HomeMy WebLinkAbout0025 FIELD STONE ROAD W A%1
Oacliol�® NO. 152 i13 ORA
Hof USA O ESEUE
»,*w�
�,,,
f�
is
r�
0
�,
O
F('� �<
H
a
4
ipf)
9 `
j' r,
q
i.
a
^^VII k.
\W
"1
V
��,\ C
lJ
trf�
k
t
t
i
r
r
r
�.
�INEt� _ Town of Barnstable Building
Post This Card So That it'is Visible From the Street Approved Plans Must be Retained on Job and'this Card Must be Kept m
1 `�8 Posted'Untilfinal'Inspection,Has Been Made. Permit
y: Where a Certificate of Occupancy is Required,such Building shall`Not.be Occupied until a Final'Inspectioni has been made. .
Permit No. B-18-303 Applicant Name: EASTWARD COMPANIES BUSINESS TRUST Approvals
Date Issued: 01/31/2018 Current Use: Structure
Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 07/31/2018 Foundation:
Location: 25 FIELD STONE ROAD,WEST BARNSTABLE Map/Lot: 111-048 e Zoning District: RF Sheathing:
Owner on Record: MCCARTHY,JAMES T&LAUREL A Contractor Name.'' ,EASTWARD COMPANIES Framing: 1
BUSINESS TRUST
Address: 25 FIELD STONE RD 2
--- ••--- - •Contractor License: 1070,29
WEST BARNSTABLE, MA 02668 Chimney:
Description: Re-Roof(Stripping old shingles). Est. Project Cost: $5,800.00
Permit Fee: $35.00 Insulation:
Project Review Req: 4 ,12
Fee Paid: $35.00 Final:
Date: 1/31/2018
1 Plumbing/Gas
Rough Plumbing:
Building Official Final Plumbing:
' l Rough Gas:
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance.t Final Gas:
All work authorized by this permit shall conform to the approved application and theapproved construction documents for which this permit has been granted.
Ar
All construction,alterations and changes of use of any building and structures shall be in compliance with the local,zoning by-laws and codes.
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 Electrical
work until the completion of the same. f'
Service:
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided,on"this permit. Rough:
Minimum of Five Call Inspections Required for All Construction Work:E- -
1.Foundation or Footing
Final:
2.Sheathing Inspection
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough:
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection
S.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final:
6.Insulation
7.Final Inspection before Occupancy Health
' Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final:
Word shall not proceed until the Inspector has approved the various stages of construction.
Fire Department
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final:
Building plans are to be available on site
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT
oFt►�rqy, Town of Barnstable *Permit
3
"s Building Department Eee
snMsznat.s, = Brian Florence,CBO
v� , `0� Building CommissionerNw�° 200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Map/parcel Number /1/ o4 Not Valid without Red X-Press Imprint
J
Property Address
O
Residential Value of Work$ �7, Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address �l�$
Contractor's Name �� � rL �,j'J(e ' y� �j� Telephone Number J(/��y�-2?��
Home Improvement Contractor License#(if applicable)
+�/O-1Oo29 Email: Z-AMe"t ,1e-)W�J�E�7�J�� • CD�'1
CoZan's
on Supervisor's License#(if applicable)_ C.c! "Q/?36 I
Compensation Insurance
Check one: t❑ I am a sole proprietorJ �, [ C�� 1�
W❑ am the Homeowner
I have Worker's Compensation Insurance J N
1 WA
Insurance Company Name -rill A Ig,
�
Workman's Comp.Policy# �/LG��,SQ/����j�� �/q 1 MITI U. 8AHNSTABLE
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Requ (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)
❑ Re-side
❑ Replacement Windows/doors/sliders. U-Value (maximum .32)#of windows
#of doors:
'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
re iced.
SIGNATURE: � �
I
C:\Users\decolI ik\AppData\Local\Microsoft\W indows\INetCache\Content.Outlook\9NNOKXY W\RESI DENTI LONLYEXPRESS.doc
09/26/17
r Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, Masida!�usetts 02116
Home Improveme`rrjk ntractor Registration
Type: Corporation
W;I F Registration: 107029
EASTWARD COMPANIES BUISN = r Expiration: 07/27/2018
TRUST , d
155 Crowell Road
Chatham, MA 02633
Uq� Sv0
Update Address and return card. Mark reason for change.
scat c, zoM osni rl Address !-! R?"wal n E__ !_pymaent 0 Last Carr!
-
,s� �ze�panvnaaizcue�a�C�ac/zuaelta
-\ Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only
(TYPE:Corporation before the expiration date. If found return to:
Nitration Expiration Office of Consumer Affairs and Business Regulation
��) (:
1 --, 07/27/2018 07029 10 Park Plaza-Suite 5170
Boston,MA 02116
EASTWARD COIIIIFANfE%B. ISNESS TRUST
William Marsh
155 Crowell Roan\
Chatham,MA 02633�
� � Undersecretary Not valid without signature
Commonwealth of Massachusetts
Division of Professional Licensure
I Board of Building Regulations and Standards
! Constrqttt6.41 j ervisor
_ s_
CS-017367 IS, `
y. a f Xpires:09/06/2019
j WILLIAM MARSH " ,a
155 CROWELt� D�
CHATHAM MA
Commissioner ldo"`" "
I
I
i
Town of Barnstable
Regulatory Services
s i
BARNSTABLE,
MAsa �, Richard V.Scali,Director
i639•
FOMp`t& Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
I, Laurel A.McCarthy , as Owner of the subject property
herebyauthorize Eastward Companies Business Trust
to act on my behalf,
in all matters relative to work authorized by this building permit application for:
25 Field Stone Road,West Barnstable
(Address of Job)
**Pool fences and alarms are the responsibility of the applicant.,Pools
are not to be filled or utilized before fence is installed and all final
inspections are performed and accepted.
Signature of Owner Signature of Applicant
rt Ac
Print Name Print Name
1 7101
ate
i
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
INFORMATION PAGE
Associated Employers Insurance Company Inst
54 Third Avenue, Burlington, Massachusetts 01803-0970
(800) 876-2765 NCCI NO 40959
POLICY NO. WCC-500-5014716-2017A
PRIOR NO: I WCC-500-5014716-2016AI Insi
ITEM Poll
1. The Insured: Eastward Companies Business Trust Poll
DBA: i
Mailing address: 155 Crowell Road FEIN:**-***6355 f!
Chatham, MA 02633-0000
Thel
Legal Entity Type: Trust or Estate
Fol
I
Other workplaces not shown above: See Location PRE
k
2. The policy period is from 06/05/2017 to 06/05/2018 12:01 a.m.standard time at the insured's mailing address. Se
3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the WC I
states listed here: MA AEI
B. Employers'Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. .o I
The limits of liability under Part Two are: Bodily Injury by Accident $ 1,000,000 each accident CI I
Bodily Injury by Disease $ 1,000,000 policy limit Insl
Bodily Injury by Disease $ 1,000,000 each employee Rat
I
C. Other States Insurance: Coverage Replaced by Endorsement WC 20 03 06 B Wo
` WQ
D. This Policy includes these Endorsements and Schedules: SEE SCHEDULE W I
t
4. The premium for this policy will be determined by our Manuals of Rules,Classifications, Rates and Rating Plans. WG
All information required below is subject to verification and change by audit. W I
Classifications Premium Basis Rates WC
Code Estimated Per$100 Estimated WG
No. Total Annual Of Annual WG
Remuneration Remuneration Premium W I
WG
I
INTRA 140019 WC
t
INTER SEE CLASS CODE SCHEDU E W J
W(3
• I
WC
I
Minimum Premium $575 Total Estimated Annual Premium $32,885 WC
GOV GOV Deposit Premium $8,679 EM
STATE CLASS
MA 1 5606 State Assessments/Surcharges ;
$32,735.00 x 5.6000% $1,833
This policy, including all endorsements, is hereby countersigned by v 05/10/2017
Authorized Signature Date
Service Office: HUB International New England LLC
54 Third Avenue 265 Orleans Road
Burlington MA 01803 North Chatham, MA 02650-1161
WC 00 00 01 A(7-11)
Includes copyrighted material of the National Council on Compensation Insurance,
used with its permission. L!u
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Eastward Companies Business Trust
Address: 155 Crowell Road
City/State/Zip: Chatham, MA 02633 Phone #: 508-945-2300
Are you an employer?Check the appropriate box:
Type of project(required):
I. ✓ I am a employer with 20 4. I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. New construction
2. I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling
ship and have no employees These sub-contractors have g. Demolition
working for me in any capacity. employees and have workers'
[No workers' comp. insurance comp. insurance.:
9. Building addition
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. o workers' com right of exemption per MGL
y � p• 12.✓ Roof repairs
insurance required.]t c. 152, §1(4),and we have no
employees. [No workers' 13. -Other
comp. insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
:Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: A.I.M. Mutual Insurance
Policy#or Self-ins. Lic.#: WCC50050147162017A Expiration Date: 6/5/2018
Job Site Address: 25 Field Stone Road City/State/Zip: W•Barnstable,MA 026(b
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 certify,under the pains andpenalties ofperjury that the information provided above is true and correct.
Signature: _ Date: 1/26/2018
Phone#: 508-945-2300
Official use only. Do not write in this area,to be completed by city or town officiaL
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone#:
F
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
I
Map M Vr� Parcel Application - �
Health Division Date Issued It
Conservation Division Application Fee
Planning Dept. Permit Fee (D
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation/ Hyannis
Project Street Address C 51 ! e��s ,e
Village_ 60es - ���dtS'/4 10le
Owner ✓ /"Al } L-4 vri e Address �� `,,eIW6 /n-iC
Telephone -OF - 73 7 - a ?9 7
Permit Request
� yo
Square feet: 1 st floor: existing�iproposed I 2nd floor: existing .�3Z proposedeTotal new Z7(,
Zoning District Flood Plain Groundwater Overlay
Project Valuatio m ZOO,construction Type 6,�00d "��he
L•ot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family(# units)
Age of Existing Structure _ Historic House: ❑Yes XINo On Old King's Highway: ❑Yes P(No
Basement Type: Full ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft)
Number of Baths: Full: existing new Half: existing new
Number of Bedrooms: = existing k new
Total Room Count (not including baths): existing new I First Floor Room Count
Heat Type and Fuel: Gas ❑ Oil ❑ Electric ❑ Other
Central Air: ❑Yes No Fireplaces: Existing New Existing wood/coal stove:O Yes �A No
Detached garage: Elexisting Elnew size—Pool: ❑ existing ❑ new size _ Baf: ❑ existi�Fg ❑v w size_
Attached garage: Xexistina ❑ new size _Shed:Aexisting ❑ new size _ Othgn --�
Zoning Board of Appeals Authorization ❑ Appeal #_ Recorded ❑
Commercial ❑Yes ❑ No If yes, site plan review# --
Current Use Proposed Use TTI
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
�cc �� le ' 0�1 �7— 33 7 2-
Name ��L I� Telephone Number 3� 1
Address 7 Lum berf /q License # C S FA Q y F36s0
02 Home Improvement Contractor# 16/ L9 G 9
Worker's Compensation # KIC I Z(o 1993
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO
Z._,�L,J -16yf
12ol zSIGNATURE DATE
FOR OFFICIAL USE ONLY
NA LIGATION#
z ATE
s
4,
C,
t ADDRESS VILLAGE
OWNER:-
DATE OF INSPECTION:
FOUNDATION
FRAME �e '04anS cz
38 cti.7 . ?
'IINSULATION o/c !� t�.. (1/� �l wa�QII, 30 ��-
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
k •
..,¢FINAL._BUILD.ING
� -.DATE CLOSED OUT
ASSOCIATION PLAN NO.. ,
I
4
The Commonwealth of Massachusetts
Department.oflndustrial Accidents
Office of Investigations
•600 Washington Street-
Boston,MA 02111
www.mass gov/dia '
Workers' .Compensation Insnnnce Affidavit:Builders/Contractors/FIectricians/Plmnbers
APPEcant Information =,,Pleup Print Le
Name pusmess/organizatiaaaadividnai): 7 CV_ lb$ eGy+. p
•Address: 7? Gclt �lt'� 14,
City/State/Zip: -4; 4 .4,4 Q�J?ZPh..##-. (f,50�) �?-,3,3 g 2
Are you an employer?Check the appropriate bow Ippe of project(required)::
1.El am a employer with •4. El am a general ca�actor and.I
employees(full and/or part-time).* have hired the sub-contractors b. ❑New construction .
2.X I am a sole proprietor or partner- listed an the-attached sheet. 7. (WR.emadehng
Ship andhave no employees These sub-contractors have 8. ❑Demolition
working for me in:any capacity, employees.and have workers' 9.
[No workers' camp.ins�ance cam.msm�ce.t ❑ addition
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.❑Phnnbing repairs or additions
myself [No workers' comp. right of exemption per MGI 12.❑Roof repairs
insurance regmred.]t c. 152, §1(4),and we have no .
employees.(No workers' 13.❑ Other
comp.hmmmme required.]
-Any applicant that checks box#1 must also 0 out�section below showing thci wo j=,compensation policy iuformatian.
t Homeowners who submit this affidavit indicating they arc doing all work and thm hire outside contractors must submit a new affidavit indicating such.
t—r ntract m that check this box most attached an additional sheet showing the name of the sub-contracbm and state whether ornot those entities have
employees. If the sub-contractors bave employees,they most provide their work=,comp,ppbcynnmber.
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.# ExpirationDate: "
Job Site Address: C3y/St AcIZip:
Attarh a copy of the workers' compensation policy declarafion page'(showing the policy number and expiration date).
Failure•tn.secme coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine vp to$1,500.00 and/or one-year imprisomment, 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
Iuvestintions of the DIA for' overa cation
I do hereby certify under th and es of perjury that the information provided above is true and correct
S e: Date:
Phone
Official use only. Do not write in this area, to be completed by city or town aacia1
City or Town: PermitUcense#
•Issning Authority(circle one): ;
.�1.Bbard of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Emor
6.Other
Contact Person: Phone#:
Town of Barnstable
Regulatory Services
Thomas F.Geiler,Director
Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A.Builder
j� 14u/' e 17,'Ceir-1 iL/
as Owner of the subject property
hereby authorize lt-�Ik-ll to act on my behalf,
in all matters relative to work authorized by this building permit
(Address of job)
Pool fences and alarms are the responsibility of the applicant. Pools
are not to be filled before fence is installed and pools are not to be
utilized until all final inspections are performed and accepted.
*�-2,
Signat=e Owner Signature of Applicant.
qC
Print Name Y Print Narne
D e
QFORM&O WNERPERNIISSIONPOOIS
OF THE
Town of Barnstable
Regulatory Services
i Thomas F.Geiler,Director
t►rnss.
n 9.".•� Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION:
number street village
"HOMEOWNER":
name home phone# work phone#
CURRENT MAILING ADDRESS:
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and
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
m;n;mum inspection procedures and requirements and that he/she will comply with said procedures 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.buildirig 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
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. i
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 formIcertification for use in your community.
Q:forms:homeexempt
Office,of Consumer Affairs& _.��ation valid fg•,`iodsVidul use only
. TAI"
HOME IMPROVEMENT CONTRACTORS i on da'c -If tot.qd return to
t �c o"J" onsumer A�fatrs and Business Re ul ion i
Registration f 161869 Tyj�i z g
'Expiration: 12[3/2012 ,Individual 01'irk Plaza-Suite 5170
ston MA 02116ROSSCON '`
F:::�:al:'n„ - 111 .. �I - ! -jam •l~, ly
MARK GROSSLEIN
77 LUMBERT MILUR 3 g�i�� per•_. �. �-
CENTERVILLE, MA 02632'1 ; Undersecretai.y Not valid without signature .
Massachusetts - Department of Public Safety
Board of Building-Regulations and Standards
Cunstructi(ii.j.;Suhervisur I & 2 Family
License: CSFA-048850 ;z
``tip::�"�•s ,,�� � �• •
MARK C GRQS§LEIN• :. .
77 LUMBERS MILLRD
CENTERVI LE MA�,02632 -�
A 1 . I
�Z
Expiratioi-:
Commissioner 12/0312013
�yTFtE ; Barnstable Old Kings Highway Historic District Committee
200 Main Street,Hyannis,MA 02601,TEL: 508-862-4787 Fax 508-862-4784
96
APPLICATION, CERTIFICATE OF APPROPRIATENESS
Application is hereby made, with four(4)complete sets,for the issuance of a Certificate of Appropriateness under Section 6 of Chapter
470,Acts and Resolves of Massachusetts, 1973,for proposed work as described below and on plans,drawings,or photographs
accompanying this application for:
Check all categories t7AIteration
ply;
1. Building construction: El New El Addition
2. Type of Buildin}: L2 House ❑ Garage/barn ❑ Shed ❑ Commercial ❑ Other
3. Exterior Painting,roof ❑ new roof ❑ color/material change, of trim, siding,window, door
4. Sig_: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign
5. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Retaining wall ❑ Tennis court ❑ Other
6. Pool ❑ Swimming ❑ Other man-made pool ❑ Solar panels ❑ Other
Type or Print Legibly: Date
NOTE AU applications must be signed by the current owner
��
Owner(print): Ia Za rl �vLC Telephone#::,/��er- 7-27rz_
Address of Proposed Work: lC Village yV / �Sf. Map Lot# /l
Mailing Address(if differ
Owner's Signature
Description of Pro osed+Work: Give particulars of work to don
/ lri✓
Agent or Contractor(print): ��(� �✓�h`� Telephone#: o—O U " T Ze -02-:3 E
Address: / q/ 2 G
Contractor/Agent'signature:
For committee us only. This Certificate is hereby A PItO D/DENIED
Date y Members signatures
RECEIVED 19
APR 0 6 2012
GROWTH MANAGEMENTGt
APPROVE® 1
QABoards and Cmnmissions\Old Kings HighwayVJKHApplications\OKH DRAFT 2011 Cerr Appropriateness DRArT.dor. APR
A 2012
2 H r Y..
f
Town of Barnstable'
Old Kings Highway
Committee c
CERTIFICATE OF APPROPRIATENESS SPEC SKEET Please submit 3 copies
Foundation Type: (Max. 12"exposed)(material-brick/cement,other)
Siding Type: Clapboard_/shingle_ other � �� ��
Material: red cedar white cedar other Color:
Chimney Material: Color:
Roof Material: (make.&style) Color:
Roof Pitch(s): (7/12 minimum) (specify on plans for nevi,buildings, major additions)
Window and door trim material: wood other material, specify
Size of cornerboards size of casings(1 X 4 min.) color
Rakes Ist member rd member Depth of overhang
Window: (make/model) material color/
(Provide ivin&)w 'I .circle.ort IarL f _rtildings, rrutjor additions]
Window grills(p.ease clreck all that ap y_: ✓ Z
true divided lights exterior glued grills grills between glass removable inuxior one
Door style and make: material Color:
Garage Door,Style Size of opening IVlaterial Color
Shutter Type/Style/Material: 19 Color:
Gutter Type/Material: Color:
Deck material: wood other material,specify Color:
Skylight,type/make/model/: material Color: Size:
Sign size: Type/Materials: Color: RECEIVED
Fence Type(max 6' )Style materiaA Color: n nD
Retaining wall: Material: le
S Highway ENT
old ing's 'ee GROWTH D/ _a�i
Lighting,freestanding on building illuminating sign
OTHER INFORMATION:
THE ATTACHED CHECK LIST MUST BE COMPLETED AND SUBMITTED
Please provide samples of pai c ors,manufacturers brochure of windows;doors,garage door,fences,lamp posts etc
Signed: (plan pr par �' Print Name
12)7c:
y2
Q.\Boards mid C011pnissioILAOId Kings Highway�OK[/Appliratio)u\OKFI DRAFT 2Ol I Cer ppropriau acss DRAF7 doe
IMPORTANT-UPGRADE REQUIRED SMOKE DETECTORS REVIEWED
STATE BUILDING CODE REQUIRES THE UPGRADING OF
' SMOKE DETECTORS FOR THE ENTIRE DWELLING WHEN
ONE OR MORE SLEEPING AREAS ARE ADDED OR CREATED. BARNSTABLE BUILDING DEPT. AT
NOTE: A SEPARATE PERMIT IS REQUIRED FOR THE 1 INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL FIRE DEPARTMENT DATE
3 PERMIT DOES NOT SATISFY THIS REQUIREMENT.
90TH SIGNATURES ARE REQUIRED FOR PERMITTING
G CARBON MONOXIDE ALARMS
q MUST BE INSTALLED PER
. MASSACHUSETTS BUILDING CODE '
t
:, ( 1 ti
� b � ;i AIV9E2SmN Tw26KZ
y I - + �� 1Z ����Iz G�L�I.S •
ASPNAr_T SN.I�I6�
4 A
RED GED�1t
CL!1Pg0A'tiD5
oe L,-�I-T H L1"F1C PoSu I
t
New POURED
FouIQog-rIOIV WI
FoortNG SEL&
Wt1�117ot.J 4- 511�II�
pCTA1�
. ZS FI�+�D,St"otU� p2
. t
i
t �
r
II
` L" �".f E�'^�::. "ram-..�:.�•� .. �
I ", � 'Si?]'ft'L'4^_Y•.x:jlt3it4'..�G'£vlFF.4._4..:!*.:.V.. -'` I ,�
v
r
O
� r
I O
I
6 � I
R
N �
r
i
I
--
i
i
i
/
N � -
o
i
4
1
E X t g i r rt G STD u C'7'v P.= EX I ST r 2J Cr ZX'-(� 5`u t7 5 tuT"E{
00 jG" p,C.. .
ova
Al
fa:NSULN, 10141
�� �?c.tSTrtilG 30 68,,: pooCZ
a E 1;.
ZT Ffr_pST0 c t� a
1
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ]
Map Parcel �T Permit#
O
,( Health Division Date Issued
/�--
Conservation Division J, /0 9/* Application Fee (:�o • cc
Tax Collector Permit Fee 3S', o
Treasurer SEPTIC SYSTEM MUST BE
Planning Dept. INSTALLED IN COMPLIANCE
�A(ITU 71-ri I_ F
Date Definitive Plan Approved b. PIt� nning Board ENVIRONV(Em f;, ,;COE AND
10� ��u b IL 7 ILA � TOWN REGULATIONS
Historic-OKH O� Ur Preservationl�;1 1
Project Street Address �'�o2� /'i?1o1 .571Yy1 e O(
Village W • 3arllfa G�✓1e
Owner Y (S C l Address �GZ
Telephone �3C0 0P - (/!F��d
Permit Request milm �oZ 1�/�T f ¢ �La
Square feet: 1 st floor: existing proposed 2nd floor:existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family u Two Family ❑ Multi-Family(#units)
Age of Existing Structure(/ Historic House: ❑Yes Q'lJo On Old King's Highway: O'Yes ❑No
Basement Type: Wf ull ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) o2U y
Number of Baths: Full: existing hew Half:existing new/,//f
Number of Bedrooms: existing 3 new
Total Room Count(not including baths): existing new First Floor Room Count
Heat Type and Fuel: O Gas ❑Oil ❑ Electric ❑Other
Central Air: ❑Yes dNo Fireplaces: Existing _ ,? New Existing wood/coal stove: ❑Yes E No
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage:D'existing ❑new size Shed:❑existing 2(new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name � �(�' pO 2 Telephone Number
Address �•i�io�� License# cS �J 0 6(o
�Z �S��'�(p 0206 Home Improvement Contractor# /3 Z�'3 j
P�rcl� �
Worker's Compensation# 7P-:2 :24 ?C-
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
f FOR OFFICIAL USE ONLY
q
PERMIT NO.
J
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
n _
OWNER
y
DATE OF INSPECTION:
FOUNDATION
` FRAME
INSULATION
' FIREPLACE ;
ELECTRICAL: ROUGH FINAL
rn
PLUMBING: ROUGIP FINAL
cr ;
1s GAS: ROUGR5 FINALez
-
-�
FINAL BUILDING n �,
rr, -.
DATE CLOSED OUT — -
ASSOCIATION PLAN NO. m
O
• The Commonwealth of Massachusetts
�1_- - (r7 Department of Industrial Accidents
F 600 Washington Street
_ Boston,Mass. 02111
y, workers' Compensation Insurance Aff davit-General Businesses
name :l/G G! - /7 ry %W6
address
work location full address:U;Yam a sole proprietor and have no one Business Type: EJ Retail Restaurant/Bar/Bating Establishment
working in any capacity. ❑Once❑Sales(including Real Estate,Autos etc.)
❑I am an cm foyer with gin 1 es(full& art time). ❑Other
// %/%%/%%////%%%%%�///%%%%%////%///////%%////////
I am an employer providing workers' compensation for my employees working on this job,
com anv name: •• •' -
address: ``
city:
bone#'
I am a sole proprietor and have hired the independent contractors listed below who have the following workers'
compensation polices.,
VA
com an
'•.•. •�Neo%r7
c1tV: .�� �•r" -a /'' hone.#: �•1 ..� y. �'•.. .'': .
r• '1f: 'Y'O .'4 yam.' '•.I /�.^►'✓':'+•
insurance co.. ...:•. ..: : T�" `��`'�^`:�'`� ': G,j oliev:# ' ••' (�-; :/' ' •'
MM
A
A///
com a ny hang:..' :..:
address
cih• ,• ' .. ,. phone#!�•' _ . :•. . .
itisurence
Fallure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or.
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and s Fine of$100.00 a day against me. I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIAfor coverage verification.
I do hereby ce nder t ains a pert ti s of rju t e inform ation provided above is true anI eor e
O
Date / D
Signature
Print name vL Phone$1 tU '
ffictal use only do not write in this area to be completed by city or town official -
city or town: permit(license# ❑Building Department
❑Licensing Board
❑check if immediate response is required ❑Selectmen's Office
❑Health Department
tr contact person:
phone#; ❑Other
(revbed Sept 20M)
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, associatiod;,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 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. Please
supply company name, 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 b'e used as a reference number. -The affidavits may be ieturne&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. -
The Department's address,telephone and fax number.
The Commonwealth Of Massachusetts
Department of Industrial Accidents .
Office of imsfigaugns
600 Washington Street
Boston,Ma. 02111 -
fax#: (617)727-7749
phone#: (617) 7274900 ext.406
I
i
oFt ro,,, Town of Barnstable
Regulatory Services
BARNSTABLE. = Thomas F.Geiler,Director
9`bA,F 039. p``� Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
Permit no. '
Date 47
-11
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. ,Q �n ,,(�
Type of Work: �I�y _ ��// nn Z,� - Estimated Cost
Address of Work: ��h�l� � �� �d 6(
Owner's Name: /
rez
Date of Application:
I hereby certify that:
Registration is not required for the following reason(s):
FlWork excluded by law
❑Job Under$1,000
❑Building not owner-occupied
26ner 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
Q:for ms:homeaffidav
Town of Barnstable .
regulatory Services
Thomas F.Geiler,Director
MM
163 s.0� Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
wwwAown.barnstable.ma:us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION '
Please Print
DATE:
JOB LOCATION: WY
number street village
.'HOMEOwNEx':f,,�?Ure1 d b s AlcraltjA Of-�
name home phone V work phone#
CURRENT MAHING ADDRESS: �S i G l cl S5( y AJ
4rr? Sf7-h 4e &7e
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 procedures and
Teaq VA 2ents.
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 EXEMMTON
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
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 conanunity.
:forms:homeexempt-
i
Oct 16 04 08: 48a PINE HARBOR WOODPRODUCTS 5087717070 p. 1
T. _.
t
rk
•moo i emu;'
.O pp`L 1v` t
j�14D
AL
I'
Application to
®1b Ringo -kigbWap Regional 3�is'toric Miotrit>t (Committee
In the Town of Barnstable
CERTIFICATE OF APPROPRIATENESS _ SEP 2004
Application is hereby made, with four complete sets, for the issuance of a Certifcate of Appropriateness under Section
6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans,
drawings, or photographs accompanying this application for.
CHECK CATEGORIES THAT APPLY:
1. Exterior building construction: /New ❑ Addition 1-1Alteration
Indicate type of building: ❑ House ❑ ❑Garage Commercial Other
2. Exterior Painting: ❑
3. Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repairing Existing Sion
4. Structure: ❑ Fence ElWall ❑ Flagpole ff Other
Aa-
TYPE OR PRINT LEGIBLY: DATE
ADDRESS OF PROPOSED-WORK ASSESSOR'S MAP NO.
OWNER ITan�� �� t lG� � ASSESSOR'S LOT NO.
HOME ADDRESS =e 4rL2 TELEPHONE NO. Z' ! 0
C:)
FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across)ant;
public street orway. (Attach additional sheet if necessary.) ;r>
• C S 5- Pld WO O 6l = "
S S c Ar
17
GJ
AGENT OR CONTRACTOR jMj6_ � -/ZY TELEPHONE NO. 771-' 5007
ADDRESS &rJimam04,
DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please
include locations of proposed signs. --9
Loaf shed, 7�r uSP af*S, of 7. �e
s��`� ,� h 0 tze Well 4/M)�f
46mmtIttee
ed � ��v ���cHcr
Vl�' Signed
Owner- ontractor-AgentF se ,n y L h
This Certificate is hereby , Date
Appro eni
e Members' Signatures: A'`
Town of Barnstable �\l� fu .cJ j l
Old Kings Highway Historic District committee Ll P p �l
2004 r`
l(
SPEC SHEET
FOUNDATION
SIDING TYPES r ar COLOR
CHIMNEY TYPE /V/�7 COLOR N
l,*
//��
ROOF MATERIAL NS5�S�1 COLOR
PITCH /f!/��
WINDOWS 1; a(oabK �u . .COLOR SIZE 3��/
TRIM COLOR CO
DOORS / - 3 f gea(l how vl COLORS 4 I,' -—
SHUTTERS /V O/'L10— COLORS
GUTTERS COLORS
DECKS MATERIALS
GARAGE DOORS A1^6 COLORS
SKYLIGHTS —SIZE COLORS
SIGNS COLORS
FENCE A A `t/ COLOR
NOTUt till out oaaplotolp, including nnaaureaanto and aaterialo/colors to be uaad, four copias of thin
tors arc required tar ouhsittal of an application. along with tour copies of the plot plan. landacapa
plan and alWation plans, wham epplioahls. -
SPECSHT
Revised 11/98
O�C /& „ 34*/e�e O)ny
Ado his � �� q
1(T
c�
\\1
` l
♦
\
\
\ \ G
G �•1
1 \ —
I \ 1
I No I -
vl
Q � 1 i I I .f•• 1 1 �i � i�� •
Iszr �.
I I • 0 1 \
IIS
1
V
Vz�, t 1\ r ►
\ �1 �i ♦ / 1 r t \
I i
► .� 1 1 1
�,/ZO
, I
1 I ►
T.
Town of Barnstable
CF THE Tp�
do Regulatory Services
Thomas F.Geiler,Director
RAMUABM
MAM
.a3a �0
Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 0-x,( t/ x� Fax: 508-790-6230
11/7�o f/
PERMT# ? 0 7 / FEE: $
SHED REGISTRATION
120 square feet or less
5*hz 42( Aalrf 9
Location of shed(address) Village
s (crW
Property owner's name T61ephone number
Naf le
V
Size of Shed Map/Parcel#
An,�Ix_I�_
Signahue Date
Hyannis Main Street Waterfront Historic District?
Old King's Highway Historic District Commission jurisdiction? T45,
Conservation Commission(signature is required) o J r
PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE
COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE.
PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS.
THIS FORM MUST BE ACCOMPANIED BY A
PLOT PLAN .
Q-forms-shedreg
REV:121901
c�
N
O
1 �
1 \
1 �
� Y
1 \ —
I \
1 �
I \
I \ 1
\ I
1 � �
' I
1
o d � l ( 1 I 1 ;I �•\ � ;
r
1
I ti 1 II ••II \ \
V
v
1
.,/
1 l
Application to
1SS9 221
a
• ' ° 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 Sectio"of Chapter 470,
Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs
accompanying this application for:
CHECK CATEGORIES THAT APPLY:
1. Exterior Building Construction: ❑ New Building ❑ Addition ❑ Alteration —
Indicate type of building: ❑. House ❑ Garage ❑ Commercial- ❑ Other
2 Exterior Painting: to
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, ��q• f !9 9 9
ADDRESS OF PROPOSED WORK 25 r/Q ld S7�ne- /�d ASSESSORS MAP NO.
OWNER (Sfat/@r) a-hd JOhnna RO6t*Qdle, ASSESSORS LOT NO. G
HOME ADDRESS Id e d TEL NO.
est V arm Shbte, OR b 81 .
FULL NAMES AND ADDRESSES.OF ABUTTING OWNERS. Include name,of adjacent property owners across any public
street or way. (Attach additional sfSeet if necessary).
,J,' e and reigare/- Emer ne Klmf r sable-
Da y& And Latjj'sg- A-rro W /� rl P /d ,S� &—C/ VV 5 b��n s h/�
nd M , t /fan k i e w�c ��id s ed u.� fns6/
6 - �'oa3
AGENT OR CONTRACTOR 2kWaf-f /0 nf7�iV =/'7G� TEL NO.
ADDRESS Cenfe�✓;�� M/¢ Oa 6 a P6 SAX a/�o
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).
l4 �G►2 ids �rr0/)f� rim 5 u Item and c>6 wn sou is all �oP/ey
P
� e><�e�ior dooms a/l ffa d/Py Re d� ���n na�ra / C�c�or ShiirS/es
/Qevr�Qi�i�IJc 3 si deAAPP96WED
� p
SignedJ,
Owner-Contractor-Agent
Space below line for Committee use.
C.
D a e he Certificate is hereby y Date 419740 7 7
T. c�Gt1R/l�Q,
TO iNkIN BARhtSIABCE— •
Approved ❑ IMPORTA If Certificate is a roved,approval is subject to the 10 day appeal period
provided in the Act.
Town of Barnstable
— Old King's Highway Historic District Committee
/t SPEC SHEET
FOUNDATION C On (''.Y '�Z,
SIDING TYPE &/)72&76R
CHIMNEY TYPE ��I C COLOR Rp
ROOF MATERIAL_n* aI '}' COLOR
PITCH
WINDOWS COLOR SIZE
TRIM COLOR t✓s'1CC/]�,e 76 en/e,4
DOORS C`a rr 7d �7a01 Ie y Xe a COLORS
I
SHUTTERS nOnP- COLORS
Cha'�ge
GUTTERS A IV in m s/ C2"fieCOLORS
DECKS Ukna n)F_Cj{ S MATERIALS
GARAGE DOORS COLORS GAa/!GQ
SKYLIGHTS SIZE COLORS
SIGNS -� COLORS '
10 rD
prr, U WED
r '
FENCE COLOR
IMMS: 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
IOWN 0F BARNSTABLE, MASSACHUSETTS BOWDINGERMI PT
`
DATE 4 19 94 TO 37223
------- — PERMIT NO.
A,-PLICANT-- ADDRESS 809
IN 0.) (STREET) (CONTR'S LICENSE)
IL i.1 v i)•ICS NUMBER OF
PERMIT TO I STORY DWELLING UNITS
(TYPE OF IMPRI.,'>'MENTI NO. (PROPOSED USE)
L.....1. Road, Wv.!,L BArnctvible ZONING RF
AT ('-CCATION) DISTRICT
(NO.) (STREET)
4 0FTWFEN AND
....'OSS STREET) (CROSS 1-Ti`ETI
LOT
LOT—BLOCK SIZE
3 9E ._FT. 11.7E By FT, LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
;'V USE GROLP BASEMENT WALLS OR FOUNDATION
(TYPE)
Sewage :7 94-671
BOND
5 q, t PERMIT $ 149.00
v ESTIMATED COST P5 0()U FEE
(CUBIC/SQUARE FEET)
t Holdings of Cape Cod
W —es t Dennis, Fla 02570 BUILDING P,
BY
IS NO RIGHT TO OCCUPY ANY STREET, ALLEY OF, K OR ANY PART THEREOF. EITHER TEMPORARILY OR
P C,F M.A N F NT L N',50ACHMENTS CN PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP-
PP'.'Ec By 'JU"ISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED
FIRCM THE 0- PUBLIC WORKS. THE ISSUANCE OF THIS PERIAIT DOES NOT RELEASE-THE APPLICANT FROM THE CONDITIONS
OF ANY APPIL;C411'LE SUBDIVISION RESTRICTIONS.
OF -r:!!EE I-APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPEC�I�7,','S 'Ul:�U I R E 0 1-C.R PERMITS ARE REQUIRED FOR
A--L CC.Nf!lRUCT!ON WCF;K: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN P
ELECTRICAL, PLUMBING AND
I !'OUNDATIONS OR FOC-INGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
2 "RIOR 7C COVERING VRLICTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
M. S F R E A D Y TC) L t.--;I) FINAL INSPECTION HAS BEEN MADE.
3, BEFORE
POST THIS CARD SO IT IS VISIBLE FROM STREET
k C ING INSPECTION t2q0VALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
'3
P
2 2 2
-y'jU
0 4J--
HEATING INSPECTION APP+V LS ENGINEERING DEPARTMENT
\� v BOARD�OF EA
3 SITE PLAN FrEVIEW APPROVAL
PERMIT 'OV!LL BECOME NULL AND VOID IF CONSTRUCTION S. t-, NOT PRocr '-;NTIL THE INSPEC- INSPECTIONS INDICATED ON THIS CARD CAN BE
Tm.:. VARIOULIS STAGES OF WRITTEN
I I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR
CON�YPUCTION. PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION.
Assessor's Office 1st floor Map A Ibi Lot . Permit# . /a�3
Conservation O ice 4th floors - SE-ing AM-
CE
Board of Health 3rdfloor � �� 5
Engineering Dept. Ord floor) House# F. W t4VORO CODE AND
CNS
Planning Dept. (1st floor/School Admin.Bldg.): TO E,9rAwx s
MAW ..
Definitive Plan Approved by Planning Board 19 w '°Ia
(Applications processed 8:30-9:30 a.m.& 1:00-2:00 p.m.)
TOWN OF BARNSTABLE
Building Permit Application,
I
Project Street Address L'OT CAO , .U)Ea±
Village it -atz- Fire District
thvncr (��.��•�'c,c�� (y r�(o cc CPC C Address PO• Bic 18C,, i-' t lu1 OZ670
Telephone
n v
Permit Request: l nt rifiY>>a [TL67J op f314.) C-q(-. F'e_-Aw IL!'� 5 :—:'
w:E( G
Zoning District ¢` Flood Plain C Water Protection
I
Lot Size � -3 1 Z Si"' Grandfathered
Zoning Board of Anneals Authorization Recorded
Current Use fI Y11- 1/'ACALIV L= Proposed Use �esS1(�� (A[
Construction Type W0 0-0 f=4M.4-::
Existing Information
Dwelling Type: Single Family !/ Two family Multi-family
Age of structure w ] �} Basement type SPb u P F h C6tJG2_CT�f-
Historic House Finished
Old Kings Highway 'ten Unfinished
Number of Baths -9-100 No. of Bedrooms -3
Total Room Count(not including baths) -%PU)O 4o First Floor
Heat Type and Fuel 1�7K W Central Air Fireplaces D 0 e
Garage: Detached Other Detached Structures: Pool
Attached ON>= ook- Barn
None Sheds
Other ther_, ' 61 /x 4')
Builder Information
Name C'I'are--yr V-�) :Z)?:>o, Sf�. Telephone number 3cA4-"3oq.(�
Address T-O � x_ OR(- .��47SQHcxn _ ST , License# QS 0 6
1"11A 5; ( C> Home Improvement Contractor#
Worker's Compensation #
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRU TION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
Project Cost
I Fee 0/
SIGNA 4910UDATE 4. z-4
BUILDING PERMIT DENIED FOR THE FOLLOWING ASON(S)
BPERM T
*!� FOR OFFICE USE ON-L Y
ADDRESS 25 Fieldstone Road - VILLAGE West Barnstable
OWNER Horsefoot Holdings of Cape Cod -
DATE OF INSPECTION:
FOUNDATION
FRAW
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINA1''13'UILDING:
DATE CROSEDsOUT: _
ASSOC—jATE PLAN NO.
if C
•ro �y�r�aa;i%i s_ i
t;j e
COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY Q • ' �"•'�:a 7ccrc�r,a cerr®nt
OF ONE ASHBORTON PLACE
MASSACHUSETTS BOSTON,MA 02108J
LICENSE CAUTION
EXPIRATION DATE COAISTN. SUPERVISOR
/11/19 9 6 EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST
R S FICTIONTHEFT, PUT RIGHT THUMB
NONE {16/30/1993 032809 PRINT IN APPROPRIATE 1
o g BOX ON LICENSE.
V 59' N'IERE'fT W BOY JR �
B O X 186 BLASTING OPERATORS
W TENNIS MA 02670 5 MUST INCLUDE PHOTO.
R1gTO(BLASTING OPR ONLY) FEE: 1 .
- 100.00 NOT VALID UNTIL STONED BV LICENSEE AND OFFICIALLY �,J,D
y'i`'';!; - S PED•oR-SIGNATURE OF THE COMMISSIONER
HEIGHT:
::.:. JUG 9 1993
TMS DOCUMENT MUST BE « SIGN NAME W FULL ABOVE SIGNATURE LINE
,;...�.;...'i.':T`�C i::.•I:i;�:.•,..•.any FIE OF LICENSEE ..
...�.....,w. I•"•.:��••I'`�I'd,�,\..:.3�. 11, Il��ji} CAFUUEDON THE PERSON OF . .
::...:i/ 11`a?+,�1:•L�: ii.r/A;%�.'•��y THE HOLDER WHEN EN-c',y�.•.1V", •: T'..�.Y' LSSIONER �• • •
. ?;btiedtt�`tToGM:J ;�piw. JT GAOEDWTHISOCCUPATION. =mom .
cif��:.yy,''. .. , '. . 1
J
rl 7
vi
tA
a.. � �n �a � � � . _ :n_ ri V :91Y I-i Q � � +lo '� •�rr.Mshp� fA� � I.'
K N as ti £ e1 ra D r4
N+ O d �W ownw�o'uir i Q ZZ
�pyl J K� J9 p t
I op
f' +V f� E� (V
I1• 9A �W t•"1 :N t� �(i) llll MO MCA•Id YOl m ,yl 1
car t�ww 2+w i3ilC N1L
i I �p�Ugy J�� 1 I� t� s ' • l�..
34 o S •usr avlr 1 j I �.
1 dd I i s N 1 7TaMa M15 A ty II---7 (� I'
e,
I � w� I•
7,9
ki
Z
i 0.6 b
o
� � I
Q-
O ;1 a Ol O,
1 N
79
r
s I �
m
4 � N M
In Y�yl C,.palm ~�I v ry.� 0 0� ^Q 1r�'^1, (`I� x+10'a•a.91� ,
In mN N m •%Lcr"Ie.Q1Y•7 P
cc. a3 °C 3 Qg
I
I II
�-, -7-7
N
O 1 It
I sN7nd b�71j �'
Z (•N- r�NoLL7A313 �IQrd31.X3 I
w3a..rw ouwv„o y'L VoQ 1
L N+nd �lY�zl �a �aYd�b{d o 1I c„Yn 11
I f Nt'Id. --joa'13 15�13 11
s-Kac w.Yna :u a�ow.Y t 3TMn Otl t.,be NV114• O—Z Fr
w'M VYI 4- 3vo ?l�ld dU 9 I
js"-i+YabY'N'I�'y lfVl-Y•PS AV9 a�9 6 O-$?Y O;Z 0'1 j'1 O-gZ
I I + I
W dad
1 �SZ II I O�Z D;b OifC ,+C�7 +,bj` • Iv 4S°i�
q u
i
'�Tt7�'7�'li W_Y 011J N51'1-!{d�Y4•b I � _ �'
5711M11 II-y_�1�13A113 t.JaC;I -- �'�'�' ;
-+t1J1�1 36 Vl GI ouy BSI 11 �£1 w•11�21 I A Wsp
3"1 N4'Nl GI-gun11�Q3$ �lN��j(7-�, U I � �GI}111 So'p�h,L /
M Ykn�1 rbl Y.21
fH'araa�s A
i---�J b ❑sn mi W4 iff ff
.7l 91
1 9'�OVI I ® m•[7N.mnaDsav2-Z
- 0 avu
•ems of y _
+ v;ar�y •soli � of ® O;I. �;,< .i';G _ 12_lL 'o I I ►bZxo£1 � � I �vcuvn �_`i��` ..
I s1GC-r.1 `i
` Nl.Y7y„ 'Son 'a:l Isnij.Ai7,.4
{ Syr'aeA zo »raze �= I d I y -— — — ii X:Aa—yht4
IHIe ai Low
amrams I I I I b N I£ O" ,a Y.,9 9Ao Rw
�O? ►CIN711� _ 9NINIb fi j
• Q o.o I I I - � 1.'7
zl it. U
o,Zl o;z O's z 0-9
+� -- 0;9Z I
a3"yaa„a1;9 .2761 � i
1 _•'L�:fir„?-b:
.znb:�x,��1S •ns9loa -"SsVd�g d
-:z;o,�y.z.e:a ,°i;�r:�i;a-._avr�4s•lu�� I
otctsK�S -7♦An131 1�AI�Q _£ _9�87'I i.v
i
(owy�'•_mLF -j I
aIVAG 1>-t�l __N4_.I _96OI 4M. a,;7 s8j��.9s1 3+n=b5 S vdoNa21voZ1
�_'�3x_oG f }7i,Y11 'Md I i I _�sol�9 y.Dy7;fi .�87!ItiO;C 3u�-3-C3316 'F/ jj
o� tl's 3eAl IIor4 off azs a ci wa'lly t t
'?a W.W'U .Yo,b `Sam 7w"4CU sia Td3lc
S,.all'tlw.TIY 'SWn r'a n'/ Oa 'h
j ���IIµII�1'�',1'�I �Iti 1 ��ry,'f�'',f''AIII •ate �ry•�pl�r�'I�7o�III EN
Ulm •aa 31n• ��
no
• :; •�•yN 4u-rwzilrn73w_'�--- FM_
— -- -- — — }
I
L IrO!� Waulsrd u�� pauYn3l�1F151�i µouYJlaTd avid oNOLLVA37-a 1NPd3 �__.'
.;.w.id-1vsz't4i1:,.+�`lsp'c:Wrw�'u;—S't'S(�+"t'� ,t::i�"2t'X•P�3Fti,�i'9rh=Y'Yer+e"�M.�3F`iFJ:in:.v.'�rt'�xvc�+.h:r�M„c•«��7;.ryar ♦+,T»»Lwrwr-ri.::vki. �w,vy�:.r;.y`rw�- 27'�+�." » .�♦„_,.tk.�...�,:;:,v•n'-- x'!=-�
TOWN OF BARNSTABLE Permit No. ..3.7.223.......
BUILDING DEPARTMENT
TOWN OFFICE BUILDING Cash 1,
Y�
X
�'�ror,rR HYANNIS.MASS.02601 Bond
CERTIFICATE OF USE AND OCCUPANCY
Issued to
Aorsefoot Aoldines of Cane Cod
Address 25 Fieldstone Road
West Barnstable, MA
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE +
BUILDING CODE.
April 7 95
.. ........... ........ ...... . 19................. ....... ............
r Building Inspector
TOWN OF BARNSTABLE Permit No. ..3.7.2.23.......
BUILDING DEPARTMENT
I ""'T I Cash
TOWN OFFICE BUILDING
�► X
HYANNIS.MASS.02601 Bond
CERTIFICATE OF USE AND OCCUPANCY
Issued to Horsefoot Holdings of Cana Cod
Address 25 Fieldstone Road
West Barnstable, MA
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID. AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE. j
r I f
April 7 95
. . ....., 19................. r'..... .�.....................
Building Inspector
� p ,
� n
o 1_
i n
i.
� K O
lk
JOQ
`t
It
.1
Q d i
t .
i M U
IZAU
W
� I O
v
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map // Parcel 7 ` Permit#
Health Division — ►� OA/ y Date Issued i
Conservation Division d � '�°" Fee.
Tax Collector "STSE
C i I ,' COMPLIANCE
Treasurer r f ° ITLE 5
Planning Dept. .U :'eNTAL CODE AND f�S
Date Definitive Plan Approved by Planning Board `f. J;iGULATIONS
Historic-OKH Preservation/Hyannis '
r
Project Street Address as 7-IEGDS�tiI�
Village 7zd ""-Sr /'Yl Z-
Owner / TA-/LG Address s �
Telephone v36P,)- Z N '
Permit Request f 15 < 31-M n 14
G
Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total new
Estimated Project Cost /01 6VD Zoning District Flood Plain Groundwater Overlay
Construction Type wa-D 75i*iNc
Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family(#upits)
Age of Existing Structure Historic House: ❑Yes 'dNo On Old King's Highway: ❑Yes Mo
Basement Type: 14Full ❑Crawl Walkout ❑Other
Basement Finished Area(sq.ft.) (ocr0 Basement Unfinished Area(sq.ft) 7S
Number of Baths: Full: existing new Half: existing new
Number of Bedrooms: existing new
Total Room Count(not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other
Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage:❑existing ❑new size Shed:0 existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes,site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name Telephone Number
Address_. 1byS A4762ro4O11 License# /1107Yy CSOs7dr-3-2- Cs a 7,,,27 yy
i Home Improvement Contractor# /&V 7VO
Worker's Compensation# �GJ
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO �flXilydd �/GG�
SIGNA z— DATE _
FOR OFFICIAL USE ONLY
PERMIT NO. -
DATE ISSUED
MAP/PARCEL NO.
ADDRESS'* VILLAGE '
OWNER
DATE OF INSPECTIGN:
FOUNDATION N-IIns/ J
FRAME •
INSULATION
FIREPLACE -
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
� rtsO f -;
DATE CLOSED OUT.
ASSOCIATION PLAN NO.
ASSESSORS MAP: IIL_
4 PARCEL, 4-9
h
NRRLNT ZONING: g/_
y BUILD/NC SETBACKS:
FLOOD ZONE: C ,
LacvJ
LDCArION YAP r,,Q_S[0•ELL
(r66-r6 LEACH r/TJ
LOT 2 LOT'(
3I.842±S.F.
(0.73: AC.) unurr
cu/sTrn
® - DR/r,
a
1 ploposto
D•fLUNO / /' ,,
1A
y/A v / re ram.-6oD
Sal ctj
4.e
/ 0
— EDL'r 01 1AI"
V//[IR
el CWSTCR
R 0! PHONE
RISER
BENCHMARK AT
rr ELECTRIC MANHOLE
/ ELEr. 76J
.71
sr
71
LEY:
EXISTING CONTOUR' --
PRDPOSLD CONTOult ""•" ""
EXISTING SPOT ELEVAr/ON: 255
PROPOSED SPOT ELEVATION:25
TEST HOLE.Y
UTIL/rT POLL:4 Uh,�
FENCE LINE:
HYDRANT. y e DEYARESr-McLELLAN ENCINEER:
V 11 SCHOOL SrRCrr P.O.Box'6]
•rSr DENNIS.YASSACHUSrrrS 0
DM/ss=QJ.Z
WOOD DECK
0II111I0:KITCHEN
BELOW 0
tOp:106 _T O STORAGE r OW. r Or O a BATH
Or w. I
L_ J I,__ 1 LAN.
I
BATH
KITCHE0 WALK-IN
8r6 x ip0 TIEF BALCONY
vuLrEp CEILING CL. CLOSET
GanAGE
176 x:71'
I STORAGE
i
LIVRIG ROOM
BEDROOM BEDROOM
t70:171 CL. '20 x 176 116E 176
OEN/BEOROOM l
116 It 136
-- .- The Commonwealth of Massachusetts
. --_ Department of Industrial Accidents
- X -- I Mice 0//OYCSI/Aaffoos
600 Washington Street
-..- " Boston,Mass. 02111
— Workers' Co m ensation Insurance Affidavit
name:
location:
city phone#
❑ I am a homeowner performing all work myself.
❑ I am a sole ,/.e/t//o///r///a//n//d have no one worlds in aIIv(//fj�acityZ.
/// ,// ,� M M
I am an employer providing workers' compensati n for my employees wo#dng on this job.
:::.::::::..:...:..:::..:........
< :::::V::9`:?` ::
>::>::::::::>:: ,:.. ..
::. ;< .
:>
tam n n me:::>;::;;: ?:'. :` ::'.> ,:
_:: M .Sddress...
.:.:: :;.:.:..::.:...
a
»::::.:
;..
:>> ::>
:::�::;::::::;::::i:::::.::>:i:::::i:::::
hone.#.......: «:>::>:::> ;:<':.. :>:.;:.::.>:.;:.;:.::.:;.;:.;:;:.;::.;:.;:.:::
: . .. -t' SZ2
suratrce co. .... .. ... . ."'
o i
// . / / /
❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who
have . . `-
:.::::the following workers'::compensation polices:.......................:::::.::::::.:::::::::.::::.:.::..:..:...................................
:.:<:>::>: >- a:>::>:e :`?. -.... < 2J %:>:'. : ` ' >t' '; 2 ': [< '. ; <is [> ' ` ' :' ` ''
come n n m
: z>>< <
ddrel? ' ::: :::::::::.::: ::: :' ::::::>'::�� :> <'? :Z <:: �� :: '?: ?�2::'-....-' is.J ::: ::::::: ` > '' <' %Y >::': ` � ':: *.....' :' `>-..- .....
"'se?n'.
;:'
.:.:::..:::.::.::..::::....::.::::............:......::....................:....<:.:::.:::...... ::.,.:::.:::.::.:......:. ........ .. .. .........: ........................
<w
:I....
.............................:..:.:... ..................................................................
..:,
11 .................:................ ...::. „ ,w
:;';.,:::�:itij.i::::..L:: :::......::i'i ......::v::::ii::!';:iy:':::::':::i: sits::i}::i�-.'-.::::•::S:C•::isii:::+.:•:v:::::;:��ii:;:isisvC::?:i::::::i:•::Y'i::::i::::i:!vi:ii:testis:::�':::i:::f::;:!::Y:::: �iiii:;:;i::,'.�:;';'�;:v:::iw
::::::n:::.::.::::::.�::.:::::::v::..:..
::�:::ii.�:.::::::.::::::::.:........
:::::n:::.:::.�:::::.:�::::::::<?iiiiii:
......2...... .....;............
::.::.::::........:..........................:.............:.....:::.;,;':.:::::. •.:,..:;:::.:; .:.,•.:::::•::•:::.:..::•.:.. ..... :::::•:::. .::::.::::•::::::::>::::.::.::•;;:;•:;•;::::::::.;;:.;.;.::..•:.•.:>a:.. G ..::�,,.;:;><-.
..........................................................................r•:.:...::...::.:::::.:::::•::•::: ::::::::::•;:....o:::;•:;::::.::::::::: <.r:....... .. ..: :>:
::::..�:::::::.:�::.�.�::::,::::::•::.�,::...::..:....:.......... ....::....:.:::::::::.::::::::::::.�::::::::. ...........,...........................<•>::>: ;:;:.....»..::.,�.c.a...na..e w,....:�..:.
unrance.ca . .......:::::.:.:.. ot+tee.#..........:
IMEMMOMMOMM,
.........�....:.:...........:.... .......:...... .......... .............................................
:»>:»;:
camp n n m
it
«<:>: «::
>: :.:::>::::..;:.;::::;;:::::;»:.;::;:.;:.;:;;:::;.::•;;::;:.:<.:;:.::::::;;:.;:.::.;::;:.::.::.;:.: :.»:.:;;:: :.;::.;' :;::.;;:<:.::.;'.:%%.:;:.;:.;:.;::>:.;:.;:;.;:.;;:.;::}:::::.::
Cdty'`:r»::<,>':<:»::::::::v::::i::::<:::>:::>:::>:'<::::<:::::::::<: ::'>::::>:::::::::::«:::>::::>:::::::>::::<:::<::>:::::::>:':::;<: ::::`:>::::::>::>>: :>: >:':: :: :::>:`:'•::::::::,..Iione ....................................................................
:..............................::.::.:..::::................:...:::::.:::::....
b
... .:...:..................::::...::::..:...::::.:...:::::::::::::.:::::::::::::::::::::::................:..:.:... .::::::..::.:. i><:>:::>
::.:.....................................................:......:....,..::..:..............;...:.................;.....:..........:..........................................:.....:::::::::•:.:;::::.;•::;.;:::.:::::::•:::::::::.::•::::::
s•
%
<•;:;•;:i;:];:n:o::::;:•:::>::::•::::.;:•::,....::•: •;;;:::»;:;;:o:•::;:>.o-::•.;;;:>;::;:::;:;:::.:.......;:>::;::;:.::o:>'%::;..._.�;•:>:;:%;..:•:»::•:>:>::;X.;:sY.:.:;:::::::;;:•:::::a:::::;:;::: :::::::r;::>:.::::;.;'::::.:::.:::.:::::..:.:..:.....::•.:.;:::::.�.•:::•:...
... .::::•::.. ...:..... ...................................... «>...:...... ': :•:::•::::::.;:.:::.:::.::::::::::::'::::::::::::.:.::.::.::.;;>:..::..............
n�nran Ct'.CQ:.... .....::::.:::::..::..::::...:::::.:.......:::...:.,...:..... .:.: ..,..:::...:.;.:::..::.:.::::.;.:::.:.:;,.:.::.: .:.: OIiN#..:...:.::::.:::.::.:::::.;::::.......:..;.::.;:.;'.;:.;:.;'.;:.;:.:.,:::.::.:-:::>...:;::..;:.;:.:.;:.;>;:.;.:.:;.<:.;:.;:
FaiYme to secure coverage sa regidred®der Section 25A of MGL 152 as lead to the impoairion of a�minal penalties of a Ste up to$1,500.00 and/or
one years'imprisomn-st as well as civil penalties in the form of a STOP WORK ORDER and a Ste of S100.00 a day against toe. I tadentand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification
j I do hereby ccvlJ fy under the pains and penakia ofpeJ�'tha the information provided above istrt,and correct
.. Signature [%�idc�2 c. k 41- / ?-,Y-4-C,�,�— Date _ /b1C
Print name- 12Zc, oal CSC I/_ �4-se H -� Phone# / � F3— 9 5 /��
official we only do not write in this area to be completed by city or town offida1 '
city or town: . peratit/license is ❑Buadht=Departmm! -
❑check if immediate response is required ❑Sete tmg Board .
❑Sdeettnen's Office
_ ❑Health Department
contact person: phone#; ❑Other
Orymed 9/95 P)N
„' _✓lie 'Varyrr�narLU/ECLI.[II. a�Jf�,Cruac/iu<retGi I
E DEPARTMENT OF PUBLIC SAFETY �.
CONSTRUCTION SUPERVISOR LICENSE
l Number: Ezuires:
Restricted°Toc- 00
FREDERICK V RASCH III
.•x
eqV.,'i868 BOURNE RD
PLYMOUTH. MA 0?360
—--—
R0VE,-E,N7 CCN ==.CTCF.S FS� S;Re�i:GN i
"f cca-c c` E.: i c_ r:c F.ec ?a=-ors a lc Spa-I�ares i
to l F:=f-@ - Fool
Ecs_o hassac„Ls=__s CZiGEs” 1
CG1N�==.CiG� - - - - - - - - - - - -- --- -- - - - --- --- ------ - -
�r.i GL_viii _VG7 CXr- a in
i I I�JI �S C-^_T—_ • S
• � t�:Gur»4autr•L/Gi C �:CLIt::d/i:
0:'.t�1.1 i OF ;113::r Safi(
i C: lz.7KZ 15(ZEf15i: {
Lam, r Yes'U tad Tc: it
• .�: •• -� - . . . .•• - �T THCX�S t L�7IZL J8
�h
• - - 4.,:,,..,�--,,. �= Z8b 1E.'sCiYht Dd `
The Town of Barnstable
• .ARMABM&659. •
MAM
Department of Health Safety and Environmental Services
ram ' Building Division
367 Main Street,Hyannis MA 02601
Office: 508-8624038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
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: ?Aj; T_Fl 4�L i7tSCM61CT {'t[(//S,A5b Estimated Cost 10, U V-c!U
Address of Work: o?S F(6iZ S r-0 0 t jQ
Owner's Name: '5f-;U inn 6 6 t
Date of Application: 1
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job Under S1,000
Building not owner-occupied
Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereby ap ly for a permit as the agent of the owner: M
Date Contractor_Name Registration No.
OR
Date Owner's Name
g1or ms:Affidav
MAscheck COMPLIANCE REPORT I v
Massachusetts Energy code I Permit #
MAscheck software version 2.01 I I
I I
checked by/Date
I I
CITY: Barnstable
STATE: Massachusetts
HDD: 6137
CONSTRUCTION TYPE: 1 or 2 Family, Detached
HEATING SYSTEM TYPE_: Other (NQn-E1.ec.triC .Resistance
DATE: 1-7-1999
DATE OF PLANS: 12/30/98
TITLE: Robitaille
PROJECT INFORMATION:
Basement Remodel
COMPANY INFORMATION:
capizzi Home Improvment
COMPLIANCE: PASSES
Required UA = 143
Your Home = 116
Area or Cavity Cont. Glazing/Door
Perimeter R-Value R-Value U-Value UA
-------------------------------------------------------------------------------
WALLS: wood Frame, 16" O.C. 340 13.0 0.0 28
WALLS: wood Frame, 16" O.C. 350 13.0 0.0 29
GLAZING: windows or Doors 16 0.320 5
DOORS 16 0.270 4
SLAB FLOORS: Unheated, 0.0" insul . 48 0.0 50
HVAC EQUIPMENT: Boiler, 90.5 AFUE
-------------------------------------------------------------------------------
COMPLIANCE STATEMENT: . The._pfoposed bui 1 ding deign descri bed here. i-
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 heati rig Ioad f_o.r.-this_-building,_and.xhe._cooling .load.j.f..appropriate,
has been determined using the applicable standard Design conditions found
in the code. The HVAC equipment. sel ected. to heat or cool the bui 1 di_ng
shall be no greater than 125% of the design load as specified in
sections 780CMR 1310 and J4.4.
Builder/Designer Date
0
r
ti
MAscheck INSPECTION CHECKLIST
Massachusetts Enema code
MAScheck software version 2.01
' Robitaille
DATE: 1-7-1999
Bldg. l
Dept. l
use
I
WALLS:
[ ] I 1. wood Frame, 16" O.C. , R-13
Comments/Location
[ ] I 2. wood Frame, 16" O.C. , R-13
Comments/LDcation
WINDOWS AND GLASS DOORS:
[ ] I �_._U.value:._0_32
For windows without labeled U-values, describe features:
# Panes F_r_ame..ryp_e -The rmaI-Br-eak? Yes .[.. _No
Comments/Location
I
DOORS:
[ ] I 1. u-value: 0.27
comments/Location
I
SLAB-ON-GRADE FLOORS:
_unheated, . _0-D"-inSUE, _R--0
Comments/Location
slab insulation to extend down from the top of the slab to at
least 0" OR down to at least the bottom of the slab then
hori,=tal_l_r_.fo.r.a-total_-distance---of.D".
I
HVAC EQUIPMENT:
[ ] I 1. Boiler_, . 90.5 .AFUE. or. hi__gher
Make and Model Number
I
AIR LEAKAGE:
[ ] I Joints, penetrations, and all other such openings in the building
envelope.-that.-are-sources_.of air leakage _must-be...sealad_ _..when
installed in the building envelope, recessed lighting fixtures
shall meet one of the following requirements:
1. Type IC rated, manufactured with no penetrations between the
inside of the recessed fixture and ceiling cavity and sealed or
gasketed to prevent air leakage into the unconditioned space.
2. Type Ic rated, in accordance with standard ASTM E 283, with no
more than 2.0 cfm (0.944 L/s) air movement from the the
conditioned-space -to the _ceiling. cavity_ The 7jgbting fixture
shall have been tested at 75 PA or 1.57 lbs/ft2 pressure
di ffer_ence and_shalJ.he labeled.
VAPOR RETARDER:
[ ] I Required on the warm-in-winter side of all non-vented framed
cei 1 i qgs, -walls.,._and fl_oo rs.
I
MATERIALS IDENTIFICATION:
i
[ ] I Materiarls and equipment must be identified so that compliance can
I be deter-mined. ._Manufacturer-manuals for-all installed heating
I and cooling equipment and service water heating equipment must be
I provided_. Insulation-R-values, _glazing.11-val es, .and.heating
I equipment efficiency must be clearly marked on the building plans
I or specificati-ons.
I
DUCT INSULATION:
[ ] I Ducts shall be insulated_per Table 34.4.7.1.
I
DUCT CONSTRUCTION:
C ] I All accessible joints, seams, and connections of supply and return
I ductwork located outside.conditioned_space, including stud bays or
I joist cavities/spaces used to transport air, shall be sealed
I using mastic and fibrous backing tape installed according to the
I manufacturer's installation instructions. Mesh tape may be
I omitted where yaps are less than,1/8 .inch. Duct tape i s not
I permitted. The HVAC system must provide a means for balancing
I air and water systems.
_ I
TEMPERATURE CONTROLS:
[ ] I Thermostats are required for each separate HVAC system. A manual
I or automatic means to partially restrict or shut off the heating
I and/or cooling input to each zone or floor shall be provided.
I
HVAC EQUIPMENT SIZING:
[ ) I Rated output capacity of the heating/cooling system is
I not greater than 125% of the design load as specified
I in Sections 780CMR 1310 and .74.4.
I
[ ] I SWIMMING POOLS:
All heated swimming pools must have an on/off heater switch and
I require .a cover unless over 20% of the heating energy is from
I non-depletable sources. Pool pumps require a time clock.
I
[ ] I HVAC PIPING INSULATION:
HVAC piping conveying fluids above 120 F or chilled fluids
I bel ow �5.F.i=t_b.e_ins_ul are .to. the.following Ieve]s _(i n.)
I
PIPE SIZES (in.)
HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4"
Low pressure/temp. 201-250 . 1.0 1.5 1.5 2.0
Low temperaxufe 12Q-ZOO 0.5 1 5
& 1.10 1,
I steam condensate any 1.0 1.0 1.5 2.0
COOLING SYSTEMS:
I chilled water or 40-55 0.5 0.5 0.75 1.0
I refrigerant below 40 1.0 1.0 1.5 1.5
I
[ ] I CIRCULATING HOT WATER SYSTEMS:
Insulate circulating hot water pipes to the following levels (in.):
PIPE SIZES (in.)
NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS
HEATED WATER TEMP (F): RUNOUTS 0-1" I 0-1.25" 1.5-2.0" 2.0+"
I 170-180 0.5 I 1.0 1.5 2.0
Town of Barnstable
of t Regulatory Services
'4o Thomas F.Geiler,Director
Building Division
nAMMB�
v� MASS. Tom Perry,Building Commissioner
i6g9. �0
'•�Fp��pt A 200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Approved: _
Fee:
Permit#:
HOME OCCUPATION REGISTRATION
Date: 3 !2 '
Name: 1&Y rel/ A. /��( (� Phone#: (0 7 (Y U -7 � 3
Address: 257 Flelcl V-)�" Village: te-
Name of Business:
Type of Business: arfi f ap/Lot: ///Q F
INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation :o
within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the
activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual
alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal
residential volumes; and no increase in air or groundwater pollution.
After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the
following conditions:
• The activity is carried on by the permanent resident of a single family residential dwelling unit, located
within that dwelling unit.
• Such use occupies no more than 400 square feet of space.
• There are no external alterations to the dwelling which are not customary in residential buildings, and there
is no outside evidence of such use.
• No traffic will be generated in excess of normal residential volumes.
• The use does not involve the production of offensive noise,vibration,smoke,dust or other particular
matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects.
• There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess
of normal household quantities.
• Any need for parking generated by such use shall be met on the same lot containing the Customary Home
Occupation,and not within the required front yard.
• There is no exterior storage or display of materials or equipment.
• There is no commercial vehicles related to the Customary Home Occupation,other than one van or one
pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to
exceed 4 tires,parked on the same lot containing the Customary Home Occupation.
• No sign shall be displayed indicating the Customary Home Occupation.
— - • If the Customary Home Occupation is listed or advertised as a business,the street address shall not-be -
included.
• No person shall be employed in the Customary Home Occupation who is not a permanent resident of the
dwelling unit.
I,the undersigned have read and agree with the above restrictions for my home occupation I am registering.
,�j
Applicant: Date:
Homeoc.doc Rev.5/30/03
TO ALL E BUSINESS OWNERS
DATE: 2 O
Fill in please: /
APPLICANT'S YOUR NAME: Z-aa/�/ /� ll����/� '� /
BUSINESS '� YOUR HOME ADDRE S: ''
Jy
TELEPHONE Telephone Number Home
NAME OF NEW BUSINESS / TYPE OF BUSINESS
IS THIS A HOME OCCUPATION? YES Nd IC/YI
Have you been given approval from the building division? YES NO 0
ADDRESS OF BUSINESS �51'!P GAS &Odd, MAP/PARCEL NUMBER /I
When starting a new business there are several things you must do in order to be in compliance with the rules and regulatio s of the Town of
Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures,
listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor- Town Hall) or if you get the business certificate first
you MUST go to the following office to make sure you have all the required permits and licenses..
GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) and you will find the following offices:
1. BUILDING COMMISSION 'S OFFICE
This individual has been infor a of any permit requirements that pertain to this type of business.
oa�
Authorized Si ture**
COMMENTS: 1
2. BOARD OF HEALTH
This individual has been informed of the permit requirements that pertain to this type of business.
Authorized Signature**
COMMENTS:
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature**
COMMENTS:
Business certificates (cost $30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must
do by M.G.L. - it does not give you permission to operate -you must get that through completion of the processes from the various
departments involved.
**SIGNIFIES APPROVAL FOR A BUSINESS CERTIFICATE ONLY.
i
N
LOT 1
Yx
251
LOT 2
31,842 ± S.F.
(0.73 ± AC.) \X (Jib 0
5�
265. 72'
LOT 3
JOB # 94-039-2
CERTIFIED PL 0T PLAN
PREPARED FOR
LOCATION :ASES MAP i11 PAR 48
FIELDSTONE ROAD WEST BARNSTABLE REEF REALTY
SCALE : 1" = 50'
REFERENCE : LOT 2 PLAN BOOK 413 PACE 99 ��k OF Mgss
N
I HEREBY CERTIFY THAT THE STRUCTURE JOH
o tiN
SHOWN ON THIS PLAN IS LOCATED ON THE DEMARE JR. ►�
GROUND AS SHOWN HEREON. -+
0 No.36859 Z
0 sum
DEMAREST - McLELLAN ENGINEERING
24 SCHOOL STREET P. O. BOX 463 JANUARY 9, 1995
WEST DENNIS, MA 02670
(508) 398-7710 DATE OFE IONAL LANDS EYOR
Application to 9999 221
• ' ° Old Kings Highway Regional Historic District Committee
in the Town of Barnstable for a
CERTIFICATE OF APPROPRIATENESS
Application is hereby made, iri triplicate, for the issuance of a Certificate of Appropriateness under Section,6 of Chapter 470.
Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs
accompanying this application for: t'
CHECK CATEGORIES THAT APPLY:
Nj
1. Exterior Building Construction: ❑ New Building ❑ Addition ❑ Alteration
Indicate type of building: ❑ House ❑ Garage ❑ Commercial- ❑ Other
Z Exterior Painting:
3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign
4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other - J
(Please read other side for explanation and requirements). ,
TYPE OR PRINT LEGIBLY DATE, Aug. f�• 999
ADDRESS OF PROPOSED WORK �;s r1e/d Sbl)e- ASSESSORSMAPNO. _
OWNER S'}ym Qhd ToAnna Robt+a; Ile ASSESSORS LOT NO. G
HOME ADDRESS /d e �' TEL.NO. 3 ioa?^ya0
esfi 'gar;,1stzL6/r, OR b 8
FULL NAMES AND ADDRESSES-OF ABUTTING OWNERS. Include-name of adjacent property owners across any public.
street or way. (Attach additional sFieet if necessary).
.16' e and r e Y6- EMer o/ skne r s1a.hle
)aV& and Loufi e, Merro w /� >CP /d s*"e / (y VV05 b•c'-n-s
I/ nd M t /�a�ki e w l Z ��a s /Pd (� � i- s"1
40d $arbalw- rnall) 54e Fig sir= 6 — Zod 3
AGENT OR CONTRACTOR -kWaft darnt 'IW -Tnc, .: TEL. NO.
d
ADDRESS Ce,(7 fer'I/�'�/� �i� oa 6`3 a Pd B0X-a/10
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). /
C14P loo mods (�On-1 1 �riM , 5 u/teis and c6 wn�u t5 a /l COP caste.
e k,,4,,r dDors a// /fa c1/Py Rem �n nafi+i-a / C�c�o� ShiaS/es
SignedJW��="'��`� IfZd� —
� r? n v r Owner-Contractor-Agent
Space below line for Committee used DoU �_
.C.
r W'644..4)
rrT
he Certificate is hereby �� IvyDateQ 9e8 9 c�u1�c��
To6uIN-er•-e�R,Msraa�— '
Approved ❑ IMPORTA If Certificate is a roved,approval is subject to the 10 day appeal period
provided in the Act.
Town of Barnstable
Old King's Highway Historic District Committee
SPEC SHEET
FOUNDATION Qo _✓e-1
SIDING TYPE ml OR
CHIMNEY TYPE �/�I C COLOR Rp
ROOF MATERIAL__Ln I-I i— COLOR
PITCH
WINDOWS k�j 00 d, COLOR SIZE
TRIM COLOR ChCC/-2!5 e 70 6,V&w Ci'Gt c.1
DOORS C�/Q 17Ci 2 xe�/ /1 e O COLORS
SHUTTERS nOne, COLORS
Change 4D
GUTTERS A U M I n u IM Cop�e�G COLORS
DECKS VJCOA n)EF-o{ S MATERIALS
GARAGE DOORS nF �U COLORS
SKYLIGHTS SIZE COLORS
SIGNS -� COLORS
Do � nyj
FENCE Allh 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.
SPPCSHT
Revised 11/98
P 04 CURRENT ZONING: RF
BUILDING SETBACKS:
BJc� F: 30' S: 151 R: 15'
FLOOD ZONE: C
5 .
Locus
A
LOCATION MAP PROPOSED WELL
LOT 2 (155- TO LEACH PIT)
31,842 ± S.F. LOT 1
(0.73 f AC.)
/ UTILITY
46,
CLUSTER
' 48 so
\ 46 / 50 52 54 56 58 , 62 64
66
68
............. 179. 87V
46- _ 3a i I... 48 ..... ... ........ / / / /
DPjVE
70. 3
TH-1 m CARACE - / s0 / /: 70 /
42-
S PROPOSE
T ` DWELL�NC 49 / ! / / / / / / 72 72. 6
!N LP 50.0 / / / / / / / , / / // /
38� / / / / , / •....../.• / / / / / / 74
45
36,, / :/ / y / / / , / / / / / / / 4. 8
3638 40
/ / i / / / / 76W
42'
177. 1
44 46" / , i 7
49' / / / / / / ' _ 68 70 74
50
_ — UTILITY, EDGE OF PAVE
54' / / / / / / / / _ — — -68 CLUSTER
i� 58 PHONE
62
/ _ - 70 RISER
►.• /
// � 265 q 2
64 BENCHMARK AT
66 / / _ '72 ELECTRIC MANHOLE
ELEV. = 75.8
68 70 74
72 /
/
74
KEY:
EXISTING CONTOUR: —
PROPOSED CONTOUR: ..............................
EXISTING SPOT ELEVATION: 25.5
PROPOSED SPOT ELEVATION: 25
TEST HOLE: -1
UTILITY POLE: -p-
FENCE LINE: DM
HYDRANT: DEMAREST-McLELLAN ENGINEERI
24 SCHOOL STREET P.O. BOX 463
DM # 24-03 --2 WEST DENNIS, MASSACHUSETTS 0,
1. VERTICAL DATUM:_ASSUMED FROM QUAD (NGVD + �_
ENGINEER: DOYLE ENGINEERING 2, MUNICAPAL WATER IS Nor AVAILABLE.
WITNESS: THOMAS McKEAN, R.S. 3. SCHEDULE 40 — 4" PVC PIPE TO BE USED THROUGHOUT SEPTIC SYSTEM.
DATE: 9-3-86 4. ALL PRECAST UNITS TO CONFORM WITH AASHTO H-10 & H-20
PERCOLATION RATE: < 2 MIN/IN LOADING SPECIFICATIONS.
TH—f TH-2 5. PIPE PITCH = " PER FOOT.
a2Lry 6. FIRST 2' OF PIPE OUT OF D—BOX TO BE LAID LEVEL.
12- LOAM 7. THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE
SUBSOIL USE OF A GARBAGE DISPOSAL.
3s' 39.9 8. ALL CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE
STATE OF MASS. ENVIRONMENTAL CODE (TITLE FIVE) AND LOCAL
CLEAN HEALTH REGULATIONS.
SAND y 9. CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR
(Soya TO CONSTRUCTION.
GRAVEL)
10. PROPOSED SEPTIC SYSTEM AND WELL LOCATION ARE IN ACCORDANCE
�1s 28.9 WITH MASTER PLAN ON FILE WITH THE BARNSTABLE hEALTH DEPT.
NO GROUNDWATER ENCOUNTERED
EPT I C SYSTEM DESIGN
WALK-OUT DECK
42
FLOW ESTIMATE: FE 3 BEDROOMS AT 110 GAL/DAY/BEDROOM = 330 GAL/DAY 3 BEDROOM
PROPOSED
2& DWELLING 24'
SEPTIC TANK: GAR
ML GAL/DAY * 1.5 DAYS = 495 GAL 1 14'
USE 1000 GALLON SEPTIC TANK 2W
LEACHING AREA: PROPOSED DWELLING
USE ONE LEACH PIT (6' x 4') WITH 3.0' OF STONE
(12' EFFECTIVE DIAMETER x 4' DEEP)
SIDE AREA. 12 x 4 x PI = 151 SF (2.5) _ . 377 GAL/DAY
BOTTOM AREA: 6 x 6 x PI = 113 SF (1.0) = 113 GAL/DAY
TOTAL CAPACITY = 490 GAL/DAY
E P T I C- SYSTEM SECTION 2" PEASTONE
OF314" - 1112"
50.0 WASHED STONE
ETOP OF FOUNDATION
\\40.41
0 0
410.661 1000 GAL ELEV. ILD—B 0 X \---40.18 4' o
ELEV. -
410 SEPTIC TANK 40.35 ELEV. 33.0
'LEV. ELEV. .. .---.ELEV.
TEE SIZES: �,0 3' 3'
UNDER INLET: 6" UP, 10" DOWN ELEV, a — 12' ol
1ASEMENT OUTLET: 6" UP, 19" DOWN ONE LEACH PIT (6' x 4') WITH
'LOOK) 3' OF STONE (12' EFF. DIAM. x 4' DEEP) (H-20
BREAKOUT CALC.: (37.5 — 36)/44 x 150 = 5'
SITE AND SEWAGE PLAN
L 0CA TION.-
LOT 2 FIELDSTONE ROAD
' WEST BARNSTABLE, MA
>` PREPARED FOR:
REEF REALTY
SCALE: 1" = 30' DATE: 7-24-94
0 REFERENCE: PLAN BOOK 413 PAGE 99
THOMAS McLELLAN, P.E. JOHN Z. DEMAREST JR., P.L.S.
L .,
` COMMO TH OF MASSACHUSETTS
p DF.FAR' RENT OF INDUSTRIAL ACCIDENTS_ -
600 WASHINGTON STREET
zanies. Canooel: BOSTON, MASSACHUSETTS 02111
WORKERS' COMPENSATION INSURANCE AFFIDAVIT
1, Everett W. Boy,-Jr.
(licensee/pettttittee)
with a principal place of business/residence ar.
24 School Street P O Box 186,E West Dennis Massachusetts 02670
(City/Satemp)
do hereby certify, under the pains and penalties of perjury,that:
f�) I am an employer providing the following workers' compensation coverage for my employees working on this
job.
Aetna WC# 006-C-23219584CAA
Insurance Company Policy Number
( ) 1 am a solrprep47r and have no one working for me.
( ] I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below
who have the following workers' compensation insurance policies:
Name of Contractor Insurance Company/Policy Number
Dame of Contractor Insurance Company/Policy Number
Name of Contractor Insurance Company/Policy Number
0 1 am a homeowner performing all the work myself.
NOTE Please be aware that while homeowners who employ persons to do maintenance,construction or repair work on a
dwelling of not more than three units in wbich the homeowner also resides or on the grounds appurtenant thereto are not generally
considered to be employers udder the Workers'Compensation Act(GL C 152,sect. 1(5)),application by a homeowner for a license
or permit may evidence the legal sutus of an employer under the Workers'Compensation Act
1 understand that a copy of this statement will be forwarded to the Department of Industrial Acddents'Office of Insurance for coverage
verification and that failure to secure coverage as required under Section 25A of MGL 152 an kad to the imposition of criminal perialtia
consisting of a fine of up to$1500.00 and/or imprisonment of up to one year and civil penalties in the form of a Stop Work Order and a
fine of-S a day against me.
Sign is dayof �6uo�-� , 19 9 LA
License//Permitter Licensor/Fermi r
Application to
1994 - 1 16
O� 0PC es ►M Old King's 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: UK New Building D Addition [2 Alteration
Indicate type of building: House Garage.. ❑ on
C' ❑ Other
2. Exterior Painting: _,. _ . _ �,.,•:
3. Signs or Billboards: ❑ New sign • ❑ Existing sign.n ❑ Repainting existing sign - -
4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other
(Please read other side for explanation and requirements).TYPE OR PRINT LEGIBLY "' DATE =4
`/
fq4
ADDRESS OF PROPOSED WORK GOT-*y r1&&)VAI6 AV wi 60� ASSESSORS MAP NO. I"L-f
OWNER �U/" r` N �`� C. ASSESSORS LOT NO. 2—
HOME ADDRESS I Q, M 194 AW WNII ; ; 04 02-670 TEL NO. -1 4- ffd `d
FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public
street or way. (Attach additional sheet if necessary).
AGENT OR CONTRACTOR&6'vqAT Ali(:WJ2'4 TEL. NO. - >
ADDRESS (•D, N �U6 j'iiJ/IrSTD/�r , !7 �2670
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).
=zo ,X 7-9 .7 gels �,45� s . , 3 sq, .
r,y1-d'
_ . Signed
- 'd;,;rer-contr:a`ctor&gAt
Space below line for Committee use.
Reeeived-by=H D C.
CQdF
+ate '1 The Certificate is hereby _0,42r`O"&� Date
JUL 2 7 1994
Time
C
g )�Mfhl OF a�APKICT-A 131 C
QLD KING'S HIGHWAY
Approved IMPORTANT: If Certificate is approved, approval is subject to the 10 day appeal period
provided in the Act.
r
Disapproved ❑
ADDITIONAL INFORMATION FOR MAKING AND FILING AN APPLICATION
FOR A CERTIFICATE OF APPROPRIATENESS
The four categories for which a Certificate of Appropriateness is required are: (application for demolition or removal is a
separate form).
1. EXTERIOR BUILDING CONSTRUCTION (new or existing' buildings): An application is required for any exterior of a
building.to be erected,or altered including windows, doors, siding, roof, light etc., that will be visible from any public street,
way or public place. The following scale drawings are required in duplicate with application: plot plan (if addition _ show
existing buildings in outline), floor plan and elevations.:-,: Also required are'snap shots of existing buildings, where additions or
alterations are to be made., No plot plan.is required for addition or alteration which does not touch the ground.
2. EXTERIOR PAINTING: An application is required for any portion of a building, structure or sign to be painted that is
visible fromya public street, way or public place. Color samples must be attached to these applications. An application is not
required:when repainting existing colors, changing to white, or using colors approved by the Town Historic District Committee.
3. SIGNS OR BILLBOARDS: An application is required for any sign or billboard to be erected within the District-with the
following exceptions:
a. Existing signs or billboards on November 27, 1974 shall have until November 27, 1977 to secure an approved Certificate
of Appropriateness.
b:_.Temporary signs for use in connection with any official celebration or parade or any charitable drive as long as they are
removed within three days of the event. Certain other temporary signs that the Committee feels does not detract from
the Act may be allowed with the prior permission of the Committee.
c. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they are
erected or displayed.
d. A single sign of not more than 1 square foot in area showing the name, occupation or address of the occupant of the
premises on which they are erected or displayed in a residential zone.
4. STRUCTURE: . An application is required to build or alter any structure within the District which is defined by the Act as a
combination of materials other than a building, sign or billboard, but including stone walls,flagpoles,hedges, gates, fences, etc.
GENERAL REQUIREMENTS
5. Work on projects requiring approval shall not be started until the Certificate of Appropriateness has been filed with the Town
Clerk by the Committee. Approval is subject to the 10 day appeal period provided in the Act.
6. No changes shall be made from the original approved specifications without advance approval of the Commission on an
amended application filed with the Committee.
7. A separate application must be filed with each project requiring a Certificate of Appropriateness.
8. Under heading of "Detailed Description of Proposed Work" give detailed data on such architectural features as: foundation,
chimney, 'siding,"roofing, roof pitch, sash and doors, window and door frames, trim, gutters —leaders, roofing and paint color.
9. Unless application is complete and legible and all material required is supplied, application will not be accepted or acted upon.
Copies of the Act establishing the Regional Historic District may be obtained at the Town Hall.
I
f
OLD RING'S HIGHWAY HISTORIC DISTRICT
SPEC SHEET
FOUNDATION 1'DIA� WNc�� i
SIDING TYPE JVHh7f, &e&IX 5N(/1/�L iS COLOR P��'IIiIK,IP•L _ 1�.
CHIMNEY TYPE 5/u&fi COLOR
ROOF MATERIAL y��- p� SN//�l�j.�j� COLOR Wl rI� UOoU
PITCH !D
WINDOW Fiy& NLd&& RIIAl4 SIZE 124-
TRIM COLOR I31�ANDD� >.
r
DOORS COLORp
�4}w,
Y
SHUTTERS
GUTTERS_ 56ft "C
I,�
r'DECK PX*4 M/Lg- �� .-U✓G}OD
GARAGE DOORS P//y AMS?I/Url'?, COL
OR
NOTES: Fill out completely, including measurements and
materials/colors to be used. Three copies of this
form are required for submittal of an application,
along with three copies each of the plot plan,
landscape plan and elevation plans, when
applicable. Plot plan need not be "Certified" ,
but should show all structures on the lot to
scale.
SP£CSRT
N ASSESSORS MAP: Ill PARCEL: 48 TEST HOLE LOGS 1V ul
,y 1. VERTICAL DATUM.ASSUMED FROM QUAD (NGVD +-Z--) _
CURRENT ZONING: RF ENGINEER: DOYLE ENGINEERING 2. MUNICAPAL WATER jS NOT AVAILABLE.
BUILDING SETBACKS: WITNESS: THOMAS McKEAN, R S. 3. SCHEDULE 40 - 4" PVC PIPE TO BE USED THROUGHOUT SEPTIC SYSTEM.
h►Jc� F: 30' S:15,R: 15 DATE:-9-3-86 4. ALL PRECAST UNITS TO CONFORM WITH AASHTO H-10 8c H-20
PERCOLATION RATE: < 2 MIN/IN LOADING SPECIFICATIONS.
FLOOD ZONE: C TH-1 TH-2 5. PIPE
PITCH
_
5� 42-9 6. FIRST 2' OF PIPE 4OUT EOF D-BOX TO BE LAID LEVEL.
.o Lows ELE12' LOAM .9 7. THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE
SUBSOIL
USE OF A GARBAGE DISPOSAL.
s6" 39.9 S. ALL CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE
LOCATION MAP STATE OF MASS. ENVIRONMENTAL CODE (TITLE FIVE) AND LOCAL
PROPOSED WELL CLEW HEALTH ;REGULATIONS.
LOT 2 (155' TO LEACH PIT) MEDIUM
9. CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR
(0.73 ± AC.) ROWEL)31,842 ± S.F. LOT 1 (y( aAVEL) TO CONSTRUCTION.
/ UTILITY cLvsraR 10. PROPOSED SEPTIC SYSTEM AND WELL LOCATION ARE IN ACCORDANCE
Oct
1s z8s WITH MASTER PLAN ON FILE WITH THE BARNSTABLE hEALTH DEPT.
� '
46 / 50 52 54 56 58 60 62
/ / / / / / 64
r 66 68/ NO GROUNDWATER ENCOUNTERED
........ .28' /
46- ..... ... ........ , ' SEPTIC SYSTEM DESIGN
/ DRIV / / '' • '• '• 70. 3
D7ECK
42
/ 4s G i FLOW ESTIMATE:
TH-1 n '�'�GA' / / / 70 / PROPOSED
fa / 50 / / ♦ : s0 BEDROOMS AT 1f0 GAL/DAY/BEDROOM = 330 GAL/D�lY 3 BEDROOM
4,� - - S IN - �/ - - --:--a- _�./- .-1s. '� /' ./. z DWELLING 24'
T ` DA�R rD �� / r i / / / r' // / SEPTIC TANK. GAR.
40. \ f / ELLIIVG / / / // / / / / / , / 7z 72. s 330 GAL/DAY * 1.5 DAYS = 495 GAL 14•
LP Ec T.t'. 50.0 / / / / / 7T USE 1000 GALLON SEPTIC TANK 28'
;/ / / / / O
/ 74 LEACHING AREA: PROPOSED DWELLING
44 USE ONE LEACH PIT (6' x 4') WITH 3.0' OF STONE
ss� ol :/ / / / / , / / / / 4. 8 cO (12' EFFECTIVE DIAMETER x 4' DEEP)
/ i i ''J / / / / / /
36 / / / / / �� / / / / / � / ! I l q SIDE AREA: 12 x 4 x PI = 151 SF (2.5) = 377 GAL DAY
38 / / / / / / / / / / 76 BOTTOM AREA: 6 x 6 x PI = 113 SF /
'� � / ' / / / ' � ' ' / ' / ' ' / / '�' (1.0) _ )13 GAL/SAY
/ �► - TOTAL CAPACITY =-490 GAL/DAY
42 / / doe / / / 177. 1
44 46/ / / / / i l / 10,
el ' - ' ' , - ' - ' - ' 70 74 SEPTIC SYSTEM SECTION.
2" PEASTONE
50/ ' ' � � EDGE OF PAYE ++
UTILITY M
54' / - -68 CLUSTER OF 3/4" - 1 1/2"
50.0
.8' ' ' '_ 0 0 WASHED STONE
. 70
PHONE IT
T P F FOUNDATION
RISER
/ i 2g5 72
64 / BENCHMARK AT
66 / / - '72 ELECTRIC MANHOLE
/ ELEV. = 75.8
68 70 , 74 40.41 a
72 40.66 1000 GAL ELEV. D-BOX 4' o
4 41.0
� ELEV. 40.18
7 SEPTIC TANK ELEV. ELEV. 33.0
ELEV. -► 4-- ELEV.
TEE SIZES: 37,0 3' 3'
(UNDER INLET: 6" UP, 10" DOWN ELEV. d --p
BASEMENT OUTLET: 6" UP, 19" DOWN ONE LEACH PIT (6' x 4') WITH
FLOOR) 3' OF STONE (12' EFF. DIAM. x 4' DEEP) (H-
% BREAKOUT CALC.: (37.5 - 36)/44 x 150 = 5'
SITE- AND SEWAGE PLAN
KEY: L 0CA TION:
EXISTING CONTOUR: °'•'
PROPOSED CONTOUR: LOT 2 FIELDSTONE ROAD
EXITING SPOT ELEVATION: 25.5
WEST BARNSTABLE. MA
PROPOSED SPOT ELEVATION: 25
6' s? 1 r Fir .
TEST HOLE: PREPARED FOR
UTILITY POLE: -•o-- � .
FENCE LINE: DM "'' = °a `` f REEF REALTY j
HYDRANT: -6- DEMAREST-McLELLAN ENGINEERING (� SCALE: 1" = 30' DATE: 7-24-94
24 SCHOOL STREET P.O. BOX 463
WEST DENNIS, MASSACHUSETTS 02670 REFERENCE: . PLAN BOOK 413 PAGE 99
DM # .�4=Q,��_2 [THOMAS McLELLAN, P.E. JOHN Z. DEMAREST JR., P.L.S.