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0429 CHURCH STREET
��� ���� a 4 i1 1 I `oi�.tcii �3`y, a sZ u i I n co z �O cn �� N �M T r ^ Q 6 N { I� 7 Town of Barnstable *Permit#26 6 /� A4mY p���4d ����'� Expire'Smonths•fromirsuedate �R Regulatory Services Fee ems?_ MAR 3 0 2009 Thomas F.Geiler,Director Building.Division w TOWN OF BARNSTABLE Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.t o wn.b arns table.m a.us Office: 508-862-403 8 Fax: 508-790-623 0 EXPRESS PER 41T APPLICATION - RESIDENTTAT,ONLY ! (}� Not Valid without lied X-Press Imprint Map/parcel Number Property Address rr ,-1 [`Residential Value of Work _/ r t 9 60• y0 Minimum fee of$25.00 for work under$6000.00 + Owner's Name&Address L[,"-(Itnu--rch �Lt ba-r�--4bi Contractor's Name �j� . Telephone Number Home Improvement Contractor License#(if applicable)_ Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Che one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Reque t(check box) 7Re-ro.of(stripping old shingles) All construction debris will be taken to_ ❑Re-roof(not stripping, Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property er t si rope ty Owner Letter of Permission. op f the ome rove t Contractors License is required. SIGNATURE Q:Forms:expmtrg Revisc061306 Massachusetts- Department of Public Safety Board of Buildim.g Regrulations and Standards Construction Supervisor Specialty License License: CS SL 99138 Restricted.to: .RF WS JAMES CURLEY 287 FULLER'ROAD. CENTERVILLE, MA 02632 I I Expiration: 1/28/2012 i Commissioner Tr#: 99138 �/ze:-faomvnu�uoea� o�✓�aaoczc�xueet7a Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Regist_rat166'=124310 Board of Building Regulations and Standards .Expira_tion _6%'I/2009 Tr# 130873 One Ashburton Place Rm 1301 Jype Individual Boston,Ma.02108 I_^_ James Curley -_ -= James Curley =_'= 287 Fuller Rd. Centerville,MA 02632 Administrator Not valid without re NNW f I . The Commonwealth ofMassachusetts Department oflndustrialAecidents Office of Investigations - 600 Washington Street Boston,MA 02111 www.m ass..gov/dia Workers"Compensation Tn'surance Affidavit: Builders/Contractors/Electricians/PIumbers Applicant Information Please Print Le 'bI Name(Business/Organization/Individual):• •Address: Q y( City/State/Zip: (�-ffl 6, Mi9- ()4(-0 n Phone.#: Are you an employer? Check the appropriate box: 4 I am a Type of project(required): 1.❑ I am a employer with ❑ general contractor and I Eaployees (full and/orpart.time).* have hired the sub-contractors 6• ❑New construction . 2.[� I am a sole proprietor or partner- listed on the•attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition worldng for me in any capacity. employees and have workers' [No workers'comp,insuiancc comp,insurance.#' 9. ❑Building addition required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions '3.❑ I am a homeowner doing all work officers have exercised their 11.VElumbing repairs or additionsmyself [No workers' comp. right of exemption per MGL 12. 00f repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' .13.❑ Other comp,insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing theirworkers'compensation policy information. t Homeowners who submit this affidavit indicating they arc doing all work and then him outside contractors must submit anew affidavit indicating such. 1Contractors 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. H the sub-contractors Izve employees,they must providt their workers'comp.policy number. Yam an employer that is provlding workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#/or Sclf--ins.Lic.M 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 6. 152 can lead to the imposition of c4minal penalties of a fine tip 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 S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the bIA for insurance coVera a verification. 16 her fy->�er th pal sand penalties ofperjur}i that the information provided ove 1 true and correc4 Signature: ?, 30 09 . ��O Date: — Phonc #: FOther only. Do not write in this area,Yb be completed by city or town official n: Permit/License# hority(circle one): Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.PlumbingInspector son: Phone#: ' OF 1HE Town of Barnstable. .� Regulatory Services �►x�sre�zE, y YASS. Thomas F. Geiler,Director .19, Building]Division Tom Perry, Building Commissioner 200 Main Street; Hyannis,MA 02601 wtt'w.town.barnstable.ma.us Office: 508-862-4038 Fax: 50B--790-6230 Property Owner Must Complete and Sign This Section If Using A Builder f r, J ass �I�GS • ' . . . as Owner of the subject property herebyauthorize to act on my behalf, in all matters relative to work authorized by this building permit application for: 4d 1 &40h � J�(�tJ Ylsi II�iCJ� (Address of Job) 4slitore o er 3 09 Date Print Name QFORMi S:OWNE"ERM]SS 1oN Town of Barnstable *Permit# �5� ����� Expires 6 montlrs from issue date Regulatory Services Fee d + 8TAMS, MASS, 1 4 2006 Tbomas F.Geiler,Director 1639. Building Division , TOWN OF BARNSTABLE Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02 601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERNHT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 1—7(o / 0 d y Property Address 42-9 C.hu rc-h v+-r-eC.f WeS+ BO,r-n S�-a b Le ,M A- (residential Value of Work �C)OD, 6U Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Jd M�'S F • 1 I I l cS 42-9 C hu rc A 6-f-r-ee 4- tBa.rnsf ab/5, �- Contractor's Name R !' Telephone Number -7 7 4 $3 b 2-Y Home Improvement Contractor License#(if applicable) 1 42 Z --) Construction Supervisor's License#(if applicable) !25d`0 Q 9 ® ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner [1�I have Worker's Compensation Insurance Insurance Company Name Ct7 Workman's Comp.Policy# 409 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side qqtt�� �teplacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note:L Pro erty Owner m t sign Property Owner Letter of Permission. H e pr v e t C ctors License is required. SIGNATURE: Q:Fonns:expmtrg fuuu Revise071405 08-08-06 10:04am From-SOUTHEASTERN INSURANCE AGENCY 508-7900557 T-996 P.01/01 F-834 '- YM ��v �• as •off • ■ r va �u %rGft_• r 1 1 VG/VA/ZVU6 PRODUCER (508)997-6061 FAX (508)991-3283 THIS CERTIFICATE 18 ISSUED AS A MA rTER OF INFORMATION Southeastern Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPOI I THE CERTIFICATE 66Z State Rd. HOLDER.THIS CERTIFICATE DOES NO AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED 81 THE.POLICIES BELOW. P.O. Boa. 79399 1 N. Dartmouth, MA 02747 INSURERS AFFORDING COVERAGE NAIC 8 mauRuc Roycro t & Kuehne Builders Inc INSURERA. Arbella Protection Insurance 6S Eben Smith Road INsuRERB. Merchants Ins Group Ceatervi l l e, MA 02632 INSURER C: Granite State Ins INSURER O: INSURER E: COVERA THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I qDICATED.NOTWITHSTANDING ANY REQU.REMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIF CATE MAY BE ISSUED OR MAY PERT.QN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIO S AND CONDITIONS OF SUCH POLICIES..LGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR D' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY BXPI T10N LIMITS GSWAAL LIABILITY 9500022738 07/03/2006 07/03/2007 EACHGCCuRR CE 4 2.000 000 X( COMMERCIAL GENERAL LIABILITY DAMAGE TO RE TED = SO OOO CLAIMS MADE a OCCUR MEO EXP(Any 0 Pareerl) ! 5 OOO A PERSONAL&AD INJURY f 11000.000 GENERAL AGGR GATE f 2.000.000 GEIrL AGGREGATE LIMIT APPLIES PER PRODUCTS-CO P/OP AGO 4 1,000,000 POLICY71 JEC LOC AU'.OMOBILB LIABILITY COMBINED SING,E LIMIT I ANY AUTO (ESeccidem) f 1,000,00 X ALL OWNED AUTOS 7AM027701409S 10/18/200S 10/18/2006 BODILY INJURY SCHEDULED AUTOS (Per Perron) f B HIRED AUTOS BODILY INJURY NON•OWNEDAUTOS (parar6dwl) f PROPERTY DAMAGE 4 (Per accMnl) incl. OAIWOE LIABILITY AUTO ONLY-EA 1CCIDENT 4 ANY AUTO OTHER TH EA ACC 3 AN AUTO ONLY. A00 f EX(ES&UMIORELLA LIABILITY EACH OCCURRE ICE $ OCCUR CLAIMS MADE AGGREGATE $ f DEDUCTIBLE S RETENTION 4 f WORKERL COMPENSATION AND X I WC STATLL TM- EMPLOYEAT LIABILITY C AW PR01 RIETORIPARTNERIEXECUTIVE E.L.EACH ACCIO NT $ 100,000 OFFICERAAEMBER EXCLUDED? WC4W392269 03/01/2006 09/01/2007 E.L.DISEASE-FJ EMPLOYEE 4 100.000 If yea,deer The under SPECIAL IROVISIONSmiow El DISEASE- LICYLIMIT f $00,00 OTHER DESCRIPTION 01:OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS For any atld all operations performed during the policy period. CERTIFICATC HOLDER CANCr=LLATION 5HOULD ANY OF THE ABOVE DESCRIBED POLICIES B CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER LL ENDEAVOR TO AWL 10 DAYS WRITTEN NOTICETOTI/E CERTIFICATE HOLDER NAMED TOTHELEFT, Town of Barnstable Atta• Bldg Dept OUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE O OBLIGATION OR LIABILITY Mal n•St OF ANY KIND UPON THE INSURER.ITS AGENTS OR RE PRESENTATivES. Hyannis, MA 02601 AUTHORIZED REPRESCNTATIVE Joan Martin ACORD 25(2001108) 0A CORD CORPORATION 1988 Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Tom Perry,CBO 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 I, Jb mp's 11 , E l I i S ,as Owner of the subject property hereby authorize (S o n J Rove Kr�-f-- to act on my behalf, in all matters relative to work authorized by this building permit application for: 4.2A Church VV68 - BCJr0SFCAD1 C (Address of Job) T�Iature of Owner Date y Print Name Q:Forms:expmtrg Revise071405 I 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 individual,partnership,association, corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §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-contractor(s)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 permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for 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 burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 i Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-OS Fax# 617-727-7749 www.mass.gov/dia �s�;�r� — 13� 1�� g J�BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 083280 Birthdate: 11/29/1964 Expires: 11/29/2006 Tr.no: 83280 Restricted: 00 SEAN J ROYCROFT 65 EBEN SMITH RDA' CENTERVILLE, MA 02632 Administrator ✓1a SI-1 e �anvneo�uuea�l/r, o�'✓llizuaclaaelt Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 141225 up, Expi ration: 1/22/2008 Type: Private Corporation ROYCROFT&KUEHNE BUILDERS,INC. Sean Roycroft -- / 65 Eben Smith Roc Centerville,MA 02632 Administrator The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations kvi 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Sean T Poyc dr- f' Address:65 E ber) GSM Hfi P-C)CLGk- City/State/Zip: C2��YV i 0e, P6 UZ(o 3 Z- Phone #: -7-14-e3(,-(o(o Z� Are you an employer? Check the appropriate box: Type of project(required): 1. am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet. $ ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its officers have exercised their 10.❑ Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL I LEJ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs insurance required.] t employees. [No workers' 13.M Other rN "ei- 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. xContractors 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 information. Insurance Company Name: G rctn j-fe. cS fade �h6Urr c� LOvn��iz.c,f Policy#or Self-ins.Lic.#: Q W N c -a 629. Expiration Date: - 2 Qj p Job Site Address: YZ9 Church S+roe__-� City/State/Zip:WC5+- 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 ce �under the pains an penalties of perjury that the information provided above is true and correct Signature:z Date:AV U Phone#: -7-74--8'3�2- G(2 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 5.Plumbing Inspector 6. Other Contact Person: Phone#: I r Fcpplica?,;on to 01b Ring'. Agigbbiap Regionat historic Mi;trirt Committee ` In the Town of Barnstable CERTIFICATE OF APPROPRIATENESS Application is hereby made, with four 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 CATEGORIES THAT APPLY: 1. Exterior building construction: New ElAddition Alteration ' Indicate type of build: 2JHouse ❑ Garage ❑ Commercial ❑ Other oD 2. Exterior Painting: X �z 3. Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign � j 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other -i TYPE OR PRINT LEGIBLY: o �r— DATE 6 ' �•5 - ..� m ADDRESS OF PROPOSED WORK 4Z9 ASSESSOR'S MAP NO. �� 76 OWNER JAMS s H. �` i?yTH G L' l��s ASSESSOR'S LOT NO. G 0-4 HOME ADDRESS yZ9 CAI ZIR C14 S W f34,?,U. OZGLBTELEPHONENO. 36Z- 3/0 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any public street or way. (Attach additional sheet if necessary.) t��i5 �{i7 C'Hv��cH 5% wr S T 13A2�157A73L0 TNO�'/ffs �F/2�sri.vc Jrftlel"VS' 3 o 5-,vAc✓ LN• �, F247D f N,4(v c Y O '?EG A nl .41 r o CH VA--CH 57-. SusHy >;` JHMt 5 JENir/NS' ZZ7 P/N,i AGENT OR CONTRACTOR � ���! `'Ut'`'''�� TELEPHONE NO. 2?y Q,36. 66e4 ADDRESS DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please include locations of proposed signs. 14, 70 � ,,� �"� itcelB,Qa-c a OO�Gr��i s+ so•«`2o-scs_ a.� ,Q,�`�'t,», �s rra/ c,.ct,L cvt 2 Lu ! 400 4a444041 D'��(/ L _ _ us:: -o:�/^✓-i�. �5 /// ,, •Q,4;,e��t�sj•J.�sow��G��c �/� p QVJ�'f pay. �� ��+•,J L�KC �'"'�"�,�� W�-� L�R,�/'G�C� W cc�� ✓^'�� • Signed 14 �c.,• Owner-Contractor-Agent For Committee Use Only This Certificate is hereby /Denied Date �6 �r � v�/� � APProv D � � � JUN 16 2006 Co Members' Signatures: i TOWN OF BARNSTABLE00 HISTORIC PRESERVATION �Y i Town of Barnstable Old King's Highway Historic District Committee SPEC SHEET FOUNDATION / � T COLOR D 'ZnotlZt i7o'' �c�ca++cy SIDING TYPE r CHIMNEY TYPE COLOR ROOF MATERIAL COLOR PITCH WINDOWS GLa 14"we-O COLOR SIZE 6 °? TRIM COLOR DOORS COLORS SHUTTERS COLORS GUTTERS COLORS DECKS MATERIALS GARAGE DOORS COLORS SKYLIGHTS SIZE COLORS COLORS JUN .1 6 2006 SIGNS ONOESNSTABLEHSOI PRERVATION FENCE COLOR NOTES: Fill out completely, including measurements and materials/colors to be used. Foue c'o of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plans, when applicable. SPECSHT Revised 11/98 1B aura 169 1B traditional yellow 170 2B sweet butter 171 2B sunny days 172 i* i 1 3B A happily ever after 173 3B A sunflower fields 174 r B 3B A myan gold 175 BENJAMIN MOORE® 027 1330 E R=1090.35' L=128.08' - -� •�` 2.9.69' BOUND SnNG 011N[ 0 W i 4 I STAKE $ MAIL FOUND SF ' JAWS H. & RUTH E. ELLIS CONBOUNDV 429 CHURCH STREET FOUND W WEST BARNSTABLE PARCEL 176-004 , / � � � � � � eta E �� II D QP II'T.r g t006 �95 do JUN :IIN ,e TOWN OF gARNSTA BLE HISTORIC PRESERVATION . �` S � r I he Commonweafth of Allassachusetts Barnstable .............. ss. .................................................. To ..................Tho.m a.s..Pe rxy.,...ox...the:................... Keeper of Records ............................................................................................................................................................................. Building Commissioner ' s Office ..............................................................................................................................................................:.............. 200 Main St. ; Hyannis, MA 02601 ........ .......... .......................................................................................;................................................. greetings. Youare hereby commanded, in the name of The Commonwealth of Massachusetts, to appear before the ............FiT.5-t..D.i,9.tr.i.ct.......................... Court ..C.ou.r tho u.s.e., Ka i n St........R-te-----6A-- holden at ... .................... within thin and for the C01,1171))Of.......Bax-nstable.................................. onthe ...........2-Is-t..................:........................................... day of ......Ma.rc-h.........:................................. at ..9.:.3.Q.............. o'clock in the ....A-M..............................XXOM, andfi-oni day to day thereafter, until the action hereinafter named is heard by said Court, to give evidence of what you know relating to an action on of..............t.o r.t.................. then and there to be heard and tried between ........................................................ .......... ..................Ja-me-s-A-.--je.nk-i-ns................................................................................. Plaintiff and James H....E.1.1.i.s.................................................................................. Defendant and ............................................... you are further required to bring with you ........................................................................................................... .................Apy..a.nd...a.1 I...document8...r.elatIng...to...propext.y..cLf..J.ames...H...--F,1-14-s.......... at 227 Pine Street , Assessors ' Map 176 Parcel 004. .............................................................................................I............................................................................... ............................................................................................................................................................................. ...............................................................................................................I............................................................. ............................................................................................................................................................................. ............................................................................................................................................................................. ........................................................................................................................................................................... Hereof fail not, as you will answer your default Under the pains and penalties in the low in that behalf mode and provided. Dated at ..........Bar.ns.tablie................................... the ............I..I.th.......... day of..................March....... 22005..... Per Furbw llwftwwvfficu,use contaft Charles M.Sabatt,Esquire .. .. ........ 25 Mld-Tech Drive .................i. -RR()�.............. West Yarmouth,VA 02673 Notary public Notary Public-iti9tiee ePthc4lee-Ge (508 Commonwealth of Mal )775-3433 Massachusetts FORM 22 LAWYERS STATIONERVC0., INC- '-t'OSTON,MA My Commission Expires TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 06 Parcel dog Permit# 6 l Health Division C 3/' � Date Issued Conservation Division 4 3S �/7�0� /VO (�£�T/on/ e-dlr /N Application Feet �. 'O� r !ool of /7,f Tax Collector �tDD o� — U k — IyL -- I I a 0 Permit Fee � /D 1' o e77 Treasurer t2 02— Planning Dept. 1 Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address ` 1 q CM4Q_ ' S F. Village W. QAA&S/W lJL Owner 04-c*- S • 0'4^65 &.LI S Address Y29 CtA046H Sj w• Q4A�41S/V1 L�E- Telephone Sb� 3(07- ' 3IY7 aL bb Permit Request fe_& yVF_ Ex(STNG A4A a-r-K e—>40/TaAI oNSbNA7yr-,&4S z aNS 1 W CT_ Nv" StffiJ A00A4 M,01- t W' ¢ &F Gd S P62 PL4NS ; 1NSTArt-L- 1 1AO PujAA 6AG w A1J1 tlrJ CD Square feet: 1st f o : existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay fi ,Project Valuation (3 o 0-d - Construction Type tN(XW FAAAAFL Lot Size 30 SF Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family C9 Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: k ull El Crawl ❑Walkout 010ther A OOI Tl W TO PPWf. f 164, 51114AO/L FS E,<tStVJ6 Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing I f''� new Half: existing new i Number of Bedrooms: existing 3 new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas 9 Oil ❑ Electric ❑Other Central Air: ❑Yes M No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use YOGU 4:40AI W 9UI%.l-%,V6 Proposed Use JUG C+"AJ6 A A.1 9E K 1/N)6STON) BUILDER INFORMATION Name WEyi 9 46J ST46L4, 6V IIAAS Telephone Number SD a - 3 61 • -7 b `f 7 Address �•rJ • BOX S f (o License# y 13 21 Z 1 t 1 b K7L Le Home Improvement Contractor# 12.4 tl 7 w- 644/J �w Lt , ASS Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO oN - r TIC 0WsTSR SIGNATURE DATE I/- 7- Q'� i rr FOR OFFICIAL USE ONLY P RMIT NO. DATE ISSUED ` r MAP/PARCEL NO. • a ADDRESS VILLAGE OWN[tR ' DATE OF INSPECTION: FOUNDATION L /c0 FRAME �—�n.C. n�,•,.c l C90✓�e INSULATION —p p . FIREPLACE _ t ELECTRICAL:', ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ' ROUGH FINAL FINAL BUILDING O - -03 DATECLOSED OUT ASSOCIATION PLAN NO. o o� CHURCH STREET � P D 29.83 R a to90.35 L = $27.61 PAULSS9°yN R. � RYLL o No.32448 6 P SU DAL.. Z 35, v 104 tL TO Cl- 0 102# 'OF BANK c� TOP El � Z i JMV14 S.F. by 3 9 • �• 0FMAB =y' PAULyG R. N ME EXISTIAIS STRUCTURES MERE LOCATED BY AN RYLco L INSTRUMENT SURVEY ON 10/9/02 AND EXIST ON No.32a4s P" THE 690MV AS SMIMV. S%UU� � 0•LL-O'2 DA TE A SM? 0R PLOT PLAN SHMING PROPOSED ADDITION 429 CHURCH STREET, BARNSTABLE, AM SCALE 1 ' = 40 - OC,rMER 2,Z 2002 CANAL LANDF SURYEYING 306 OLD PL MOUTH ROAD, SAGAXORE BEACH W f CHURCH STREET p,4avt— do 4 \.kOF MIASS PAUL 9°y D 2 .83 R a f 090.35 L = 127. 61 R. RYLL t� `o No.32448 .v-t- a 4a azr ..- _ 104¢ ° TO CL - -- ® 102# ,OldBTO A y !� cy TOP ' � SfED lW cl &VVYf S.F. by 3 f� �, �• \\kOFM, PAULs� R. N 7W EXISUNS STRIXMES WERE LOCATED MY AN o No YLL48 INSTRUMENT SURYEY ON 1019/02 AND EXIST ON P� THE 67OW AS ShUMV. su�v dr VA TE A WES ONA L L A SIR VE YON PLOT PLAN SHOWING PROPOSED' ADDITION 429 CHURCH STREET, BARNSTABLE, AIA SCALE 1 = 40 ° OCTOBER 22 2002 CANAL LANDF SURVEYING 306 OLD PL MOUTH ROAD SAGMORE ®EACH, HA RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50,00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE 11-7 square feet x$64/sq.foot=, U Cl� x .0031= Y ` plus from below(if applicable) ACCESSORY STRUCTURE>120'sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00, >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: i square feet x$96/sq.foot= x .0031= STAND ALONE PERMITS Open Porch x$30.00= (number) 'L x$30.00= 60,o0 Deck (number) Fireplace/Chimney ' x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee 10 . projcost 1 Y , The Commonwealth of Massachusetts -_ Department of Industrial Accidents _-_- - Office Off17YOSI 98tfnns• - 600 Washington Street Boston, Mass, 021XI 11 ro 3 / Workers' Com ensation Insurance Affida ovation• hone# --• - ci all work arysel£ � � ... 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'..::.:,.r::;:.?t••rh .:a� n.,.....r.,/ r l ?• !. .r.. ••:• ,rr,.,a•:,F,�• I. •rn, .. .{• ,•:. :r +5..4!}•:•.;••:;f:..r::•:4}:[ ,..}Y.}.•. ,. ...;'l:i`:'y :#:<•..�f.`: :3i!; E.i�irs: ,r4+.?:•oy?v:t.:<t�:•<..,,:t5'r.:�:?{d,�t,:•.r45`y}fu.:?::{:�3•. i^v}Sfi?4;:'t :.a r•ta:Y:rr:•:}:•».,.....::..}{{.ir,,:•xi{.f.t.y�.!y;.Y,; r.S.bi fii :�II�Jt1T�BI!ememl C `enaltie3 Or a t�E4p t0 51��4DD in OrRD FyauretouiredgnderSeetionlSAbfMGL152cari]eadtntheimpositionoicrlrrdrsalp _ �sniunent as weIl�s dvil penalties in the forms or a ti i0isT the eoverageand.a� catiane of UO a dap againttma I�derstsmdthat a' one ye, p !nt ;be forwarded to the Office of IILvestig •• ,, copy of this Staten - .. t3c�the-in ormatian pr-ovidednbnxe-issr �correct - f 1 51 en perjury f f _ /� I do hereby c �. .� �/ '�O�i ✓v��. Date rw f�• one# priht name do not write in this area to be completed by dty or town oMdal oMCW use only .' OBudaing Department 13eanit%license# ❑Licensing Board city or town. OfSe_ eontsd person: .Information and Instructions vlassachusetts General Laws chapter�152 section 25 requires all employers oprovide nthe serviceers compensation of another under ahoy chontract ! ees.._As quoted freir om tl�e,law , an employee is;defimed as every p „ )f hire,'eRpress or imp a oril or , An em layer is defined as an individual, liartnership, association, corporation or other legal entity, or any two or more of p - the foregoing �gagdd in a point eaterprise,-and including the Legal representatives of a deceased employer, or the receiver or trustee of an individual,pa�er�p, association or other legal entity, employing employees. However the owner,of a .. dwelling house having not more thanthree apartments and who Tesides therein;•or the occupant of the dwelling house of another who employs persons to do maintenance,construction o b d to be aak on such 1 dwelling house or on the grounds or 'building appurtenant thereto'shall riat because of suchemployment employer. GL chapter 152 section 25 also states that every state or local licensing-agency cysh n forold tan he,a u licant who has M y PP of a•license or permit.to operate business or construct buildings to the'commonwealth „ . , not rodubr the' cea acceptable evidence'of eompliancewithtlie insuracecoveaacgTtquireod. Additionally,nnan ublicworkuutr7 P of its olitical-subdivisions shall eater into y P commonwealth'nor any P. acceptable evidence°f e�pliance with the insurance requirements of this chapter have been presented to the contracting authoAty ... •. '. .. .. .. ,l .• .' .r .. J• • T r•' • •. ME t Applicants \ . Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all maybe artment.of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and submitted to the Dep `^ date the affidavit. The•affidavit should• e,returned to the city or town that the application for the permit or license is Accidents. Should you have any questions regarding the'last"oilif yQ being requested,not the Department of Industrial at the number listed belo obtain a workers' compensatialz policy,Please calttlie Dep w�' NO city or Towns .. . ,- �, the affidavit is complete and printed legibly, The Department has provided a space at the bottom of`ths Please be sure that the applicant. Please. affidavit for you to fill out inthe event the Office of Investigations has to contact you regarding pp ,.. vits �• ...-�-•T �—.. num' �TS'ie•affida raay�ie'r - fill iri C.-Pe zmzcense riu�nb er which wilLb e ns _ " be sure.tothei.arrang 'eats have' been the Dep ed,, of FAX e'ss o �. ..,,,,•• artm ,r• y....-.• ,,: �• .`. . , � •, .3 estions, ations would like to thank you in advance for you cooperation and should you'have anygu The Of of JnTestig. , ,.s. _, . .. all. please-do not hesitate to give us a c FIN The Department's address,telephone and fax number. v_,,... .. The•Commonwealth Of Massachusetts •Department of Industrial Accidents Oiflce at 1nYesttgatlons • 600 Washington Street Boston,Ma, 02111 , far 4: (617) 727-7749 11/08/2002 10:41 508-3852818 ALL CAPE INSULATION PAGE 02 Brewster Town Hall 50988.5800E p. l ENERGY CONSE kTION APPLICATION FORM FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION and ADDITIONS 780 CMR Appendix J (effective 3/1198) Applicant Name: 5i''D4rnr e,8/wj I Site Address. Oo- Applicant Address: _f 17� 6,21...._ City/Town: Ia��ar�sLt 4A—,, Use Group, _ Date of Application: Applicant Phone: a?)3fos2� Applicant Signature: Compliance Path(check one): [) Prescriptive Package(Limited to 1-or 2-family wood frame buildings bested with fossil fuels only) Package(A through KK from Table JS.2.1b):_ Heating Degree Days QiDD,u)from Table J5.2,le (For items d.through i., fill in all values that apply from Table J5.2,lb:) a. Gross Wall Area sq.ft f. Wall R-value R b. Glazing Area' sq.fL S. Floor R-value g- o. Glazing%(100 x b+a)�__ % h. Basement wall R- d. Glazing U-value U- '. i. Slab Perimeter R- o. Ceiling R-value p^ J. Heating AFUE [] Component Perfortnaucet"Manual Tra.de-Off"(Limped to wood or metal framed buildings only) Climate Zone(from Figure J6.2.2) [] Zone 12 [J zone 13 Zone 14 Attach Trade-Off Worksheet from Appendix J„(end HYAC Trade.OffWorksheet, if applicable) © "check Software Attach Compllance Report and Inspection Chacklfst printouts, Systems Analysis OR 0 Renewable Energy Sources Attach Mass Registered Architect or Engineer Analysis ALTERNATIVE FOR ADDITIONS ONLY, a.Gross Wall+Ceiling Area iggi ,sq.ft. b,Glazing Area' )qp sq.ft. c.0laaing%(l00 x b.a) PV V. (�7 ADDITION with Glazing%(c.)up to 40% may use 780 CMR Table J 1.1.2.3,l below: MAXIMUM•U•value MINIMUM slues snestrstioe Ceilin Wall noon I mement Wall tab Perimeter,depth 0.39 R-37 -13 R-19 I R40 I R-10,4 h 0 "SUNROOM"addition(greater than 0% glaxiag-to-wall and telling gross area) Attach"Consumer Intbrmatlon Form"from 780 CMR Appendix B. Official's Name: Official's Signature: Application Approved [a Denied Q Date of Approval/Denial: Reason(s)for Denial: (provide additional details as needed on back side) Qlazing Area may be either Rough Opening or Unit dimensions, eaRs 06/12/98 r' ti FZME F, Town of Barnstable Regulatory Services sARxszns . ' Thomas F.Geiler,Director 1639. `°� g Buildin Division TED Ma's a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal, demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. ' f Type of Work: SWAG-w NOt Ti NQ t Df-Gj�%S Estimated Cost 0 QU Address of Work: 1 L l. CQ�l� S 1 gs 1 'YDLl- �2(p(o Yj Owner's Name: M Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permi a agent the owner: KVV6Sj MO 7 Date Contractor Name Registration No. OR Date Owner's Name Q:forms:homeaffiday. L r Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration`; 120878 Ezpiatton 3113104 Type.Private Corporation i WEST BARNSTABCE BUILDERS'I WfCHAEL KINGSTON'_ WEST BARNSTABLE,MA 02668 Administrator 72. ¢ BOARD OF BUILDING REGULATIONS: :y License CONSTRUCTION SUPERVISOR Number.=CS 023212 Biffl date'04/12(1949 {Ex fries ` PO4/12/2004 Tr.no: 20267 I x I Restnctetl 3100-_ MICHAEL L KINGSTON 9 GREAT HILL RD � o I ! SANDWICH, MA'02563 Itt ? i Administrator i ' 4 Assessor's ,map,and .lot (number ........................... N. ....... .. :'ter Sewage Permit number ..:.............................�. .�..... ' +. w o w �F THE TOWN- -Of BARNSTABLE Z BAWSTABLE,6 to i y t' I •G1 ; Jw MA8 . °0 1639• `•� �B1KDING' INSPECTOR, - �/' •''i `fit' it 1 J _ APPLICATION FOR ERMI,T TO. CbT1S CT ?!1 12�x$t U}TE FtOf-iQ li�IJITit7id TO F�ISTT.TC 1)i•TELLTi G. • �• TYPE OF 'CONSTRUCTION t1UUD • ............ .�..................:.......; .......................:.. • ......:........ ♦ -........u......`.........}................-........Se (ember 26............f;................ { ..................................................19..75. ,TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to' the following information: Location Church atreet. ,(West Barnstab?e ....................................................................................................................................................................................... Proposed Use Residence............................................... Zoning District Residence F .....................Fire District .West Barnstable , Name of Owner James H. Ellis ...............Address Church Bt. , West Barnstable Name of Builder ,Edward.F. Johnson Address ..................................................ln . , West Barnstable .................. .................................. Name of Architect None Address ............. ..................... . ..........................:......................................................... Number of Rooms Or1.................................................Foundation ' Cement block ................ .............................................................................. Exterior Wh2t6 cedar shi.n.4es Asn}lalt sh;1)vlaa ............................................................Roofing .................................................................................... Floors fine Interior . ... rn.... ...........................i ..................................................... .................................. Wood stOYq 14nnn Heating ............................................................Plumbing ...............................................:.................................. Fireplace None .......•••••••••_••••••,,,,,,,Approximate Cost ++1, UU ....................................... / Definitive Plan Approved by Planning Board ------------------------------ Area . f Diagram of Lot and Building -with Dimensions Fee ^�'� ........................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 0 / v N v� V i x p O CO 0 f ' y ^Q 38 R � � _ _ r Nil A. at ti • Tr_ v9S" % I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... ..... ............... ........... V Ellis, James H. A=176-4 No ...1.79.5.8.... Permit for ....add...t.o..sYAIe.... family dwelling. . ........... ................................................. -4Z Location ...—q.chur.c.h Stre t . ............................. ........................... ............................ West Barnsta le .................................................... ........................... James H. E is .......... ............................... Owner ......................... h B a H r �r,e t t')na..-.s.... E_ i ..... ... Type of Construction ........ ....frame..................... .......... ......................................... ........... ...................................... Plot ............... Lot .............. Lot ................................ Septemb er 26 75 Permit 'Granted ......I....................:,***".......19 Date.of Inspection .................19 ............... ...... .......Date Completed ....... 19 .,PERMIT REFUSED ................................................ ............... 19 ....................... :........................................... ................................. ........................... ....... ........... ............................................................................... ................................................... ..................... Approye/ ............................. ..... 19 ............................................................................... ................ ........................................................... Assessor's map and, lot number .........176; !.. y. 14 oy .. Se,ageiP?ermit number .......................... ...... .........,.... .... .. T"ET° TOWN OF BARNSTABLE i BAHHSTADLE, i �D-M D:UF DING INSPECTOR G� i6�9 f.; (J -1 C. CONSTRUCT A 121x8l ONE ROOM ADDITION TO EXISTING DWELLING u APPLICATION FOR) PERMIT TO . TYPE OF CONSTRUCTION ...........WOOD �1 September 26, .............................................19..7 5.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Church Street West Barnstable ........................ .... .... ................................................................................................................. Proposed Use Residence Zoning District Residence F Fire District West Barnstable Name of Owner James H. Ellis ,..Address Church St. West Barnstable ............................... ...................... ........................................................ Name of Builder ,Edward F. Johnson ..............Address ....Plum St.,..West Barnstable ............................. ................................. Name of Architect ............None ................Address ...................................... .................................................................................... Number of Rooms One...............................................Foundation Cement block ................ .............................................................................. Exterior Whi.te. ..cedar. ...shingles..........., Roofing Asphalt:.,shingles...................................... ...... . .. .... ...... .... Floors Pine Sheet o , , ......................................................................................Interior .........................T'..��................................................... HeatingWood stove ........Plumbing .........None................................................................ .................................................... Fireplace .....................Non.....................................................Approximate Cost ... l�500................................... . ............. 1 ...,5�. Definitive Plan Approved by Planning Board -----------_______-----------19________. A Area ........... Diagram of Lot and Building with Dimensions (� Fee ....... .. 5 SUBJECT TO APPROVAL OF BOARD OF HEALTH Q � � N oXl N o v C CO N C er, t I N w ` to 7 vas 0 I� w Z Lf I ' 4z' I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ��D Name .... ............�.....�r�`."-............................... - . ' ' ' ' ' - ` ' ^ . ^ ` ' . . . ' ` . . ' ` ' . / ` ' � . . . . ' ^ , ^ " - Ellis, James H. 17958 add to single family dwelling Church Street West Barnstable James H. Ellis September �6 Date Cam' PERMIT REFUSED ^�—._—_—_.------...--_---.. lA -------------.------------. ' . . —.------..------.--~-------.— ' . ^ ' —.~------^-----------------. " . ` --------------------..--.—_ ' ` , ................................................ lA ^ . -------------------------^ ~ .................. ........................................................... | i �N � Application to n � 01b �j f�' `i � p -Regional �iotoric 33ivtrict CAYC mitteE 202 NT 27 AM 9. 6the Town of Barnstable CERTIFICATE OF APPROPRIATENESS t ,pplication is hereby made, with four complete sets, for the issuance of a Certificate of Appropriateness under,Section of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and oA plans, 'rawings, or photographs accompanying this application for: ;HECK CATEGORIES THAT APPLY: =` `_. S- ;. Exterior building construction: ❑ New I Addition El Alteration Indicate type of buildin : ❑ House ❑ Garage ❑ Commercial ❑ Other ?. Exterior Painting: 3. Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign t. Structure: ❑ Fence ❑ Wall El Flagpole ❑.Other TYPE OR PRINT LEGIBLY: DATE ADDRESS OF PROPOSED WORK C4WILC," Sf w-&Q- ' tkASSESSOR'S MAP NO, 17 OWNER t MRS. �ES �t.�-� S ASSESSOR'S LOT NO. 00 HOME ADDRESS `{Z9 C"&5A SF w• -6'�`��' � t-A• ��6 ELEPHONE NO. ��o�L� 9Y7 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any -;public street or way. (Attach additional sheet if necessary.) AGENT OR CONTRACTOR M 1y'e K►N6Silonl TELEPHONE NO. TW 74Y ADDRESS To WEST AA4J5%1VA1'E- By�t.G62S'. P.O.BoX DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please include locations of proposed signs. Signed Owner-Contractor-Agent For Committee Use Only This Certificate is hereby-A NanP-ft I Date Approved/Denied Committee Members' Signature . i Town of Barnstable Old King's Highway Historic District Committee SPEC SHEET FOUNDATION ODW Wot-c- c �� S . M+?V-f 15fu 51-1,4 6 SIDING TYPE W-C • A(-( LE s COLOR CHIMNEY TYPE ryiA COLOR At 4jUf j!�;ot if 17/4t Q ROOF MATERIAL 1 ��/to � OLOR PITCH WINDOWS S COLOR W 41—17� SIZE 1 0L4A/ TRIM COLOR DOORS S��✓6 r%Vryty COLORS W SHUTTERS /v COLORS A44-- GUTTERS w�frTK rr'"'/ �A)JM COLORS L/)f7 J — DECKS P'61 A4 MA:TERIALS GARAGE DOORS dolor COLORS SKYLIGHTS A)l SIZE COLORS SIGNS /" COLORS FENCE COLOR NOTES, Fill out completely, including measurements and materials/colors to be used. Four copies of this form are required for submittal of as application, along with Four copies of the plot plan, laudscape t' plan and elevation plans, when applicable. SPECSHT Revised 11198 istoric District Committee Fee Schedule 07/01/2000 Town of Barrrsleble's Old fling's Highway H ti r .r Certificate `- :Residential tificate of Appropriateness After work - ;;:Certificate of Exemp on Afterwork _ - Commences Commences A; ,c-- --- --- --- iDweilings •.. Dwellings _...__---- - __.__.._� _ ---- ----- -- �:Sheds,under'120 sq.& 20.00 _ 40.00 .,' Additions/Alterations �- _ - 60.OD 110.00_-334:Addition/Alterations 120 sq.ft. 50.00 25.00 100.00 50.00 ±• 60.00 110.00 _ *;Other Bldgs:over - House/Garage - 110.00 _� Exterior Painting 20.00 40,00 - 60.00 Sheds over 120 sq.ft. _ 60.00 - New Sign 20.00 40.00 r.>' 3 35.00 .�s .Hor Painting -._-_ ___.._-_-... ---- - 60.00 Existing Sign -20.00 40.00 ti sjs;Fencing --------- 35.00 20.00 40.00 --I 3s:6. 35.00 60.00 - ."Fencing -- C- .- Wall -- 20.00 40.00 C__ r `� 35.00 60.00 :Wall Flagpole -�� 20.00 40.DD +�ir� 35.00 60,00 i: Flagpole at,ak,Retaining Wall 20.00 40.00 ' 60.00 Repaint Sign _ W 11� Lamp Post 35.00 20.00 40.00 w 35.00 60.00 =�� Retaining Wall - i Unlit Marquee _-_.___._. ----- - 20.00 40.00 _ r.• 35.00-.. 60.00 ?Lamp Post fri �:T;�:Awnings _ - - '-- - ._ ..._._ - - - 20.00 40.01) �J Other to include Siding/Roofing 35,00 60.00 m.iUnlitMa uee •.rr w �}}7 `gi n FdS A;';- "-'w FC-"s.:����p+ ,-G; i:A` °:°x' :_5 :, Awnings -- - 20.00 40.00 > f u.j}' Fes ..,,� 9;Ati1•?ti •'E•�'"a-::':.i�. rR „-d�,'.} _ C 'j Other 20.00 40.00 (n r Certifcate of Appropriateness After work :n G) :•+'. r..c•GF,.•:y+5�:.. i,,fl, Y�+;rii' 3.-0 �� 5, r-c4y�-.•..- _ Commences Commercial 110.00 + �I • £,r _ `ram°Addition/Alterations 60.00 RBI Lp 110.00 210.00r;Certificate of Exemption }t;k New Bulldings/Educational 110.00 S r' 60.00 k >'Sheds over 120 sq.ft _ 35.00 60.OD __'; Commercial Aker work _ .:Exterior Painting --- '-••-- -'- - - Commences-._._-••- 35.00 60.00 ate `:New Sign - �- _ r'} _ 35.00 60.00 - - -- �, Existing Sign -...--- -- -' ter.--- ' 35.00 60.00 _ AddlGoril I erations 60.00 100.00 ; .'.:Fencing ----- - _ _-_-•-- - --'--'-- 60.00 New Bldg.under 120 s .ft. 50.00 100.00 yz Wall --------- 35.00 ---- - ''+ "Flagpole 35.00 60.00 9 Exterior Painting 25.00 50.00 - 60.00 New Sign 25.00 50.00 35.00 ut?.Repaint Sign- --- %� 25.00 50.00 _ 35.00 60.90 Existing Sign 40� Retaining Wall _ -••--- '' 25.00 50.00 60.00 Fencing VIp. Lamp Post --- ---- -- 35.00 •-------'- - -- 35.00 - 60.00 = Wall 25.00 50.OD y_->Unlit Marquee - 25.00 50.00 35.00 60.00 T Flagpole _ •:Awnings - -- 25.00 50.00 :Other-ta include Siding/Roofing 35.00 60.00 ?Repaint Sign y,���+��i••,- .c '• 25.00 50.00 -1 ir': i„...�I,,.,••--e> S ••"fLYirG fi �r .s�. rti- , �^ze Retaining a '•;e„✓ ::S�A?ra:£ r SST#cYi`�:a%p�aT a?:�i .< .^..'_rt4 ..+. 25.00 50.00 Lamp Post I:Certificate of Demolition Certificate of Demolition A-f Unlit Marquee 25.00 50.01) After fr?Awnings 25.00 50.00 -_ q'e* -- --hr �!:•: - Other Bld s.over 120 s ft- 100.00 200.00 Double the Application Fees F 9 q• -•- e.r4v';Residential&Commercial �Building 110.00 J Gg 110.00 -- -1, -Garage to ,M1 00 Accessory - -f4 `IpPartial Demolition 60.00 --- - i Please Note:Applicant will be charged the highest fee for multiple ° - projects under one certificate. i.e.Application for Additon/Alteration - I' and Lamp Post will be$60.00 total __--- -_ Filename Effective July 1 , 2000 O:FEE2nu0 SHEET NO. OF LK CALCULATED BY DATE CHECKED By- DATE SCALE 77 2A 1 A /d, -1 T I I W, 1 1@ 12-' i Y2-' T V� F F T A-� -r oo T-T-r 1 2jx (sl s"/�'j 7-IK *lc-t' c-ol rl vvrs q, '777A-c 1 &xIt"I�11 ql3e -Ml V- wo -71 L Ik 17 , (ink) -7 e�" 77,�VZ -VIV-9- 6�� -wri C77V o 2-7 b 77 H AV To :01�f i 77�j L 1M. ox, gpw ki V F �/Vo o'r-7.1�em 11 P N W 7E, r-I JOB— OF CALCULATED BY 144 LK — DATE- '7 )(rn RV DATE st SCA 01V 7-7- (o 4�22/17-7 'AA� 10 12-LI-6 Ji -T-T7 jr "n-4, v lvi-I e77 I// 4-r, vv-,4 1 77 1 le 77-1 j i i i Ul=1 c —7. --44 1 Vi" F- -7 7 " T-1 7 f T I T 08 0 F SHEET NO. CALCULATED BY m 1A DATE - 7-OZ- CHECKED BY DATE P SCALE V� A, 774W c< 717��6 191Y FT . I ZAk L, )i� CfNk I e�C4/AJ,'- __L�45��7 -j -x " 6. f Z V106-k 1 7b Soc� I 1z,/ i 7yv 17 F7i 1 �v, I �q s vi 1/� (1-91. i I it'A x 46 cb 1,6�g 1 rl ELF A_ i El Mll A I (122 E.I /60 I CL_ 7 ZAP. '174 Ft L-4 416 - A A--?S-