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HomeMy WebLinkAbout0312 CEDAR STREET u i a P Ily ���,�� (/i���7 l _. . ._-_., �y.� __.. ,...� - - . .� , - . - . _ t . ,�: �. .. k i �I 1 0 ( f.2ti1�1 I ' S 5 � I Jf Town of Barnstable *Permit v#(� Expires 6 months rom issue date Regulatory Services Fee. ...,_ AAA^R ► •: E_-.,;-x-.? • E p IT 1639. `0g Thomas F.Geiler,Director Building Division O"=C = a 2 011 Tom Perry,CBO, Building Commissioner ;�_1�J���l � ,�Pi� !�aLf 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma us W Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY i Not Valid without Red X-Press Imprint Map/parcel Number 3 1 , 013 1 OU3 7Residential rtyAddress 3�2 C e d ti✓ S W' 4 /Z a!J['R f3 I e Mq Value of Work i 0 U`y U Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address P Pv 6o K 'q 3-4 U/ t3AtztvJrg3je� m.4 o a.(a`� Contractor's Name G 4 V G U �t d-rA do i'l Tel one Number J �� A,�f 1 of Home Improvement Contractor License#(if applicable) Ll�t)U 1 4 d Construction Supervisor's License#(if applicable) { o aworkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name A C Z p Y c p,e V 41 Workman's Comp.Policy# A) VJ L C 'i ri- Y 32 d d Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping..Going over existing layers of roof) Re-side d a2 9v 5 r»co'—, H S1'jt✓l7'l�vvv�t a�i�e ❑ � #of doors G a [Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner mus ign Property Owner Letter of Permission. A copy of t How I rovement Contractors License&Construction Supervisors License is requw SIGNATURE: C:\Users\decollikWppData\Local\Microsoft\W dows emporary Internet Files\Content.Outlook\DDV87AAZ\EXPRF-SS.doc Revised 072110 I Page 7 of 7 Capizzi Home Improvement Inc. Specifications and Estimates STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I, DIAN6 , OWN THE PROPERTY LOCATED AT 312- 60AA-5 i, IN Vy iA f�� ,�,�,�, MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER: r n OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit, MA 02635 APPLICANT'S:TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: Client#:47298 CAPIHOM ACORDry CERTIFICATE OF LIABILITY INSURANCE DATE o,�' 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 Karen Walther NAME: Rogers&Gray Ins.-So.Dennis PHONE o EM:508-760-4630 FAX (A/C,No): 508-258-2230 434 Route 134 E-MAJL P.O.Boz 1601 ADDRESS: waltherka@rogersgray.com PRODUCER South Dennis,MA 02660-1601 CUSTOMER 10#: INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:National Grange Insurance Co. Capiai Home Improvement,Inc. INSURERS:ACE Property&Casualty Ins.Co Capiai Enterprises,Inc. INSURER C: 1645 Newtown Road Cotult,MA 02635 INSURER D INSURER E: 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 I TYPE OF INSURANCE DL UBR POLICY EFF POLICY EXP L S POLICYNUMBER MM/DDNYM (MM/DDIYYYY1 LIMITS A GENERAL LIABILITY MPB1075H 6/08/2011 06/0812012 EACH OCCURRENCE $1 OOO OOO X COMMERCIAL GENERAL LIABILITY DAMAG O RENTED PREMISES Ea occurrence $500 000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $1 O 000 PERSONAL&ADV INJURY $1 OOO OOO GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000 OOO POLICY PRO- LOC $ A AUTOMOBILE LIABILITY M1 M2F,,644 6/08/2011 06/08/2012 COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) 500,000 .1 ALL OWNED AUTOS BODILY INJURY(Per person) $ BODILY INJURY(Per accident) $ X SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ X NON-OWNED AUTOS $ X Drive Other Car $ A UMBRELLA LIAR X OCCUR CUB1076H 06/08/2011 06/08/2012 EACH OCCURRENCE s5,000,000 EXCESS L1AB CLAIMS-MADE AGGREGATE s5,000,000 DEDUCTIBLE $ X RETENTION 10000 $ B WORKERS COMPENSATION NWCC45843208 12/25/2010 12/25/2011 X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000 000 OFFICER/MEMBER EXCLUDED? N WA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1 000 000 - DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H more space Is required) - Additional insured status is provided under the general liability when.required by a written contract with the certificate holder CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town Of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE 0 198 -2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009109) 1 of 1 The ACORD name and logo are registered marks of ACORD #S67537/M67480 MEE ..•, • ✓rze vrarrmanu�atua cf✓G2va.acliucet� office of Consumer Affairs&Business Regulation --License or registration valid for individui use only riOt:iE tI iPROVEMENT CONTRACTOR before the•exgiration date. If found return to: _ Office of Consumer Affairs and Busines§Re;ulation - Registration` 07,40 Type: 10 Park Plaza-Suite 5170 Exaira,i h Supplement Ca id Boston,N A 02116 CAPIZ7j i,0IAE 4 GARY GUSTAFSl��v'�@w 1645 Nevrton Rd. ' - d�- Cotuit,MA 02635 ��: Liaderseaefgr{ n'o. d without signature �. �t:z�s:zct�u�rtt�_ Qrl1.ti►-tmitnt iif Put>tic Sat°ct} awird of Building Re+-c�t:tFiu.txr <tnci$tartctards f Construction g perv'tsar License License; Cs 74640 GARY rtISTAFSON 8 SHORT WAY SANDWtcH,MA 02563 Expiration, 14t291 42 Tr,-. 7058 " t f cThe Commonwealth of Massachusetts DepartmentofludustrialAccidents . Office of Investigations 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information TIease Print Legibly Name(Business/Organization/Individual): A P C 4-rvYd t1_m,' f TAJO Address: 1 G 45' N-eui;own 1 P City/State/Zip: .��F+�►f . M� 62t gs Phone A,r�e,y`ou an employer?Check the appropriate box: Type of project(required)- l.L�VI am a employer with 'LlQ.t. 4• Q I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. El New construction 2.El I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g; Demolition workingfor mein an capacity. employees and have workers' Y P tY• 9, ❑Building addition [No workers'comp.insurance comp.insurance.1 ed_ 5. We are a corporation and its 10.0 Electrical repairs or additions required.]] officers have exercised their 11. .Plumbin repairs or additions 3.❑ I am a homeowner doing all work ❑ $ P myself.[No workers'comp. right of exemption per MGL 12-El oof repairs insurance required.]t c. 152;§1(4),and we have.no employees. [No workers' O.J • Other comp.insurance required] *Any applicant tbat checks box#1 mast also RU out the section below showing their workers'compensation policy information. ` t Homeownei;,s who submit this affidavit.indicating they are doing all work,and then hue outside cop"dactors must submit anew ew affidavit indicating such ;Con&A.ors that oheckthis.Sok•niust aftached•an additional sheet showing the name of the subcontractors and state Wttetber or n_ot those entities have employees. if the sib-contractois have employees,they mast provide their workers'comp:policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is mepolicy andjob site information. Insurance Company Name: A C 6 p Yo�-eR f y r4✓vq L/'� 0;(/d illm NL e l�? G G `�S� �3Z G,P Policy#or.Self-ins.Lic.#'. Expiration Date: Job Site Address: 3 I G City/State/Zip: W bS A X IV' Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).. Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up'.to$1,500 00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurancS,6verage verification. I do hereby certify un the i and penalties ofperjury that the information provided above is true and correct: l � Sintiature: . Date � a � G Phone#: 5 0 Official use only. Do not write in this area,to be completed by city or town officiaL City.or Town: PermWLicense# 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 t, F . Town of Barnstable- *Permit#g Expires 6 mo hs from Issue date Regulatory Services ®P � . Thomas F.Geiler,Director l Building Division �, BAN n 3 20 Tom Perry,CBO, Building CommisstonetQ�/� �� 200 Main Street,Hyannis,MA 02601 O�Biq�N www.townbarnstable.ma.us `STAe�F Office: 508-862-4038 Fax: 5081 90-6230 EXPRESS PERMIT APPLICATION - PRESIDENTIAL ONLY ©1 O ojNot Valid without Red X-Press Imprint Map/parcel Number Property Address a (vQ�JI Q JE�Residential Value of Works dQr Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address 1,a Yee i'e O �o n— 1� : epa rNsAN P� l E MA 0 ? co b� Contractor's Name 1' j� 1 .�}� ZQQct>1T Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) (0 2-Lo 3 k 5 *orkman's Compensation Insurance Check one, ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation-Insurance Insurance Company Name �ra\/O l e c5 l�S W orkman's Comp.Policy# e) -- CJ 'd �D\A A 65 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) P[�,Re-roof(stripping old shingles) All construction debris will be taken to a 'r' 1 ❑Re-roof(not stripping. Going over existing layers of roof) i ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) *Where Tequired: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home 1=rovement Contr ors License is required. SIGNATURE•' Q:Forrns:expmtrg J Revise071405 0 Property Owner Must Complete & Sign This Form If Using a Roofer / Builder. (Please return this form with your signed contract, thank you) (Print) U ��� vI�` as Owner-of the subject property hereby authorizes Paul J. Cazeault & Sons Roofing Inc. To act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) � I � SZ- L✓ (�CiJST/�F3 l.� Signature of Owner Date /V 0S, Tel# 3 6 a -ip ( 3 Board of Building Regulation' s an tan �rs One Ashburton Place - Room 1301 Boston. Massachusetts 02109 Home Improvement`Contractor Registration Registration: '103714 Type: Private Corporation Expiration: 7/9/2006 PAUL J. CAZEAULT & SONS, INC:-.::I Paul Cazeault 1031 MAIN ST OSTERVILLE, MA 02658 Update Address and return card.Mark reason for Chang El Address Renewal Employment Lost Card DP$-CAI Co SOM-04104•GIO1216 ,!� ./�LC 1009)NJtOltlll(000/L O�✓!°laddQGNL6P�4 - M'}X Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Liccuse or registration valid for illdivillal use only Rogistr 103714 '".01 before tile et e expil:Ition date. If found return to: Expiratlon`:1037106 Board of Building Regulations and SU111d lyds one;wiliurton Place Itu1 1301 Private Corporation ►;1,s1ou,Ala.02108 PAUL J.CAZEAULT;&,SONS,.INC:; Paul Cazeault • l l-�" - ✓!ie i�Jan>a�ua o�✓vlaooac�u�ae(a ' 1031 MAIN ST t ` "r;�: CL--.�r�r�✓ BOARD OF BUILDING REGULATIONS OSTERVILLE,MA 02650 Administrator n License: CONSTRUCTION SUPERVISOR ! I Mi' � ;I Number;.;;CS� 026325 + I Birt 959 Expires;10/20%2007 Tr.no: 7696.0 Restricfeii T00 °f PAUL J CAZE = � 1031 MAIN ST � I OSTERVILLE, MA 02655•. '' Commissioner ; va 1 Cnv1a_Uc, mrr Utnoo - 7 — - ... .. ___--.-•---- _Administrator Board of Building egulations One Ashburton Place, Rm 1301 Boston, Ma=02108-1618 a License: CONSTRUCTION SUPERVISOR LICENSE-> . .,�s Birthdate: 10/20/1959 Number: CS 026325 Expires: 10/20/2007`..1_ F.•_- Restricted To: 00 r 1 - -i'r� �: •P PAUL J CAZEAULT 1031 MAIN ST $, OSTERVILLE, MA 02655 Tr.no: 7696.0 Keep top for receipt and change of address notification. DPS-CA1 0 SOM-04105-PC8698 Keep top for receipt and change of address notification. oF, T Town of Barnstable *Permit# ?S-S- 7 f-', Expires 4 months from issue date BMMgrAB , : Regulatory Services Fee ?5 MAM `0�� Thomas F.Geiler,Director�EOAA`� Building Division Tom Perry, Building Commissioner X-PRESS PERMIT 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 AUG 2 6 2004 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTMftff BARNSTABLE Not Valid without Red X-Press Imprint i Map/parcel Number , 3 I () ( 3 ()() 3 p Property Address 3 1 a C,15;b S ':Wtesidential Value of Work S� Crx) Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address 7 V1 w c_ PE-L' y S14 Contractor's Name L t� 2 L-�t�S D tJ Telephone Number a— a ' Home Improvement Contractor License#(if applicable) 7 C/ Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor N4; ,'l 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. rmit Request(check box) r� n �Re-roof(stripping old shingles) All constructio "�1n debris will be taken to .0g,?jn f A 1� �O C. �L� ❑Re-roof(not stripping. Going over existing layers of roof) . ❑ 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 Owner must sign Property Owner Letter f Permission. Home Improvement C�orsLicenses req ' n � ` f Signat ure .. 0 +� �ne ' n l..P I'a 1 �C Q:Form:expmtrg " ^L Revise063004 4.07 � � ' � R 1� Application to: ePE °E` Old Kings Highway Regioitlal His�Oric District Committee in the Town of Barnstable for a CERTIFICATION.OF EXEMPTION Application is hereby made, in triplicate,for the issuance of a certificate of exemption under Section 6 and 7 of Chapter 470, Acts and Resolves of Massachusetts, 1973, as amended for proposed work as described below and on tans, drawings, or photo- graphs accompanying this application. . TYPE OR PRINT LEGIBLY DATE P SED WORK &A9 �� S S RS MAP NO 11.5 10l 3o0 ADDRESS OF O A SES 0 OWNER ASSESSORS LOT NO. HOME ADDRESS �' 'y"` TEL. NO. '2 224 a Z (U 6 5 AGENT OR CONTRACTOR ndj62 �I 0 141�ja)62 �y ADDRESS,n �31 w � W Q TEL. NO, 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 lot,and, if an addition is involved,show• ing location of existing building. ez cue _ SIGNED Space below line for Committee use. : Owner-Contractor-Agent Received by H.D.C. The,Certificate is hereby Date Time By Date Approved ❑ The categories of work entitled to exemption are listed on Disapproved ❑ the�back of this form. ------------ �pTME Tpk, Town. of Barnstable *Permit# 8� Expires 6 months from issue date N aAMSTABtE ' Regulatory Services Fee 9�A 1639 MASS. Thomas F.Geller,Director /�V P®RE S PERMIT TF0"A0'i Building Division Peter F.DiMatteo, Building Commissioner A U G 2 9 2001 367 Main Street,.Hyannis,MA 02601w Office: 568-862-4038 TOWN OF BARNSTABLE Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY rl l Not Valid without Red X-Press imprint Mapiparcel Number I 3 Property Address p [ &esidenrial - Value of Work 15�& Owner's Name&Address Contractor's Name cJ (, Telephone Number mp Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) t fir - ❑Workman's Compensation Insurance " Check one: ❑ I gn a sole proprietor :1 am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Permit Request(check box) _-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacemeni Windows. U-Value ( •44) ❑ Other(specify) *Where red: Issuance of this permit do not mpt compliance with other town department regulations.i.e.Historic.Conservation.etc. Signature Q:Forms:erpmtrg:rev-070601 ' .N•�...,��1� on to Vo •s Old Kings Highway Regional Historic District Committee in the Town of.Barnstable for a 070 CERTIFICATE OF APPROPRIATENESS. Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: ❑ New Building ❑ Addition Q Alteration Indicate type of building: ❑ House ❑ Garage 2'Exterior Paintin g Commercial Other 9�- 3. Signs or Billboard : ❑ New sign ❑ Existing sign g ❑ Repainting existing sign 4. Structure: Q Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). , TYPE OR PRINT LEGIBLY DATE_ `�/�`/ 7 ADDRESS OF PROPOSED WORK /, 1.���?. St -6g, S-r ASSESSORS MAP NO. 131 OWNER ( b ASSESSORS LOT N0. �'• 3 n HOME ADDRESS ,S/ �/ �i J/L/V /�?J�t"TEL. N0. �� �� •,� FULL NAMES AND ADDR SSE 6 ABUTTING OWNERS. Include name o adjacent property owners across any public street or way. (Attach additional sheet if-necessary). AGENT OR CONTRACTOR TEL. NO. ADDRESS DETAILED DESCRIPTION OF PROPOSED WORK: Give, all particulars of work to be done (see No. 8,other side)' including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). r, i,�4 'A)7 Signed .x Owner•Conimater-ftefif Space below line tar Comniittc=uic-" Received by H.D.C._ Date: R '•;The Certificate is hereby Date Ti n Approved . ❑ IMPORTANT: If Certificate is approved,approval i subject to the 1 day appeal period provided in the Act. Disapproved ❑ i 3i 66- Sr 4,5 /3 i 13A1e-A)S'f14 ISLE I-p7- ,d /3 - 3 0 MR-S A-- S.9 3—&a R e wssr 6/ bg Iq U�t 642,*st0,61-4 d ya6616 �o AAA Sr EST j5i9��sfi¢ �9 Da( 6,? � Town of Barnstable s Old King's Highway Historic District Committee SPEC SHEET CHIMNEY TYPE COLOR ROOF MATERIAL COLOR PITCH WINDOW. SIZE TRIM COLOR a) G L,/ DOORW COLOR 7)c��•�-/ 5 /�JS'(= SHUTTERS LE;AZ L)j GV ► /�� � COLOR GUTTERS DECK GARAGE DOORS COLOR SIGNS COLORS SIGNS COLORS SIGNS COLORS FENCE COLOR NOTES: Fill out completely, including measurements and materials/colors to be used. Three copies I of this form are required for submittal of an application, along with three copies each of the plot plan, landscape plan and elevation plans, when applicable. Plot plan need not be "Certified" except for new homes, but should show all structures on the lot to scale. SPECSHT /aO TOWN Of BARNSTABLE'. MASSACH U8ETTS 'vo ASSESSOR& YAPS Al 3.O0A_. rat pv*v 1 e wry �O R`. 1• ' © {o 1 v 1.0oHt: I.OIK- 4� ` o p 1 34 13-7 i `. CO 1.01•c. �J O 1.51� o �° . I5-d �� ! 1.49 1 :! 10, ,� � J>�•f�p J�,`p ! O ` gyp. 4y 4,° /j-5 fC moor • r 1 o 2 1i �0 /► o ' to fo o i .. r ',W 2853 Bei e sw 2'959 Renwick Beige SW 2305 ,� C6 i � L� __ _ -rc—.-_$,+:je.,�.--.T '-r+A ']�.i.'Yt�--�,wr-:e,��.;.` r-- •+;. c=- _ '• - r' tis+�ay{ry�r`'.i,'S?J,r rN •.a _. _ .. ..„- e,.;a`: _ Assessor's--map and lot number ................... ................. p QyOF THE t0`♦ Sewage Permit number e! - ZAWS'TLDLE, i House -number ................... .1..!?t�..............................:....... 9 rnea - 4p 1639. a' R TOWN OF BARNSTABLE , BUILDING INSPECTOR 3 APPLICATION FOR PERMIT TO ►,_ ( TYPE OF CONSTRUCTION .... .�d.t�.... �! �z .:.............................................................................. ......................19.......... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..... ..........5f...............�?�' {`.........a. ................ `.:.. >.................................. f Proposed Use ......SJ..!Q.Ut...... ..!t1 !�? .�.�.�...... ?.C..�.!. .................................................................. Zoning District ......... ...............Fire District � Name of Owner ...e.!.l. lv ......�J t.....Q :�..1�...................Address .....?:T.............�.....15 ...;!.?,J•....Y.. Name of Builder .......��... ... c�...............Address II...V. .. 2i �.................... Nameof Architect ......................................... ........................Address .................................................................................... Numberof Rooms .......0.6........................................................Foundation .............................................................. Exterior ........ a S/ !!'!/ .......................Roofing ....d`�S J�!r9.f7 .......................................:................. ...../.. Floors N� Interior (�i �...... .. —.................................... Heating . . ..........................................................................Plumbing .... ..........................j 7'17'L...................................... Fireplace ....A.........................................................................:...Approximate Cost ....6 .�.��v ................... Definitive Plan Approved by 'Planning Board -----------_______-----------19 _ . Area / �O . Diagram of Lot and Building with Dimensions �, �j Fee ......, .. ...................... SUBJECT TO APPROVAL OF BOARD OF HEALTH s . J t P S RE OCCUPANCY ERMIT IRE .REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of,.the,,Town of Barnstable regarding`the above construction. !�„ Gc � � Name••���r,-�sc.vJ... .. . . .................... O3c70Z7 '. PECK, DIANE V. A=131-13-3 No 2.4 4.4.3... Permit for .....lh...S t.ory............... .. .. ....... 1 31-13-3 ory .................. Single FaM4,ly Dwelling...... ...... ............................................................ .. ...... ..... W) Lot #3, 312 C Location ...................... a S.t-gee e t .................... .... ...... ....................West...Barnstable........................ .... ..... .. .... .. .... ..... Owner ....Diane......V.,....Peck.... ..... ............................ ....... ... .... Type of Construction ...Frame........................... ............................................................................... Plot ............................ Lot ................................ Permit Granted .....0.c.to.ber.,...7 L.�......19 82 .. .. .... ........ Date of Inspection ....................................19 Date Completed ......................................19 00—/0 5A_kssor,s map and lot;nuniber ..................... .............. ..... Sewage Permit number ..... ....................... ell .... ... .. ....... House number .................. .. ........................... 1639'Vox,*- TOWN OF BAMNSTABLE BUILDING. INSPECTOR APPLICATION FOR PERMIT TO ....... • TYPE OF CONSTRUCTION ...... ............................................................................................................... r... ...............*........ 19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: -Location ..... ja 2................................... a4(??9.&......... ............ . ......... .............. ProposedUse ..... ...... . ............................................................................. Zoning District .........121�.... ...................................................Fire District ........u.,277A........ C�j .. Name of Owner �.)A,!�1 ......0. (L..,�...................Address .... ..................... ...... ne-VO...... j.... Name of Builder' A-r a- °LLB .5;:............ ...............Address ..�l................RtL4a11................. ... ........... .. ........ Nameof Architect ..................................................................Address ........................................;........................................... Numberof Rooms .......45........................................................Foundation ............................................................... ExteriorftAf��JA.......................Roofing .... ........................................................... Floors ... tu.................................................................................Interior ......................................................... HeatingP.1.1..........................................................................Plumbing .... ....................................... Z?,47_17L...................................... Fireplace ....)...........................I.................................................Approximate Cost ....� 0 ........O'n.0 / ....:.................... Definitive Plan Approved by Planning Board ----------------—---------- Area ./Ez..�....................... Diagram of Lot and Building with Dimensions Fee ......I:r .............. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform. to all the Rules and Regulations of the Town of Barnstable regarding the above construction. z- �? Nome . ..... ... ............ .. .. ......................... c7 0 Z < � PECK, DIANE V. ' 24443 l� Stozy |�b ---._- Permit for ---�----- ........... S ' l ]7 ~�Iv Dwelling ----~--......----...--....-~--.. . � Lot �], �lar °°Location -.----,.~--�I2---Ce---.---St�eet--.. � ' � West Barnstable --.~-.-.-..--.....-.---.-------. � - - Diane \/ PeckOwner ---.----�-_--------_-_-. ' � ��ame - - ' Type of Construction ---- ---------- --- . ^ ----'-^-''^-~--'-'------^~----- ' . ` Plot ............................ Lot ................................ - ' ` , - � ~` October 7, - 82 - nh�6 ---.]g � Permit/ -- - - - Dote -----l9 ' -~ - �o�e Completed ' - ` ,- . . ' . � - ^ ^ ` ' � ' ` - . ` . � . ' ` . ' . / ! ^ ^ ~ . ' . ' � n � S .Q4 ti �.GGZ- * 1 z..ss �eOo&EO&A.Ac0r b1Af.J C EGtC, r�AY.�.�'3T/a�t_E A��ESsc3f�.5. titAt� . r-b% L1�T 13 2 i•,/Grt EAY �'!l�G�T/F)*' TN/gT 7";NE� !�V/�»t��.t./6• - S�w4WA.1 C>A/ TiwIS ,o�L:A4A/ IS 40C•97'00 O.V 7W& I�GaF.� CC.vF'OG.1.9 TO 7'�w.t ,x'b.R✓y.V�i- `� �� `*Y TAw& 7-OW" Ofr rnaj-r HkjcM„ �`�A�' ry PIAW A.1 c'OAv�7�-4k./C TB•a. � A HNE G1� � -� wn crs er�9inr�r�r,y , 6s civic.. ��v�i.vrwta � SS_ L sP A/V .sv rV.sYo.r3 ,�'OCJTE GA^-*-r ,4R90tJ'T'", .tilAsZ. y-er� tee. VPNE4 0`E utM Application to ;�r•;, • � OB E•�'M��E�a1. . Old. Kings Highway Regional Historic District Committee in the Town of Barnstable for a i CERTIFICATE OF APPROPRIATENESS . — �a 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: 1. Exterior Building Construction: $ZMew Building []:Addition ❑ Alteration Indicate type of building:XU House ❑ Garage g ❑ Conpnercial ❑•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 exnlariatior,..3nd:reguire.rrients). ; TYPE OR PRINT LEGIBLY DATE July 14, 1982 ADDRESS OF PROPOSED WORK Cedar St. , W. Barnstable ASSESSORS MAP NO. 131 OWNER Diane V. Peck ASSESSORS LOT NO. .1 — HOME ADDRESS 307 W11lOW St. , PO BX 103, TEL. NO. 362-3169 W. Barnstable, Ma. , 02668 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property.owners across any public street or way. (Attach additional sheet if.necessary). SEE ATTACHED AGENT OR CONTRACTOR David Pratt 888-76'14 TE L. NO. ADDRESS 10 Ploughs Neck Rd. , E, Sandwich, Ma. Mail : Box 39, W. Barnstable Ma. 02668 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). SEE ATTACHED 1 Signed Er' er � Owner•0EKfXaMr Q{ Space b1y9C4+uRt�4r r4FF1 'F"ttee use. Diane V. Peck Received WALE Date The Certificate is hereby Date Time B JUL, Y Approved [ IMPORTANT: If Certificate is approved, approval is subject to the 10 day appeal period provided in the Act. Disapproved ❑ i a _. M � � ��:� -- _ �..r � - . . - - fl 7� � � �W �%�� � _ . i • ` TOWN OF,B AR,NSTABLE Permit No. _`_ZL,IJ� e Building Inspector l.�aar Cash OCCUPANCY PERMIT Bond r Issued to Diane V. Peck Address lot..## 312 ('.Pdar StraP1�-*Waet- RnrncYahla «siring Inspector �; � ��' Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department/:j // � Inspection date I 1-lBoard of Health r - Inspection date 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. '. . ec,is � �r/... �... ./. .. t..o.._r_....._= � Buildintnsp................................ A%ppiluailo n to Old King s Highway Regional Historic District Committee in the Town of Barnstable for a �j O , 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: 1. Exterior Building Construction: ❑ New Building Q Addition Q Alteration Indicate type of building: ❑ House ❑ Garage Commercial ❑ Other 2 Exterior Painting:' ❑ 3. Signs or Billboard : ❑ 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 AA � (� �. rDATE 117 ADDRESS OF PROPOSED WORK �, �r�f?. S( �i f'1C JV��/ ASSESSORS MAP N0. 131 OWNER /Jf 1.1,VL� ►/ t�•.� ASSESSORS LOT N0. 13' 3 HOME ADDRESS 36L 16 VANX //' FULL NAMES AND ADDR SSE ABUTTING OWNERS. Include name o adjacent property owners across any public street or way. (Attach additional sheet if necessary). AGENT OR CONTRACTOR TEL. N0. ADDRESS DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8,other side), including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). ,[l gffilr., F,20 AJ 7— A,1/V 6- SIA)7 7 Z 5 Pr &V--p;__ UV� � Signed Owner•C� Space below line for Committee use. �71 Received by H.D.C. .. l �> ate —+G + j he Certificate is hereby a /I� edl C —30 Date r �• , Tirllftf :n P A 4 N n C 'IMPORTANT: If Certificate is approved,approva Is subject to the 10 day appeal period provided in the Act. Disapproved' ❑ 45 4,9 L) 2n-R-S A e_e"S r - I�t���s-r g 2�s�gL 114A dAL too �J6�B• ��s-rye« Ag Pa&kf- ------ b-s s-611 1.1 1482�9 i � o s 50 &,bale_ sT G✓E5T �/9��stf�B� /9 Do�(v1�8' • , Town of Barnstable " Old Kin 's Hig hway ghway Historic District Committee SPEC SHEET CHIMNEY TYPE COLOR ROOF MATERIAL COLOR PITCH WINDOW SIZE TRIM COLOR_ A.) CK. DOOR COLOR 11C t�j(-4-1 S SHUTTERS ,� , /L) i � COLOR GUTTERS DECK GARAGE DOORS SIGNS COLORS SIGNS COLORS SIGNS COLORS FENCE COLOR NOTES: Pill out completely, in 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. SPkCSHT L• �� TOWN OF BARNSTABLE• MA83ACHU8E•TTS 'vo ASSES SOO MAPS `YY AS 3.00A4. WILL POAD All, b ♦o r° /.0QA&rQ— Oil I 1.01•L 6• - 0 13-t rc� Q , 10-7 rs . . ` ` �O 1.01•G. J O 1.51 fit,,.. ° - �b� 1 O <�` © 13.6 0 • lb �� • �. 0 /j-a to 6 1.4v.C. r ♦O, o i%..t. 1ys Luo'c.. ' ii ;° (ro� •mac ti o k;.• '` � `t� � L. /!-5 fit• K 1 1 / / �� 0 / / IF y / Op �s / I / '9 O i0 to r' / If v` ,* 1 .Ib 0 0 ?�► •i ry 0 yy '� hf o / 'O `♦ J� ® yp �11y 9 �,� s� 40 ♦ /.e 2 41C . so to I � LQ.ci�t�lr V SW 2858 z: z Beige sw 2 59 Renwick Beige SW 2805 I�ws '� � � ` .� ®.� � � � - ..— �; � � - �� _ � �i -� ��4.• :%...a . :�.. • '_,� rj:•:-���::at'a°aS,,�.._may:_•.. . 1. �y ��.y+`�=:r?: r. -_.- ���i;=' f..�f.+''� __?sue �� � r � � ��� Is,� . ��� ��� � . L -- I Engineering Dept. (3rd floor) Map / Parcel 01,q,D Permit# S a House# Date Issued / Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) ;F/Ir � Fee -2 Plane g ep . ) SEPTIC SY �`►E T BE Defi ve an ng d 19 INsT/4LL@D ANON M �MI/ 0� OF BAi STABL�I�®l MEN �� Aa� Building Permit Application Street Address _��cq �h?_ �T Sillage 0 Owner :2� 1✓C�� Address A W�— Telephone 2C, "-) Permit Request (A AAA CV2LS First Floor square feet Second Floor '�� � � square feet Construction Type 1 Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size ! - /�, /{C Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure .13-14S Historic House ❑Yes �No On Old King's Highwa; es )E�No ,.P►— Basement Type Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) A) 61 Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing / New Half: Existing New No.of Bedrooms: Existing "Z, New Total Room Count(not including baths): Existing New First Floor Room Count S Meat Type and Fuel: ❑Gas ` ebil ❑Electric ❑Other Cent`21l, r ❑Yes ? No /Fireplaces: Existingx New Existing wood/coal stove�Yes ❑No 4 Gara JJ�tached(size) Other Detached Structures: El 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 t���A Proposed Use 2p S aQ0 Builder Information Name K/ N J� r• 5 0 4k� Telephone Number S' C. 2- L/ Address /(, o C"+1-c�, s"/ License# CC)s V& y Home Improvement Contractor# /0 2—/ 9 Worker's Compensation# Ld 2.0 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 7o cr ram., SIGNATURE DATE BUILDING PERMI DENIED OR THE FOLLOWING REASON(S) 9`J33 tO ilviJriYi97rt,1gf 1-4 , --� } ji �., . ...:;. urn• _ .. -. � `� � 1 r� J. 41 1 - d,twe i. '. The Town of Barnstable BNAMARNUMBIZ Department of Health Safety and Environmental Services 0 3 Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-790-6227 Building Commissioner Fax: 508-790-6230 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. 1*6 Uf Type of Work: Est.Cost D� D Address of Work-:- Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied < Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED WORK DO NT VE CONTRACTORS FOR APPLILE HOME ACCESS TO THE IONS PROGRAM OR GURARANTY FUND UNDER MGLO 14ZA SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR llwnnre Nema `tee The Commonwealth of Massachusetts Department of I ndrtsetlialAccidents 600 Washington Street y Boston,Mass 02111 Workers'Compensation Insurance Affidavit ll,'tmr: l9cation: city h ❑ i am a homeowner perfor eninn all work myself. Q I am a sole proprietor and have no one working to any capacity ❑ I am an employer providing workers'compensation for my emplovees working on this job. ralODany name City: 'iRI►one•#; !teanee coi olio 'ty I am a sole proprietor,general contractor,c homeown (circle one)and have hired the contractors listed below who have the following workers' compensationrpolices: - rani pony name: vo, h+' �cl hlvS a r' hdncg. insiirAriceim., Ala," �'��� stir vy��'r. ad • :U O f;ptttnany name: cth^ htLllf..N'. ia9urance co. ' eoli yam' Failure to secure coverage as required under Section 25A of MG1.152 can lead to the imposition of criminal penalties era fine up to 3t,500A0 and/or one years'imprisonment as well as civil penalties in the furor of o STOP WORK ORDER and a fine or$100.00 a day agninst me. l■oderstand that a copy of this statement may be forwarded to the Mee of lovestigatinas of the DIA for coverage verification. I do hereby terrify Ze pains and pens/des ofperja f at the b fornmdon provided above is true and CO,Signature A, arc /1c�� 4 Print numC I" C�V hcnc# �Kl t� - l C)v3 ff'-mcw use only do not write l►►this area to be completed by city or town ulnciel Litheck permMiccmc N Building:Dcli )�l icensingiate reapoacc is►equired �CclectmtOHeafth n phase#; -Other 'lei I fmvi%ed sros PIM • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB LOCATION : 'Number Stre address Section of -town "HOMEOWNER" . Name Home phone Work phone PRESENT /c J MAILING ADDRESS d ity town State Zip cc The current exemption for "homeowners" was extended to include owner-occ:- dwellincs of six units or less and to allow such homeowners to engage an dividual for hire Who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person(sj who owns a parcel of land on which he/she resides or intends tc side, on which there is, or is intended to be, a one to six family dwelli attached or detached structures accessory to such use and/or farm structu A person who constructs more than one home in a two-year period shall not considered a homeowner. Such "homeowner". shall submit to the Building Of on a form acceptable to the Building Official, that he/she shall be resna- for all such work performed under the building permit. . (Section 109.1.1) The undersigned "homeowner" assumes responsibility for compliance with thLl Building Code-and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum pection procedures and requ#eme. and that he/she will comply with said pro edures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be requir: to comply with State Building Code Section 127.01 Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner ,performing work for which.,a- bur: permit is required shall be exempt from the provisions of this section , (Section 109.1.1 - Licensing of Construction Supervisors) ; provided ti Home Owner engages a person (s) for hire to do such work, that such Bar, shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assz the responsibilities of a supervisor (see Appendix Q, Rules and Regulz for .licensing Construction• Supervisors, Section 2.15) . This Pack of a often results in serious problems, particularly when the Home Owner hi unlicensed persons. In this case our Hoard cannot proceed against the inlicensed person as it would with licensed Supervisor. The Rome" wne ` as supervisor is ultimately responsible. :.l. ... To ensure that the Home Owner is fully aware of his/her responsibiliti communities require, as part of the permit application, that the Home * certify that he/she understands the responsibilities of a supervisor. last page of this issue is a form currently used by several towns. Yo•, care to amend and adopt such a form/certification for use in your comma s _\ r Application to 1996 092 s► otµµs�eµ O` Old Kings Highway Regional Historic District Committee in the Town of Barnstable fora CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: ❑ New Building ❑ Addition lir 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 S N ADDRESS OF PROPOSED WORK 31a CEb AQ BHk�uSTAB�E ASSESSORS MAP NO. 131 OWNER ����✓� v ASSESSORS LOT NO. /3 - 3 HOME ADDRESS 3/a (,CDAQ sT V� 6A2nJST/�gL� TEL. NO. 3 6a " 90�y3 To 13OX 03 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 JD h(A/ J-0,406D A/ TEL. NO. 3r'ooZ ' oZ 7/ ADDRESS � P C4U2G14 1ST 14)' 6 141CA) '6Lg /44 '0'210 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). w 4/„- - /✓o4Ttl 5 p U TH 44)J# �4-D D Sicy��G�f7 - s0 v TH FCC /A)er- Signed OVEN' Owner_ c�--w4ne-for-6ommittee•use. ) Rd�64MJ W lt.D / 91 L �Pate C tificate is he eby Date U1 q --L/41& , X Time Ti_E"J;`10F BARNSTABLE g�4�aIiVG'S HIQHAAY r, ­on^,,T A��T• �E ...,...,�o ;� ,.,,.,,,,a,, annrnvai is Subiect to the 10 day appeal period t : ADDITIONAL INFORMATION FOR MAKING AND FILING AN APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS The four categories for which a Certificate of Appropriateness is required are: (application for demolition or removal is a separate form). 1. EXTERIOR BUILDING CONSTRUCTION (new or existing buildings): An application is required for any exterior of a building to be erected or altered including windows, doors, siding, roof, light etc., that will be visible from any public street, way or public place. The following scale drawings are required in duplicate with application: plot plan (if addition — show existing buildings in outline), floor plan and elevations. Also required,are snap shots of existing buildings, where additions or alterations are to be made. No plot plan is required for addition or alteration which does not touch the ground. 2. EXTERIOR PAINTING: An application is required for any portion of a building, structure or sign to be painted that is visible from a public street, way or public place. Color samples must be attached to these applications. An application is not required when repainting existing colors, changing to white, or using colors approved by the Town Historic District Committee. 3. SIGNS OR BILLBOARDS: An application is required for any sign or billboard to be erected within the District, with the following exceptions: a. Existing signs or billboards on November 27, 1974 shall have until November 27, 1977 to secure an.approved Certificate. of Appropriateness. b. Temporary signs for use in connection with any official celebration or parade or any charitable drive as long as they are removed within three days of the event. Certain other temporary signs that the Committee feels does not detract from the Act may be allowed with the prior permission of the Committee. C. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they are erected or displayed. d. A single sign of not more than I. square foot in area showing the name, occupation or address of the occupant of the premises on which they are erected or displayed in a residential zone. 4. STRUCTURE: An application is required to build or alter.any structure within the District which is defined by the Act as a combination of materials other than a building, sign or billboard, but including stone walls, flagpoles,hedges,gates, fences, etc. 'GENERAL.REQUIREMENTS 5. Work on projects requiring approval shall not be started until the Certificate of Appropriateness has been filed with the Town Clerk by the Committee. Approval is subject to the 10 day appeal period provided in the Act. 6. No changes shall be-made from.the original approved specifications without advance approval of the Commission on an amended application filed with the Committee. 7. A separate application must be filed with each project requiring a Certificate of Appropriateness. 8. Under heading of "Detailed Description of Proposed Work" give detailed data on such architectural features as: foundation, lY^ N•1' 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. 7- i 3 3 14g L) 7MR-S 3 &,b qk ekc-:5-r �i9�lE s Ago IA6j sT S-r Town of Barnstable Old King's Highway Historic District Committee SPEC SHEET FOUNDATION SIDING TYPE COLOR CHIMNEY TYPE COLOR. ROOF MATERIAL COLOR PITCH WINDOW S C YTIT4 NK) I —SIZE TRIM COLOR DOORS COLOR SHUTTERS GUTTERS DECK GARAGE DOORS 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", but should show all structures on the lot to scale. SPECSHT St ►;Rio;:�' �, ir s � [Mimi �• v i i i I� r 1,. V � t • .IAJ i� i�� e x ,'�l��•I•�`;'� "'�ti..o�'�+.. .vim - _ M `'ram _� �•s `� t Y ti�.. �.�'�-M,+ •1 ate..r' --a• .! .�-` _ '.i''t� ��.•-ram.� Im17DniRGP AN[ [�`!�J I v i i i i i i yy .�� w.v I i �� •S' 1. • ti � - �� �� _.�i� 1, .. • � �•+Sr "tom ��.�'.,. `i`�.i n OMMAI I I R I