulatory Services • Fee SIT i Cindy Lane/P.O. SS P r.4-1 mas F.Geiler,Director amstable,MA 02630jX Building Division SEP 0 2005 Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 ,TpWN OF gARNSTABLE www.town barnstable.ma.us Fes; 508-790-6230 a Office: 508-862-4038 , EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X Press Imprint Map/parcel NumberZ�j L��Iole �3 Q Property Address. Zesidential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Q �g 5-4 C� —el - Telephone Number Contractors Name Vim/ �o Home Impr ovement Contractor License#(if applicable) 1 a-o 3 t/ Construction Supervisor's License#(if applicable) nWorkman's Compensation Insurance Check one: 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 Going over existing layers of roof) ❑Re-roof(not stripping �r Re-side ,. maximum.44) [] Replacement Windows. U-Value this t compliance with other town department regulations,i.e.Historic,Conservation,etc. *where required: Issuance of permit does not exemp ***Note: Property must si rop Owner tter.of Permission. Home ovement Co a icense' quired. SIGNATURE: Q:Forms:expmtrg Revise071405 BoardoiBu mg KegmuOEU HOME IMPROVEMENT CONTRACTOR r% Regist io ' 100390 1-dualI)Wn of Barnstable *Permit# 7 Expires 6 months from issue date STURGIS ST.P Sturgis St.Peter �gulatoU Services Fee 65 Ciridy Lane/P.0 o = yVe,a` � SS P mas F.Geiler,Director � 3RE Barnstable,MA 02630 Adiuiui'straior-.. Building Division SF P 0 2005 Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 TOWN OF BARNSTAB�E www.town.bamstable.ma.us ' Fax: 508-790-6230 Office: 508-862-4039 EXPRESS PERMIT APP I CA RI�ON ess ImprrS�ENTIAL ONLY int NotVali � Map p/ arcel Number Property Address IJ � � � � � Z residential Value of Work iy Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address �.-�. QiJ ��1��0 i� Telephone Number Contractors Name PP l 6-0 3 47,0 (if a licable) Home Improvement Contractor License# Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: I am a sole proprietor I am the Homeowner ❑ I have Worker's Co`m`pensarion Insurance Insurance Company Name N 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 Going over existing layers of roof) ❑Re-roof(not stripping. g �r Cl Re-side ❑ Replacement Windows. U-Value maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property must si rop Owner tter of Permission. Home ovement Co a icense i gtured. SIGNATURE: Q:Forms:expmtrg Revise071405 I Application:to. ePE Old Kin 's Hi way Ike tonal'Hisroric district Committee g g Y g in the Town of Barnstable for a CERTIFICATION.OF EXEMPTION Application is hereby made, in triplicate,for the issuance of a certificate of exemption under Section 6 and 7 of Chapter 470, Acts and Resolves of Massachusetts, 1973, as amended for proposed work as described below and on plans, drawings, or photo• graphs accompanying this application. t TYPE OR PRINT LEGIBLY 2-Z409 DATE JQV00-5 ADDRESS ORPROPOSED WORK �^�� ASSESSORS MAP N0. OWNER �'✓V� ASSESSORS LOT NO. 0 HOME ADDRESS ° TEL. NO. AGENT OR CONTRACTOR ADDRESS 0 ,w TEL. NO, _JbZ Y This application is for exemption of proposed exterior construction on the ground that: ❑ (1) It will not be visible from any way or public place. (2) It is within a category declared entitled to exemption by Old King's Highway Regional Historic District Commission. (Check applicable box) PROPOSED WORK: Describe and furnish plan of proposed work, showing location on tot,and, if an addition Is involved,show ing.location of existing building. LV L� C 0 1 SIGNED �4 -Ow r•Con ctor-Agent Space below line for Committee use. . a Receive .D.C. The Certificate is hereby Da t /v'— Time -APPRDVM a%W W ftmanw— BY Date Approved ❑ The categories of work entitled to exemption are listed on Disapproved ❑ the back of this form. �ptNE Tq� Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as wrier of the subject property �a hereby authorize S " to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) 14&f Owner Date Print Name Q:FORMS:OWNERPERMISSION °FIHE,°wti The Town of Barnstable BARNSTABLE. ' Department of Health Safety and Environmental Services 7 MASS O t63q' �0 "fEOMA� Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection Location ,l�I � h Permit Number Owner Builder One notice to remain on job site, one notice on file in Building•Department. The following items need correcting: n d AS Please call: 508-862-4038 for re-inspection. (� N Inspected by Date V© Z-� U i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# 4 6 V(2 Health Division � p� Date Issued "i .Conservation Division es, 6 �l/e Fee �(425-60 Tax Colle r. . ' c SEPTIC SYSTEM MUST BE -01 Treasurer INSTALLED�N MPUANCE E 5 Planning Dept WIT SNVIFtONMENTAL CODE AND Date Definitive Plan Approved by Planning Board N"` �°OtN R _ ULATI Historic-OKH Preservation/Hyannis Project Street Address �� 7 I�OLP�S�n G� Village Owner Pr /�'., Address `�G�X _ Telephone - S� V Permit Request yl'U ` ©�2_ Square feet: 1st floor: exi ting-&* proposed 5Uo 2nd floor: existing 600 proposed — Total new 6 Estimated Project Cost 9 v Zoning District Flood Plain Groundwater Overlay 11 Construction Type 0000 P7'1 M IC% Lot Size 113 193l() S�r Grandfathered: ErYes Cl No If yes, attach supporting documentation. Dwelling Type: Single Family Qao" Two Family ❑ Multi-Family(#units) fi Age of Existing Structure fl1(7 Historic House: ❑Yes UYIN'o On Old King's Highway: N!1 Yes ❑No Basement Type: 0 Full tg Crawl ❑Walkout ❑Other f Basement Finished Area(sq.ft.) ea - 0 Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing & 01 new •Total Room Count(not including baths): existing new First Floor Room Count L Heat Type and Fuel: CVGas ❑Oil .❑Electric ❑Other 62�4 Central Air: 9Yes ❑No Fireplaces: Existing 2. New Existing wood/coal stove: ❑Yes Ca<o 4 Detached garage:l�existing ❑new size b Ov " Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:dxisting Wnew size% Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ M Commercial ❑Yes No If yes,site plan review# Current Use Proposed Use r BUILDER INFORMATION Name fly �J ���Z-793 Z Telephone Number , Address �. ®� Z�'l License# OS6.5Ito Home Improvement Contractor# MX 4&244 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE �2 FOR OFFICIAL USE ONLY c PERMIT NO. - , DATE ISSUED MAP/PARCEL NO. ,J ADDRESS VILLAGE OWNER DATE OF INSPECTION::; FOUNDATION r FRAME INSULATION FIREPLACE �I ©� glo ELECTRICAL: ROUGw- - FINAL PLUMBING: ROO-61" FINAL ra � GAS: ROf Ufa m FINAL FINAL BUILDING t, I DATE CLOSED OUT S �: ASSOCIATION PLAN NO. ' The Commonwealth of Massachusetts r--��--"-� 'al Accidents • �=• = Department of Industrial �- _- • __ Olflce ollmresti9atioos - 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance davit location '7�� L-Q/"/�(�1 �--� hone# ✓� � Z cG�Z_ city ❑ I am a homeowner performing all`Work myself am a sole proprietor and have no one woiidn in anv � �y/ %'///%O///%////////////%////%//////////%%�%%�%/�/%%%/%%% %T/%/ %%/G%%% /''///%////�''00� %�00 , ensauon for my emPlogtres working on this job. workers .....:»::> an em 1 rounding ... :::._::::.:.:::::XX .:..: .:::::.... .........:............... .......... ............ ............................................:n........:.:+rim....}....... ::.}'::>.:.:.:::.:.::.::.i:.i:::......?.................................................. co en �..:.:.:.�r•i':-i}z::{<:<::�:>s:?::>s»s::»�F�:::: :z:>'{:>:<::>s:::z:>:z:>s::>:zi;s>:�»::z:>:::::�::'::�:r::::::`::::::::r:::<::::::::r:::::;:::�i:::::::::;::' .�::.��:_}:{•Y}:•::•�:?��ii?:iJiii:? }j}?ii:• v:::•::::::nw.::;;, :: i::::.v:::nv::•:::::::::::n•. r:.3}... ...................:...: ...:{•:}:{?•::??•Y}}Y:•:�ii}::.:;:{:?:?:^i:is�}:?•::}:4:�i:?{::�•:::•}>:::•:}::•:::{?^:v:•.:::.:::- ..... .........................................r... .......... .....:...-..:.by........ ..... . . .:..;............. ...........:.. ...:::.:::......................,.::::::::.�::.::::..:.............................. .>:::.......:..:..:::.::....:...:::.:.�:>:..: fain cJ Jnsnrance�co°;:.?;: one and have hired the contractors listed ow who I am a sole proprietor, eral contractor,or homeowner( ' have olrces. :::.:::::::::;:::.::'{.Yin:?;.:;?;.;......:.;:.i:.}:; workers on p ....,.,,..... .... the g ............... ..................................r................. .... :... ......... .:::..::::.... .;;:::.iY:.;i:?. ant ... .........:.:::::::::::{.:;}:�}.:iii;;;:;:;;::<:;:.:<.;::;:::i::;:::;:::::::::s::::}::�:; i:.::;:::::.}:::;:<::Y::;:::;:i;::;:::;:?:ii:.;>::;;',•'{:;::::;::ir:4:;:6;i:•:i::::o::::. coo ................. ::.:::.........t..::......:..,.:». ............. . ..,�:}::................. .. ....... ....... r:{4r..nv ]t•}rn ....... ...... ......................::::::::::YLY;{{4:•Y:;}}:?' .... ...... ....... .... ........ ................ ...... .rev.. v,, :�}y"�......... .......................................... 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IX v.v................r......::::4::::.v.v:'•::...........:1fx?v.4:•}.vnvv:.:. .......... ..... .....::....::w::.::::::,:•Y:•::�:•}}}}}:•i:'::` {?ii::••..':..u:::•,}.->v.}v:v:}}}}iiYO'•`:•v:...:...v ........:•::•......:::..........:•:r::::r rrxn•. ::::::!•:.....................:•r$v.:. .....v..{r rY. .}.},Tr v....... ...:..................................... .::::::........... ..............rY...::::5:....... ...........m:x.n.... .:•:.vv4. 1,••:..:,�..Y.�.:.vv:v:..x,:4:4}:4:?•:•:::•._ O�i�•�-'�I••::v:: an Failure to secure coverage as required under Section 25A of MGL Va can lead to the of rinmud penalties of n Sme to Sr.500.00 and/or one years,imprisonment as well as etvn p�in the form of a S?OP WORK ORDER and a'flne of Sr00.00 a day against me. I uiiderstaiid that° copy of this statement may be forwarded to the OMW of Invesdgadtow of the DIA for coverage veriflcatlon• that the in provided above is true and come I do hereby eerhfy under the and p ' . of perjury ,..,` Date /Z signature Z V Z_ i Print name oMcial use only do not write in this area to be completed by city or town omdal perimitilicense tJ ❑Building Department city or town:— ❑Licensing Board ❑Selectmen's Offlce ❑checkif immediate response is required ❑Health Department phone#• - ❑Other contact person: Unwed 9/95 PJA) Information and Instructions to to provide workers' compensation for their Massachusetts General Laws chapter 152 section 25 requires all employers quoted fimn the"law'', an employee is defined as every Person in the service of another under any co act employees. As qu . of hire, express or implied, oral or written. partnership, association, corporation or other legal entity, or any two or more of An employer is defined as an individual, p representatives of a deceased employer, or the receiver or the foregoing engaged in a joint enterprise, and including the legal rep , association or other legal entity, employing employees. However the owner of a trustee of an individual;partnership house of dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling another who employs.persons to do maintenance, constructionor 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. on 25 also states that every state or local licensing agency shall withhold the issuance�who has r renewal MGL chapter 152 sects in the commonwealth for any applicant of a license or permit to operate a business or to construct buildingsthe not produced acceptable evidence of compliance with the insurance coveragew require ea erformance Additionally,ublic wo until commonwealth nor any of its political subdivisions shall enter into any P acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracnng authority. Applicants the box that applies to your situation and Please fill in the workers' compensation affidavit completely,by checking n+��*arce as all affidavits may be supplying company names,address and phone numbers along with a certificate of' Also fi sure m sign and submitted to the Department of Industrial Accidents for won of insurance coverage. or town that the application for the•permit or license is date the affidavit. The affidavit shoes be returned to the city Or any questions regarding the "law"or if you being requested,not the Department of Indusrtrial Accidents. Should you ensatida policy, lease call the Department at the number listed below., are required to obtain a workers' comp P �'�P ` City or Towns late and rioted legibly. The Department has provided a space at the bottom of the Please be sure that the affidavit is comp P to contact Yan the applies• Please affidavit for you to fill out in the event the Office of number. The affidavits may be re=as6d t" be sure to fill in the pejm i cease number which wdl be used a reference the Department by mail or FAX unless other arrangements have- been made• The Office of Investigations would like to thank you m 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 Investigallons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 730 CMR Appmdis J Table dS=b(continued) • Prescriptive PaekaM[or Oat sad Two.FAu*Residential Baltdiap Heated with Fossil Fuels MAXIMUM MINIMUM Wall floor Hase�mt I—: Slab Hearing/Cooling t7laauB 8 C Wall hun E�rcierrcy' Area'(Si) U-value= R� J R� R�� R value' R valud Parkaae 5701 to 6500 Heatlng Degree Dana' l3 19 10 6 Normal Q 12'/. 0.40 3li 6 Normal R 12% om 30 19 19 10 3S AFUE 13 19 10 6 $ 12% 030 3a !3 � N/A N/A Normal T 1SY• 036 38 19 19 10 6 Normal U 1Syfi OA6 2S N/A -N/A ES AFUE V 1S•/0 0.44 38 13 6 95 AFUE w 15% os2 30 19 19 10 13 25 NIA N/A Normal X 13% os2 38 19 2s NIAN/ANormal y IBOA 0.42 .38 6 90 AFUE Z 19% 0.42 3s 13 19 10 6 90 AFUE AA 0-50 30 19 19 10 1. ADDRESS OF PROPERTY: .5 2. SQU ARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: f '� 4. %GLAZING AREA(93 DIVIDED BY#2): z; /y S. SELECT PACKAGE(Q—AA-see chart above): i NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: g4orms-080303a 780 CMR Appendix J Footnotes to Table JS2.1b: Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excludingexcluded from the ors)U-v to ere gross wall area,expressed as a percentage. Up to 1%of the total glazing area may be excl For example,3 &of decorative glass may be excluded from a building design with 300 ft of glazing area ce with Z After January 1, 1999, glazing U-values must be tested d documented ed by the manu from Table Jc l Se3a. Ur in cvaludes are for the National Fenestration Rating Council (NFRC) test procedure, whole units:center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized � construction. R 30 sul. If the may be substituted achieves the R 38 insulation thickness over the exterior walls without insulation and R-38 insulation may be substituted for R49 insulation. uC�ei1���u�represent must behpla d between stun of cavity insulation plus insulating sheathing (if used). For ventilate ceilings, the conditioned space and the ventilated portion of the roo£ 'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding,structural sheathing,and interior drywall.For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R 13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces, basements, or garages).Floors over outside air must meet the ceiling requirements. T a entire opaque portion of any individual basement wall with an average depth less than 50%below grade must } mc_t the same R-value requirement as above-grade Windowsdoors � meet the door U--value requirement ba:,ements must be included with the other glazing. Basement &-scribed in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3,4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J52.1a NOTES: d U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. a)Glazing areas an 111 t-value requirements are for insulation only and do not include structural components. r than 035. Door U-values must be tested b)Opaque doors in the building envelope must have a U-value no greate and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing loe U voice requirement components comply if the fordo area-weighted e-weighted average U- value of all windows or doors is less than or equal 43 /Pj�ETner�~o• The Town of Barnstalble 1 Services •`anxrvsr�si.E. MASSg Department of Health Safety and Envlr0-, a 9�A 059• Building Division �fD MA{ 367 Main Street.Hyannis MA 02601 Ralph Crossen Office: 508-862-4038 Building CommissiOnz 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 no registered than four dwelling units or to st<==es which are adjacent to such residence or,building be done by registered contractors,with certain exceptions,along with other requirements. - - - __Estimated Cost �v , Type of Work: Oy Address of Work: ' Owner's Name: pp Date of Application: v I hereby certify that: Registration is not required for the following reason(s): []work excluded by law ❑Job Under S1.000 []Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: UNREGISTERED OWNERS PULLING THEIR OWN PERNUT OR DEALING WITWO�DO NOT HAVE CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT FUND UNDER MGL c. 142A. ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner:. s Registration No. Dace Contractor Name OR Date Owner's Name a:for ms:Alfidav yy ✓fte i�anvnzoruuea a�✓/�aaacacfu�aelZa BOARD OF BUILDING REGULATIONS ` License: CONSTRUCTION SUPERVISOR Number: CS 036316 ' f. Expires::05/15/2002 Tr.no: 26193 : F Restricted To; 00 BENJAMIN H BASSEft- PO BOX 761 r!,�•,�,— ,act,) DENNIS, MA 02638 Administrator i a• s/-T ✓/ce��o.iivaooeruaal!/c'o�✓ raaacleuaetla f' ':HOME IMPROVEMENT CONTRACTOR Registration 110644 Type.; -INDIVIDUAL' . : Expiration 11/03/00 BENJAMIN BASSETT BENJAMIN H..BASSETT. 1060`MAIN ST ADMINISTRATOR DENNIS MA 0.438 r QUERY PROPERTY: QUERY END QUERY PROPERTY PENTAMATION----------------------------------------------------------- 08/16/99 PARCEL ID 133 063 GEO ID 31977 LOT/BLOCK 15 DBA BAD CHECK FLAG PROPERTY ADDRESS OWNER BURCHILL '-'L54-=--_,-_-- CARLSON LANE JOHN J & ANN R -W-BARNSTABLE P 0 BOX 9162 BOSTON MA 02114 PHONE DISTRICT WB DEVELOPMENT STATUS C ASSESSOR'S CODE CAPACITY (NOTES) ZONING DIST/ZOC RF SEWER SYSTEM FLOOD PLN/ELEV. WATER SYSTEM OKH? Y # BEDROOMS ZBA DECISION FAMILY APT LOT SIZE 43995. 6 OPER/MGR NAME WET LANDS MULT ADDRESS USE 101 PROTECT DIST AP (N)EXT / (P) REVIOUS / NO (T)ES / PER(M) ITS / (V) IOLATIONS / (G)EOBASE / (E)XIT This value is not among the valid possibilities i �p,e � , 8: 00- 9.30 Assessor's map and lot number ./�!/WP.. O�i</ ?"E,�t4/,� OF o ffI�IC S'YST'ES WPC' `o Sewage Permit number .......... ..— ... n d .... ..............-..... e I B9H�f STAID House number ...................... ..t ..................•.... V977H TITLE � M0.°a i E1 c Eh� ONMENTAL CG �pY a�O TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..... /3v� /� i�CSTa2 E......TO..... '2i�iA/r¢Z.................................. TYPE OF CONSTRUCTION .........G.vGK4?....... .z(q 7 Y- ...................................................:................................ E .:.....2. 19.g TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......95...� �% ... 5.7............SOACISH ��2/nS sVao)viSioN ,,�, �3�A,1, ............ ............................... .................................. Proposed Use Zoning District ....... .F........................................................Fire District ..W S..!. f3.9..t2s �9P>LE ........ .... ................................... Name of Owner ,C34.P.F.ls i�..�'29!ZEi`�Nrr,—Z/4.........Address .............................................:. /�2 @ Name of Builder .....a. !.. <etZeV�....g!!��b . 2? / 4 oCN.u�S Address ..............3..................................................................... Name of Architect ..�CN..��!tYW��� ............Address ..�:...."�.Ln?��T�� . ................................ .... .... .................................................. Number of Rooms ..................................................Foundation � .. UNOCrZ ALL Exterior ......G.C.l� ��....... .................................Roofing ........ ......................................................... K ao /U .Interior .......5./.1 /�Q4 Floors .. fl...... ....w......t2C............................................. ............................................... Heating .......0/1 ......xr�e!CjF .........................................Plumbing .................................................................................. Fireplace . .................................Approximate Cost s�00p Z- d C,. .. .... Definitive Plan Approved by Planning Board �_oT__z¢________19__�_' Area ......................................... Diagram of Lot and Building with Dimensions Fee ......... ................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH � � 1601 \ P�H 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 .......hY......PE720N. ..................................... - c�q Construction Supervisor's License .... ......... r _ BODFISH MRKETING, INC. 27649 Rebuild & Restore No ................. Permit for .................................... ........Sing;L,�k...F4Rji.ly..Dwejj.ing...................... ....... Location .......U.1ii4a..S.Lreet.......................... West Barnstable ............................................................................... BPdfish Marketing, Inc. Owner ................................................................... Type of Construction ..... Frame..................................... ................................................................................ Plot ............................ Lot .......... . ..................... Permit Granted .... .................19 85 Date of Inspection .........."/..lg Date Completed ................ ...........19 Assessor's map and lot number THE> .......... Sewage Permit number ......... ...1..!i ?... ' AJ i BAaBSTADLE, i House number ......................' .�''.5. � ✓ 90 raea pl�c.................................... p 1639. `0 Mid TOWN OF BARNSTABLE BUILDING INSPECTOR 1-0 • tf APPLICATION FOR PERMIT TO ..... !�� C$7 o2 it To 6ei�11V,I,L ........y. .............................................................................�............... TYPEOF CONSTRUCTION .........�!U���r�.............. ............................................................................................. ... E ........2..7.....................19.8 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... t�....A/�!// 5T I3GDriS/-1 F/-/e/71S SV[3D)✓/. /ICA) ......... .' 13if/cN..................... ................................................................................................... .............. Proposed Use .......1�G../ D��/TiN� ...............................................................:...................................................................... Zoning District ....... F ....................Fire District ...W.. .. ���1/zNS7..!9[3L,E Name of Owner /-�c>1F/S H /�/A�,eETi A)C.,. it/G „.Address BO G k 56 q G✓.......................................��/�iU5 ............................................ .............................................. Name of Builder .... ��L«���....��U'� !Zs..............Address 2� 4 .00N�cJi S y .......... .......... .................................................................................... Name of Architect ...............................Address f'f—NL/17CdT/� .................................................................................... Number of Rooms 5"�X ...Foundation ��rci�,. ` 7�6 f/ G NOt: 6LL .................................... Exierior ....... t?;&' ..................................Roofing .......lr. /1o`l!Q.........................:............................... Floors ... i��/, ..!....l�jpGr� . ..........................................Interior ........5/-/ 2GC,� . ..... ....... ......................................................... Heating ...... ................... .........................................Plumbing ........................................................ Fireplace ......EXiS.j.i�U f� i�./ '...............................:.Approximate. Cost �006; i ................ . .........; Definitive Plan Approved by Planning. Board °___UT__2 4___ 19 Area .........................................i Diagram of Lot and Building with Dimensions 3 Fee r ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH � � N (�vF i 160 1T w f t� - 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 .....::'. .......p .I.................................................. Construction Supervisor's License ........` C-�....,,,_. BODFISH MARMING INC. A=133-1 No' ..... Permit for Rebuild 8, 1�:e'AtSe .................................... Single ............ Family Dwelling.................. Location ....OJ��..atmrgt........ ........... ...... .................... Owner ......Bodf.i.s.h..Marke:W!9.:' ........... .......... Type of Construction. ........Erma........................ ................................................................................ Plot ............................ Lot":' ............................ Permit Granted ................19 85 Date of Inspection ....................................19 -19 Date Completed .................................... Engineering Dept. (3rd floor) Map �Parcel 2�J, ermit# 9 LI House# - Date Issued Board of Health(3rd floor)(8:15 9:30/1:00-4:30) ; �,'� Fee g� riannJ'� ��ra C' tlfE►p, Q.$LR F � ?A y 19p�`y���re� f• a , � �• 'MASS- 1 , TOWN OF BARNSTABLE ' Building Permit Application '� •. J, Ject Street Address lfz,�G VillageIts - 6 Owner = / ~ Address Telephone -Permit Request &-,U 17 'G x 7' 6 Dy%,� - r1- f- First Floor ( � 2 square feet Second Floor (d0 square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size 2- Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure -1°° -#- Historic House ales ❑No On Old King's Highway PYes ❑No Basement Type: P Full 20crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) /V 474- Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing 7� New Z- Half: Existing New No. of Bedrooms: Existing y New -17- Total Room Count(not including baths): Existing 7 New 7 First Floor Room Count S' Heat Type and Fuel: �0 Gas ❑Oil ❑Electric ❑Other Central Air Yes ❑No Fireplaces: Existing New Existing wood/coal stove 3YYes ❑No Garage: ❑Detached(size) 2 X �/ Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name (��!�r� / Telephone Number 3 6 2 ^ 73 v�/ Address G/ License# / Home Improvement Contractor# //f 69 a Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FO THE FOLLOWING REASON(S) C FOR OFFICIAL USE ONLY t PERMIT NO. } L p ' DATE ISSUED'- -MAP/PARCEL:-NO.; , ADDRESS` x VILLAGE 1� OWNER DATE OF INSPECTION: FOUNDATION FRAME 3 j INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. t LEI Ut 77� PQ d 1 - Q t� ' �L�� 'lid 0 �`• � i ` Q = � � �� f -- -_ J_\���\ � � �� s � � � � �Q ,� �I � _ � � � , ,cr�Gu/ w a 4-4-- l ra11Ty j3e�/Y1 "ego... i �, ry ew I I ry\ �Jr- .- -71 E Application to ��199 6 1 6PP„S of : s �► - 5 6 Old. Kings 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 t LC ADDRESS OF PROPOSED WORK I L � ASSESSORS MAP NO. OWNER Js h/V 91rL-1/ �� ASSESSORS LOT NO. ©� HOME ADDRESS -"Z2' _('-A TEL. NO. FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). $,fVC-*- tf 2-27 G R Rc.,S o/Y 4-aN'Ae-- tv, l?. /�/Y"ArdP-b /)14�'Ffa�-L 2C G4/ZLSoN �-cW� lv�$r cLGl2i1'rTsrP<.� 041 c- a c` l3Qdrd.f/' CQ/LLS'aA/ Z-qA-"-e R&-si— j)ar_.2& s 3- Ca v IV AfZIV�—. It tr (''2tea Lo es'Gk ell. / o A&C' e Lce wc�Y C.Q/2 �t/' ,raN� (.�• . ll� 68' AGENT OR CONTRACTOR LPL �eQC�O�S TEL. NO. �6Z 23Z/ ^ ADDRESS 6 9 SMAIS1a.6,L -f 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). rrn�1,�in,- ,,RA L f�c� GX(Ze,s' Signed v ~° Owner-Contractor-Agent Space below line for Committee use. R-eceiysedyjy 'V� U Date The Certificate is hereby Date .� g I�0 Time AUr AUG gyWN dF—BAR NS-T-111 ABLE 1 UL�iCii•lii-S wi1hP9+��twar �.J Approved IMPORTANT: If Certificate is approved,approval is subject to the 10 da appeal period provided in the Act. Town of Barnstable Old King's Highway Historic District Committee SPEC SHEET FOUNDATION CjJ C/y/ �Q SIDING TYPE CL,Q P�f��AS Slj/�G�es COLOR CHIMNEY TYPE GeA17/z6-L- COLOR J /?( C__ ROOF MATERIAL !.y d'0 43 / COLOR d /Z a Z- PITCH /(J)/I( 2- WINDOW D04AZO?- SIZE k 7 ,& /VO GU I N OO W,. D/L- dap', TRIM COLOR (/✓I(/� GyDD.J S /N6�-�P JZOpr- of 4-9/60 w44-'Ls DOORS COLOR SHUTTERS COLOR GUTTERS w. I DECK GARAGE DOORS COLOR SIGNS COLORS O D FENCE COLOR 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. SPECSBT (� ,, o, �`-, �. _ �. ,\ �� . . �..,� � �� �/`\�v J \.. / ��� � O`''T` � .9 �� w i 0 ! zt- ,►fait' iz4z� �3 J. Sj I y rtrt nn nn �: 4(`ac i f �..� ,-.1`• it - �p 'I 91�1' ' I d F -ti� � I �t \ i1o���� \iL—•— i • '• .. .. `✓2j 1109)U/Y/,(JgLI.�jCQLCfL�p.`v ",..w♦cG'/LCIiJeL[6. ' DEPARFKENf OF PUBLIC♦SAPEfY �+ CONSTRUCTION SUPERVISOR LICENSE ',Number.. 'Expires: Restricted T'o: 00 CARL W BERGFORS• sr 69 ALLYN LN BARNSTABLE, NA 02630 ENT;,�,;C :R��CTO�t f M.eN, ?'.•=�h `YP ' 4 NU V1�DUt1 out F jh" "a.� ,aaoMi�isTan��,•R�.� #TAd���A O2� < �� �� Wiwi r , 1 M � / J i N v d � r V t� `9 m r. v M d �WE� , The Town of Barnstable MAM Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW. i SUPPLEMENT TO PERBUT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: /a � a� � Est.Cost 3 �� Address of Work: Owner's Name Date of Permit Application: G 9� I hereby certify that: Registration is not required for the following reason(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 11VIPROVEMENT 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.; Owner's Name • "'� i''•'�' •` T.ln• CuntnuonN•caltli of Atassacliasem. Department ojIndustrial Accidents : 1 O!llceallasllAatfoas . ,. . •�.• . 600 11 1rslti»won Street Boston.Max 02111 workers Compensation Insurance.Atfridavit �ARnlica�nformatlon _... �.. Please i'RiNT`,e 1�1 _ - In on —��.�il� G citi, nhonc 3�z�2�2F 1 am a homeowner performing all work:myself. am a sole proprietor and have no one working in any capacity .�.. I am an employer providing workers' compensation for my employees working on this job. rih Anne#• •insurnnee eo, nniier t! I am a sole proprietor,general contractor,or homeowner(curie one)and have hued the contractors listed below who h, the following workers' compensation polices: v rih nhone Ih insurance holier t1 . • ... ... m �• c• •t Rhone 0! -su-nitee co- holier 0 �Xtiach additionsi'sheet if aeeessar�;,�+ •►..� -- "••'•'r•''"• - Eailure to smart coverage as required under Section ZSA of 111G1.IS2 can lead to the Imposition of erumttaa penaium of a tine up to6L5ii11Ao aad/ot one years'imprisonment as well as civil penalties in the forth of a STOP WORK ORDER and a Qne ofS10DA0 a day against me. 1 understand thst coin•of this statement may be forwarded to the Me of 111ST"igatious of the DIA for coverage retiBadoa. I do herehr cerrljl•un rr the pains and penalties ojpedurp that the injommdion pttsrided above is taste and corrne • � 6 I9g6 Sienatune ate Print namePhone# &2— oMcial use only do not write in ibis area to be completed by city or town olIIcial permitAiteose 0 hounding Department tin•or tows• OWE Board ' 0 cheek if immediate response u required OSdeetmea's Okla C3lieaitb Department ` phone f!; M01her__ contact per .!.Information and Instructions Massachusetts General Laws chapter 153 section 25 requires all employers to provide workers' compensation for U employces. As quoted from the "law".an emplm�ee is defined as every person in the service of anotherunder any contract of hire.express or implied, oral or written• j An empinrer is defined as an individual. partnership.association.corporation or other :Ugal entity. or any two or m 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 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 1 or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an emnlr. MGL chapter t53 section 25 also states that every stnte.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 chapte been presented to the contracting authority. (° :.s..._ Ip..t•T3.•i:^.... ...!' y•.:'•�,:.;� .�•'.LA� '^.,:.- .►:�--. ��;iY:' ...a..�!!tt.'.ty 4+�.ni_•�,?;:..�{, •r 1 Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation an supplying company names. address and phone numbers 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 affdavit. 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 requir to obtain a workers' compensation policy,please call the Department at the number listed below. ' q......r _ : � . . ...- .��"S�;!�.^'ct�'• •ram. ... . 'vr. ' �.Y..." Le��" lE1 1':n �I4JtiiL••�•�L•. -• .. 'c:.• �:.�r?';:•:��...i;�c•.�,.1':.�*.a7=3:��.S='�= -tr%'s• gr',w..:.:.r "�..�►•....'•err �, .� ::irk .... _• � "' • City or To«•ns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom the affidavit for you to fill out in the-event the Oili��i be used as a reference numf Investigations has to be you regarding The affidavits ie maybe r�etutnec be sure to fill in the permit/license number which w . 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 questir please do not hesitate to give us a call. _ 7 _ i.ir,:�Y: : :•:ii •1.��.::use' '�%:.�.«��, w�ii.! I..�iiw•��+ '.�:��tia•w.r• The Department's address. p�•�` tele hone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents l �. Office of inuesd9adons yr 600 Washington Street �c _. Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 ext. 406, 409 or 375 € . . , .. . . . > .. S01L LOG . �' Tom of NcL E . J5 -,s, O N 0. 1 N O. 2 . . . z . �, . . . . . r o�M ' : i r . .. . - , . ..-. . - TOf'SD/1_ I . . 3 - . . _ . . _- . , � ,: , L 74:1 L' 3 • < 1 74. 3 _ . l. • ..- 1 f t 5 f TOP Of FOUNDATION EL.. - _�_, o ,.. _�.z. .- . 7V► D v . 0 b i. . _ r r b _ r ALL s • e _.. _ :..:alb i.,Z?" � , .,' E f. , - .- i : '. : i e ., • z . . t. p _ - - i 3 , • eo N E '� - - 1 .N!/rtll/YIUVY! . fDVE . 7/ 56 ,;. : .. i r .^ 71 39 , , r - ,. r----.• , • : _, , NED '.STONE t 2 ,COVER I./ . WAS �.a - - . 7 9 2 , o E l. _ o v d' =Z N. .i 7/.7� i o xlz IN.EI do ° , I- ,G 9.57 i; a . ; �i IN.El, �e o p �. a. - 0 0 0 o,o.. 3/4 1 1/2 - WASHED-.,STONY . D/B W/ 6 SUMP ' , z • A 0.'n' p. D d ° ° 1 - D o 4 LI UID LEVEL 6 Cr 14 4 0 e - p • e` a O_. O a d o o , v re • O � c • p :, ob . o b o0 4 o� EFF. DEPTH . �, 6 t 5 . Q .m - �,6 . - b V y PERC - 'TEST RESULTS - . c . . O O by D _ . --'' :: ti . cp:poPb , � .. ,. . ' . • .J• p v U : I L� I :4w"w.�Mj11///,A - ; PRECAST SEPTIC- TANK WITH . 00°6o PRECAST . LEACHING '- PITS. : - PERC RATE:` CAST IN PLACE INLET AND 7 , ooe, o ; �' ° -� � EL. �3 8 . - NO.: r� SIZE:, . :e� -s pr:_a �r WHITNESSED BY,. - ;.. �,;, -:I �- ". F_.�-r $�uNsm r BOA EA TH j OUTLET T S PER TITLE IC , r RD OF H _. SIZE : o �. N K •-}' — IAs �` .�� DATE. gig_ CS O G A TA ,4 cv•.rt� t . . __— . s ,. : 1 .�"L0NCs x .4- Io wtnE x s- 8 a� P ,e DIAL ..,• .. �' -- . e _ .. , • _- - .- - . . , j , _ , - _ �� . �_ . ,. . 1- �'�<so . r . '� r �,: t , PROFILE : OF PROP SED SEWAGE SYSTEM - ,' . . - �A 2t�1 S T A :.. : SYSTEM DESIGNED BY THE TOWN Of REGULATIONS... AND E GE SCALE •. 1/4 - 1 0 1 STATE TITLE V FOR SUBSURFACE DISPOSAL OF S WA - _ _ - __ _ _ - t _--�-- .. : ;. , ti t,Nr p • . , , ; �YoaT :(� ��, D . A�% --'� . , : � ¢' �, . . :,. , . I , r,. c CA Nrr- �: p o s . ; . 4 ,. - . , . Ee, �n . },, - L �r C� . . . , :. Y, ,, , r `�. . _ ^d ti x P �, , - -.. ,.:'. N . B . : . . , , � � : , 5 . -•., { ALL PIPES SHA L BE S HEDULE __4 P.V.C. SEWER PIPE 1. L C 0 a . . .:,. r II r .._ . . , > . G9.9 .t D ER F T EX EPT FOR .: . �, •.:. 2. All PIPES SHALL BE SLOPE 1/4 P 00 C :9 X �• ' .. - .W ` THE .FIRST 2 FEET OUT OF THE D /B WHICH SHALL BE LEVEL , ., , I , . •, a . s 1 , r . . . 33 ;> . a ,. , , - O > : > , G 3 B D 1 A DAY • PER BR. GAL70AY - - 3• DESI N FLOW E ROOMS AT 1 0 G L r ti �: , '�� ..fix. �r- r• . X be r �.,. . € Q ,Q ... ,. .. ,, "`"E .. ,� SEPTIC TANK SIZ E X GAL � " - . : �a . _ , : . . . . L- w Y u } a~ . :F, .: „ . T X. C� T .. f.. <• '*r*' c� . - f GOO , . . .,.. -.. .: , ,... . .: . '4" ... ,.-. '.:..;.. .... ': �.-..,i- .. :. -. :.a � �a.:. '... - 'I ..:. . .: .. a R~. 1 _B AR GE DIS'P S L t. _ s USE GAI. W/ G BA D A . _ �. o . . 9 3 ' _ -' . _ r . O. r :. N tt T. /�C t r ACF'T /-l:' N� F� - A . X G _. - - �. f D EFL: y: ,�-.. ff: f1 i� LEACHING SYSTEM. U E , r „_ , . . . ��• S . _ . . ., _ � _.. : T . y _f . r t� '`& n O r ST !a fd > <f -. �i / H;' � : .: ,,.., L s / + a`. . .. . - �'a ` 13 L9 : . ._. ' "•` !` 7 ,, �, • >- E' 5 . y C GL M ,^ :- ...: ti , --v... r . . : �c 3 G is L. Qn :. s . Z... ? Y .,. >. ,, . - EFFECTIVE AREA. SIDE . , ti . . , . _ ,y t V .. a - .. V . - . c .r ... _ �- .. I b4. .I r. ►"C f .A „ , , _ . ,.l f t TT - , - , - BO OM :,�. .; i , .. w, s ;. y a- ', I - _. . • , ,. 4�- 1: +tom. : • . pT [a �. F -� .. E �. l Y rr L ,s T r. ;, a TD AL FLOW r . : r t _ . - y:: : N !(/�dS I p� .' :� ti � , E ` �+ S . .. _ E .E X W/ GARBAGE Q�SPO Al TOTAL RE D . FLOW � '� ' , , � x _ ' C . .5 v "T mix f Y. s : r; , D - �' E W GAL/ AY : :: - o RES RVE FLO - ., ::- . . . . . ' _ _ e f : _ . :: S5 '27 $ , n. _. . . - ',: . SUADIV/S/CN PLr4/V . ,(30DF/�N FA.2M - REFERENCE PLANS . = .. - i G AUG_ Z8 /9P4 N'. .l�oYLE EiyC�-In/EE�E' IJ _ . : - - ^ _ .'�Y _ _ �. . .. -,r _ ' 4 t /'i(/ MEAN SEA L E✓�/ . ' - , . ; FL FdAT/DNS R Fh . � t . I R API ROVED BY . - , . . k _ �A �� BOARD OF HEALTH __-____- - , - ,� 4 o s . . ' , . . • . : DATE . . - E SE A I PR PERTY OWNER : . o ,BO�f,s� M,��CET„�U T�,�. . SIT AND W G E PL - . , O J/3c x Sr 4 H_ ��'w ` �t OFq titK f''.x„�� �DR• ,50AC), S y MA�X6T/NG ,. INC.' `,. � ��sT��� as oz� �� -- or Roo °y %, ToTiTl "%_4, 3 1BEDROOM SINGLE FAMILY DWELLING . ,_ 0 �� �� .. .DATE . 2 2� -:�-.5 NcrrE-. "m IS 1-01T jpU£5 I4C,7, L/E /N 7-L_oc'D P/-AfW ' 44 �` � � ���,t E ._ • --- ____ . __ _._... . .__. _ —..--- __. ---- ---— - +,. i , - + y� '�S�T E H�O�� �, �l L,�, ,o>~AL� �` DOYLE ASSOUATES .FALMOUTH ' MASS . i f r - .. ,: _ .. .. . .r.. -::•.. i - 9 _ - - - ___.. ____ _._- __._ -- _. ..__. -.-. _.... - — - -- -- --- i I iL_ L_ __._.. L __ - I