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0410 HIGH STREET
/o 9611 71 llll � UPC 12543 LOR HASTINGS. MN i r r r ° t • a -•�:,.:4•cfa_.:_ _.-:�^l:�+as�.....n,.:...!-_....c.-_�.�-y�.a.:_-.�..,a..i.;:1. •.,. �_-_:.=:;��L:an.t..ca.v....�..a:�'+t:A•a.�'1 _ - - ^.�._.c..��$:.r�'JB::�AN�� ',._.1-',tifiJn....,..a.::liLaCdN.�:@ivL"'��.=".a-1�"-"-'�'�M'.�.::.4_ _ �..L..N.:aiYS�Yu``ilGal. _ _— a o ( tT-6 ao l �l F"E rp , Town of Barnstable *Permit# Expires 6 jTs ate Regulatory Services Fee awxrvsTasr�.`I MAC' Richard V.Scali,Director A 039. 152015 52015 rE0 MA't t7 T � OF Building Division BAR,VS AS Tom Perry,CBO,Building Commissioner CE 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Map/parcel Number. `'� ( „ Not Valid without Red X-Press Imprint � (/ / �/ fi Property Address (!, Li < I?Ci `L5,4 4 �w Residential Value of Work$ `� f au Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name/�b�C C y�i C Telephone Number 6 C ,�P6 Home Improvement Contractor License#(if applicable) l �P r/' �� Email: �-17�<r�( Construction Supervisor's License#(if applicable) o 4orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I the Homeowner I have Worker's Compensation Insurance Insurance Company Name [- zj, �i Workman's Comp.Policy# ( rC��31 3r17<"YD -- Copy of Insurance Compliance Certificate must accompany each permit. Permit Re guest heck box --- e-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 13A ❑ Replacement Windows/doors/sliders.U-Value (maximum.3*#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. •Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the H Improvement Contractors License&Construction Supervisors License is requir SIGNATURE: Q:\WPFILESTORMS\building 9 ' for ns\EXPRESS.doc Revised 061313 ..Estimate 984 Date Mar 31,2015: Cape & Islands Construction Co. P.O. Po Box 210 Centerville Ma. 02632 Terms 508.775.7663 Ship:Via ,Ship Date i Pat Lawlor 410 High St. W. Barnstable, Ma. 02668 i 508-362-8227 ID Description Ext Photo CERTAINTEED Certainteed Shingle Roof 5,100.00 Strip existing shingles from front and rear main roof. Secure any loose sheathing. j Install Hicks brand vented aluminum drip edge. Install Wip brand Ice&Water Shield to all eves, rakes, valleys and all protrusions. Install Rhino brand Synthetic Felt Underlayment. Install Certainteed Quick Start starter shingles to all rakes&eves. Install Certainteed LIFETIME Landmark architectural shingles to match new sections. Storm nail all shingles. (State building code requires 4 nails, we use 6) Re-flash all vent pipes with new boots. Install Rigid Vent II ridge venting. I Remove and dispose of all job related waste. leave your property looking like we were never there! Provide all manufactures warranties and LIFETIME warranty on our labor, if it ever fails due to our workmanship we fix it,forever! It's The Best In The Business. Please note our wind warranty is also the best And longest available ANYWHERE! I Total /, L ( v i � i Page 1 License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation F . 10 Park Plaza,-Suite 5170 jl Boston,MA 02116 i v d w bout signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards %-OnStTILK lon Supervisor License: CS-074660 JOSHUA X KOI(* PO BOX210 %M¢ CENTERVHJZ MA Y �c Expiration Commissioner 02/12/2017 I (9/. 'cpomvr�aor�c� ��ac<ru�eC7 s I IRS=Office of Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR W1,istration: s165936 Type: piration: 016 _ Private Corporatioi. •n CAPE 8 ISLAND CONS:TRUCTxI.O,N CO INC. 4 i,t -T:IQ x JOSHUA KOURI 55 ELM AVE. HYANNIS,MA 02601 -'` Undersecretary Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construe ion Supervisor License: CS-074660 JOSHUA X KOW PO BOX210 � ¢ CEMRVILLE 1VIA Expiration Commissioner 02/12/2017 ;z` A (MWDD/YYYYJ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW: THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the Policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the Policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s . PRODUCER FRANK L HORGAN INSURANCE AGENCY INC NTAL? 44 BARNSTABLE ROAD HAMS` PHONE PO BOX 250 FAX HYANNIS MA 02601 Are No` ADDRESS: INSURER(Sl AFFORDING COVERAGE NAIC 0 INSURED IISURERA: LM Insurance Co oration 33600 CAPER ISLANDS CONSTRUCTION COMPANY INC INSURERB: PO BOX 210 INSURER c: CENTERVILLE MA 02632 INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 20102526 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NNSR ADOL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE ( SD POLICY NUMBER MM/DD MM/DD LIMfTS COMMERCIAL GENERAL LIABLrrY EACH OCCURRENCE $ CLAIMS-MADE D OCCUR $ MED EXP(Any one person) i !, PERSONAL 3 ADV INJURY S ' GEN L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE ' s p. POLICY a JECT LOC PRODUCTS-COMP/OP AGG $ OTHER • AUTOMOBILE LIABILITY _ COMBINEDN I $ Ea accident s ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per person) S t AUTOS AUTOS BODILY INJURY(Par ecrident) 5 HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE $ ' Perae6denl f UMBRELLA LIAB OCCUR ' EACH OCCURRENCE $ ' DCCFSS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION I. A WORKERS COMPENSATION ,i $ AND EMPLOYERS'LIABILITY Y/N WC5-31 S-377540-014 5/7/2014 5/7/2015 STAAR UTE 0 OFFIANY PCER/MEMBER EXCLUDED?ECUTNE N N/A EL.EACH ACCIDENT $ 10000( (Mandatory d 1e and EL.DISEASE-EA EMPLOYE $ 10000( If yes, under DESCRIPTION OF OPERATIONS bebw I IF-L-DISFAqF-POLICY LIMIT S 50000( DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Addloonal Remarks Schedule,may be allached If more space is required) Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers'compensation coverage CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 200 MAIN STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN HYANNIS MA 02601 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORED REPRESENTATIVE LM Insurance Co oration ©1988-2014 ACORD CORPORATION. All rights reserved. a ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD �`'_ CERT NO.: 2DID2526 Lucy Garfield 5/7/2014 7:38:38 AN (POT) Page 1 of 1 1 T The Common"wah*of Mamachwetts Department of Jndnsfrial Accidm& 02 Off we o,f`Titvestigations 6#0 Washington Street Boston„M4 02111 - nnt�rvnsasxgou/dio Workers' Gompensatian Insurance Affidavit:Biddders/Contractwm/ElectriciansfPlambers Applicant Inform of an Please Print Legibly Name C kf C C - Address: o✓ 2 t ( city/State/zip'- phone 47 Are u an employer?Check the appropriate box: T of project 4_ Ism a. eral contractor and I Type lu'o] (required): L I am.a etnployerwith `(r ❑ l 6. ❑New construction employees(full and/or parttime}_* have hired the sub-contractors. 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees Them sub-contractors have g. ❑Demolition employees and have waaoers' u�orkiag for in any capacity- surattce I 9. ❑BtiilcTiag addition No wodmrs' comp. x insurancecomp. 5. ❑ We are a corporation and its lfl_❑Electrical repairs or additions rec.pd d ha ve ave exercise their I L Plumbing 3.❑ I am a homeowner doing all work officers �repairs or additions myself[No workers'comp- right of exemption.per MGL 12.❑Roof repairs in[�r anus.required.]I c.152,§1(4�andwehavetm employees-[No workers' 13.0 Other comp-insurance regL iced-] 'Playis applicant flat checks b=#1 aaui also fill out the section below showing the¢woriters'comtpe�tion policy informatiM3- t H iswho sabarit this affidzwt indicating they zz doing all weak and dLm hue outside coutractors moot submit a new affidavit indicating sack. Contrxtncs That check this bax mast coached an additional sheet showing the neon of tm sob-c�and state wbethw ornot those entities ham employees. If the sob-convactcas lm employees;they nnmp uvide thew workers'comp.policy number. I am an empdaytitr that is pratf AbW workers'compensation inmrancefor my esrpdayms. Bdow is the po6ry and job site information. ' Insurance Company Name: L-GA / 1�1,14,vi �Li c ' Poky 4 or Self-ins-Lic.#_ �C� � 31 S-- 3174; /c)— FFrpstation Date: o Attach a copy of the workers'com lion policy declaration page(showing the policy,number and expiration date). Failure to secure coverage as required under Section 25A ofMGL 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 far insuranTlcverage v erifit ation. I do hereby certify u a d n ofpeejary that the in,forma#iion prim abM is true and correct. Si e: Date: Phone M ��1 9�, 1:2—7 6 — O,fciaf use only. Do not write in this area,to be completed by city or town o flSciai City or Town: PerrmiitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department. 3.Cityfrown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: 6 • t Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"__.every person in the service of another under any contract of hire, express or implied, oral or written." An empkyer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelImg house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Iocal 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 applicantwho has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the iusu-ante. requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the wodcers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name:(s), addresses)and phone number(s)along with their certificates)of insam-ance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation imsm7a,ce. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for conf i mation of msur nce coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-inm=ce license number on the appropriate lime. City or Town Officials I Please be sure that the affidavit is complete and printed legibly. The Department has.provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant_ Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple.permit/license applications in.any given year,need only submit one affidavit indicating=eat policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the-affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth of Massachusetts . Department of Indmtrial Accidents Offiiee of fnvestigatiom 600 Washingtou Street $ostou,MA G1 I I I TeL#617 727-4900 e)t 406 or 1-977-MASSAFE Fax#617-727-7749 Revised 4-2"7 www.mass_govfdia TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION bi Map /.� Parcel'.'. , 6✓� -' ' Application # Health Division Date Issued Conservation Division / -.Application Fee Planning Dept. _; `Permit Fee % .Z Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address Village Owner � ����� W'�'� Address Telephone 51 2;,) 7 Permit Request } J S. uare feet: 1 st floor: existing ` �ro osed /0 3 q g p 2nd��floor: existing �v( proposed L� Total new Zoning District Flood Plain Groundwater Overlay Project Valuation �oQ®a Construction Type Gy L � �ot Size a � Grandfathered: ' ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family .A. Two Family ❑ Multi-Family (# units) Age of Existing Structure 3i JO�Z Historic House: ❑Yes CCNo On Old King's Highway: ®Yes ❑ No Basement Type: C&Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) L?�� Number of Baths: Full: existing- new CD Half: existing © new Number of Bedrooms: existingonew Total Room Count (not including baths): existing new J First Floor Room Count= r Heat Type and Fue: �9WOil ❑ Electric ❑Other _ = C) Central Air: ❑Yes 46 No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 4No Detached garage: ❑ existing 0 new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing=O new size_ !V Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 4 I Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes 13 No If yes, site plan review # Current Use / Gl' ��' ��� ` ��✓� Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ��� 't.� Telephone NumbersvF'��o -#6 Address 094 License v � AAS V/ Home Improvement Contractor# / s Worker's Compensation #0v49 ,0%;?Q40 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE -`�`S ©�� s C r FOR OFFICIAL USE ONLY- ,. f i APPLICATION# w 1 4 DATE ISSUER .- -!PARCEL NO,_ ADDRESS, VILLAGE j OWNER DATE OF INSPECTION: 3 FOUNDATION FRAME v�' l� la c(s l!RtU`P✓ D(� f L IR{tit-� cT ,1 Td fi fG�O�s ' _ INSULATION: j FIREPLACE ELECTRICAL: ROUGH FINAL } PLUMBING: ROUGH FINAL QA'S`:'-i;GG ROUGH FINAL -'FINAL BU:IL'DING '_ . Wvq/ft /L`kq, DATE CLOSED OUT _ l '? ASSOCIATION PLAN NO. �I AC RO v® CERTIFICATE OF. LIABILITY INSURANCE DATE( ' r 4/19 20 19/2011 1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND; EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER DOWLING&O'NEIL INSURANCE AGENCY CONTACT NAME: 973 IYANNOUGH RD PHONE IAIC.No.Ext): (508)775-1620 Arc No): 508 778-1218 HYANNIS, MA 02601 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A: LIBERTY MUTUAL GROUP INSURED ROBERT GLOVER INSURER B: DBA ROBERT GLOVER BUILDING PO BOX 703 INSURER C MARSTON MILLS MA 02648 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 9997141 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDD MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE (a RENTED ) $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO LOC $ AUTOMOBILE LIABILITY EOMBBD nt)SINGLE L MIT $ ANY AUTO BODILY INJURY(Per person) $ ALL AUTOS R AUTOSNED ULED BODILY INJURY(Per eccident) $ HIRED AUTOSNON-OWNED PROPERTY DAMAGE AUTOS Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR I CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ $ I $ A WORKERS COMPENSATION WC2-31 S-320856-011 4/19/2011 4/19/2012 WC IMITS TATU- 0�7 1- AND EMPLOYERS'LIABILI Y Y I N ANY PROPRIETORIPARTNERIEJECUTIVE E.L.EACH ACCIDENT $ 100000 OFFICERIMEMBER EXCLUDED? ❑N N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 100000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 500000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) THE WORKERS COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR ROBERT GLOVER Workers Compensation Insurance:Part One of the policy applies only to the Workers Compensation Law of the State of MA. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF BARNSTABLE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 230 SOUTH STREET ACCORDANCE WITH THE POLICY PROVISIONS. HYANNIS MA 02601 AUTHORIZED REPRESENTATIVE Jeff Eldridge ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD CERT NO.: 9997141 CLIENT CODE: 1364178 Deb Derochemont 4/19/2011 5:36:03 AM Page 1 of 1 This certificate cancels and supercedes ALL previously issued certificates. r The Commonwealth of Massachusetts r 1 Department of Industrial Accidents Office of Investigations 600 Washington Street �JIk,j Boston, MA 02111 www.mass.gov/dia r ;- Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: A& 76 City/State/Zip:IJAOD`IS 11111.6 �� �� Phone #: 's7oeio!; AV Areyou an employer? Check the appropriate box: Type of project(required): 1.� I am a employer with 1 4. ❑ I am a general contractor and I 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2. ❑ I am a sole.proprietor or partner- listed on the attached sheet, x �• ❑ Remodeling ship and have no employees These sub-contractors have S. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL I LEI Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.}t employees. [No workers' comp. insurance required.] ]3.❑ Other *Any applicant that checks box#1 must also fill out the section bclow 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. tContractors that check this box-Must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site ,information. _ Insurance Company Name: L '2_ /! �/a� Policy#.or Self-ins. Lic. #:W Cog— 1S' 3 Expiration Date: 7 ~ ©�'t Job Site Address:.4110 1/1z�! 570 City/State/Zipfit) Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). w 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$.1,500.06 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 un afns a Alt' o erju ,that the information provided above is true and correct. Si natu Date: Phone# o `p 7 e 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 Inforxmation and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership,association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely;by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other-than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation-of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,:please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the Affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant . that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 021 1 1 Tel. # 617-727-4900 ext 406 or 1-877-MAS.SAFE Fax # 617-727-7749 I Office nsurnerIffluireVA mess egu a on HOME IMPROVEMENT CONTRACTOR -.Registration: <:d11157 Type: Expiration: 1'21, /2012 DBA R.` OVER BUILDING_CO ROBERT GLOVER' PO BOX 703/13 CUR+TIS',BO'G RD-' 4 MARSTONS MILLS, MA02648 Undersecretary ,�•_ Massachusetts- Dcpartmci t''`it:Public S:ifct�° nd Stand.iids g•otlIA Of Bitildiu�' Rc"ulations a CorjstructiOil Supervisor Licerise:.` License: CS 39868 Restricted to: 00 ROBERT J GLOVER PO BOX 703 MARSTONS MILLS, MA 02648 Expiration: 5/24/2012 Tr#: 23910 f " use ontY � individuf •, " License or reg�stratio date. I�fonnds;ness Regulation Lac re the ecpirationx fairs d Bu an befo sumer Office of Consume on Suite St�� 10 Y ark NIA p2116 Boston, ti nature Without S �¢ of valid " I.tif.. y " " 1 m ' I' ' oFT"FT � ` 'own of Barnstal&' o . Regulatory Services utrxsrAs[.� MAR& � Thomas F. Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 nww.town.barnstab le.ma.us office: S08-862-4038 Fax: 508-790-623 Property Owner Must Complete and Sign This Section If Using A Builder 1,a�' jL�� , as Dwner of the subject.property hereby authorize � ��!/,�� to act on my be in 22 matters relative to work authorized by this building permit application for.. ss ofrob) ignature of Owner Date Print Nude If Property Owneris applying forpern-iitplease complete the Homeowners License Exemption Form on 'the reverse side. Town of Barnstable y�� of Tru rye Regulatoty Services a�ttxsr�s[s Thomas F. Geiler,Director ' AIM sb39- Building Division p. �� Pr'n { Tom Perry, Building Commissioner 200 Ma.ia.Strect,_Hyannis, MA 02601 www.town.barnstable-ma.us Office: S09-862-4038 Fax: S08-790-5230 HOit�[R_OWNER LICENSE EXEWTTON Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone tl 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. AE1<T MON OF HOMEOWNER '. person(s)who owns a parcel of land on which he/she resides or irifends'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 constrycts more than one home in a two-year period shall not be considered a bomeoRmer. Such "homeowner"shall submit to the Building Official on A form acceptable to the Building Official, that helshe shall be responstble for-all such.work performed undcr_the building permit (Section 109.1.1) Tile undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The tmdcrsigned "homeowner"certifies that.)ae/sbe understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/sbe will comply with said procedures and requirements. e Signatilre of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet o 'larget.will•be required•to comply with the State Building Code Section 127.0 Construction Control.- HOh2E0 WNER'S F m2-T-iON .The Code states that "Any homeowner performing work for which a building pernvt is requited shall be exempt from the provisions of this scctioa.(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner ermgagcs a parson(s)for hire to do such wofk, that such Homcowna shall act as supervisor." .Many homeowners who use this cxcmpdcm arc unaware that they arc assurning the responsibilities of a supervisor(see Appendix Q, R.ulcs&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often rc ults in serious probiems,particularly when the homeowner hirrs un)iccnsed persons. In this ease,our Board cannot proceed againsl the unliccnscd person as it would with a liecnsed Supervisor. The horbcowna acting as Supervisor is u)timatc)yresponsmb)c. To ensure that the homeowner is fully aware ofhisAcr responsibilities,many communities require,as part of the permit application, that the homcowncr certify that he/she undcntands the responsibilities of a Supervisor. Oo the last page of this issue is a form currently used by several towns. You may caret amend and adopt such a form/certification for use in your community. R1l l e SE- 1 Ce, It WC Ccride to flood Cons•trrrction r'ft Hf{,k 110 nip//. kllilid Zorre M,-ISS,'IC111ISCtts •ClIeCICliSt f61- C01111),IxaI1Ce (780 C1'Irz53bI.2.I.1)' Loadbearing Wall Connections / Lateral(no. of 16d common nails)................................(Tables 7).....................................•....I.......... 2 ✓ Non-Loadbearing Wall Connections Lateral(no.of 16d common nails)................................(Table 8)....................................................... Load Bearing Wall Openings (record largest opening but check all openings for compliance to Table 9) Header Spans ..............•.... , .................................(Table 9).................................._5 ft_C5 in. 5 I Sill Plate Spans ........................•...............................(Table 9).....................................C ft-B in.5 I ✓Full Height Studs (no. of s(uds)....................................(Table 9)............................ ...•....................... Non-Load Bearing Wall Openings (record largest opening but check all openings for compliance to Table 9)' / Header Spans.............................................................(Table 9).................................. Co .ft Q in. 5 12, Sill Plate Spans.... .......................................................(Table 9)..................................Zp,ft min. 5 12" ✓Full Height Studs (no. of studs)....................................(Table 9)....................................................... Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously'i Minimum Building Dimension, W / Nominal Height of Tallest Opening2 ...........................................................................�$<6'8" ✓ SheathingType..............................................(note 4).................................................... Edge Nail Spacing.........................................(Table 10 or note 4 if less)........................ in. Field Nail Spacing Table 10 ................................................. ( m. P 9(n ...............................its)( ) � Shear Connection (no. of 16d common nails)(Table 10)..................:..................................... � Percent Full-Height Sheathing.:.................:...(Table 10)...................................................2�&% 5%Additional Sheathing for Wall with Opening > 6'8"(Design Concepts)...............:.... Maximum Building Dimension, L Nominal Height of Tallest Opentng2......................................................................$A.�<�6'8 ./. Sheathing Type..............................................(note 4)....:................. ......................I....... Lz_i�`[. Edge Nail Spacing..................................•.....•(Table 11 or note 4 if less)........................" in. ✓� Field Nail Spacing........................................ .(Table 11 in. ✓/ Shea Connection (no. of 16d common nails)(Table 11)..............................I..........::............ 2. Percent Full-Height Sheathing.......................(Table 11)...................................................2 /o 5%Additional Sheathing for Wall with•Opening> 6'8"(Design Concepts).................:.. Wall Cladding / Ratedfor Wind Speed?.......:...................................................... ............................................................... 5.1 ROOFS / Roof framing member spans checked?.......:................(For Rafters use AWC Span Tool, see BBRS Website) ' ✓ Roof Overhang ........•..........................................(Figure 19) .............y' ft 5 smaller of 2'or V3 Truss or Rafter Connections at Loadbearing Walls Proprietary.Connectors Uplift................................................(Table 12)......:...-.................................U If V, Lateral................................:.............(Table 12).............................................L= If ✓ Shear........................:......................(Table 12)...................................:........S= plf . Ridge Strap Connections, if collar ties not used per page 21... (Table 13).................. ----pff Gable Rake Outlooker...........................................(Figure 20) ......:.....,�ft s smaller of 2'or V2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift....................:..:........................(Table 14)............................................U= lb. Lateral(no. of 16d common nails)...(Table 14)........;..............................L= lb. / Roof Sheathing Type................:.:................................(per 780 CMR Chapters 58 an �9) ..........:. v/ Roof Sheathing Thickness.•...................................:..... ..................:................:........E!Z in. - 7/16'WSP Roof Sheathing Fastening............................................(Table 2).....................:.................................... �I� Notes: 1. This checklist shall be met in its entirety, excluding the specific exception noted in 2, to comply with the requiremenis of 780 CMR.5301:2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the.WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 ..e. Comer Stud Hold Downs per Figure 18a and Figure 18b ' Exception:Opening heights of up to 8 ft. shall be permitted when 5%is added to the percent full-height sheathing -'requirements shown in Tables 10 and 11. The bottom sill plate In exterior walls shall be a minimum 2 in. nominal thickness pressure treated#2-grade.. AlVC Griide to H/00 i Co I'StJlfctiO/! ill fir.' l� lYir-id Ifi-eas: I10110 1•Virrrllorre Massacllt1sett5 C1.leciciist for Com limice (78o .wfrz 5301:2.1.1)t ' Check Compliances 1.1 .SCOPE V Wind Speed(3-sec. gust)............................ . 110 mph Wind Exposure Category .........•.... ..........................................•...... ...........B Wind Exposure Category................Engineering Required For Entire Project ......•................................0 1.2 APPLICABILITY stories 52 stories Number of Stories (a roof which exceeds 8 in 12 slope shall be considered a story)—_ Q < 12.12 RoofPitch ......................................••.....................................(Fig 2) ........................................... (Fig 2 ........•.................1� ft 5 33' Mean Roof Height .............................................. ..•...:...•....( 9 )....•.................. 9 • Building Width, W ...............................I.............................:..(Fig 3)......................................... .......... ;2 ft 5 80 Building Length, Fi 3 'ft 5'80' L ................................•...•.........................( g )..................................... <3:1 Building Aspect Ratio (L/W) .......,.Z.....................................(Fig 4)................... - Fi 4 ...........................(a,_ 5 6'8, Nominal Height of Tallest Opening ............................. (Fig )•.••••••.•.•••••••• 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2)................................................. 2A FOUNDATION / Foundation Walls meeting requirements of.780 CMR 5404.1 ....................................................................... Concrete... Concrete Mason ........... ...................................... --- 2.2 ANCHORAGE TO FOUNDATION1'3. 5/8"Anchor Bolts:imbedded or 5/8'Proprietary Mechanical Anchors as an alternative in concrete only P 9 9 (Table 4 .in, 5 in. BoItS acin -general .............•.......•...:..............:.( ).................:................ Bolt Spacing from end/joint of plate ...............:.............(Fg ).....:..•.........:................. -• Y14' Bolt Embedment-concrete.........................................(Fig 5)..........................•......:...:.....:.... nZ 15" Bolt Embedment-masonry.................. ...........•..........(Fig 5)............r............................... Plate Washer................................................................(Fig 5)..................... ..•......................>3"x3"xY" 3:1 FLOORS (per 780 CMR Chapter 55 ............... ................... v Floor-framing member spans checked ..:..........•..................(p P ) ft <12' Maximum Floor Opening Dimension....:........................•.....(Fig 6)...................)... Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall (Fig 6)..:............•................... . . Mbximum Floor.Joist Setbacks ft 5 d Supporting Loadbearing Waifs or Sheanvall................(Fig.7).............................I........................ Maximum Cantilevered Floor Joists ft s d Supporting Loadbearing Walls orShearwall................(Fig 8)....................................................... Floor--Bracing at Endwalls..............:......................................(Fig 9)................................................................... Floor,Sheathing Type ........................................................(per 780 CMR Chapter 55)........................ .......... . in. er MRFloor Sheathing Thickness ............................. (Table82)Cd nails at5in; g .ed�e/ eld Floor Sheathing Fastening............ .:................:................... 4.1 WALLS Wall Height t/ Loadbearing walls.•....:..•:...................................•.........(Fig 10 and Table 5 Zi.�� s 10' j ................(Fig 10 and Table 5 �' ft 5 20' t Non-Loadbearing walls......:......................... { g ).................. . ...in.5 24'.o,c. Wall Stud Spacing (Fig 10 and Table 5 ....... ' 7 & 8 Wall Story Offsets (Figs )........:......................•..... _ ft 5 d .4.2 EXTERIOR-WALLS' t Wood Studs Loadbearing walls......................................:................_(Table�).......... .....................2x ...................: ft:.........2x - Q in. Non-Loadbeanng walls ............................................. (Table 5) Gable End Wall Bracing 1 . Fi 10 ......... Full Height Endwall Studs............................................( g ..f z W/3 WSP•Attic Floor Lehgth......:..:................ ....................(Fig 11)..•.....•.....•.................:............ ft a 0.9W Gypsum Ceiling Length (if WSP not used)....:...:..........(Fig 11)............................................— and 2,x 4 Continuous Lateral Brace.@ 6 ft. o.c. .. (Fig 11)..................................•...................:...... or 1 x 3 ceiling.furring strips @ 16"spacing min. with 2 x 4 blocking @ 4 ft, spacing in end joist or truss bays f1 F!'C' Grrirle to 11'Unri.CUrrstr rrction irr J/i,lr I'Viirrf;(rens: .111J nrplr ll�irrrf LUrie massachilsetts C:heddist for C 011113liance (780 CA:.Ill 5301.2-1.:1)' 4. a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio, determine Percent Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7/16" and be installed as follows: i. Panels shall be installed with strength axis parallel to studs. ii. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction, panels shall be attached to bottom plates and top member of the double lop plate. iv. On two story construction, upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel. Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates, band joists, and girders shall be a double row of 8d staggered it 3 inches on center per figures below: Vertical and Horizontal Nailing for Panel Attachment 5. Glazing protection: a) new house or horizontal addition—required if project is i mile or closer to shore (generally, south of Rte. 28 or north of Rie. 6) b) vertical addition—not required unless there is extensive renovation to the first floor c) replacement windows—needs energy conservation compliance only(chap 93) 6. Wood Frame Construction Manual (WFCM)for 110 MPH, Exposure B may be obtafned from the American Wood Council (AWC)website. --WHEN THIS EDGE RESTS OIJ FRAW ING USE&J NAPS AT G'o.r !I ur I 1 1 CC I II tl I q t H ;y . I 1 tr II I ! . I I O i1 Il•� r r I I I/ t r I .J 11 Q rr I C7 , I X r Q W ! It a w i t i i ' i I FRA1M111 MEMBERS �___«y I l i 1 I; w6UTERMEDIA7E I it 7 I1 t r w z i.G ii a U Ir J it r IL t I ! It 3"M W. II 3 1 III i _ STAGGERED NAR•SPA CkVG I NAIL PATTERN PANEL PAIJL EDGE DOUBLE NAIL EDGE SPAC 4C DETAL See Detail on Nexl Page Detail Vertical and Horizontal Nailing Vertical and Horizontal Nailing for Panel Attachmeni for Panel Attachment Sc� 1�1 c�oc-C �J l-T l o p Daniel.E..Br;.aman."P E. -- 4-(o ._ to S_T_2tE�C--T 189 Harbor Point d. ca nnaquid. -02637-0361 ' -0 13 . < < cc.�5 o2��S V_:-,) c=_5 c VV a c_,c . c,L-j z-"e.::)/P l2 b v�l�_Tl o r:I, �Zsc t 4-,`t no-_-•F- 3 cQ.'�4.5 _ l � 10 2 S utit p 5 o r.1 . Cc- l n Of qss' o T 'C 'm ' A I 1 �of.HErowy Barnstable Old Kings Highway Historic District Committee RA „STA8M ; 200 Main Street, Hyannis,MA 02601;TEL: 508-862-4787 Fax 508-862-4784 MA-y�p1639. 16 9. rEOMA<� 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 that apply; 1. Building construction: ❑ New ❑ Addition N Alteration 2. Type of Building: 2�House ❑ Garage/barn ❑ Shed ❑ Commercial ❑ Other 3. Exterior Painting, roof ❑ new roof ❑ color/material change, of trim, siding, window, door 4. Ste: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 5. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Retaining wall ❑ tennis court ❑ Other 6. Pool ❑ swimming ❑ Other man-made pool Type or Print Legibly: Date: ®/9C�~ , Address of proposed work: House# Street: r�/� / Village Assessors Map Lot# / L3 Description of Proposed Work:�Give particulars of work to be done: Agent or Contractor(print):4CKA&Ojj&?../ 1�� Telephone#:sSde— 70 Address: Contractor/Agent' signature: NOTE All applications must be signed by the current owner Owner(print): / LLLJCJ Telephone#� o Owners mailing address /`1P✓' � +��C`'✓ l.�/ ,, Owner's signature: For committee use only. This Certificate is here, APPROVED/ NIED Date Members signatures RECEIVE MAR 2 2 2011 TOWN OF BARNSTABLE Any conditions of approval: HISTORIC PRESERVATIO ApR Sowo of aaN'9hwaY Comm 1 Q:IGMD-GroupslOid Kings HighwaylOKHNewAppIOKHCert Appropriateness 07.doc I Town of Barnstable Old King's Highway Regional Historic Distrigt Committee CERTIFICATE OF APPROPRIATENESS SPEC SHEET Please submit 4 copies Foundation Type: (Max. 18"exposed) (material -brick/cement, other) Alt' Siding Type�9Y✓/U material: jVkdr 6 Ae— Color:Xt Chimney Material: A/a 6c Color: ACx � e Roof Material: (make &style) /�r/01 44Kaj Color: 6t14t?,tt1'r,i&26 Trim material ���i�i Color: n Roof Pitch: (7/12 minimum) ex� Window: (make/model)�IGi '�' �y material 0 colorIle Size(s):Ow e 0 X 113'— 6 19/ye a x if Door style and make:llm material Color: IU Garage Door, Style 1010014-10 Size Material Color ShutterType/Material: Color: Gutter Type/Material: ��/��%/ .ca � ,�jfS fy� Color: ��✓ /i� Decks: material Size Color: Skylight, type/make/modeU: material Color: Size: P' \, Sign size: lva Type/Materials: I M Color: Fence Type(max 6' ) Style . ,�,9ff, material: MAR 2 olor: Retaining wall: Material: TOWN OF BARNSTABL EuWORIO PRESERVATION Lighting, freestanding on building _/ W ---illuminating sign Please provide samples of paint colors and manufacturers bA' PPRGV ows,doors,garage door fences, lamp posts etc ADDITIONAL INFORMATION: Town of Barnstable rommittee Signed: (plan preparer) print name tel.no. Location of application: Street no. 5 Y je Street 1;;9P / 4:571 Village Lam. Q:IGMD-Groupsl01d Kings HighwaylOKH New ApplOKHCenAppropriateness 07.dor to 4- HISTORIC PRESERVATION i 1 Nt s: RECEIVED ►R TOWN OF HISTORIC .. • RECEIVED MAR 2 2 2011 TOWN OF BARNSTABLE HISTORIC PRESERVATION i LoT 3 ax 4 ti - ^ d T I •i 1` /A .�. � I I • 7, g 37. �a •.B. /Se.is GEORGE 9yy Tait /b�e�ber�i nS .ti►v14,'.17 On ib r �D/off o J. not�i�i �hc F/oac� j�.-d A�c2 UANIDEs r77r;a:a;:;y/7:v7�`c. u�df-ooas�i ) 22723�� isTO Q, U '0/7rOf*med 76 71`ic 2oniS law.z a� { oil Baf/7 J16/G 4&7 Con.11rucl< cl P2 0 T P Z ..4 /'V L NL� IN `V- A.2.,1STA 3L,= 4 /o ,4'i�,u Sre�.�j 1 aT �ierence JW V SD Y T �d1'' ��i 1 ' • a. a�fritj.�1'::ii. ✓�-d...� �". '., r•y+'ts r `'ali3. '�•: ea N t�r Qr� -•::r 1�.^ai:�. a �:,� k^:r;::�.,-• � ilLt� -.jf:E%-r�� 't• 7'+`.�c,.�'�',i`i3�1• �o-'asa. ,�i-3:�4 y�P'•l�C`}��tic 1��"._`�+1�Rxg.� � � 4i.+� a^— �,�,'".T..-�^ �^�-„1 _ �^ �{,,,�+.•''�sk�-•�A?�'S'''z�y1c m ��'r'�:x�f�� •�,.'�;E.,��S•:a>r:- s =i9.„���•"'i'S.�_r,�fi�ry�;ltc�,�>tiK�f,'�r.#@-t��131'='1� ,�.$k, r .s_^i•^_z �,��`�=�'x�£'"'�.�.�' s _ � "_ TOWN OF BARNSTABLE LOCATION.. //6 SEWAGE # VILLAGE /� VVV �; ��' ASS.ESSOR'S MAP & LOT .�.�:• fy i INS:TALLER'S'NA`ME-&'PH'ONE' SEPTIC. TANK CAPACITY LEACHING FACILITY:(type) i (size) :> NO. OF BEDROOMS PRIVATE WELL OR'PUBLIC' WATER BUILDER.OR O..WNER. DATE PERMIT ISSUED: DATE: COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No ;,; + : 4 1 PROPOSED DECK for Lean Sirotd at #410 High Street House West Barnstable,Ma. covering appm 175 sq.ft. IV IY �I Typical Detail galvanized steel joist hanger 4"x 4"railing posts alomi mmm flashing balusters spaced 4"max I"pt spacer 2"x8"attached to frame m every 32"with two 1/2"galvanized bolts 514"x 6"pressure treated Decking 2"x8"pt-16"on center 2"x8"double beambolted to posts 4"xV pt posts-T on center Imax distance 10' 10"sonatubes-4'below grade r i Drawnby Brian Hennigan MAML 4066349 MA.HIC#122260 (508)420-2417 Approval /, Le , Sirota PROPOSED DECK for Leon Sirota at #410 High Street How West Barnstable.Ma. covering appm 175 sq.ft ' fV 14' I Typical Detail galvanized steel joist bangen ahrmatma flashing 4°x 4°raging posts 1•pt spacer baLuten spared 4°max 2'x8'attached to frame M every 32°with two m-gakamzedbolts 514'k 6'pressure treated Decking 2°x8'pt-16'on center 2°x8°doable beambolted to posts 4°xV pt posts-7 on center max distance I ff 10°sonatubes-4'below grade Drawn b Brian Hennigart 1!I< ML 4066349 ffiC#122260 (508)420-2417 approval Z Le Scrota • ✓Ice i�omvnzauaea�t o�✓l�aasarlu�ael� ate' BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 066349 Bi rthdate: 06/21/1960 Expires:06/21/2003 Tr.no: 12447 itestnc d To: 00, BRIAN H HENNIGAN � 33 BOSUNS WAY MARSTONS MILLS, MA 02648 Administrator ' •� � GTE -P� �u 4�✓l��l�w• Board of Building Regulations and Standar " . HOME IMPROVEMENT CONTRACTOR Registration: 122260 Expiration: 08/08/2002 Type: INDIVIDUAL BRIAN HENNIGAN BRIAN HENNIGAN 33 BOSUNS WAY _ MARSTONS MILLS,MA 02648- ; Administrator TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map I I Parcel 0q & Permit# �r Health Division 1 Date Issued .3 Conservation Division tw,ow, Fee O a Tax Collector LI�'p� Treasurer /i0 laA/ SSPTIC SYSTEM MUST r.r INSTALLED IN G011 i2 Planning Dept. g6�_-V-V 4� WITH TITS.',0 ENVIRONMENUI.`'G�%W'Z_7 Date Definitive Plan Approved by Planning Board TOWN REGUL OR-4 Historic.-OKH 44OW 91W v,I Preservation/Hyannis A6W/ 4� i Project Street Address /D Village I l !75cL,)5'4 Owner Z--r—a S 20 7 r=3 Address IO Telephone 150 t( Permit Request12Q ,6A a C5`:.a �.✓ .c� canckdrA p0s, Square feet: 1st floor: existing�3( proposed 2nd floor: existing proposed Total new Valuatiorf7 _s\00 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Z. O Z A-c LA_4_ Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family U Two Family ❑ Multi-Family(#units) Age of Existing Structure 1 S'7'1 Historic House: ClR Yes No On Old King's Highway: @ Yes Basement Type: ❑ Full ❑Crawl V4alkout ❑Other Basement Finished Area(sq.ft.) l Basement Unfinished Area(sq.ft) C�DO Number of Baths: Full: existing Z new Half: existing — new Number of Bedrooms: existing— new Total Room Count(not including baths): existing S new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ®'Nr�o Fireplaces: Existing New Existing wood/coal stove: ❑Yes QAo Detached garage:O existing ❑new size Pool:O existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ S E P 1 0 2001 Commercial ❑Yes ❑ No If yes, site plan review# By Current Use. - --__ _ _ Proposed Use ` I _ BUILDER INFORMATION Name .. .-J l cZ -3 Telephone Number Address 3� t ���.JS .�Jo, v� License# O (o (�3 .�✓l�,Sv .wt.L h �/V� Home Improvement Contractor# 1 Worker's Compensation# N !S ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO c;1 G SIGNATURE A DATE o t FOR OFFICIAL USE ONLY PERMITNO. DATE ISSUED ` MAP/PARCEL NO. ADDRESS VILLAGE >• ._OWNER'.. DATE OF INSPECTION: s l FOUNDATION FRAME INSULATION ` FIREPLACE \ " ELECTRICAL: ROUGH FINAL �} PLUMBING: ROUGH FINAL GAS: ROUGH FINAL- FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. � 1 „ o F IME ' . .� The Town of Barnstable • 1naNSTAs[.E. 9$ HAS& �0� Regulatory Services 16�Eo N9.- Thomas F. Geiler, Director, Building Division Peter F. DiMatteo, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. .00 Type of Work: 4, ice ,,titR.�� Estimated Cost D Address of Work: Owner's Name: Date of Application: /0 I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the.agent of the owner: 0 43 1 D O Registration No. Date Contrac r Name g OR Date Owner's Name q:forms:Affidav:rev-070601 The Commonwealth of Massachusetts =j Department of Industrial Accidents • ' ,� -�••: , ,�- Ol//ce of/ayesUgaUo�s 600 Washington Street -- ` Boston,Mass. 02111 Workers' Com cessation Insurance Affidavit / name. AL location: C,�._ hone# 'LO city ❑ a homeowner performing all work myself. 4 I am a sole R'etor and have no one d= 1n anv acrt° workers' cessation for my employees working on this job.::::: :::;::::::::::.+:::::::::.:::.::..;'::::.:::.:.:..::.. ::.::::.:::.::: :.: 1 am an over P :.:.::..::.:.........::.::::::::.. .......:.::::::.:::.......:: .; :.:::::::::::L.;;:.::: ::::.;:: .........:.:..... ga . .......... ......... .::::::::::::.::::::::::........,........r::::::..:................:................ ............:. >:::::>:::::: .....<'>::::><:>:>'<:>'»::>.>::::> <:> one .. Z. RIF ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hued the contractors listed below who have Polices:workers P ..........................................................................:......................:::.�:::::::.:.................,......,,...x...,>::•::::::... comp ..... .................. .................:::::::::::..:.:.;;;:.;::i.:;:.:.;;:>::>;:;Y:>::>:::::: Y:>:;»>:»>;:::«;:<>:«:::<:>:?«<::<::::;:::;:>::::::::<:»::::::>:;:>:::::>.::;;:::.»::«.:.>;>:: R. the following ::::::::::..................::::.::::.::::.: ....::.:::::::........::.:.::::....:::.::::..........::::::::.:::.._::::.:.::.:.:.........:.::._:.....::;:.:.::::::.. »:.:;::>:.;:.::::<.>;:.:;:.;:.. .......... ::::........ ........... s •isti�i:�:+`isY:}iiijii{'?Y�iyi:;iii:;iiJ:;iiiii:j'Y;v�i:yij:'ii:yiiiik?Y�ii:`vi:ii }�;ii`ii:;:jviii;i::YYY?J:iv�:is^:" i:'4i:�ii;;:>�:j?v`i':YY�i:YY:;>.j:Y•,:�:yYYY�i::L i:f . err :'�:Y�ii ii:•:•iiii:Yi4::�>::ii:iiiiv:i:;:}: :j::;:;;�{:}y::j:' J:;:::I;:;ii�::l::::i:!;�::;:_'�;i:i!�:`i i}iii i;>:;:?j::i:•.:;.i';'Jii:CGiw:.�:::::::......... . 'v.'YY ;{4:Ji;:::v::r..:iti;4•r::;:i;Y:;}>:•i:•x?:•>:•>::J:•>ii:?4::i i:•:iY{>:iii?X{iL:S�i:•........... ..........:....... .. � ' 1 .. .............:.:....:ii::::w:.�:::>ii:•i:h`:^'4:•v::>';i:4Y�>i»:•»>L}{•.;.:..:.::ii:?^:•w:v....... ` ....... ........ ............ .•::�.:::.:...,.........,..r.:....,J,.>;.:�:.>:....>.................... hoes ::3r:%,Y�Y.:;::�'�<;:z:::::i: ti>:<:'<:::ss{i::�:::�»:<>:�i:<::::::ii:>::>�::::=:z>s:::<:>:<:r;<:::<:::?;:: i:;:;z�:;: <y'<:Y�:<::<::;;.;:•;:;{.;;;:�::.:::::: ........................................... •:...........:x...........w.x.......<..Yv. ................ ...::....• :aAv:.n..vr +b•.:Y'4......n..........Y.4..:::::: ...::::::. ............ .................................. .................:::::::.......... :.::. mom. ...... ;1t8rQ '. HIIV "tldres a .......:..... ..:: i ::.::.;:;.;;:::.::>:::::> ....................... .... ......:. ........................:.......... ........... ..........:;>;::»:<:»:<::::::;: bne .. ........ :;i.;}}}:•.;y.:!{::•:?::v:.};{•»'{.:v.:...++�;^Y.iii:J>i;J:•:;»...:.::..••+:v.v.L}:•:?;:{{�i}:•i}};}:ij+::t:r?-::w:....:....:::.�:::•:.:�........ under Section 2SA of MGL 152 can lead to the impamtlon of er�nal penalties of a Erne ap to SI,S00.00 and/or Faflmm to seem coverage as required one yam,taprisomamt as wen as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I�ders�d that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby certify under the pants and pennallier of perjury that the information provided above is tnu.and coned Date signature Print name n. Phone#��j oincisl use only do not write in this area to be completed by city or town offldsl peradtiUcwe# • ❑Building Department city or town: QLicenang Board (--]Selectmen's Office ❑checkif immediate response is required ❑Health Department phone#; ❑Other contact person: Urand 9/95 PIA) Information and Instructions ' Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers*an e��a°IIer�V heir Mass erson in the service employees. As quoted from the "law", an employee is defined as every p of hire, express or implied, oral or written. ,J-1rati ( ' ' E entity,.' two or more of An employer is�defined as an individual, partnershlu s ai o reopresentatives of afdeceased em-plover, or the receiver o, the foregoing engaged in a joint enterprise, and m r r,yV g 1 'r, ,r,; t.:• � -...._ trustee of an individual, parmership, association or other legal entity, employing&if loyees:�, owever..the�owner of a not more than three apartments and who resides therein, or the occupant of the dwelling house of dwelling house having house or on the�grounds or another who employs persons to do maintenance, construction or repair work on such dwelling PP building a urtenar t 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 nt who has of a license or permr renews it to operate a business or to construct buildings insurancecoverage requir d.in the th for any Additionally,neither the not produced acceptable evidence of compliance with the insfor the erformance of public work until commonwealth nor any of its political subdivisions shall enter into any contzact have been presented to the contracting acceptable evidence of compliance with the insurance requirements of this chapter authority. , Applicants ' compensation affidavit completely,by checking the box that applies to your situation and Please fill in ,he workers comp with a certificate of insurance,as all affidavits may be supplying company names, address and phone members along a Also be sure to sign and submitted to the Department of Industrial Acciderrts for °II of insurance coverage. or town that the application.for the permit or license is date the affidavit: The affidavit should be rewmed to the 3' have a�gttestians regarding the"law"or if you not the D art:nent of Industrial Accidents.•Should you being requested, compensation policy, lease call the Department at the number listed below. are required to obtain a workers' comp P c5',P City or Towns bl The Department has provided a space at the bottom of the Please be sure that the affidavit is complete and printed legibly. the applicant. Please affidavit for you to fill out in the event the Office of Investigations has to contact you regarding be retmnR t^ be sure to fill in the peimit/license mmmbei which will be used as a reference number. The affidavits may the Department by mad 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 hes iate t�oagrve us a call. _ /////������jjj��j�j�jj�j�jj�j���/�j/ 3 rY"v-+�-:}i%; C....... ;�,•,t ��� The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Invest1gadons 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 i Assessor's map and lot number `� .......!.�..1.......li� ... 7 7 7r � SEPTIC SYSTEM MUST BE Sewage, Permit number ........................A.�_3................... INSTALLED IN COMPLIANCE WITH ARTICLE II STATE;N {. 7"E T° TOWN OF - B A R NST D TOWN F Z EAHBSTADLE, i I BUILDING INSPECTOR 00 i639 `00 APPLICATION FOR PERMIT TO .............................................'U� '70 / IUD.... LI;I' ................ . TYPEOF CONSTRUCTION. ..............c.,/. ................................................,............................................ ............./.........2 ...........19.... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according-to the following information: G O7 � / j n ,� /S 7�C Location ............................................ "�.r�... ....... ..........!! ... ..17 ✓ 1........................... ................. ProposedUse ..... /.q ��.;1..:... - .. ........................................................................:. Zoning District ..Fire District .. .: �C�=/ ' ._,. Name of Owner .d// � ..f (itD/,T/ .... /S .Add res Name of Builder .. ........................Address .� y / ..��...� . oDA/ .... ....�JT .. �L� Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..................................................................Foundation ..C).CG.. .......... Exterior �1. ... .s/�'/01� ?. oofing ............ ................................. Floors .Interior 10XywA4L. Heating 3` �5-rLC�.�V�..���...f��0/.Z .,....Plumbing ...........�.......�...... �........................................ Fireplace ................/....M.��....................I..........................Approximate Cost �J Definitive Plan Approved by Planning Board -----------_------_-----------19________ . Area ...................�............. fto Diagram of Lot and Building with Dimensions Fee ........C:074_1!......................... SUBJECT TO/ APPROVAL OF BOARD OF HEALTH �Kl � 1 2�O I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ^ � Name .... ................ Fish, Daniel & Judith 19264 1 1/2 story No ................. Permit for .............................. ...... single family dwelling ...................................... High Street Location ............................................ West Barnstable ................................................................................ Daniel & Judith Fish Owner ..................................................... frame Type of Construction ......................................... ................................................................................ A .Plot ............................ Lot .................... ........... • Permit Granted .......June 3 ...... . 77 ........... Date of lnspection�/P 19 .Date; Completed ... ...........19 PERMIT REFUSED ................................................................. 19 ............................................................................... ............................................................................... ............................................................................... ............................................................................ Approved .................................................. 19 ........................................................................... Assessor's map and lot number Sewage Permit number ......%%`..�.... ,.:................. ................... THE T��♦ TOWN OF BARNSTABLE Z BAUSTADLE, i Mb 9. .e� BUILDING INSPECTOR 'Fp yit(a• t w APPLICATION FOR PERMIT TO ... ' ' ° .. .: TYPE OF CONSTRUCTION ...................::............ :.................................................................................................. ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location „ ......................... ProposedUse ..... .. ...... '........ r....:::.: ...... .. ...::.`.: .................................................................................................. Zoning District .......................................................Fire District ... ' ' .. ... .... .................................... ......... ......... .................. Name of Owner ......... . ... ��. k /" ✓ Address Nameof Builder .... ...............................................Address ................................................... .:� „ Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation ........:..:....:......:r............/._....................................... Exterior ........... . ............... .Roofing ....... ' .. :!. ��...................................... Floors ......................... ..............................................................Interior Heating s....... ....'. ......:.. ....Plumbing ............................ ................................................... .. Fireplace .....................................................Approximate Cost ............... ............ ... Definitive Plan Approved by Planning Board -----------_------_-----------19________ . Area Diagram of Lot and Building with Dimensions Fee ...............:..:......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .... . .. .... ........ .........' ........................... Fish, Daniel.. & Judith A=111-46 19264 l 1/2 No --._-- Permh.�x ----.�--��v���—.. ` ' o1ogla faidi�� ' ------------'' ----'----- ~. ' Stibet _ Location . gant Barnstable --------'------------------ Owner ..............Dao1el..&..Judith.Fish __.. ' . Type of Construction ----��am .................... ' -------------..,-------�,----. . ' ' - A Plot ---------. �t --_________ ' ' / . . . ' ' June 3 77 Permit Granted -------------.lg Date of Inspection ------------l9 - Date Completed --'--'-------]V / - . . . . ^ . . PERMIT REFUSED -----_—...----.....-----..— lA ' ' - ` , ---' . . . ''ff-------' , . . . ............................. . -V-------^~— --- ` ^ ' ` Approved ................................................ lA . --------------------------. . ' . . ----------------`-----.-.--.. . ' . . - .,.a..a.•..r+ra r.s.a�.ya�„�i. l�`�':J 7"7':t'T7^9�" �,,,.g rlil'"Z - T- .-.r .+._..-•.,�.-. w. a•0IL LOS \XYZ'I�U><A\V�i.ur-�K�/./.�..ui��V!/ 0./iA/•C!./Y £38.7 f4' 2•,PEASTONE LOAM If FILL• 12• MAx, tl Lo t"0.I. oisT �;. 0 DIN. 1000 C a 1000— GAL. e ,o GAL. I� ' PRECAST OR o e t I o SEPTIC 6'�� o�^ BLOCK I � � TANK I; o o SEEPAGE PIT 0' .0 I 82.7 e , I; •oe°° , 0 I 4Ir 20 MINIMUM . •'. ° n C o 7 FOUNDATION IY2 WASHED STONE I SCALE I"= 4' ! 777 ELEVATION SKETCH r` 11 PERC. RATE tM/N rn.c SCALE,: I"= 4' TEST BY : c�u,.t•T...•w�R•�. a � • TOWN INSPECTOR: —tl& Pwl..l ~wao4jo BACKHOE OPERATOR +�...ey 4.ow—v0% TEST MADE ON °+a.ua.�../ ✓,, i 917 _+1 / o, 1000, 10� 47 6 S .t . bz vto aoo csA"-• /� -� l /;001 toe i 0 1 /i�o cs,K CONL�G�7ti / / AA 4, { 1 s.r✓••o Ts...0 - Fc r✓.�,p�o7�.•r1gDc / Va, Fuz�aE 9 / exRolaSwV p0 N / if / 1!t i lo Ile * 6 / rr VA"t �5 - Br. j wr3 N „La cs re sw�i Gi r..Q/ I 1 • � �� `�i q� �-� '��/ , G o n/�jDla+f fp T/�c zb�v/ivG �y-L.aw 3 (�; ♦ �� 00'.-/ �'�� v� >�'d :✓t.vN oi= b°9+tNbf�4"SL��I►� 1 OF o JAMES H. o / -4S? No. 11029 b \ uNoEF��IEO t Towy wQY ` 77 APPROVED BY BOARD OF HEALTH 96 lop DATE 19— ' H OF RE'ryWl�x d . ' Y CHAPMAN y ,o p No. 2765A �_ a$ EX�STI►ac� �\.EVAT�p►J O TE���,� f B TLl=,r PvT SS/ANAL ELEVATION SCHEDULE PROPOSED SITE PLAN 1 I. INV. AT FOUNDATION =91.oa 4 SEWAGE SYSTEM DESIGN i 2. INV. INTO SEPTIC TANK -IN p , 3. 1 NV. OUT OF SEPTIC TANK (,.�csr �.o,MivS:nsdGE'• .rr.o s,t , 4. INV INTO DISTRIBUTION BOX ;• • SCALE: I"= so' .�s.otof/ ig•7 7 5. INV OUT OF DISTRIBUTION BOX = $gyp C-S,39 1 6. INV INTO SEEPAGE PIT = boll CAPE COD SURVEY CONSULTANTS pL ROUTE 132 7. BOTTOM OF PIT HYANNIS, MASS. Q A DIVISION B08TON GURNEY CONSULTANTS. N. B. BOTTOM OF STONE LAYER - U�•s8 � ram. .jai �r-•� f ���C � - �_ - - •� � �- � � Ili XX • - _=_-,�_' -`- _ -="a.iaar' 'a++ 8� .-"s,. r'"v ;r•.��et••7-Z - - —- - " _ -_T Ll w li ' ''I � E;E' I:'. ,s� s ,.� . 1� � r-' I i !I I� r r! i, �I � j i f� E'j •l i � I "QS DANIEL E. .1N RAI —a � p 'rS/0, � Erg rid S w-c P Satj oL t Ps ter..., .. '•.,.. - CG r r ,r.. i 1 � W.r.�7r'_�x• r ( 1 n cL�wq a.:aAM. r n r •' ��ti„ S `[.t �f ray Q= . 711? .spa_` OF Nis ,Id e y�• If -44 SoNOT�PJ�"5 `rI, �aISTE�+�° �a n. wrx i 1 d ' ; i 1 ~\�� `t. _ }1. .� � ! .._:.F7fCIf�1Sl:�7�•'re.:=-- � ___ _-g Y�aye'sr'�;_.___.._...... . I i M. 7- ------------- -7, .II ^! —_._— I .Y ( \ .— t�4$ `rwY••tLV.r+r 9)=-GoQIJY�C.. Id3 ...:. ..:.. i r \� r RECEIVE® ! . et_a=ate -.tea—T=_ - +�L.. L-�-`-� +�'--�' 1—'-i. > , ♦\i4'.i .:du�Ji.-�:1trT -..__—_... �^ —i•i� 1 f I t MAR 7 L ; ' ! TOWN OF BARNSTABLE -- - ' I I HISTORIC PRESERVATION . ,• ��y-A ��1—.1�� .— ,;fi.__--__.___. -.. ..—._ L.W-:C:"SRC—.1^.Yr—= � � �T _ .� _ ,j� - 1 ---. - __ --•^— APPROVE All APR. 132011 \� .'C..�a:l�:� ��.=;P.a;:•��L:'�v'--zi�.;a7;; �t.ww.� r—bF"�;w3'.. Town of Barnstable \I Old King's Highway Committee xuIts z � y r ceaz V II r ' t �i azs ca au�R s b 1�5 71 ' � � t� �� i! ,� ft( h-- -- �,. ^•avg��ii.'•.TrT�'6'r�aaxra•_s�'•'.•'- r6'�toa dA��� �- �tasb' �f. j'.. . � .. ': i f �- � L � '�i•� � .�� :.fa.:.c-5..- ..S�M� .._.... � Ekes lay a. � 3� L.�41fl.4e1L H.I. gf --------- 0`1 �mr�r�4�k3s,b.a�E6 " RI I = 1 i i APR. 13 2011 itr _ '�i '' +}I 1�i , i;1 .�•� �rsun,, :=a�+?i4aq'��. � :�F; t 1 Town of Barnstable ; - r x ,�; f ( �I r � -----1- Old King's Highway sr . Committee ';i di !'! ii' i cx�4rryc rc'nib NyvSo;nlea: I -- !! rj RECEIVED MAR ;::. __.......-- -._.._...- -...._ , TOWN OF BARNSTABLE HISTORIC PRESERVATION - f