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0041 COVENTRY LANE
Oxfonar NO. 1521/3 ORA A f I` _ j ao F Town of Barnstable *Permit# Expf 6 months from issue date MASS ' Regulatory Services e • a�atvsrwsi,R • e�e� Thomas F.Geiler,Director 1 Building Division Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.to wn.barnstab le.ma.us Office: 508-862-4038 EXPRESS PERT APPLICATION - RESIDENTIAL ONLY 508-790-6230 MI V Dr t Valid without Red X-Press imprint Map/parcel Number �J V Property Address [•Residential Value of Work % $dQ Minimum fee of$35.00 for work u. nder$6000.00 Owner's Name&Address Contractor's Nam l,e Telephone Number_ C15,36 a j4a7 Home Improvement Contractor License#(if applicable)_ Construction Supervisor's License#(if applicable) ©Workman's Compensation Insurance 06P S Check one: ❑ I am a sole proprietor J�1` ❑ I am the Homeowner [;4-I have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name l- Workman's Comp. Policy# s,2,j�0 ;�.3 11 i $ �opy of Insurance Compliance Certificate must accompany each permit. 'ermit 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 #of doors ❑. Replacement Windows/doors/sliders. U-Value (maximum.44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. GNATURE: i WPFILESTOPLMS1 Iding permit formslEXPRESS.doc vised 070110 i The Commonwealth of Massach useits Department oflndustrialAccidents ►' ^ Office oflnvestigations 600 Washington Street Boston, MA 02111 t? r www.mass gov/.did Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): iyfQ D U£ e l d Address: ?-Z)• SCAA /DES City/State/Zip:MA&+okxs Kits MW Dab 8' Phone #: LS0836,,A/qF7 Are you an employer?Check the appropriate box: Type of project(required): 1.a]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.❑ I am a sole proprietor or partner- listed on the attached sheet. 1 ?•. ❑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 10.❑ Electrical repairs or additions required.] officers have exercised their 3.❑ l am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §](4), and we have no 12.❑ Roof repairs . insurance required.] t employees.[No workers' 13.0 Other comp, insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowner;who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tConhmctors 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 enrpleyees Below is the policy and job'site information. n Insurance Company Name: Nr�tem f am.i �S(JGI0 Policy#or Self-ins.Lic.#: c 0 O LO 1 S Expiration Date: / Job Site Address: l ��v �,/ v6 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,S00.00 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 DIA for.insurance coverage verification. I do hereby c under t pains and penalties of perjury that the information provided above is true and correct Signafore: Date: Phone#: seed 9Qf7 Official use only. Do not write in this area;to be completed by city or town bfftciaL 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 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-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 iii the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill io 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 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 f oFTy Town of Barn-stable o Regulatory Services * Thomas F. Geiler,Director ` E 659. A. Building Division Tom Perry,Building Commissioner 200 Main Street,Hya=is,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owter'Must Complete and Sign This Section If Using A Builder I, ✓µ C e S �_ %��i✓lG�Y l.' , as Owner of the,sub.ect property J P Pert3' here by authorize au. ito u E d C-p I e to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) 11-2 signature of Owner Date Print Name If Property Qwneris applying for peinmit pleas e complete. the Homeowners License Exemption Form on fthe reverse side. Town of Barnstable H Regulatory Services BrE Thomas F. Geiler,Director ILL�P %& Bul ding DIvision rfOµA{} Tom Perry,Building Commissioner 200 Main-S3 ag4_Ayannis, MA 02601 www.towmb arastabl e_ma.us Offs ere: 508-862-403 8 Fax. 508-790-6230 HO1vMOWNER LICENSE EXEMPTION Plisse Print DATE JOB LOCATION: number street village "HOMEOWNER": name barn phone# work phone# CURRFNf MAIL G ADDRESS: eityAown state rip 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,providcd that the owner acts as supervisor. DEFINITION OF HOMEOWNZR pm-son(s) who owns a parcel of land on which he/sbe resides or intends to reside, an which-there is, or is intended to- be, a one or two-family dwelling, atfached or detached struct axts accessory to such nse and/or farm structures. A person who constmr-ts more than 6ne home in a two-year period shall not be considered a homeowner, Such "horneownci"shall submit to the Building Official on.a form acceptable to the Building Official, that hdshe shall be respoiinble for all such work performed'ander the budding penn-iL (Section 109.1.1) The umdcrsigncd `homeowner"asstnrncs responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned'homeowner"ccrtifics that hdshe.Imderstands the Town of Barnstable Building Department inspection procedures and require e:nts and that he/she will comply with said procedumes and requirements. Signature of Homeowner Approval of Burlding•Official Notc: 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. H011�OwKER'S EXEMF'rION The Code states that: "Any bomcowoer pcfnrrrang work for which a bnnilding permit is requiem shall be exempt from the proyisiars of this section.(Section I D9.1.1-Licansihg of construction Supervisors);provided thet if the homeogver eogagrs a pason(s)for hire to do such world that suCch Homcawna shall ad as supervisor,• )vtany homeowners who use this ecaaptiao are unaware that they arc assuming the responsibilities of a supevisor(sec Appendix Q, Rules&R.cgulatians for Licensing Construction Superyisars,Scction 2.15) This lack of awareness bRarn rwu Its in serious problems,particulm-]y when the homeowner hires nmlic=cd parsom in this case,our Board cannot proceed against the unliccnaed person as it would with}licensed Supervisor. The homeowner acting u Supervisor is u)firrmtOy responsible. To cns=that the homeowner is fully awaresp of hiArrz onnbilitirs,many communities require,as part of the permit applieadon, that the homeowner certify that he/she understands dine responsibilities of a Supervisor. On the]an page of this issue is a•form currently used by several towns. You may care t amend and adopt such a form/ccrtiBc2lion for use in your community. 05/16/2011 09:29 5084209227 MARK W SYLVIA PAGE 01 DATE(MMIDDIYYYY) ORS® CERTIFICATE OF LIABILITY INSURANCE 0511612011 THIS CERTIFICATE IS ISSUED AS A,MATTER OF INFORMATION ONLY AND CONFERS OR LT O RIGHTS E COVERAGE AFFORDED BY THE PORGIES CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, 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 polioy(les) must be endorsed. If SUBROGATION IS WAIVED,subJect to the terms end conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer lights to the certifcate holder in lieu of such endorsemen s. oNTACT PRODUCER NAME: Anna Se our Mark Sylvia Insurance Agency PHO ,n1•(508)4 !8-0440 Axx No):_(508 20-9227 771 Main Street 59* •anna marks I►Ilalnsuranoe.com PRODUCER Osterville,MA 02655 stoMe6(RR; INSURER(s)AFFORDING COVMRAGE NAIC 8 ►NBUR M A,. Farm Family Casualty Insurance INSURED John Bourque and Steven Cole INSURER B,: dbe Bourque&Cole Custom Homes&Remodeling INSURERC: PO Box 1005 Marstons MIUs•MA 02648 INSURER D INSURER E: _ •• COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L�TRR A UCY EFF POLICY LIMITS TYPE OF INSURANCE POLICY NUMOFA OOr"W M D A GENERAL LIABILnY 2001 1_6471 1211112010 1211112011 EACH OCCURRENCE is .1,000,000 A�TB'� 100,000 Z9P MERCIAL GENERAL LIABILITY PN - ' — ""CiLAIMSdMDE C1 OCCUR MED F-XP(Any cnp mon 5DDo PERSONAL&ADVINJURY 1,000,00D GENERALAGGREGATE S 2,000,000 GREGATE LIMIT APPLIES PER PRODUCTS-COMPrDP AGO $ 2,000 000 CY 7 PRO UDC $ SINGLE LI AUTOMOBILE LIABILITY COMBINED MIT $ (Fa acddanl) ANY AUTO BODILY INJURY(Per PInos 6 ALL OWNED AUTOS BODILY INJURY(Per a SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per seddant) NON.OV4MED AUTOS UMBRELLA UAB OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS MADE AGGREGATE 9 DEDUCTIBLE - S RETENTION S X V40 STATU• DTH- A WORKERS COMPENSATION 2001 W6185 12/14J2010 12I14/2011 M(TS AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETO � �I E.L SAACH ACCIDENT S 100,000 OFFICERIMEMBER R/PEXCLUDED? (7J N)A (Ni ndmary in NM) E.L.DISEASE-EA EMPLOYEE S 100,000 if" �rdar E.LDISEASE-POLICY LIMIT $ 500,000 OESCr dPwIl N OF OPERATIONS below DESCRIPTION OF OPERATIONS I LDCATIONS I VENICLES (AV=h ACORD 101.Addltlaml R6111131%SClledula,rf more"NCO Is raqufred) Carpentry Partners,John Bourque and Steven Cole,are not covered by the workers compensation policy. CERTIFICATE HOLDER CANCELLATION (508)790-0230 Town of Bemstable Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 200 Maln Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, Hyannis,MA 02601 AWHORRED REPRESENTATNE A 14� 0 1908-2009 ACORD CORPORATION. All rights reserved. ACORD 26(2009/09) The ACORD name end logo are registered marks of ACORD Miissachusetts- Department of Public Safety. Bo. A of Building Regulations and Standards ; Construction Supervisor License ` License: CS 57382 Restricted to: 00" JOHN D BOURQUE 80 CROCKER RD W BARNSTABLE, MA 02668 Expiration: 7127/2011. Commissioner -Tr#: 18015 i � "' 1 bd° `4de ' License or registration valid for individul use only Office of onsumer airs u mess egulation 1. g y _ HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: ,4:109751 Type: Office of Consumer Affairs and Business Regulation Expiration: 9124/2012 Partnership 10 Park Plaza-Suite 5170 Boston,MA 02116 B QUE&COLE IUSTOMHO:MES&REM. 4•i:!� �--;'="w>;____._(vim JOHN BOURQUE�\ 80 CROCKER RD. WEST BARNSTAB Undersecretary Not valid without si ature 4f COVENT RY LANE ook �A6 w - t LOT 3 .w� LOT > w x LING DwUNDUGTI LOT 2 k 30,030 ± S.F. (0.69 + AC.) co 139 3 x 22o 5 3 NOTE :OFFSETS TAKEN TO FOUNDATION CORNERS. JOB # 93-020 CERTIFIED PLOT PLAN PREPARED FOR LOCATION :ASES MAP 110 PAR 4-3 COVENTRY LANE WEST BARNSTABLE REEF REALTY . SCALE : 1" = 50, REFERENCE LOT 2 PLAN BOOK 454 PACE 96 -o��rrr���. I HEREBY CERTIFY THAT THE'STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. �� G cG9 STRUCTURE CONFORMS TO SETBACK REQUIREMENTS OF THE pvtt� ?eST,J ;rtt"�t' TOWN WHEN CONSTRUCTED. STRUCTURE DOES NOT LIE IN A FLOOD HAZARD ZONE. a �O,:; S5�r. c, ' ti! frA `'•ter.....•.r fit✓\ DM fir: -•+,:o.....ter.-...s''-W DEMAREST - Mc LELLAN ENGINEERING ` S 24 SCHOOL STREET P. O. BOX 463 OCTOBER 31, 1994 WEST DENNIS, MA 02670 (508) 398-7710 DATE PR ESSIONAL LA SURVEYOR g COVENT RY 1 LANE w LOT 3 /x� N LOT 9 1pcp I" oN�R�ON 3O f0 T 14 FD LOT 2 z 30,030 ± S.F. (0.69 + AC.) co .,39 3"' 22� y3 cD JOB # 93-020 CERTIFIED PL 0T PLAN PREPARED FOR LOCATION :ASES MAP 110 PAR 4-3 COVENTRY LANE- WEST BARNSTABLE REEF REALTY SCALE : 1" = 50' REFERENCE : LOT 2 PLAN BOOK 454 PAGE 96 �uc I HEREBY CERTIFY THAT THE STRUCTURE .OH y SHOWN ON THIS PLAN IS LOCATED ON THE, a Z Gn GROUND AS SHOWN HEREON. DEMMEST`M. v ,10.3GO59 co 4., su. � DEMMEST - Mc LELLAN ENGINEERING f 24 SCHOOL STREET P. O. BOX 463 SEPT. 13, 1994 WEST DEAMS, MA 02670 (508) 398-7710 DATE OF SSIONAL LAND VEYOR �. ' • ' Application to �o �� 1,99-4 0.60 •� 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: C� New Building ❑ Addition ❑ .Alteration Indicate type of building: ® House Garage ❑ Commercial ❑ Other 2 Exterior Painting: ® y 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑.Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY ---- DATE 0 1/S. ,�294-/ {' ADDRESS OF PROPOSED WORK -4 T Q L4 tZe a 12(/ 4,9 A/P, ASSESSORS MAP NO. OWNER f6 ,L-- )!I XCl/'Ar,(� ASSESSORS LOT NO. �3 HOME ADDRESS e19, )?O d .e I,�(�' IVA Do2479 TEL NO. _39y-3209A FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). AGENT OR CONTRACTOR 9(0—eo- lj:�' j2e,�-rJZ i(ld TEL. NO. ADDRESSQ'&G1t�,.4 I�� `,�/�P,AJAJI"1 „ 4,;210 . r DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8,other side), including t • 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. (Atiach additional sheet, if necessary). -)U x_ `Tkcc ( Ca f �5T`(�-N�tcS w&L-L I t"C7 to fi'fA `t-wo eh,� }�-�-•�-c..}{� c v��rc�� ! 0 f/f,S,g d _ Owner-Contractor-Agent Space txiow hne for Committee use. -oewred•t�. to ert ate is herby Date M� r BBC r LQ KIN GNWAY Approved i= IMPORTANT If Certificate is approved, approval is subject to the 10 day appeal period — provided in the Act. ADDITIONAL INFORMATION FOR MAKING AND FILING AN APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS The four categories for which a Certificate of Appropriateness is required are: (application for demolition or removal is a separate form). 1. EXTERIOR BUILDING CONSTRUCTION (new or existing buildings): An application is required for any exterior of a building to be erected or altered including windows, doors, siding, roof, light.etc., that will be visible from any public street, way or public place. The following scale drawings are required in duplicate with application: -plot plan (if addition — show existing buildings in outline), floor plan and elevations. Also required are snap shots of existing buildings, where additions or alterations are to be made. No plot plan is required for addition or.alteration which does not touch the ground. 2. EXTERIOR PAINTING: An application is required for any portion of a building, structure or sign to be painted that i vlslhle from a public street, way or public place. Color samples must be attached to.these applications. An application is no required when repainting existing colors, changing to white,or using colors approved by the Town Historic District Committee 3. SIGNS OR BILLBOARDS: An application is required for any sign or billboard to be erected within the District, with th following exceptions: a. Existing signs or billboards on November 27, 1974 shall have until November 27. 1977 to secure an approved Certificat of Approoriateness. b. Temporary signs for use in connection with any official celebration or parade or any charitable drive as long as they ar removed within three days of the event. Certain other temporary signs that the Committee feels,does not detract fror the Act may be allowed with the prior permission of the Committee. c. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they erected or displayed. d. A single sign of not more than 1 square foot in area showing the name, occupation or address of the occupant of t. premises on which they are.erected or displayed in a residential Zone. 4. STRUCTURE: An application is required to build or alter any structure within the District which is defined by the Act as' combination of materials other than a building, sign or billboard, but including stone walls, flagpoles,hedges, gates, fences, e, GENERAL REQUIREMENTS S. Work on projects requiring approval shall not be started until the Certificate of Appropriateness has been filed with the To% � Clerk by the Committee:'Approval is subiect to the 10 day appeal period provided in the Act. 6. No changes shall be made from the original approved specifications`withbui advance;approval of the Commission on amended application filed with the Committee. 7. A separate application must be filed with each project4requiring�a�Certificate of Appropriateness. 8. Under heading of "Detailed Description of Proposed Work ,give`detailed data on such architectural features as: foundati. .. -chimney, iidin�µ roofin roof9 � • g. pitch, sash and doors, window and door frames• trim, gutters —leaders, roofing and paint cc 9. Unless application is complete and legible and all material required is supplied, application will not be accepted or acted ur -. Copies of the Act establishing the Regional Historic District may be obtained at the Town,Hall. a . f 'Lancaster Whitewash Sandy Hook Gray. PIN OL0 K I'NG'S HIGHWAY' H I STO;R L C: 0 I STR I C ', • - t=O;UNDATION .6u2E 5I 0I NG TYPt�i.�+,.i:r . CciL�_ R ty =su CH I MNCY TYPE i ROOF MATERIAL ►v c,l�S COLOR Q(^_N�E nrr RLTCH_____ WINO0WS VCO . cu �tc L _ -- - ' . SIZE- .• __..7_�. _�.. TRIM COL6R W E�� \ COLOR �1biCo SHUTTERS. ... GUTTERSQ.S- ZL-Sc _ GARAGi* .1009i7S _ i4►�E �. l4Sc�N COLOR: NLaS'�GfL-. (�kiTEtcwi Ili I 1 I_ r.� -- Nate F't 1 1 Cut cofhp I eto I y.. I nc I u,d.t mg. meat,urements ::and "torials/C:olor* to. be u�eci,, ,Thwee eop i e.s. of th i - form are requ i red for- sutm i tto l Of an Epp 1 t C t.t on.. a l cng w l th thr a co.A i e5. each of I the plat pla,�; landscape Olan and eleyation olan, . -when applicable:: APFAUU" � R l btp l an nded not 6e ''Cer-tified". hut. 15hoU 1 ( cr.%cw a 1 1. struCtur'es On the. lotU - . • COV"ENT�Y- o �3: _ LANE ��• LOT z, 30,030 ± S.F. (0,69' 4 AC.) rn, LOT S' x p . PROPOSED DECK SKETCH PLAN PREPARED FOR- APPROVED REEF REALTY � LOCATION : LOT 2 COVOTRY LANE: WEST BARNSTABLE DNj REFERENCE : PLAN BOOK 454. ,PACE 96 DEMAREST-McLELLAN ENGINEERING SCALE : I" = 50' 24 SCHOOL STREET P.O. BOX 463` WEST DENNIS, MA. 02670 DATE MAY 4, 1994' .. A4"ALT FOi r no .. Jj O ..- no A M G �•�uR �" GR -----. gTl.A um OL. IY�Y]'FLIMJ 4-f- ,.. FRoltt' Et�e.Tlol•I _qm .� I �... _- 9t Aa_w D.A.wvwA . ' — _ 'l"�rtL.�• I � .�.T,fwyC10K tl�1-111 t +�- '. 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Jr4zz In -_,� 5 SK L vLlilY iF� 31k4°x�/n�.—_ uu�vn wrern z 4 RAN Z`1 REVERSE Pool Q•xIL•FIv4E " n+ z'xid'f�Ft�f�a'IWbi _ . - q .ZrrL+Tes G ll?a.c. Iw4'Y�Es a 18•0. .t. II '1•MF VBtf ware I II II II ..._ .. .__... e oeo l3^Ys AT uv.T 9�PK4v�S I II �I U II IwN swwr.6 Frf ��g II II it II 11 h Z•x8•C1.Y/R:O.C. ���C�A L II it II II 11 r s'cY FIee�IMs I I T W`22`R II I I 'rZ.T o: ZZ+xlz•irons AIA-Ocr.�wu L�+ I I Z P44"puTcs 1iHLL 6 Ib• C. Kfrof FAM• Rµ Rra��Iv.p•t I I a o,sn�rtwl R-II I . P I I1 III —4Ar-Ae'e�OHO, 0PIO�f4w55 vnee N3UV'T�on R-Po Z•x4•swoe R-zo Qxly Fa.. �Jls.G IV"aa. I ty"x(i I Jii h AtczKC.4-f-K.: 1 W M 60iL 9-PxIZY`v.y'er i ,�.� I I 10 Fl lo^ftor�v coeLoe o I G cerw su e:4 Pra oayP-PFQ'P CE 4F I f• I I e pvFcw .,�..,. �, _ I. ,..c.NOY,<s:-P•xIG1'pcApY>:r3 el��wG -I"xl.�TIL'se�yo.c. . lVeawt fl_, I I I I ._ Z•*.•ew..rsYsall.be. NIYN 1•xy�IMIK�RS •jdlxjobao•COI,FT-';- MAIM. ItOUSE Ds n4.SEGTIoM nuD.�+T1zY �G� sE�l«a . �"�•�]olt-FKhHWIi HEN F.eF� .lr. . EA"r= A. t1AnN ItoUR Ir+,uL�IoN 55sno a . . U.L".A55EI1 BL.Y R=30 U=.o39 Z" Ib7or R.ASeENBLY� Rl ZO L) C5 • WALL.I.59C181.Y R'kz e 2128 a qc, gyp, - 57Q U=.ZS Y'� �ENN65TR1"T1oPl a IZ.717o ru: ua=.It3(.for.M�7a18s/Goe�r214(47)1-51eZs) • ax".w xuew. fWlL,ol•.� SECTION', iFf Anr Il C•w)?4y xo;�L �03 N'v�l�- evo�s�ro Nc�3. . oil LA Q1 N>L> fp ry 05 . Q � O A dau x•� r (� ci)s S asr� H•s 4 asv�' yrtis y�r>' 61.s z ago i•�s 3[as» c1.c ST • F' �_� I__1 L_� L_� L , N 1 olny eM sz,xrs �09 qi 1+tH9 iacop I r . g` � ;!� f • rpm _ �Z�ZZ O�Y � .. . -_ ._ _ r r j COMMO IE OF MASSACH JS 'TTS . ..- `a OFI'A MENT OF INDUSTRIAL ACCIDENT'S=. = -. boo WASENGTON ST RW :,aka: C.arno � BQSTON,MAS'SA-HUS-US 02-1_,1.1.: rp 55YpnE-• WOR1iCERS` CAMI'EIvSATION INSRAlC AFIDAVI' ' j, Everett_. w. Boy._Sr. (liuntet,/pertn�se� i with.a principal,plzcc.-of business/residcdce=fit: 24 ScLWI Street46 West Dennis Mas chM is *2:6 _0 (Gry/Stte/Zip) do hereby certify, under the pains and penalties of'perjury,that: J I am an employer providing the following workers' compensation coverage for my employees working on this job. Aetna WC# 006—C-23219584CAA. Insurance Company Policy Number ( � 1 am a sole'proprietor and have no one working for me. ( J 1 am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation insurance policies: Name of Contractor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Number 0 I am a homeowner performing all the work myself. NOTE: Please be aware that while homeowners who employ persons to do maintenance,construction or repair work on a dwelling of not more than three units in which the homeowner also resides or on the grounds appurtenant thereto are not generally considered to be employers under the Workers'Compensation Act(GL C. 152,sect 1(5)),application by a homeowner for a license or permit may evidence the legal status of an employer under the Workers'Compensation Act I understand that a copy of this statement will be forwarded to the Department of lndusaW Accidents:Office of insurance for coverage verincation and that failure to secure coverage as required undo Section 25A of MGL 152 can lead to the imposition of criminal penalties consisting of a fine of up to S1500.00 and/or imprisonment of up to one year and civs3 penalties in the form of a Stop Work Order and a fine.of-S 100.00 a day against tne. Sig d thi 2✓Id day of k , 19 Lic nsee/Permittec Licensor/Permittor a DEPARTMENT OF PUBLIC SAFETY COMMONWEALTH ' ONE ASHBORTON PLACE -"'Cca[.'= '�,•• OF G_•.I;icccwcrorrcv ccrloop MASSACHUSETTS BOSTON.MA 02108 L i S:E K-S E CAUTION EXPIRATION DATE CG�ISTit. SIL,PERVISOR FOR PROTECTION AGAINST 03/1 1/1996 EFFECTIVE DATE LIC-NO. THEFT,PUT RIGHT THUMB R STRICT`IONS PRINT IN APPROPRIATE NONE ¢ ,16/3Q/l993 ..._032809 6 BOX ON LICENSE. 6�51 EvF_P,F_- :I BOY JR BLASTING OPERATORS }1 033-42-4928 � WODENNIS MA 02670 186 z MUST INCLUDE PHOTO. SS _ z ' . _ PHOTO(STING OPR ONLn FEE' /��1 PAID - 1 0 0 0 7 NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY 11 �•�•:�', \��� HEIGHT: SIGNATURE OF THE COMMISSIONER , .... DOB: JUN 03/11 /1954 `\ NE . NATURE U 1✓{/ SIG. F ABOVE Alt, NAME W FULL e... .� SIGN t" THIS DOCUMENT MUST BE �•��llii.i�iYi.�dlil'C;:or�a;l�'ti.'�i: 7URE OF LICENSEE . ,;t+•s i���;..-:.,'�.,f.''I.l'\'� CJfiR1E0ON THE PERSON OF 1T} 1]l 11 �,.� Ip THE HOLDER WHEN EN- 7, �ON� GgGEDWh1ISOCCUPATION. •, 5 Assessors office(1st Floor): SYSTERPii W3UST BE oSINE>o Assessors map and lot num 44F-1, 1;�l CoINSTALLED IN CMI&LIANCE nservation(4th Floor):ti Board of Health(3rd Flo WITH TITLE 5 ,Sewage Permit numbs ���`�®� ���'Q1L CODE AND t Dsa»r�ntD . rua Engineering Department(3rd floor): + � A_ 'TOWN REGU�,-M NS °o v N&'q \�a° House number rr Definitive Plan Approved by Planning Board APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only t TOWN " OF ,BARNSMABLE BUILDING INSPECTOR APPLICATIOW FOR PERMIT TO TYPE OF,CONSTRUCTION RMD60/ Slnl�G� �lL� �GU�IUG, 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to they following information: b-u� Location y�2 `ft1 k, Proposed Use 4511D fu1' Zoning District a J Fire District Name of Owner r 9 Address�"/y r /� �U�� �i �1�D1�is1A1/� Uvl f G 7d Name of Builder&1W WAW AID 1495qtl� Address ► • �N ` �JrS`T p 1�1 s, �7t� Name of Architect Address Q Number of Rooms Foundation 8 /r�Q��e Wz FO4h a ) !✓w Exterior Z�61( O11 �AW14*9 04AP5� Roofing Flo s 15tl T � CO PL���� Interior Heating d A �`/��1 Plumbing Fireplace S� /"`A"1,4m Approximate Cost Area !/ Diagram of Lot and Building with Dimensions Fee S1cE V9 r TW-461 51-rc— R-o-q q0A'J0 I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstab gar ing the above construction. Name r Construction Si ipervisor's License o AMEK. HOLDINGS OF CAPE COD 41 COVENTRY LANE, WEST BARNSTABLE � r � 1 No 3217Z Permit For ONE STORY Location Owner Type of Construction Plot -�' Lot • f e Permit Granted Sept. 15 , 19 94 I Date of Inspection: Frame 19 ^� Insulation 19 _ 4' 'Fireplace 19 , Date Completed / ' 2 19 r 1 J �..SIr-:-Sr^".�.iy-:J+.1.r.:'^ .:,Y..�.._: ,'.•�_"_n_�+ti^..� �r'•i.:,,L i•.,: .:• .. ..vy , ,..a,r.,,y:w,�s;x..;� +a�.:.,i� -,..:.."ywa*ro'•,.. ...,,,,,r...�..v...-rw.. --v.�.•.r _ � �.,v^•- � o�7wrro TOWN OF BARNSTABLE � _ .=_.,� Permit No. .5....:......... ` BUILDING DEPARTMENT � I TOWN OFFICE BUILDING Cash .... L111p�r .670• � HYANNIS.MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Amek Holdi4s of Cape Cod Address 41 Coventry Lane, West Barnstable USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID. AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. January..6........ 19.95............ .................. ... Building Inspector I ��•.° °�.� TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN dkleE.IBUILDING NAM -- °+ HYANNIS, MASS. 02601 MEMO TO: Town Clerk I 1 FROM: , Building Department i DATE: / 9� i An Occupancy Permit has been issued for the building authorized by BuildingPermit $k......!_. /_CJ ................................. ................_...._._....... ........ __. ...__ .. issued to ... .. mP!. Please release the performance bond. D Tr)\A/M nr RAONCTID.AIE II, .Airl I C",IfET're UIL ING PER"'r NVOIN a 1/0 -0jy-063 DATE September 15 19 94 PERMIT NO._N9 37032 APPLICANT Everett W. Boy ADWIESS - - Bo.,*c 186 , West Dennis, YAA 032809 (NO.) . (STREET) 4CONTR'S LICENSE) PERMIT TO build dwelling I 1 4� SiLr..0le family dwelling NUMBER OF I STORY DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) lot #2 41 Coventry Lane, West Barnstable ZONING ICT RF DISTR (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT—BLOCK—SIZE BUILDING IS TO 8 —FT. WIDE BY FT. LONG BY —FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) Sewage #94-432 REMARKS: BOND AREA OR 1704 sq. ft. 100,000 PERMIT s 85.25 VOLUME . —ESTIMATED COST $ FEE (CUBIC/SQUARE FEET) OWNER Amek Holdings of Cape Cod BU ADDRESS Box 186 West Dennis, MA ByILD THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- ► PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL -APPROVED PLAINS NIUS7 EIE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO LATH). FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. I POST THIS CARD SO IT IS VISIBLE FROM STREET B ING INSPECTIOV"IQVAL� PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS Lip 7 "e_ 12w- 2 2� 2 ,0 10/2-Zi g- 41 o cl 7 F 3 0 e-, 10� 3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 , C�_ ��V�'Ts BOA OF HEALTH t li, /Z OTHER 4 SITE PLAN/REVIEW APPROVAL 17 -0-TY WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIOULIS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. PERMIT ;S ISSUED AS NOTED ABOVE. - NOTIFICATION.