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0043 DERBY DRIVE
_ e o dui � �► � 1 UPC 12543 No.S� 3LOR HASTINGS. YN ,P-.;._�,, .„mac-s,• -: a•7.<:L' - ..� i<;, -.� .:�.-. -�..� -..�-w. _.-. 't� r,� �I�..!.1p�- _ -;>,�n"•'� �A� ABLQ 9QDI"(ZM0_ULICATION TOWN OF / Map t Parcel _��� Permit# 6 S Z Health Division 9 -�Sf /�Jo2 Off_ O Date Issued 2 0 S o 2 Conservation Division ! I Z&160V �� ®rSEEPTIOt pplication e Tax Collector 0 V��- 07 Germit Fee l�?%�601 Treasurer SY M P1UST BE Planning Dept. IMSTALLED IN COMPLIANCE Date Definitive Plan Approved by Planning Board IfVITH TITLE 6 ENVIRONMENTAL CODE ANG Historic-OKH Preservation/Hyannis TOM REGULATIONS Project Street Address^��� I Tf:8zS LA N .' Village Owner 1AVC-� -� SV 'D6RO-'%k PIZ- Address G=- Telephone 5oF 3C D-- O V66 Permit Request 1 'LC a0 ff - 51 NG L !s O - Square feet: 1st floor: existing proposed J*0 2nd floor: existing NNO proposed Total new aQ q Zoning District Flood Plain Groundwater Overlay Project Valuation 30,00G) Construction Type WD4't> LF Lot Size q/, S 7-DL S. E. Grandfathered: ❑Yes No If yes, attach supporting documentation. Dwelling Type: Single Family JX Two Family ❑ Multi-Family(#units) Age of Existing Structure 3.5 Vt-5, Historic House: ❑Yes XNo On Old King's Highway: ❑Yes 9No Basement Type: ❑Full Xcrawl ❑Walkout ❑Other CE9 LL- Ut D ei' _ E 6 6 sTRuc - Basement Finished Area(sq.ft.) -- D - Basement Unfinished Area(sq.ft) O0S E -rt NG� Number of Baths: Full: existing new - 0 Half:existing new to - } Number of Bedrooms: existing new — 3 &--k;sTl N& Total Room Count(not including baths):existing 7 -new— First Floor Room Count 1 41 C W Heat Type and Fuel:*as ❑Oil Cl Electric ❑Other 4��- 6,LPVEA;T- Central Air: ❑Yes ArNo Fireplaces: Existing :i\IDN G New�#�r►c� Oxisting wood/coal stove: ❑Yes KNO L._.��-- Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size 'Attached garage existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes KNo If yes,site plan review# Current Use (RSl d_PA -+(a Q Proposed Use ,Q BUILDER INFORMATION Name SO S A% ��� l�'�J S 1 Telephone Number� �O$-3.C-9 2- Address (5)U) 1 6 1k License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO T®W/V O r -8,4R /s 41_-7 ,ZA F=t 1,L_ SIGNATUR DATE i FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED try `' I. r �� � ! \ •? - MAP/PARCEL NO: ADDRESS/ r , , ., �n r 1 VILLAGE OWNER - _ C4 "r DATE;OF INSPECTION: FOUNDATIO"' :t 'Z f ; FRAME ,6�rX W Q y/ ?/d 3 7 \7 r t INSULATION D/t, • FIREPLACE ({� ELECTRICAL: ROUGH FINAL`-� ^ M PLUMBING: ROUGH FINAL-1 GAS: ROUGH`-, e FINAL i- `� t •� FINAL BUILDING c C n " 'DATE CLOSED OUTLj ASSOCIATION•PLAN NO.,- , ' r� i r ON y U ni o v A In M � hWeO � � N1�^ � ��scns I\ pO � v �j � o oa Az} yj 4 J h •h �y°jvivoo `P m � 0 1 l N o / n ��Q/ ' 13003 14 i - oFVE,, =`. Town of Barnstable .Regulatory Services BAMSPABLE. ' Thomas F.Geiler,Director MASS• r 9�pr1639. �.0� Building Division ED MP Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME-IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: ,rA_A l t Ly ,&o n AXP I Y i c? I Estimated Cost-0 00 O 'I t� t R t'S CAA/ LJ Address of Work: '1 3 Owner's Name: 5U 5-4 N `F_]PA.V 1t> 12 C OS I C�— Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 B ding not owner-occupied _KOwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. Date Owner's Name Q:forms:homeaffidav i _ The Commonwealth of Massachusetts Department of Industrial Accidents =- — office Ofloyesfiffa offs 600 Washington Street Boston,Mass. 02111 iiiaiii iiii/////%////// %%//�%/��%%�/%%Compensation Insurance davit name V SA M �— 1 location: ,A 3 -C2 1=5 1 `R 0-S L4/U L ci W, —RA4 N LL7--7 ©Z�OV I am a homeowner performing all work myself. I am a sole rietor and have no one working inany ca achy em 1 er rovidin workers' compensation for ruy employees working on I am an P oY P $............................:::.::.:::::::.::::.:qF :....::::::::r:::.::::.:::•:::..;-:::.::::::::::::..:::.:::.:.:::::::.::.::..:.::::::.:.,:.:}:::::..:::.:::.:::.::::::::::{.;:.S;YY:{.}:.?:.:;.;55:.: man ix • YL::y';y;:;t'isiiii'}"r:?iv:l{{:?:..:?v::is:;?i}(:'r,'{;is:i'v'?iii:::':!i ....:-i:;iti::: : +::?:y$ }ii is j '•}:i;isi:?is?::•L::i:;?}:;;5:i}:;::::.}::{:::.v::�.................. .................................... ct fin'�iurance�:cv>:::<:;:>::;•>5<:>:«<:;:{>:>::>:><::.5:55?Y:,S:{:::.>::.;:i:::.:;.>'<;::.?:�<::::::•::. .; ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have win workers' co en sation polices: e folio mP ........................................:.........:...,.,............ .., ,,... :::n......: ........;:..: . .......••••.:v.. :::P:i:4:•:v::{•5:•5:•iiYYY::4:r::: :cam an :na .....::::.:...:....:..:..:: ..........,... .....r....... .......... .r........ ... .. .::..... .............. ....................... :.�T^i::�i�ivi':'ii':;%ism:{ti{is�i;Si;i:;:;::y!;;:ii:r::;):{<:f:;i:;:j:.;:;{:i:vv}'{.;iii:{j:;i:�:.;in$istC::;F;:;:;:;[:;v+:::::::'T.tiiii}ii:4i'+�iy:;:ji:t::iv:i'rj'}ii.'•ij:��i:.L:?ii:{;:ii!t:>}+:��yii::�i:{?;:iJ::{iiY:�iij::�i:iiiY�::;:ii;4ii}::ii$;{•i?:v? 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As quo ted j 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. i 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 supplyingcon an names, address and phone numbers along with a certificate of insurance as all affidavits maybe '4. company r' 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>s have any questions regarding the"law"or if you being requested, not the Department of Industrial Accidents. Should 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 affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license'number which will be used as a reference number. The affidavits may be retmned to the Department by mail or FAX unless other arrangements have been made. 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. %0 The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents 0Mce of Investigations 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 ' TabLi, .Sh(o zd-ed)Bs Fla ' prn�ptt�e Pxcksts+far6-asrd TtrrF�+�Y MA}aM11M" R,� floor Ssae� F�q a dlg . Glariafi � R.yalua t Xrvsiu� W� P� pt 5701 'ta 6500 Hestl DiSzs� IZ;4 0.40 i3319 IO ss � D.539 30 10 • 6,`S jsas! - i Zs Nortasl T 19. U .1Sy, 0.46 3i 13 ZS N/A WA tSAFVE y lsh o.44 31 10 i 30 19 I4 141A Norsasi Sy 15•/, QJ2 . 13 X I E'/. .31 19 ZS i !o AFVE 0.41 3E 13 13 CAT � l9 29 10 am 30 DRES 5 OF PROPERTY: _ . 1. AD Z, SQUARE FOOTAGE OF AL`L FOR WALLS' 3. SQUARE FOOTAGE OF ALL CILAZIN �b % GLAZING AREA(#3 DNIDED By#2): 4 g; SELECT PACXAGE(Q—AA-see chart aboye): KmN' ; ' OTHER MORE INVOLVED METHODS OF D G ENER•GY'REQVIREMEN'IS NOTE: ARE A AVAILABLE.•ASK US FOR THIS II�IFORMA'IYOH' $UILDING INSPECTOR APPROVAL: NO: YES: q;to�.1g80303a • r Fcotnoie's to Table',15.Z.lb Glazing area is the ratio of the area of the glazing assemblies (including sliding-class doors, chyl�ss'wall basement windows if located In walls that enclose conditioned space, brut excluding opaque doors) area. expresspd as a percentage. Up-to 1% of the total glazing area with,300 may be excluded•front ft•of glazing area. oa For example;3 fr of decorative glass risay be exclided from a building designs f -value requirement. _ after January 1, 1999, glazing U-values,must be rested and documented by the manufacturer in accordance with the National' Fenestration Rating Council (NFRC) test Procedure, or'takea:from Table 11.5.3a U-values arc for whole units:•center-of-Mass U-values cannot be tiled. a e cei in R-Yalues do not assume a raised or oversized truss constructs°II- If °'uuulatio bsu achieves the R 8 The '; insulation thickness, over the exterior waUs without compression; R Ca insulattnn may a sir iissuOf caviry latian and R-38 insulation may be substituted'for R�-49 Insulation Ceiling R- a snYalues g ust bresent e placedd between insulation plus insulating sheathing (lf.used). For.ventil�ated cciliags,.iasuiatmg, the cor4tioned space and-the ventilated portion of the.roof. if use Do not include Wall R-Yalues represent the sum of the wall cavity.kM111rie� Plusa in��9 meat con d be met EITHER exterior siding, structural Sheathing, and interior'drywall. . . Wall nquiremenis 'apply to by R-14 cavity insulation'OR'R-13'cavity tastslatioa plus K-6 insulating wood=frame or mass (concrete,inasoonry,ov9)Wall uncoc�ed spans un nditi°ned ccraat apply io wlspaces, basements, Q The floor••requirements apply to fl or garages). Floors over outside air must meet the ceiling requirrmer ts• The entire opaque portion °f any individual basement wall with as average depth Iess than 50%,be o canditioned rnc_t the same R-value tequirement•25 above-grade walls. Wiadaws and sliding gl s requirement bc,ements must be included viith'the other glazing. Easement doors must meet the door V-Ya1uc d-scribed in Note b. ' The R-value requirements are for unheated slabs,Add an additional R-Z for heated slabs, more ! If the building utilizes elettric resistance heating use compliance approach 3;4, r S. If you nP�an�°°���li west' than one piece-Of heating equipment or.more'than i e selected gacka8 P efficiency must meet or exceed the efficiency rcquiredby 'For'Heating'Degree Day requircradrsts of the closest city or town see Table J51.1a HOTES,: 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 strticttrral components, b) Opaque doors in the building envelope must have a V-value no greater than a3.5, Door U-values must be tested and documented by the manufacturer in.accordance with the NFRC test praccdure°r falcon °m the door U-value in 'Cable 11.5.3b. If a door contains glass and as 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.- r than glass door may 6e exfloor, ltior,basefrom basement won i�dge�or ciawi space wall component includes two or more areas with c) if a ceiling,wall, flo r, different insulation levels, the component c°mplies if area-weighted average R ya]ue is greater than or equalto th e R-value requirement for that component, Glazing ar door components comp3S for o�ly if the �-WG1ted,average U- value of all windows or doors is less than or equal to the U-value rcquirsment(0, _ 43 1 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE $0 square feet x$96/sq.foot= T x .0031= 8S plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x .0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x .0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= AS, (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool_ $25.00 Relocation/Moving $150.00 (plus above if applicable) ,&7, 8b Permit Fee IN Sq is rill co 0.6 .h WN � � f IVt ~o O �M E b n wp00 - G x D o o . I � e Ct) do V i � ti r The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 )ffice: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION (� Please Print • DATE: 12 JOB LOCATION: �A� WO JZ number ��' street p 1/)0�ap_���— _� village "HOME �/OWNER": � f) V� J��)�— �[/f C��7`!yC\-'TLJl t)oe a-16_c)VJ^O, name home phone# work phone# CURRENT NAMING ADDRESS: -3 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 building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The 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 p c ures and requireme eo 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 pen-nit 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 work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed-Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. TNIr+ CLERK Application to BARNST)OW kffii'.5 9ftb nap 3�keg'ional 319iotorit Migtritt (fommittee 2g)2 gEC -2 AM 10: 40 In the Town of Barnstable CERTIFICATE OF APPROPRIATENESS ! zrn :: Application is hereby made, with four complete sets, for the issuance of a Certificate of Appropriateness under�Section 6 of Chapter 470, Acts and Resolves'of Massachusetts, 1973, for proposed work as described below and- n plans, drawings, or , i this a=licatinn for- CHECK CATEGORIES THAT APPLY: I E5 =' r- 1. Exterior building construction: ❑ New Addition ❑ Alteration Indicate type of building: House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: 4 . 3. Signs or Billboards: ❑ New Sign ❑ Existing Sign . ❑ Repainting Existing Sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other TYPE OR PRINT LEGIBLY: DATE ,�, �%I��►�- ADDRESS OF PROPOSED WORK� 1 r�--It { �, l� T44S6SSOR'S MAP NO.� OWNER '��.?V�� �a�A A ;' ��— ASSESSOR'S LOT NO. HOME ADDRESS A:;� �1`�I�C (�Y�G !kPf�77 !��AJ-r-A TELEPHONE NO.aDr)— FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any public street or way. (Attach additional sheet if necessary.) o .,+l erl e),P,,�ojur— r �0 1JC IT-.- � R �% , 1nnl1! yl A-�^l-�0 A i. V4,ter �- Q� Yr l hr�c ols �� 1 cam_ pia '7,An e \,'J���1 �f\1 -fi �i�r ��-�',f� �,L,1 c� LEI/ �'�/.•1 � \�3�� c �tit/l ,m AGENT OR CONTRACTOR f 1c�1rY 'yJ� �P✓i� TELEPHONE NO.5�5? f' .ADDRESS DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please include locations of proposed signs. Si ned-a�&\ 1 l i Q Owner-'Contractor-Agent For Committee Use Only This Certificate is hereby A VED Date Approved! ied Committee Members' Sign s: David and Susan Derosier 43 Desires Lane W. Barnstable, MA 02668 Summary of Proposed Addition We propose to add a 20' x 24' family room onto an existing 3 1/2 year old colonial located at the above address. The existing structure is 36' x 28' with an attached 24' x 24' garage. The house is approved as a 3 bedroom 2.5 bath home. The existing house was built by Fitzpatrick Home Building of Sandwich. The existing home is situated on a cull de sac with similar homes on each side and approximately 17 acres of open space behind. Addition features: • The one story addition will be attached to the left side of the existing structure. • The foundation will be a poured concrete crawlspace. • There will be a vaulted interior ceiling with 2 skylights in the rear. • A palladium window will be front facing (see photo of similar addition). • There will be a six foot slider to the existing rear deck. • A natural gas "heatilator" style fireplace will be vented to the side. • We will be matching the existing styles and colors (white) to the current structure. • The construction will require removal of one oak tree (wrapped in yellow caution tape in the photos). • Disturbed ground will be either seeded lawn or bark mulch. • The addition does not require the relocation of any utilities. 9>'1Gj zelia5O Div rit;ifi bA be r 1 -By a ' C�Ctilal"O fnoc:. yiiale. ";I'S x 'CIS.t bt. ril ;}30golcl W i rlS Plfw � �:: `Gr fi Y ,?,u913 l ar'C+usa 9tl: 3 17t if�lli�J}G • w rlic.2d i r��flsyhs:� � �; ��: �1���;ir�s;{� �i :.�:cl�,1.�s1'f' .���rt�t� '�S,s `�S �i�uwi's , "ai:7 es,, #cd ►J;ti ?txa qd 7 i3ffit� f ibia f oc flip Pgffts?d ,rArniG'He j gt, flu, ta b inutia sli clillUt� TlP1St�l;`9 gn� #131itf f# Ei�^ir3 ii s U A i�a.°:;tr {' �!E4 t?f�ti:CCl tC N bos •'�}i1i3 r+liia fiei s''l o! be-d)stic> ad iii+.ti floi ii'>4: , 1r71'c mw alfr ' _ .!�:f.'• `r}�>.'1(F.�•is1�`�'•:�S"fC7:)�f::?l`;l.iaC�•� U� tl:�':r iICIiS�3�4L1L1 �3f4�� 'lF3.)1 fii�• tl� C#[a.t ;`i S.dl w on,�1- {,i � f . i � � ,. � ..ta=t1l ,,�fii1•,V f3 J,, iilYr/f?l,..t'i'l' r . :a 1'ifiX'1 10 1�0,41 3aLt pr-' f'sx,Imml e.-- �it��;�+1o"nivi ilfsli�Fiit�ti: t� - • :ar' }i:1:?€} € 5j.i fi t2i':s witc?: 147,t loot:is r, ed ii?w ,�a ' -ra Sri! off MW eosigelil efv�2:�i:+ €i3 ��!" s !n-nisezi A • #�lc�'f"!'..l� �;`f13 4�# t�i'S •h'} �"l�it}�^r ��i'ilv.acti��t;=' �tti �iX� :3t'## �sClit?��;3!(` �'�Gr fiiVi! r��tr'.! ��1e 1+dEsilt'�r,i1'. z :�G?L��j �',f so �3iml-a 43vornai 1�2lit�};J 4.1 t0�1�:1'tici'ip'1 :1t2 ti i:lm A�-d ia nwel h-wi-mleir) i.-isoclei sdi A .i UfJ.riwi7t, t"1o;,t.?k:i, 96T ������� � � -a _� r � � ��� �� r /� �,..... ,.\ /. /I 1 l � � l v,; 'rrM- y � ey . 1 � !l v T � �, '.1� • _ _ .5 � '�_�,. __ i ' �� —+ �_ I Y }:r`:_ f:. �,� .;'.Y. tip• rZ a ,.'�ti J A i ..tit. r•� + '�y�d'• / h T .� • d" i�t y tsi'�1t,• t. �/�4 v�-� SY`ie e �. Jt- Al y •y, - IA, Ole III II PI � 1 •AII��� �� __,� 4 C�'�. -�" ..^. i M F CcCr� �40 (,tsq CC u, i t Ak .. : �1 r..• }'S� �` 1H •. 'y �� �A'* `tom �_ �, y5. yQ\ -e bv k -�C-c wqr-w ' � - x � ? �f.-�. i ;'fir:�j " • , +. z.4 �M I is : � .� ,l�r.a` a .p." - +'I�IIO .' - - �. � � +a�^np�2 �5c � 1I(/�d� vN� 1 Town of Barnstable Old King's Highway Historic District Committee SPEC SHEET FOUNDATION �O' X "1 ' " 8�x I ' WALLS W.-Tht CRAWL S3'3-CG' ACCL,5S• .,-,I 50c rg r —+>oQRG-:Doil SIDING TYPE �• � COLOR ����r�� S(Pe' f- R6A - Vfli 1T0 R Al G0:5 NATV /}L. CHIMNEY TYPE /( ONC COLOR /45�1-Ff9 U t-T' ROOF MATERIAL AT?0+I TF CTU RAL S �1\I C�D OLOR >L4-C K— AA-TC�'{ (�X(STD Al G PITCH �N��-iZsOld 3uI��ERs sECc�-r�o�Bcc r+u�(,� GhSE�1it(�rUT�t- F�AI►=�toON . �t ALA-Z>k UA WINDOWS COLOR Ul�t�IT L SIZE ��k SY� 1 ��S�roEN r t I�FAL>- Gd N TRIM COLOR �N-P ©N 'B V I L t- S DOORS �G"Lt;' S-I D(/Y G D & /k COLORS Ft( Tt7 SHUTTERS h01V& COLORS GUTTERS /Y�U `` l V�` CUSS COLORS DECKS 1-_ Xf ST/N G MATERIALS GARAGE DOORS �� s z'i/y COLORS _R SKYLIGHTS V L [.V X �� SIZE � x 1'16 COLORS. 'L XI- RI©k SIGNS ���W�� COLORS FENCE 14 ©'U b COLOR NOTES: Fill out completely, including measurements and materials/colors to be used. Four copies of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plans, when applicable. SPECSHT Revised 11/98 -- I Town of Barnstable's Old IGng's Highway Historic District Committee Fee Schedule 0710.112000 Residential Certificate of Appropriateness _After work Certificate of Exemption _ After work Commences Commences -- Dwellings -- __ I I Dwellings -------- - --- __ I I K - u Sheds,under 120 sq.ft. - 20.00 40.00 I.I Additions/Alterations - 60.00 110.00 Addition/Alterations 25.00` 50.00 New House/Garage 60.00 110.00_- Other Bldgs.over 120 sq.ft. 50.60 100,00 I Sheds over 120 sq.ft. 60.00 110.00 --4' Exterior Painting 20.00 40.00 Exterior Painting _ -^ 35.00 60.00 New Sign 20.00 _ 40.00 r.a2 2 Fencing __ 35.00 60.00 Existing Sign 20.00 40.00 I I s Wall -_ 35.00 60.00 Fencing 20.00 40.00 "Flagpole 35.00 60.00 Wall 20.00 40.00 I I Q Retaining Wall 35.00 60.00 Flagpole 20.00 40.00 Lamp Post _ 35,00 60.00 Repaint Sign 20.00 40.00 W Unfit Marquee __ 35.00 60.00 Retaining Wall 20.00. 40.00 _ L Awnings _ _ _ 35.00 _ _ _60.00 _ Lamp Post 20.00 40.00. I `t m Other to incude Siding/Roofing 35.00 60.00 Unlit Marquee 20.00 40.00 .. - Awnings 20.00 40.00 Certificate of Appropriateness After work Other 20,00 40.00 Commercial Commences Addition/Alterations 60.00 110.00 New Buildings/Educational 110.00 210.00 Certificate of Exemption ___• I I Sheds over 120 sq.ft. 60.00 110.00 I I Exterior Painting ..______35.00 ^_ -_- 60.00 Commercial _ - After work New Sign 35.00 60.00 Commences Existing Sign _ _ 35.00 - __--- 60.00 _I I ' Fencing _ 35.00 60.00-• Addition/Alterations 50.00 100.00I-I_ Wall _ 35.00 60.00 New Bldg.under 120 sq.ft. 50.00 100.001 I y Flagpole 35.00 60.00 Exterior Painting 25.00 Repaint Sign 35.00 60.00 New Sign 25.00 60.00 I_ Retaining Wall ' _ 35.00 60.00 Fisting Sign 25.00 50.001 I Lamp Post _ 35.00 60.00 Fencing 25.00 50.00 I I Unlit Marquee 35.00 60.00 Wall 25.00 50.00 Awnings 35.00 60.00 Flagpole 25.00 50.00 Other-to include Siding/Roofing 35.00 60.00•_ Repaint Sign 25.00 50.0011 - Retaining Wall 25.00 50.00 Certificate of Demolition Certificate of Demolition Lamp Post 25.00 50.00 _ Unlit Marquee 25.00 50.00 After work Commences Awnings - 25.00 50.00 Double the Application Fees Other Bldgs.over 120 sq.ft. 100.00 200.001 1 Residential&Commercial I I Building 110.00 I Garage 110.00 Accessory 110.00 _ J Partial Demolition 60.00 Please Note:Applicant will be charged the highest fee for multiple projects under one certificate. i.e.Application for Additon/Alteration and Lamp Post will bq$60.00 total olFeEmee Effective July 1 , 2000 . 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I �� � i• � III I \ ' JP- Am' i� �� _ =�. ...:_���. � •• 4FM � I � • o f o O � � mzR' jm • d x' oll i. 4 1 t 71 1 to QS -�, Gu, Fv kk I xl GN lit �\ Or Ak qt. b I '6i . 41 r: -P 4 C P � I I I � •. : 1 A- \ V N 1 � o Ila 71 z o 0 2� �I GN o ' of o- p r , C4 I rVIC O.N 10 i iA ^� � r Fi � .• . � . i �- � Imo • . "' � .. . . � � �� : .. . is � '��� � . �. .• I '. . I N I f l 1 ,f � k : 'I -- - y tA- (� . LQ N C. — -- _ -- - -- - -- i I i - i I I ! .I- i � ' !�- f ! i- I- ( -j---•--I- i I T4 1- a O_ --- t-� i � i I .! Ty O I I I i i I I i I -± —�--�' ---I--- -{— I- - '- - -i- '. • _. ;__ i _. 1_ i ' - .- '- �--- I ' .. !Vi IC` iR_;. �_ _ � -i� �I--��i---�- -i -- ! I ! ► I I I i i ! ! i � i � i � fi� �- I ci '� - — -- - - - - - I---i 4 .. J ! c -- r _ il i I I I I - I T T_[ liaj ----- ----- I ! � -; , t . I I I I I i i 1 IO' ' I ' 1 � { ! •I i ! ! I � - I i 1 j i —I --- 0 I r 11i l ! . I !r ; III ; I I . III � i � � II , i � I � ! I--I—�--!---� ---!---; __ ! - I � _i_ �__. I � I �_ . ; !_ � 'd i .l--- ! � _ I _ ; . I I � -- --- �_._ R I �, ►�_I , 1_1 - j -1----- -------�--�—— - I III T � II � � d_ , I , �� � IIIIII ! iI ;; I ;I ! I 1 ! _I - ►-- I--- I' — I I I �•i:` i , � � � 1 i I I ; �i ! I . 1_a I � . ! .i _ _ I - I- -�---- — I-- i j .i_ i l i i l j i ! j i '; i � ! l i l l i �� � �C i� i 1. ► I i . I � , b�. � , . ��. �a �' (� , ��. ,�., . 0 �� P`OFTNErO,,� The Town of Barnstable BARNSTABLE. • Department of Health Safety and Environmental Services MASS. a 2639 `0m p�EDMpyp Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: Map/Parcel: ©82� ook-003 Project Address: z13 t(j,3, Builder: 04-0140ki- The following items were noted on reviewing: �r ),4p .) T(2o vile 5V 61,.,+T/ov 2) T«- /-i,3 A-- els RA'GT�25 Reviewed by: Date: ti q:building:forms:review TOWN OF BARNSTABLE CERTIFIG`�T.E.�;9F OCCUPANCY ; PARCEL/ID 000 000 139 GEOBASE ID , ADDRESS 43 DESIRE'S LANE PHONE WEST BARNSTABLE . ZIP� LOT. - 2 BLOCK LOT SIZE IDBA DEVELOPMENT. DISTRICT PERMIT 38718 DESCRIPTION CERTIFICATE OF OCCUPANCY PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: ' and Environmental Services TOTAL FEES: BOND $.004 �� CONSTRUCTION COSTS $.00`, 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE' P. t:] E .- _ ; * BARNSTABLE, • MAS& 1639. FD MA'S BU1L?DP0GdD IsI,6N BY DATE ISSUED 05/27/1999 EXPIRATION DATE 7ZA t)F11 Ef:,(}: T:v'F n I F)r,-?t „r k'ta.ic�t�'• : E,:-.�,.:, ��Et,ti�rI z i��,�, >:�" t'J�.( N 11,/:~ tcj:'.c�;�/�'..:�,�' P• "i •;t++r1�':3':--;�� F ;UIr TI r 3>i TM, f'"A F'MT ++ . - 'ti_tz L•K t' if a ,t't . ' -,. Department of Healtji, Safety Y,r1 ,�, r ;; and Environmental Services t,jSTS '{v 'K), _10 J. i 1(t h ,�{{� ( q r t t o A . l�1!'�9 i ETAGEdD i l�1 M J,. _ * BAR�N�TpAppBM • MAS& Fp�l A BUILDING DIVISION M- 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 FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND 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. VISIBLEPOST THIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSP CTION APPROVALS ELECTRICAL INSPECTION APPROVALS ow- 2 . ,I tt +� 2 ,N I s f7s�16/,,ZXi 2�faAl— J'l ,J' ©� fa,�� 3 /. % � ./'/� Ni, 1 AN INS TI �ROVS ENGINEERING DEPARTMENT l /Il i 7 rK/ 2 BOARD OF HEALTH rl Z 91 afc �rzY9y C OTHER: r v M. SITE P REVIEW APPROVAL Now b* WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS,ISSUEp AS TELEPHONE OR WRITTEN NOTIFICA- ,TION.. cr NOTED ABOVE. £ TION. �w4 1l L y*. . r ' 1 4- -AAScheck COMPLIANCE REPORT Z-s--- Massachusetts Energy Code ; Permit # MAScheck Software Version 2 . 0 Checked by/Date CITY: Hyannis STATE: Massachusetts HDD: 5973 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 1-25-1999 DATE OF PLANS: 1/22/99 TITLE: lot # 2 Desires Lane West Barnstable MA. PROJECT INFORMATION: Derosier COMPANY INFORMATION: Fitzpatrick Home Building Co. Inc. COMPLIANCE: PASSES Required UA = 466 Your Home = 443 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 1584 30. 0 0. 0 56 WALLS: Wood Frame, 16" O.C. 2376 13 . 0 3 . 0 169 GLAZING: Windows or Doors 286 0 .400 114 DOORS 84 0 . 350 29 FLOORS: Over Unconditioned Space 1584 19.0 75 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans , specifications , and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections 780CMR 1310 and J .4. Builder/Designer Date 114jze _ XaScheck INSPECTION CHECKLIST ssachusetts Energy Code MAScheck Software Version 2 . 0 lot # 2 Desires Lane West Barnstable MA. DATE: 1-25-1999 Bldg. ; Dept . ; Use CEILINGS: [ ) ; 1 . R-30 Comments/Location WALLS: [ ) ; 1 . Wood Frame, 16" O.C. , R-13 + R-3 Comments/Location i WINDOWS AND GLASS DOORS: [ J ; 1 . U-value: 0. 40 For windows without labeled U-values , describe features : # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: [ ) ; 1 . U-value: 0 . 35 Comments/Location FLOORS: [ ] ; 1 . Over Unconditioned Space, R-19 Comments/Location AIR LEAKAGE: [ ] ; Joints , penetrations , and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations or installed inside an appropriate air-tight assembly with a 0 . 5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: [ ] ; Required on the warm-in-winter. side of all non-vented framed ceilings , walls , and floors . MATERIALS IDENTIFICATION; [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications . DUCT INSULATION: ( ] ; Ducts in unconditioned spaces must be insulated to R-5. Ducts outside the building must be insulated to R-8 . 0. DUCT CONSTRUCTION: [ ) ; All ducts must be sealed with mastic and fibrous backing tape. Pressure-sensitive tape may be used for fibrous ducts . The HVAC system must provide a means for balancing air and water systems . TEMPERATURE CONTROLS: ( ] ; Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] ; Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in sections 780CMR 1310 and J4.4 . MISC REQUIREMENTS: [ l i Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems . ----NOTES TO FIELD (Building Department Use Only)------------------------- • V4&r of /'Engineering Dept. (3rd floor) Map Par Permit# House# ym 'ate$pyid Z.3 -9 4 Board of Health(3rd floor)(8:15 -9:30/1:00-4.39j FNSTgt j�`SYSp' , _ �0,3 oa _c#J--ter , - Conservation Office(4th floor)(8:30-9:30/1:00-2:00) FI yV/ rV/T /N CO , ''N 6 IVA r rm Planning Dept.(1st floor/School Admin. Bldg.) r'Q Definitive Plan Approved by Planning Board - 19 ��/c c fps /- of P � ennM 't t63q. � TOWN OF BARNSTABLEf 'E° ''' Building Permit Application Project Street Addres - S12PS, l - " Village ir. Owner a , C L Address L)rtXkJa Telephone Ppd' 30 7 S - Permit Request ��✓t�s{yvc.�" a�'rx �� �o �oh► 1 !.�/ � � 02 �� First Floor fOde square feet Second Floor ! 6�0 square feet Construction Type Estimated Project Cost $ loe Zoning District Flood Plain Water Protection Lot Size L Gf Grandfathered PYes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes A(No On Old King's Highway Yes ❑No Basement Type: gFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) ARt Basement Unfinished Area(sq.ft) loe cp ,+ Number of Baths: Full: Existing New Half: Existing New / No. of Bedrooms: Existing New . Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes �&o Fireplaces: Existing New W Existing wood/coal stove ❑Yes No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) Attached(size) ;Z�z Y ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes �No If yes, site plan review# Current Use ZAritli, Proposed Use A AL 6 Builder IInfoorrmation Name L „ �i� "I�elephone Number aw' �67 Address 63) && /j t-f License# _ K)LI S q 16 le Home Improvement Contractor# Worker's Compensation# A/C 11_7W 6-2 I 1 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 TOS=s � �,✓i �-('v,ry v SIGNATURE DATE o 22114, BUILDING PERMIT DENIED FOR THE FOLLOWING REASONS) a 3�� 4� FOR OFFICIAL USE ONLY , PERMIT NO. DATE ISSUED - t MAP/PARCEL NO. - ` ADDRESS VILLAGE € OWNER ` DATE OFINSPECTION: FOUNDATION FRAME INSULATION 2Z� e FIREPLACE' s - ELECTRICAL ROUG ► FINAL PLUM, &G: YROUGH FINAL t GAS: ROUGH FINAL c) FINAL BUV ING DATE CLOSED OUT ASSOCIATION PLAN NO. ' i I I — �00 43, 1 fli rD i � o w 0 c w N rn w N a z aN � \ a t o-+ Wray o Z 10 � m Z � � OD v n a SktAj b y Application to 11998 2 92 Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, id triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973. for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: )0 New Building' ❑ Addition ❑ Alteration Indicate type of building: q House ❑ Garage ❑ Commercial ❑ Other ' Z Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall - ❑ Flagpole ❑ Other (Please read other side for explanation and requirements)- TYPE OR PRINT LEGIBLY DATE I -o2a -9i 8 ADDRESS OF PROPOSED WORK S 19 AJ t✓ ASSESSORS MAP NO.S IOU o T RNS OWNE + nC ► ASSESSORS LOT NO. r! 09UQZ HOME ADDRESS ► TEL NOLQq,WA -,-301-S FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). 1L ar 1 t i1.) 11 ��cp' c . jiu �a nslo- ,/e aal-8 AGENT OR CONTRACTO TEL. NO.% ADDRESS r r �' DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done(see No.8,other side), including materials to be used. if specifications do not accompany plans. In the case of signs,give locations of existing signs and proposed locations of new signs. (Attach additional sheet.if necessary). c � l �U �, r � � Signed T. Upr(er-contractor-Aqent" " ce below line for Committee use. Gj re _: /� V a-,0r�0 Date 7,ae rtificate' er$by _ NOV 2 Q �me Bin Approved ❑ IMPORTANT: If Certificat s approved,approval is subject to the 10 day appeal period provided in the Act. Town of Barnstable Old King's Highway Historic District Committee O SPEC SHEET FOUNDATION SIDING TYPE COLOR 2j�Z CHIMNEY TYPE COLOR ROOF MATERIAL COLOR PITCH WINDOWS �y�r6 -A.4ddly^ COLOR ,-& SIZE !� TRIM COLOR . n DOORS COLORS SHUTTERS �� COLORS GUTTERS ��u.41 V COLORS DECKS MATERIALS 4- T GARAGE DOORS 5''�� / COLORS �i�- •-�� � v � SKYLIGHTS SIZE COLORS ; , . SIGNS COLORS FENCE /(,/� COLOR NOTES: Fill out completely, including measurements and materials/colors to be used. Four copies of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plans, when applicable. "SPECSHT Revised 11198 y . _.�:r, ^.�. ti..�:sF• y..-, ..+y r., - r __ -\, � i�•".���^-4.-•. -..^ • ..'kr�" � �v'- ��.^��r-t��.r r{!- ��.r..f a.� 1 �Jw..,'t,v!��..�Y"r e" fL INE ' . &t The Town of Barnstable • sAi NSTM&659.c e • Department of Health Safety and Environmental Services AtFDNIO'�p 1y Building Division i -u367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner PLAN REVIEW Owner: tTa P A7�z l LK Map/Parcel: 139 I �- r Project Address: LOT 2 DL S I CS U4, Builder: The following items were noted on reviewing: 0 COD( P-C- ou 1"&k►mot m Q) N& a F GLk ?-W1N G K7TA PIT- e ' Please call 508 862-4038 for re-inspection. &NI 17 � Inspected by: Date: q:buildingArrns:review -� 6e, The Commonwealth of Massachusetts Department of Industrial Accidents Office of/o�esdgadons ,.: 600 Washington Street `.--• ;,� Boston,Mass. 02111 Workers' Compensation Insurance Affidavit 1140 name: ,— G location / O r R of C�N city (.�✓ °�-� t��^S` ` ��'�� phone# Pr—,r-- " �J ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working in any capacity ❑ I am an employer providing workers' compensation for my employees working on this job. company name: ..... ... .. . address city phone#: insurance co. oiicv# ❑ I am a sole proprietor, general contractor, or homeowner(circle one and have hired the contractors listed below who have the following workers' compensation poli cs: tom anv name — ✓ /I address- 1 J L1 . ....:.;.. / g�J pone A. dtv h T�JT�Sf•�aLT ri%mil co. . `, �.t/Q / 1�»;:•r: ..... . olity# C <::>:: insurnnce :. eom anv name. address: city- ;..:::... .._ phone :.:. insurance co.. %�% /%�/%%%%/%/ ///% /%/%/%/ / Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me- I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage veriIIcadonn. !do hereby certify der th pains an enalties of perjury that the information provided above is tru%antJ conecy �2 7—l11 J Signature Print name� /G"���/ ` ` L-4 /G� Phone# ofncial use only do not write in this area to be completed by city or town of vial city or town: permittilcense 0 ❑Building Department ❑Licensing Board ❑check if immediate respome is required ❑Selectmen's OMce ❑Health Departittent contact person: phone ft• ❑�u'�� (Rvuee*9S PIA) I f 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 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 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal .of it 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 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. 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 affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be retuned ie the Department by mail or FAX unless other arrangements have been made. 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 Accidentst Office of Inveftadons 600 Washington Street 4r .. Boston,.Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 i 6 6 9 6 u - v 6 u 6 e , 9 6 . 9 Western Surety Cpany e r u v a LICENSE AND PERMIT BOND v e ` For County,City,Town or Village Only-Not Valid for Bonds Required by the State.Not Valid for Contract, ; 6 Performance,Maintenance,Subdivision,Agent to Sell Hunting and Fishing Licenses or Utility Guarantee Bond. 4 e F KNOW ALL MEN BY THESE PRESENTS: BOND No. L&P-4 2 9 2 9 2 81 That we Fitzpatrick Home Building, Inc .' �. Village orest a eMassachusetts 6 of the of , State of , as Principal, e and WESTERN SURETY COMPANY, a corporation duly licensed, to do business in the State of -Massachusetts , as Suety, are held and firmly bound unto the Town of Barnstable , State of a s s a c u s e t t s ,Obligee,in the amount (Valid only when a County,City,Town or Village is named as Obligee) of One Hundred Eighty & 00/ 100--------------- DOLLARS ($ 180 . 00 ) (NOT VALID FOR MORE THAN$25,000) _ lawful money of the United States, to be paid to the said Obligee, for which payment well and truly to be made, we bind ourselves and our legal representatives, jointly and severally. THE CONDITION OF THIS OBLIGATION IS MCA, That wh reas, the Principal has been licensed to construct a single family d-welling at of 2 of Lane West Barnstable, MA 02668 Lot frontage is ee by the Obligee. FORE; if the Principal shall faithfully perform the duties and comply with the laws and or1S, ''g�all amendments), pertaining to the license or permit, then this liglation to be void, 0� se a n full force and effect for a period commencing on the t day of � �Q ,9 January 19 9 9 and ending on the t day o'";Ow t�`19= January 2 0 0 0 � unless renewed by continuation certificate. •hi b c�,r aay Irminated at any time by the Surety upon sending notice in writing to the Obligee and to to "r�c1a1, the Obligee or at such other address as the Surety deems reasonable, and at the expira- tioKY ti" days from the mailing of notice or as soon thereafter as permitted by applicable law, which��Vee t 'this bond shall terminate and the Surety shall be relieved from any liability for any subsequent acts or omissions of the Principal Dated this 15 t h day of J a n uJ a n u a� 1999 . f X 7r) ,-i C 6 e:j Principal Principal Countersigned WEST RN S U E T Y C O A N Y 6° BY - BY T ` Resident ent President P 6 ACKNOW DGMENT OF SURETY , STATE OF SOUTH DAKOTA l (Corporate Officer)6 j County of Minnehaha ss u On this day of ,before me,the undersigned officer,personally u appeared Stephen T.Pate ,who acknowledged himself to be the aforesaid officer of WESTERN e SURETY COMPANY,a corporation,and that he as such officer,being authorized so to do,executed the foregoing instrument for the purpose therein contained, by signing the name of the torpor n by himself as such officer. ; IN WITNESS WHEREOF, I have hereunto set my hand and official se . 6 , + n J. RHONE s r NOTARY PUBLIC SEAL SOUTH DAKOTA SEAL S otary Public, South Dakota My Commission Expires 6-12-2004 Western Surety Company • 101 S. Phillips Ave. r Form 849-A—12-97 Sioux Falls, SD 57104 • 1-605-336-0850 ° Yl ® NO PC 1 � u ACKNOWLEDGMENT OF PRINCIPAL ' P . (Individual or Partners) STATE OF y P ss i County of `P ° 1 On this day of ,} ,before me personally appeared , P ° P ° P ° ` known to me to be the individual_ described in and who executed, the foregoing instrument and' ° acknowledged to me that—he_ executed the same. u My,commission expires w :" Notary Public ACKNOWLEDGMENT OF PRINCIPAL (Corporate Officer) STATE Of, ;1 ss County,of On this ; day of ,before me, personally appeared , who acknowledged himself to be the of , a corporation, and-that he as such 'officer being authorized so to do, executed the foregoing- instrument for the pur- ># •r poses therein contained,by signing.the name of the corporation by himself as such officer. My commission expires Notary Public CL P L .- .. ' ern P z p •i'� 9 V) PQ p, , P N U y Y. G $I 20 0 ✓ U/O7I?/IYtd7td/¢QGUL d�•!/CQ�J(LCIZ[1J8 DEPARTMENT OF PUBLIC SAFETY t CONSTRUCTION SUPERVISOR LICENSE Nu®ber:,- Expires: — -- — Restricted'To: 0e x V"w MICHAEL T, FITZPATRICK PO BOX 154 FORESTOALE, MA 02644 i �� �^ � .' I 40tso*p. WAL AfaAZ FFR I _ L L L. y t� P�u1Li7�NCi C ri• IP-o• -O' 1'r.lO'.. 1' �-ea�targf• o s' � �- . .. �p LXb•A'te� vrps�H cn• 9�. UK pll.d � 1,• �, �.4 N 4 '-0 �IU I i4 a. 0,43' P�'" uvwu IZ —.— otool-oll ----- ,�, I �' �Qb' LdL01.lIAL k1�GAR ojdn�l7W�iv M/►.• ri�1111.Di6Y�!� ri'-Y q'-'I' �'-.I' q'-�' �'-�� rye-II• ' �. . . .I laa►rvl2ar� + L.1�wa�L war09. L� -.---- ' � � : TyYd7.��..4'b►ae�fa�rl,ir�c� Lo- - Fu�fl�7iowli1*+J ��. .24 7-7 �•.�� ::III-.j0'.. . •I_G� _ —4,•=p•.. P�' o' �'-d ow a Q w O"V O ' u 6 O H -'*10 t, 7 QfuK - I7 y h b'-�O' '-b' b+-,�• y p Nip 'Vln ov J IUV— rZPAr21c.K . Ilaluu IGl4 �lv^A � Q lug1- - - t - - -- - -kc- 7w Ij LB�/�.rIO1�J °""�. • • ----Y ' ' A . A amaw mom Ow M909903M iN Alt 'tt � 1 t� h /i s r „. STANDARD FEATURES o The largest viewing area in each class size is obtained with true widths of 36" and 42". o Caliber minimizes the steel surround and maximizes the viewing area for a better-looking fireplace. e A very realistic wood-like fire is created with large burning embers, ran- dom flame, and logs with hand painted detailing. o Top or rear direct vent allows installation along interior or exterior walls, belowgrade, or in corners; available in standing pilot or electronic igni- tion systems. e "Quick-Access Glass"keeps routine maintenance simple and creates a tight, sealed combustion chamber; uses only outside air for combustion. o A modulating flame.control,means variable Btu input (up to 32,000 for • • • the Caliber 60 and up to 35;000 for the Caliber 80) and flame height. Heater listed to ANSI Z21.88. o Tested and Listed to UL Safety Standards;Limited Lifetime Warranty. FINISHING MATERIALS When finishing the Caliber, combustible material may be brought up to the sides of the fireplace but must never overlap the black area. The black metal may be completely covered with noncombustible material only, such as marble, tile, stone, etc. Warning: You cannot cover any of the grilles on UNIT AND FRAMING DIMENSIONS this unit as this may create a fire hazard. Outer flue Model A B C D E ' 8°diameter Caliber 60 36" 41" 241/2" 715/8" 505/8" 8'I•— C—• Caliber 80 42" 47" 301/2" 785/8" 551/4" 23° 33V2° ,s° 32" 1 e Gas line 381/z" ® knockout 2C/8" 38" I 1/2" I A 81/16 261/2„ l3 o-- -d I 35/e p E 2'/z" 1 *Interior firebox 1 •71/2" Electrical JillW. depth: 20" knockout ROUGH FRAMING DIMENSIONS Caliber 60: width - 42'14",• height - 38314" cavity depth - 23112" Caliber 80: width - 48114" height - 38314" cavity depth - 23112" Options not pictured: CLEARANCES TO SURROUND/COMBUSTIBLES BC10/11/12 Fan controls • Minimum mantle heights: 0"to 3"Mantle Projection - 45"* FK4 Transaxial fan • 3"to 6"Mantle Projection -41"*; FK160 160 CFM fan • 6"to 9"Mantle Projection - 44"*; CKVP LPgas conversion kit • 9"to 12"**Mantle Projection -45"* CKVN Natural gas conversion kit • Minimum window height- 40"** • Minimum recessed shelf height to bottom framing-38518"*** QUA QKE4B Quick Tile trim • Top of standoffs- 0"Floor - 0'" Back and sides of fireplace -'12" RCA60D, RCA80D Refractory lining Ceiling -30" TK6B/S, TK7B/S Polished brass/Stainless steel trim kits *Mantle height listed is from the BASE.of the appliance. TK47B/S Polished brass/Stainless steel trim kits **12"is the maximum mantle projection allowed. DFBC36, DFBC42 Bay front ***These dimensions can only be obtained when using the rear vent system. TKB6, TKB2 Polished brass bay door trim kit CERTIFICATIONS/GENERAL CONSIDERATIONS • Certified for installation in bedrooms, bed/sitting rooms and mobile homes. • Consult local building codes for local installations and operational guidelines. VENTING SPECIFICATIONS • The rough framing dimensions shown above represent the distance from stud to . 5" inner pipe; 8" outer pipe stud only and do not take into consideration the addition of sheetrock/drywall. • Wiring for an optional fan kit or remote control must be done prior to finish- • Horizontal runs. I" clearance ing the installation. bottom and sides; 3" clearance top • For best results, do not construct the framing until the unit is in place. • Vertical runs: 1" clearance • A hearth extension is not required. MODELS AVAILABLE GCDC60 41"wide standing pilot, naturalgas GCDC80 47"wide standing pilot, naturalgas GCDC60E 41"wide electronic ignition, naturalgas GCDC80E 47"wide electronic ignition, naturalgas GCDC60L 41"wide standing pilot, L.P.gas GCDC80L 47'wide standing pilot, L.P.gas GCDC60LE 41"wide electronic ignition, L.P.gas GCDC80LE 47"wide electronic ignigion, L.P.gas Available r � • ti Bator 4-3 4 Hearth Technologies Inc. 1915 W.Saunders St. • Mt.Pleasant,IA 52641 800-843-2848 • fax 800-259-1549 For consumer information: 800-927-6841 heatilator.com • fireplaces.com HEATILATOR is a registered trademark of Hearth Technologies Inc. This information is provided for planning purposes only. Please refer to 73071D CG 09/02 installation instructions when installing this product. The Town of Barnstable BAMSTABM � MAM �m� Department of Health, Safety and Environmental Services 39. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner January 27, 1999 c ��iq . 3 Mr. Michael Fitzpatrick Fitzpatrick Homebuilding Co., Inc. PO Box 154 Forestdale, MA 02644 Re: Lots 1, 2, 3, &4 Desires Lane, W. Barnstable This letter will acknowledge that Lots 1, 2, 3, & 4 on the attached plan are buildable lots from a zoning perspective. Sincerely, I i Ralph M. Crossen Building Commissioner RMC/lbn g990127a •JHN-25-1999 17:10 REALTY EXECUTIVES 508 �47 0851 P.01 J.J ifivil u�.Zt tm iuuili►uc uuvui l'AA.JVUIIULUUI fAVC i TOM of NARRSTABLIS PLANIRUG DOMM FORM a IMLE"V of Y•O'1'8 =DER CQVENAZlT Barnstable, Heeaachwsettss.D:cefip,. 16. 1998 The nnderatgned, being an authorized agent of the plaaainq Board of Barnstable, ltassAohunetts, hereby certifies that the follgs$�g lots maed by TIMOTHY HI�lCKLEY REALTY TRUST IX -securfnq t e %;vvenaAt cat 9., 19 18, an reeorded in Barns able ' Diet7tict Maeda, 8aok 18• 1'ag 33 S of witle NO. Docn�ietlt�memo (or registered en COrtifteate entitled" DEF NZ- p—"'i'�'^, ), and shown On a plan a FOR HANNAA AND HER S-SaERS REALTY T UST" E T BAttNSTABLE MASS. PREPARED and reeazde w A �a ppe s D .��� 1997 T 7,� xegisberecl in eafcl Land RegistryanieHititi�t,4��.PIge 27 or released fr9m the restrictions as to aaie and bnild�,ng spG fared hereby Bard CGVesiant. r-----1, Ote� hereby i Said ]LOUYota are de6ignated on said plan as follows: in LOT 1 .L0 2 LOT -LOT 4 'DES IRLS LANE and LOT 5 LOT 6 L CAPES TRAIL Anthozi�ted Agent A, Roy Fa gren, Ch Planning bOaxd rman of the Town of Barnstable c acoa,r�uxa or X"BACKaSZ225 Barnstable. Kassaebuse�ttar as 19� Then paraaAy apt Q o P.J of the Pln�tiag Ba= ox e x n .v 00 authorised agsrit a®kncswlego lagoing it�stnt to be the�gasBC�t a d deed of S*id Mn�� BaUd,, before me. "ABVU After v_"ordLnWj, xetoto to: m+ eomission expires$ Town of 114;astable Plaming Poard IA G. MACS, NOT i 230 South street pUBI1C Byannia, HA 02601 estkc l3. TOTAL P.01 1 •..w•r r �••w••� - �roo�rncrwr,i-:r bii:`• CO l � . y Wl9rr•= ia®mr rr�Ral•.a 1•. o�a>d awr f.�n r me• ' vsloc7 r + J i m-O Was •w .f 1) na I{fll iw ro m•w• : �—q�+.+.mct..Ti f�• am�uroe sml A S OCY.Y�f�f•�� C �LW O � �4 ow lam r•.ralyy � 1 �®/•VRCf�[MYrt�I.X K>w- r to • ma.f a 0 i IJ■-i 11 r_wvco y6 rf•n<IA•( w AD �� s l 'aVat A d4^n.f O/R ww 4O v}•1 L M �• 3� . 'wfLfK frirl ' r 7tiat ( ar� T .YO•f al a• � ,�� - � ••.+a.f w n Ju'' � � w��fao�1O a oaw m foo_-c w�a lrw• �" � aoaam r•mrwu w.r of.rr• wwr.� - Mrr r a+M+r�o 7r..s•row w w.,.Cn f 1 (` •aria?f p� •Of�in•n•fvl Yt~MI f C ==K IM O • +=f nn, ' c Irl �I �� r•"'. 1 fw = w rfrtr f •Na�f w� M�rc*ali �1. �+//�/_I ' Tf•e V� LT.B LOLA � VT r / r/ L1 . • 1 t •♦•o.� ....� rlr.•Id•r \ 7wrf/Y.L•a•fw f u •ram f 1. 7w tiwso 1y f.N ta.-ww us \\ \ E i K� o.+�.i vi'.i.w'R"f � � l•rQ•q A.viti r•rtN'W Ifmp r�r Y MRI. �a i� Yt.Im rt]f fop w®r r•bmio•Q•�Qay faLr ? CAPES •� • •+*nr• •>w,,,.r r \ \ 3 Iol■ao. LraA w�a.�.evomr r � eo•rnt ruw s i:i; LaLA ; sHow �uu. ESTATES a w.K •-.rw r o•+f tf�as �4 � f 7Rra� OEM BARN STABIF,MAST w•m n n •.n '�� feaar . •w. ,,,, 1=� -.1'I-woo . 3 µ""" " ww aao sa�p ran wn rf.r • n~ir�j�` � f fr`aRl•, • µN e.vl• f�W f YlJ1 I:r:/R-• ♦ T ti •+nr.r f irfar as. f anti• Isw- arwrrrr• � �e�i I•^^> �l _ nis f r.>rer• p /cw ,uw f i moM ' 1 Ir.ae Il ..•rr •fn rrr a+aa r 1 avto► s."Ln- .afr aar M♦rl•/ f arvrr. inav••aff • ,r;� it fv a�s•I'■ +••-ten '•� �^w�mr,n� •,w,l,�„�_R � � � �o.na cra• enp/neeril¢ brn •~ f.fao altsr•-nws �•w.t l�•wo•� ,2L 3 N l9 G P4� J QA S� U , SS J P C) N 35'55'28" E 40.17' - > ti b,'S ti N 36'10'32" E 156.13' N 47p8'35" E •. . E EASEMENT DETAIL y�. 59.8 •.•• 125.31, 1" - 50' c� /(p LOT 2 41,572tsf 0.95tac rn SHAPE FACTOR: 21.99 N 0 a3 �� �Tp� 2e .prr• o cn /N A. � N LOT .1 m A*. LOT 3 , ( 40, 0.94tac \ SHAPE PE FACTOR: 20.68 9 46,148tsf 1.06tac SHAPE FACTOR: 17.51 Ln SHAPE FACTOR COMP. LINE 3 tD. \39'0$'13" W u� w N 38'1 3'29"'E 262.15' I \ i • i-� 4 p. DIN .50' <.eA LA Lp Lo �% ' • • W m LOT 4 DESIRESLn LANE 44,386tsf 1.02tac o�J+ SHAPE FACTOR: 16.97 cp CD n o o'OD � . c L !tL e�l o I OVA Apirl" dw, VT mm., 14 777= lk 07 r :0000, .............7 ylf4 e4 e A) Aj IJ zc -Apr LX f IS MV LEI 4N I .. ".,' - I . : . . . .. ,� .. - � I .-'.-'.t:�'� I . � � ,.' . . I . 1. I : -, , - - . - I� , " � .. . - . , � � . I . - .1 '7� - ,�',. .'.,� � ,",': . -' , - � . -..-� I I '. - -.. ,,I�' , _0. ,;��.I 1.'.�,� , ,c - '.' -��'.. -,'!, .-,- ',. ..- - , �.',`-4 , . � I %. . I . ' 'I * ' � ..,. 1..��,-I ...� --, , ' -* - - ----�' I �'-;,I.,. �I. I.�, � I ."-"'� � � . , - �-;� , . :� -- . - I I -,.�:�', .� - � , - , ,��' � - I . �t I :'. , �' �---�'''�- ' , I .tt ,. . I . 1�- � . -. � " . .' � C� I . . 1..-, 7.�1� W'.- .1 - . .- .:��'.. ., ....:',. .I'I.* '- ;-;*-, � -' rx�,4 - I.�.. , �'-'-.I ;�- I. . ��.' .. I i�- '.� I --, �..', �-V'�-'h� ,- ,"� _'-" . �..t'. - %-- " - ,' : . 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