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t. �14gECYCIFpqz UPC 12534 No. 2153LOR ��bsrcoet�'a HASTINGS MN H U Q o� T HomewoW,,rnGo Energy, Inc EPT. JUL T OwN OFBARNST Permit Cancellation Request ABLE HomeWorks Energy is requesting the cancellation of the following building permit: SCANNED Permit Number: EXPR-21-669 02. 02 Address: 11 Desires Lane Barnstable Massachusetts 02668 Reason:The customer has declined to move forward with the insulation and weatherization work. We will no longer be planning to perform any of the originally contracted work at the associated address above at this time. Please cancel out this permit that is attached to this notice. Please reach out to the specified number below if you have any,futher questions regarding this. Thank you. Sincerely, I Adam Glenn CSL:#106148 Ex: 7/30/2022 HomeWorks Energy Inc. 101 Station Landing,Suite 110 Medford,MA 02155 wxpermitting@homeworksenergy.com (781) 205-2201 Town of Barnstable Building �.: �....,-.-•,.-•"--.w- «.,....*..*.+wa,.••e-....a.,ar*.--s*..+.++-.,.+..++..w.,..,�...-,..w.x..-+...>.-.•.w-r--...✓.-...-....ry... -.�..,s,,.._�. B����� Post This Card So That.it is Visible Fromalie Street Approved Plans Must be,Retained on 1ob,and this Card.Must,be Kept Posted Until Final Inspection Has Been Made µ ec Where a Certificate of,Occupancy,is Required,.such Building shall No 'be Occupied.until a Final Inspection has been'made Permit Permit No. B-18-1532 Applicant Name: SWEET,ANDREW Approvals Date Issued: 05/17/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 11/17/2018 Foundation: Location: 11 DESIRE'S LANE,WEST BARNSTABLE Map/Lot: 088-007-006 Zoning District: RF Sheathing: Owner on Record: VIER EECKE,JAN W&DONALDSON, DEVIN.M Contractor Name PAUL M DOWNING Framing: 1 Address: 11 DESIRES LANE Contractor License: CS-074247 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $ 1,424.00 Chimney: Description: 1 DOOR.29 U-VALUE y ' Permit Fee: $35.00 Insulation: Project Review Req: l Fee Paid: $35.00 Date. . 5/17/2018 Final: J Plumbing/Gas Rough Plumbing: -��---• ' \BuildingOfficial --_ Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the'approved construction documents for which th s permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical f, The Certificate of Occupancy will not be issued until all applicable signtures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing i — �` Rough: 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Q p Town of Barnstable *Permit# - � 'i% Expires tS months from issue.date Regulatory Services Feed • �►xtvsrasr.�, . 9 1 0$ e d V.Scali,Interim Director Building.Division Y l MAY 152018 Tom Perry,CBO,Building Commissioner ✓\ �_�Ii�taO Street,Hyannis,MA 02601 = 1Q2 �NI�NS A �� town.bamstable.ma.us Office: 508-8 2 038 Fax: 508-790-6230 EXPRESS PERMT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number a 8 ��7"0 z 6 Pro a L S /P S Zr� K✓rty Address Residential Value of Work$ Minimum fee of$35.00 for work under$6000.00 , Owner's Name&Address �I y/I Doll A V S o✓1 r� �r S Ln . - c✓ �I� �G6 901-711-d3? Contractor's Name? :5 O7 / 1 Telephone NuJ mber Home Improvement Cdntractor License#(if applicable) //�7P� Email: q Stk)toz l29q a aMor V.- C_6,4) Construction Supervisor's License#(if applicable) �7 [ /orktiian's Compensation Insurance - << Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name 1V4T1PA#L lit /V/aAJ Y'// � 1A)5 Workman's Comp.Policy# 4 S� J S Copy of Insurance Compliance Certificate must accompany each permit Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) [❑ e-side Replacement Windows/doors/sliders.U Value • 2-11 (maximum 35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire.Permits required. *Where' required Issuance of this permit does not exempt compliance with other town department replations,i.e.Historic,Conservation,etc. ***Note: ope wner must sign Property Owner Letter of Permission. o y the Home Improvement Contractors License&Construction_Supervisors License is it SIGNATURE: 4.0 Q e iced 61313 SIbuilding 4t \EDTRESS.dpc Revised 061313 7 L/f r_ SPECIAL SERVICES CUSTOMER INVOICE Page 1 of 6 No. H2612-74565 Store 2612 HYANNIS Phum-(SM 778-8948 65 INDEPENDENCE DRIVE SteWerson:ACC1 SC HYANNIS,MIA 0260i Reviewer:VXG1123 'h "` 'REPRINT DONALDSON DEVIN (517)esQ�o 14*' 11 DESIRES LANE °d W f3ARN.STBLE J*w-"- paf'io door kslall 2019-05-09 01s:12 MA 02M BAfINSTABLE MERCHANDISE AND SERVICE SUMMARY y.•• Y- r., - •=:4`';rtiiyi .i'•�:��'r; .-g;fir: STOCK ANDISE Ti0 BE DELIVERED. ' t : p.._.. :r.. R09 OWO-262-314 4.00 EA 314"X3-112°XW PVC BOARD/ A O 13.22 Sam R04 0000-702-836 i.OD EA 1X4-16FT PR6VED F.t8DW! 33 4�8 R050900 458 056 16.00 L>= I IM X3.112 PFJ WM444 CASNO/ 8ft Y 51.94 $31.04 I= 0000-734-834 1.00 PHEROSEAL ALL PURPOSE VVI-M 10.1 OZ! A Y $5.58 -58 R07 1002-01-477 1.00 EA 6'XW 1MNtDOW&DOOR SEALING TAPE 1 A Y $17.97 sli.97 ROB OWG-715-499 LOD RL MULTI-PURP 16"1t48'ROLL INSUL 5.3SF/ A Y 48 RIO 1001-22S-531 1.00 EA 50 PD UNIVERSAL FRAME OFT/ A Y >I m_ $09.00 R11 IWI-226-M 1.00 EA 60 PD IOV PANEL 6068 SS 1 A Y 195.00 136.00 Al2 1001-71 SB7 1.OD O FIX EA 60 P PA EL 6068 SS/ A Y 25.00 125.00 R19 000"16-922 1.00 EA 5%70 PD BFT SCRN/ A Y .98 • tb28 DELIVERY lI ORM MOM IMJWW GATE:WT DULE INSTALLER WILL DELVER MDSETO: SITE OF V D az �yw►r � onU�at 007 Page 1 of 5 No. H2612-7456S CUSbRW CAVy SPECIAL SERVICES CUSTOMER INVOICE-Continued NW*: DONALOSCM Page 5 of 5 No. H2$12-74585 RAd +TELY.CANCaLATMS VufMN 72 NHS.wwu BE RMMDFM TOTAL CHARGES OF ALL MERCHANDISE & SERVICES Pam►Id(P* f a2a z� A.90 DAYS DEFAULT PQUCY; SALES sax 7 MTAL ?he No�+B Depot rownes the 40W tO t deny r e see the Mk.podr�y sign(r►store,for deter' BALANCE M E 00 i I • I r 4 ter„n•� Ir' t*y S hns�lr I Page 5 of 5 No. H2612-74565 C„ Q„ Cam, r R a.�:�� `..H it tB•�ta6P, af!•�e 3 .. P. � �! i '. `. I e,.. P I � ` PAUL M DOWNING 180 KESMCK ROAD BROCKTON MA 02302 Commissioner 04MR2019 The Commonwealth of Massachusetts Department of IndustrialAccidents 2 Office of Investi ations g J �__• _ , :J t— '. ' r' �r r I Congress Street,Suite 100 Boston,AM 02114-2017 www.mass gov/dia Workers'-Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers AATJlieant Information Please Print Lezibly Name (Business/or,Qanization/Individual): I A t,UL &)1 fJC. Address: City/State/Zip: (�; �� Phone#: Are you an employer?Check the appropriate box: 1.El [ gun a employer with °-- ❑ I am a general contractor and I Type of project(required): employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 3. 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 required_] 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 insurance required.]t c. 152: §1(4),and we have no employees. [No workers' 13.❑ Other _-r comp.insurance required.] "'Any applicant that c.hecl—box'l 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 anew affidavit indicating such. Contractors that check this box must attached an additional sbeet shm'Ang 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.Lic.•#: Expiration Date: p Job Site Address: City/Stale/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 cert under the pains and penalties of perjury that the information provided above is true and correct _. S i allature: t �"` ! It:_r! Date: — --- -- - — - Phone#: a� Official rise 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.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: The Commonwealth of/Massachusetts Department of Industrial Accidents Office of Investigations I Congress Street,Suite 100 Boston,AL4 02114-2017 a y www.mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'blv Name (Business/Cirganization/Individual): . Address: /o 90 S , y2w / VXNP1- Citv'State/Zi : S'l paA),I;�b Af , d/S-'Y5-- Phone : 7 7L�" 7 " 02 Are you an employer?Check the 4propriate box: Type of project(required): A. general cowactor and I : ]. I am a employer with�'� t— I am a 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors l n listed on the attached sheet. 7. �Remodeling 2. I am a sole proprietor or partner- ship and have no employees These sub-contractors have i g, �Demolition I wor dng for me in any capacity. employees and have workers' 9 U Building addition omp.insurance.,[Vo workers' comp. insurance c 5. ❑ We are a corporation and its I 10.�Electrical repairs or addition, � �] officers have their I ave exercised 11.❑Plumbing repairs or addition ;.[ I am a homeowner doing all wort: ; myse)lr. No workers' comp. right of exemption per LMGL 12.❑Roof repass insurance required-]t C. 152,§1(4),and we have no ' �/ i employeeg. [No workers' ; 13•l Other comp. insurance required] I , ri l •Ary apoccant Ohm cchccks box ii1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing a0 work and then hue outside conttacrnrs must submit a new afEdavit indicating such. :Contractors that check this box must nnaehed an additional sbeet showing the name of the sub-convactors and state wbether or not those entities have --tmpioyea. 1 the vb-conmaors have employecs,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the police and job sire information. hisu-mce Company dame: /`x�rylrr/L� /VQ bitic�� (/N/O/✓ //`G ��S �B — Policy#or Self-ins.Lic.#: W Ci / S 7 o Expiration Date: 3 Job Site Address: e— City/State/Zip:W✓ 36-r Sty iYt'_ ' ✓tit✓� 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 tin to$1;500.00 and/or on4e-yeimprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day ag ' stlator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DL9 re coverage verification. I do hereby certify tin e i ar the information provided above is trite and correct Si attae: Date: t R- Phone#: — FFIRaoard nly. Do not write in this area,to be completed by city or town offrciaL or : PermitlUcense# ority'(circle one): ealth 2.Building Department 3.City"Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Coutset Person: Phone#: - -- Office of Consumer Affairs and Business Regulation' 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Type: Supplement Card Registration: 112785 HOME DEPOT USA INC Expiration: 04/22/2019 2455 PACES FERRY RD C-11 HSC ATLANTA,GA 30339 Update Address and return card. Mark reason for change D Address ❑Renewa! ❑ Employment ❑ Lost Card -_ — Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Supplement Card before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 112785 04/22/2019 10 Park Plaza-Suite 5170 90ME DEPOT USA INC Boston,MA 02116 ANDREW SWEET 2455 PACES FERRY RD C-11 HSC ATLANTA,GA 30339 Undersecretary d ithOu signature I .d►CO CERTIFICATE OF LIABILITY INSURANCE Doin2n0"ill THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or 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). CONTACT PRODUCER NAME: MARSH USA,INC. PHONE FAX TWO ALLIANCE CENTER ac No 3560 LENOX ROAD.SUITE 2400 E-MAIL ADDRESS: ATLANTA.GA 30326 NAIC A INSURERS AFFORDING COVERAGE CNI01642069-HomeD-GAW-18-19 INSURER A:Old R cIrsuranceCO 24147 INSURED THE HOME DEPOT.INC. INSURER B:New Hampshire Ins Co 23841 HOME DEPOT U.S.A.,INC. INSURER C:HorneRisk CaDfive Insurance Company 2455 PACES FERRY ROAD INSURER D: BUILDING G20 ATLANTA.GA 30339 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: ATL-004353439-16 REVISION NUMBER: 3 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADOL SUB POLICY EFF POLICY EXP LIMBS LTR TYPE OF INSURANCE POLICY NUMBER MMID WDDNYYn A X COMMERCIAL GENERAL LIABILITY MWZY312717 031012018 ON112019 EACH OCCURRENCE S 9,000.000 DAMAGE TURENTIff—CLAIMS-MADE OCCUR PREMISES Ea occurrence S 1.000.00D LIMITS OF POLICY XS r MED EXP(Any one person) ;S EXCLUDE OF SIR:S1M PER OCC PERSONAL&ADV INJURY S 9.000,000 GENERAL AGGREGATE S 9.000'000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY JECT PRO LOC PRODUCTS•COMP/OP AGG S 9•0� S i OTHER: A. AUTOMOBILE LIABILITY MWTB312718 031012018 031012019 Fa aBINN D SINGLE LIMIT S 1.000.000 X ANY AUTO BODILY INJURY(Por person) S OWNED SCHEDULED SELF INSURED AUTO PHY DMG BODILY INJURY(Per accident) S AUTOS ONLY AUTOS PROPERTY DAMAGE HIRED NON-OWNED S AUTOS ONLY AUTOS ONLY Per aecrdenl S UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS LAB CLAIMS-MADE AGGREGATE s S DEp 11 RETENTION S B WORKERS COMPENSATION WC 014122577 (AH,NH,NJ VT) 03/012 031012 018 019 X PER OTH- STATUTE ER B AND EMPLOYERS'LABILITY YIN WC 014122578(WI) E.L.EACH ACCIDENT S D310112018 03/01/2019 5,000,000 ANYPROPRIETORIPARTNERIEXECUTNE OFFICERIMEMBEREXCLUDED? N N/A 5•�•� (Mandatory In NH) EL.DISEASE-EA EMPLOYEE 5 0 qes,describe under Confined on Adc%onal Page E.L.DISEASE-POLICY LIMIT S 5.000.000 DESCRIPTION OF OPERATIONS below C Excess Auto 297-1-10011-00-2018 031012018 031012019 Linn: 4.000.000 r DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION HOME DEPOT USA.INC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2455 PACES FERRY ROAD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING C-20 ACCORDANCE WITH THE POLICY PROVISIONS. ATLANTA.GA 30339 AUTHORIZED REPRESENTATIVE or Marsh USA Inc. Manashi Mukhegee �Cauoo►y ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo aro registered marks of ACORD • AGENCY CUSTOMER ID: CN101642069 ,.� LOC#: Atlanta A�ORp® ADDITIONAL REMARKS SCHEDULE Page 2 of 3 AGENCY MARSH USA,INC. NAMED INSUREDTHE HOME DEPOT,INC. POLICY NUMBER HOME DEPOT U.S.A.,INC. 2455 PACES FERRY ROAD BUILDING G20 LRIER NAIC CODE ATLANTA,GA 30339' .EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TrrLE: Certificate of Liability Insurance Workers Compensation Continued: Carrier:Indemnity Insurance Company of North America Policy Number.WLR C64783191(AL,AR,FL,ID.IA,KS.KY,LA,MS.MO.NE,NM ND,OK.SC,SD.TN,WV.WY) Effective Dale:0310112018 Expiration Date:03/01/2019 (EL).Limit:S1,000,000 Carrier.New Hampshire Insurance Company Policy Number.WC 014122576(DC.DE.HI,IN,MD,MN,MT;NY,RI) Effective Date:031012018 Expiration Dale:03/01/2019 (EL)Lunt:S1,000,000 Carrier.ACE American Insurance Company Policy Number.WCU C64783221(QSI)(AZ,CA,IL,NC,OR.VA,WA) Effective Dale:03/01/2018 Expiration Data:03/0112019 (EL)Limil:S1,000.0D0 SIR:$1,000,000 SIR for the stales of AZ,CA,IL,NC,OR,VA,WA Carrier.National Union Fire insurance Company Policy Number.XWC 4595580(QSI)(CO,CT,GA,ME,MI.NV,OH,PA,UT) Effective Date:031012018 Expiration Date:03/012019 (EL)Limil:S1,000,000 S1,000,000 SIR for the states of CO,ME,NV,MI,OH,PA,UT S750,000 SIR for the slate of GA S350,000 SIR for the state of CT Cartier:National Union Fire.Insurance Company Policy Number.XWC 4595581.(QSI)(MA) Effective Dale:031012018 A Expira6on'Date:.031012019 (EL)Limit:S1,00D.M0 SIR:$500.000 TX Employers XS Indemnity. Carrier.8linios Union Insurance Company Policy Number.TNS C4916693A(TX) Effective Dater 03/012018 Expiration D ate::031012019 (EL)Limit:S10.000,000 SIR:S1.000,000 I ACORD 101.(2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION i� Map '6 z2 9 Parcel 0 0 Z 0 o(- TOWN OF BARNSTABLE Permit# SQ(29 Health Division �5. �� -yz2 3-I y-� �; 5� Date Issued Conservation Division S� 3�1,3�D a ��a �R�44AM � � j' ° (448—Fee 10% Tax Collector_-aOn 1 d L- r 1,, - 3l j� �'�iS`OB pp �eG �D1 Do Treasurer D — V0 L — 1 02 SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Planning Dept. VM TITLE B Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND TOWN REGULATIONS � Historic-OKH Preservation/Hyannis Project Street Address // n P:'S I R/z S /_AV f Village cu/Q r 6A-P Ais no R c& AtA-e Owner &L f- Co L L./L )LIV FQ L i-e, V -Address__1! 0 r S 1 ze iL S [.-A.v,4- Telephone � �s$;?_�2 6 YJ3 Hoiket e,fcL_ <p1 3 L 7 7a3S---' i Permit Request _/ Square feet: 1 st floor: existing 874, proposed S,I 2nd floor: existing proposed Total new :Valuation °- 3'26,00 dgw Zoning District -51olzNr4Flood Plain Groundwater Overlay Construction Type 451 jltw t Wez o r-AA 144 Lot Size / ACg of Grandfatliered: Cl Yes B-96-11f yes, attach supporting documentation. Dwelling Type: Single Family Q Two Family ❑ Multi-Family units) i Age of Existing Structure I Yx Historic House: 91es ❑No On Old King's Highway: @-Yes ❑ No,: Basement Type: mull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 100 Sd Basement Unfinished Area(sq.ft) V,)v sa, Number of Baths: Full: existing 2 new Half:existing j new Number of Bedrooms: existing tj new Total Room Count(not including baths): existing .. new First Floor Room Count _ Heat Type and Fuel: VGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes i3No Fireplaces: Existing NA New Existing wood/coal stove: ❑Yes QI- o Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing Cl new size Attached garage:Ukle*xisting ❑new size Shed:@Ming ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes R o If yes, site plan review# Current Use�[�e�"► Proposed Use }fe A x BUILDER INFORMATION' Name / A Lj L r2 ic V Telephone Number Address Hv m t y t J u A-A' License# Home Improvement Contractor# I Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO S DATE .j FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO: ADDRESS VILLAGE } OWNER- I — DATE OF INSPECTION:. FOUNDATION i FRAME 4 r INSULATION t FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH ;!a e- FINAL GAS: ROUGHS < FINAL AM FINAL BUILDING ; _ fi`C)C., >rq " DATE CLOSED O_UT Ej ra3 ASSOCIATION PLAN NO. U' c, i�tip' 'aa�s` ,1, �"�"'^�.�"...ry�=`:...v+.l°^.�..� • Y.... ►Il�ll �II: III � _ � "���� � : .. 3 Yi �a ti FEB 5 2002 Application to & b �` ling'E; 3WObialp Regional 3biotDrir �Wgtrttt Committee In the Town of Barnstable 2 00 7 CERTIFICATE OF APPROPRIATENESS 0 ry Application is hereby made, with four complete sets, for the issuance of a Certificate of Appropriateness under Saor= 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on Mans drawings, or photographs accompanying this application for: -- CHECK CATEGORIES THAT APPLY: zc CYJ 1. Exterior building construction: New Z Addition El Alteration Alteration r i�1 cn Indicate type of building: ? House ❑ Garage ❑ Commercial ❑ Other cA 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Renting Existing Sign ElElpai 4. Structure: ❑ Fence Wall Flagpole ❑ Other TYPE OR PRINT LEGIBLY: DATE ADDRESS OF PROPOSED WORK / % D i S iRIZ S i_A W/= ASSESSOR'S MAP NO. 0 Z ice_ OWNER &L C}.0i�L ►: /✓AJ /—o L 17 ASSESSOR'S LOT NO. Uo 7 Ct HOME ADDRESS ii P i C 12, /1, 5 L_4AJ1 W. Ali RMSTASAli_ Mn.TELEPHONE NO.�bJ 34.1 A/3 c cc M FULL NAMES AND ADDRESSES OF ABUTTING OWNERS including those of adjacent property owners acrosny public street or way. (Attach additional sheet if necessary. t 7 LJc•Tr;:..T,,4is D,-:ta-rA-iSSC,-)Pi$f/.inc•i;,!�Aa/vs A �R M4.4itt i 7-3 r/noo7►4Y A ,43,63eAq►fNo13;ic-ia'� c:AP44 i r2/AL•^ w.-3Alt. Sr4,6i.& i-1Ac1L►Y -y NAQY. J1=Ai%�kIJ L GROS"i %1c7 CA)'l_.S TRIAL ' w>✓� T 43Aa'A/Sifi/ilE MA-. v�[LY 7-j Knwr:e, I JR -,c LYNa M. CRAM S /IGT&-.^ A Z 0 S : M LAMA---- ul;-t; AARNS:AALj�_ 1A . c,2L6i '7=7 �/1R>;Y STRia lT /C /)Ejil�F_� LANr oit-4 e 1~i1��r}L,;IrL ♦A iAti. .SiirC.%.�,is. "lri=:r�n/3 SS0AJL4 Atli))t.5;4y,E,,�: Q;-ALr'f ,A' MA p2c-3; AGENT OR CONTRACTOR TELEPHONE NO. ADDRESS DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please include locations of proposed signs. . WILL 66 RI':FLAC9/N s rxtS//ti•;JKL,;01-A c� ,q.IV"AIJ 40 ID 4-1 0,4AJ)r);//c.ti •.... . 9L /6"X 22., J. l W,LLlj4V4 .4 t oM,i 4arrz• / G :.{q7/tv:I Y.%.'iN 64J4-,W/L,1#ri5AT,--,q (gi rl{ yl S14 /A.1 Lf JN k j,-5 ¢• F'iNrP.rcti -4 PNAu.,rec: 5 ....• ►3,- IiAXVh/r0 -5i11 /Lai/rL4i"11►r1:mle i:41ii/w3I>J ALL 4AJ1AJ )e„i> cv,cL 14 M a/� l%/Ns � ��c r�/1�'1: T/l1 Si1MiL �t.s A'/'j,-c,=//:+.;- C.,� v/_4 &4 "/)> ..u/ci .6: 711L c:.ue.y, l//Wi 44 /N�'/i !� ".4K HQDirie%/ /}L' /.1.4i,:t, 7C ,eisr /•43 Signed Owner-Contract r-Agent For Committee Use Only This Certificate is hereby Date ? Approved/Deni d FEB 20)2 Committee Members' Signatures: APPROVE Town of Barnstable • ' '"= : Old King's Highway Historic District Committee , SPEC SHEET FOUNDATION l j/U C i? r- 1}l SIDING TYPE C L?i7A1r COLOR /VA TVR A L. CHIMNEY TYPE A/A COLOR ROOF MATERIAL A s P14A L. T COLOR JjA 1 V ARD S L A'rIG �r- PITCH t'o /Q1Sit_ TC /Z �^t Z'�J j ..i �•i)tJii t IZNp WINDOWS AA 2 V IM COLOR aiJ{ i 1-1�, SIZE TRIM COLOR W rl !Tr DOORS FXfFR/c2 1__jX S I): c^2 COLORS NAAcc id SHUTTERS COLORS GUTTERS !::14 ,rT A L U M !Aj Nt COLORS j ,:tl IT/i DECKS Nly MATERIALS GARAGE DOORS N /V COLORS SKYLIGHTS N A SIZE COLORS SIGNS NA COLORS FENCE COLOR F E B 5 2002 NOTES: AN. p e ncluding measurements and materials/colors to be used. Four copies of this re r d r submittal of an application, along with Four copies of the plot plan, landscape plan and\��ie///levatioa p ans, when applicable. SPECSHT Revised 11/98 TEMPORARY TURN AROUND N/F FREDERICK HILLS 8) HOUSE UNDER CONSTR. G� pp LOT 7 gyp. 43,686 sq.ft 1.00 Acres Dc 2$9 O 110 6 SO. LOT 18 LOT 20 JOB # 96-224 CER TIFIED PL 0 T PLAN LOCATION : LOT 7 DESIRE'S LANE W. BARNSTABLE, MA -SCALE : 1" = 50' DATE : OCTOBER 3, 1996 PREPARED FOR: REFERENCE LOT 7 LCP 40599B VA UGHN HOM UILDER S I HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE tM OF GROUND AS SHOWN HEREON. ��' o AR NE at aoe-ae2-+s�� N. r« eos 3ez-�eeo s OJALA H Down cape engineering, taa q °��9 Eo i° CIVEL ENGINEERS LAND SURVEYORS ------ — ------ ---- main eL >wmut. ma 02675 DATE REG. LAND SURVEYOR q Assessor's Office(1st floor) Map >[� Parcel • do Permit# J / Conservation Office(4th floor)(8:30-9:30/1:00- 2:00) cj�, Date Issued g R-7 —/6 Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) Fee �.12 3/d. Engineering Dept. (3rd floor) House# 1 4 tNE Planning Dept.(1st floor/School Admin. Bldg.) �`/ � � lojectt"Street ve Plan Approved b Planning Board 19TOWN OF BARNSBuilding Permit Application Address Village / /J Owner a2,4Zn2k& 2, , Address 'j!3 �/�� s /'I fa,tJe� /�` A TelephonePermit Request O �c 4 First Floor �f� square feet Second Floor square feet Estimated Project Cost $ 400 Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway ZA9 Number of Baths No. of Bedrooms Total Room Count(not includi g baths) C d First Floor Heat Type and Fue M Central Air ,VZ) Fireplaces Ad Garage: Detached Other Detached Structures: Pool D-Attached y Barn .( None Sheds Other uilder Information Name �r// Telephone NumberA�" Address `Z 7;i?oz7 S �fJ-+t/`�" License# ©40Z :�t3z l Zj Home Improvement Contractor# ZnD Sn Worker's Compensation 4 r2 f /7--2 7072 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PER DENIED OR THE FOLLOWING REASON(S) i FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED `• MAP/PARCEL NO. ` r ADDRESS ` VILLAGE - OWNER DATE OF INSPECTION: , FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL tiM , PLUMBING: ROUGH FINAL GAS: ROUGH FINAL d4a °2 FINAL BUILDING r i , � � • t DATE CLOSED OUT r ASSOCIATION PLAN NO. Footnotes to Table J5.2.Ib: ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area. expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example:3 ft'of decorative glass may be excluded from a building design with 300 W of glazing area. 2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken*from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness,over the exterior walls without compression, R 30 insulation may be substituted for R-;8 insulation and R-38 over may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing(if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum of the wall cavity insulation plus insulating she (if used). Do not include tu exterior siding, structural sheathing,and interior drywall.For example,an R.19 requirement could be met EITHER by R-19 cavity insulation OR R-13'cavity insulation plus R-6 insulating sheathing: Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(snch as unconditioned crawlspaces, basements, or garages).Floors over outside air must meet the ceiling requimmeats. 'Tre entire opaque portion of any individual basement wall with an average depth less than 50%below grade must mc_: the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned br..,ements must be included with the other glazing.Basement doors must meet the door U-value requirement d_scribed in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3;4, or 5. If you plan to install more than one piece of heating equipment or morn than one piece of cooling equipment,the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1.a NOTES. a) Glazing areas and U-values are maximum acceptable levels.Insulation R values are minimum acceptable.levels. R-value requirements are for insulation only and do not include structural components. b) Opaque doors in the building envelope must have a U-value no greater than 0.35.Door U-values must be tested and documented by the manufacturer in accordance with the NFRC tat procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(Le.,may have a U-value greater than 0.35). c) If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 I Table Jab(oesdosad) prc criptive Paehasa for 06 and'10Familr Ruid"mW BatldhW ftaaad wrtb Fad Fuels MAXIMUM Glazing Glazing Ceiling Will Floor 8aaeme� E1H 91ab °O�g d=Y' Airs'(•/.) U-value R-value' R valual Rrvvvd Rwakaaf 8. pack= 5101 to 6500 B DaTreat Data' Q 124'. 0.40 38 13 19 10 6 R 12%. 0.52 30 19 19 10 6E9!79 s 12!4 0.50 38 17 19 10' 6T 15% 0.36. 38 17 25 WA Ii/f u 15% 0.46 38 19 19 10 6 its 5 AFUE v 15•/. 0.44 38 13 25 WA WA F1 W 15% 0.52 30 6 85 AFUE X 8%. 032 38 17 25 WA N/ Normal ommi Y 25 WA NAFUE Z 18% 0.42 38 17 19 10 6 90 AA is% 0.50 30 19 19 10 6 AFUCTE L ADDRESS OF PROPERTY: S 1 !2 S Cr//S d,+R iySTidee l A'A 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: /(?� µ 4. %GLAZING AREA(#3 DIVIDED BY#2): S. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DEIF.f MnMG ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: g4bmis-080303 a . : The Town of Barnstablele $ Regulatory.Services 0 9- Geiler A,fa,ut� Thomas F. , Director Building Division Peter F. DiMatteo, Building Commissioner 367 Main Street,Hyarirtis MA 02601 ;08-862-4038 Fax: 508-790-6230 Permit tio. Date- -AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW . SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A.requires that the"reconstruction;alterations,=ovation.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: 11 Af'S /.'�� ,t 14 A/ /,� RA.e ti c Tam�� "" " ^ ' nn , OwperpsName: Dui �' I_�LLIlL/Gd/ AnL_d.I Date of 4pplication: I hereby certify that: Registration is riot required for the following reason(s): []Work excluded by law ❑Job Under$1,000 , ❑ Iding not owner-occupied QOwner pulling own permit ,:Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED. CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THEARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL:c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name. Registration No. Date owner's Name r oFtrte r� . The Town of Barnstable BARNSTABLE, 9� MASS. Regulatory Services r A� e Thomas F. Geiler, Director Building Division Peter F. DiMatteo, Building Commissioner 200 Main-street,Hyannis MA 02601 . ce: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: /6 Z JOB LOCATION: // /.�/—'-5 I R re- q A/yl number street village LIII "HOMEOWNER":_?A U t_ F0 L T Y S"O$y'G?,G y/ 5'0 8 34 7 7 0 3s" name home phone# work phone# CURRENT MAILING ADDRESS:_8 D,E S I R IE < L AN/i _WC ST AARA15TARLrr MA ozc cY 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 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 buildine permit (Section 109.1..1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said pr cedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states.that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such wdk,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:FORMS:EXFAIPTN r The Commonwealth of Massachusetts === Department of Industrial Accidents oxce ofloee$9921/90s . 600 Washington Street •Boston,Mass. .02111 Workers' Com ensation Insurance Affidavit name A v [., i•,0 L i y location // D L.S 1 R r S L AA_1A city �/��' A A ti���4��-/� /yI�? /� 2 L t � phone#\�Ob' ❑ I am a homeowner performing all work myself. ❑ I am a sole etor and have no one worldn in capachy � %/%%%%%%%%%%%%/%%%%%%//%%/%/%%//%/%/% ////%//%/%%%%%%%��/%%%%%/%%%/%/%%///%/%%%%%%%%%/��%%/G%%%%%�/%%%%%%/O% I am an em Io er rov, iding workers' compensation ❑ P Y P.....................................................::. a n am .� l m nY t'O A r w :< l+T �.+.................... . ,•:.fir gel � ::..:ice••�) •Y .Cl s ..ji...,i..%'%'+'.'''';: ��'�::-•%nisi:::::$:':ii:4i::i}:;'fiY{:;isi;:i;{%iiii:%:{:;!::::�::is��::i!::i%i::ism::::Y:i:::::iiii::i::i:::!::!:i':%::ji::i::i::::i::i:�::'•":::'-':�:'::'%i':::.:':'...":i�':i:�.iia :liisttr0ace cb:•.:.:. ..' »:<::;.:;::;.Y:•;:;;::<::<:::>:;;:':;;::.;:.i::{;::;;>:�::;.:{:;;:;:. ::.;;;:�:;':::;.>:<.::.;:.;;:.>::>;'>%'«�::;;:. ❑ I am a sole proprietor;general contractor, MAN r.homeowner circle one)and have hired the contractors listed below who have the followin workers' co ensation polices: g ::.::::..,..,:•::.:::::.: man.::neme.. -.... .... .. .............. Y.:.:{{•?}i}::•Yi)Yii:;^:•Yy:YiY:;{{:•:Y:;v::•:.v.v:::::::.v::.v:•............................. ... .................n..... .. .:ir�•��::??:`��:;i:;:j�:'j•>%':%i::}i:t%!}}:;:j}�'?%:fii:J:�i:?:4:%`FL+ii?+:i%iiiiiiii:'{%:%�::v%i.;~.;:}Yii:>>::;:;':;::;ii:: i '}ri{;i:::!%YY:!;iY?isi%is5viii::jl%ii:%i'l.�i':{•iY::�: a� Y �4 iii?�}ii%iiiCSi: iii$yjj;Y^i:+Y�}i`iiiiii};i:{:ii:t^'r�F%iiiii'%ii:^:{{;4;•YY}Y:{v:•YYi:•:�:SY:B:•:}::i:::nY{..{::•;.;;;,y;•,v::::::nv.:...�..-r. :•Y � •i:;•Y::;vY,:v.•:'++::Y'v::{•:'v::?::•,+i'v%:•:'•ii:::{.Yx;...y{;.. ........................... .•.x% ::: -..r .. ... ::.v w:r.:•::v .;.. ...:::•Y:::.y:::::.v:::::::::.:v::::::CvY:iviii:^:i{�:i ti%jiiiji(::• L ........ ..:. .. .. :� .i.v:... ii':.iiiiii:•:ii:::iY:ti^::::;Yi:;;iiY;yiiiiY;;;:.::v:::::::..�;......... n��. )Y;:r:..: :. .:;. r nviiY• v .�::::.•:• ':•::�:�.:-:.y.i..:..:.v.v::.:{v'�•.•..•.%::?....:.:v:• :v:?� :v.•:YY:-..•{{:YYY;:y'::::::..:..:.vi:}i:.�::A::v:•9:4iT'ii{{:y;i::;}:.�:%:i;:j.i .. ... XM!•... ...� ... ............ ....r. ....Y...-. wn,:::•w:+.iiWo i::v:O.,w::::::::,•;, ...:.; ................................:. ..v. ... .�...............».... ..... ...... ..:. ..... .. :: ....- :. ............. ....y��. y::::....................:::::.v:::::';+.4:;{{4:�:J;{•Y;�YY;{•:iY' M1{v'.,rt:wn ..... :iY':'v:^: Y:•Y};{^: ;;;Yv ::.•{:+Y;{{p}:':':.. 'y:{:ii%iiii:?i<4iii+:ii?:;i:;ti:i?: �:M�ii:::::%:^::::fi: :i1}J:'%iii:::%v>::::::'?ii:{{{8:;•::•:Ci:{:{.;}iiY:•i::i}::iY::4::i+:4i:+i';::ii:;:�:ilf?:':':% ;2:::%o-i::.: :.:••::.•{•:;::"::.�.:,.;:.:' :: :.:. : .. ............................. Ori ...................................::::::::::::::::::::..:::::::::.Y:';•i:•:iii>:.;:.:;::>r:.;;:;.>:.>:;<.:�:ii:{{•ii::•::iri;Y:{.::.::X. X. X. ....................... ...r•:>:•Y:•:Y.�Y:�:;•Y):a::•::{•YY'.;riiYY:{:{{•YY:;;^+:%::�•.:::......... .: :.�.': ..... :: :YY:•:Y:�:�:Y:•Y:Yii:�:_:Y:{•iYY:::.Y::i:.i%::::%::;•Y:•;:�Y:;;. '•�i):%;:::Y•i:.i:�i::•Y:{•>:>�>;;%::%:y:i;•Y:>;:. ..................:........:...... ;came::{.;'{•>;:.::.:<+: •++:::•:::;.::.:::�:. •>:�:< ...... • v- •G �a r ... ts' z----... -r ..............:::.........................:...................................................... ::.�:Y:::.i:{.........................!.........:.......... ...:.............. ....�•iiY:+{... :........ .............................................:.:..........�:::::•:.•.s> .�::::.�.:.:'. ::. ::. ::. is... ........,................ ....... ....... ......................... Fapnx to secure coverage as required ander.Seetion 25A of MGL 1.. can lead to the imposition of criminal penalties of a fine up to t1TS00.00 and/or one years'imprisonment as wen as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I underatard mat a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties ojperjury that the information provided above is trw and coned . signature n . Date 2 O 2 Print name A tl L -ry L 0>/ Phone# .SD official we only do not write in this area to be completed by city or town official city or town: per init/llcense# ❑BaF:D Department ❑Idcg Board ❑checkif immediate response is required ❑Seln's Office Agomm _ ❑Heepartment contact person• phone#; Oth ociw d 9/95 P]IU i Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal'eiitity, or any twolor 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,section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. 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 affidavits may be submitted to the Department-of Industrial Accidents for confirmation of inw ce 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. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavitfor 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. The affidavits may be returned to the Department by mail or FAX unless other arrangements have-beenmade:.- -�-___......_ .._.__ . .._.._..._..:_._�. . The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of lovestlgadons 600 Washington Street Boston, Ma. 02111. fax#: (617) 727-7749 phone#: (617) 7274900 ext"406, 409 or 375 ' J s•o" ;1 -- w..or.. I g 1 •I 1 to G.O. 1 i I i It SA i� N rn I iINil 13 ' d v 5,6- � p•6.. i 6.O•• I .I. ic .-.FRCi'L-�1K�11rJT�EiI.. t . o , � O I:n • I I ;�' I C 1 W „ TEMPORARY TURN AROUND ,per 1 sr� FREDER CK HILLS ti HOUSE UNDER CONSTR. ti ti o� pp LOT 7 gyp. 43.686 sq.ft 1.00 Acres . Dc /0 6 LOT 18 LOT 20 JOB # 96-224 CER TIFIED PL.0 T PLAN LOCATION : LOT 7 DESIRE'S LANE W. BARNSTABLE, MA SCALE 1" = 50' DATE : OCTOBER 3, 1996 PREPARED FOR: REFERENCE LOT 7 LCP 40599B VA UGHN HOM UILDER S I HEREBY CERTIFY THAT THE STRUCTURE OF SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. ARNE `yam at nos-ae2t s N. I t� tsoe aez-tteao 3 OJALA H down cape a wf o' /0�3 Ali s 4 os CIVII. ENGINEERS -- =—_---- --- to LAND SURVEYORS t3o mdm aL. ymmouth, two 02575 DATE REG. LAND SURVEYOR Ck THE • IMAJ= = The Town of Barnstable MAM 9. Department of Health Safety and Environmental Services M Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner ate, R9 7 To Whom It May Concern: Please be informed that a Certificate of Occupancy has been issued for T 7 Si�ES rUt (�LS%�s3�ti1S%R�.Ct #74 0-266F The Town of Barnstable has no further interest in any performance bond for this property. Sincerely, bondrele j6 t naTlonaL Lumbermens Mutual Casualty•American Motorists Insurance Company InSURance American Manufacturers Mutual Insurance Company•American Protection Insurance Company companies Post Office Box 859197, Braintree, MA 02185-9197• (617) 380-7100• FAX(617) 380-7399 i August 19, 1997 TOWN OF BARNSTABLE DEPT. OF PUBLIC SAFETY 367 MAIN STREET HYANNIS, MA 02601 Gentlemen: VAUGHN HOMEBUILDERS, INC. 43 TROTTERS LANE MARSTONS MILLS, MA 02648 1012 3SE 900 221-00 On AUGUST 21 , 1996 our Company issued the above-captioned STREET PERMIT @ #LOT 7, DESIRES LANE, WEST BARNSTABLE, MA 02668 Bond. Since the agent has informed us that this bond is no longer required, we request that you cancel this Bond effective SEPTEMBER 23, 1997. I'm including a copy of this letter and a self-addressed return envelope for your convenience in confirming cancellation. Thank you very much for your time and cooperation. Very truly yours, AMERICAN MANUFACTURERS MUTUAL INSURANCE COMPANY OA BOND DEPARTMENT D0388 BRA 9-g6 28M q PCOMPIEW Z 258 -643 855 I' Post Office Box 859197 AVG 2 n T .i° !D E 2 .7 7 Braintree, MA 02185-9197 ;.1 �,. 700�72 S. TAGE RETURN' � � � FL5T _ -U. r Pl- 191- 1 / II k •' III 1 l i i tl • • 1 j • . • • , I - • r i TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 000 000 063 GEOBASE !D ADDRESS 11 DESIRES LANE PHONE (508)428-3832 WEST BARNSTABLE, MA ZIP 02668— I LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT PERMIT 20004 DESCRIPTION SINGLE FAMILY DWELLING (PMT.#17539) - PERMIT TYPE BCOO TITLE CERTIFICATE OF. 000UPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services i TOTAL FEES: , BOND $.00 Ox CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY *, ; * ■ARN3PABLE. • \ sr MAS& OWNER VAUGHN HOMEBU I LDERS, I NC. , y ' 1639. ADDRESS 43 TROTTERS. .LANE MARSTONS MILLS, IIu C \' BUIL G IVI I- �I BY DATE ISSUED 12/16/1996 EXPIRATION DATE TOWN OF BARNSTABLE ••�..`„. _ BUILDING PERMIT PARCEL ID 000 000 3 GEOBASE ID ADDRESS 11 DESl I:n"�'S LANE PHONE (508 )428-,3}• WEST aAktIIS'i'I+i3LE, MA " ' ' ZIP 02868-- �:. LOT BLOCK . LOT SIZE DBA D.EVI L,,.,PMENT DISTRICT PERMIT 111539 DESCRIPTION SINGLE FAMILY DWELLING (SEW_PMT_ #9E;-4'2'?) PERMIT TYPE BUILD TITLE NEW RESIDENTIAL BLDG PMT c:ONTRACTOIRS: 'U AUGHN, JOSEPH Department of Health, Safet', ARCHITECTS: and Environmental Servicesy ' !UTAL, EELS: $310-00 ;0N: T UCTIUN CUSTS $100,oCU.00 101 SINGLE f AM HOME DETACHED 1 PRIVATE P ( ' MASS. _,WNER VAUGHN H MEBU:I LDERS, INC. .. 039. ADDRESS 43 TROTTERS LANE D f MARST(�NS MILLS, MA BUIL D IONBY DATE ISSUED 08/27/1996 EXPIRATION DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED APPROVED PLANS MUST BE RETAINED ON JOB AND FOR ALL CONSTRUCTION WORK: WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPR0yAI,.$ PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS OeP 91-7w -Z3-9G.ez�/ 2 � 2 /N,4/ 2 ILL> 3 r 1 HEATING INSPECTION A PROVALS ENGINEERING DEPARTMENT 2. (O,AcR�D FFtH TH OTHER: SITIt P N REVIEW APPROVAL (2,bz 6 WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVEDTHE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. ,ZOM Al �+^.« y...v'.+ �.•. ,.. ."r .,. ..i- ..r• _ .. .... ..` y . .. -ram.•r.V• .- «..r' -l^".�'•. - l . 114E r, The Town of Barnstable BARNSI'ARLE. A p Department of Health Safety and Environmental Services MSS. 0 ��Foy Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner i Inspection Correction Notice -1� t Type of Inspection w' p Location tit� Permit Number Owner Builder C,In ri One notice to remain on jobsite,one notice on file in Building Department. The following items need correcting: Please call- 508-790-62 7 for re-inspection. Inspected by Date T j j j 2; 1 i i � 2 j 14 4 ULJ .J cl 3 0 � • The Town of Barnstable 98ARNSTAB".� Department of Health Safety and Environmental Services MASS. 1639. �0 CFOH1A�6 Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection \v Yr r i y Location °Permit Number Owner L) 4"U ' Builder ()(`1 C.` One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: 01 - C42) 1 U e A v PC Ive r.. c r Please call: 508-790-6227 for reeinspec((tion. Inspected by Date .: Application to ' •1996 996 133 ♦� MP Old Kings Highway Regional Historic District Committee m in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application Is.hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed -.vork as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: New Building ❑ Addition ❑ Alteration Indicate type of building: ® House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). / J TYPE OR PRINT LEGIBLY DATE ADDRESS OF PROPOSED WORK 4�10f 7 7) '; S eo'5 ASSESSORS MAP NO. CKE OWNER �A,>>?i'� S� ,r/nti T�'�T �[/Ic f-s� 'Eai t�161 ASSESSORS LOT N0. 00/ HOME ADDRESS .��� F�11�nu7f � lC`n��Py � jMA TEL. NO. � 7E-g209 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). {�I¢v C) !7x' ,� - �,��✓� G��-� 1— i� �N`"�i,4l�z MA n-���L� -,�O I L/ f�`&IC"PAt � ��C 17�i L�>^T I1 nz11�dU�s-� VA �]�R0 ii r r;11 'fD - AGENT OR CONTRACTOR �` Pt- �A_ �\1T.�^ TEL. NO. 14D2 '—Pl 3 ADDRESS GT 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). 3u i�D 5,,�q(,� --rA')k QaLOiv;A L H-t+Ac -e-A a CAe 6ARA6F ! V � 0 LI Signed Owner• o ractor•Agent Space below line for,Committee use. he Certificate is hereby Date A ,.TirAgL 2 y���c n,t\RntS ABLE v. .- LD r,11,1 HIGHV A Approved ❑ IMPORTANT: If Certificate ' ap roved, approval is subject to the 10 day appeal period provided in the Act. nicannrnvarl (� J� a� 09S1 / 3/6� ao 99ZL 5 � - I FS Town of Barnstable ! Old King's Higbway Historic District Committee SPEC SHEET t 3�1 GACN && FOUNDATIONll9/,l,.t� as x y - NRTvRAi-•- � ! Ri I o7 .e 5+ -S�+nr�L E- SIDING TYPE"''" — ^' ""�'�- ^e COLOR R V CHIMNEY TYPE �li.� COLOR �: - i - c�5►/� 51„w,�11 o COLOR ROOF MATERIAL "r, PITCH �'� SIZE o?yYa WINDOW� TRIM• COLOR Gv i �A���c f,P�t1,eeA COLOR IhR,eGt�N DOORS -Ae �ri 7;, 2,,,e f i -SHUTTERS !�N GUTTERS 1 •DECK r � tGARAGE DOORS O� ��� A'f"ff1Ct-,Pd—COLOR ✓Y1/�� /L7 NOTES: Fill out completely, including measurements and ma quired for submittal to be used. Three copies oftis - form are re ittal of an application, along with three copies each of the plot plan, Q landscape plan and elevation plans, when applicable. Plot plan need not be "Certified" , but should show all structures on the lot to scale. Fy SPECSHT +:a\ ati : :y r !'i t �[i• K t� '.,a+ - %r Y r4 t 7 �'}Y S,a li.')tv t y;` �,,� l .c L ".d a j:.•. >. r / 't .r r'i ) y 6,A` �f�. ,C7'�g „r f .�'ra � .. -`i, .y. 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I SETBACKS: FRONT - y , - - - ' ; I G�f.A•h-1- _ ._, r: A _ SIDE # .,: . , ., REAR - I r, - - MiG / /x�.J,/) PLAN REFERENCE: - .Y . ✓�44-0 I . \ ,. w I PAL ,.f ., - , \. - A . l ,Z o F I sl e`� . 1 . , � - t h e1 1 , o� � _ wr u 4a 6 r� ` iZ i �114 I I2'` 11 �i5 I - i 0 1 1 � Z. + ,nbi' t'p 11 t\iQ;'' l v fc . . :. - eft p - - - _ .. t .. - - ..� { , _ '" - . . , _ .. - ii - } .',r- r _ /a° ./ .. NOTES: ' E'`` i - Y . ._ ._ t I . , f, C J - - . .� lr;•5 / Y ` F -� r . r J j a .; ( 1.0 I_ � r v4 I I GARBAGE DISPOSER - �I�� A• • ff _ _ :" J} SEPTIC DESIGN: Is r✓- C 1 f � .DATUM iS w. :�- l ..• a: I� GPD GPG` . OESlGN FLOW: BEDROOMS y��� _ I= :. . .- N1CIt�AL WATc ri iS . ,, I_ 1 ' t ) 2 M - , ,d- ..: ...;, i; � ? \ �.. USE A .�' GPD i7ESIGN FLOW , ` 3. MINIMUM PIPE PITCH TO BE 1 8 PER FOOT. ? 6 - i ) Ids' i +4' l •. ; .:.; I / , . SEPTIC TANK, __. GPD ( _ ,� °�2.� GALLONS 4. DESIGN. LOADING '.FOR ALL PRECAST:UNITS 70 8E AASNO H }} _�-_ , . ' .Z.1 '. t �L 5. T E MADE WATERTIGHT. : . . /:>6,= /;. :: . s ' t. PIPE JOINTS 0 8 . , u w>,:�.. • �/ , �, USE ;A GALLON SEPTIC TANK ,_/ - / r- . CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. , : , ., • . . , ;. ,_:..•- ''..f. r,�• w;. �,.,� \. i LEACHING - ca T r� , ". , :, -Y'" y 6r .L � __ 6 ENVIRONMENTAL CODE TITLE V S , �' ,l ,. , -' _•,.>-- . , , •' l ".' .+.. �•1� Y I r s}3 , �' �S`i ' P(� T 1 P N 1S FOR PROPOSED WORK ONLY AND NOT TO BE �,6..��---�- ,�.. 1 r f s.DEs. �.��_ __ G-�-, ) �_�.3 G �. Hs LA �11 � ss -..'"~ ; ; a,;�� "' USED FOR LOT LINE STAKING. 3zo : r T,�rtl(os y OM. - - - r._.._ �' GPD . �'� BOTT ( . : ) /- I�. 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4 PVC. ' �,1�� f y i' 1 - v f;1,Jr �fl_ S.F. M GPD .. i - f FI pA J fy1 ;^I, �� 3 , r , A., - ./r '� �. .•� I A � s ' t �,� •�� t� r 10. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT /, / /� i _- ,�� ' -N, °"�`1'` �--' HEALTH AND P R SSION AINE t A'vt � TION BY 80ARD OF EMI O8T D 1 " w:I". f r M1 -' v , . . ,V ., "I ca '',. S t� t '4y �a { i 7 rIr , / �_,:_ I - 17 ' ROM BOARD OF HEALTH. - I I , . k p r J1� \;� •ram-, /J� / � ' : �JJ . � .i""i ( `'`�, I p .1 , of : - . .. /0. - "�� - , '' / - , , 1�- ' �,, 3 IN THE TOWN OF: r , f i . w �, t; - , ;ter �,M ' B o k!Fes"' j�- a--„r1� �.I-) . l � i (_ ' r . ti ,.: , PREPARED FOR: r..._t c' t� r4 • �jo t-4�fM1 '_- 4'2`�,., I :. ' APPROVED DATE - • . 1 ,;,,. `�, � Feet e , `r 2's . a } - " 0 p C�.� ,, - . . - `•• I ALE. _ �- . .e _ ,�, :SC DATE• . . 4� �. : ►.. I�F1+� a , -�' i4 "" ; - ,/rb--,Gb•", I /, 1 �' �� ,` r rL-sJ r r, (A p 2.1 I _ r ►bO R! ,?/Z�t-1 Coy 5�f�►I - _ . �; d c ry - d 2 ip 1 _ ,` . � - `�N - 4f has' C�OWI2 CA�1�' el1g111 @eT112g, IlT C. �T OF ,� �t �, . . • s :k n o ARNE H �Gs .. t.-., ER S O'A. . ' . , Ai1N , CIVIL ENGINE K E . . Si 4i rA c Esoe O-R"W ; LAND . a• PFIbNE SOb-3e2 • 5 0 7�Z3 9< ,.:. : outh of ' x • MUM, .S. 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