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HomeMy WebLinkAbout0211 CARLSON LANE d I i j I I' i I � I � I I i i J�p,EC�'UfpCp UPC 12543 NOS fi'�'s7co � HA.9TIflG9.mN ""�� .._:... .. ", '..`�!;+*t�"t;c,�a�a'.�i_3.:.N....n::t.._�•� _ii..:......nfuie.��auu.'�F'.s'_,._r+.._"T .w,..�8 �r,��:"- - y..' _ . f ,� _i1 1 � T 4 i r�� y i .f• A 1 , C ['TI k �,�- t .. 3 ('�tWo Vol 0 aT' 13® i i j TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 13 3 Parcel Permit# �lO Q Health Division Date Issued Conservation Division C1 3 ee�z 17, 50 SEA d IC SYSTEwa ��� ,u' Tax Collector44� ,(X,�gSTA1LLEDINCOMPLIANCE Treasurer i � TH TITLE 5 ENVIRONMENTAL CODE AND Planning Dept. TOWN REGULATIONS Date Definitive Plan Approved by Planning Board Historic-OKH' Preservation/Hyannis Project Street Address —De1 Lor 4-- S N .Village Owner�uG'T— H*9 N-ffA� Address Telephone Z� Permit Request o _ i `C� ►��� t N SY Sc,�°� vv�V��v�� OrD L Square feet: 1st floor: existing proposed 2nd.floor: existing proposed Total new Estimated Project Cost -ZS5­d0'boZoning District Flood Plain Groundwater Overlay Construction Type Lot Size GrandfatthJered: ❑Yes ❑No If yes,attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes O No Basement Type: ❑Full ❑Crawl ❑Walkout 0 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: 0 Gas ❑Oil ❑ Electric ❑Other Central Air: O Yes ❑No Fireplaces: Existing New Existing wood/coal stove: 0 Yes ❑No Detached garage:O existing ❑new size Pool:O existing P(new size 6X Barn:O existing ❑new size Attached garage:❑existing ❑new size Shed:O existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial O Yes ❑ No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name_ Mr-r 'C Co\-L^P�� Telephone Number q36 k 40O Address i�1 � /U)� License# � C�7Co7_0(S� t �� U �►�' Home Improvement Contractor# Worker's Compensation# _ i�^ O'Z3 14 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE _ Zd 19 FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED , MAP/PARCEL NO. ADDRESS VILLAGE OWNER • DATE OF INSPECTION FOUNDATION FRAME INSULATION h` FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH A FINAL GAS: ROUGH ` - FINAL ` FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. - I �J — lNJ ' - - - __ �s i )ffice: 508-862-4038 Ralph Crosses *ax: �508-790-6230 BuiIding'Comtnissio::e: Permit no. Date Zo 'f; 1 AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,rmovation,repair,modernization,conversion, improvement,removal,demolition, or construction of an addition to any pre"aisting 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 contzactozz,with certain exceptions,along with other requirements. . r r Type of Work: �o C��,lc9 tii�,.� t� Estimated Cost Address of Work: 1 -1- Owner's Name• - - �,,,,,,�,raZ Date of Application: ^�e I hereby certify that: Registration is not required for the following ranson(s): Work excluded by law [3Job Under$1,000 Building not owner-occupied C30wner pulling own permit Notice is hereby given that.- OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME LOVEMENT 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. rn Date Contractor Name Registration No. OR Date Owner's Name q:fbmU:Affidav Z j. - '� -- Olfica ollarestfaatfons 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance davit `nciar�ut icy%//%� �� / / �i, !// //i ////�/�i�,%%%,'�///�/////�%M"".. name: �7C'yGi '�' _ fie „• location city phone'# f�G Z-" ❑ I am a homeowner performing all work myselL ❑ I am a sole aroarietor sad have no one working in amr capacity ® I am an emplo�,�ezypzoviding tivorkers' compensation for my emplavees working on this job. . comonnvname: address: �A"�—�'�`L`� �.�r.�.�'� • : " - :. .... .. city: }� , �-J Y�.. ✓U vo,— phone#: �-1�C� C�(0 insurance cn. Oiicv# ---------- am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the folloning workers* compensation polices: comonnv name: address: 'S,..::«y.:. ..... dtv: shone oitev31 #" comnnnv name: ,., vM ..:.... address: dh- nhone#- inuarance co. ........ r..::..:+:£a• Oiit v# .: w'.,•n w..:::':''':cblyr�ji:sri v...;'±;..•L.;'.'::'. FaIIure to secure coverage as requited tinder Section ISA of MGL 152 can lead to do imposition atc indual penalties of a Uae up to st300.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a ttt a of SIOL00 a day against me. I understand that a copy of this statement may be forwarded to the Olnce of Investigations of the DIA for eovetage•erimdon. 1 do hereby cenify i 4114 r�der the p • an penalties of perjury that the infonnadonprovided above is&s midearreelSigaamz k Date _ Priest name Y t 1 �- - `�.`^^✓�--•�� Phase# [contact 7p�erson: write in this area to be completed by city or town otlidai citytown: pettnit/lltamse q Q$uiWin;Deparnnmt ❑Licensing Board nse is required ❑Selectman's OMce ❑Health Department phone#-, Other_ feewen y9S P1A1 Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for the•:: employees..As quoted from the "law", an employee is defined as every person in the service of another under a y, cow`- of hire, express or implied, oral or written. An employer is defined as an individual. partnership, association, corporation or other Iegal entity, or any two or more the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the recce�•e: trustee of as individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do e , construction or repair work an such dwelling house or an the group:s c: building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renew—, of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who ha-,: not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neithenhe . 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 ofthis chapter have bees presented to the comrMC=^_ authority. , ----------------- Applicants • Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a cetifi=mc of insurance as all affidavits may be submitted to the Department of Industrial Accidents for caafirmadon of insurance coverage, Also be sure to sign and date the affidavit. The affidavit should be retuned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Departm=has provided a space at the bottam of the affidavit for you to fill aut in the event the Office of investigations has to contact you regarding the applicant Please be sure to fill is the permit/liccase number which wM be used as a refc==member. The affidavits may be rcaaed io the Department by marl or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. � aaG /r.: The Deparaneat's address, telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Me of la>resdaatloas 600 Washington street Boston;Ma. 02111 fax#: (617) 727-7749 phone #: (617) 7274900 eat 406, 409 or 375 P 7ti' o -fq - 72 . v L� 132.2� ANY c��t VIP, �1Jaac[�o1J s�-bµW aJ-�-}�s lrx�t c� -t-r�4 As o %G cArz1. W � >�cva lsrAt�c-�,Mq c s �1 t� M1�.1 Ha gtlx, +1 T a sp f rWE3Fa so,1113 SCALE: "� r /o tµtN of • �s� STEIIEN 78 40 N L l�T� •.ru��t510��� -P.o. c 1►q lfia► T hq,ou.�5 j I • 1 1 . i 1 ti � 1 f,/u, •,1 1 . , t ./ / N ,• I � p ?it - , �, v " r h 1 i j lot N if r i N - r,to 1 � 1 �! t 1 tl 0 \ 1� r 2l1G'i91� G,rT06� OF BARNSTABLE . LOCATION L07-.5 .5JG (2A e4.5011 LA . SEWAGE # 93- 5O`5 VILLAGE to, 3A/zN5TA84-E ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. M• C . N! `Z. J7'"YeE j SEPTIC TANK CAPACITY �- I w -� LEACHING FACILITY:(type)LC-AcH P r (Z,) (size)6'X G ssoNE NO. OF BEDROOMSZ PRIVATE WELL OR PUBLIC WATERIJELI_ BUILDER OR OWNER 134e4)CC- HC-GA97Y DATE PERMIT ISSUED: 9 "Z .3 DATE COMPLIANCE ISSUED: l 2 -1 - 13 VARIANCE GRANTED: Yes No �C G` .y . 7Y7 7•.., Via: n, F �'�d�91.:f i H PR OVEN ENY`COM[RA�tOR V•'r "'s Ypoli� 4 I D I.D. Al 'y p iRl'fiti I§,03/28I0rW.*,- a''J'S te'�' +' ..,, lS✓ X ir.., "ate; �'..n,���g 2i 7�- %-z wst p ��UMARWICH t z.. :1+'• , L/dpNlt092(lIBCLG[IL O�✓I�GCLOdCZf,/LUdP. b i BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 062015 Birthdate: 04/22/1958 Expires: 04/22/2001 Tr.no: 8789 Restricted To: 00 MARK J COLEMAN 2 BARKLEY WAY N HARWICH, MA 02645 Administrator'. i E/�L�R� eN�Me «< »x « « max wR 3/22199 µ, faY•i2i0%4%jXMawYµ x .x<t ..:5:...... s,«.w.x:........'��r x PRGDUClR 508�790-1030 THIS CERTIFICATE 19 ISSUED AS A MATTE OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MCSHEA INSURANCE AGENCY,INC. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 32o WEST MAIN STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 320 WEST MAIN STREET COMPANIE$AFFORDING COVERAGE HYANNIS, MA 02601 0°AANY NATIONAL GRANGE MUTUAL INBURBo -, I COMPANY LEGION INSURANCE COMPANY M J COLEMAN 8,SON } B 2 BARKLEY WAY COMPANY N HARWICH,MA 02945 C _. _.... COMPANY D •.ara.�.:.a: ,w1e.... .«... ;"waa+u°•`'...a,d• i•vnu ,...ni3,'.e�$::,".. ... :: ........._... ............. »>..... 'S ,.;Ali!oe,oxq''pke»x« ..53.':fi.CkxZaeis�.'.,?,iaouz««a:'�.w�"` %`.!:<•,v:psrw.» rroxe r�,:w:$.' '.^.-:w.wn>��o»:wxe:m<�r...,. ..:".. �so,o...�... «•r.».r THIS LS TO CERTIFY THAT THE POLICIES 0o INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMSO ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY R84UIREMENT,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 13 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH_POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS ___,••_„ TYPE OF RefLIRA1JCB �— POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS OATE(MWDDTYY) DATTJLMWODJYYI A GENERAL LIABILITY MPJ12508 B28198 &29/99 GENERALAGOREOATE i 2,000,000 RONMERCIALGENERAL LIAIILITY PRODUCTS•COMPIOP AGO I 2.000,000 CLAIMS MADE U OCCUR PERSONAL 8 ADV INJURY __ i 1,000,ODO OWNER'S a CONTRAOTOR'B PROT EACH OCCURRENCE I 1,000,OQO FIRE DAMAGE(AnY ane US) i 500,000 '- MEO EIP(Any One Breen) I 10,000 AUTOMONLE LIABILITY ,COMBINED SINGLE LIMIT f ANY AUTO ALL OWNED AUTOS BODILY INJURY )PST D9150I1) f 3CHEDVLIO AUTOS HIRFDAUTOS BODILY INJURY I IPK BCDOWII) NON.OWRJED AUTOS PROPERTY DAMAGE B GARAGE LIABILITY AUTO ONLY-GA ACCIDENT i ANY AUTO OTHER THAN AUTO ONLY: "•,*:`"� 'a'x,aD}%°:-�°'0�'0C'`a EACHACCIDENT f "- AGGREGATE I NiCBJISLJABIIITY EAOHOccuRRENCE S UMSRELLA FORM I AGGREGATE f -_ OTHER THAN UMBRELLA FORM i wORKBRB COMFBNSATION Aw WW-0285314 3/13/99 31l3/00 X TORY I.IMIT6 I ER ..e:rN aax: EMPLOYERS'UANU ITV I EL EACH AGGIOENT I> 100.000 ttIE PROPRIETOR) INCL CL DISEASE-POLICY UNIT I 500,000 PARTNERSAXECUTNE EL DISEASE-EA EMPLOYEE f 100,000 OFFICERSARE: X EXCL OTHER DESCRIPTION OF OPERATIOMSILOCATION WENICLE510PROAL ITBMB. 505-700-3459 n<,<,h«rwp'«y:w:.• .• nofti.iiwui..:��.r..wt«e>l:de'ti%•� '���J�in::xo�`l tl•n'�S:a'�'aaa:�i�x' ra�a�4e'iM,ey:�:yo�ttx<•w'�in~.�<•.�.w nwttYi.:x.«<•y:w•.'o , ,y:rd.,w...:oxb»y•a,. a'6>.x«<eiR;x p:9taxaa,..., ,agwo,ox,nu.. '.......�Ty'y..... ' wirn�,r:�ikM»�Vi01fAWNx.Ynv».ew ...✓ .. »x�,OgA'Iv.w•w......... •••••• SHOULD ANY OF THE AYOVC DBSCRIBED POLICIES BE CANCELLED BEFORE THE ANCHOR POOLS EXPIRATION DATE THEREOF, THE ISJUINO COMPANY WILL ENDEAVOR TO MAIL 143 UPPER COUNTY RD. 10 DAYS WIUTTBN NOTICC TO THE CERTIFICATE NOLOEA NAMED TO THE LEFT. DENNISPORT,MA 02639 BUT FAILURE TO MAIL OUCH NOTIC■ BHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY ITS AGENTS OR REPRESENTATIVES. AUTNORIMS64CPMSSNT VG ' ....... ocnea.,icria�.iA,".:ax>.n¢a:<«n:..xt.x.:;o><x.x.xx+x«ut��ai,�y�+�"xxx".•.kn,rw3'�a"aikaib'»x4sx'xxece�<.,�'"„-.'�:w�""�°'a�e°�3�t<S"pi,a,ei,a•• •. exaf.CeeY,tOeti:4a.xyn�aYw......,..., .. ,a>�.x.......x. !«ixax•x,.»x:a•xwr, »........ :ttn:•+:. tp N . .A""' PN»0»x9N .M+A:F�.ltntryiai ?.::::.DAT : A X. CORD ::::.:::: :: ::.:: .. .:::: ::::: :.: ::: ::::: : : : :::>:: :: :::::: ::::.::. :. . :..:: . :; :::: :.::.::.::.::.::.::.::::::::.::.::.: ( ) �, :.:: T1: :I. ': :.::.t ::.::.::.::.::.::: ' 1 � t . " t�. ........................:::::. 04 26 ::::::::.::::::........................................................... 1999 PRODUCER (508)584-2300 FAX (508)584-2187 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Fredericks & Gerardi ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Insurance Agency, Inc. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1313 Belmont Street COMPANIES AFFORDING COVERAGE Brockton, MA 02301 CNA INSURANCE COMPANIES COMPANY Attn: Ext: A INSURED COMPANY ...... .........................................................:... ............................................................................................................................... Anchor Design & Pool , Inc. e 143 Upper County Road .................................................................................................................................................... Dennisport, MA 02639-0000 COMPANY C .................................................................................................................................................... COMPANY D :..;:....................:....::....:::.;;:.;:.:: ;;;:.;;; :.:.:. :......::.;:.::.;:.;:.::::::::: ;;:.:;::::::.;:.;:::::::::.;::::::::::::::.::::;:;;:.;:.;::::.::.::.:::::::::::::::.:::::::.:.:.:.::::::::.;:.:::::::::::.:::::::::::.:::.::::::::.::.:..::::::.;;::::::::::.;:.;::::::::::;:.;:::::::.;;::::::.:. ::::::::::>:«<:::»»>::»::::>::::::::>::::>::::>:«:;::<::>:....::::>::::>::::»:<::<»>:....:>::>::»::>:<:::>::»>::»»::>::>::>::>::>::>::>::>::>«<:<::>::»»»>::>::>::>::>::>::>::>::>::>:<::<:>:<:::>::»:<:»::::>::>::>::>::>::>:<:;«:;;;;;;:.;:.;;:.;:.:.:.;:.;:.;; THIS IS TO CERTIFY THAT TH E POLICIES OF INSURANCE LISTED� BELOW HAVE BEEN EEN ISSUED TO THE INSURED NAMED AB OVE 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION: LTR; DATE(MM/DDNY) DATE(MMIDDNY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000 ...............................................:........................................ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 1,000,000 ................. ....... ?` CLAIMS MADE X OCCUR : PERSONAL&ADV INJURY :$ 1,000,000 q :......: Cl 30718106 04/09/1999 ': 04/09/2000 ............................................ ......................... ......... OWNER'S&CONTRACTOR'S PROT: EACH OCCURRENCE $ 1,000,000 ........................................ ................... E DAMAGE E(Any one fire) :$ 50,000 ............... MED EXP(Any one person) $ 5,000 AUTOMOBILE LIABILITY ANY AUTO : :COMBINED SINGLE LIMIT 1,000,000 ALL OWNED AUTOS X : SCHEDULED AUTOS BODILYrperson)INJURY :$ A :....... 3279516 04/09/1999 04/09/2000 ..................................................................................... X : HIRED AUTOS BODILY INJURY $ X : NON-OWNED AUTOS : (Per accident) ...... .................................................... C�1 �r PROPERTY DAMAGE..............$.................................. GARAGE LIABILITY A ANY AUTO (� ..A�.................................... O ONLY-EA ACCIDENT $ R 1ONLY. Y � OTHER THAN AUTO Dowling ' ................EA AGGREGATE:..CH ACCIDENT]$$................................. EXCESS LIABILITY nC+e A9encY; EACH OCCURRENCE :$ lO00000 ....................................................................................... A : X : UMBRELLA FORM Cl 30718106 /09/1999 : 04/09/2000 AGGREGATE :$ 1,000,pp0 ..... ................................ OTHER THAN UMBRELLA FORM g WORKERS COMPENSATION AND x WC - O - TORY LIMITS: ER ::::: EMPLOYERS'LIABILITY ....... EL EACH ACCIDENT $ lOOOOO A THE PROPRIETOR/ WCC130718090 : 04/09/1999 04/09/2000 ..............................................>.......-............................... :...... X : INCL : EL DISEASE-POLICY LIMIT :$ 500000 PARTNERS/EXECUTIVE ....... ...................................... OFFICERS ARE: EXCL: EL DISEASE-EA EMPLOYEE:$ 100000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS ::::::::::::::::::::::: ::..:::::::::::::::: ::::::::::.:::::::::................................................................................................................................ 2Y: :::::::::: :: :::::2: ::; ::Y2:?:::::::::yr'.." '...'...y.':::::::::::::: : ::: :: :: 2:::s2 :::::::: Y22Y::Y:: ::::::::::::: :::::::::: :2:::::::::;:::::::: :::::2Y:: .......................................................::.::::::::::;::;::::::.....::................................................................:VJS{i�.. i{. 'Q)Y::::::..:........................................................................................:::.:::::::::::. ..................................................................... ..........................::.:. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Town of Barnstable 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Town Hall BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Building Dept. OF ANY KI _a.UPON_-T_€'C$M ANY,ITS AGENTS OR REPRESENTATIVES. Hyannis, MA 02601 AUTHORIZED REPRESFcATATIVE Dennis Ger d'6. ............................�'Y .... . ., n. ... :: .. ::::::: ::::::::::::.. :X ..... " ..::::.:. . Application to � 99y :14. 1 r Old Kings Highway Regional Historic District Committee in the town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, iri 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: - I..Exterior Building Construction: ❑ New Building ❑ Addition ❑ Alteration Indicate type of building: ❑. House ❑ Garage ❑ Commercial- ❑ Other Z Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: GJ'Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). /Q a TYPE OR PRINT LEGIBLY DATE, ADDRESS OF PROPOSED WORK 5911 t,1T�� ASSESSORS MAP NO. - ASSESSORS LOT NO. O OWNER HOME ADDRESS TEL. NO. 3Coa- �,C�a3 D FULL NAMES AND ADDRESSES.-OF ABUTTING OWNERS., Include name of adjacent property owners across any public . C., street or way. (Attach additional skeet if"necessary►. AAA iM TEL NO. AGENT OR CONTRACTOR _ -_ r - ADDRESS \33 t-�1-�A'e�C' \ ""� • �O([1y,�` D�Q�P� 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). V JA\ Signed wner•Contractor•Apent i tline for Committee use. to Cert' ' ate is hereby ate 9 P•' 9199� T e TOWN OF BARNSTgBLE • Y Approved ❑ IMPOL =�f Certlfi to Is-appr_ r/ovalrls_subJect�t� /o the O�d�ay`appeal period Oc2O Zf-) ©a� ��1�So�16jfClG!'��s���C/ [mil' .✓�/'[/� W V/��/ '.� _ �, . i l 6 �a { Town of Barnstable ' Old King's Highway Historic District Committee SPEC SHEET FOUNDATION SIDING TYPE COLOR CHIMNEY TYPE COLOR ROOF MATERIAL COLOR PITCH WINDOWS COLOR SIZE TRIM COLOR DOORS COLORS SHUTTERS COLORS GUTTERS COLORS DECKS MATERIALS GARAGE DOORS COLORS SKYLIGHTS SIZE COLORS. SIGNS COLORS A\,>,y,►FENCE COLOR � `l�1�_ �h ` (�C1�h \lM�h COLOR�\�``� NOTES: Fill out completely, including measurements and materials/colors to be used. Four copies of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plans, when applicable. { SPECSHT Revised 11/98 14 m . v Lls 132,21 • � � Y ���(TAT � • G���l� �� '�C�rJ �1:1�jiaJ s�-b�1�.1 a.�-�-}rs �s . st-b4evaa3AQ'�-f�°r ITS CA=L50O W•� � JSTAt3c.li—,Mq• c s � MIS HaK� gux a S9frWE3M 30,1113 SCAu—=: INS 1 /O t�%.TN OF N+ � • I,3vQ S�rr�Cl�l i • Nq . I 40 �y0 sun�E+�� p o.8rx I l�j `�tm-1ot.t�{�(;hq,otri75 -- M C O R IP O W A 4 lE® 133 UPPER'COUNTY ROAD SOUTH DENNIS,MA 02660 •'(508)394-4800 FAX(508)394-6735 a� ! � ti� •-�+ x` .'� ` �� '` .ckr � cy ,� `u �o' ss",y''k"FFa�" 0� r`' i � t "Y�j {a >T° • r � r,.� °PF�, � :.'� �y;s' �W 83 � Yes, ��ltgj.� Q � alr A:. 11 � i'rb C'^ �k .�, w�•r'' 'A,��y'.P�'. F 65 ''..4 > •�y. s ^r:- ,r G3 o t �s� tea. `✓ cry . i..a ;�� �-� ''. � •,� �'#�'xl, � iF' .�., � l as r r y a i 3 ; Sr � - �'+�`•'F''+ MAP � � YK� �L�vi��� C •A� �c r 4 r �y N` 4'Black Vinyl Chain Link SPECRAIL ' S 1 - The Bennington '+ 4 ' This fence is designed to blend into the natural cadence of virtually an landscape. Embracinga Y p traditional fence style it comes with an accent of spear points across the top. ��C��a•��t'a t, i 1 S2 - The Berkshire t Like the Bennington, the Berkshire recreates elegant tradition but comes with staggered spear point picket tops. 1 r - � 15: t 1 t S3 - The Essex With its classic smooth rail top and traditional spear points below, the Essex is designed to meet the most demanding aesthetic needs. } •} yiq',�'��,1 N��KYF FENCE STYLES Of course, all styles that have traditional spear points can be custom designed with flat top pickets or Sl - Bennington S2 - Berkshire S3 - Essex S4 - Saybrook designed to accept A or B finials. Also every one of our styles are available in Residential-Wide, Commercial and Industrial grades. - - - - 1 ORNAMENTAL FENC"ES.,, 1 .4:♦ S4 - The Saybrook This classic design with a smooth rail top reflects the R 4 # V quiet mood of a late spring evening. a E t C I, S5 - The Newport (shown) ,. ,,a• Inspired by the life of the ocean this scallop design I„ - .rsrryrq � with traditional spear points is a statement of grace. S6 - The Citadel t The Citadel's crown design with traditional spear points suggests the power of authority with a subtle ease. S7 - The Horizon The Horizon has a view in mind with its classic design, smooth rail on top and picket spacing of 11/2" between 1 3 pickets is built for harmony in the landscape. S8 - The Falcon (shown) With every other picket thrusting a spear point above the top rail'and with 11/2" picket spacing, this fence . , was created to make the vision of your landscape soar. S9` - The Storrs The height of simplicity, this fence with smooth top rail has been modified so that pickets do not extend ' i ! through the bottom rail. Available in 54" heights, i it meets the demands of pool codes everywhere. S5 - Newport S6 - Citadel S7 - Horizon S8 - Falcon S9 - Storrs ~� ti f . f'.t.- ' • • • • Sk.* 'k�..:e'7#'4 1' �R;`� fir "'. • J Yip+.,��- • • • v 1 . �IIIIII1111I111111111111111 � � I • • • • • • _ • -1'7'.• '�1�4'!Y•.�X +�t hYy^r�34�Q � ! ` .{�ry y..1�L�'` �.•�- «: fM�I� t a A ���:"�y`6'� i" ,�• r, a i' - '�i�y, .l.ety f 1 � 1e. a ,y S�� �r .L`Nft AIN- • • • • �t.wfr`k+•' 't •:t.�.-. �l4 �),..� ` ` S„•, r�• •`;F '� `J + srti 1.x j!a• #���`+f��► . • •• • •• • -• • • • • • i�.�"`_ S •� �r :. t! 'Y.Z�- Cam.`Jt; -AM% ''. -a'�r.,: •. 0h 't A. � •' ,"ham ]�, W.C•�� !' t . •L L;>...:� y :..i� 1 N 1 '� k 'Y+}�5 - 1 -6i1 Q - � �� 1� �► 'at•�. f1,.r.*n'�. �• /� � � ems,..may) �� :��'. �f P ���a. ti. • �„j° .s _ !71� � ,«•►''�r'•ti< .ice a 1 '+"�;:�� � r �y�st QCI tA D k IN :)D O � 3 o � CZ5� 0 \ i 7 vi 1 Y rrl e r 10 4 \ r O O� r N i �oFrt+irgy Town of Barnstable *Permit# 0 ` Regulatory Services >; ` 6m rl fr„rissu d w �V�gtB. ; F 6 Thomas F. Geiler, Director FI MA . Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 www.town.bamstab le.ma.us EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Fax: 508-790-6230. Nnl Yalta tvlllioul Reif X--Press Imprint Map/parcel Number v Property Address' - C �Q,�,►�I sz� keu,-,O_ Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name Address��ItiCe_., �-�- CLf Contractor's Narne Telephone Number Home Improvement Contractor License#(if applicable) I(_D Construction Supervisor's License#(if applicable) �.a-CSo PERMITSS & orkman's Compensation Insurance 11 Check one: [' �.Y ❑ I am a sole proprietor ❑ lam the Homeowner _ TOWN OF BARNS I ABLE 2-fhave Worker's Compensation Insurance Insurance Company Name � - Workman's Comp.Policy# - Q( L P�p r� ��17c) Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box)- Iff Re-roof(hurricanenailed) (stripping old shingles) All construction debris*will be taken to `E ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value #of doors (maximum .35)#of windows *Where required` Issuance orthis'pe oes n exempt co liance with other town department regulations,i.e.Historic,Conservation,ctc. ***Note: Pr erty Owner ust si operty Owner Letter of Permission. copy oft ome I oveme t Contractors License & Construction Supervisors license is require 3IGNATURE: ?AWPFILESIFORMS11Ji ilding permit formslEXPRESS.doc revised 072110 Tlie Commonwealth of Massadiusefts Department of Industrial Accidents Office of Investigations a "` 600 Washington Street Boston,MA 02111 svmv mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Let=ably Name(Bnsmrss/osgmiation&&vid : Address_ La — City/State/Zip: 1,-� (� f Yl�Phone#_ Ar�Iam employer?Check the appropriate box: Type of project(regaired)- with 4. ❑I am a general contractor and I ❑ loy�(�ari s have hued the sub-contractors 6. New construction 2-❑ I am a sole proprietor or partner- listed on the attached sheet y- ❑Remodeling ship and have no employees These sub-contractors have g_ ❑Demolition w for me in employees and have workers' working any��y- I 9_ ❑Budding addition [No wogs'comp-insurance comp.insurance required-] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3-111 am a homeowner doing all work officers have exercised thew 11_❑Plumbing repairs or additions myself(No wodoew comp- right of exemption per MGL 1 of repairs insurance r ]t c.152,§1(41 and we have no employees-[No workers' 13_❑Other comp-insurance required] •Airy app&cant that checksboa#1 unist a1w ml oar the section below showing their wokers'compensetion policy imfania im 1 Homeowner,wbo submit this affidavit=&ca=g they are domg all wait and then hue oawde conuactots mms-submit a new affidavit indicating such lUnnuctots that check this boa non attached as additional sheet showing the mane of the sob-connsctQrs and state whether or not those aunties have employees-If the sub-conaaaoa have employees,they toast pravide dim wakes'comp-policy number I am an employer that is providing workers'compensation insurance for my employees. Below is flee policy and job site information n y Insurance Company Name: Policy#or Self-ins.Lic.#: WE>• qQ CAP �D( - Expiration Date. ' Job Site Address: L-�Il ( st✓Y1 �'�`-� N� 7�ttyfStatelZip: t'1� OZCDCe Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c, 152 can lead to the imposition of criminal penalties of a fine up to S 1,500.00 one-year imprisonment,as well as civil penalties m the faun of a STOP WORK ORDER and a fine of up to$250. day a - the violator. Be advised that a copy of this statement may be forwarded to the Office of Imres. - of the for insurance coverage verification. I �hfeby certify epains and penalties of perjury that the information provided a is in rued coned Si : Date: �� PL Official use only. Do not write in this area,to be completed by city or town q f4ciaL City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector S.Phunbing Inspector 6.Other Contact Person: Phone#: 6 ns rr'•art^ V I I Office of Consumer Affairs and 2ulsiness Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116- Home Improvement oatrctor Registration _ Registration: 165907 Type: Private Corporation Expiration: 4/6/2012 Tr# 2954M TL HITCHCOCK CONSTRUCTIOWS` z_ It THEODORE HITCHCOCK 55 LISA LANE WEST BARSTABLE, MA 02668 _ram yv� Update Address and return card.Mark reason for change. nrs-cat 3 50H}ovo4-G1m2r6 0 Address Ej Renewal Employment host Card ---- _.. -..__ .... Office of Consumer Affairs&B esa Regulation License or registration valid for individul use only HOME-IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Regislratlon::A 65907 Tye Office of Consumer Affairs and Business Regulation Expiration: 012 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 kTTLTCHCOCK0OW- JRU=Qk ERVICE INC. 4 THEODORE HIT r' (a, =- ' -_...,Ja 55 LISA LANE ' WEST BARSTABLE,iIfi68r' llndersry N� j chirp Massachusetts-Department arf Public-Safety Board of Building Re-_ulations and Standards Cons°Tuctyc'Supers;is-ax Specialty Ucense License: CS SL 99828 Restricted to: RF,WS TED HrrCHCOCK 55 LISA LANE VVEST BARNSTABLE, MA 026M Expiration: 6/1rM2 ( mmi..i+mer Tr# 99CO -iCACORD. CERTIFICATE OF WBUTY MSURANCE (2l03n010 IMCERfl I E6MSMASAEATTMof iW0.YluoO gip 81W01E711ECMFWd14lROLDoL TM $.tea LI BELOW. �'�'�'�r�s�s---cstss��s•,���,e�.....s�a�� �� S`lE�ric�3rTK �BY7'E P?9 r WORTANT.Utbo '-_+`�'3-'�zd�'-�� �s'+..:3 .r� •Ii.°':£a3y`k'1��R ��--_a`-''�- s����=��rr�:���`.' ��IT99IVE tanesan0 cordgnDoholderlaanADOftBWALU ftpogayOn)amdbo 4w=d.ffMWtOGA7=j5WAWED660494taBn esn8featehaDdQrht6oO�s +�Yreq�andan*mmftL Aim.oDUifm Mc 4*smtwl•.gr totn� PRODUCER CONTACT MAKE PHOM11AMPALUMBOM AWY (Af4 FAY A�►N4E� FAX 4S27 FAiMOUTH BRAD 6mm MIC6 Xk A!s•2PMESSz PROGLICER COTM,MA 0285 CUSTIOMER77NHW ®S BRED MURERF)ARORDMCOVERAGE RAW$ TLC COMrmC MM SERVICES INC INSURSUM 55 USA LANE INSURERD: WESTRAR?WAM ZMA MW OBE: COY CEt7iFbGtiENUNI�t: NSUIMRP. T198Ei10 F9RoiT1HEP�JR��4a�p ISTeIBHOBBIOtE8�i66®7071E8 �pgpyEPORDt5FOt[REVO N �EtOt 6Alin TIMOR CFMWCMURMOHOIt�300C�TMig Zp 7EMAt8EEi5� THE@60RAHCEAR�0CLJ Ot71�3 �t��TMAMIMV M%q AOCFSM , L�rssm�HewrpnvESEe�►eEn�r�e�raamaAne� t�oF ult GENERALLWBII)1Y �� vot�9�u�8t 1 f umm COMMERCMLGENERALUABOM CAMOCCURRENCE $ CLAM E °ccuR DAMABE70RENFEDPRIMSES(Fa ) s "mEXpV*aepsmoo S GENL AGGREGATE LtOBiAPPtM PER: � $ POUCY PRQjT 1AC PRODUM-COUROPAGG 8 AUTOMOBILE MBRM ANYAUID CONSWFDSVOGLE AILOWtEDAUTOS Ulff(Eaacdano iSCHEOLIFEAUM BODQ.Y W. M HRMAUFOS (Perp-wo � SOORYQdRIRY $ . NON40WNEDAUiOS (F-amumo PROPS DAK4GEUMBR13JAUAS Comm lPh►a� EXOMLIAS MADE MUMBLE AGGREDATE REIHYRON g $ S - WORKERS10MVENSA7MAHD umumBTB aim ENIPLOYER'slIMAM YHt iti"MM ELEMifN ffliENr $ (00,�p AW EXCUAMT N ELDER-EAEMPUYYEE S 1D0000 obnft mymmo. uye*6 1,"0etuft ELoomm-POUCYt.OBT 0 9itW0F0PaVnX N ft§m OESCFupn AtOPSbr34. ;~2aCAc'f0'+.a.s.' ;�an& •TMBFYLAMnNYFRtR EMMID7$B MBMn,BaWECDNOwCRK=CqWe09ERACM CERTNVATE HOLDER CANCEUAON -VWMDAMOFMAMMOESCIMMpoll=BECANCEUMOOFM • 1liEE�A7�0A7E7} YAIb Df W A ' WANTHE POtlC1'PRO ACOM25MMOM Cbarks J ch* 1 ACWW CORPORATMN,.AU'Fbbft resenm& f Qay 18 11 01:28p Ted-Hitchcock 1-508-362.8020 p.1 „ 41 Town of Barnstable KAM Regulatory Services Thomas F.GeRer.Director 'Building Divisiou Thomas Perry.CBO Building Commissfoaer 300 M-du sit, I?yaanis.MA 02601 www.towU.barnstable.ma.us Office: 5MS62-4038 Fax: 508-790.6230 Property Owner Must ComPlete and Sign This Section If Using A Binder `D o Ce I-�-�G 2 T �` ,2,Owner r,r the ctihjec propPrry hereby authorize I-h C I C-0c lK (5f*'l ;o ace on m.v behalf; in all matrm. reaative To work authorized by dus building permit appicarion for: CAkCso N LSE L, . -SP2�S770r&CC (Addrms of Job) Signature of 06ner Date Print Name Q:Forms:'auildingpmnibeaW�i ' Rovisod 111107 Id WdSt7:ZT TTOZ 8T 'AeW 0028 Z9£ 80S 'ON 3NOHd 61ae6aH aonjg WObj TOWN.OF BARNSTABLE BUILDING PERMIT APPLICATION Y r Map J40 -Parcel , Permit# Health Division s ���� Date Issued Conservation Division 1 Z S 0 a 0 ST BE �+ SEPTIC SYSTE�II Tax Collector ` INSTALLED IN COMPLIA , WITH TITLE 5 Treasurer �. : 4z-z. )0/'0/ENVIRONMENTAL CODE AND Planning Dept. 'VOWN REGULATI0IiS Date Definitive Plan Approved by Planning Board /V �` 1 Historic-OKH Preservation/Hyannis + Project-Street Address f C2 r X$CJ✓n da^t Village �„>. 13 2 rzu/R 64 _ r Owner Address sgil'!P Telephone 1��,3 G aZ— /G 3 Permit Request G.)or.,e4 ,/"k Square feet: 1 st floor: existing proposed 2nd floor: existing proposed . Total new Valuation , S 3 S C40 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 0 Two Family O Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes 0 No On Old King's Highway: O Yes 0 No Basement Type: 0 Full ❑Crawl O 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 0 Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric 0 Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: 0 Yes ❑ No Detached garage:O existing 0 new size Pool:0 existing 0 new size Barn:O existing O new size Attached garage:O existing ❑new size Shed:O existing O new size Other: i,✓ x)u , d-e_r_ � Zoning Board of Appeals Authorization 0 Appeal# Recorded❑ Commercial O Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Na a Telephone Number !9 c 419 Addr <5lV4Z �la, License# A-ii�" Home Improvement Contractor# N�O � Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �-�� FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED _. MAP/PARCEL NO. �-' ADDRESS �'�� VILLAGE OWNER ,' DATE OF INSPECTION: x.� FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: RO�V-Gi FINAL PLUMBING: ROUGH< " FINAL j GAS: RO.UGe ti " , FINAL FINAL BUILDING DATE CLOSED OUT j ASSOCIATION PLAN NO. _ The Commonwealth of Massachusetts Department of Industrial Accidents -= . fmce of/mresffooffoos 600 Washington Street ems; Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: location: ' r city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole p rietor and have no one worldii in achy [i"I am an employer providing workers' compensation for my employees working on this job. t ::...:.:. coma8nwnstae: ::. ...... ...........:........ :::.�:.;_.:...........::: :. ::................. ... ............: ' :..: iisura ❑ I am a sole proprietor,general contractor, 4T homeowne circle one)and have hired the contractors listed below who have the following workers' compensation polices: _ : , _' ; t � ::::.::: comaany i�.. ..... �. :: . ... ..k.......... 4. ' i•}iiii:{4:4:Ct^:iii:�:iiiii.:4::�::::ii:�:}ii::v::•:i'r:_::�:vi•:�::4:�:i::^i:i:.iv:.n::.::..•••........:. '..1iii:i:i+:} i:isiii?iiJ:C�}'ii::y::jj;..}::.;:•.�:::::....:::. : :.. :...:...:.. .:b�::. : :::._:::::::::.: ::.::.. .:::::::.:::..::.:.::.�:::.�:..;•<.;:.:;::::._:::.::;.�.�:. OUR�:,. � ::3�€:�:�...::.;.......:..... ...��i�..:;:..�� �;"'"" .tisnranceeo:,. . � G'' : psnyl►ame:, :::::: ::>. ::>::<css>:z::<:;:>s:;::::....r -.... 'ddess�>a city`..... litww 0 FafimY to secure coverage as required under Section 25A of MGL 152 can had to the imposition of criminal penalties of a fine up to 51,mo0 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above it trw and correct Signature Date r Print name a '2- e- �l/ Phone# 5-0 official use only do not write in this area to be completed by city or town official city or town: permdt4icense# ❑Buffding Department ❑Licensing Board ❑checkif immediate response is required ❑Selecunen's Office ❑Health Department contact person: phone#; ❑Other��_ 0evued 9195 PIA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law",an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of ad eiceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. r Applicants f`F -Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of msiiva*+ce coverage. Also be sure to sign and r date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should YOU have any questions regarding the"law"or if you are required to obtain a workers' compensatiioa policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out is the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the p&ift1liceose mrmber which will be used as a reference number. The affidavits may be retammed'ie the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Departrraent's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of InvestlnaUans 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 - - phone#: (617) 7274900 exL 406, 409 or 375 r F tKE tp� �sT The Town of Barnstable 9�A Awe$ Regulatory Services rEo Thomas F. Geiler, Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing 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. Estimated Cost Type of Work: e z ti Address of Work: �� r l �✓► �`��"' Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied [�wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. I SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR (� v Date Owner's Natne q:forms:Affidav r 08/04/2000 08:55 5087750754 WELLER ASSOC PAGE 02 CA T G� hit � J V IIT loO AN COP% Ipj's qs�& C*wLso-,3 cW�•L 6 P'�-AMA• bw&-ts �1 M� Nei %Loa rtAj pock. 3®I pa S seaf ice . po.0wc r . 200 ) n AWIC06m to o Old Kings H#w ay�Hist+oric D�st4t Caiiimittice" �' In the Town of 9anleibble fhr a 2C '; 16 P;1 ' l 2 5 CTIFICATE OF APPROPRIATENESS. Application b hwnby meft bhuiplieft for the ismance of a Cw 1f1cm of under Section 6 of ClrspW 47% Aces aM Rasopas,of M*nd*AoM 18' % for pm, work'n dsaaribsd below and on plan, dawin¢ or phaftwo Hs d* appl'uda for: CNECK CATEOORIft1rH^T AMV1. 1. ExtirW BWlduy Comwuc ion: Q New Buldi ❑ Addlt%n Q Alteration Neaots type of buil&W 0 Hm= ❑ cww ❑ comwmcw ❑ Other a Exterior rw+tin« C3 * Signor BMbowds: ❑ Now sign ❑ Exbft sip ❑ Repainting �ti nns + 4. Saucmw Q Faro ❑ wan ❑ f wale ❑ O hor____b1t�s2a06 kc can, ,,Qcc)1�,arTvin (Please rand oftr side for mplanation and nquba nentO. TYPE OR PRINT LEGMY DATE /.2/�, /TOG. ADDRESS OF PROPOSED WORK - all CsL r I s0n J i^c- ASSESSORS MAP NR------1 3 OWNER nt] z- 1e-<r f`> ASSESSORS LOT NO.60 HOME ADDRESS- 15-'4fr7 A TEL NO. S-01r-36;- /love Z-, FULL NAMES AND ADDRESSES OF ABUTTING OWNERS Include name of adjaw w property owners saes sny pubft stroet or way. (Attach addtional sheet it nscasary). Cd,nun -_l 13o& ,e r ao 7 Cvr rl x.- o�z � `� . 132rel !�L-xn zIr C-i 2r. ,,nC /I AGENT OR CONTRACTOR ke4,1jh TEL NO. Syk - Y 7 q�;k, ADDRESS & 6fzy,-A-. <t. Ace 44 y �fri,/ 7,4 [.;?G 3 S DETAILED DESCRIPTION OF PROPOSED WORK: Gins all particulars of work to be done Including materials to be used, if specifications do not accompany plans. In the cm of signs,give loeadons of sxisting signs and proposed locations of new signs (Attech additional sleet,if rimmerVI. • � w�v c�e.-. c•�PL �C a 3 � ?r /a � 5iicxoe- /Oor) k o/ le �e .4 S wearr,Po s. �.y sec.yc /�a� ,f-1 r •t /. n il`1, �+' ,tU Signed ��•_ G✓ Slam below Nne for Wimolm ua.> �, On v i is herby Dom /- /0 -I V z I� I` U t C l d zuud AUaTABJ QLV '.iIVG'S HIGHWAY i i 010 Town of ft stable old Imes Highway 13istoric I?istrict Committee SPEC SMsZT FOMMATTON SIDING TYPE COL08 CSIMpaur TYPE COLOR ROOF MATERIAL COLOR PITCH S COLOR SIZE TRIM! COLOR DOORS COLORS SHUTTERS COLORS GUTTERS COLORS DECKS l,� X -1 3 GARAGE DOORS '��(Vx COLORS °� �t .t����1� ., SKYLIGHTS SIZE M COLO V SIGNS COLORS S� P� �O�Nof�SN\GNW COLOR .� NOTES: Pill out completely, including seasureumLs and aaterials/colors to be used. pour copies of this fors ere romri r1 fnr ...r...a.._• _s ,_ .. 100 Ft: Abutters List for Map 133 Parcel 61 This list by itself does NOT constitute a certified list of abutters and is provided only as an aid to the determination of abutters. The requestor of this t list is responsible for ensuring the correct notification of abutters. Owner and address data taken from May 2000 Assessor's database. Mappar Ownerl Owner2 Address City Stat Zip Country 110036 MADONNA,ROBERT P&PAULA M 208 CARLSON LN W BARNSTABLE MA 02668 USA 133027 - WITTENMEYER,JOSEPH H&CATI-1Y A HIGH ST W BARNSTABLE MA 02668 USA 133028001. KATTEN,GILBERT M&DEANNA H 70 HIGH ST W BARNSTABLE MA 02668 USA 133060 HEGARTY,DONNA A P O BOX 651 W BARNSTABLE MA 02668 USA { 133061 HEGARTY,DONNA A P O BOX 651 W BARNSTABLE MA 02668 USA 133062 MARSHALL,R MAYNARD&TR MARSHALL,DONNILEA TR 26 CARLSON LANE W BARNSTABLE MA 02668 USA __.._... -.-.......--------_ ._... -- - -- ---- - — - ---------- --.. _... ---------- ---—------ -- —-------..._.—._ 133063 WILSON,JEFFREY W&GE0RGIA M PO BOX 126 W BARNSTABLE MA 02668 -A O p Z3 o Z .A o T'•c m � - Tuesday,Septe 9,2000 Page I of o 08/04/2000 08:55 5087750754 WELLER ASSOC PAGE 02 2 0 O 7T � ' 10 G, .00 N not, S•�_ J r rn p V rl pEG 1 - F bp, AY • TOwp K�14G,S N�GHW O AA AM "ObT 5 M+ NaM • � � tyrtN Ni 20U1s `010 e cr m ION 0�0 k3N," c� 007 1 0 IA, . r e'- KZ- The Town of-Barnstable Z snaxsz":__ K. $ Regulatory Services Eo Mo. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE. a— 1- 01 r� JOB LOCATION: 02 I \AKI SU-n �'► S � number stint village "HOMEOWNER": `/O 14 Z3 name Ili home phone# work phone# CURRENT MAILING ADDRESS: 70 _.,( CD ' -)-�rn 0�(¢Ca� 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 w engage an individual for hire who does not possess a license;provided that the owner acts as supervisor. DEFINMON 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 structuues. 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 resnonstble for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signaatre of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work.that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unawam 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 personas 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 helshe understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:FOAMS:EXEMPTN Application to 19 � y :14. 1 Y• ���•�` ►� Committee Old Kings Highway Regional Historic District in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application Is hereby made, id triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter.470, Acts and Resolves of Massachusetts. 1973, for proposed work 'as described below and on plans, drawings or photographs .accompanying this application for: CHECK CATEGORIES THAT APPLY: 1..Exterior Building Construction: ❑ 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: l;'Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements►. /a a TYPE OR PRINT LEGIBLY133 DATE ADDRESS OF PROPOSED WORK �� LyiD ASSESSORS MAP NO. ASSESSORS LOT NO. 0(D O OWNER TEL. NO. 3(Qa' \LQa3 HOME ADDRESS FULL NAMES AND ADDRESSES'-OF ABUTTING OWNERS.- Include name of adjacent property owners,'across any public - , street or way. (Attach additional sheet if.necessaryl. c, 1� ccf.� kA�WW AGENT OR CONTRACTOR `T� `^C �•t ��� TEL NO. ADDRESS �33 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). ` �` �.��•�.: �n.�.,r. Oc ra.rc�•ev�{o. �ern o Gd C-\r C.�. u•v� \��\' o 5z c't'ep ✓OYt�G�(/y+.i —�� Signed wner_contractor-Agent It line-for-Gommifeeuse �y8 • _ c e 9 to is hereby ate P Cert ate' 9199� IV QA60 U� T e - 70WN OF BAR�lSTABLE Approved ❑ IMPO f-Ce, If te-Israppr. rowal`ls��subJect to O day aJp�pe/al period .� � IQ, 1�- - OC O A\Y-zit - G-C 222�; 6o 5;7Ofoor .&,s� - v IV 6 np � 5 /IY����'vim^- •I�IY /��'��� �� I 1�-�- oho A\r, -)A-v\- YNC"\ rQ. - c.cJ��,� 0-1 Oa 5 22 0 r r� ! j r r t 36 °1�3 d(P � �`� �.. (c.'�) lam. 1\� �' i��'1•� c � �- `r , /33 ' o Z-7 \ rN J OTown of Barnstable ' Old King's Highway Historic District Committee SPEC SHEET FOUNDATION SIDING TYPE COLOR CHIMNEY TYPE COLOR ROOF MATERIAL COLOR PITCH WINDOWS COLOR SIZE TRIM COLOR DOORS COLORS SHUTTERS COLORS GUTTERS COLORS DECKS MATERIALS GARAGE DOORS COLORS SKYLIGHTS SIZE COLORS COLORS e FENCE �� I°t ��h�(l C�nc`�v. \`M COLOR,�\��-\� NOTES: Fill out completely, including measurements and materials/colors to be used. Four copies of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plans, when applicable. SPECSHT Revised 11/98 L r �RE�=_T 1. 7y. _ 1. obi � k •-\ I-�,��� �J �a.. I L ow a0 M co r 'I 72,* S'� ' (n • v PA G�`�i�e > 'per �>L6%Qsa l a3"�-{�s AMM U%Ai-0 - � � sE-b�J►� �4 �►�� rr� Its '.G c�,tzLSai ( �•1 �1�(" aJsTAt3��'Mq' c s '(�tr M��1 NaK� gux : S ic+�it R 3o�1`I93 SCALF-1- 7.9 N 11ABq , s 'pc.� I1� �1 �hq.Otli a�SUArE+�� ..�,••g� W C O R P O R A T E® 133 UPPER COUNTY ROAD SOUTH DENNIS, MA 02660 (508)394-4800 FAX(508)394-6735 u " sign . o a�, T �, e . w r iZ.* x y,(iF-.•p,j� �d'; 0.�_.,'�! 'i j..4+�'' +C%.. 'M '' � �{` � - _� �t $g��y'i' ""�p ''' '"6 q`�aF �4 ,� s z.iw!fi�° y°2.• `�, r � ^ ? - 2 :S" z h rN, r µ ACV =s - .i;t�,,.�'� air _ t � � ..i'' �lk.-'�' •=°� 4'Black Vinyl Chain Link ORNAMENTAL. FENCES J f S4 - The Saybrook This classic design with a smooth rail top reflects the quiet mood of a late spring evening. S5 - The Newport (shown) y y: .QA Inspired by the life of the ocean this scallop designI11 �I�. � with traditional spear points is a statement of grace. ' o , S6 - The Citadel ti � The Citadel's crown design with traditional spear points suggests the power of authority with a subtle ease. S7 - The Horizon 1 4 The Horizon has a view in mind with its classic design, smooth rail on to and picket spacing of 1 /z between ! � p p P g pickets is built for harmony in the landscape. S8 - The Falcon (shown) With every other picket thrusting a spear point above ` the top rail and with 11/2" picket spacing, this fence was created to make the vision of your landscape soar. 1 S9 - The Storrs I The height of simplicity, this fence with smooth top r j rail has been modified so that pickets do not extend f I through the bottom rail. Available in 54 heights, ' it.meets the demands of pool codes everywhere. S5 - Newport S6 - Citadel S7 - Horizon S8 - Falcon S9 - Storrs SPECRAIL ' S 1 - The Bennington This fence is designed to blend into the natural cadence of virtually any landscape. Embracing a traditional fence'style it comes with an accent of spear points across the top. i Y S2 - The Berkshire - Like the Bennington, the Berkshire recreates elegant tradition but comes with staggered spear point picket tops. �44{• � Xr S3 - The Essex With its classic smooth rail top and traditional spear points below, the Essex is designed to meet the most demanding aesthetic needs. .Ufy.' _r FENCE STYLES Of course, all styles that have traditional spear points can be custom designed with flat top pickets or S 1 - Bennington S2 - Berkshire S3 - Essex S4 - Saybrook designed to accept A or B finials. Also every one of our styles are available in Residential-Wide, Commercial and Industrial grades. � J 0 NOVIg� T owN OF gA G-S Rl�rSrAB f N H�GHwAY Mots ,Z I l ClR froiV L N )3)9 R 1V S rnb 1 r- /3 ,4ry _. DECK L - i 1 f i O I � j Engineering Dept:(3rd floor) Map J Parcel 44ermit# House# .Z �� ate Issued 13,0 Board of Health(3rd floor)-(8:15 -9:30/1:00-4:30) !r�' . ,o6 Conservation'Office(4th floor)(8:30-9:30/1:00-2:00) Z } YsTENI MUST BE Planning Dept.(1st floor/School Admin. Bldg.) 1A" 0 a � efi 'tive Plan Approved by Planning Board 19 � ENVIR;ONM B RAND TOWN OF BARNSTABLE TOWN ®NS Building Permit.Application Project Street Address l ( cl, els"Clu Ax T Village Owner . . .p.Qlr_/UA �' Address �i�i�,Sd/�1 /U Telephone Permit Request 77 OW First Floor square feet Second Floor square feet Construction Type /„'O O? Estimated Project Cost $ -- Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.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 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None Q Shed(size) ❑Other(size) i Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use Builder Information iName Telephone Number Address 1�� /S 6 &3 License# f T YiM AJ C,5 A-tI4 Home Improvement Contractor# 1010,3 Worker's Compensation#�oP 48 F6 VI'e 20 s6 PS�_ NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESU G FROM THIS PROJECT WILL BE TAKEN TO IGN DATE 12�BUI_A ER IT DENIED F E FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. 2 DATE ISSUED r " MAP/PARCEL NO. I ) , r r ADDRESS I VILLAGE ' OWNER , i DATE OF INSPECTION: FOUNDATION ,Y 9'j G7 FRAME I INSULATION] 'f FIREPLACE ELECTRICAL: ROUGH FINAL - PLUMBING: , tOU�}J■ FINAL r Y sa' p . GAS: AAI :FINAL FINAL BUILD � `{ a DATE CLOSED O ASSOCIATION N �� ' � . l�,�OP�s�v �zZ•t r • I f v Ny 1� tea., m N v "Is IsLFop- � rt � �s TIW_R � tte. 1 / tO,�I H Of 'y4 .a S7EWN 1 B N 70 ---..w.:_-.�,,.w.wr�rr,a�.w.�w+«Wcww<.".,...:.,,,.:«:..c:w..,wiw�.4n.•...�....�.r-e...... :a � � ' wr�uiMlsrrMlw", 0.: Cj 11, ! ,/ • _%fit f-�� � I ; t � L r Application to Old King's Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, id triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGOE AT APPLY: 1. Exterior Building Construction: ❑ New Building Addition [] Alteration RI 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). r1 TYPE OR PRINT LEGIBLY DATE ADDRESS OF PROPOSED WORK r91J — 01 ( , `cSC3AJ f`4) ASSESSORS MAP NO. 3 OWNER ;y ��F 1 -•lJah!/V/4 �7 CtdieT ASSESSORS LOT N0. HOME ADDRESS _��i C .0 a/1� �/V TEL. NO. -242 16 673 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 a TEL. N0. ADDRESS)! 460 o 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). 1770 Signed v Owner-Con or-Agent Space below line for Committee use. f'f Recerved bye H D C. p -.Date dThe Certificate is hereby Date 47���,� 9. Time n n - -- �Cl�l u of I r�n l dam-4 Approved ❑ IMPORTA If Certificate is approved, approval is subject to the 10 day appeal period provided in the Act. 0� � Town of Barnstable ` ' ,y, -' Old King's Highway Historic District Committee SPEC SHEET FOUNDATION SIDING TYPE 6Z14P COLOR CHIMNEY TYPE COLOR ROOF MATERIAL COLOR y� PITCH l WINDOW SIZE 1 � TRIM COLOR ��/� � �� 7A DOORS �/� — C�l1(/�� COLOR. SHUTTERS COLOR GUTTERS [VA,'47 71P DECK GARAGE DOORS h/ �— „ COLOR SIGNS - * COLORS g? FENCE COLOR NOTES: Pill out 1.p,,.tel.k,. 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. Site plan should show all structures on the lot to scale. SPECSHT o d c ° 3r y I I .ri il Lo !fflo I II; 's 4 a .�, •gt,ua'3�• •,tvu.�''vh7 '7S+��i3'&.Vsn'4�` - `' Y NOME IMPROVEMEKim UKTRACIOR r }: RegWrat<on 10 395" Type ;x*INRYIDUAfI �a Exp Tatio 17%23l96 i �yy. 4 ��A � J6�Te90Ty, M Cau f �MQ �33�A 8azter YYAvenue� � ti dfarmouth MA Q1671�,�� „ADMINISTRATOR � -5 ril)4 '� �Ai"_��S�4 t�`l ti `^v` i.�'"1 k��i1'Y.: �'tti•.. �{��.6� �� /ce �anvnz�r"cuea�z o�,i'�/�o,�ac�iccaeCCa I . -D��ii l n 6 IQn t •ij - G)n_ 1 • uXpz_?,: Birt` at?: :a - !!cSt)il;'y OniY — - 7yi?d• �`.;aii9 b �J �11�79d5 I -. 73,iIV a9icfS — ilStiiCt?a,To: 00 i -a:lur? to co5S2Sc a cur:-en. t"_i-ar1r: @ .r: ' �►+�.v ;i`:'v� W �} 150 -` 1----- --- -dVliCctlB� f' '-•-• --.-..5'. X DA _:tXT-7R V i t i Tlrc• Cunrntunl�'calt/t of Afastiachu gilts jz:- Dc parttncrrt of Industrial.4ccidents . z � ;: - !ram= O1�cP�llnyesugatlons 6011 !f uAingtun Strea Bmvwn. Jfas.v. 03111 �• Workers' Compensation Insurance Afrtd. vit a„�lilicint inftirmatimi • � Plc�se PRINT Ie�iLily"��'� mine CE ' cation o21 f hone cite n 3aa /��6 0 1 am a homeowner performiri:all work mvself. I am a sole proprietor and have no,one working in any capaciry [I I am an emplover providing_workers' compensation for my emplovees`working on this job. enum tnc n tmt COC- O t:/G 2--4/A/G ct •t(ldrecc• YOZ) cite �'T X /?) S. !/`r nhnnc fit• incur trice rn. 6A)u.d � �Q [i I am a soie proprietor, general contractor, or homeowner(circle ntte) and have hired the contractors listed beio« N ite the followin: workers* compensation polices: cnm nnc• nhnnc• atltlrccc• cite•• nhnnc a• incnrnnrr rn nnlicc•0 -� —•- •f.. Yam^ _��� �.--_•�..... _ - r �._� \�.T T1 S. _ T� - .r. conirinriv natnrc addrecc- city nhnnc it• incur•tncc cn _ policy to Attach additional sht:et if neeessa_ry..:•:. --'..r:=::�::: "'...• .••.:._':.ti�..".`_...�•• r'-.,to S1 . 0 ant Failure to secure coverage as required under Section_SA of;11GL 152 can lead to the imposition of criminal penalties of a line up to S1SOU.UU ant one c cars imprisonment:t.%%•gill:is civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a dap against me. 1 understand th:. cope of this statenicitt may be furcc•arded to the Omce of lnvestir.ations of the DIA for coverage verification. I do hereby certify under r a is and penalties of perium that the information provided above is tare uud correct. Si_natur• Date Print name Phone; — ' Official Ilse univ do not write in this area to be completed by cir or town ofricial or town: permitilicense i# r 1 luilding Department city C C3ucensim:Board f Q check if imincdiatc respunsc is required 0scleetmen s Ufrice t: 011c2ith Department r- __-- ^tither .lassachusetts General Laws chapter 152 section 25 requires all employers to provide workers compensation for their mpiovecs. As quoted from the an enipinree is defined as every person in the service of another under an\• ontract of hire. express or implied. oral or written. .n emplqrer is defined as an individual. partnership. association. corporation or other legal entity. or any two or more . 1c fore�_oittu encaged in a,joint enterprise. and including the legal representatives of a deceased emplover. or tite :cci\•cr or tntstee of an individual • partnership. association or other legal entity. employing employees. Ho\%,ever the xncr of a dwelling house having not more than three apartments and who resides therein. or the occupant of tile. \.Cliin,_ house of another who empinys persons to do maintenance , construction or repair work on such dwelIing h_ous oil th_ :_rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. 'GL clt:iptcr 152 section 25 also states that cvcn, state or local licensing, agency shall withhold the issuance or neival of a license or permit to operate a business or to construct buildings in the commomveaith for any — Plicant %%-116 has nit produced acceptable evidence of compliance with the in coverage required. iditionali�.. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the -formanee of public work until acceptable evidence of compliance with the insurance requirements of this chapter ita -n presented to tite contracting authority. i licants sse fill in tiie workers' compensation affidavit completely, by checking the box that applies to your situation and pivin_ company names. address and phone numbers as all affidavits may be submitted to the Department of ustriai .-accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. Tile 4avit should be returned to the city or town that the application for the permit or license is being requested. tite Department of Industrial Accidents. Should you have any questions regarding the "law' or if you are required brain a wori:ers' cotnpettsation policy. please call the Department at the number listed below. v or Towns :se be sure that file affidavit is complete and printed legibly. The Department has provided a space at the bottom of i�davit for you to fill out in the event the Office of Investi?ations has to contact you regarding the applicant. Pleas ire to fill in the permit/iicense number which will be used as a reference number. The affidavits may be returned to Department by mail or FAX unless other arrangements have been made. Office of Investi=ations would like to thank you in advance for you cooperation and should you have any questions. se do not hesitate to _give us a call. Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents rr r office of Investigations 600 «'ashington Street Boston,Ma 02111 fax #: (617) 727-7749 . phone #: (617) 7274900 ext. 406, 409 or 375 The Town of Barnstable 9 9. Department of Health Safety and Environmental Services �°r�,,,ot� Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissi For office use only Permit no. ... . Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: AbA/770e\,- Est. Cost 5� Address of Work: d > Owner's Name e Date of Permit Application: — 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 IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR ��.,� �•.� . TOWN OF BARNSTABLE BUILDING DEPARTMENT _ ssaiaT = TOWN OFFICE BUILDING SAM t639. � HYANNIS, MASS. 02601 MEMO TO: Town Clerk t' FROM: Building Department DATE: 12 (2-7 a� An Occupancy Permit has been issued for the building authorized by BuildingPermit $� �6 Z Z-9 _.............................................................._...._._.._......_........ issued to r c ..._.`�_......� ,q ^.✓ .. ......1_ ....°.�s ........:�:. ......_.._..._...... __ Please release the performance bond. TOWN OF BARNSTABLE Permit No. 36229....... BUILDING DEPARTMENT t """ ! TOWN OFFICE BUILDING Cash HYANNIS.MASS.02601 Bond ,,,,,,.... i CERTIFICATE OF USE AND OCCUPANCY Issued coBruce & Donna Hecrerty Address 211 Carlson Lane, West BArnstable USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE,WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. �� I June 30, g4 Building Inspector R'` .. i 1i'AiI..-'.1+.ry '. -. - . .. .�; .. ..�- _t - - y •. T.cv -..«'.+.T"yn wY-. •P"-.-wY.M.}.r�.u; y�.a�.,Yrw^ .+Y;+j�.•�`."w� ....,y-"'t..` y,.,,i. 4 W1 TOWN OF BARNSTABLE 36229 Permit No. ................ BUILDING DEPARTMENT , TOWN OFFICE BUILDING Cash YL HYANNIS.MASS.02601 Bond ......x........ CERTIFICATE OF USE AND OCCUPANCY Issued tOBruce & Donna Hecterty \ Address 211 Carlson Lane, West BArnstable USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE!VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BV"THE BUILDING'INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. June 30 g 4.......... jr B ilding Inspector ; ,TOWN OF BARNSTABLE, MASSACHUSETTS BUILDI 'N G "PERNt DATE 19 PERMI;NO... NQ 36229 APPLICANT Ir ADDRESS 7f: -0 (NO.) (STREET) (C ONT R-_SL I C E N S E I PERMIT TO "i 'i.1.�. NUMBER OF STORY J7, (TYPE OF IMPROVEMENT) No. (PROPOSED USE) DWELLING UNITS AT (LOCATION) & !?: T"RSL.'i�l_% ZONING (NO.) DISTRICT (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) SUBDIVISION LOT LOT—BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: Sewage #93-505 AREA OR VOLUME PERMIT $ (CUBIC/SQUARE FEET) ESTIMATED COST $ FEE OWNER ADDRESS BUILDING DEPT. BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED 'UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE INSPECTIONS REQUIRED FOR APPLICABLE SEPARATE ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(REAOY TO LATH). 3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE. OCCUPANCY. -POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2/ 2 /K �✓� f� Z 3 HEATING INSPECT16N APPROVALS ENGINEERING DEPART ENT .9DA LTH OTHER,JQ C-ai v Pr\ 16 4 iEW APPROVAL WORK SHALL NOT PROCEED UNTIL THE INSPEC- F—PERMTIO!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CAM CAN SE' TOR HAS APPROVED THE VARIOUUS STAGES OF WORK IS NOT STARTED WITHIN SIX MOKTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE.. NGFIFICATION. 7 Izz't i r N m s•` ro v L% 13Z,-z r iaJ s�vW aJ-�4r. Foe- s _ �, 5%•�o CAt��'J W.� �1�e+�2►Jsy(�lt3C��f-1q, �q��g -�� M�r�l M►�r1��LL� H OF bgs�9� S F�1�F-R Sol19T3. SCALE- / STEVEN BA • 79 b C OPPSS10NP , 'p o. sac k\g `AR►-4 �tT Mq.OZ.I-'5 - y (sd)�-8t31 • _ i , j l!I i 1' S ii I I � !IIIt :1 ! !III lilllli `f!II!��I• 1. !° f - � �I i II II Irlll�:• I illl'!�I�i ►�,� � - ' II' I I�;j.Hl � � � I III II III I L i is i si-mmmum, l it 111 l i II :�I rtld t Imo, 1..:. 1 '.1: I . II 11 I IIII P�I nl unn n unni n If - ._ � I1 ul nn 1 1 1 m m, n . I I � I IIII li a • Lab I I •I ' i� ii� i I... � I ! ' ; I III!IIIIII11111d:i ,� 11 ' , llij lilt i I;�Ilil � '• i I I � ;� 'I IIII IIIIIIII!II i !',; .Illl;rl;;;;ll• =� h i 11W1..� ! r i I 'salilf�� lil �II!II;I�`-11i��, 1 Ilillli lilni!illll i�l'Illilll`III;. ,;;:Ili!,�::;��,% ; . :f ! i 6 ' .�L�.� i,�-S�`rY�. .;% h� 't�w_•t �...•- '�' � -Y iAS ��� }� i i.v-.Fz "aII � � - -a."� 3 7ot ''�`Y.� �.;-_ �i'�:t �_-4.'�w I � I p7mmm1 I I 'II _ 1 I itj sRR I ; II -� - 1 I - I m� 3 1,9 r MIN = 3 :1 I f E T D i c2 �c i e G 4 4 t i � tk:Z2' —. NE 31 I{ �: c e 1 I I - I �0 A R 1 F y` -- 1 ep 31 4F 71 1 I •3 ,a L 1 9 ' e 9 l , i e , ti 4 �? - c q' i 00 A 3c c cD ` q 6 u I - j �m cp ;I z — , • , � m O 1 Ilrr��� ' — — O s � k _ J i • = 4 i _ o ii I I u T 4 • it L T ' , V y I � r k: r � u N i 1; � ,_..., r-�.r...�-.ti ..��s.smrr�.-a.-f. �f 1..:.d -.- .:-E,.,-.1._..lJ.+,k�_:•a�.�.sf.._f> ..f-_,_F.-�__�� - ..., - i � \ c q, \ t i I � I I• i I' I I ° i ? la I n4 Itt I i � y I• , �I I ; A Z � r N P' W j 1 ' / / I n 1 li;l I I t T-�---- h I j - n � a - aj 3 I r II i I i E c a r a s iI 1i � - u( i `��I I V S. -I't iL --+ss a"r�v.e.. t�i.��•'4�T' '_��3..�. .^P * ,:,,, ,�?-`',t�5 G •t K 1 'r;. Ii 1 s - r O \ a - 0 B j I •Y r 9 1 7� iIIt t - � i COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY . OF ONE ASHBORTON PLACE Failure topoasessacurrent MASSACHUSETTS BOSTON,MA 02108 MassWusotts State Building Code C L N-;E of tA/sllcsasa. EXPIRATION DATE 3 ,g C O N S T R. G U P E R V I S O R CAUTION 0 S/1 T/1 9 9 6 0 EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST RESTRICTIONS THEFT, PUT RIGHT THUMB NONE 0 6/3 0/1 9 9 3 009013 PRINT IN APPROPRIATE 6 R BOX ON LICENSE. (iRE.'GC) RY CAULEY r -1293 3 3,1` Ft A X T r k AV BLASTING OPERATORS SS P 0)98—W.J w YA04-OUTh r 02673 = m m MU T INCLgDE PH-TO. PHOTO(B705/11 /1949 ONLY) FEE:( (�(� ' � I ,1� 1 "• NOT VALID UNTIL SIGNED BY LIC D OFFICIALLY HEIGHT: STAMPED-OR-SIGNAT OF THE C MISSIONER DOB: J U L. 0 8 1993 THIS DOCUMENT MUST BE CAROFSI4at3 IN FULL SIGNATUR E THE HOLDIED ON THE PERSONOF E-DF LICENSEE 0 �� THE HOLDER WHEN EN- ,� OTHERS•RIGHT THUMB PRINT GAGEDIN THIS OCCUPATION: ER --------------- 86vulSINIWGV I19Z0 vw 'alnowiq M anuany :81XE9 V sib Aa�neo 'W A106919 - 4h/£Z/LO uot'}eatdXa r ltlll0IAI0NI - adAl cc.�90f �ot;e�;st6aa R COMMO TH OF "SACHUSETTS =E`= DErAKY]YE T OF INDUSTRIAL ACCIDENTS 600 WASHINGTON STREET BOSTON, MASSACHUSETTS 02111 fames.: Cam0oei �c--,rss�one WORKERS' COMPENSATION INSURANCE AFFIDAVIT t (licensee/permincc) with a principal place of business/residence- at: (City/State/Zip) do hereby certify, under the pains and pena.16cs of perjury, that: [ J 1 am an employer providing the following workers' compensation coverage for my employees working on this job. Insurance Company ^ Policy Number [ ) 1 am a sole proprietor and have no one working for me-. [ ) I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation insurance policies: Name of Contractor Insurance Company/Policy Number ?game of Contractor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number 0 1 am a homeo-wncr performing all the work myself. )VOTE: Please be 2ware that while homeowners who employ persons to do maintenance,construction or repair work on a dwelling of not more than three units in which the homeowner also resides or on the grounds appurtenant thereto arc not geaeralJy considered to be employers under the Workers' Compensation Act (GL C. 152,sect. 1(5)), application by a bomeowncr for a liccnsc or permit may evidcncc the legal sutus of an employer under the Workers' Compensation Act. 1 understand that a copy of this statement wil)be forwzrdcd to the Department of Industrial Accidents' Office of Insurance,for.eoveragc verification and that failure to secure eovcr2ge as required under Section 25A of MGL 152 can Jead to the imposition of_st*minaJ penalties consisting of a fine of up to S1500.0 or prisonment of up to one year and civil penalties in the form of a Stop Work Order and a fine of S100.00 a day against . Signed this day of 19 s4 Licensee/Permincc Licensor/Permirtor Application to JPNEG 9j.J1� OgCP�S,�P�S��P M`GH Old Kos Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: HECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: New Building ❑_ Addition Q Alteration Indicate type of building: House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY j�� ✓' DATE3�T � ADDRESS OF PROPOSED WORK 4 d'C cyltso't L,�J w�"" �' ASSESSORS MAP NO. OWNER �� '� �c�NNA N�G/ Ty ASSESSORS LOT NO. 4= HOME-ADDRESS )OO +96Y 1/,50 1&."s !"r 9 TEL. NO. I'Prr 25�90 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of.adjacent property owners across any public street or way. (Attach additional sheet if necessary). e AGENT OR CONTRACTOR /� y TEL. NO. VS —"5nFO ADDRESS & &-X � 17� /�lJA1/S H11 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). o JUL 1 6 1993 TOWN OF BARNSTABLE Signed LD KING'S HIGHWAY 1 1 Owner-C actor-Agent Space below line for Committee use. Received by H.D.C. r f Date The Certificate is hereby Sk a to Time G By Approved IMPORTANT: If Certificate is approved,approval is subject to the 10 day appeal period provided in the Act. Disapproved ❑ - ADDITIONAL INFORMATION FOR MAKING AND FILING AN APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS The four categories for which a Certificate of. Appropriateness is required are: (application for demolition or removal is a separate form). 1. EXTERIOR BUILDING CONSTRUCTION (new or existing buildings): An application is required for any exterior of a building to be erected or altered including windows, doors, siding, roof, light etc., that will be visible from any public street, way or public place. The following scale drawings are required in duplicate with application: plot plan (if addition — show existing buildings in outline), floor plan and elevations. Also required are snap shots of existing buildings, where additions or alterations are to be made. No plot plan is required for addition or alteration which does not touch the ground'. 2. EXTERIOR PAINTING: An application is required for any portion .of a building, structure or sign to be painted that is visible from a public street, way or public place. Color samples must be attached to these applications. An application is not required when repainting existing colors, changing to white, or using colors approved by the Town Historic District Committee. 3. SIGNS OR BILLBOARDS: An application is required for any sign or billboard to be erected within the District, with the following exceptions: a. Existing signs or billboards on November 27, 1974 shall have until November 27, 1977 to secure an.approved Certificate of Appropriateness. b. Temporary signs for use in connection with any official celebration or parade or any charitable drive as long as they are removed within three days of the event. Certain other temporary signs that the Committee feels does not detract from the Act may be allowed with the prior permission of the Committee. c. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they are erected or displayed. d. A single sign of not more than 1 square foot in area showing the name, occupation or address of the occupant of the premises on which they are erected or displayed in a residential zone. 4. STRUCTURE: An application is required to build or alter any structure within the District which is defined by the Act as a combination of materials other than a building, sign or billboard, but including stone walls, flagpoles, hedges, gates, fences, etc. GENERAL REQUIREMENTS 5. Work on projects requiring approval shall not be started until the Certificate of Appropriateness has been filed with the Town Clerk by the Committee. Approval is subject to the 10 day appeal period provided in the Act. I 6. No changes shall be made from the original approved specifications without advance approval-of-tl%`Commisszon on 'an amended application filed with the Committee. ` 7.. A separate application must be filed with each project requiring a Certificate of Appropriateness. " 8. Under heading of "Detailed Description of Proposed Work" give detailed data on such architectural features as: foundation, chimney, siding, roofing, roof pitch,-sash and doors, window and door frames, trim, gutters —leaders, roofing and paint color. 9. Unless application is complete and legible and all material required is supplied, application will not be accepted or acted upon. Copies of the Act establishing the Regional Historic District may be.obtained at.the Town Hall. a •1 OLD KING'S HIGHWAY HISTORIC DISTRICT I • Spec- S1-Zeet Foundation Type �6y�� 164, eko��' Siding Type Chimney Type /C Color '/� Roof Material 51 ���� '�-041/iU(gL£ Color Pitch Vindows ��� Size Trim Color Doors � ��'�- Color Shutters Gutters T - - -Deck -170CA-�- A6M Garage Doors PAA 6 S Color Notes: Fill out completely. Including measurements and materials/colors to Three copies of this form are required for su�mzttal of an applicat along with three copies each of the plot plan. landscape plan and plans. when applicable. 'Plot plan need not be "Certified" • but should show all structures to- scale . it�6 4u��- 171 C. �20 low ocr al'y,1, AW //0 .6 5 "Assesspr's office(1st Fbor): Lo+ Assbssor's map and lot number O�p I SEPTIC THE C SYSTE Tp` Conservation(4th Floor): INSTALLED IN C Board of,Health(3rd floor): Sewage Permit number ENVIROIVMEWITH a' Engineering Department(3rd floor):. ^ �J� ��� NTAL House number cZ� TOWN REGULATIO r� Definitive Plan Approved by Planning Board —��U — �� 19 V APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M only P v TOWN OF ��`BAR STABLE ' BUILDING INSPECTOR q APPLICATION FOR PERMIT TO �✓0aol �� �iry� ��• , °�f 1�,�f ��j � TYPE OF CONSTRUCTION _ e-)v v� 19 L.Z— TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 6)6A,50,,0 l/L 6"d 6A61;�S7A 6,"r i Proposed Use Zoning District ► PF Fire District w• � ►C � Name of Owner L;&O' t 6 d42LV/1 e 6/V7 Y Address PO SoY //-5;0 7- Name f1 ax�r� � �X &35 of Builder ����� Address Name of Architect Address Number of Rooms �7" Foundation ,I�GII� l C7/UG�� 7j� Exterior / Roofing Floors Interior j Heating � �J - - Plumbing ��r Fireplace Approximate Cost ©d Area Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the a ego struction. Name Construction Si ipervisor's License t�) HEGARTY, BRUCE & DONNA t I`do 36229 Permit For BUILD DWELLING Single Family Dwelling F Location 211 Carlson Lane (Lots 5 & 6) West Barnstable Owner, Bruce & Donna Hegarty i Type of Construction Wood frame Plot Lot Permit Granted- 93 October 12 19 Date of Inspection: Frame-- 19 Insulation 2 19 Fireplace Date Completed 19 pp o�Sew, fr CI' ; co E�� . Ic . ,_._ . . , , _ _ , . - _ . , I - ' . R. M 3­_I­�-I�_,-I-.I..�.C,-.,-I..;I--.-__-,I,.4-­.­,1-._'11_.­i-..,._-1-�.I..,_-­.,1.,-.:I:I.__,I.._-.I,­-..:,I_-.,."I,---­.I_..-­..I.I-�.__...;X1.I­.,.�--,..�',_­.fr-;dJ 7�I.I­I.1�.,.�1-I-.-'I­I-I..oI­-.'..,�L.I-..-__....­%....,.,__..--.I,1_-­­.-__p;_..'..­.I,.1 1_-.t_�1.1I.-i..,.1­-.I.'.1I­--,...--..._.-A I--­.'I".I.'.._,-1A1 I_I--_-._..._-._1.1".­1­..__1\_'__',,,....­.1.1.,.-.-...­-I 1-,.1.-_I--�..,_.I.I f,L..II-..__.-.I I.f-..-..1I-_.-:W.-..?­.I".;I,.---.I,­1.I.I.I,I:_-.._".II I_'!I-:--I:L-'/I..-,I I--_.-_'II I.,/.'II_I.a r-/_'L1.I.?/i--7V.I.I.,I..:II.I II0-_.II,.­.1�I-._.I-:-,..,,.I.-_-...I._.1.,i.II I I_-­-.-,-.I_.,­,,.�-..­. .._,w - . ,.. - Y c- .' ... :. .,. - • .. .4. - •._ ,.F{Y•+•-• s:-7�+ti��,n3'.�. .,.•Fr .• - L -w - :t •^S`+i'- .... r' - + gL II Y ,fir � !'.. 1 • - .• ,.v r t ). , ... ._ ,.... .. , . :. .._,- :. ; - _ . . . :. _ � _ a GENERAL , . - , _ r SPEC '* r ` r - 1�OTES AND - � ; • .. ,' _ ! .n - a - _ L t� . �rr _ r. a ... �• .. y\ _ y a. , - :r. d. , r • w . .. _-,, • ► R .. . s _ _ L . -. - -�• i 1 .:�< • I ils are t ca for ail �*-.f ► ..,.' r ,, .,',.- r ,, , e _ � - 1 All design deta yp p� Pe � '" .� v. • y ww _ _ ..':. .... , ; • _ �.. ,. _- .- /'T _ t'� , - �, .i r , . 2. All .concrete is to be la ,�, � L .1 .,. ., _ _ r a t n a �; f u . ..3 is o be `co solid ted ,�, *,. c as a m no th r•. �,� Y1--.1. -- --- P� -.--` - using standard methodspfore preventing segregation and honeycombin of con- '�a , ;: �, • '` ' WxL ' A B c t g i' i , . . - _ , re e. - , ` - , ' .„ - - .. - --- - �_ - - - _ - _ • sec .V -_ }-.... - ' - ) a 'sec _ - _ , - e -4 o rr: ` :. = /8 x 3lo /8 �- _ _ . , _ _ 3. r nd assoiciated footing ,shall be constructed at all skimmer lot a ionsr -' * F_At. _� - WxL g , Pilaste a = 3 :. r /& x3G l e - .._ , - 4.� i " W w , - _ - - _ _ - 4. All concrete reinforcment shall be 60 ksi ( rade 60 steel rein - i4_jc firer ] f f orcr -l19z 32 /G g 20X40 /4'r Z8' i4I -: - } 10'O 5. All concrete -shall be 3 500 psi, 28 day strength *concrete and shall have a ',.Z i _ rI �6 rZ4 -----�Z -=--------- - =_ -- - ---- -------- -- -� 1. 12t x24� I Z' - � max►mum six (6) inch slump. 1 , 6. The .minimum allowable soil bearin ca achy shall be 1000 y,. ti � j ' l,_l,­ttti,.;-,I-,T,f11 . TYPICAL [BAR LAP - DETAIL g P psf. Ways shall � I. bear on undisturbed soil. � r -- . ._ !o u ' l h 1 _ _, _ F , - earance s a 1 be p ov►ded between el rein rye STD ment and skim fixture STD. RECTANGLE - - A two (2) inch nirnurn c r /i A er ste y - . - ,• ♦k . 3 t I I - . Alckfill a{! c lug _ compa .led-to 9096 standard proctor. - - �� sti - - o{JG Pot - --6 - 8 I b _ �� - { - -- - • s L E x 4 0 t�I = 'A -- __ - - _ -- - - - - _ P Y r ations RECTAldG 20 wIJT_,ow 9. Construction of all reinforced concrete is to tom 1 with ecommcrid . . _ . -------- - ---- o- �rn�t�� ACI3 3 n1 r of d d �aY - - - ----- - e r e k , ,.of 18 8 u ess othe wise n or specif' „- _ _ _ --- �- _ �_.� . : a . . a . ,A�,I,&PW:R0 ,.,.­_­1 IZ i_I,�',Q:4; I,,_,3, 1ft.:. . -- ---- ----- - -- - - - _4 DESIGN ASSUMPTIONS . t�If 4.5 "IL"_,,--�I f1.4., . - - . - _ C ?��1-,II,,V4 t,p­"#�-.I-,,A�,,,L_,._I*.­IZ1",I_,i1"-."'_S,,I,.,- r _-. __ _.-}+ __-�_- �_ __ - - __. _ - g�S fie t ti ., 'Qt . - I. facts -and warranty limitations. V, L Structural design is based on the assurned : _ etbl hd h C- s e rete ons t M 1 r '". A _ _ I I A - _ _ •F . c eon anua . a is a in t c P rma-c tru ¢,�r I . - -I I 2. Owing to varying site specific conditions, the pool structure is not designed ' y ,r . r I W^L A �, i _ 0 for any earth or fill ground movement caused by factors which may include. � � . I j { not be iirnil d to, expansive or otherwise unstable or unusuai sails, acts ,,,, _ „ , i o u� / - -, - = - -- mod. last, _ ices or acts of others. f' r. .- ! - • - /gr '� , ;4-; -- . * . WXL A - w ., K AII 1.1 Ii III b n� . disturba r .,., - . /(v X» , : ,1G•-rf3I 3. Design loading <on pots walls_is based on an empty pool witFl a 62.,i pcl eyuiva- .',. �, _ .�. ' / /Copy 321 /Z /U , -- s a log the ere wail height rd a .u,l o! �';'r s - ,. J r I , -�- lent �1L"d ere sc,rc e�tPrior to d a n ent' a p0 -w--d rz* , _A,' �! /4 x�� ' ,► 20x �O Co with ba a in plat 4;`+ ,.y , . Z- 1 - ckf I e r • � y ► i � � ; - _ A 4. Pool wal.s are, not designed for surcharge loads exerted by wheel loadings �, ,- , g 'i f eV� ' ' /U z of -�J=ixs" -- - within four _(4)._feet___of_ pocii aa11 from construction equipment weighing morex"; ' , '�' than 2500 !bs or any other addtional loading condition imposed on the pool Q:: - ' { . y t structure b;• ,existing or proposed adjacent structures. . ` -.. "I 5. The oval kidne and figure "8" pools are not designed to withstand interior A -_ •tom r ••� ,L TYPICAL WALL SECTION y 3 hyprostatic loading without being backfilled. - �' STD. GRECIAN r-,w_ , / GRECIAN: 20'x40' ` } •t ':y4 ► - x - '}t ,4 _T v.�.,;Ut-0 I,.I;.1&*,tI I"I ,_,,`m­.,,1"­*.­I,_iz,z*1i.1e-.,`:"-, . . -- - _ cr # ■► - - -.. * - - - - _ - _ - -- - _ - n. ,f• '�. .,• .a . -.s - __.__ - - -. . - . _ -- -._ ... - /, _�` , �5 erg} f/ilY'�✓A4�r kfQL P :N , ' -b,� 9. r g - &, & *.. (/ 4' l�f K r ��^`��/� I _t (' to &'M�z'°,�� � _ v` WXL A B G ti _ a -{i '4' . . .b t - $ ` . . WxL . A i ! . I i ,v ,,, .. I ., � f ,-, / I I ' V ZO.- 46, /S , 1`',�,I l Ot QI I r-�- \ � 1 , � � *- 3 ITI�e, � - 1ty 11.0 � .�'� � r / �i �. 18 y 43 ZO 18 ! I _ \ .-, S j . 1 C:, /O 4.C. ;�, , r_,, : I I � ,, x, i ^`' I Y V b �L SO OF 1,uA�L '•. - _ ... . _. I a ` _} `') LAZY `L'• 20'x36'x46' li - I -- R i. `,,, { STD. 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