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0172 CHURCH STREET
a u F 4 i I NTIER Solutions, nc. gy Town of Barnstable Final Inspection Affidavit Date: V// Thomas Perry, CBO Building Division 200 Main Street Hyannis, MA 02601 RE: Insulation Permits Dear Mr. Perry, This affidavit is to certify that all work completed at: Street: Village: i has been inspected by a certified ui ding Performance Institute (BPI) Inspector. All work performed meets or exceeds federal and state requirements. Permit application nu ber: l sd�Q7� Issue date: —j Sincerely, Francis Sheehan President Frontier Energy Solutions, Inc. 502 Harwich Road �-- Brewster, MA 02631 Office: 774-237-0410 Email: fssfrontierenergy@gmail.com TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION TOWN QR BARNSTABLE a01 5� ?S Map Parcel h�� Application # 5- Health Division i ,7 ?Q AM I,�: Date Issued Conservation Division Application Fee Planning Dept. r�� rS� Cs Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address/7 Village Owner 1 j 0000 F.I Address 7 NCEWSL Telephone Permit Request e7VU To ftT T i c_,�, ,fi t - -�" f p rC�lV) ]Tn2 L IE= 1 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new .Zoning District t j Flood Plain Groundwater Overlay Project Valuatio �a J'l�- Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Y 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 Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes L3'No If yes, site plan review# } Current Use Proposed Use APPLICANT INFORMATION _ (BUILDER OR HOMEOWNER) Name fCol-I c J P S WbIephone Number 7R9 I—UY/ Address HAO&E 1 License # /OS22�ff `I-- � �A 0Qb :3) Home Improvement Contractor# Worker's Compensation # G/ov-6aS 31S ALL CONSTRUCTION DE RIS RESU TING FROM T I PROJECT WILL BE TAKEN TO 8 1 hys SIGNATURE DATE — 2- - 1 FOR OFFICIAL USE ONLY r <APPLICATION# DATE ISSUED ,MAP/PARCEL NO. ADDRESS VILLAGE ' ' ,k OWNER f � DATE OF INSPECTION: _ ,F. .s FOUND T/�,,,,IONS -4ii6l+kfTs0U.-.r,MGcJU,"hIT=' 'FRAME r -; INSULATION;, :,,•. FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING':' DATE CLOSED OUT' — ASSOCIATION PLAN NO. f i Town of Barnstable ° Regulatory Services NAM' Wih9rd*.SctA for BuRding Division Tom Perry,Bm1ding Commadoner 200 Msia Strec%IIysn -"MA- 02601 www town.barastablem&us office: 508-8624038 Fax: 50$700.6- 30 Property Owner Must Complete and Sign Tbis Section _. .._IfPim:-- ..ABWUexc_...___ .._.._.._. as Owner of*e.sub ect ro l . P PAY - herebyau for to act on iiaybelfaif, in aU mmers relative m =&o&ed by this bu&rmg ' application for. . (Address-6f j %"PWl fences and a&arras are the re p. mMi yof-ihe applicant. Pools aye no,r:to be:f -or t ed'befoxe fence is wed and ag f al MEW accepted- Azd S o er -"ogAp*= A Ag 19W-J r— Trv��( 5 Pnnc. a Priam N mie 39QUN&?PIS Date Q:F0RMWWAPXMU=WW00LS The Commonwealth of Massachusetts Department of Industrial Accidents` I Congress Stree4 Suite 100 Boston, MA 02114-2017 www mass.gov/dia tR orkers' Compensation Insurance Affidavit: Builders/ContractorslElectricians/P umbers. TO BE FILED WITH THE PERMITTINO AUTHORITY. .Applicant Information Please Print Lezibly Natrie (Business'Organization/Individual): tyro,� Lf rn('L irAt,/ 4U.-b d n S_ --Inc i Address: n City/State/Zip: ('�;�i,j r�+r RA C2� � t Phone #: �- 2�S Y (3 f 11 Are you an employer"Checkthhe 2ppropriate box: Type of project(required): l [3/fam a employer with I.Q employees(full and/or part-time).* 7. New construction 2. I am a sole proprietor or partnership and have no employees working for me in 8. 0 Remodeling any capacity.[No workers'comp.insurance required.)3.0 l am a homeowner doing all wort.myself(No workers'comp insurance required.]* 9. ❑Demolition � 4,[][am a homeowner and will he hiring contractors to conduct all work on my property I will 10❑Building addition i ensure that all contractors.either have workers'compensation insurance or are sole 1 1.El Electrical repairs or additions proprietors wirh no employees, 12.❑Plumbing repairs or additions SM I am a general contractor and,l have hired the sub-contractors listed on the attached sheep These sub-contractors have employees and:have orkers'comp.insurance.- 13.�Roof repairs 1 r 6.n We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other 152,§I(4),and we have no employees.[No workers'comp,insurance required] Any applicant that check,box#1 must also till out the section below showing their workers'compensation policy information_ t Homeowners who submit this affidavit.indicating they are doing all work and then hire outside contractors must submit a new a_idavit indicating such: :Contractors.that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. fain an employer that is providing*workers'compensation insurance for my employees. Below is the policy and job site information. -{ Insurance Company Name A K .t"lv j&\ tA. 61VV CA,4-Jr Policy#or Self-ins_ L ic. #: ,-i(i(�'` `� � S-2U( _ Expiration Date: 3: l W 2-01 U Job Site Address (�`�C �� City/State/Zip Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).. Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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$250.00 a day against the violator. A copy of this statement;may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby certify under the pains a ties of perjury that the information provided above is true and correct ( zSrSSignature:- Date Phone#: -7 7 L- 2 3� - G U Official use only. Do not write in this area,to be completed by city or town official City or Town: Permitfi icense# Issuing Authority(circle one): 1.Board of health 2. Building Department I CityfTown Clerk, 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact.Pers.on:. Phone#: C%/ceoni��eo��nevl o/C�l � .�J I,i or registi afion valid for individnl use only Office of Coasomer Af�irs&8aainEss 7 WE IMPROVENUDIT CONiiRACTOR before the ezpu-ation date. If found retum to: i$tratiorc 16b854 Type: ?i Office of Consam r Af1hirs and Business Regnlati0u k 4 iratioa: -9l8f016:.,.. 1 LG..._. l0 Park PIaww Ta-Suite 5170'';`` Boston,MA 02116 FRONTIER ENERGY SOl{n1bNs".1 .. j - FRA=S SHEEHAN 502 HARWICH RO BREWSTER,MA 02637 Uudersee:ttarp -LAI/ with signature of Publ-,ment- ic Ulassacbusetts-Depm Said Restricted To:CiS1 tC-Insulation Ce or 'Board of€WIding.774gulations ar►d Standards- Construddi n Supen'asu'r-Sp eeial2 i ense:CSSL-109941 "f �J1 Elmw terft;-Q2b32 4 t` Failure to possess a current edition of the Massachusetts State Bm1dvm Code is cause for revocation of this Fcoenw- '�'"� Expiratior .:i For OPSlicensinginfomntionvisit -_lt r/DP5 CorrJ»iissioner 07117IM6- ;\ l•' 3/ 16/2015 12 : 35 : 39. PM 8626 Q 02/02 A � CERTIFICATE OF LIABILITY INSURANCE DATE(MMID 03n srz015ol5 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 pollcy(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 00509-001 NAME: Jeffrey Ford Rogers&Gray Insurance Agency actNo.El: (800)553-1801 Farc.No.: (508)398-0246 434 Route 134 EMAIL South Dennis,MA 02660 ADDRESS: INSURERS AFFORDING COVERAGE NA IC INSURER A: A.I.M.Mutual Insurance Company INSURED Frontier Energy Solutions Inc INSURERB: INSURER C• 502 Harwich Road INSURERD: Brewster, MA 02631 INSURER E COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: ITHIS 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. ILTR TYPE OF INSURANCE �U POLICY NUMBER I�PO��� ) � � ? LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL L!ABLITY I ( ( I DAMAGE TO RENTED I S I PREMISES Ice occurrence I CLAIMS-MADE occur, I I ( ;,TIED—T;AaY one perscn) fIi I ` I PERSONAL&AD!INJURY )$ GENERAL AGGREGATE $ I I LEtL AGGREGATE LIMIT APPLIES PER: I PRODUCTS-COMPIOP AGO1� OLICY rT OC ' I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ I !Ea accident i I ANY AUTO { j BODILY iNJURY(Par psrson) S ALL OVJNED SCHEDULED I 1 I I BODILY INJURY Per accident) AUTOS ALTOS HiRED.AUTOS `JGN-OWNED I I PROPERTY DAMAGE AUTOS I I I !Per accident" UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE I I i AGGREGATE S yyp IR{DCCRDg�I RCTCCNTITIICN $ ; I ` S7 U I y AND EMPLOY MF0 LIABILITY I I I X I-M LUNS OEF ANtY GR"PR'E 0R/PARTN�P.JEXcCUT!VEYIN I E.L.EACH ACCIDENT I S 1,000,000.00 A OFFICE IM8MBEP EXELUt5ED7 I. NIA VWC-100-6015315-2015A 3/14/2015 3/1412016 (Mandatory in NH) E L.DISEASE-EA EMPLOYEE S 1,000,000.00 u099 PEP.ATIONS below I E.L.DISEASE-POLICY LIMIT 's 1,000,000.00 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional RemaAs Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION Town of Sandwich 16 Jan Sebastian Drive SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Sandwich,MA 02563 THE EXPIRATION DATE•THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 2630 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel. �J� 3 Application Health Division Date Issued (D Conservation Division ` � ' . Application F Planning Dept. Permit Fee S • 0 Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis, r r V Project Street Address _ /72, 6ff7/&11 67--7-G F67-15 1 7W Village W 1 1 9AMI&L_ Owner j�fit�t/ t/Il,401149e.)/7_ /7-,dax)A 1 . Address Sit[� Telephoner//) f� 3 'S 92S1 �� !09-36 7=- qM 7 Permit Request 2 Cam_'. /�T�> S(J,(�� /V/ S�QUGirL�/ Square feet: 1 st floor: existing proposed 2nd.floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Ltlb Lot Size �. 2S Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family; 2"" Two Family ❑ Multi-Family (# units) Age of Existing Structure 2 Historic House: ❑Yes U Ko On Old King's Highway: ff�es ❑ No Basement Type: 2'1�611 ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) 0 Basement Unfinished Area (sq.ft) Number of Baths: Full: existing ?i new Half: existing new Number of Bedrooms: I existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: Chas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes Lr Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: alexisting ❑ new size_Pool:.❑ existing ❑ new size — Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes O'<o If yes, site plan review# =0 _D s N Cn 0. Current Use Proposed Use T, Rol APPLICANT INFORMATION N m w _ (BUILDER OR HOMEOWNER) Name �/�N y� vsC//�A/ye/( Telephone Number 75 9 2� j Address 1-744 CIAIIICrl 5J__ License # Home Improvement Contractor# Worker's Compensation # i ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE `lo RV) 20)D E " FOR OFFICIAL USE ONLY 'f APPLICATION# Y DATE ISSUED : MAP/PARCEL NO. ADDRESS _ VILLAGE' OWNER _ r DATE OF INSPECTION: I.I,: FOUNDATION f?�4�GR4'-w-R'Rx0geSome- . FRAME 4 Sr c aj tck- f '7 tr ok is «cC/'�/�F�—d INSULATION FIREPLACE r - ELECTRICAL: ROUGH FINAL f" CC PLUMBING: ROUGH - FINAL N _ c GAS: ROUGH FINAL w FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO..'.-' ' The Commonwealth of Massach usetts 1 Department of Industrial Accidents ,. ° Office of Investigations 600 Washington Street Boston, MA.02111 s www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Indivi dual): /7(/?�� 1✓� ���i`���/ Address: ��� �f'��H s City/State/Zip: / Phone #: 5 - 37S r9Z5� Are you an employer? Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with 4. ❑ I am a general contractor and 1 6. ❑New construction einpl6ye6s(frill and/of part-time).* have hired the sub-contractors _ . . -_ __ _...__.._.__ ..... .. _.. 2.❑ I am a sole proprietor-or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition No workers' comp. insurance comp. insurance.# r utred.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs required.]insurance re u t c. 152, §1(4),and we have no q employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins,Lie. #:. Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer d r ins and penalt' erjury that the information provided above is true and correct Signature- Date: Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority (circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector S. Plumbing Inspector 6.Other Contact Person: Phone#: ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- AND TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00) Applicant Name: y Site ress:Add /��l/I� C�`,�D�c/ �� J?2 Cl�i/�Glf 5� print Town: Applicant Phone: -3 Applicant Signature: Date of Application: NEW CONSTRUCTION: choose ONE of the following two o tions 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE- AND TWO-FAMILY BUILDINGS MAXIMUM MINIMUM Ceiling or Slab Basement ❑ Option 1: Fenestration exposed Wall Floor Wall Perimeter AFUE HSPF SEER U-factor floors R-Value R-Value R-Value R-Value R-Value and e th National Appliance Energy R-10, Conservation Act(NAECA)of .35 R-38 R-19 R-19 R-10 4 ft. 1987 as amended,minimums or greater as applicable Note: This form is not required if you choose either of the two versions of REScheck as listed below. ❑ Option 2: REScheck Version 4.1.2 or later variant software analysis must be completed 780 CMR 6107.3.2 REScheck—Web which can be accessed at htt-P://www.energycodes.gov/rescheck/ ADDITIONS ORALTERATXONS,TO EXISTING BUILDINGS OVER.5 YEARS OLD*. *Buildings under 5 years old must use option#1 or#2 in New Construction section above. Complete the following formula to determine the % of glazing: (a) Gross Wall & Ceiling Area equ4ls Formula: (100 x b_ a) SF 100 x — _ % of glazing b a .(b) Glazing area equals SF If glazing is:< 40% use the chart below. If glazing is > 40.% roceecl to "SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM Ceiling and Slab Perimeter ❑ Fenestration Wall Floor Basement Wall R-Value U-factor R-Value Exposed floors R-Value R-value R-Value and De th .39 R-3 7 a R-13 R-19 R-10 I R-10, 4 feet a R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area(i.e. of compressed over exterior walls, and including any access o enin s). SUNROOM—An addition or alteration to an existing building/dwelling unit where the total glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fill out Consumer Information Form (found in Appendix 120.P) Town of Barnstable OF'IKE r o Regulatory Services r BARNSPABr.E Thomas F. Geiler,Director trtass. 9�A i639. `0� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION /� Please Print DATE:�10 �/I�I lO�D _ JOB LOCATION: C#0264- SF 0W$ number nq ,1 ` ' /�/nn,/ n/street /�;�p village p "HOMEOWNER": ��/V/l/ 'i/, (J�(�(W& l �`l(/D 75 -q25/ S -30-969 7 a ' home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and j to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. Wre 6omeowner"certi s at he/she understands the Town of Barnstable Building Department ures irements and that he/she will comply with said procedures and ner 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 constriction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFMES\FORMS\homeexempt.DOC Town of Barnstable o� Regulatory Services snxxASS.. g Thomas F. Geiler,Director Fo 39. a Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section ` If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERPERMISSION w- -E Ire r, EZ E2 430 � LE9Cf/ I Dior- gz.46 B O' Per f�, g Q/7 r fz..-�s3 •SEWAGE . f t s STE 47 a �. 417 fz.�s� y ^� �•• . �t ' rA�rtc a.S14 74 EZEV ToP of ,, 1 3 EY/JT/NG . So.ao / ! Ez.47f �t.47.3 } -rift s!/NG WELL i 12 PRELIMINARY RA�Ec 6� _ En � � � V,g2,ABLE bviorn' 7� A47W--EZiS„gTio vs afu- 0Al 1u / CERTIFIED PLOT PLAN LQCATION .WEST B�,,p-?Y- 9�GE�•vlAss. SCALE . .i . . DATE MAC i4 /978 PLAN REFERENCE-. EDWARD E. KELLEY CUMMAQUID, MASS. 02637 EZ/ZA8E7;V OF L9 �qyl .ISM, . . . . . . . . . . . . . . 4 / EDWARD �. E. Y I CERTIFY THAT THEiSTi/vC �'�NDAT/oN No 2 1101- SHOWN ON THIS PLAN IS LOCATED ON THE GROUND �a AS SHOWN HEREON AND THAT IT CONFORMS TO THE STE�yo� SETBACK REQUIREMENTS OF THE TOWN OF �ND SURD . .. . . . . . ...WHEN CONSTRUCTED. - fJC ToN /P fi/A rlB�/�/ DATE MgeC-.!/ r ,HE ray Barnstable Old Kings Highway Historic District Committee MUUMABLE ; 200 Main Street, Hyannis, MA 02601, TEL: 508-862-4787 Fax 508-862-4784 A s6390. e\00 'fD1A�� APPLICATION, CERTIFICATE OF APPROPRIATENESS Application is hereby made,with four(4)complete sets,for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,Acts and Resolves of Massachusetts, 1973,for proposed work as described below and on plans,drawings,or photographs accompanying this application for: Check all categories that apply; 1. Building construction: ❑ New Ei Addition ❑ Alteration 2. Type of Building: ❑ House ❑ Garage/barn ❑ Shed ❑ Commercial 0 Other 3. Exterior Painting roof ❑ new roof ❑ color/material change, of trim, siding, window, door 4. Sign : ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 5. Structure: ❑ Fence ❑ -Wall ❑ Flagpole ❑ Retaining wall ❑ tennis court ❑ Other 6. Pool ❑ swimming ❑ Other man-made pool Type or Print Legibly:' Date: �7 10/(2 Address of proposed work: House# M, Street: Cf/U2Glf Village III &dj? ;/CAssessors Map Lot# Description of Proposed Wo�r/k�:..Give particulars of work to be donne: J7�(��(�op/l', , / a� '/y X 20 Agent or Contractor(print): Telephone#: Address: Contractor/Agent' signature: NOTE All applications musttbb st ned by the current owner fell Owner(print): _8aQ 4) V, (��jlf/U�L L Telephone#:_�� - 37s"925/ ��l�Sj-3 67—rf�9 Owners mailing address: 7 fiSFdl2Cf/ S� Owner's signature: _ or committee use only. This Certificate is hereby APPROVED/DENIED I D E C E � U E I Date Members signatures I ' FEB 17.• ` TOWN OF BARNSTABLE HiSTORLr,�' PRESERVATION y ditio approv MAR 10 2010 Ue Old King- Highway Committee 1 C.(Documents and SellingsldecolliklLocal SetlingslTemporary Internet FilesIOLK110KH Cert Appropriateness 07.doc f y Town of Barnstable Old King's Highway Regional Historic District Committee CERTIFICATE OF APPROPRIATENESS SPEC SHEET Please submit 4 copies Foundation Type: (Max. 18"exposed)(material- brick/cement,other) Zt t 010 _50paO45- �y W-310 X 02 . Siding Type CL_Ag&�90 material: Color: /IJ/ Chimney Material: Color: Roof Material: (make& style) Color: (,c0L/79F�-TD Trim material /�I G1�Q N� �/�//�l Color: 77) /V/9-7r/f Roof Pitch: (7/12 minimum) Window: (make/model), ( 666 material 1/_WL, e color 62.�eej-) Size(s): �D 6�O U ,l( Door style and make: /J�J�P42 /� ru) �0611 material VIA).&61,44 Color: Me4W Garage Door, Style Size Material Color Shutter Type/Material: Color: Gutter Type/Material: )fty ll)(hp Color: 0 ffld f6l t Decks: material /J//tJL= Size 3 x 6 Color: it/}477J1/1JYL, Skylight,type/make/model/: VAWX K06 material Color: Size:WY 34 gr _ : .. . Type/Materials: _Color:w,-noor— NIP Si size: _ Fence Type(max 6' ) Style material: Color: MAR Retaining wall: -Material: Tewn of ga►nstable Old King's Highway Lighting, freestanding on building illuminating sign Committee Please provide samples of paint colors and manufacturers brochure of style of windows,doors,garage door, fences,lamp posts etc ADDITIONAL INFORMATION: ARM &I/ Gr ---— —, Signed: (plan preparer) print name TOWN OF BARNSTABLE tel. no. Location of application: Street no. --Street Village Village 2 C:(Documents and SettingsldecollikVocal SettingslTemporary Internet FllesIOLKIIOKHCert Appropriateness 07.doc i i Town of Barnstable Geographic Information System February 18, 2010 1 W03001 130012 #2140 #2135 154003002 #2130 130014 #0 154002 154004 #0 30017 #20 92049 154007002 177001 ® 154005 #50 #0 #40 154006 ® #106 154007 #72 • e 130016 #29 IV 153007001 #240 15300400022 ® 154007001 #45 #80 153018 #122 153033 153006 153004004 r153005 #172 �#196 #59 •1,160 `�.a 153022 #47�03 C~vRCf�Sp #216 153021 5 #230 153008 s 153003 ��� 153007 . #282 153009002 #0 5P 153032 #260' O i#324 153004001* #181' 153009001 #21 t`�� a #302 153026 #215 129011 153012002 1 111!10 Cop C,q20 p� #93002 # 0153012001 #286 0 #33910 F y #263 129003 yhy q� 153011 10 1290021 S�Rfi ,�'4S FsrJ W 153029 153031 #311 176007 #1039 ® �C Rr 2 #60 #19 �153012003 #359 PW '153034� �'QO �r4P FS 4 #249 1 Feet 153016 1 00400r 1r035 153024 153025 153015 #246 176001003 # #1051 #90 #134 #238 #65 DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:153 Parcel:033 N boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:ODONNELL,BRIAN J&MAUREEN Total Assessed:Value:$418200 Selected Parcel _ 1'=100'may not meet established map accuracy standards. The parcel lines on this map {IV are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner: Acreage:1.17 acres Abutters boundaries and do not represent accurate relationships to physical feaiures on the map Location:172 CHURCH STREET • such as building locations. Buffer r� ! if 1 i!:i " Y1n Adak iR AFF *A4' .. a :r .S� 01/18/2008 Al .4! u re6n a n Pon n. r-t 6h u r�fh 66 : fir ��_�ve,r.:l1-1.___ �_;� �-?-._,c��.� � �� � ��' • �.. . .�u�-. � __:��t-t-� _ � ,� --- �t,`V!�'a-1��=t�.�C�1:_C��1�.O..r1G/ G�. 1 sp �- - P PROVE�-v � =mac. - - �-��•. L .r I I ..eX� n� r� � A MAR 10 2010 , I _ � l _ Town of Barnstable Ki 's Hi hwa�(] ��� � �4) Mgt ,Old a Committee p �Z, ►� r 01 FEB 1 7 AV _ TOWN OF BARNSTABLE Y HISTORIC PRESERVATION y .�- f:&b,-7, 2Q1a • 51 f , , r: mm _6�2h+ tea.--Una _zv a t3 j 2- 4 / nne Ae -- ' jai 1-41 1-7 i C� c E P i p r IT FEB 710 «�o" - . . MAR Town of B%sVabje TOWN OF BARNSTABLE I : old K�mrndtee HISTORIC PRESERVATION �---------- Ivac Y4"- lop vat �j • u y A o z 4 . �. I I 1z -61h u <a r 1 O - ,nafi ex 1 r CPLvt - (g) r7 - I - 4 vi + - APPRO - FEB 1 7 - MAR 10 2010 TOWN OF BARNSTABLE Town of Barrsrabte ! HISTORIC PRESERVATION Old Kingt Highway ` ___ Committee v wd NEW - - wit ti " '. -Y irsOla MARA D Mo . I Town of BaN19h�5y J old K mmittee-..Mom i FEBM-a I Y-1- VU 1 7 TOWN OF BARNSTABLE � � 71 1 6 HISTORIC PRESERVATION - IMPORTANT ANY CONSTRUCTION THAT INCREASES LIVING SPACE BEYOND 1200 SQ. FT. PER LEVEL MAY REQUIRE THE INSTALLATION OF ADDITIONAL SMOKE DETECTORS. 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'...._.. ........................^...........-......... .._..... ........ ........ ........ ........ ......... ...u' ....:.... ..... P.. ............_..............._...................._............. .... ..... ...... ..... ............. S: ,b.... _ ............ .... ._.. . .... ... ..... .. ....... z . c t 4 . ..... ..... .... .... ...... . . . . . . : . . . . . . . . : : : : ......................... ..............:....... ..... ..... ..... .... _ - �U ✓ V), �Uwe, Town of Barnstable Old King's Highway Historic�Di�strict,CemLm"ttee wwsn� � I v r.;: �'1:.6 MA $ 200 Main Street, Hyannis, Massachusetts 02601 D (508) 862-4787 Fax (508) 862-4784--; _„ 1 9: ?6 MINOR MODIFICATION TO PRIOR APPROVED PLAN 972 CMR Rules and Regulations, Section 1.03(2), 1.03: General Procedures (2.) (a.) Only minor changes may be approved by the Committee without the filing of a new application and a new hearing. Minor changes include alterations that can be done without a detrimental impact on the overall appearance of the project such as altering a single window or door change or a minor change of colors. All minor changes by amendment will require the local Committee's or its designee's approval. Submit 2 copies of the application and supporting materials and documentation Applicant(s), print name /�////� V. 64110`621 li Address of proposed work: .House No. Street Village Assessors Map and parcel no. Date of approval of Certificate of Appropriateness /0 MhY2 Proposed Minor Modification: 6,66 /)�),Ochj �F 1A)VVI XgMfi 6- 7z� a aA) Signature of applicant: Print name: k) tel no. �/V- 375:07,61 cur-&X- -767--9X) 7 APPROVED/DISAPPROVED: signed - CHAIRMAN DATE: APPR VED CC: BUILDING COMMISSIONER APR 27 2011 Q:IGMD-Groups101d Kings Highwayl0KHNewAppIOKH Minor Modification Form 07.doc Town of Barnstable 1 Old King's Highway Committee Print Quote Page 10 of 12 ITEM FRAME SIZE LOCATION PRODUCT CODE DESCRIPTION UNIT QTY TOTAL PRICPRICE 0007 MAN UFACTU RER:Andersen Windows and 1 Patio Doors RO Size=5'7 7/8"Wx4'87/8"H Unit Size= 67 3/8"W x 4'8 7/8"H Composite Unit Part Number.0000000 Mulling Location:Factory(Direct) Mull Priority:Vertical Mulling Material:Narrow Mull Perimeter Extension Jamb:White- Painted,6 9/16',Job Site Applied, Complete Unit Unit Code/Item Size:TW2846-2 Operation/Handing:AA-AA COMPOSITE:72 IN,DRIP CAP,WHITE QTY 11(1)2222525 $15.65 COMPOSITE:Mull Assembly Adjustment) -$13.93 0000000 COMPOSITE:TW46,JOINING KIT, WHITE VERTICAL NARROW TW TO DHI $12.22 (1)1612006 COMPOSITE:LABOR,APPLY MULL 1 $20.11 0000000 COMPOSITE:TW46,CASING,WHITE IS $6 22 VINYL WRAPS 1624156 COMPOSITE:TW46,EXT JAMB,WHITE $28 24 SIDE 6 9/16 WALL PR PI1(1)1694608 COMPOSITE:TW/TWf28-2/DHP/TWT56, EXT JAMB,WHITE HEAD AND SILL 6 $31.81 9/16 WALL PR PI1(1)1694624 $100.32 $100.32 RO Size=2'10 1/8"W x 4'8 7/8"H Unit Size= 400 Series Tilt-Wash,Single Units 2'9 5/8"W x 4'8 7/8"H Unit Code/Item Size:TW 846 Operation/Handing:AA Exterior Color:White Interior Color:Pre-finished White Glass-Type(Top):High Performance Low- E4 Glass,Divided Light with Spacer, APPROVEDColoma F Glass Type(Bottom):High Performance Low-E4 Glass,Divided Light with Spacer,Colonial APR 27 2011 Interior Grille(Top):Grille,Interior, Town of Barnstable Old King's Highway Committee http://vendorapps.homedepot.com/usp/PrintQuote.jspx 2/26/2011 ►p o a L�re6n r/--t 6h Li r 6h 1-7 _ a �1.. l: ,:_ _.:al:i- _n.:.. PV- ► _ C 1 t-�,�� � Vic I MAR 10 2010 l ►�I>I `�j fig, i , fM� � ' n fII II I I I ) I Tow of Barnstable t' �- }-•f- -�- 1- +- -�-I— T -+- -� - ® Old Comm tt'ee way 1 U s�agte IO a�� FEB 1 � ,� �o otd coy` TO�AIN OF BARNSTABLE j '(P -�— Al HISTORIC PRESEP;d8TION - fib,�, �2�►� @k 1 c�� �.����� . Z was I l id /9 Ri=S 64 7-0— &`7= " 0E :01W az136a. 319V1SNV9 40 Nl'AO.L_ DIME TOWN OF BARNSTABLE Building Application Ref: 201001302 * B"N&rABLE, Issue Date: 10/28/10 Permit y MASS. �Ar1639..A� Applicant: ODONNELL,BRIAN J&MAUREEN D Permit Number: B 20102331 Proposed Use: SINGLE FAMILY HOME Expiration Date: 04/27/11 Location 172 CHURCH STREET Zoning District RF Permit Type: RESIDENTIAL ADDITION/ALTERATIO Map Parcel 153033 Permit Fee$ 50.00 Contractor PROPERTY OWNER Village WEST BARNSTABLE App Fee$ 50.00 License Num Est Construction Cost$ 10,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND 16'X24'SUNROOM AT REAR OF HOUSE THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: ODONNELL, BRIAN)8z MAUREEN D BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 172 CHURCH ST INSPECTION HAS BEE E. W BARNSTABLE,MA 02668 Application Entered by: SS Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY YR PERMANENTLY. ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY CTION. STREET OR ALLY 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 FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health SNEFT / of .? / cal�Y -•v-a",� �8 86 ti 38 1 j � LE•9Cp � Dr3•T LL.48,8 �� � � Per Box. .XI �f y EZr�.�•! ..SEW.9G� �/� � -Ty p ` �p 3 � 74 EZ EV Top + V .So. EL.49.i F �z.47.3 '• Ez•47•� -w t EY�S7iNG � W6tL i 1 T VA¢//9 BLE wioTw PRELIMINAR f I � v �oTE•-EZE✓.aTiovs B�ssa oN.�ss�•�ea ATo's CERTIFIED PLOT PLAN LOCATION .WEST BR,�v-F !Fig SCALE . / �,,. . . . DATE !`?A xs!i4 i978 PLAN REFERENCE . .QEiyC LoT°'z, As EDWARD E. KELLEY s1,6WA1 o.y p4,0,, CUiiMNAQUID, MASS. 02637 OF A4.T� EDWARD 4p VE I i vn/OATigN Y I CERTIFY THAT THE it �!3T!^•G No 23�4 SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE p `yIsTE*kya� SETBACK REQUIREMENTS OF THE TOWN OF °. �Ho SURi� qAre�/sr!jB. . .. . . . . . ...WHEN CONSTRUCTED. �qC Ton/ P. /7A-7 DATE M. 9ers✓f4�97- TQWN OF BARNSTABLE BUILDING PERMIT APPLICATION , �?oo�� �S Map Parcel Application# � Health Division r - Conservation Division 1!i. j 4 �;i Permit# Tax Collector Date Issued rl o Treasurer _ ;zV1 — Application Fee 00 Planning Dept. 4 Permit Fee �o Date Definitive Plan Approved by Planning Board l� Historic-OKH L Preservation/Hyannis ` Project Street Address 172 61fv1,2C# 57/2e VillageL�G+y� Owner A1(/nAJ \ �/�lq U2 ,0, 0220/dSk Address l7Z CHA61-1-517� Telephone 3 , Permit Request /- Square feet: 1st floor:existing 6 26 proposed 77� 2nd floor:existing o proposed Total new 5 3 Zoning District 12 C--s Flood Plain Groundwater Overlay Project Valuation 3 F ( 0 v Construction Type Lot Size 93 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Cr' Two Family ❑ Multi-Family(#units) V Age of Existing Structure SI y/z5 Historic House: ❑Yes & o On Old King's Highway: ❑Yes ❑No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other S�A� Basement Finished Area(sq.ft.) _14A Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new 1 Half:existing new Number of Bedrooms: existing �.— new I Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: U/Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes 2 o Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ I Commercial_ -❑Yes O'No If yes, site plan review# ` I Current Proposed Use �a g � / / BUILDER INFORMATION Name Telephone Number !; � ?,61 5 Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE 11VWd DATE L FOR OFFICIAL USE ONLY. PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE• „ OWNER DATE OF INSPECTION: FOUNDATION ©K 1W, — I LF - O 6 tz— I'4 FRAME f INSULATION Af f ,/ z � 'k FIREPLACE +r ELECTRICAL: ROUGH FINAL ' II( PLUMBING: ROUGH FINAL GAS: ROUGH FINAL) � e Q � FINAL BUILDING S o DATE CLOSED OUT ASSOCIATION PLAN NO. w � a � C % Aj x o m Z O CA N v �p OZ m0D m � Cn co \\Ir Z -0 �DmQ 34 �p m n O D Z O T N ' cn m ccii n -4 Z m n m? CD Z T O C p m x -0 OOrn m m .( i � m m 7o C T EB co m in ou m m � m --4 N '^ c m 9 O m OOi n Z m D Z � � N Q O -� p 0 CW:mA nrn = m C v cn o v rn mmm Z rn o CMD MW O - J'!7 � � ` :* � m v o - rT � Z � v m m IT1 GAMY A. ELLIS SCALECP : ;�,ovtt4 t 1 u r-6en 0 01'on& ` DATE: Ina, 1 : S B C , INC . SHEET N0. 141 MAIN STREET YARMOUTHPORT, M.A. 5087-362-9802 is77 27 -- L-4 S° LIN 17 +; fit, < V. U-A VR I , — — \ � M--T y �i I I I _ aQ� l �ho � ovai�on�; GARY A. ELLIS SCALE: _ DATE NS.-;B.--.c- --o%-: IN C;-.0 I ii ,ir 14:1: 1►�AN STREET :. x. _ �6f SHEET NO. �.L.._. _ :._>_ YARMOUTH 'ORT, MA . :' S08 362--�9802� I r. � mi - / al I c' 47 Sid I I � _ tZ i 1c) \ tt 1Q, 'I aPoGi�d �kl► ���+� �� � GARY A. ELLIS SCALE: :. atc DATE:..:: S BC INS, SHEET .N REST .T 1,4.1 MAIN ST -` YARMQtiTH, 0, I4i 508 362 98t�2 -77 II----- ---- - -- ..i ; I Irj 2 �xl � kW 642 .I IP- I � I ��� ��• i ' I � �.. � a � I r I - QP kk S �A I � - I � F � a pro�� �Id'rfron� enauror�; GARY A. ELLIS SCALE: Ian M�Uree� Ol i�-�b I V dam' DATE: NSBC, INC - � Z, SHEET -NO et - 141 MAIN S EET �1 or rl � . YARM. - RT; MA 51 $ ��i 9802 l r, mza 1�Z CH w2_6 vv/i 'b-tl 7/1Y4 wftk' Ql C4956 j Ham:kf`E The Commonwealth of Massachusetts Department of Industrial Accidents Office.of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Elects icians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: ��Z CNyCf l S City/State/Zip: 7w/(/ �414 Phone : 5eeC7 7— Are you an employer? Check the-appropriate box:. Type of project(required): 1.ElI am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 1 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for mein any capacity. workers' comp. insurance. 9. ❑ Building addition [Now ere' comp. insurance 5• ❑ We are a corporation and its r ed.] officers have exercised their . 10.❑ Electrical repairs or additions 3. am a homeowner doing all work right of exemption per MGL 11- Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' comp.insurance required.] 13.0 Other Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. -ontractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site uformation. asurance.Company Name: 'olicy#or Self-ins.Lic. #: Expiration Date: Db Site Address: City/State/Zip: Mach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). ailure to.secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ine up to$1,500..00 and/or one-year imprisonment, as well as civil penalties in thie form of a STOP WORK ORDER and a fine f up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of ivestigations of the DIA for insurance coverage verificatio . do hereby c.e r nalties o f e ' ry that the information provided above is true and correct i ature: �-7 Date: hone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Ins 6.Other pector 5.Plumbing Inspector Contact Person: Phone#• Information and Instructions ' Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an indiyidual,.:paMership;,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. HoweveT:ttie 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 workvn such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence-of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if. necessary,supply sub-contractors)name(s),address(es) and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below.. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials . Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permiMicense number which will be used as a reference number. In addition,an applicant that must submit multiple permit(license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"'the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that-a valid affidavit is on file for:future permits or licenses..A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and.fax number: The Commonwealth of Massachusetts . Department of Industrial.Accidents ..Office of jnvestigations 600 Washingion-Street . Boston,MA 0211 L. Tel. #617-727-4900 ext 406 or-1-877-MASSAFE Fax#617-7274749 Revised 5-26-05 www.mass.gov/dia °FVAEr 'Town of Barnstable Regulatory Services Baxxsr^sM ' Thomas F.Geiler,Director sb3q `0$° g Buildin Division Q',,l fo r�u•� Tom Perry,Building.Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the`reconstruction, alterations,renovation,repair,modernization,conversion, improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence.or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: Estimated Cost Address of Work: 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$1,000 ❑�B ding not owner-occupied L!�Vwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: I Date Contractor Name Registration No. /�uL D G 3' �vWe/ - Date Owner's Name Q:fotmslomeaffidav ' '='°5I°J�Zlb feeatlartseT) •�Yang rud:' prnetiplir°PsekxEre tar Oasand Tiro-Famiy Raideat4l Sn3ldtn�t$rated 1d ' MAXfMUM .. � • � •t3eidnElCaoiin� . g Glaziai CeiltisB -wall , Floor . 'Will fetes E4WFmcd ZMcle q' Aras C/o) V•nkia, 1(•YaluI? A nlue R Ya(uo° R Y Val to 4100 Bastin DegreRD+ !3 19 . 1Q Noraml Q. 11`!. -0.$0 3E. _ • "19 19 !Q' b• .. �Fortaal • R 1Z`Ji 0.11 30 !3 19 8 129A O.SQ 31 IdlA 0.1 33 .. 19 . 19 30 •::�Ifk _� _. . Y..:�: �,15°J, • • 0.4#-.•, as 73 33 NIA i7�►FU� 77 aS'!a Q.i2• 30' 19. .. 19 10 atrial . 15% 031• 3a • 32 N« . "' ?lotmal R 9E !9:• 31 N!A N/A y 18yi 0,41•. 6 90 AMy ,• .18y: . 0,4Z. 3E 13 •. 19 10 , 19 1-9 la a A 13% t1.S0 30 :.' ' 17E 00-1�. Cif/ / 1.'ADDRESS OF PROFERTY; ' .. , OF 2 $QVABB FQOTAGB • aE' ' OF ALLCt�IN ' ' 3 gQVARE FCfOTA . .=' . 4. %GLAZIN4 AREA #3 DIVIDED BY#2)' $, SELECT PACKAGE(Q AA-sea chtrt®hove); ' •. Nt'j�'g;;. ©'i i£It g,�OL+YED IYIETFi0D8.OF DETBRIS+QPFI G EN.BRGY P1 , .. .ARE AVAILABLE, ASK US FOR THIS TNRORMATION.. . • EUMDINCr INSPECTORAPPROVAL: 2� G5 x 2 YES; N0; gicrms•�g4393a - 4S'6 Town of Barnstable o� Regulatory Services i sniwsTasi.E, ; Thomas F.Geiler,Director 9q, 1659.MASS. �� Building Division AlfD MAt Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-79076230 HOMEOWNER LICENSE EXEMPTION Please Print DATE:I�N "" / �� _--- JOB LOCATION: I numbbernl street C. village Q "HOMEOWNER!': �i//v� //�/V�21. � � —37 — ( Z� Y04 -34/-9d9 7 .name home phone# work phone# fir,i CURRENT MAILING ADDRESS: S/ft C city/town state zip code .The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units..or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one of two-family-dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be reMonsible 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 un @ eowner"certifies th t she understands the Town of Barnstable Building Department p o rocedures and re nts and that he/she will comply with said procedures and re Sigma meowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. . HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack'of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons.-In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the pemut application, that the homeowner certify that he/she understands the responsibilities of a Supervisor, On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt r BOISE' -Double 1-3/4 x 14" VERSA-LAM® 2.0 3100 SP Roof Beam\R1301 BC CALCO 9.3 Design Report- US 1 span No cantilevers 0/12 slope Thursday, July 13, 2006 15:36 Build 047 File Name: B ODonnell_ODonneII.BCC Job Name: Brian& Maureen O'Donnell Description' RIDGE Address: 172 Church Street Specifier: City, State,Zip: W. Barnstable, MA Designer: Joe Madera Customer: Brian O'Donnell Company: Shepley Wood Products Code reports: ESR-1040 Misc: 10 12 I t r ":SY ''�u.i..E kK'v �,�k' a ! R. ! 18-00-00 BO,3-1/2" B1,3-1/2" DL 1474 Ibs DL 1474 Ibs SL 2700 Ibs SL 2700 Ibs Total Horizontal Product Length=18-00-00 Load Summary Live Dead Snow Wind Roof Live Tag Description Load Type Ref. Start End 100% 90% 116% 133% 125% Trib. 1 Standard Load Unf.Area(psf) Left 00-00-00 18-00-00 15 30 10-00-00 Controls Summary Value %Allowable Duration Load Case Span Location Disclosure Pos..Moment 17839 ft-Ibs 53.4% 115% 3 1 -Internal Completeness and accuracy of input must End Shear 3498 lbs 32.7% 115% 3 1 -Left be verified by anyone who would rely on Total Load Defl. U341 (0.617) 52.8% 3 1 output as evidence of suitability for Live Load Defl. U527 (0.399") 45.5% 3 1 particular application.Output here based MaxDefl. 0.617" 61.7% 3 1 on building code-accepted design Span/Depth 0.61 % 1 properties and analysis methods. P P Installation of BOISE engineered wood products must be in accordance with %Allow %Allow current Installation Guide and applicable B_eari_ng Supports Dim.(L x W) Value Support Member Material building codes.To obtain Installation Guide BO Post 3-1/2"x 3-1/2" 4174 Ibs. 47.0% 45.4% Spruce-Pine-Fir or ask questions,please call B1 Post 3-1/2"x 3-1/2" 4174 Ibs. 47.0% 45.4% Spruce-Pine-Fir (800)232-0788 before installation. BC CALCO, BC FRAMER®,AJS- Cautions SIMPLE FRAMING ALLJOISTO,BC RIM BOARD TM' BCIO, Column at Bearing BO analyzed for bearing BOISE GLULAMTM'only,column analysis has not been performed. SYSTEM®,VERSA-LAM®,VERSA-RIM Column at Bearing B1 analyzed for bearing only,column analysis has not been performed. PLUS@,VERSA-RIM@, VERSA-STRAND®,VERSA-STUD®are Notes trademarks of Boise Wood Products, Design meets Code minimum(U180)Total load deflection criteria. L.L.C. Design meets Code minimum(U240) Live load deflection criteria. Design meets arbitrary (1") Maximum load deflection criteria. Member Slope=0, consider drainage. Connection Diagram L�br d— a c a a minimum 2" e_5„ b minimum=-3" d'= 12" Member has no side loads. Connectors are: 16d Sinker Nails Page 1 of 1 8071SE- . Double 1-3/4" x 11-7/8" VERSA-LAM® 2.0 3100 .SP Roof Beam\RB02 BC CALC®9.3 Design Report-US 1 span No cantilevers 0/12 slope Thursday, July 13, 2006 15:36 Build 047 File Name: B ODonnell_ODonnell.BCC Job Name: Brian&Maureen O'Donnell Description: Header at Old Exterior Wall Address: 172 Church Street Specifier: City, State,Zip: W. Barnstable, MA Designer: Joe Madera Customer: Brian O'Donnell Company: Shepley Wood Products Code reports: ESR-1040 Misc: io 12 03-06-00 BO,3-1/2" B1,3-1/2" DL 784 Ibs DL 784 Ibs SL 1403 Ibs SL 1403 Ibs Total Horizontal Product Length=03-06-00 Load Summary Live Dead Snow Wind Roof Live Tag Description Load Type Ref. Start End 100% 90% 115% 133% 125% Trib. 1 Standard Load Unf.Area (psf) Left 00-00-00 03-06-00 15 30 01-00-00 2 ridge Conc. Pt. (Ibs) Left 01-09-00 01-09-00 1474 2700 n/a i Controls Summary Value %Allowable Duration Load Case Span Location Disclosure Pos. Moment 3215 ft-Ibs 13.1% 115% 193 1 -Internal Completeness and accuracy of input must End Shear 2114 Ibs 23.3% 115% 3 1 -Left be verified by anyone who would rely on Total Load Defl. U8220 (0.004") 2.2% 3 1 output as evidence of suitability for Live Load Defl. U12767(0.003") 1.9% 3 1 particular application.Output here based Max Defl. 0.004" 0.4% 3 1 on building code-accepted design Span/Depth 3.1 n/a 1 Installation n o BOISs and E enginsis eered wood products must be in accordance with %Allow %Allow current Installation Guide and applicable Bearing Supports Dim.(L x W) Value Support Member Material building codes.To obtain Installation Guide BO Post 3-1/2"x 3-1/2" 2186 Ibs 24.6% 23.8% Spruce-Pine-Fir or ask questions,please call B1 Post 3-1/2"x 3-1/2" 2186 Ibs 24.6% 23.8% Spruce-Pine-Fir (800)232-0788 before installation. BC CALC®,BC FRAMER®,AJS-, Cautions ALLJOISTO,BC RIM BOARD- BCIO, BOISE GLULAMT"' SIMPLE FRAMING Column at Bearing BO analyzed for bearing only, column analysis has not been performed. SYSTEM®,VERSA-LAM®,VERSA-RIM Column at Bearing B1 analyzed for bearing only, column analysis has not been performed. PLUS®,VERSA-RIM®, VERSA-STRAND®,VERSA-STUD®are Notes trademarks of Boise Wood Products, Design meets Code minimum (U180)Total load deflection criteria. L.L.C. Design meets Code minimum(U240) Live load deflection criteria. Design meets arbitrary(1") Maximum load deflection criteria. Member Slope=0, consider drainage. Connection Diagram f—Ibr —d a c a minimum=2" c=7-7/8" b minimum= 3 d= 12" Connection design assumes point load is'top-loaded'. For connection design of'side-loaded'point loads, please consult a,technical representative or professional of Record. Member has no side loads. Concentrated loads are not considered in side load analysis. Connectors are: 16d Sinker Nails Page,1-of 1 BOISE- Double 1-3/4" x 11-7/8" VERSA-LAM® 2.0 3100 SP Roof Beam\RB03 BC CALCO 9.3 Design Report- US 1 span I No cantilevers 1 0/12 slope Thursday,July 13, 2006 15:36 Build 047 File Name: B ODonnell_ODonnell.BCC Job Name: Brian&Maureen O'Donnell Description: Header Above Slider Address: 172 Church Street Specifier: City, State,Zip: W. Barnstable, MA Designer: Joe Madera Customer: Brian O'Donnell Company: Shepley Wood Products Code reports: ESR-1040 Misc: 12 3 4 "� F r �'Ys s r V z � � � r �y .:. ye a •y �, " <<, r :• � ,.; ,,r5 vs•� sY'3 a 06-00-00..> - B0,3-1/2" B1,3-1/2" DL 952 Ibs DL 952 Ibs SL 1440 Ibs SL 1440 Ibs Total.Horizontal Product Length=06-00-00 Load Summary Live Dead Snow Wind Roof Live Tag Description Load Type Ref. Start End 100% 90% 115% 133% 125% Trib. 1 Standard Load Unf.Area(psf) Left 00-00-00 06-00-00 15 30 01-00-00 2 ridge Conc. Pt. (Ibs) Left 03-00-00 03-00-00 1474 2700 n/a 3 ext wall Trapezoidal (plf) Left 00-00-00 30 n/a 03-00-00 60 n/a 4 ext wall Trapezoidal (plf) Right 00-00-00 30 n/a 03-00-00 60 n/a Controls Summary Value %Allowable Duration Load Case Span Location Disclosure Pos. Moment 6164 ft-Ibs 25.2% 115% 193 1 -Internal Completeness and accuracy of input must End Shear 2273 Ibs 25..0% 115% 3 1 -Left be verified by anyone who would rely on Total Load Defl. U2334(0.028") 7.7% 3 1 output as evidence of suitability for Live Load Defl. U3782(0.018") 6.3% 3 1 particular application.Output here based Max Defl. 0.028" 2.8% 3 1 on building code-accepted design Span/Depth 5.6 " % 1 properties and analysis methods. P P Installation of BOISE engineered wood products must be in accordance with %Allow %Allow current Installation Guide and applicable Bearing Supports Dim.(L x W)' Value Support Member Material building codes.To obtain Installation Guide BO Post 3-1/2"x 3-1/2" 2392 Ibs 26.9% 26.0% Spruce-Pine-Fir ask questions, please call (8 B1 Post 3-1/2"x 3-1/2" 2392 lbs 26.9% 26.0% Spruce-Pine-Fir 00)232-0788 before installation. BC CALCO, BC FRAMER&,AJSTM, Cautions ALLJOISTO,BC RIM BOARD TM BCI&, BOISE GLULAMTM SIMPLE FRAMING Column at Bearing BO analyzed for bearing only, column analysis has not been performed. SYSTEM&,VERSA-LAM®,VERSA-RIM Column at Bearing B1 analyzed for bearing only, column analysis has not been performed. PLUS&,VERSA-RIM®, VERSA-STRANDO,VERSA-STUD&are Notes trademarks of Boise Wood Products, Design meets Code minimum (U180)Total load deflection criteria. L.L.C. Design meets Code minimum(U240) Live load deflection criteria. Design meets arbitrary(1") Maximum load deflection criteria. Member.Slope=0, consider drainage. Page.1 of 2 BOISE' Double 1-3/4" x 11-7/8" VERSA-LAM® 2.0 3100 SP Roof Beam1RB03 BC CALC®9.3 Design Report-US 1 span No cantilevers 0/12 slope Thursday, July 13, 2006 15:36 Build 047 File Name: B ODonnell_ODonnell.BCC Job Name: Brian&Maureen O'Donnell Description: Header Above Slider Address: 172 Church Street Specifier: City, State,Zip: W. Barnstable, MA Designer: Joe Madera Customer: Brian O'Donnell Company: Shepley Wood Products Code reports: ESR-1040 Misc: Connection Diagram Disclosure b —d— Completeness and accuracy of input must be verified by anyone who would rely on output as evidence of suitability for r particular application.Output here based on building code-accepted design c properties and analysis methods. I Installation of BOISE engineered wood •1 • products must be in accordance with current Installation Guide and applicable building codes.To obtain Installation Guide a minimum=2" C=7-7/8" or ask questions,please call (800)232-0788 before installation. b minimum=3" d = 12" BC CALC®, BC FRAMER®,AJS- Connection design assumes point load is'top-loaded'. For connection design of'side-loaded'point loads, ALLJOIST®, BC RIM BOARD- BCIO, please consult a technical representative or professional of Record. BOISE GLULAM-,SIMPLE FRAMING Member has no side loads. SYSTEM®,VERSA-LAM®,VERSA-RIM Concentrated loads are not considered in side load analysis. PLUS®,VERSA-RIM®, Connectors are: 16d Sinker Nails VERSA-STRANDS,VERSA-STUD®are trademarks of Boise Wood Products, L.L.C. '• , Application to 01b Ain'# A '91111ap 31zginrrar 3biVimric Mf0trid 0,um hire In the Town of Barnstable CERTIFICATE OF APPROPRIATENESS lication is hereby made,with flour complete sets,for the issuance of a Certificate of Appropriateness under Section Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, vings,or photographs accompa6ying this application for, ECK CATI=GGRiES THAT APPLY: ;xterior building con �Addition construction: New New Alteration Q �;'•; nd(cate type of building: u House ❑ Garage ❑ Commercial. ❑ Other _ � :• -:xteridr Painting: ❑ `° signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign w structure: ❑ Fence ❑ Wall ❑ Flagpole •❑ Other pig O.R pRINT LEGIBLY: DATE DRESS u n 'l FNERK��� /n19UN 10' ASSESSOR'S LOT NO, or ME ADDRESS 172 Chi Sf IDS! , TELEPHONE NO. 75`19SI .L NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of ad)acent property owners across any 1I1c street orway. (Attach additional sheet if necessary.) 2 ��r0SOK) O. GN 5' ks7, fSi aaf� ��1� ENT OR CONTRACTOR ,�� Orc�itd TELEPHONE NO S-376 -g2Sl DRESS I7 SCRIPTION OF PROPOSED WORK: Give particulars of work tp be done, including materials to be used. Please Jude locations of proposed signs. AV,,OiT1aA)/'-_0 CTX(51-W4, &L56, '17/ X 1��� , /o /Yl__76�04 lls 57Aot"d Signed O - o ctor-Agee • `LLJ V+ JUN U S LUUb This Certificate is hereby Date rove De e ax GAP. STAc,,.LE Committee Members' Signatures: . n HI'.URIC FRESERVA 10 I `'� Town of Barnstable OId Ding's Highway Mstoric District Committee SPEC SNEET )=ATION �/ taw :DING TYPE C�v/✓/ �S �Gfl COLOR iIMY TYPE �2/G/� COLOR ' oe&7./ )OF MPiTERIAL S'�hr�/bLtS COLOR •2 on ETCH MOWS U�'JL � ZU�� COLOR SIZE 'L�f� RIM COLOR 13a6e 7V Ar9L i�1S/7116 L2919 G� OORS /�G �� • 67 COLORS C �/V f HATTERS �l� - COLORS IITTERS e#y/A)L/#? z2 zyy:�Z# COLORS_ �/) ECKS /��� MATERIALS {ARAGE DOORS �/� COLORS ;KYLIGFiT5 KV �(o SIZE �/MJWOLORS DE � E E SIGNS N COLORS 2006 • HIp�►/@J pF STpRic pBAR�STtiOLE cENc>j COLOR RESERVATION OTESt Till out eomplately, iarluditsg measurements and materials/colors to be =ad. lour copies of this torn are. raquirad tar submittal et as applieatiea, along with lour Copies of the plot place, laadseape •-- --' -`--...,-- -,.-.. Wes.- .....t i..�i._ 0 oltr- ..,;, A09 III Ak r a• .. a - N1} C�yA i�::.�+'rt�'v w .- — ..ram"" �a• � � � � • i i i � G t, • tY Ili t;-S � �r„_ -: ,��.- fir,�' '►' 3':�"''''��t`. +�'r -µ -� r 1 1'71 CHW204 57P-.-,� M&A rD 65� .ftao 1j9C)LOVAf 60 W 67 / D AW ,� / i ui i .i I .J�+�js .`.� � �.._ � `�9!> tt .tit r � "nt:� { ``�'v.��^' •` y!'}'�J. � t•_, �;r, i�/ � it � .� , " ' �_ �;����`i y\jti"�� Tit -• _ -ram„•� � �� �r. �T.+'/�y' ''* �.r •`` b-� Q / , / 20� � 0 ,�ez, ,1t,�IE.f.�•C�+ pya(�a 3»ire ry .�.}• ty9`' 0 r J Awn Jill Ai Zt r �� i S l�JG �LCVd9�7v.�.� r..�fc1a 64 5 r . A-041 T10.A) GPI L L 136- /7 A&' r 77DIft It #TC14 W � CIS%lAfb UA06e RMF UJV6 4,40 5177?UC7-VR-. i S#Z;)o /s /0 ram" ",0/71dA) IJ/LL, 70F.4" 100-y � �v��0vcJ . w s� � CD � r I i ;fit '{ �+.s" •„+letx ~ t,� �'te�•ro tz "5�,7- WNI 061 s'W a'tr `, 9 •Cj�� y;v�.}41 ".�" +'�; �- S 4 � •�"t� � - Y�� � ,- �.. � e ,'�L.'iF �'4 4_�` A33a a1 r7 p�.n�'T�• X..� �J�s J �iS fr < •' r ,.�-� ".na'•.:w a 't� S�iw c.+rtw :��, �`t '�} ��.cLe�r' �^�`�� L : � •�� =�. 'aye. +cy{6•�I``x ��•d �{' :7�ti ICrA �-"•'�_•,�•a'�, �� ''1,,� 5' '3°'t•��' 1?�T±•�'�':t;�,,;g�'��s '.�i,er. .. 2 ,�,�4e 1t- "J•'^{�r1,4:�,.- �;l'�y�i's.�x'z� i1�' +.•�L ew '�,..� ��+�.w? l'�1 ��Y:•-.-�����t'���^f � fir•�' '`jetC-.#�.�^ � .��at :ti:�.. _i. �1 � � - Jt v V r t d • o F7 IT4 cif �� oar 6 c lt` Assessor's maptand lot number ...15...3.7 3.3 ,1 �� r *THE Sewage Permit number ........................................................ INSTALLEU W House number ...... WITH TITLE oo A"aea TABLE� ENVIRONMENTAL COW: o 39- TOWN 'OF BARNST"AR`L'. - b BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ..................................... .............................................................................. TYPEOF CONSTRUCTION ..... ?o................................................................................................................. ....... . .................19gb� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location !... ls ... .........: .LZGI..N .`�... 51............................... ....... ProposedUse ...... ... ... ... ..... .......�,Orrz ..... ,_............................................................................... ZoningDistrict ...... ... ........................:..............................Fire District .... .�N�. ... . ........................... .............. or Name of Owner/ % ' �� /.. /...........Address Name of Builder ...............Address J0'...;�4., '.45 .............................. Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .............Foundation ...�4o 4 ..................................................... .................................................................. Exterior . t t �'..r ...t!................'&........................................Roofing .... .. ....y............................................................. Floors ......................................................................Interior ...... ................ .......................................................................... Heating ......./..V/.....................................................^.........Plumbing .........(1,/�............................................................ Fireplace /"� ......................................Approximate. Cost �av Definitive Plan Approved by Planning Board --------------____-----------19_______. Area 1 Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH � I OCCUPANCY PERMITS REQUIRED FOR NEW WELLINGS I hereby agree to conform to all the Rules and Regulation`s of the Town of Barnstable regarding the above construction. Name........ ........... 12................... .............................. Construction Supervisor's License Q�S Y0Q HAMBLIN, A. P. & E. 27781 Build Tool Shed No ................. Permit for .................................... .........A..q...ge.s.s-o r Y....t.Q .. . .. ..... ................ Location ......1.72...Ckluzcb...S.treet............. .....................W.eat..B.axastiabla.................. Owner ..........A t...R.-t.... B.9....Hamblin........ Type of Construction ..Frame.......................... ............................................................................... Plot ............................ Lot ................................ Permit Granted 1.9.1...............19 85 Date of Inspection ....................................19 Date Compl4ted ....... ...........19 3 Q� 3/ w— —E L� H , EZ. x � �4r 7 s Ez.4zs yXr- EZrf,�! .SEWAGC , a 4/y le-z.,VV77 I Ez 47.3 9.4e 3 a h .1E1�1/C 0 \ A 7-0 I j f I! -�_ EZEV. -pof 10: (1,1 i Ea'fJTii✓G i , ' r ez.47 3 Q..47.r ,owp i E,r�sn,�G W6ZL % �• EL.43•7 - _ - - � y¢.7 f ep l/i9ziABG6 WiDnti' CS / NOTE-EZ.6UAT/ONS BASFG oN AS.TUMe'D DATA^! CERTIFIED PLOT PLAN LOCATION wEsr Bgw.rrA�cE, !�Irass: SCALE . .! . . . . DATE 10ARcq/41.i978 EDWARD E. KELLEY PLAN REFERENCE CUJJIMAQUID, MASS. 02637 .S OW" 0N.A PG v F e /9LToN P i4.vp �Z/Z4BETf1 ,q.vz> MIA sssn— 2croeoE� 11v PL.B.— EDWARD a E. _LveY I CERTIFY THAT THE !ST!�!G !vri!4 ATinN "' No 2 10► SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SU�4 SETBACK REQUIREMENTS OF THE TOWN OF . . . . . . . . . WHEN CONSTRUCTED. DATE I A c2 PETITIONER: WEsr Vf�eNSTABLE MAss. r REGISTERED LAND SURV YOR kill As'Asor's map and lot numb , :... ....... GG Bpi TN E t0`y Sewage Permit number i. P........... ;. .. . .... Q... l` d e�P �� J t • Z H6SB9TdDLE, i House number .................................................................... Maea • 9 1639. 1 Mwt TOWN OF BARNSTABLE BUIL�14�,..ININSPECTOR t -APPLICATION FOR PERMIT TO .... .�.. 14.. ................................................. iTYPE OF CONSTRUCTION ............- ".......�..�......... ... j ...�.1!C! .Y.. .....19 ..M.� 7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby ap lies for .....a permit according to the following information: Location ...1. .. : •l� 7...S. '.....G /.../. . ... .. . ............................................................ ProposedUse . . .... ................................................................................................................................................... ZoningDistrict ...d. ..........................................Fire District .............................................................................. Name of Owner 142Z./..P..�!...../....7../!?:!5.`..?.??. �.!.:!..Address/., i.C:.l�.,�........ ..: .�./�.. ....... .. ... .,�!�� Name of Builder ........11 .........Address sName of Architect ..................................................................Address .................................................................................... Number of Rooms ..................................................................Foundation✓ at-, !T--:............................................. Exterior-�9. .. ...Roofing Z Ce .............................................. ........................................Interior .................Floors ... ................................................................... Heating .......................................:.......................................:...Plumbing j Fireplace ..................................................................................Approximate. Cost ........<... � ....................... Definitive Plan Approved by Planning, Board -----------_______-----------19_______ . Area /.... v..r".............. Diagram of Lot. and .Building with Dimensions Fee .................i./ 7 ...................... .. , i SUBJECT TO APPROVAL OF BOARD OF HEALTH s ..r ` • !.,....� �. • , it OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding a above construction. Name eal_z��.. .......... . . . LL!zel ....... Construction Supervisor's License .................................... . 25759 Build Garage No ................. Permit for .................................... ` —������� . ..tg...Z�Y�Ili�g.__.___.. 173 Church Street Locohon ---------------------. West Barnstable ---, ................................................................... Alton P. BaoUzliu � Owvner ---------~------------' Frame � . Type df Construction -------------- , . . � ----------..---------------.. Pkot —. -------. Lot ---.------.. ' ' � ' November 9 , 83 ^ � ' Permit G,on**6 -------------.lg ! Date of Inspection ............................. —..lV ^ ~ . + / . '. ' . " ' ` ^ \ Assessor's map and lot number .. J`^3... . ..3......... THE 2"a Sewage Permit number ....... House number .........1.7 BASHSTOIILS, SEPTIC SYSTEM MlS�T �� s6 a fi ,TE� ®i�RS� 9. LI �N1_I. CE oo�pYPYa�9 TOWN OF BAy1S' A =T ,E�n� � 7^ BUILDING INSPECTOR APPLICATION FOR PERMIT TO .............. ............................ ��:�Y�1i��...fir................... TYPE OF CONSTRUCTION .................. '...�� ®..................... ....J.f?l 1.�...................................................... ............. . ...3............19. TO THE INSPECTOR OF BUILDINGS: The undersigned rh�ereby applies for a permit facdcgording to the following information: Location .........1q;2.... (:Yll...� :.....lxl1 ft... .............J�s�JJ.f� r.............................................................. ProposedUse ...... . .......................................................................................................................... ZoningDistrict ......RE........................................................Fire District ......W... .. . ........................................... Name of Owner .... .....................Address .....I. Name of Builder ..ZL9.h.n...�h.n.,�?!;?n...................Address .e......1.6.0.. l . .. . J� w.:.`: . Nameof Architect ...................:..............................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exterior . ..................Roofing .......1� ............................................... Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing ........................../....................................................... Fireplace ..................................................................................Approximate. Cost .... (�sD ............................ . Definitive Plan Approved by Planning Board -----------_______-----------19________. Area l�f�/� f`���f ......... ... ..................... . Diagram of Lot and Building with Dimensions Fee `— SUBJECT TO APPROVAL OF BOARD OF HEALTH /21 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. / Name .�..... . .0.... ...:..... � .............. Construction Supervisor's License .................................... HAMBLIN, A. P. No .... Permit for ...Bi1Ud..Addjtj_,0n.. .............S2-Pae..Fajni1y. --Dwe1ajng................. Location A,72..Church..StxeE?,t........................ .................WA... t:ab.11a.................................. A. P. Hamblin Owner ...... Type of Construction ............Frame.............................. ................................................................................ Plot ............................ Lot ... ............................ Permit Granted ..........................October 3,..............19 84 Date of Inspection ......................................19 Date Completed ............ ...............19 V. TOWN OF BARNSTABLE,_ Permit No., a Building Inspector { slE[1T►X Cash OCCUPANCY PERMIT Bond ^ "No building nor structure shall be erected, and no land, building or strueture�shall be used for a new, different, changed, or enlarged use without a ,Building Permit'. therefor; E first having been obtained from the Building Inspector. No building,shall be occupied until a; certificate of occupancy has been issued by the Building Inspector' Issued to Address ._, Wiring Inspector Inspection date� � a ' { -0c 4 Plumbing Inspector Inspection'date Gas Inspector a ' w Inspection date.. '9 Engineering Department Inspection date THIS PERMIT WILL NOT.BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED:I BY'.THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. , re ' .............. ..........., 19......_. ..... <. Building,Inspector r - w- 64 Z. P � � P/r Box.. 01, i 6G 4!.7 .� fL.4A9S y tz.4.s:7 sysre'y 47 j .a B� B•�3 C 1� . �SEpT/C O a 7;2?KA-- EZ 4 Vv Top of 1V 1 y E7fr1TiNG t � .�� . s S w 4 � 1 I Eli3>/NG ` — 4,5_ Vq 3 PRELIMINARY • II�oTE-�t$V.9T/orvS Btlsdv ON AssuNe� /iTu`1 CERTIFIED PLOT PLAN L-OCATION WEsr BAr?n(sTi9�Gt SCALE . . „ `�° . . . . DATE eMIE / EDWARD E. KELLEY PLAN REFERENCE Az As CUMMAQUID, MASS. 02637 . : * * ' �. * . ' — * * "* * * * * Z-Z/Z48E7t/ /`7. f Q,'D.0 Z1A1 A.vo `SK D sss AeErbepE-D i/v AZ.Bt- 29B F�' 4i EDWARD E. Vey I CERTIFY THAT THE No 2.:10'D -SHOWN ON THIS PLAN IS LOCATED ON THE GROUND 41 AS SHOWN HEREON AND THAT IT CONFORMS TO THE s7ti -ko SETBACK REQUIREMENTS OF THE TOWN OF BIND SUitl� QA �TA� . .. . . . . . . WHEN CONSTRUCTED. DATE M.aers✓i4 i97' PETITIONER: WEsr l3AeNSTABLE MAss. cry REGISTERED LAND SURV YOR . sN�7 z o f � s.rEz-TS TOP OF FOUNDATION CONCRETE COVER ' CONCRETE COVERS 4' CAST IRON 12"MAX. 12"MAX. • PIPE (OR 4"ORANGEBURG(OR EQUIV.) EQUIV.)— MIN. PIPE- MIN. EACH - � PITCH I/4"PER. PITCH 1/4"PER.FT. PIT PRECAST _ LEACH I N G INVERT INVERT o • Q�;' PIT OR ` o EL.`'`�i:9�... INVERT / DIST. 4/So w EQUIV. SEPTIC TANK EL.....•.. . . . EL >_ . . o INVER7 BOX . "''"" „�a- /000 GAL. INVERT �a INVERT w w o: •;�. 3/4 TO I I/2 �4i.00; s' _ �o\per _ WASHED ' w STONE DIA.:!id A"&A/&- PROR LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE /V'oTE— sole. Goa 087?9/,v6D �,enr. 6o,wzo aF-..y�1c.T1/ 2�.eos. SOIL LOG WITNESSED BY : ' DATE T.^!E!; !97�• TIME._. . .. .. . . . . P,9uc Diu ee.4 Y BOARD OF..HEALTH I TEST HOLE I TEST HOLE 2 ENGINEER ELEV. . s34. . . ELEV. .. .. . . . . . . � r W'���Q" DESIGN DATA yE�o,,, sfwo NUMBER OF BEDROOMS . . . . . .2. . . . . . . . j 5, TOTAL" ESTIMATED FLOW . . 2zo . . . GALLONS/DAY BOTTOM LEACHING AREA ?8 So . SQ.FT. /PIT SIDE LEACHING AREA . . .�88 •2). . . SQ.FT./ PIT Fi^iE GARBAGE DISPOSAL ^!"^!E. . .(50% AREA INCREASE) S,q,vp TOTAL LEACHING AREA . Z�7oo SQ.FT PERCOLATION RATE .Lf7s 7�V . 2 .: MIN/INCH LEACHING AREA PER PERCOLATION RATE `Ta. .. SQ.FT. • , o .WATER ENCOUNTERED 1 NUMBER OF LEACHING =PITS _ THOMAS E.•KELLEY CO. ' APPROVED . .. . . . . . . . . . BOARD OF HEALTH ENGINEERS-5VgygXOJZS i 346 LONG POND DRIVE _ SOUTH YARMOYJTH,lAASS. DATE. . . . . . . . . 02664 AGENT OR INSPECTOR PRELIMINARY ��1"°F"'Ass �H OF ?�� T O Z 'Z EDWARD oG E �+ �+ C<!-.ecy .sT WE3T dAP�/STABLE . kEY 0.24260 0 N v No 261DL O A90 FGISTEPF'\��``� FFSS/ONA1.�a� • STE y0. PETITIONER WE�T,dge.vsr4,6 `9ASs• �h� Su���' ;VIU2217 Fh,� 040 THE COMMONWEALTH OF MASSACHUSETTS TOWN OF B AR\ST BLE BOARD OF APPEALS ---------------- NOTICE OF `6TARIANCE Conditional or Limited Variance or Special Permit (General Laws Chapter 40A,Section 18 as amended) Notice is hereby given that a Conditional or Limited Variance.or Special Pt+rmit has been granted To..................................A-ltgn•-P• &_-Elizabeth Hamblin - - - - - -----------------•----------- t'. Owner or Petitioner Address.......................... hurch Street--------------•---- . --------------••------•-----------•-------------------------------- City or Town................ Jest Barnstable,_ h!A_02668 Lot in Assessor's Records �--- Identify Land affected ------------------------------- by the Town of Barnstable. Board of Appeals affecting the rights of the owner with- respect to the use of premises on_Church.Street__-________West.Bamesabla____---------------------------- " Street City or Town the record title standing in the name of Alton P. & Elizabeth Hamblin ------------------•--•-----------------•------•---------------------------------------------------=-------------------------------------------- -------- whose address is.:. Church Street ti%Test Barnstablef TvIA A2o58 . . --•_---_.._.. --•-----_------ -------------- --------------------- •-•----- Street Cityor Town State by a deed duly recorded in the_33amsta0ble__________________County Registry of Deeds in Book 882-------- Page--91------------1 -------------------------------- ------------Registry nistri.q,of the T and Court Certificate No----------------- ------------ ---Book ----------------Page_..------------- The decision of said Board is on file with the papers in Decision or Case No._197.5=22______- in the office of the Town Clerk of the Town of Barnstable. Signedthis------------day of------------------------------------------------- Board of Appeals: , ....... ram- ----- --------•-----------•-----_----------------------Chairman Board of AppeatS --------------- ---•--------------------•-----------------•---------_Clerk Board of Appeals ................................................19........ at..............o'clock and---------------------------------Ininut.es ----M. Received and entered with the Register of Deeds in the County,of -------------------------- --------------- Book i ---------•--•-•......... Page........................ ATTEST .............................•__..........---•-•----._.. Register of Deeds . 1 PO4THE TOWN OF BARNSTABLE OFFICE OF BAaa9rB,MABL BOARD OF HEALTH aj °°a0)a639 397 MAIN STREET o0!IAY HYANNIS, MASS. 02501 To : Building Inspector From: Health Department Subject: Test hole and Percolation Test A examination of the soil at (Lot) (Address) ( Village) was made on 6 - 11 - -7 and found to be suitable for sub-sup face sewage* at .site or test hole. Building Permit 14ill not be approved or sewage per,is issued until H2alt.^_ Department receives t1170 con?es of plan showing building, sewage systems and all other de-cails listed in' Board of Health instructions to sewage applicants. This approval does not constitute a final decision concerning the installation of a sewage syster,. P.11 State and loca 1 Health regal :tions �.�alv to i;7al approval. (-.3ignatur e) 6/20/75 _ I ,�; a .s.., �,_.,__...•,� ,;:'s�. ,,,y4 a �r �-i �f., z � � „'+rs'>t "'arw:�+. .�•+:�° � yr�y a ,c�+C"�t'����.x � ,..�e, .. 3 �a .1pk� -6"*{�i:�aSEM i 4�?` S� 'fio'n�t r"�"nw�ea'`..""T'�.. _ �. wr�1��•.�• T� "�o ��" .�� ,may (+ •f'+�i S`i..+ R 1 i S`��:. �' � S 'SCw +IIj 1:.1+'T+,', �''I y} -:T1 .{ .^ a s ,� X ..r�,y"+s!'*,tL^'T•xF'-,1� S �• g,, \ '3• '�`.r. - _ . • {{ h a-}iY�+., '.76•r,; r9�+.i C`\ie '�' .L r• /wt—.�.. .a` " ,>• M11' �,'1�'•' � ` i ? r.rr •Ui"'! - ,»�':'.k.� �wti' ,•t "Y", 'a:`. .•.' �,,�. •, g �7- x �Wj � � t ' 4 .w'��... 't �:«,� ��_,i'""'rC ,z,1�Y�',,rr�• ..;�� j�r I1G �rf� ;#`�.c t e� ..e x ;S,K•C w�r� .+,+�,.. ti g ••� � �� }9F.,.:, ? �6�.� r •ry*j.- �� .� _ a`-'4,Y ,1:�:r- a �f J'� ,:�,.f t•� Fhe+�':��.�''� �n tom'' \':~ .. ' ROVEMENT CONTRACTORS REGISTRA.TION' � ' Board of AI Building Regulations and Standards n ' � One .Ashburto P _ 1 _ ,Boston Mon Sa lace Room .1301 chusettS 02108 (.'keij n,: +i •! `:+�.{-. �:. - HOME IMPROVEMENT. CONTRACTOR Registration '102149 TYPe — INDIVIDUAL ExPiration 06/30/94 _- — - John Johnson HOME IMPROVEMENT CONTRACTOR t John J . Johnson Registration. 102149 160 Church Street Type ' INDIVIDUAL W . Barnstable MA 02668 Expiration 06/30/94 . I� John Johnson i John J. Johnson 160 Church Street ADMINISTRATOR V. Barnstable MA 02668 �� l .N �}tldOON3NM tl3O 031tltlV3 f�. .7Y�j � V a NOStl3d 3Nl N0 pO SINl #j. 3.Nos }N3Wf10 `61 g6L!lZ/Sop il3NpISS1WW03a^1tlN015 '9 335N301'1 do ;1Np13H NJ v4v N`JIS r 03dWVis "e1 O}OW 1 3N113N(1I"O'S 3N}3n08d'1�1jd134 �ON," 11 3tlf11tlN015 V1N(1W3VAlow V IA�N°tld0 0 O,S fx d .33d y S S Z A,Td%31J'0 ONv 33SN3311 A0 O3N`yS tI 1, 80g0—h�—LZO flO1S 3SNc_; "931 •� N 0 dW g�sfW3 . 091. 3NON 686E �. , i. E ; d g.99Z H� NNO` SNpI1pIb1S3b 3Sd31 „31.1S3 d�.dS- I NONI"► Sfl P3a O 331 3104 0 ;. Y S36 16 dp0 Np0Il4dbl9d,X0 l- t6600c'/90 ol � 3d43f,.J3343 Q ,-1 013S 1�O(Qls� 0 96 ►otlssvw I3 + �0b3No Su3sn L 0.�90d a0SI�3SN30I1 ,' , pe ,Y: Hl1tl3MNOWWOp �1 . 30d W Ol Dab b0A M '. g�ZZO wW Ol0<< e 33 j 03b1(1�03H0 3Sp"YJN3 ;1 ;S�rH�l 0 3Pjl? f d3 "u ,63a»0),3NOW 8. t, 6 /,13dx4 1.i1ay.•. �.b,rl.-_.v�.�.. -v.�_-. ....Fa^. r. l3 .....Y.KL�:. - � �f��'{_ -,3. -. _.-.r.\ .4. .... ,e � 'S .}Yi...-'.. _. ,., a/. —. ...:, y - Application to S��A`'OE"StEP�G"S Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a f , 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 R 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). C TYPE OR PRINT LEGIBLY DATE r r. L ADDRESS OF PROPOSED WORK 7 CIS vr`C � S4 ````� Sl`,"-ASSESSORS MAP NO. OWNER _ �'• �°'" '`" ^ s '�' ASSESSORS LOT N0. HOME ADDRESS 1� ? c �` `N`c�` TEL. NO. 3t' 23 OO FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way.J (Attach additional sheet if necessary). y t)�� -,vU�w50 O C � hC � � -t � �SI �G AGENT OR CONTRACTOR (/} J "1 1ti S(3w TEL. NO. 1 V 1 )- L 7 1 ADDRESS L.... f) F (<��� r � $ � 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). I � M y rG h o VS � -,L D D Signed Spa wne ita owner-Contractor-Agent 14ce� ey DC ff� scat s hereby Date o2 FE$ if,p low e By fAmiqN= TOWN OF BARNSTABI� Approved IMPORTANT: If Certificate is approved, approval is subject to the 10 day appeal period provided in the Act. Disapproved ❑ Form "A-1" 6I64 OLD KING'S HIGHWAY HISTORIC DISTRICT Spec Sheet Foundation Type Po v r-e 1.� w�' -T ti o 9 Siding Type Wo o� Chimney Type l{j Color t,-\ II�� h o w S Roof Material s ��-i - � �. Color woc� La �`r ,�c�-r Pitch Windows ,� v�,1.. �"�� •` Site (Z G Trim Color Doors Color Shutters Gutters A rv�, Deck Garage I u w o rid- ►1 ct , w < Color nooQ U Notes: Fill out completely, including measurements and materials/colors to be used. Three copies of this form are required for suamittal 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. ` _ f 93101 e%' 1 LOCUS 1p p MINIM i r M4RH4 ARCfL 4 MINIM 6000 0 ;F s pt eK p6) 4HORH W. -E ' f e' °4s'?6 n� pO.100 r 'ca ' 2 o°j g ?s8 86 3/8 86 ti \ N o a o\• 2 d; 38,266 SG.FT. 40,559 SOFT. \10 fi 4 hoof ROD ; W 'f,. GORDO N 1 �! �O ex.131 t0 . VI .0 ' - ~ 11.65 y�o \ 4.15 IP 135.29 / — 165.02 _ CebB-- N87038'40°W 13S ?pT4°/8, 29.84 Co. 271.34 --- --- 02"14 106.32' — �; 144.84 • ) S 85°04������ `.:��� ce ���` WAY H STREET VARIABLE WIDTH U Pa_1o7 ` ..��....—... -.` �.,.r..�•,-���+.�,w�r-��..«::;..W.�.i:ic` ----=""5EE'-PL-:BK.-40- A \ II j REFERENCE RULER lill� ll � lll � � llr `Il � � � l � � PLAN OF LAND iR WEST BAPINSTABLE , LASS. FOR ALTON P. ANo N LIZABETH M. HAMBLI N AUGUST 21, 1975 SCALE 1"=40' Assesso-rs'Office(1st Floor): - Assessor's map and lot number �-� r 33 SEPTIC SYSTE 9,3 Conservation INSTAUED IN Board of Health(3rd floor): �; 1Vo W Sewage Permit number �s7Vsrm {-3 �•Q �r�n� Engineering Department(3rd floor): P. `GOWN REGU House number ��� Definitive Plan"Approved by Planning Board 1g r , APPLICATIONS PROCESSED 8:30-9:36 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO 1'3 a� l �q rc a 9 Q TYPE OF CONSTRUCTION 19 7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: (tTop:) Location 172 C u/�c S'frz s Proposed Use Zoning District Fire District Name of Owner /lcr ;.. ^� S�i^� Address C K c 4 Sr 41 C.,�•, i���4 Name of Builder V 1 h Jd h 3 ,Address C c S f (;v v, ( Al C Name of Architect Address Number of Rooms Foundation ( O . 11- c( C'.0, Exterior Woo }'0,J k — C /' k0i: V 4 Roofing 4"'j2� l 44 Floors COh c is e.�� Interior Heating N1 Plumbing Fireplace IV/A Approximate Cost _ �D Area __ .5A, Diagram of Lot and Building with Dimensions Fee i -Z s� 1 � P I� -2° Y OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS C S-f. I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License �,o 1 r"� HAMBLIN, ALTON li No 35712 permit For BUILD GARAGE 4e Accessory to Dwelling Location Lot #2, 172 Church Street West Barnstable Owner Alton Hamblin Type of Construction Frame Plot Lot i Permit QrwQ, March 2 2, 19 93 Date o nspecti —�`� 19` Date Completed 19 Ira ¢ r w Assessor's office(1st Floor): Assessor's map and lot nu r .Map. r 3 a7 O 3 3 0S THE>o SEPTIC SYSTEM MUD� BE v`' � Conservation o INSTALLED IN COMPLIANCE ;� ., Board of Health(3rd f oor): �7 �. {�/ 5 >i ssanr�nt Sewage Permit number _ / �� �IO � ,� ENVIRONMENTAL CODE AND 'oo re,o`. d° Engineering Department(3rd floor): House number /72 c 4 vA c C •s� TOWN REGULATIONS 0 Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M."and 1:00-2,00 P.M.only TOWN OF BARNSTABLE . BUILDING INSPECTOR APPLICATION FOR PERMIT TOrci-v TYPE OF CONSTRUCTION 4/0tICI 19 q,-z. i TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: /, Location 7 2_ C`4 ✓,tC 4 Sf" We sf ✓>c,ftn.� �f ti ��� � c's Proposed Use Zoning District Fire District Name of Owner 141-,, �-�c. �., y.'�.+ Address l 7 C J f Name of Builder J,h N ✓� h �-c d Address /1- o C 4,, Name of Architect ` Address 1 Number of Rooms Foundation -41,4. Exterior G/1 n K Roofing roa 4 c/f 44—c'c 4 k Floors 941 Interior d0- �z c. C �� Heating IK y cv4 //— �c re Sc),, Plumbing NZA I Fireplace �/A Approximate Cost S S`U Area G L2' Diagram of Lot and Building with Dimensions Fee �® q0_S rl � i j'g N • 99D Pj hU 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. i, Name Construction Supervisor's License Q --� . HAMLIN, ALTON P. No 34967 Permit For BUILD ADDITION Single Family Dwelling Location 172 Church Street p` ` West Barnstable a r Owner Alton P. Hamlin Type of Construction Frame Plot Lot j Permit Granted April 14 , 19 92 e y Date of Inspection 19 Date Completed 49 1'� 19 4 � o. i �t� - {/ 900 0 _.. J . T COMMONWEALTH i DEPARTMENT OF PUBLIC SAFETY OF 1010 COMMONWEALTH AVE. MASSACHUSETTS BOSTON,MASS.02215 . ENCLOSE CHECK OR MONEY ORDER LICENSE EXPIRATION DATE �` j- CONSTR. SUPERVISOR FOR REQUIRED FEE, 06/30/1993 6 EFFECTIVE DATE LIC-NO. ; MADE PAYABLE TO RESTRICTIONS NONE O6/30/1991 005'409 "COMMISSIONER OF PUBLIC SAFETY" I = s m JOHN J JOHNSON". ' 1 (DOiNOT SEND CASH)., 160 CHURCH SS N 027-34-0808 W BARNSTAB MA 02668 P EASE • NOTE FEE INC-R—EASE PHOTO(BUSTING OPR ONLY) FEE: .),,C F _... 100.00 E FECTIVE FEB. 1 , 1989 t •`? �.. HEIGHT: + NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY F _ .'.�r. DOB ` STAMPED OR SIGNATURE OF THE COMMISSIONER '1� p 06/ 21/1946 D NOT DETACH LICENSE STUB THIS DOCUMENT MUST BE SIGN NAME IN FULL-ABOVE SIGNATURE LINE CARRIED ON THE PERSON OF SIGNATURE OF UCENSEE TE HOLDER WHEN ENGAG. ' OTHERS RIGH. 'P4iNT EH IN THIS OCCUPATION. COMMISSIONER 200M-2.87-81429 I • Application to VP�G 0�E VtH c/ 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: 1. Exterior.Building Construction: ❑ New Building Addition ❑ Alteration Indicate type of building: ❑ House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: Q 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 DAT. E ADDRESS OF PROPOSED WORK 17,E G�iv-tc�. Sr ��sr �'""`J'�`�Cc ASSESSORS MAP NO. OWNER r1/f� — / "~� "� ASSESSORS LOT NO. O 3, 3 HOME ADDRESS TEL. NO. FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). / `7 C7 G v i`c 4 S r s —t/!t 4 S Y AGENT OR CONTRACTOR r/dye^' `J�/�! ma's ' •`— TEL. NO. ADDRESS f� G44-'K-v4 S � 4/�'s� /JGr•. .-.irc, r 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 ` ct Signed W.cn�„ � •-- Owner-Contractor-Agent Space below line for Committee use. ReclReEbUILD-F.V E 0 Date MA-'� ( 3 The Certificate is re by to d— Times r NblAukv By Vi-'rrar.^sa -r-: ar�'Cci�r. 4. WOE Approved JlwpOPQ�i_W: If Certificate is approved,approval is subject to the 10 day appeal period V VV provided in the Act. Disapproved ❑ `�H� OLD KING'S HIGHWAY HISTORIC DISTRICT S P E C S H E E T FOUNDATION i c�u /t %ucL L✓/ c' c� f` " '1 SIDING TYPE C4. - zoo COLOR CHIMNEY TYPE - A/ COLOR ROOF MATERIAL //s . 3 , S %�% COLOR X?esc/k," PITCH �D Z SIZE WINDOWS ��e�i� !7✓ �� TRIM COLOR DOORS � 7�e- Ck�'s tJ� COLOR 6-11w l- SHUTTERS GUTTERS j DECK A/4 GARAGE DOORS / "/'f COLOR R E C ONMA 1) F i 1 1 out Completely, including measurements and ` a , j materials/colors to be used. MAR Three copies of this form are required for submittal' f an application, along with three copies each of OLD Kl 'S NIMA he plot plan, landscape plan and elevation plans , whey;, app 1 i cable. y �,:-•._ ..r=,:,�•t^°� "-' *P l oTb -plan need not. be "Certified" , but should show APPROVED' a 1 1 structures on the lot to scale. Assessor's map and-,lot number .... 3 PROF TH E Tyr Sewage P'ermit number ............................................ ........... MARNS'TAXLE, House number /zv...irasa ......................... ........ 1639- 101 VIAR TOWN OF BARN STAB BUILDING INSPECTOR APPLICATIONFOR PERMIT TO !......... ................................... ............................................................................ TYPEOF CONSTRUCTION ..... ..................... ........................................................................................... .........44...... ................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following hZfbrmation: ..........!......................................................................Location .................................... ... ...... ProposedUse .................................................................................... c .............................. ................ Zoning District ....... .............................................:,Fire Distri't ... Name of Owner ...........Address ................................ .... Nameof Builder ...............Address .........................................=. .................................... Nameof Architect ..................................................................Address .......................................... ......................................... Number of Rooms ............ ....................................................Foundation ........................................................ Exterior ........... ........... ............................................................Ri5ofing .... ............................................................................. Floors ..................Interior ......................................................................................... Heating ..................................................................................Plumbing ................1.1.................................................................. Fireplace ..................................................................................Approximate Cost ....................... ....................................... Definitive Plan Approved by Planning Board -------------------—----------- Area .... ..............)...... ........... 0 Diagr am of Lot and Building with Dimensions Fee ....... .............t........ .Z SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW �WELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name...... Construction Supervisor's License ......... HAMBLIN, A. P. & E. A=153-33 3-3 27781 Build Tool Shed No ................. Permit for .................................... Accessory to Dwelling ............................................................................... Location .......1.7.2....Chu.rc.h...S.t.re.e.t.............. .. . ....... .... .. .. .. .... .. .. West Barnstable ............................................................................... Owner .............A. P. & E. Hamblin .................................................... Type of Construction ....,,,,Frame..................... .. .... .. .. ................................................................................ Plot ............................ Lot ................................ Permit Granted ..........Apri.l....1.9.1.......19 85 Date of Inspection ..... .............................19 Date Completed ............. ........................19 44. Assessor's map and lot number J`^3....... �+ / N -Sewage Per'mif number t I EARNSTULE, i House number r rasa S �O 039• 9 �OMAYd� TOWN _O F RARN;S�T-AB1 E i BUILDING -7IFNSPECTOR--�,_,µ APPLICATION FOR PERMIT ,TO .. LP.�... � .. .511t................. ob TYPEOF CONSTRUCTION ......................... ....... ... ........................................................ TO THE INSPECTOR OF BUILDINGS:''r The undersigned hereby (applies for a permit according to the following��information: Location .........�. h. .!,...:t U�3? .1`ll.... :..... . . . .. .� � .17Q1J.��4-...................... ProposedUse .....: .��� 1 ,�2. Y... . .......................................................................................................................... �-, � �� �ning Distract ..:...(.'................................... ..�../......................Fire District .................f..,...A...'..�..,................................................. Name of Owner ..../. ..: .....�-�k.C�.�1`1.�Li-INf....................Address .....�.(7—Z Ct'^�.5. :...w..&7.vs�. Name of -Builder . . C` .h.n... ...................Address ......�.((�r�..w,�.(.0 r�.�..1��. .................................. Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exterior ..... !� `.�.h. i�5..................Roofing ................. .1.i ..? . ............................................. Floors `.....................................................................................Interior ........................................................................... �. . Heating ..............................................................:...................Plumbing .............................................................................:::... Fireplace ..................................................................................Approximate. Cost .... .... ... r....................... ...................... / TO—R/ Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area ........ Diagram of Lot and Building with Dimensions Fee f.0i.` SUBJECT TO APPROVAL OF BOARD OF HEALTH i Z__ 2� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS " i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ` Name<�i�2 z,f.....:..... r!l.. i; /. -c.-.............. Construction Supervisor's LicenseC.................................... HAMLIN, A.: P., A=153-33 No ...27047.. Permit for ....Build Addition .............................. . ...... Single•,Family Dwelling.................... N014� �tXggtLocation A .. 1 .. ......................... .. ........ ............................. Owner A. P Harrblin ................................................................ Type of Construction ..F.);aW............................... ................................................................................ Plot ............................ Lot ................................ Permit Granted .....Octob�--r 3, 19 84 ...................... Date of Inspection. ......................................19 j Date Completed .................19 4P j��-- ,3�. Jam' �• p,(/, iDe �- ,3-!S -7 � Assessor's map and lot number 4t SEPTIC SYSTEM MUST BE SO INSTALLED !;ICO;4?LIANCE W Se,.wage:;:Permit number ..................................................: WITH ARTi ALE II STATE SANITARY CODE .A . � _ AND TOtiJi� Q�FTMET��♦ TOWN^ OF BARNST HE 4r o Z EA"ISTAJO, " a BUILDING INSPECTOR `y d: APPLICATION FOR?PERMIT TO .:........ .�� TYPE OF CONSTRUCTION ti i ........."!.........I..PJ................19.7,7 P TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according t?,-,he following information: • r Location ................:.... :s?��.�a/�..�-. .�............... ....... ..�.�...+....... ..... ... . ,....s.✓.����.......... ProposedUse ....... .. .. ................................................................................... ...... ................ ................................ ZoningDistrict ......................................:.................................Fire District ........................................................ ....... .. .... aP, 1,4"-Address .` o..C' �1..�/d.......�.;c�:.t:.. .. ..... Name of Owner � ..:... .......... ... /..... .. �zt:�.•. v Name of Builder • / .....Address Nameof Architect ..................................................................Address .............. .. ................................................................ Numberof Room ...............v............................................Foundation ....................... 4) Exterior ....... vQ® ....................Roofing e Floors .. .S !x/ .-.40z..................................................Interior ..!L �... .............................................. IG. Heotin ... / C./✓2.G..rr................................................Plumbing ...... cQ ../............................................... Fireplace ...........................Approximate Cost ...............�.................................��:><7"� . Definitive Plan Approved by Planning Board _ L_____-----------19, s _.. Area `.... ...I........... Diagram of Lot and Building with ,Dimensions Fee ........ SUBJECT TO APPROVAL OF BOARD OF HEALTH G 641 0 o I�► �G A OIL I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . '. l..:.... Gz',<�t1••!•� ......... Hamblin, A.P. & E.M. 153 5 -No PP .... Permit for ....... ........................... Location 17.2..rh1UrWX..0..................................... ..................... ......................... Owner Type of Construction ..vtoo.d..frame.................. ................................................................................ Plot ....... Lot ...#5..................... .................... Permit Granted .....Aqr.c.h!..1.5 19 78 Date of Inspection ....................................19 '7 7 Date Completed 1 )- ...... ............. ...........19 .PERMIT. REFUSED ................................................................ 19 ........................................... ................................... ............................................................................... ........................ ....................................................... ............................................................................... Approved .............................................. 19 ............................................................................... ............................................................................... Assessor's map and lot number ...... .. Sewage Permit number .............. .......................................... T"ET TOWN. OF BARNSTABLE Z BARMABLE; i o war a' BUILDING INSPECTOR AI-FLICATION FOR PERMIT TO ....... �....!.. /. .'.. .............................................................. TYPE OF CONSTRUCTION '` .. .��..................19:Zl'.7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to,,the following information: / i/ " � J Q l Location ..................... �.c. r.�:./,.........?Z1...:.1./. z._;,:?'..... t.t :C.t::,1../�� L.G:.......7 /�,........................ z.Q� ProposedUse ....... .. .r(..4.F .............................................................................................................................................. Zoning District ........................................................................Fire District ............ (....... ................................ Name of Owner .�:1...1.�V.C� .^/��... ��./.r.:. /,�,.4...Address ... .....Z! �F....... Nameof Builder ....................................................................Address ..............................................r...................................... Nameof Architect ..................................................................Address ................. .. ............................................................. Number of Rooms ..................................................................Foundation�l./.:.....l:....1 f`✓..<...c..�<..l..c;�..........�............ Exienor .... ........`. ..... .... ......... ......... ................................Roofin d> r�..;/.�`: .r:.�.� ! ...1:...4 ........ / f Floors r.: �..1 ✓. �f .Interior /✓1.;� .. o<................................................ l../.:.:... :............................. / l Heating ... ..,....`.c...i��..e:.. ..................................................Plumbing ...........1/.. .Cl c _.,............................................... Fireplace ............. ....................................................................Approximate Cost ... ......... ......... ........ ......... ....`.............:>` Definitive Plan Approved by Planning Board 1__----_-----------19 __. Area ��%v�r !'.:iy�.. Diagram of Lot and Building with Dimensions Fee ............................................ SUBJECT TO APPROVAL OF BOARD OF HEALTH �e `1 r I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .... ....... ........ .... .............. Hamblin, A.P. & E.M. .153 No ...2QQZQ... Permit foic9nstructin&............ ........ai,Ag..e..i Mi.1x...Ciwg11ing....................... Location ....17.2...Ghuxch..S.t.... ..................... ...................Wes.t-Ba=&tAble........................... Owner ...................... Type of Constructi n .......WQQ.d..f'KAM............. ............................. .�. Plot .................... ... Lot 45..............�........ Permit Granted .March..15....................1978 Date of Inspection ......1.............................19 ` 1 Date Completed ....... .............................19 PE IT.REFUSED .............................�................................. 19 . 1'.. /.. .,... :................. ............................I..................•. ..R......................... ......... r. ......1:.�11................\/............................... Approved ................................................ 19 ............................................................................... ............................................................................... f Assessor's map`and lot number:..... :`:W.'. �-� --+ .. THE �Sewage Permit number .. .. ... �Q (/ Z BAWSTADLE• i House number •.................:...............................:....................... so Mae& p t639. \00 �0 mo p. TOWN OF. BARNSTABLE BUILDING : INSPECTOR APPLICATION FOR PERMIT TO ............................................................................................................................. TYPEOF CONSTRUCTION ..................................................................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby ap lies for a permit according-to the following information: Location ...1. ..•<,,,_• .. 1..?"('.�1...S..7..... ............................................................. ProposedUse ...... ._.. ! ........................................................................................................................................................ ZoningDistrict .../� . '.....................................................Fire District .............................................................................. Name of Owner � 7A��........................ 6,�/.�/..Address/.c!X. l-3.. / .. ............ .�!��o I Name of Builder ........it ..............Address Nameof Architect ..................................................................Address .................................................................................... ....................................Foundations ���.az --r Number of Rooms• ................:............. ..�..1�..-�............................................................ Exlerior��2' �% .Raafing C -C .. . . . .. � .................................................... y Floors /��!r . ..... ............................................!.......Interior .................................................................................... ............Plumbin i��. -Q--� Heating ..................................�.. g . .. .. ......... .............................................................. Fireplace ..................................................................................Approximate. Cost ........e.! 42......................... Definitive Plan Approved by Planning Board ------------_ . f/ ---- - 19- - Area ...... ..... Diagram of Lot and Building with Dimensions Fee �/! ��................... ......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH, OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 4 I hereby agree to conform to all the Rules andRegulotions of the Town of Barnstable--regarding the above construction. 6 Namev.. �... /�/ ... ................................... Construction Supervisor's License .................................... oAso/^Im, ALzvm P. ^^-153-033 , ` 25759 Build Garage _ No ................. Permit for .................................... ' ��...t�...[�Y�][li��.------ ' - ' ' 172 Church Street Location ---------------------. ' � West Barnstable ' -------------.------'------. ' ' Alton P. Baodblioe\ ' Ovvne, -----._'�-------------- ' ]7zaoo� Type of Construction - ---------'---- ' . --------------------------. ' Plot ............................ 'Lot ----------' ' / ` ^ � November 9^ 83 ' Permit G,ono*6 -------------.lV ^ Date of Inspection ....................................lQ - Dote Completed '----.-------lq . . ' ' ` ' | ' � . �~-� w�~ . . � ' ' � ' ` . � . . \ | � [ ]` [R153 033 . ] LOC] 0172 CHURCH STREET CTY] 05 TDS] 500 WB KEY] 88274 ----MAILING ADDRESS------- PCA] 1091 PCS] 00 YR] 00 PARENT] 0 HAMBLIN, ALTON P MAP] AREA] 80AC JV] MTG] 0000 172 CHURCH ST SP1] SP21 SP31 UT11 UT21 . 93 SQ FT] 1881 W BARNSTABLE MA 02668 AYB11978 EYB11978 OBS] CONST] 35500= 0000 LAND 33900 IMP 97900 OTHER 11400 ----LEGAL DESCRIPTION---- TRUE MKT 143200 REA CLASSIFIED #LAND 1 33 , 900 ASD LND 33900 ASD IMP 97900 ASD OTH 11400 #BLDG(S) -CARD-1 1 97, 900 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #OTHER FEATURE 1 11, 400 TAX EXEMPT #PL 172 CHURCH ST WB RESIDENT' L 143200 143200 143200 #DL LOT 2 OPEN SPACE #RR 0308 0181 COMMERCIAL INDUSTRIAL EXEMPTIONS SALE] 01/97 PRICE] 1 ORB] 10577156 AFD] I A LAST ACTIVITY] 02/26/97 PCR] Y ti R153 033 . A P P R A I S A L D A T A KEY 88274 HAMBLIN, ALTON P LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RF 33 , 900 11, 400 97, 900 1 A-COST 143 , 200 B-MKT 109, 800 BY 00/ BY ML 2/93 C-INCOME PCA=1091 PCS=00 SIZE= 1881 JUST-VAL 143, 200 LEV=500 CONST-D 35500 ----COMPARISON TO CONTROL AREA 80AC ----------------------------- NEIGHBORHOOD 80AC WEST BARNSTABLE PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 339001 LAND-MEAN +01 1432001 99229 IMPROVED-MEAN -10, 250 ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 1001 LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP] ADJS/SB/FEAT STR] STRUCTURE ARR] AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [000] DATA- [ ] XMT [?] 5 f R153 033 . P E R M I T [PMT] ACTION [R] CARD [000] KEY 88274 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR oCMP NEW/DEMO COMMENT [B34967] [04] [92] [AD] " 55001 [LK] [01] [93] [100] [NEW J [WB ADD'N ] [B35712] [03] [93] [AD] A 95001 [LK] [01] [94] [100] [NEW ] [WB GARAGE ] . . . . . . t _ .,.,� -- . . , . .: - . ,: . - . 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