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HomeMy WebLinkAbout0080 HOLWAY DRIVE y ° s UPC 12543 No.53LOR op HASTINGS,MN -ct,•..:a-�-�r.-:,^^'r^"'��--r;--•�+.�-�....-.... _` ...,.:�.s t. _' _ '�"�"�"'••' ..�.'...-.�.�.�.r` �..�_ x.� - -- + "-,.'�^-�.'+ -�+a.. �^-r.:+�r•-�--���-.Rr,...+��.+..—. `'.-'-•-- _ '-"•-r -- I TOWN OF BARNSTABLE R I S E Division of Thielsch Engineering,Inc. 2012 t`[ikt. — p.1 `1• 6 1341 Elmwood Avenue ENGINEERING Cranston,Rhode Island 02910 DIVISION Thursday, February 23, 2012 Town of Barnstable Thomas Perry, CBO 200 Main Street Hyannis, MA 02601 RE: 80 Holway Drive; West Barnstable, MA Barnstable Building Permit#: B20120264 Dear Mr. Perry, This affidavit is to certify that all work completed at 80 Holway Drive; West Barnstable, MA, has been inspected by a certified Building Performance Institute (BPI) inspector. The following insulation was added to the attic: ➢ 2.25" R-10 FSK faced semi-rigid fiberglass board insulation to knee wall and common wall areas ➢ 2"rigid foam board, that meets sections R-316.5.4 and 316.6 requirements of building code to one attic hatch All work performed meets or exceeds Federal and State Requirements. Sincerely, Erik J. Nerstheimer RISE Engineering Residential Installations Department RISE Engineering; A Division of Thielsch Engineering I - 401-784-3700 •800-422-5365 •Fax 401-784-3710 , 128687 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map l Parcel :-Application # Health Division Date Issued Z Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Boardr/ Historic - OKH Preservation/Hyannis Project Street:Address 80 HOLWAY DRIVE Village WEST BARNSTABLE, MA 02668 Owner MARY G. JACOBANIS Address SAME Telephone 508-362-1959 Permit Request PERFORM AIR SEALING MEASURES; INSULATE KNEEWALL AND COMMON WALL AREAS; INSULATE ATTIC HATCH; INSTALL VENTILATION CHUTES (PROPAVENTS) PLEASE SEE ATTACHED COPY I OF CONTRACT, CHANGE ORDER AND AUTHORIZATION FORM FOR MORE INFORMATION. Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new 26ning District Flood Plain Groundwater Overlay Rroject Valuation $2246.32 Construction Type Lot 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 ❑ No On Old King's Highway: ❑Yes ❑ 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 _new Total Room Count (not including baths): existing new First Floor Room Count f; Heat Type and Fuel: ❑Gas ❑ Oil ❑ Electric ❑ Other (7) t =' a Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood}coal stove ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing --0 ne 0. size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: N r � Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use T INFORMATION APPLICANT NFO N O (BUILDER OR HOMEOWNER) Name RISE Engineering A DIV. OF THIELSCH Telephone Number 401-784-3700 ZEULUX ENGINEERING EXT. 6133 Address 1341 Elmwood Ave, Cranston RI 02910 License # 100459 EXP. 3/12 Home Improvement Contractor# 120979 EXP. 3/12 Worker's Compensation # 3730961-01 EXP. 1/1/13 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO RI Resource AplcovAy ; OHNS , RI SIGNATURE DATE Erik Nerstheimer for RISE Engineering; A Division of Thielsch Engineering FOR OFFICIAL USE'ONLY APPLICATION.# ' 'D ATE,ISSUED E _ - _, MA_P__•/PARCEL NO.. ADDRESS VILLAGE OWNER s DATE OF INSPECTION: i FOUNDATION;): FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL :� �.�, �t4�R: } GASta. . ° ROUGH �-�< FINAL `� j';°s FIN'AL:BUILDING� • :•�� • '� . �a°<. A t ,DATE CLOSED OUT " ASSOCIATION.PLAN NO. Fy 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): RISE ENGINEERING; A DIVISION OF THIELSCH ENGINEERING , Address: 1341 ELMWOOD AVENUE- City/State/Zip: CRANSTON, RI 02910 Phone #: 401-784-3700 OR 800-422-5365 Are you an employer?Check the appropriate box: Type of project(required): 1.® I am a employer with 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 shipand have no employees - These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' ❑ [No workers' comp. insurance comp. insurance.x 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 [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no 13.❑ Other INSULATION employees. [No workers' 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 isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: THE PRESTON AGENCY, INC. Policy# or Self-ins. Lic. #: 3730961-01 Expiration Date: 01/01/13 Job Site Address: 80 Holway Drive City/State/Zip: West Barnstable, MA 02668 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 certif nd the 's and nalties of perjury that the information provided above;is�tr �u and correct. Si ature: Date: / l ERIK NERSTHEIMER FOR RISE ENGINEERING Phone#: 401-784-3700• EXT. 6133 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#: r THIEL-1 OP ID: 27 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/01/1311D0,Iff2 ) 2 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 401-886-8000 CONTACT The Preston Agency,Inc. 1350 Division Rd Suite 303 401-885-1700 H N FAX o E:t: No PO BOX 810 E-MAIL East Greenwich,RI 02818-0810 ADDRESS: Judith A.Wright CPCU AAI ARM INSURERS)AFFORDING COVERAGE NAIC If " INSURER A:Zurich-American INSURED Thielsch Engineering,Inc.Thielsch Group Inc. tNsuRERB:American Guarantee 8 Liability Hi Tech Realty Inc. INSURER C:Twin City Fire-Hartford Attn:Trent Theroux INsuRER 196 Frances Avenue D:North American Capacity Cranston,RI 02910 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDD/YYYYI IMMIDDIYYYYJ LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000. A X COMMERCIAL GENERAL LIABILITY X - 3730962-01 01/01/12 01/01/13 PREMISES Ea occurrence $ 300,00 CLAIMS-MADE OCCUR MED EXP(Any one person) $ $,00 PERSONAL&ADV INJURY $ 1,000,00 GENERALAGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY X PRO- LOC Emp Ben. $ 1,000,00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 2,000,00 A X ANY AUTO 3730963-01 01/01/12 01/01/13 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) s HIRED AUTOS NON-OWNED PROPERTYDAMAGE AUTOS Per accident $ S X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 B 7 EXCESS LIAB I CLAIMS-MADE AUC-4857188-01 01/01/12 01/01/13 AGGREGATE $ 10,000,000 DED I RETENTION E $ WORKERS COMPENSATION WC STATU- TH- AND EMPLOYERS'LIABILITY YIN X T RY LIMIT ER EACH ACCIDENT A ANY PROPRIETOR/PARTNER/EXECUTIVE 3730961-01 01/01/12 01/01/13 E.L.E y 1,000,00 OFFICERIMEMBER EXCLUDED? ❑ N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEEI b 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT 1 $ 1,000,00 C Property Section 02UUNHE6930 01/01/12 01/01/13 Property see Belo D Professional Liab DVL000026802 01/01/12 01/01/13 Prof Liab 2,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) When required by a written contract. CERTIFICATE HOLDER CANCELLATION TWNHARW Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Division ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD I ui tam utaaus Page 1 of 1 4 The Official Website of the Executive Office of Public Safety and Security(EOPS) MwS.Gov Home Public Safety Department of Public Safety Licensee Complaints License Type Construction Supervisor License# 100459 Restriction WS,IC Name Erik Nerstheimer City,State,Zip North Scituate,RI,02857 Expiration Date 3/28/2012 Status Current iNO complaints f0Und for OR Licensee. Backio Search i t��achtra•tt� '�. 1l of ilirtl1�frartnti'nt • 1'irf)br A.Constr Kull lice Construct. jV Illatlrfl4•:frrrl\ •rhtal License: CS SL 1 ipervisor specials t•rr► rl:rr�1. . Restricted to: WS 00459 Lr'-�ense c 81K NERSTHEfMER NORTH SACITV CHAPEL ROAD ATE,RI 02857 r••nuni"i•nr��- Ex,rr r ation: 3/28/2012 Tr;:. 100459 http://db.state.ma.us/dpS/licdetails.asp?WSearchLN=CSL1 00459 4/20/2011 Off ce-o onsumer aiVnd. usiness e u ati on g 10 Park Plaza - Suite 5170 ; Boston, ��-�ssachusetts 02116 Home Improve contractor Registration Reqistration: 120979 f m / Type: Supplement Card z ' ` Expiration: 3/25/2012 THIELSCH ENGINEERING ERIK NERSTHEIMER 1341 ELMWOOD AVE. CRANSTON, RI 02910 E � � a .ir `ate Update Address and return card.Mark reason for change. Address ❑ Renewal Q Employment Lost Card DPS-CA1 0 5OM-04/04-G101216 �/e TOom�mzonuiea�.li �.�.Craaac�ueella . Office of Consumer Affairs&Bu iness Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation RegistrationLIA�79 Type: 10 Park Plaza-Suite 5170 Expira;: -T Supplement Card Boston,MA 02116 Iry THIELSCH ENd ERIK NERSTHEl11 1341 ELMWOOD',3` ��— CRANSTON,RI 029Fa%;=' ?"% • - Undersecretary Not valid without signature i • OWNER AUTHORIZATION FORM (Owner's Name) ' owner of the property located at. t ' (Property Address) (Property Address) ' hereby authorize (Subcontractor) ' an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. Owner's Sig t e iL •- 2 9- /i Date o va (JjDEC 2 9 2011 J � Town of Barnstable *Permit# pFTt18 Tpk, Expires 6 months from issue date • Regulatory Services Fee sr►itNsfiABL ems-.. -'r ?:;.:... ,Thomas F.-Geiler,Director ..Building Division" _�T - —. _Tom Perry, Building Commissioner 200 Main•Street,- Hyannis,MA 02601-- A P R. 1 ' Z005 Office: 508-962-4038 Fax:'508-79'0-6230 _ — BA; i�STA6- ... -• -�XPRSS: ER1G�'T1�Y�IC�i"Y'LON =•-RESIDE- Not Valid without Red X-Press Imprint Map/parcel Number 136 035- Property Address : Residential Value of Work �O Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name 11�a • Telephone Number 508•'1�\' 9730 Home Improvement Contractor License#(if applicable) 4� Construction SupeMsor's License#(if applicable) , 0Workman's Compensation Insurance Check one: ❑ 1 am a sole proprietor ® .1 arnthe Homeowner Ihave Worker's Compensation'Insnrance . Insurance CompanYName Worlanan's Comp•Policy# Copy of Insurance Compliance Certificate must be on file. permit Request(check box) [] Re-roof(stripping old shingles) All construction debris will betaken to ( g layers of roo UZ []Re-roof not s m . Going over existing Y fl rr,, +.A.( 0 Re-side V 4 LA 1 ®Replacement Windows. U-Value (maximum.44) *Vhere required: Issuance of this perrdt does not exempt compliance with other town department regulations,te•historic,Conservation,etc. ***Note: Property Owner roust sign Property Owner Letter of Permission. Home Improvement Contractors License is required. Signature Q:Forms:exp�g Revise063004 • S . i _ The Commonwealth of Massachusetts -- - Department of Industrial Accidents _ ONI�sll�r�sd�atl�s' 600 Washington Street Boston,Mass. 02111 Workell'S' ICOMD ensation Insurance Affidavit-General Businesses ra address' s} state �� zip 02bG� v Cyr." Cehme# M)G SG2' L9 59. rity work site location fu ad es ❑ Business Types ❑ le proprietor and have no one Retail❑Restaurant/Bar/Eating Establishment I am a sole . working any capacity. ❑Office❑Sales'(including Real Estate,-Autos etc.) ❑I am an ens toyer with ens 1 es(full& art time . Others/�� am as employer providing workers' compensation for my employees working on this job, addr•essr ' . At. ., ;�r,:. . bone IVV. .fnsuranee.Co- Oil IM — I am a sole proprietor and have hired the independent contractors listed below who have the following workers' . compensation polices: address:. ;,4:: hone.#;' sit insiitence co. - ME / oddressi - _ . r . 113hone ci fiisu'r'ence66,: IN r,'.•;.;:j:'^':'.: t: ..• :- •`•?'•:. j :�i ••. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or and e of coneopy of this statement Imprisonment be forwarded to the 011iee of investigatioe form of a ns of the DIAfORK �orcoverage vmetitication.00 a day against me. I naderatand that p Id I o hereb certify er the pains and penalties of pert ury that the information provided above is true and corned ' ate Signature Phone# Print name ' `official use only do not write in this area to be completed by city or town otlfefal permitilicense# QBuilding Department city or town: ❑Licensing Board ❑5electmea's Office ❑check if immediate response is required ! ❑health Department contact person: phone#; ❑Other ?u (ievned Sept 2DM) 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, expr ess or implied, oral or written. aruiershi association,corporation or other legal entity, or any two or more of An employer is defined as an individual,,pp, 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 maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the afrdavit. -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. OEM City or Towns Please be sure-that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill.out in the event the Office of Investigations has to contact you regarding the applicant_ Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits maybe returned to the Department by mail or FAX unless other arrangements have been made.' The Office of Investigations would hike to thank ybu in advance for you coop eration 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 of a of fear Madens 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617)727-4900 ext.406 I i —• Application to: JP�EOP`E,p� fy�`t� Old Kings Highway Regional J . isjotic District Committee in the Town of Barnstable for a CERTIFICATION.OF EXEMPTION Application is hereby made, in triplicate,for the issuance of a certificate of exemption under Section 6 and 7 of Chapter 470, Acts and Resolves of Massachusetts, 1973, as amended for proposed work as described below and on plans, drawings, or photo- graphs accompanying this application. . TYPE OR PRINT LEGIBLY DATE —Aori` S. 2AOS ADDRESS OF PROPOSED WORK __ `0 Wpmkh.n ,, ASSESSORS MAP NO. :��,.,_', OWNER N1E3x( ��r+(pann t s ASSESSORS LOT NO. HOME ADDRESS in, V L VLR TEL. NO. SOB •302-1•� _ AGENT OR CONTRACTOR ADDRESS TEL. NO. This application is for exemption of proposed exterior construction on the ground that: ❑ (1) It will not be visible from any way or public place. (2) It is within a category declared entitled to exemption by Old King's Highway Regional Historic District Commission. (Check applicable box) PROPOSED WORK: Describe and furnish plan of proposed work,showing location on lot,and, if an addition Is involved,show" ing location of existing building. t�—_>p tic wa w —t•� a vct.� s t 2� Cl 2, o ve �r l Z� Uon cL w.% u 61e. e/V to d . v SIGNED Space below line for Committee use. . Owner•Contractor-Agent Received by H.D.C. The Certificate is hereby Date Time OL 1'%nQ0N BY Date Approved ❑ The categories of work entitled to exemption are listed on Disapproved ❑ the back of this form. P�oFT rohti Town of Barnstable *Permit# �S S/74 Expires 6 months from issue date ,,,�, �,�, Regulatory Services Fee M"%639. •� Thomas F.Geiler,Director . A'ED 1i1°`� Building Division Tom Perry, Building Commissioner R ES CryyE R F f 1 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 F F B 'l. 2004 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIA BARNSTAEI c Not Valid without Red%Press Imprint Map/parcel Number 136-6 3S Property Address 250 \A,�wav ._�)Irkke. � ; ryt ®2.6(;-R [,Residential 1 Value of Work 31,]n6 Owner's Name&Address & =)f 1 QJZ06 AA t S Contractor's Name .�e.\AAV_N c 1V c, y ( Telephone Number 4i 10�0 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workmen's Comp.Policy# Permit Request(check box) [� Re-roof(stripping old shingles) All construction debris will be taken to c by�� .c�0,r 0c91t.Ac ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side' ❑ Replacement Windows. U-Value (maximum.44) *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. Home Improvement Contractors License is required. Signature , Q:Fomvs:expmtrg Application io- PNEt}O,,E�,N Old Kings Highway Regional'.Histocic District'Committee in the Town of Barnstable for a CERTIFICATION.OF EXEMPTION Application is hereby made, in triplicate,for the issuance of a certificate of exemption under Section 6 and 7 of Chapter 470, Acts and Resolves of Massachusetts, 1973, as amended for proposed work as described below and on plans,drawings, or photo- graphs accompanying this application. v TYPE OR PRINT LEGIBLY DATE ADDRESS OF PROPOSED WORK ASSESSORS MAP NO. OWNER _tea�cu J 01_611 d�b� ASSESSORS LOT NO. HOME ADDRESS - icy L�,�l 4'�u-� ,� �� TEL. NO. 362-'t 9 S� AGENT OR CONTRACTOR t AAA o A ADDRESS 07- 19L j TEL. NO.'42.8 33 b This application is for exemption of proposed exterior construction on the ground that: ❑ (1) It will not be visible from any way or public place. (2) It is within a category declared entitled to exemption by Old King's Highway Regional Historic District Commission. (Check applicable box) PROPOSED WORK: Describe and furnish plan of proposed work, showing location on lot,and, if an addition Is involved, show• ing location of existing building. 5 VT '' � � e� cS ��� Ceda4- s�► i�les c ,� y-e-t�la�i+�o L<5�AAA r c Arno [ S Igo - ""IL C� l Lc 1 OL L.,e l SIGNED Space below I mmittee use. . OWner•Contractor-Agent Rece' The Certificate is hereby pJU E01WE ; it i�B 2 0 7004 HSTOR�IOF AESERVATIO Date Approved ❑ The categories of work entitled to exemption are listed on �y TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 03G� Parcel —035 Permit# y/ -3 S Health Division �—ZU—v2 �3 'J2 Date Issued D a O a Conservation Division Sr 6-�t �)-65::L Application Fee Tax Collector Permit Fee,$ 3 O,d D Treasurer ICU -Q SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Planning Dept. Aoo g. c /,- YM TITLE 6 Date Definitive Plan Approved b Planning Board ENVIRONMENTAL CODE AND pp Y 9 TOWN REGIJI.,'.-TIONS Historic-OKH Preservation/Hyannis ,Project Street Address 80 Eb1wa.y -Driv(a. Village \N&S+ '3axv -51r "6 to ' Owner wy_-xy G. Address so l- k v _k�)r\ve *Aa--Tjm, sicb1.2 Telephone ) 3G2- 659 Permit Request R e ku< <d decl_ a.,,A a.dd I Q , Ao dap kli. Square feet: 1 st floor: existing ►co t7 proposed ►(o►:7 2nd floor: existing en 7 proposed 8t3 Total new 24-6 Zoning District R F Flood Plain Groundwater Overlay Project Valuatiorr Construction Type /1 Lot Size O,62. c c.\-eZ, Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ® Two Family ❑ Multi-Family(#units) Age of Existing Structure 1!Y Year s Historic House: ❑Yes M No On Old King's Highway: ❑Yes ®No If Basement Type: 3 Full ❑Crawl 3 Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) l G k7 t Number of Baths: Full: existing 2- new o Half:existing t new 0 Number of Bedrooms: existing 3 new o Total Room Count(not including baths): existing (0 new G First Floor Room Count 4- Heat Type and Fuel: ❑Gas DO Oil ❑ Electric ❑Other y Central Air: R Yes ❑ No Fireplaces: Existing 2 New 0 Existing wood/coal stove: ❑Yes A No Detached garage:❑existing ❑new size r+fA Pool:❑existing ❑new size L4 A _Barn:❑exist nlg ❑ne%-) size.-N A Attached garage:11 existing ❑new size nix Z22. Shed:❑existing ❑new size NSA Other: -i (r) Zoning Board of Appeals Authorization ❑ Appeal# pia Recorded❑ co �cl m Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name Eroo,c 5 Lm s Y,5. Telephone Number BOB- 3L2 l 5:9 Address 8o License# _ Vkl d" A 02��a �� Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE r++ DATE0 r�� FOR OFFICIAL USE ONLY ,,SERMIT NO. DATE.ISSUED MAP/PARCEL NO. ' ADDRESS VILLAGE OWNER ' r DATE OF-INSPECTION: ✓4 -6 C d FOUNDATION: FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGI FINAL GAS: ROUCI15 ej FINAL FINAL BUILDING00 DATE CLOSED OUT- ASSOCIATION PLAN NO.1 1 A I I I II I � o i I i `9 �✓ ' p z -21 to 16 — 1.0 Cl L'I z � et k =tea � z °FZMEr° Town of Barnstable Regulatory Services ` BAMS''BLE' " Thomas F.Geiler,Director Mass. P� 039. 'OlEp�(A Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. ° 0 Type of Work: NEw "%�i►=.cV_ Estirriated Cost 6 $4>0 Address of Work: to kAptrwA.r ]�R wt We.cT IRAe-w SrA(3LF— Owner's Name: N.Ax Lx G. 3ALM fb Aw l S Date of Application: S cP T• W 2L-O'L I hereby certify that: Registration is not required for the following reasou(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: 911G(oz Date Contractor Name Registration No. OR Ci Date er's Name Q:fon-mhomeaffidav . The Commonwealth of Massachusetts R ,Department of Industrial Accidents -' Office aflnyestigatians - - 600 Washington Street Boston, Mass. 02111 Workers' Com ensation Insurance AffiMAMdavit 01 naMR me: , ' location: �L A6A�- � �j$-3G 2• -1 • ci •I am a homeowner performing all work myself. •• I am a sole r rietor and have no one workin in ca acl�p %%O/GO//����%%%%%//%/%%%%%/%////%%%/%%%%��/%%%///%/G�/�/%////%�%%////%�/�///�// ' com ensation for my em loyees worlQng on this job. Y?4•:»:•.vo>,+Y.,.QY:c3y:{;c:<:;!fr�w}::<}•4:;c;?;r'.;' Y?:k:::}•;:tiy ,}:`>%°:> %xrE. 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I mtders{and that a' copy of this statementmaybe forwarded to the Office of Investigations {� •:._ I as hereby�e n he�ai�s and-pe es-of-perjury-thaj-the-infor ado r-avidedabnye isstu�a�d couect -.. �. � 2oD2 • Date ge•1p�". • 1fo, . Si tore � f.N ... ,. •• . ,� .:.�., :.��•name .r'. Phone# 't!�n�� '�2- Ig59�_..�• 1S ' Priat � eMcW use only do not write in this area to be.completed by city or town official permitllicense# C3Building Department city or town: QILieensing Board ❑Selectmen's Office ❑ checkif immediate response is required ❑HesAiDepartment phone#; �Other eontactperson: r-f..A 9/95 PIA1 Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from `law", an employee is.defined as every person in the service of another under any contract .of hire, express or implied, oral or written.. - artners , association, corporation or other legal;entity, or,any two or more of An employer.is defined as an individual, p h1P . the foregoing engaged m a]anti enterprise,-and including the legalyrepresentatiyes of a deceased employer, or tlie'ieceiver or trustee of an individual..partnersEP, association or other legal entity, employing employees.— o`. —',the.owr er:.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 theretd shall not because of such employment be deemed to be an employer; MOL chapter'152 section 25 also states that every state or local licensing agency shall withhold the issuance br 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. _: . . f.. .. r r... Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation cad Please suppjy g cnpany names, address and phone numbers along with a certificate of insurance as all affidavits maybe 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`haw"orif.ygu y lease cil :die Depa#b:iE it at the number'listed below:.: are required,to obfaia.a workers' compensation policy,p RE City or.Towns .. Please be sure that the affidavit is complete and printed legibly. The Department has provided as 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. Plea�yys••e. be sure to fill inthe'Perauttlicensennmber winch wffbe'used a's a reference numEer."Tfie affi&vits uaay�ie'ze -t�? y mail of FAX unless other arrang the Department b eriaents have been made: .. -., ..w', _ investigations would like to thank yo id for cooe u n advance yu pration and should you have an estions. . The Office of Investig. ..,• .. ,.. y - yam?' . please do not'hesitate to give:us a call. " The Department's address,telephone nnwealth Of Massachusetts 'Department of Industrial Accidents Me of Investigations 600 Washington Street , = ' Boston,Ma. 02111 fax ff: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 _ i V/es-- N,s le (508l 3G2-_ �9s� ►haw-e. rec.��t.�c� �,p c�v«.� -�Yv.�.�. �se����� -�-o 1r2 c�<<a C.. is�,�� CJ� C f- 1 %-(A► o (\—at,-,$� (a,,Lc� C. 3 1� � o,tirZ vt c l4��p►- t i lUo .�-� Cu.c� A-A.L 3 tv�c v- l� r - f i oil LU tz Q ge a �n , , '10 e O i,c N� A $p 3� gillg 1p �7, 0 1 y P R 91 LLJ QJ = I . �E 25_�I 3C g Q p O (j :'I ' ;t ► :� 1 x I i 1 iil i „ 6 i '\•.�-•� ,�; ; i:;/'ice/!� ;�' ". ZZ 00 to \IL ir ZZ \ III • ' � ` I I l l i l -� Ic • � 11 r l l i l 0 m +--- ----,------------ -- -- BILL INQUIRY - --------------------------------+ (Action: Find Next j�rev ` Browse Output History Detail . . . I (Query the receivables file. 1 I Year Type Bill # Cust 4 Notes/SC Bill Name Ph 1 1 2002 RE-R 13958 91023 N JACOBANIS, MARY G TR I Parcel ID 136-035 80 HOLWAY DR 1 1 W BARNSTABLE, MA 02668 1 Prop Loc 80 HOLWAY DRIVE 1 I � 1 1 1 Int Date Billed Abt/Adj Pmts/Credits Interest Unpaid bal I 11 12/01/01 2, 431. 04 . 00 2, 431. 04 . 00 . 00 1 12 05/02/02 2, 431. 01 . 00 2, 431. 01 . 00 . 00 1 13 I 14 I 1 Fees/Pen: . 00 . 00 . 00 . 00 . 00 1 1 Totals: 4, 862 . 05 . 00 4, 862 . 05 . 00 . 00 1 I I 1 JAN 1 Owner: JACOBANIS, MARY G TR Due 09/17/2002 . 00 1 I Per Diem . 00 1 I Int Paid . 00 I 1 3 of 24 1 i Town of Barnstable �P�oFtHe rgl�o Regulatory Services BA ' Thomas F.Geiler,Director STABLE, 9 MASS. 16J9. Ate. Building Division TFor Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 5P_P %fin 2007, JOB LOCATION:. 80 WeS+`3cx�ns�l2. number 1 street village "HOMEOWNER": Mgng Cz s,l``3=64hAV5 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 l09.1.1) 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 requirements. r Signature of Oleowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger.will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt i , r LAJ is LLJ I ��I r: V a m O • • O N 3 HI e _ J ---------------- co CV i ,�TME TOWN OF BARNSTABLE Permit ...... • BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash -39 HYANNIS,MASS.02601 Bond "� S CERTIFICATE OF USE AND OCCUPANCY Issued to Cc,;,), lloln� '2iU..c. Address U do ;- '' a I)r.Ly,. _,rat ty lJam.w 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. U.. ..f. 19 .. i......... ......l.. Building Inspector l � I 1 TOWN OF BARNSTABLE BUILDING DEPARTMENT _ 11saaaTAU TOWN OFFICE BUILDING rua t639' HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by BuildingPermit u..D _.............. .......... .................................................................._......._.................................»_. issuedto ............(.//�J�/( . ....... ....................... /1,G1O .....................................................�_. ... .....___......�. _..__ Please release the performance bond. TOWN.OF BARNSTABLE, MASSACHUSETTS BUILDING PERMIT ,/ y� DATE/1 -Ella19 PERMIT NO." t; APPLICANT V_4J'� �'Ik•/ � IZIZ ��/ A DRESS IND.) (STREET) (CONTR'S LICENSE) • NUMBER' OF PERMIT TO (_) STORY DWELLING UNITS _ (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ZONING AT (LOCATION) e5 ct) DI! A *DISTRICT ' (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: S �` AREA OR PERMIT VOLUME ESTIMATED COST $ FEE POIAI BIC/SQUARE FEET)OWNER 7— BUILDING DEPT. . ADDRESS BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET; ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THRE#�cc CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIP'E,D FOR' CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WdRK: ELECTRICAL, PLUMBING AND . I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL_ INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL IN (READY- 70 BEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE - . OCCUPANCY` POST THIS CARD SO IT IS VISIBLE FROM STREET SUILDING SFFEECCTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS TI 7 z z rl�il 2 / Z 3 HEATING INSPECTION APPROVALS NGINEERING DEPARTMENT OTHER 4 BOARD OF HEALTH -7 0 I WORK SHALL NOT PROCEED UNTIL THE INSPEC• PERMIT 't/!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VA.RI000S STAGES OF WORK IS NOT STARTED WITHIN Sl;' MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE WRITTEN GONSTRUCTI011 I PERMIT 1S ISSUED AS NOTED ABOVE. NOTIFICATION. e y r.' i q !v �7- — — �a ti o T ' � 3 U � %j �, . L o CERTIFIED PLOT PLAN LOCATION / sT BA,ev 'rf3c3GE SCALE . .�.��°.5.; .... DATE 1 PLAN REFERENCE fU 9 p EC)J+�IFiHD yG� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . t .--LLEY _ N Flo. 25100 �O I CERTIFY THAT THEIST/MG �DUNDiy�TJo.v !I T De, SHOWN ON THIS PLAN IS LOCATED ON THE GROUND ` L AS SHOWN HEREON AND THAT IT CONFORMS TO THE / SETBACK REQUIREMENTS OF THE TOWN OF s BHPivSTitS3L „ .. WHEN CONSTRUCTED. DATE HF��Z. 9 lyS7 8677Y fiyt cam/ - �� f 'REGISTERED LAND SURVEYOR i ` I Application to 8S>NpN+P t�6 P GN OPitlS�E S�.8• Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed 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: RM House ® Garage ❑ Commercial ❑ Other 2. Exterior Painting: M 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 a 3 ADDRESS OF PROPOSED WORK ofa0 w Z 'a ASSESSORS MAP NO. 13 9 OWNER �CfI 4 f /3 lT IV//e17 ASSESSORS LOT NO. v HOME ADDRESS _ c/-&/ A/o ee. dS 7{« v• Ile' TEL. NO. S/.rz-o FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). 3V 764-e r✓a-, d.. w.,6. b 3 G /�GCLc�cc� �11. Ct/cCP.u,,,,�ie ) 71tCc D i3 fe 7- -271.4 v ,_.,..i /a.S- /rGu�...�L c✓ 8 o YG b r ,[ All, %� �3 1�.��yaty O . ]yJ[ D 73Lto X44f Z �e l�,��y �U�tc�c /0 v6/' �: dO / 00 AGENT OR CONTRACTOR ��i�t� ��• TEL. NO. - 5/Z,L /s ADDRESS ��+-��a-�-�-e ` CS le- ue //Q 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). Signed Owner-Contractor-Agent Space below line for COVITitlee use. Feceived by H.D.C., Date The Certificate is hereby D%te Time - 0CT 2 4 1986 ,d ./� Approved IMPORTANT: If Certificate is approved, approval is subject to the 10 day appeal period provided In the Act. Disapproved 0 ` Assessor's offioe'(1st floor): • T'c Sys Assessor's map-and lot number ......3� ........Lo.TLEDIN COMPUArAC' OAT"Er0 '''�) f ' 'STAL TIT6.E 5 Board of Health (3rd floor):' Q --y� wITN o" Sewage Permit number ........ .. .g.......l.l.-.�...•......... CODE A� • r_MV1RONME GU�,po ) t 33ARBSTABLE Engineering Department (3rd floor): v �C� �raea6 House number {�^ N RE 'oo +6}9• ......................:.... .a. .fir..... ......... ' c gar APPLICATIONS PROCESSED '8:30-9:30 A.M. and 1:00-2:00'.P.M. only - APPRO .VE TOWN OF . BARNSTABLE 8 St le C° servati°n °m�i S I L D I H G I N -P E C T O R s � ' gnedAPPLICATION FORaffRMIT T - ./.' � ......1.......;. /..+'/✓.1...................................................................... TYPE OF. CONSTRUCTION ............ . ..5 ��.......'.. . 71.'!. ................................. ........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: location ...... ......./`.v. ..�� ��....!7(Z.eve...ri..wS7....F�.�1�2N.StAbLsr............................................................. Proposed Use ......SJN%4Z.....FAW11...... .5!,ie.LLlw! ................................................................................................. Zoning District ..............!.1 ..............................Fire District ......... Name of OwnerC4p.E...�!.1.4.7t.......T..Tvo!"t.................:....Address ........E 5�N0• r')� tDZ53] Name of Builder ........................Address 3/Z ..:?.A.....k.r...S. NoW.(L ....MA............. Name of Architect ..........................Address •C�.'. ....��....... :SQNp�!'ICF�. ..('�!� d P Number of Rooms .........S�t.V��l/ ....Foundation ...$...�Rt1�!`E ...t�?n'�'Q((rT�...ot".. �M ......... Exterior ...........H ,..C �......................................................Roofing, ��- R('...................................................... w QeA •Floors .....p kNp..........................................................................Interior ........ ��U Q!7!..r. ........................................ Heating F'4ace4.....NOt....WAT6VR ...........L//............Plumbing ....Z.�i......�r.\ ..................................................... Fireplace .... ....................................................................Approximate Cost ...... � ................. ........�.. Definitive Plan Approved by Planning Board _____ 19 All Area .. . Diagram of Lot and Building with .Dimensions �- Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 19p6 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....... ... LVC............-..................... Construction Supervisor's license / 33 .................................... CAPE POINT TRUST W No Permit for ..... tory............ Single Fami-i D '11m b, . .............................. .......... 6bcation Lot #20;-, 80 ...?rive ............................... ........... W. Barmstl ble ........................................:;; . ....... ...................... 0. inv-Trutt wrier ...... t ........ .................... Type of Construction ... ................................................ .. ... . .. . ...................... Plot ............................ Lot .................................. - Permit Granted .....Marh 10.......................I............ 87 -19 Date of Inspection ....................................19 Date omplet d .... ........ .... .... ............19 62, Assessor'-s, offioe�(-tst floor):' t number .. 13(0 .. "Lc�T a of THE Tc Assessors map an'd to : ...........:............. Board of Health (3rd floor ). �... d , Sewage Permit ri��b�r ........... ............ti.....0 ....................... ` \ BABWAS& LE, Engineering Department (3rd floor): c k. . ..�. p 1639• \0� .. 'rt a .......... DNA House number ... .. . . . .... APPLICATIONS PROCESSED 8:30-9:30 AM i and 1:00-2:00 P.M. only � � - 1`� TO ��,'� N;f; t F, BARNSTABLE B)U 11 D I N-G, I N- P E C T 0 R APPLICATION FOR PERM TYPE OF CONSTRUCTION A t. ..../:iA:, 1�.........7..a.°!./7/'/. ................................................................. o �7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...... T... .. .......l�.U.L.W q V....? (z1 ...,... `! 51 ....R� �'N ''A � ............................................................. Proposed Use ......,S�NGL ..... {:M1. . ....... w.exul."!�..................................... .......:......:............................................. Zoning District ..............'..L... .............................................Fire District .........(•vl. ?�!�) ./! ................................. Name of Owner �t`' :.: !^!'t....."['R.�s ..... � GX.. Z7......: :::' :Ard�. f�� �a53 Address ............... 1 Name of Builder . A�t� L- WAS Q �.................. .:'. Address /s........�.. t . S!�NDW f N�A.:.......t............................._-... .... ............. .. .......... Name of Architect .:L9.u.�S....NLLF VAS...........::'...°....°.,:.Address .U'.@Q �!* SgNAfirIC.�....M� . Number of Rooms S�V•=A.L....................................::..-.,Foundalio'n ... :: hOLX! � �i S?NC-V�T.1�.....oN �atlN J........ Exterior .......WNr!£....0 4l�.r....................................................... Roofing .....Q�t�.... -.�.c�AL'................................r . . Floors .... ........................................................................Interior .........�.. /� �!T/. !J . ........................................... Heating.,..... t .....a. .i fc ...................................:.Plumbin �' I..... ? Fireplace ..................................................................................Appro imate'Cost ............ ....., Definitive Plan Approved by Planning Board _____&y- 19__ �. Area ............................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT' TO APPROVAL OF 'BOARD OF HEALTH I 1 i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .... Construction Supervisor's License q 3 .................................... CAPE POINT TRUST .Fr_ A=136-35 � No- 30497 permit for 11 Story N.tvtr............ ` Single Family Dwelling Lo/tion •..Lot #2O , 80 H®lway Drive .................................. a j. W. Barnstable Owner Cape Point Trust ............ . . ................................................ Type of Construction Frame ............................................................................... Plot ............................ Lot ................................ March 10, 87 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 FFo�Txero• TOWN OF BARNSTABLE - Permit No. . p�. 7...... BUILDING DEPARTMENT Cash TOWN OFFICE BUILDING 1,� �1 uv� HYANNIS,MASS.02601 Bond ......��.,....... CERTIFICATE OF USE AND OCCUPANCY Issued to Cane Point Trust Address 1 Ot- �?.O P 90 Holw�Nj, Drive- 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. ......O (?)q p 7..2........, 19....8.7........ Building Inspector , 'SAMDY ►SEck.. 6'� � fk1J4y DRIVE LeW S f �p i / Dec F�� M'4 c9 G�'AT MA2S4•{ES '� -- nta,w Locus MAP 0 It .�_` _ l 0 2 S, a o 0 r ,\ FLCx)DPLAIvU 20gr.A3 EL 1k,0 ALL GMAC tA(,vD / -7 d � � o 4 • EXXSr0C, WCU— I 5 crrc.� — 40 pnJEuLIn1CT 6 % 1 p -� �WEUJ't3 \ 444 E4,i S't i Li s- w Et_l,. T,F F"C). S4,o't - j4 =�sl-+totes � 3Z / SIX / L 3. So 86 k4 - Q C.t3 FuII �.�1��t}� ��� � • S;NGLE FAQ I Lv 4- 3 F-t--c1i � Q - --- _ -_ No &A2L39GE D►Sip sA l_ _ Ito Y, 4= 4-4o G, P D. DAILY t=tow - - _ SEF'nc TAIJr- = 44-o x ISo7 = 660 (-3-,P D. 4 Gt3. FNo. y 5E 16-0 0 C-01(... TA tJ� D ISPo SAL f=1 use. .(4) 4: &ALLYS. w17-74 2rsTo/UE c � T PLA !� _ 20 S1tcWA l_L.. AREA = 2 24 s. F - - 2 2 - s.F- Y, 2.� - 5(0 G.n D. po-MoM AREA /60 S• F. ` N ° , 3�4-� twASHSD5rN6 VEST iJ7-11z►3STT13LE N'l16'S • / O s,F. Y- 1• 0 = /60 P. h. �' V (4) 14,4' &AU J- -T*ZD-rAL. bE st GIJ = 720 GG. P. b . 'N Fo IZ `T oT-A L. -DA I L: (=t.o� . 4-4 G P D. i s?o SA L F►C L X� So H -T. 1 Pt-Rcol.A-'iou RATS 29? 1" IQ 2 MIu ofz LESS No scALC AL 1r� 30' 3v►.�E Is- 199 TEST No LE p- BAY,TER. NYC , T.Q C- Zf-\/ Xae1 t_b to g I-I 116 esmvm BY seMY r-)auutf,�G SAID.S.o.N. R1XTEf2- £ "E, -=Qc PR-d 1` C SS t o N/�L_ L�4 N Su fL v l_Yo t2S R F G = 53,o FG = `sv S , �D. 40 �—— I P.V.C. ) �'' t u�. SI ._. C &I IU C G P, EZ tud• box mv- 1^►v G4C-. So.6' �rv-1` V 1 LL-E u0 i • INJ 90,•2.•' S o.4i So, P7 7,c •��t OF M. 6i v 48,o &12AVbL &ALLE`( u TA�z_ r• WlSLtAM PETER yG� Gt I.��TE M Uo SULLIV AN AN �! �, , 9 Ho. 1%334 0 No. 29733 c�tzT► t=Y7�i gT CIE ?k2o�sED w 46. o 1 0' 21 4 2� T DtiIEU.I tJG SNc�u►J HEREoQ C=;t L 5 No"TES 1 M��. - 8' S Z� W ITH rtT-IC SLOE: UNE AQD S,-T Eta C)a'__. � �� FSS/0,,,A L th�� SAMD �� 12C �tR�ME►uT nF TH E-T�=��rJ . o f (A`) LoT " 1 t3oot� 24 g PAEE• I o 13 EL.38.8' B,�J5TAt3l.G AQD is tJo-r Lcwreb (t3) ELCVATiotvS ZASE-U OQ I�•G.V. o` �k: �:11�-1 tN T H� Fl�> P�QI t�. -t-'ow►.� i3�Gt� MA2i. R..N�. 22 �-i.. 33. 26 � � � tJ I'E � � y Wit,.. - (?�" UECAUSE. of -DP-'QCwAy L.oc-A t toQ Atit) -17je -DEPTH OF- SYSTE /� 1 sr �c11� i 7"rE U1Zov��i THIS ?LAW I s NoT EASED off+ �l1J I ►�sTR-v?tEJ�JT- / I 6-ALLEYS Mc�ST BE OF HZo co/vST72�CT/0iJ. svrLv�Y AND THE o FSC-j-S SNowr.r SFtoQt_D I No'(" u SEO -To (.,oT LW ES. _ o� C0tj-ve.t-6c7-11o,.1 �`( �mil`-• fl�i�� S��"i t� U`` " a� - q 3 a5s-