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0031 IRONSIDE DRIVE
OXforcr NO. 152113 ORA MAW w use. b� _ �� — — .t. ' ,� I 1 P 11 i 1 :� �' i A 9 i a 3 J {{{�{ \ y ''I 4:. ,.s ... .� ry?, �skev� +c; t 'A pCL`c— GZ Y0114�� �Y p�rgcv� CONTRACT Customer Name___��L�G _v�� r0 ��__•_ 3/ 1/�/��'>4�� ''�.8��/�_ _ SKETCH contract Date __ �_ �� _________�_ al-" _DMik ATTACHMENT Customer Phone_ S2� _ �G� __ Contract Pr!ce!Q 1• 7 7 / ! / 1 Y 10 ,1 ,,Y ,] I. 16 ,/ 17 11 l0 p0 III 17 77 7] 7{ 71 71 71 :10 a1 77 77 N 7! 71 �) 71 7/ /0 /1 17 I] /1 1{ /E 17 •1 N A 41 01 M !/ 61 IN >D 00 1 t i I I r ' - _j• - I. I I , i 7 . L 1 , 9 •I- I �" ons..I.. .I..._ ..j.. � II , , 12 14 ' � I I• ! ,to t i 20 13 Is I. ! .. �., .tom//�y� ,r{ 'i•- .i I 1. I ; f' , I �. ;.: I J � � . �.. . . . . .+.::..r.. .( . • :.j: 33 01 l ; ... .. ...1.. .............. I ,,. .�... ...: ::�._.. ,i. --T", t w I t... I. .., .; ,. ,. i. 76 NOTES: %/w / 1. 1 rR of 27,24w C 'Each box equals one fool unless othorwlse noted.This Akeloh Is It good Isllh I reP rasen lallo7l of the work to be done,It s under stood that all dimensions derived from this Akelch are approximate,and that ell locations of outlets,light fixluros,plugs,)asks and/or switches s.Lb}eot to change II necessary. TO'a�^.I �� I?^�f! 'T I ON 6 ern 7 Daniel &Alison Di Iulio - 31 Ironside Drive West Barnstable,MA 02668 May 1.3,2014 Mr. Robert McKechnie Building Inspector Town.of Barnstable Regulatory Services 200 Main Street Hyannis,MA 02601 Dear Mr. McKechnie: This affidavit serves to inform the Town of Barnstable the intended use and rationale of my finished basement. We are finishing our basement within our single-family home located on 31 Ironside Drive,West Barnstable,MA 02668. This newly finished space, installed by LUX Renovations; LLC of 60 Shawmut Road, Canton,MA will be used as an additional family/entertainment room only, and will not be used for any other purpose. Please use this signed note as our formal proclamation of the intended use of this space. If for any reason you should require anything more,or if you should have any further questions,please feel free to contact us directly, thank you. Sincerely � 1 { Daniel& Alison.Di lutio Homeowners TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map \ `. O Parcel O V .l .' A- licatio l#` p Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Add r ss II�CC Village S Owner I E(. D"40 Address Telephone 59 362 Permit Request RVOY&601601— U S/A/G 4,W6US6 eAJ)AJ6 6 ;fW_ t:jd �rA!1 S�1/•�1� s .4 Ffm)L br� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Q Flood Plain Groundwater Overlay Project Valuation [ 7 100 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family a,--'Two Family ❑ Multi-Family(# units) Age of Existing Structure His House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: 'Full ❑ Crawl U4alkout ❑ Other Basement Finished Area (sq.ft.) 630 >Pf 66,- 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 Heat Type and Fuel: ❑ Gas' ❑ Oil Electric ❑ Other Central Air: ❑Yes g No Fireplaces: Existing New Existing wood/coal stove: ❑Yes No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ a r --a Attached garage: existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: o 1 lV1+A11 +V O4 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ (D ro Commercial ❑Yes No If yes, site plan review # --- cn Current Use Proposed Use rn APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number 2! / —17 5-IIN:) Address 66 569o#ab r K0,*) License # 7q fJ LCA-11ZZA� gt 020U Home Improvement Contractor# ! 37 q `iV Email ( f��Sh �i oci UI1, Worker's Compensation # WO ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO u ✓ SIGNATURE DATE �J r`7 l FOR OFFICIAL USE ONLY f APPLICATION# i DATE ISSUED: MAP/PARCEL NO. ADDRESS VILLAGE OWNER `DATE OF INSPECTION: C � FOUNDATION j FRAME s INSULATIONS FIREPLACE ELECTRICAL: ROUGH FINAL f PLUMBING: ROUGH o FINAL GAS: ROUGH FINAL FINAL BUILDING 8fW mK -71ac/lq. M DXTE%CLOSED OUT ASS D ATION PLAN NO. i 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 Leizibly Name (Businessiorgamzation/individual): �lit/f^/g �ieN/'�� U/9S �I�r�/Vl•�/1�/N� JytT�sst-t Address: S11,4WIMIr A090 City/State/Zip: ,q�iy /1'!� OZtIZ/ Phone #: gl. Jaw. 440(w Are you an employer? Check the appropriate boa: Type of project(required): 1. I am a employer-with. 2 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$ �• � Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance S• ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions ,152 ,and we have no myself. [No workers' comp., c. §1(4) 12.❑ Roof repairs t employees. [No workers' insurance required.] 13.7 Other comp. insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information t Hoeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new nffidavit indicating such m 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 and job site information. J Insurance Company Name: Policy#or Self-ins.Lic. #: A(f— 74 Expiration Date: ✓`` �7'�Ol� Job Site Address: 31 l/9OM t 0 f /Jntif City/Statr/Zip: 144S7-1f4?*fP13l F_15f e-VIS 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. 7doherebjy,cerd r the and p alt'es ry that the informa 'on provided aboove isstrue and correct Date: J Phone#: �0 771`(07S Official use only. Do not write in this area,to be completed by city or town ofeial 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#: ,'AC<>RVCERTIFICATE OF LIABILITY INSURANCE D/20/ DD201/Y 9 20/ 3 3 ! 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 fiFFORDED 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(les)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). PRODUCERWmj�` S. Cordaro Andrew G. Gordon, Inc. PHONE (781)659-2262 FAX Hol.(7e1)659-4725 ikG_ AIC 306 Washington Street bill@agordon.com EBB INSURER 8 AFFORDING COVERAGE NAIL of Norwell MA 02061 INSURERAPeerleas Insurance 4198 INSURED INSURERS Pil rim Insurance CO an 1750 Lux Renovations, LLC, INSURERC:Star Insurance Company dompany 8023 DBA Ovens Corning of New England INSURER D: 60 Shawmut Road INSURER E: Canton MA 02021 [INSURER F COVERAGES CERTIFICATE NUMBER:Lux 092013 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 I ADDL SUOR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE $. _ 1,000,000 X COMMERCIAL GENERAL LIABILITY MI n $ED 100,000 A CLAIMS-MADE FX OCCUR 8512651 /5/2013 /5/2014 MED EXP An one n $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO- LOC $ AUTOMOBILE LIABILITY M81N D SING LIMB e 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED GC10007161409 /17/2013 /17/2014 AUTOS AUTOS BODILY INJURY(Pat accident) $ X HIRED AUTOS X NA�OSWNED PROPERTY DAMAGE $ Uninsured motorist Bt spift Emit $ X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAR CLAIMS-MADE AGGREGATE $ 1,000,000 OED I X I RETENnON$ 10,000 L8511953 /5/2013 /5/2014 $ C WORKERS COMPENSATION X I WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000 000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) 0428715 /24/2013 /24/2014 E.L.DISEASE-EA EMPL0YEq$ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Lux Renovations, LLC ACCORDANCE WITH THE POLICY PROVISIONS. DEA Ovens Corning of New England 60 Shawmut Road AUTHORIZED REPRESENTATIVE Canton, 14A 02021 Y. Cordaro/CORWIL &aoI-off ACORD 25(2010/05) ©l988.2010 ACORD CORPORATION. All rights reserved. INS025(201005),01 The ACORD name and logo am registered marks of ACORD r a y t. , :. MBA SE r E a N �T 1 t FINISHING SYSTEM e DESCRIPTION r) .°ai: t's„.ps%::j'<y"!•'•�L::,:�:..ii.L' .'<>,3`>:�:::''::i'art? The Owens Coming'Basement F•nishing System rs comprised of lightweight 5ber glass ram , z pa Innis which lace conventional nets.PVC ( replace naming)and foamed PVC trim moldings (which umber r:. replace trim I ),Tt►e trim mOldtng5 snap into the lineals,holding the panels m place. and Wall Moldings panels are easily rgT10VCd to ,•:�: � ;v:�'''�.,�5;F'>'•• >�:'t:ri:'d,:.r provide easy access to a home's foundation walls.Because traditional wood and Paper- � t ; k based building materials are replaced With fiber glass and PVC materials;the Basement Finishing >N " System offers inherent resistance to morstuce, mold and mildew.*The system is covered by d lifetime limited transferable war anty" " - ko m Owens 'h Wig- USES The Owens Coming-Basement Finishing System is an innovative system designed to vtwtate and finish basement vtak it insulates, acoustically treats and aesthetically finishes - walk in a few simple sbeps.The system can be installed over both masorry foundation walk PHYSICAL PROPERTIES and interior partition walls built with either wood or metal members. Pfn"tarty Test Medtwd Yahm For fiber Glass Bowes AVAILABILITY WaWVapor Sorption ASTM C 1104 <2%by wt 120NF 94'x 48'x 2-12'Panels 95%Rti Lineals Compressive Strength ASTM @ 10%deformation 25 Psf Trim Moldine_ A25%deformation 90 psf Cone Molding Thermal Resistance ASTM C 518 R-I 1 Vertical Battens Normal Density ASTM C 303 3.2 PCF Base Molding For panek Outside Comer Casing Norse Reduction Coefficient ASTM C 423 lamb Extender Type A Mount 0.95 Chair Rail Surface Burning Characteristics ASTM E 84+ Class'A Flame Spread 25 Color Choices. Meets Class A Bum Rating Smoke Developed 450 InteriorTextile Finish Fire Classification NFPA-286 Meets Acceptance Panels:"Linen Mist'woven fabric• Criteria Trim:All trim available in White or Woodgrain. Mold fjesistance 338 Pass 1 ASTM C In addition.vertical trim available in fabric look ASTM C 1 Pass finish or fabric wrapped to match panels. --r,— +The amine dwuteiars of the Mated contpowe panty cove det—seed m accordance Walt ASfM.E&{,This scan• dad rhea u es and desotbes the properties of rtatcnars products or assemblies in rtlsDorKe to heat and Ramie under CODE COMPLIANCE ccnbv ed W)Mtory conditions Data frorn ASTM E 84 test t a not be used to describe or assess the fine hazed or frite ri*of materials,products or assemb4es When considems as of the factors pertinent to an assessment of the fire hanrd of 2000 BOCA Evaluation#21-24 a particular end use.Velues are reported to the nearest 5 raieS 2004 ICC Report#NER-635 `While the rrator&and design of the Owens Corrtng'" Basement NvgvV SYstern resm mold aid mldew the - System can rat prevent or mitigate mold if the cortdit*rts nuts i ry for mold Vomb otherwise erbst in van bm rnent. "Sce actual Warranty for detaits,im'tations ' .. am MOnrtiM( t oFTMEtalti Town of Barnstable Regulatory Services Al '$ Thomas F..Geiler,Director r .Building.Division Tom Perry,Building.Commissioner' 200 Main Street Hyannis,MA 02601 www.town.barnstable.ma its Office: 508-862-4038 Fax: .508-790-6230 Property Owner Must 'Complete and Sign This Section If Using A Builder 114-0 Q as Owner of the sub'ect hereby authorize aV* l B to M- to act on tay behalf in all matters relative to work.authorized by this building permit. RO-1s)96, l� . (Address of Job) I Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are erformed and accepted. Signature of Own Signature of Applicant D".1 Print Name ' Print Name. Date Q:FORMS:OWNERPERMISSIONPOOLS 6/2012 Town of Barnstable t Regulatory Services �xxsrnsLK Thomas F.Geiler,Director . aUss. 11.61 Building Division. Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma:ns Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER!': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner.'Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she.shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner L 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 responsrbrlities of a supervisor(see Appendix Q; Rules&itegulations 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 Massachusetts,-Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-079893 DANIELFWAIW ' 488 KENDALL RD t r TEWKSBURY WA 01876.., r ; Iji% Expiration i Commissioner 10/05/2015 Office o . onsumer A airs i d 3uslness ulation g 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 137943 Type: Supplement Card OWENS CORNING BASEMENT FINISHING Expiration: 1/29/2015 DANIEL WALSH - --- 60 SHAWMUT RD CANTON, MA 02021 Update Address and retprn card.Mark reason for change. SCA t 0 20M-W11 r_ Address j_- Renewal :] Employment Lost Card [lice of Consumer Affairs&Business Regulation License or registration valid for individul use only "`" r ME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: ;.- l?� Office of Consumer Affairs and Business Regulation �. � Aegistration: 137943 Type 10 Park Plaza-Suite 5170 �—011 � �" Expiration,Q9/2015 Supplement :-ard Boston,MA 02116 OWENS CORNING BASEMENT FINISHING SYS DANIEL WALSH 60 SHAWMUT RD -- L'�--- CANTON,MA 02021 Undersecretary Not valid without signature 157 - &06/� TOWN OF BARN-STABLE 2014 1'1 s 4.21 PN 3- 419 CONTRACT Customer Name SKETCH Contract Date_ ATTACHMENT Customer Phone _Di WQ ,rlact Price 4 U ,G 4 11 U !11 X S, rr M t. 75 26 37 20 21 b 91 32 37 L: 16 a6 A L I A :K, .! 1J .] V .0 .i N .Y 50 p! W 33 f+ -- u se sr - , 1 t : tt fr I _._...{.._�--. -.,._ G- - - — i - ..._. _F , ( _. , 1 MAI. r 13 : -T __ .. —•...__ - 1 � .1 - 41 1 r 1 1' 1 I � , _ , , 1 7 1 r n i r r 1 r 1 i i 1 _ !NOTES: 'Farb box equals one torn unless otherwise noted.This sketch is a good left-., representation of the work to be done.It is understood that all dimensiuNS derived from this sketch are approximate,and that all locationa of outlets.lion -- fixtures.plugs,lacks andlor switches are subject to ohange 0 necessary. CONTRACT Customer Na4Af� _ /z(�-�l(� .LRvjJ 31 T,e- SKETCH Contract Date ATTACHMENT Customer Phone Contract Price a :q m 31 at a, >. ]] X ]1 ae M •1 u .3 IS 0 17 N .• ae 61 Q7 as a. Y 5e a) ee Yr tie 1 I 1 ram•I � + I j i � I I i I t --r-- i �-�_ 4—i -�-�.__,. i I i r' -I---, j I ' '--- �l -r._.�- --i--{—•�--}--- -- — — ( I '! - - - - - �- - --- —T 'r' _ • _ _ I 1 r 7 _ i - : -f1- I J � -� '� 1 i 1 r- � 1—t- -�--F- - --1� 1 --}-- - - I-t--:--- --�—, - •I---� - �--- - ------t---f--- r•-^--�-----I-- e . _ I ' 1 I i —� f. I_ _T_-_,_.-__qmqj _ II " I r _ i I :. , ( _... .! _. -�•/r l���-! - _ I _�_.+.-"_ -__i_ _ t 1 7- I I I i- — _ 1 I ; _ - I — _ r _ ♦ , 1 1 s a /�,'� ' n 7 t IF- a] ; , I NOTES: Each box equals one toot unless otherwise noted.This sketch is a good faith i representation of the work to be done,it is understood that all dimensions derived from this sketch are approximate,and that all locations of outlets,light fixtures,plugs,jacks arxVor switches are subject to change it necessary. i CONTRACT Customer Name-- SKETCH Contract Date__. ,Q{ —`�!•.'J�f�l�t.ST�l'�G __4 -�� ' ATTACHMENT Customer Phone _ &N __ Contract Pr1cgL4 1y_�_._ ,• f 0 4 1 1 1 Y 10 11 ,,1 la 1. if 11 17 IsIa !0 11 rl n a/ al !1 >t al 11 30 31 01 31 a+ 31 71 3I 11 01 10 U /: A u U 16 41 U O 60 01 61 M 7 11 N f0 r I : 1 , i .� e 1 — gam.. _ 7= �_... _,,..... 7...- f • .• Ice 13 14 }. i.. .,. .. .. .y /� . .�..._•_ :5�� ! . E . t��' ice.. IN: 1 I. _ _i..... L:............ L.... 11 24 `•Ili 1 :.t: �...•!..... a.. ;. I . , �. j•.. ,. go �, �" '.;. �. _... . I •..� Gam;. .,. G....' T�/Kt% �OL7ft ,i'l r 37 ! , I ;. .,. .;.Y...j• aS.'j.. ._._.... /..i..,,,,,,.�_.... ..�. ..!. .F .. �y I I I i ., ! j �,�,..�.—:7 gym. (. .,. or .... . ..... t 33 'Each box equals one toot unless otherwise noted.This sketch la a good faith NOTES: 7 r• f M L repreaenlallon of the work to be done,II le understood Il,at all dimensions 4t t e ?� derived from this sketch are approximate,and that all locations of outlets,light fixtures,plugs,jacits and/or switches am subject to change If necessary. i Town of Barnstable Regulatory Services Richard V. Scali,Interim Director KASS.BARNSTABM Building Division s63q IR�� ► Tom Perry,Building Commissioner R — 7 �0�4 200 Main Street, Hyannis,MA 02601 - BARfLST6[3LL i, VAS �JAT00�! www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT# � ) —` VZUS-C) FEE: $ SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less EST -E/lWSi/�6�� Location of shed(address) Village Property owner's name Telephone number lo �y14� (140 SQ. �r ) 1 / 0 001019�� Size of Shed Map/Parcel# 44 Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old 1{ing's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:304:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:110413 i Town of Bamstable F Old King's Highway Historic District Committee 200 Main Street,Hyannis,Massachusetts 02601 (508) 8624787 Fax(508)8624784 CERTIFICATE OF EXEMPTION Application is hereby made,with four(4)complete sets,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 photographs accompanying this application: C� Date Address of Proposed work, Assessor's Map and lot# I i o 2 / House# r street /y 1 I>2- Village; application is for an exemption of the proposed construction on the grounds that work: Will not be visible from any way or public place �.. Is within a category declared exempt by the Old Kings Highway Regional Historic District Commission ' ❑ Other t t c (101 Description of Proposed Work: to ` V���9 G� s��� `(VG 0 )J (lDlJCAkrf- 3t VCj< _ PS Aalp '1 A.-' . r CIF-O,+A- cI-A 6o14A-OS� S/-f(-)'7'-.tis A ti O SOIL S (/4'G2 •'�1.�"F�Lf N"�S j� Mr�CI� l�r!/���E� Agent or contractor(please print):/� Tel.no. SO y 3 Address a 6PU rl� AIV-Al Owner(please print): ��t�F� �'���'t Tel no. �� �36 D Y Owners mailing address: 31 - ��S i! �/`! /L it N S--, A D Q4 Signed,Owner/Contractor/Agent �-- For Committee Use Only This Certificate is hereby Approved(Denied Date: Committee Members Signatures: oQ n A 2014 of gamstable ZoanOld Cing Any conditions of approval: off�MWe� C.Wocuments and SeWngsldecoII&Vocal SettingslTempormyIrdemd Flles10LK110KHEumption Form 07.doc • L n tom. 1 J _'7 ` ISLANDER �. ' ' �`„��� t--�` �: `n�fr SIZES&PRICING KIT °� f •f ° " 8'x12'. . . . . . . . . . . . . . $4,040 �'t 'fr` _ _ 4 - - ;x+ ,•• l 8'x14.. . . . . . . . . . . . . . .4,730 8'x16'. . . . . . . . . . . . . . .5,430 _ = - leer� x1 10' 2' . . . . . . . . . . . . . .4,990 - 10'x14' . . . . . . . . . . . . . .5.870 - 101x16' . . . . . . . . . . . . . .6,700 10'40' . . . . . . . . . . . . . .8,420 12'x14. . . . . . . . . . . . . . .7,080 12'x16' . . . . . . . . . . . . . .8,010 12'x20' . . . . . . . . . . . . . 10,040 12'x24. . . . . . . . . . . . . . 12,030 - .. 14'x18' . . . . . . . . . . . . . .9.390 x� 14 x20' . . . . . . . . . . . . . 11,790 ., 14'x24' . . . . . . . . . . . . . 14,060 i s Plus Tax eo The Islander has the same salt box roof design and charm as the Vineyard Overhang.This d6 design does not have the covered rear roof portion. It is all interior floor space, perfect for i people who prefer the saltbox style but have no need for the overhang.Add the craftsman trim package for a true architectural gem! t� �r `� l � +.,1 •� � � / ^�f-• �1��1� a �ti �;� � � f a r t �1,'J_J �' r' � _.._. IL Town of Barnstable Geographic Information System March 23,2014 110001020 #35 ) 1 110001019 #31 T� �s �10- �Q b %0, 111059 x0 0 18 Feet 110011 >xo DISCLAIMERS:This map Is to plamkq purposes only. It is not adequate for legal Map:110 Parcel:001019 boundary oetermhation or regulatory interpretation. Enlargements beyond a she of Owner:DI IULIO,DANIEL h MACK•DI IULIO, Total Assessed Value:$428800 Selected Parcel ED V-100'may not meet establIaW map accuracy standards. The parcel Ines on this map W E are only graphic represemeuons of Assessor's tax parceb. They are not true property Co-Owner: Acreage:0.80 acres Abutters bourdarles and do not represent accurate relationships to physical features on the map Location:31 IRONSIDE DRIVE } such as bwiiding locations Buffer z Town of Barnstable Geographic Information System March 23,2014 110001020 #35 oL 9 � 110001019 #31 Xl 111069 #0 08 Feet 11 011 DISCLAIMERS:This map is for planning purposes only. it is not adequate for legal Map:110 Parcel:001019 Selected Parcel boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:DI IULIO,DANIEL&MACK-DI IULIO, Total Assessed Value:$428800 1'=100'may not meet established map accuracy standards. The parcel lines on this map E are only graphic representations of Assessor's tax parcels. They are not true property Co Owner: Acreage:0.80 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location:31 IRONSIDE DRIVE such as building locations. Buffer S t , y Town of,Barnstable *Permit#26 G t-(7 4(9 Regulatory Servicesee m issue date • g rY • URtQgPABM • "M Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Lnprint Map/parcel Number Property Address 31 1RpKj5j-0E_ DR Residential Value of Work$ 101 000, Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address_ 1461 ih 1 1 UL.1 O I 3( lRnrlSl�F�D2 W. Bf}RuJ '7 �Bl.�.. Contractor's Name rl' T 1�f o2SSo Telephone Number '50�2- Lj 9 Home Improvement Contractor License#(if applicable)_[ 7 3-73 J_ Email: P U S S a JU Wwbo W SP 1•/07M 4W Cad!� j Construction Supervisor's License#(if applicable) rkman's Compensation Insurance Check one: ❑ I am a sole proprietor JUN 27 2013 ❑ I am the Homeowner [r]l have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name V_1dW'tY M JTU4 L� Workman's Comp.Policy# (ye.3 3 15 1��3 1 A'� (�— Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ''Replacement Windows/doors/sliders.U-Value 3 l (maximum.35)#of windows .2s #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 Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: A QAVYTFILESTORMS\building permit formAE)MRESS.doc Revised 061313 {F" �.;Y:,•� L f ✓` �lg_ti'j4#r'i m rYifb"t+?;��" �; 'x5:_ .=�a�df 4'S2•." � :�"`�+', tr �l y� 4 4 '� �'' ..r -� i- :,•.� �,:..7�v h�,,;�+y� �. k tIlk. J r � f�pr -'�i'�i ,�%��"�+� ��a: .� {r��, �:bw+47`' �� ,� •1� (R1� /�' ���'; it ,y���� Y����i� �h}' w rw;f., x { w ..,pt, ;A. ll .n f: .h ! ;•,f. r r # •;{ "4 d,. ✓_� {,.La .3.: ; ,�, � 4 ;s a'r �l e.y �n r �c, •'4?'"t !`��� � r. � i:d � FB�S' �f �w ',y^'.. L �} y�, n .s. y,4,{F�.V r •�.' £r.� f «�{ j":E a�Y»... x t ,} ��ii?,�'i ,:!'� i � 4 t f , I r ' i I I I f i t , Persson Construction, Inc. 22 Colony Ave. Bourne,MA 02532 Phone: (508)759-8959 PROPOSAL SUBMITTED TO: PHONE: DATE: 'tea! ,�i 1(IC I , $- off. -�P�'3� 6/3113 STREET: JOB NAME: ARCHITECT: 31 i 0 a1*i S fay. CITY,STATE AND ZIP CODE: JOB LOCATION: DATE OF PLANS: G.J. 6&ew 5 t 11 Bt-- � Lik We hereby submit specifications for: Remove Z windows from openings and remove to the dump. Install a_T_ Harvey . CLaSSw_ U;u yL_ replacement style windows into old openings. All windows come with double locks, half screens, and low-e glass. Windows come with lifetime warranty on frames and all working parts;and 20 year warranty on glass. Job site will be left clean. Options: ✓Advantedge glazing t.,-- grids L over fo full screens wkl color Mass Home Improvement Contractor's License # 102365 CSSL# 95507 You have 3 days to cancel this contract We Propose hereby to furnish material and labor-complete in accordance with above specifications,for the sum of: �� /plow, CO) 6 ND bpU49--s Payment to be made as follows: 14j-&b CO ,juJ,Jj &UA�JC_F_ aN C0 MP LE_--(761-J Any work preformed beyond the scope of this contract will be billed separately Authorized Signature: as extra work. This includes conditions d which could not be foreseen by the b contractor. In the event the customer does not keep the payment terms,work . shall cease,and customer agrees to pay any legal fees incurred to collect payment. work progress is subject to weather conditions. Note:This proposal may be withdrawn if not accepted within 30 days. Acceptance of Proposal—the above prices, specification,and conditions are satisfactory and are S1Q11atUTe:pt� hereby accepted. Payment will be made as outlined. Date of Acceptance: Signatur tref" ' • 4 .U. Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor Specialty License: CSSL-099507 KENT E PERSS�N 22 COLONYAVE.NUE BOURNE MA 02532,` ~� Expiration Commissioner 01/02/2014 V/Le Wanvr oquveaNt ol�eachuael&j face of Consumer Affairs&Business Regulation License or registration valid for individul use only before the expiration date. If found return to: OME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation egistration -'ti73732 Type: 10 Park Plaza-Suite 5170 Expiration-� 1a 014- Private Corpora Boston,MA 02116 PERSSON CONSTRUUT_I.ON INC: KENT PERSSON � 22 COLONY AVE. ••���"=%'" � %�--�_�- .I �i"p�� j BOURNE,MA 02532 _ Undersecretary Not valid without signature Persson Construction, Inc. 22 Colony Ave. Bourne,MA 02532 Phone: (508)759-8959 PROPOSAL SUBMITTED TO: PHONE: DATE: '�tc,1 D t l UL.li 0 -018-3(pa.—Y4P 3 2 sl3`13 STREET: JOB NAME: ARCHITECT: 31 /�q� s ram. °D-eL CITY,STATE AND ZIP CODE: JOB LOCATION: DATE OF PLANS: bi, &ww 5-rt1&-E t,(t We hereby submit specifications for: Remove Z� windows from openings and remove to the dump. Install 2�5' Harvey CLItSSW_ V a u yL— replacement style windows into old openings. All windows come with double locks, half screens, and low-e glass. Windows come with lifetime warranty on frames and all working parts, and 20 year warranty on glass. Job site will be left clean. Options: ✓Advantedge glazing e� grids L over (o full screens w&� color Mass Home Improvement Contractor's License # 102365 CSSL# 95507 You have 3 days to cancel this contract We Propose hereby to furnish material and labor—complete in accordance with above specifications, for the sum of: C� /p�pp0, co) -refi —rm U54 ND uu4cs Payment to be made as follows: X ,5—OW 43l , )Wu Jj 6&,A kF— 6ii CoMPLf--77't0 Any work preformed beyond the scope of this contract will be billed separately Authorized Signature: as extra work. This includes conditions which could not foreseen b the contractor. In the event the customer does not keep the payment terms,work shall cease,and customer agrees to pay any legal fees incurred to collect payment. work progress is subject to weather conditions. Note:This proposal may be withdrawn if not accepted within 30 days. Acceptance of Proposal—the above prices, specification,and conditions are satisfactory and are Signature:p` hereby accepted. Payment will be made as outlined. n Date of Acceptance: 3 Signatur : /`5 The Commonwealth of Massachusetts rDeparbnent o, IndustriaiAcciden& Office ofInmfigadons 600 Washington,Street Boston,MA 02111 n�rwmmassgov1dia Yorkers' Compensation Insurance Affidavit_BuMerslCon ' ians/Plumbers Applicant Information Please Print Upffily Name :��Krr �R sSo til Address: Aa C 0L oN-1 A✓G- City/State/Yip: Aoogpic` Phone# ?IS-I? OrT1 Arse,.you an employer?Check the appropriate box: Type of project(required): 1.fS1 I am a employer with 4. ❑ I am,a general contractor and i 6. ❑New construction employees(full andlar part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or parbw- listed on the attached sheet. 7. ❑Remodeling ship and have no employees. Tie sob-contractors have g_ ❑Demolition wodring for me in any capacity. employees and have Workers' [No workers'comp.insurance comp.insaranee.I 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 haue exercised their 1 L❑Plumbing repairs or additions myself [No workers'commp- right of exemption per MGL 12.❑Roof repairs insurance required.]l C. 152, §1(4),and we have no 13.[t6ther 'yiAmou.)1 employees.[No Workers' comp.insurance required-] ;Any appbcant that checks box#1 mast also fill out the section below showing their workers'coon policy infflrmatim Homeowners wbo sabaait this affidavit imcating they ate doing all work and tLm brie outside conuactors mast m it mit a new affidavit indicating such lConizactors that check this box mast attached as additional sheet showb g the name of fire sub-caortwcmw and state whether aruot those entities Lave employees. If the sub-contactors brim emplayees,they must provide rhea workers'romp.policy number. I am an empk9mr that isprvvkhWg workers'compensation insurance for my empiojwes. Below is the palicy and job site information Insurance Company Name: .J fQ JEc2T`1 V4Lrrud(— Policy#or SeSf=ins.Lic.#: td C S 315 US S 103 Q /2- Expiration Date: I&A-3 Job Site Address: 3! /,f0iV 5IDf I& City/Statelzip: W, AugRVS , 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 tie form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator. Be advised that a cagy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties ofpedury that the information provided above is bue and correct Signature: �'�-/Ju,��— Date: Phone#: Sd R 7S 9 8p� Ojj€cial use only. Do not write in this area,to be completed by city ortown ofrciaL City or Town: Permit/I,icense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.(drown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone 9: 6 Vic.F' rt w4f }xD .w i�Pfr7! *4 �1i�(iF �% � 3ki1�'> y �HlJ. y`yf� Ay� "ajyr 42A� �• •� '+ '{,rµ.���� �� 1 �4115 �� � -� 'Y � .;h•�{� 1 �i� 9Sy,�f k�j•�!} i i�� q�t`''�:1 �,y,�1,{.y��,� � g i71p. ` i !d""_I..`, ' ;Y•�.'y, IK•. %\L�#(� �'I• t_KN. � 'i��'��lM.i 1�3 1 ^ ��� ��. _S7'f� � .171�M�' i K� � i j. y '� � �,.}f� y��� �i�,r.�§� ;k�- 5`'f, ��•3h�.�" 1� � ,,,� '� n�.�,,; l t�6., , siry� � y �li- �,,. ,�t,Cr't�gy i;!• �'-D }. t �,`�7 � � .'1.. �� 1 ,ti i' Cyjj. 'i � e. �Y -w �::t di i - .:� � 'r,•: � �Rr�,� i �(r+.'Ft t 'A�M1;.(!, " _.3 -,, � F4��st t r %�i�i 3 � n�sT.�.a.�.,Y :�1 T ` S' 2 "c:�'- �'�t'• r ,i r .;Y�'^� ,��{i� � yy'L , q..q 1,. 1 I I i IME Town of Barnstable : 'Regulatory Services IMASS. Thomas F.Geiler,Director 3L639.� b.Ep�„�►+ Building Division , Tom Perry,Building Commissioner 200 Main Sheet,Hyannis,MA 02601 www.town.barnstable.ma.ns Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date QFORM&OWNERPERMISSIONPOOLS 612012 Town of Barnstable Regulatory Services Thomas F.Geiler,Director 3 61 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number sheet village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: - - - - city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OIL 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 i acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner;performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such 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. C:\Users\dewHikWppDatEL\Local\Microsoft\wmdows\Temporary Internet Files\ContentOutlook\QREGZUBN\E3l?RFSS.doc Revised 053012 al op Fr Town of Barnstable *Permit# O� ire 6 ma fr Exp om isue�e ' Regulatory Services Fee + + + RI MASS.TX 14�k1 Thomas F. Geiler,Director � Building Division Tom Perry, CBO, Building Commissioner. .- 200 Main Street, Hyannis,MA 02601 www.town:bamstable.ma.us Office: 508-8 62-403 8 Fax: 5 08-7 90-623 0 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Vadd without Red X-Press Imprint Map/parcel Number Property Address 81 fflow residential Value of Work '7,4po. Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address D4N D i 31 (Ito/V 5 i DZ. r7/: contractor's Name 420 j' af'. 5so6-J . Telephone Number TOZ' Some Improvement Contractor License#(if applicable)_ /Q 9, 3 :onstruction Supervisor's License#(if applicable) 7 9,56 7 PRESS PE MIT ]Workman's Compensation Insurance Check one: MAR 16 2012 ❑ I am a sole proprietor ❑ I am the Homeowner ['I have Worker's Compensation Insurance TOWN OF BARNST/aBLE isurance Company Namd -4t13c,a,'T-J PtoT t+LL orkman's Camp. Policy# 1,4&.1 . S(.5'343 lea b 1( opy of Insurance Compliance Certificate must accompany each permit :rmit Request(check box) 2 Re-roof(stripping old shingles) All construction debris will be taken to �&y,Q, )E_ ❑ Re-roof(not stripping. Going-over existing layers of roof) I ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum.44)#of windows *Where required: Issuance of this permit does not=cmpt compliancc with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License& Construction Supervisors License is required. IGNATURE: ¢ -s - ?'he-Common wealth-of-Massachusett — -— - Department of Industrial Accidents Office of Investigations . 600 Washington Street Boston,MA 02111 UV www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual):. 1(, KJT -Address: 2 COLONY -i9✓F__ City/State/Zip: BOOR K.)E- . . A4A- Phone.#: Are you an employer? Check the appropriate box: Type of project(required):; 1.LJ 1 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 ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp.insurance comp,insurance.t' ' ❑ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.[�,Roof repairs insurance required.]t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK.ORDER and a fine of up to$250.00 a day against the violator.-Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature• �;t - Date: %311G //Z Phonek 2r'4- 8'76_9 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#: J ' i Information 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 workon such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment tie 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 wont until acceptable evidence of eompliznce withthe 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-contiactor(s)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 permivUcense 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 io 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. r. The Department's address,telephone iri fax number:. The eammouwWth of Massachusetts Dgputment of Industrial Amidi mts Office of Invest gatiaus 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 of 1-$77-NIASSAFE Revised 11-22-06 Fax# 617-727-7749 ' www.mass.gov/dla I FROM-GH Dunn- BB 508-759-7177 T-095 P001/001 F-356 I / 8/3/2011 5:56r13 AM PST (GMT-8) FROM: insurahcevisions.com-TO: 15082950360 Pagel 2 of 2 `a�/o7 �- ,�co� CERTIFICATE OF LIABILITY INSURANCE DATE MluoDrrrrn THIS CERTIFICATE IS ISSUED AS A MATTER OF [NFORIAATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE 14OLDM THIS CERTIFICATE DOES NOT AFFIRMATNELY OR NECATNELY AMEND, E]CTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANGE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORED REPRESENTATNE OR PRODUCER,AND THE CERTIFICATE HOLDER- IMPORTANT: K the aertil9esrte holder in sin ADDITIONAL INSURED,the pollcy(les)mull be endorsed. If SUBROGATION IS WAIVED,subject to the tunm aed con tdons of the policy,certain policies mar require an endorsement. A statement on this cerifficafe does not confer rights to the cw1fflc#v holdwr In Geu of such andomament e. mmcER G H DUNN INS AGCY INC rrr Cr 191 MAIN ST PMOL4r 132 FAX(AIC BUZZARDS BAY, MA 02532 MURER AFFORONd COVERAGE ume e ►IatrRNLA: I I Egry MUTUAL CMLip INSUWP SON CONSTRUCTION INC °ISOIB' 22 COLONY"E M NSURsto: BOURNE MA 02532 INS UaBRo: N9IURER E: R�LIP.PR G: COVERAM CERTIFICATE NUMBER: 10821011 REVISION NUMBER_ THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LASTED 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 OEFTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDMONS OF SUCH POUCIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, R TYM OF NeURANCE POLICY m—tAwFR KNM POUCH'Erf f""brItrem In" sn1T r EACH OCCURRENCE S RENTeO CDMM5VJAL GENERAL LYtaMY 8O e i CLAN3MAtIED OCCUR MEDW(My onoporam) b PERSONAL A ADV INJURY f USNERALA00REGATE S GENLAaaw-iATELPAR APPLIES PM PR0pUCT6•00)APIOPA00 L KticY F1 PRo LOC i AIrrOMIOEp.E(.lAerLnY e S ANYALITO BODILY IN JLW 1Prpion) ALL1*M 3CHMULF�n UMN-YINJURY(Per 0=wwr AU= AUTOS HREO ALTOSAUTWer ocK�r� • s A LJAB OCCUR EACH OCCUIWENCE f EX LIM HCLATMO-MADE AGGRECATE i DED RETENTION i i b b A woroums CowBNSATION VyC2315-363103.011 Bl2/2011 8/212012 ,�TATu- 41�I Am fuPLDYCmr WAFLAV Y I N V=�IX p a N f A E.L.EACH ACOIDENT f 6n0 D (mwwwd..w"M Urn EL DI8[aA5t:.pA EAiLaYE i O E DTIONOFCPERATIONSbebw ELM-GASE•POUCYLI.UT f 00D 4 CRbTntr OR OPEAATIDItS/LAGTIOTI'SlV1.iiCLE3 ACOr�tet,Aaanl«Ia rta*m rI{r ecrvpuM,dmo,n ryem l■reeWrod) Workers Comperrsa6on Insurance:Part One of the pol)cy applies only to the Workers'CompcahnIon Laws of the Slate of MA. CANCEL SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES M CANCELL.Bo BEFORE - THE EVIRAMON DATE THEREOF, NOTICE WILL BE OeLNERfiD IN . ACCORDANCE WITH THE POLICY PROVISION& l AUTHORJ2E3I REPIMEFNTATIYE Jeff Eldrfdae ®i988-2010 ACORD CORPORATION. All rights reserved, C ACORD 25s(2010/65) / Tha ACORDp nanm and logo ere mglatsrbd marks of ACORD Sbl� corm uaulaw�:L ►4 F-PPe — aLZA"ve*vi ui y tl■u.d/m rtULcac:;. is r&�c 1 oe 7 So 3� Persson Construction, Inc. QQ 22 Colony Ave. CY' Bourne,MA 02532 Phone: (508)759-8959 PROPOSAL SUBMITTED TO: PHONE: DATE STREET: JOB NAME: ARCHITECT: f I�a�v piaE CITY,STATE AND ZIP CODE: JOB LOCATION: DATE OF PLANS: (/J� /3UX)5Z1qPLCL 1%.q We hereby submit specifications for: Strip off old roof shingles from entire roof and remove to the dump. Inspect roof deck. Install a layer of 30 lb. felt paper on entire roof deck. Install ice and water barrier on all eaves and in all valleys. Install new aluminum drip edge on all eaves, new flanges on all plumbing vents, and new flashing where needed. Install new 30 year Tamko architect style roof shingles on entire roo I Color will be � r it" Y, u.5� C, l Install Shingleve II ridge vents on all ridges. Job site will be left clean, and all debris will be removed to the dump. Start date (weather permitting) finish date MA HIC #102365 MA CSSL #99507 YOU HAVE 3 BUSINESS DAYS TO CANCEL THIS CONTRACT We Propose hereby to furnish material and labor—complete in accordance with above specifications, for the sum of: C-s 7 00� wv�,c>< ;7bL�,/�•Pv� Payment to be made as follows: ;e'Q.,40D.Od ADWxJ, e9ZA&icit O�J U'4149CE-MA.1 Any work preformed beyond the scope of this contract will be billed separately Authorized Signature: as extra work This includes conditions which could not be foreseen by the b contractor. In the event We customer does not keep the payment terrors,work shall cease,and customer agrees to pay any legal fees incurred to collect payment. work progress is subject to weather conditions. Note:This proposal may be withdrawn if not accepted within 30 days. _ Acceptance of Proposal—the above prices, Signature: �� I Q 1 c 1 JD I i specification,and conditions are satisfactory and are hereby accepted. Payment will be made as outlined. 3 I % Date of Acceptance: Signature: r� // /L i , ---- die anvnzoo a ' Office of Consumer Affairs Jsiness Regulation License or registration valid for individul use only VPESON HOME IMPROVEMENT CONTRACTOR before the expiration date. If foundreturn to: Registration: y=102365 Type: Office of Consumer Affairs andBusiness Regulation Expiration: 7/1/21012 Private Corporaticn 10 Park Plaza-Suite 5170 Boston,MA 02116' ROOF,NG ANUSIDING/IINC. Kent Persson 22 COLONY AVE. BOURNE,MA 02532` �Uzi% Undersecreta ry Not valid without signature ?M Massachusetts —Department of Public Safety Board of Building Regulations and Standards Construction Supervisor Spccialt License: CSSL-099507 KENT E PERSSbN 22 COLONYVENUE BOURNEMA 025 3F2 i �. Expiration Commissioner 01/02/2014 t opTME � Town of Barnstable *Permit# -3 7 fzf O� _.,._• Expires$m nths from issua ate�tBARN�� ; ,.... ._. .�._., :::::Regulatory Services..... Fee.. . eb ,gyp ,0 - Tfiomas:F.Geiler,Director -- ...._.. :...._.._ �...:...._:..Building•Division _.. Perry, Building Commissioner o .200 Main.-Street,- Hyannis,MA 02601--... - ��ESS PF -' ` �° ' _• Office: 508-862-4038 Fax:-508-79'0-6230 •-•. . ..::: :,.:..:;-.,..... :•;:•.:: :��.:;: �•....::. . ...... .. . . •. . . . ...•, :MAR, l,`.. 20�5 -..•. :::: � • • .- .... ... �XPRE•S�:�ERIGIIT��'�Y;IC•ATION - RESIDENTIAL •Q6= BARN ST,.';`�l, nn nn �Noott Valid without Red X-Press Imprint viap/parcel Number 11 D 11 1 W�2- ?roperty Address 1 N d(rc_-4 dto 2/Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's N.Tmma 012Z I l ` Telephone Numb . •moo / (�/�` �-T • Home Improvement Contractor License#(if applicable) � l) L`'f U Construction Supervisor's License#(if applicable) [ Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ am the Homeowner [] I have Worker's Compensation7nsurance —Uqsn" co, Insurance Company Name 1 Workman'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 be taken to ❑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:Forms:expmtrg Revise063004 Town of Barnstable do . Regulatory Services q0g Thomas F.Geller,Director Building Division �fo � TomPerry, Building Commissioner 200 Main Street, $yannis,MA 02601 wwwAown.barnstable;ma-us Fax: 508-790-6230 office: 508-862-4038 Property Owner Must Complete and Sign This Section If Using A.Builder n i I Lk 1 ,as Owner of the subject property �✓. �to�act on rnybehlf; ':hereby authorize:' �'C . l�Q t�7 j • a . i all nistters relative to work authorized by this building pernvt application for; w LAAd � 3 Signature of Owner Date Print Name �iU , o CAPIZZI HOME IMPROVEMENT INC . 3/m SPECIFICATIONS AND ESTIMATES PAGE 6 OF 6 STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I, OWN THE PROPERTY LOCATED AT IN MASSACHUSETTS. I HAVE AUTHORIZED CA I . I HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER: �— OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: I LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: 0 I APPLICANT'S ADDRESS: 1645 NEWTOWN RD. , COTUIT, MA 02635 APPLICANT'S TELEPHONE: 508/428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: ACCEPTED BY DATE THIS PAGE IS PART OF AND IN CONFORMANCE WITH PROPOSAL # •�6-06 03:57pm From-AIG 978-818-69U3 T-1Z4 N.UR/UUZ t-I[c e '1 1Ti '�•�I.•�I�,•' �' .i '• + ' 'J-ail....� n , ',.: '"tJ;•'fir,..•• :.,hl t t:r'''-E' '' '.,+ :9• i• �: �,,` �>ifJ�l:_';:;` Cekt' INSUiRANCEr•. .' , p` :f W�:•!j;t�'�t ',r,'� �01 �/0`k'. PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Employers Ins Group Inc HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Fitchburg, MA 01420 281 Main Street, #1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW 20 COMPANIES AFFORDING INSURANCE COMPANY A GRANITE STATE INSURANCE COMPANY INSURED Resourue Managements Inc 201 Main Street,SL(Ite#6 Pltchburg,MA 01420 THIS IS TO CERTIFY THAT'THE_POLICIES OF INSURANCE LISTED®FLOW HAVE BEEN ISSUED TO THE INSURED ' NAMEp ABOVE FOR THE POLICY PERIOD INDICATED,NOT WITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OP ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED THE POLICIES DESCRIBED HEREIN IS SW LMCT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.• -POLICY NUMBER POUCT MTFCTM DATE IOIJCY EXPIRATION DATE A COMPENBATION D C,MPLOyMIT UANZY EPROPRIETOW LIMITS ART+ cUT1vE PFIGp7.lAR� it'•'w•:.:. .::.i�M•.•�; it Na o sxc�Ct C Group 12f25/2004 12/25/2005 STATVTORYLIMrr3 0477182 !d; EA t.i• .�t„• r-APPtm m MA Operations OrOy, . _ EAGCM�%'r 5s POY LW S S00,0 E C PTION OF OPERATI0fISEl1/FiIiIXIgS/ppFGlpl rT1aRp9 S 100.ODC RE:COVERS THE EMPLOYEES OF THE NAMED INSURED LEASED TO:CAPIZ7J HOME IMPROVEMENTS INC,1645 NEWTON ROAp, OTt11T MA 02535. CERTIFICATE HOLDER ANCELLATION oprF-a CAPIZZI HOME IMPROVEMENTS INC MIRAMN DATE YHEREDF,TmtssutNCQCOMPANYWMLMDDCIES 09 F VORTOMA 12 1645 NEWTON ROAD DAYS WRITTEN NOTICE TO THE CSTFW LATE HOLDER NAM®TO THE LEFT.BUT COTUIT, MA 02636 FAILURE TO MAIL SUCH NOTICP SHALL IMPOSE ND OBLMTION OR LIMILrry OF ANY KIND UPON THe OOMpANY,ITS ACCHn OR REPMENTA1TVM AUTHORIZED REPRESENTATIVE l/� fiWdo"?B"uV9;aRegzula ;it'ol Stand=eff One AshbuF on Place - Room 1301 Boston. Massachusetts 02108 Hoene Improvement:-.Qogtractor Registration ` Registration: 100740 Type: Private Corporation Expiration: 6/23/2006 CAPI=I HOME IMPROVEMENT, INC. Thomas Capizzi, jr. 1645 Newton Rd. Cotuit, MA 02635 Update Address and return card.Mark reason for change. Address ❑ Renewal n Employment Lost Card ! ✓�ie L�onrmaor:caeall�i o�./l�aaaaclwaelto Board of Building Regulations and Standards License or registration valid for individul use only ,= HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: - Board of Building Regulations and Standards Registration: 100740 One Ashburton Place Rm 1301 Expiration: 6/23/2006 Boston,Ma.02108 Type: Private Corporation CAPIZZI HOME IMPROVEMENT,I %omas Capizzi,jr. 1645 Newton Rd. �_�,�, ,rz.✓ _ Cotuit,MA 02635 Administrator Not valid without "r ✓fie % -mmzonzuweall� o1,1&aa:aac1wse& BOARD OF BUILDING REGULATIONS ;. License: CONSTRUCTION SUPERVISOR u Number: CS 057032 _ Expires: 09/26/2005 Tr.no: 7171.0 Restricted: 00 THOMAS X CAPIZZI JR � 1645 NEWTOWN RD COTUIT, MA 02635 Administrator l Co11u1ro1rrtlealth ofAl'assachusetts Departinent of Industrial Accidents ' - atice al/ffresagalioas r 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit I location: f1LY ❑ I am a homeowner performing all work myself 1[Lonc ❑ I,am a sole proprietor and have no one working in any capacity am an employer providing workers com ensatton for my employees working on this fob. -15 ILI atidre 11i` L �`c1 phone H (t I Ila W=C ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who h;•: the following workers'-compensation polices: cIfv :: Dhorie� comoany:neme• chip• shone b irisnrJtnccco' policy d Failure to secure coverage as required under Section 25A of l%1GL 152 can lead to the imposition of criminal penalties of s fine up to S1,500.00 andhur one yearn'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of St00.00 a day against me. I understand that a copy of this statement may be forwarded to tlhc Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and p allies of perjurt�that the information provided above is true and correct Signature ly, I Date _ Print nJtrttc Phone d •�'I I I`r\ �h n •C 1 official use only do not write in this area to be completed by city or town official city or town: permittlicensc M -Building Department �y QLiccnsing Board Q check if immediate response is required [)Selectmen's Office C)liealth Department (contact person: phone q; -O(her Vcviucd V95 P1A) 27 Harvey Industries A Proud ENERGY STAR Partner H.u-VVy Vinyl \AliIKIMA+,My I'IN I1'RGY SIi1R (ILIAIIWd thr0u( hout (Iw U.S. w+ith I.ctw-I"Mrg(m ghtr.ing: LNFAGY S AR qualified w+indmA!S arc 40%) more (•flick llt than \,vinclowS thilt nu•Ct MOSt national Ixlildin CocICS. 11' all i)roduc'ts in the U.S. wcrc I;NE'RGY S AR qualified, W(Al saVC $100 1)IIII0Il in energy costs over the ncm 15 years. 1?NEAGY S'1AR windows arc good frn- the cnVirollnunt, using ICSS fiOSSil fuCls which CausC air i)0111.10011, smog, and global warming. Source: U.S. De)xirtment of Ewro.Must use Low-E/Argon to uchiLw ENERGY STARrctting. U and R Values U-Value: A nu•asurc of heal I]-:msmission. Flu• lower the L1-\alit•, the Icss heat hiss. R-Value: A mcastn•c of it winclow's resist,ulcc to hcm conduction.Tllc higher the R-\ahtc,the hello a willdow is able to insnlatc. V-V:du-in ac-rdmur aiih NHW-Illo,bawd nu ehulr\,ho-,.:du.,. Clear Insulating LOW-E _1,o\\'-1?/Ar<on* >Air Infiltration VINYL WINDOWS U-Value R-Value U-Value R-Valuec =U-Value R-VtI c el'm/fl' ChISSi(•Double Hung(Nlec•hanical) 0.50 2.00 0.37 2.70 0.3-1 2.91- .(lei ChLssic•1)01,11)1c HungOV(-Idcd Sash&Franu') 0.49 2.04 0.38 2.63 0.34 2.94` 10 Classic Acoustical Doublc Hung Sl'C.40 033 3.03 0.25 •1.00 -0.24 -1 1.7 ] .09 Signature Double Hung(M(TIIani(•al) 0.50 2.00 0.37 2.70 ' U.31 2.94 04' SlimliIW D(lttblc Hung OVeldc'd Sash& Franx•) 0:50 2.00 0.37 2.70 0.33 3.03 .09 5liniline Single Hung OVc](1ccl Sash&Frame) 0.50 2.00 0.37 2.70 0.33 3.03 .08 Vinyl Casement/Awning 0.4.7 2.13 0.36 2.78 0.33 3.03 .01 \/illy] Casement/Awning&'Thermal Pancl 0.32 3.13 0.26 3.85 0.25 4.00 .01 Vinyl Designer Shapes 0.49 2.04 0.34• 2.94 0.30 3.33 ---- Vinyl Hopper 0A•7 2.13 0.35 2.86 0.32 3.13 .08 Vim-] Picture\\'inflow 0.4-6 2.17 0.31 3.23 0.28 3.57 .01 Vinyl Rollcr-2 i,itc&3 l,itc 0.50 2.00 0.:311 2.63 0.35 2.86 .09 VINYL NEW CONSTRUCTION WINDOWS (2-Iilr) Vi(-on D(n11)Ic Hung(\Vcklccl Sash&FI-MM) 0.50 2.00 0.37 2.70 0.33 3.03 .10 Vicon Single Hung 0Vddcd Sash&Franu') 0.50 2.00 0.37 2.70 0.33 3.03 .10 Vicon Classic Double Huttg(\\'c•Idcd Sash& Frame) 0.49 2.04 0.36 2.78 0.33 3.03 10 Vicon C.Lticmcnt/A\\,tting 0.47 2.13 0.3-1 2.94 0.31 3.23 .01 Vicon Pic•lurc•\\'inflow 0.47 2.13 0.32 3.13 0.28 3.57 .01 Vicon Designer Shapes 0,4-8 2.08 0.32 3.13 0.29 3.I�i .0I Low-E/Argun** Low-E/Krypton** Air infiltration WOOD WINDOWS U-Value R-Value U-Value R-Value tMa.1csty Doublc Hung N/A N/A 0.35 2.86 13 ;Majesty Fixed Casc'mc m(mv) 0.36 2.78 N/A N/A JH 1\laic•sty(4scmcm/Awnilig 0.4-I 2.4.1 N/A N/A .02 t\1aicsty Pic•turc\\'inflow(DI-1) 0.3.1 2.9.1 N/A N/A .10 Tempered Tempered Tem)ered DbI.Temp. Air Infiltration Clear Low-E Lo\v ./Arg Low-E/Arg el'n,/ft' PATIO DOOR U-Value Ii-Value U-value R-Value U-value R-Value U-Value R-value Hal-vc'y Solid Vinyl Patio Door 0.49 2.04 0.41 2.50 0.37 2.70 0.35 2.80i .09 *All vinyl windows with Low-E/Argon qualify for the ENERGY STAR program throughout the U.S. "The use oh tempered LOW-1:glass mad•clli-cl BNI?RG),S AR(Iualilicatiun in)-out-rc;giun. U-and R-Values arc subjcc•I to ch:uigc tcithuut nulic•c. 11/04/2002 12:48 915087906238 PAGE 01 Applicstion to Old Kin is' Highway Regional Historic District Committee g in the Town of earnmble for 9 CERTIFICATION OF EXEMPTION Application is hereby made, in triplicate,for the issuance of a certificate of exemption under Section 8 and 7 of Chapter 470, Acts and Resolver,of Massachusetts, 1973, as amended for proposed work as described below and on plans,drawings,or photo• graphs accompanying this application. _��O� TYPE OR PRINT LEGIBLY 0 DATE ADDRESS OF PROPOSED WORK �v ASSESSORS MAP NO,' D O OWNER t w ASSESSORS LOT NO, ...�A. A �W[�BSc (hD�f .. b� HOME ADDRESS TES.N0. AGENT OR CONTRACTOR ADDRESS "6* ' NAAkA TEL.NO. Th's application is for exemption of proposed•exterior construction on the ground that: (1) It will not be visible from anyway 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 on addition Is Involved,show• ing location of existing building. P� w, MOWi�. -rv\ � vyu C G�� tl tr vJ ' 121Y40 SIGNED OwnerCantr ►•Agent Space below line for Committee use. Received by H.D.C. The Certificate is hereby Date ,fTime By Dote Approved ❑ The categories of work entitled to exemption ere listed on Disapproved 0 the back of this form. �TMt=' ti The Town of Barnstable Department of Health, Safety and Environmental Services • a�utasresrt.. _ Building Division j, is� ,0�' 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph M.Crossen Fax: 508-790-6230 Building Commissioner Home Occupation Registration Date: L2— Name: o r done#• 3�a . ba Address: village: Type of Business: Map/Lot: b d INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4.1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pickup truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. j • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have re d agree with the above restrictions for my home occupation I am registering Applies; Date: Homcoc.doc *IMF , TOWN OF BARNSTABLE Permit No. ......:...06.i<l377 �&�6 BUILDING DEPARTMENT I ""'r ! TOWN OFFICE BUILDING Cash ,Ii• HYANNIS.MASS.02601 Bond „X............ CERTIFICATE OF USE AND OCCUPANCY Issued to Horsefoot Holdings of Cape Cod Address 31 Ironside Drive West Barnstable, MA 02668 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. July 13 95 ...... .. .. ...... ..... . .. .... 19................. ............................ ............... Building Inspector ; N LOT 40A CO! �, yam• LOT 39A ►_, �d 34,773 + S.F. (0.80 ± AC.) O b � 57. 3'CONCRETE FOUNDATION C b TY 76.3' 6� 10A 76 1g1 E SY PG opE� JOB # 94-039 L39A CERTIFIED PLOT PLAN PREPARED FOR LOCATION : ASES MAP 110 PAR 1-19 IRONSIDE DR. W.BARNSTABLE SCALE : 1" = 401 REEF REALTY REFERENCE : LOT 39A PLAN BOOK 421 PACE 57 � I HEREBY CERTIFY THAT THE STRUCTURE `cT�� OF y � 9 SHOWN ON THIS PLAN IS LOCATED ON THE t z, GROUND AS SHOWN HEREON. R DEMAR"ST,JR. 0 No.36859 a DEMAREST — McLELLAN ENGINEERING SUR��� 24 SCHOOL STREET P. 0. BOX 463 MAY 19, 1995 WEST DENNIS, MA 02670 (508) 398-7710 DATE OFE IONAL LAND SJjEYOR Otis ull NWPE' Wl IT— 19 PERMIT NO. �ArildG{ANT GVi'Yr.tt '�. �(2l`a:,:ilo ADDRESS B10. 30:: 18bv «. Dt.Y'P .. 032809 (NO.) (STREET) (CONTR'S LICENSEI PERMIT TO ull'_ Ct. QWr- ii:,•: Si-, -L< _L.mil j residence NUMBER OF 1 (=) STORY DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) 31 irmi.:;ide :)2-_�•'�=• Ini=��r -'31:c.`sZ'.::b.1�.' ZONING ZC DISTRICT (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) SUBDIVISION LOT 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,_,wagu ir95-1033 AREA OR )• C• 136,000 PERMIT "=3•48 VOLUME ESTIMATED COST � FEE (CUBIC/SQUARE FEET) OWNER i'_i li!)t Holding Ot C%pe C., ). 3tr: liib W• DeT111�c> i'A 026) ) BUILOkNG ADDRESS ' ' BY z -'' 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 THREE CALL -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND 1. 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 INSPECTION TI TO LATHE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POSUrIHIS CARD SO IT IS VISIBLE FROM STREET BUILDING IN IO AL PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS q 04 w d,J Na1�-/tcC,�Jtb liuv>3 jr 3 HEATING INSPECTION 4ROVALS ENGINEERING DEPARTMENT 1 / _9S�OLTH OTHER SITE PLAN R IEW APPROVAL WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. Assessor s Office 1st floor Ma �,! Lot b ✓� t t i � / Permit# Conservation Office 4th floor Si; -2432; /QfDate Issued ✓r 9$` Board of Health Ord floor 9-y- 0.33 0- ve Engineering Dept. Ord floor) House# 3 l 1•='.15 Planning Dept. 1st floor/School Admin.Bldg.): MAW • �t+areei.t. _ Definitive Plan Approved by Planning Board � v G 19 A lications rote -9:30 a.m.& 1:00-2: m. SY MUST D _ AR CODE)--) TOWN OF BARNSTABLE Building Permit Application M-'�� � TI0Nd Project Street s 1' -3q A --r:p b �fLti UP C �rs r lr� 39 0� j Village i✓�'r �II(RNST>tk$L� Fire District E^7-rls1"14I3L Owner "OKSP—C20C51 "1.( 1 (Dr-C C. Address P j Telephone SOO_ �`�a-�•—3C3�� Permit Request: /a7L4r Zoning District ^ r Flood Plain Water Protection Lot Size 34,"6?s Grandfathered Zoning Board of Appgals Authorization Recorded Current Use NLbQ tj—t' Proposed Use RgS.- M F "y I aI-- Construction TypeSPA M¢ Existing Information Dwelling Type: Single Family Two family Multi-family Age of structure N EAU Basement type --9b n C� fc-y—,, r r= Historic House Finished Old King's Highway !#I I Qr S _ Unfinished V Number of Baths —t:3 No of Bedrooms tit, Total Room Count(not including baths) 1 First Floor s Heat Type and Fuel PA W q S Central Air Fireplaces ©►v im j Garage: Detached Other Detached Structures: Pool Attached `'rujo CAM(— Barn None Sheds Other Builder Information Namc ]EVt R?-t-r 413 -R6i .Ay(— - Telephone number �-3cj:yo Address ?.p License# y::5 z 0!7 LV r �A[!�t is M►4 Home Improvement Contractor# Worker's Compensation # C44- r NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Project Cost 1 cs Fee 5. -/8 SIGNATUREEllDATE ► L�j ,� BUILDING PERMIT DENIED FOR THE FOLLJMG REASON(S) z979- /s T/ '"" ' `� rn� BPERM T iv0 G�9 FOR OFFICE USE ONLY y, 5/3/95 —37- 06 110.001.019 AbDRESS 31 Ironside Drive VILLAGE West Barnstable Horsefoot Holdings of Cape Cod OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL d GAS: ROUGH FINAL FINAL BUILDING: i DATE CLOSED OUT: ASSOCIATE PLAN NO. e X L` L • i COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY •s a ccnm�t OF ONE ASHBORTON PLACE MASSACHUSETTS BOSTON,MA 02108 C"`-"`i`cc.:so terrcvoccfloq� of iSf.;li;.4r rv. L I C E%-S E CAUTION EXPIRATION DATE C G 1 S T Ft. S Lt^E R V I S 0 R 3/11/19 9 6 EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST ; .,• RESTRICTIONS THEFT, PUT RIGHT THUMB NONE o ')6/30/1993 '032809 a PRINT IN APPROPRIATE i BOX ON LICENSE. 61513 o k'J[PF—TT a BOY JR g H 0 X 186 BLASTING OPERATORS c W DENNIS MA, 02670 m MUST INCLUDE PHOTO. PHOTO"TING OPR ONLY) FEE: ,I - PAID �♦;,..,, 100.00 NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: s PED-oR-SIGNATURE OF THE COMMISSIONER ;� JUN 9 1993 �'"'j�j;i+lii',.<r:?"•T+�'i�i`J:' THIS DOCUMENT MUST BE « SIGN NAME W FULL ABOVE SIGNATURE LINE 2a CARRIEDONTHEPERSONOF GNATURE OF LICENSEE t,.:-. •V� I�1G1��+;;3.. 1/'�lilf�Il - `:: THE HOLDER WHEN EN- . '. •-�'-"-- A l�f'T �'PND,fT GAGEDINTHISOCCUPATION. ISSIONER D.P.S. Commonweak._.01 Mamackwetti 2epartntent o1 J zLjt ia[—AcciL t� 600 f/V..4k.9ton Street James J.Campbell !/�ojton, Massac�ikeette 02111 Commissioner Workers' Compensation Insurance.Affidavit (licensee/permi,,ee) with a principal place of business at: - !,� - v o city/sore/zip) do hereby certify under the pains and penalties of perjury, that: /`(-)"""'I am an employer providing workers' -compensation coverage for my employees working on this job. Insurance Company Policy Number O 1 am a sole proprietor and have no one working for me in any capacity. () I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Number. Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number () I am a homeowner performing all the work myself. understand that a copy of this statement will be forwarded to the Office of Investigations of the DIA for coverage verification and that failure co secure coverage as r fired rider Section 25A of MGL 152 can lead to-the imposition of criminal penalties consisting of a.fine of up to 51,500.00 and/or one years' impr onment well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. Ot Signed 's — day of 19 � Licen ee/ rr ttee Building Department Licensing Board SeIectmens Office. . .. Health Department .:._ _6....:.: TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403,'404,•405, 409;..375.. • Application to Old King's Highway Regional Historic District Committee in the Town of Barnstable for a' CERTIFICATE OF APPROPRIATENESS Application is hereby made, iri triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: [;� New Building ❑ Addition ❑ Alteration Indicate type of building: C� House ] Garage ❑ Commercial ❑ Other 2. Exterior Painting: R] 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_J=ri 1 3, 19g5 ADDRESS OF PROPOSED WORK Lot 39A Ironside Dr. . W.Barnstable ASSESSORS MAP NO. 1 1 n OWNER _____Horsefoot Holdings of Cape Cod, Inc. ASSESSORS LOT NO. 39A HOME ADDRESS P.O. Box 186, W. Dennis, MA 02670 TEL. NO. 394-3090 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). I *** SEE ATTACHED LIST OF ABUTTERS *** AGENT OR CONTRACTOR Everett W. Boy, Jr./Reef Realty Ltd. TEL. NO. 394-3090 ADDRESS P.O. Box 186, W. Dennis, MA 02670 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). 50' x 26' four bedroom colonial style new dwelling two car drive under garage red brick fireplace, full walkout cellar in rear4fhoe.,, � DD0 0 D Signed Space below line for Committee use. Received by H.D.C. Date r The Certificate inhere y Date —I Ti me By Approved ❑ IMPORTANT: If Certificate is approved, approval is subject to the 10 day appeal period provided in the Act. Disanoroved 71 ADDITIONAL INFORMATION FOR MAKING AND FILING AN APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS The four categories for which a Certificate of Appropriateness is required are: (application for demolition or removal is a separate form). 1. EXTERIOR BUILDING CONSTRUCTION (new or existing buildings): An application is required for any exterior of a building to be erected or altered including windows, doors, siding, roof, light etc., that will be visible from any public street, way or public place. The following scale drawings are required in duplicate with application: plot plan (if addition — show existing buildings in outline), floor plan and elevations. Also required are snap shots of existing buildings, where additions or alterations are to be made. No plot plan is required for addition or alteration which does not touch the ground. 2. EXTERIOR PAINTING: An application is required for any portion of a building, structure or sign to be painted that is visible from a public street, way or public place. Color samples must be attached to these applications. An application is not required when repainting existing colors, changing to white, or using colors approved by the Town Historic District Committee. 3. SIGNS OR BILLBOARDS: An application is required for any sign or billboard to be erected within the District, with the following exceptions: a. Existing signs or billboards on November 27. 1974 shall have until November 27, 1977 to secure an approved Certificate of Appropriateness. b. Temporary signs for use in connection with any official celebration or parade or any charitable drive as long as they are removed within three days of the event. Certain other temporary signs that the Committee feels does not detract from the Act may be allowed with the prior permission of the Committee. c. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they are erected or displayed. d. A single sign of not more than 1 square foot in area showing the name, occupation or address of.:the occupant of the premises on which they are erected or displayed in a residential zone. 4. STRUCTURE: An application is required to build or alter any structure within the-District which is defined by the Act as a combination of materials other than a building, sign or billboard, but including stone walls, flagpoles, hedges, gates, fences, etc. GENERAL REQUIREMENTS 5. Work on projects requiring approval shall not be started until the Certificate of Appropriateness has been filed with the Town Clerk by the Committee. Approval is subject to the 10 day appeal period provided in the Act. 6. No changes shall be made from the original approved specifications without advance approval of the Commission on an amended application filed with the Committee. 7. A separate application must be filed with each project requiring a Certificate of Appropriateness. 8. Under heading of "Detailed Description of Proposed Work" give detailed data on such architectural features as: foundation, chimney, siding, roofing, roof pitch, sash and doors, window and door frames, trim, gutters —leaders, roofing and paint color. 9. Unless application is complete and legible and all material required is supplied, application will not be accepted or acted upon. Copies of the Act establishing the Regional Historic District may be obtained at the Town Hall. e i Old Kings Highway Barnstable Lot 39 A Ironside Drive Abutters: John M. Kelly Tr. High & Cedar Streets P.O. Box 560 Mashpee, Ma 02649 Seaside Assoc. P. 0. Box 29 Momument Beach, Ma 02553 Elsie Crowder 46 Camp Street West Yarmouth, Ma 02673 Weeks Crossings Comm. Assoc. P. 0. Box 560 IVlashpee, Ma 02649 Ronald and Kimberly Passalugo 35 Ironside Drive West Barnstable,.-MA 02668 OLD RING'S HIGHWAY HISTORIC DISTRICT SPEC SHEET FOUNDATION Poured Concrete Sides/Rear: White cedar shigles Natural SIDING TYPE Front: Red cedar clapboards COLOR Hopi White CHIMNEY TYPE Brick COLOR Red (new/used) ROOF MATERIAL Asphalt Shingles COLOR Weatherwood I PITCH 7° '. WINDOW Rivco double hung w/grilles 8/8 SIZE 24/24 TRIM COL OR White DOORS Paneled Steel COLOR Blue Spruce SHUTTERS Vinyl Color: Blue Spruce GUTTERS Seamless aluminum (white) DECK Pressure treated wood (natural) GARAGE DOORS Paneled masonite COLOR Hopi White NOTES: Fill out completely, including measurements and materials/colors to be used. Three copies of this form are required for submittal of an application, along with three copies each of the plot plan, APPROVED landscape plan and elevation plans, when applicable. Plot plan need not be "Certified" , but should show all structures on the lot to scale. SPECSHT ww � Q4 > q air ) v CI3Cq +� , O �o a� �66 y NOV 02 194 03:59PM REEF REALTY Lam" LOT 404 `� 01NACk' PSa• 7yr IRONSIDE *' DRIVE LOT 39A Q 03±,S. . 6 LN xj +.D. �9 -%x 6 ek +a, PROPOSE ?' DECK I t%k OF l,�q SKETCH FLAN JOINZ. �E1AMrf. JP PREPARED FOR: REEF REALTY NOV. 2, 1994 DATE F SIOM L LAAm S OR LOCATION : ASES MAP 1f1 PAR 1-19 IRONSIDE DRIVE WEST BARNSTABLE REFERENCE : LOT 39A PLAN BOOK 421 PAGE 57 DM SCALE : r = 50' DEMAREST—NCLELLAN ENCINEERING 24 SCHOOL STREET P.O. BOX 463 DATE : NOVEMbER 2, f994 PrEST DENNIS. MA. 02670 i I ENVIROTECH LABORATOWES, INC. • MA Cert. No.: M-MA 063 449 Rte. 130 . Sandwich,MA 02563 (508)888-6460 . 1-800-339-6460 FAX(508)888-6446 CLIENT: Reef Realty LOCATION: 39A Ironside Drive ADDRESS: P.O. Box 186 W. Barnstable, MA W. Dennis, MA 02670 SAMPLE DATE: 12-20-94 COLLECTED BY: Clifford Well Drilling DATE RECEIVED: 12-20-94 -TIME: . 2:30PM SAMPLE I.D. : 152 JOB TYPE: New well WELL DEPTH: N/A RESULTS OF ANALYSIS: Parameters Units Recommended Limit Result Coliform bacteria/100m1 (MF Method) 0 0 pH pH units 6.0-8.5 6.20 Conductance umhos/cm 500 102 Sodium mg/L 28.0 8.7 Nitrate-N mg/L 10.0 0.10 Iron mg/L 0.3 0.05 Manganese mg/L 0.05 0.007 Volatile Organic Compounds See report enclosed EPA 601/602 ug/L Chloroform 1 Yes No WATER IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED. XXX 1 Date 47- c� Ro ald J. aari r Laborato Director IT = Less Than • GROUNDWATER ; ANALYTICAL EPA METHODS 601 and 602 Volatile Organics (GC/PID/ELCD) Field ID: 152 Lab ID: 9552-01 Project: Reef/39A Batch ID: VG2-0515-W Client: Envirotech Sampled: 12-20-94 Cont/Prsv: 40mL VOA Vial/HC1 Cool Received: 12-20-94 Matrix: Aqueous Analyzed: 12-21-94 PARAMETER CONCENTRATION REPORTING LIMIT (u9/L) (ug/L) Dichlorodifluoromethane BRL 5 BRL 5 Chloromethane BRL 5 Vinyl Chloride BRL 5 Bromomethane BRL 5 Chloroethane BRL 1 Trichlorofluoromethane BRL 1 1,1-Dichloroethene BRL 1 Methylene Chloride BRL 1 trans-1,2-Dichloroethene BRL 1 1,1-Dichloroethane BRL 1 cis-1,2-Dichloroethene * B 1 Chloroform BRL 1 1,1,1-Trichloroethane 1 BRL 1 Carbon Tetrachloride BRL 1 Benzene BRL 1 1,2-Dichloroethane Trichloroethene BRL 1 BRL 1 1,2-Dichloropropane BRL 1 Bromodichloromethane BRL 5 2-Chloroethyl Vinyl Ether BRL 1 cis-1,3-Dichloropropene BRL 1 Toluene BRL I trans-1 ,3-Dichloropropene BRL 1 1,1 ,2-Trichloroethane BRL 1 Tetrachloroethene BRL 1 Dibromochloromethane BRL 1 Chlorobenzene BRL 1 Ethylbenzene BRL 1 meta-and Para-Xylene * BRL 1 ortho-Xylene * BRL 1 Bromoform BRL I 1,1,2,2-Tetrachloroethane BRL 1 1,3-Dichlorobenzene BRL 1 1,4-Dichlorobenzene - 1,2-Dichlorobenzene BRL 1 QC SURROGATE COMPOUND SPIKED MEASURED RECOVERY QC- LIMITS a,a,a-Trifluorotoluene 30 31 102 % 87 - 113 % 1,2-Dichloroethane-d4 30 33 109 % 83 - 117 % I BRL a Below Reporting Limit. * Non-target compound. Method References: Method 601 - Purgeable Halocarbons and Method 602 - Purgeable Aromatics, 40 C.F.R. 136, Appendix A (1986). i --------------------------------------------------------------------------------------------------------- f �E '1 �V rA- P S f eC=MD am S � !i Comm bi o i11 ] � D I�� - I L.--j i � lik m - -l1•:iJ; x it �t it i -,�k 'j•,II Tlil 1 ��•� EMI o-- _ �Illi,, N r1!11� rrt f. J Til to �- RI G .4. .N I v 17%71 v �0- 0 'p � F -711" v �_• 1"l'�d �F O r-1mVrom>� I'Ps 9 G L Z" rj 0 aSP- oZ ,�r- a — � u5 um`� aNm -vv r i n CN NNNC 01i1` -c x k } V lP x - n I R O K % I -0; P6 C,cC, 6 I ar. =.NCWck oO 0 fj S IR C ADAtJ O 4 A �� � K n o v _ 1% I y o < b � . Z N N J4 Ak , o F m Qr 31 OFol•_ tl M �m � „ a r N 0 � It � \ r �� F\\ � F r\r\ Z� •� � � N 9 p b � 1 �.l�l• r N h�ON N � �,• NON W 0 J6{ �0 < n Ipi IN m pn 61 � _T —1 r� � 1V N VIp ,Ih O� nN 31 T Lh i 0 �� - � n\t (6p 14 1 N iofp��6 e i I u 1 j1 1 1 19 Ib • N 9 �N N l -� J s I t � dIW o.0 ovCiG I u I r �rTb f� I— „ 4R � � I d � 3 4- 4Fl r _ t: M fr,,t.t:C FoP FAR tmNE-uNoL Sit = IZtr E-'ERosT Font. R s4waoa 24 o i o� r i (� r r 3 4 - Q N ASSESSORS P: -170 -------- -� PARCEL: 1-19 KEY: EXISTING CONTOUR: y} PROPOSED CONTOUR: .............................. ENGINEER: DOYLE ENGINEERING 1. VERTICAL DATUM. ASSUMED FROM QUAD (NGVD �. CURRENT ZONING: RF EXISTING SPOT ELEVATION: 25.5 1 WITNESS: JERRY DUNNING 2. MUNICAPAL WATER S NOT AVAILABLE. o E+ BUILDING SETBACKS: DATE: 4 S. SCHEDULE 40 - 4" PVC PIPE TO BE USED THROUGHOUT SEPTIC SYSTEM. 9 PROPOSED SPOT ELEVATION: -10-87 F: 30' S: 15, R:15 TEST HOLE: PO 25 PERCOLATION RATE: < 2 MINIIN 4. ALL PRECAST UNITS TO CONFORM WITH AASHTO H-10 8c H-20 ,4�• LOADING SPECIFICATIONS. FLOOD ZONE: C UTILITY POLE: -0- TH-1 TH-2 5. PIPE PITCH =114" PER FOOT(UNLESS NOTED OTHERWISE). FENCE LINE: 61.0 661 6. FIRST 2' OF PIPE OUT OF D-BOX TO BE LAID LEVEL. 5 HYDRANT: -b- ELEV ELEV Lows . ® TOP SUBSOIL 7. THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE RETAINING WALL. USE OF A GARBAGE DISPOSAL. .O ss' __m S. ALL CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE STATE OF MASS. ENVIRONMENTAL CODE (TITLE FIVE) AND LOCAL LOCATION MAP MEDIUM MEDIUM - HEALTH REGULATIONS. LOT 39A WITH WITH 9. CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR 34,773 SF COBBLES ,ANBD La TO CONSTRUCTION. GRAVEL GRAVEL 10. PROPOSED SEPTIC SYSTEM AND WELL LOCATIONS ARE IN ACCORDANCE WITH MASTER PLAN, ON FILE WITH THE BARNSTABLE HEALTH DEPT. do 138- 1 1 49.5 126- 1 11. DESIGN ENGINEER TO VERIFY SUITABLE SOIL CONDITIONS TO A DEPTH d 'r° 1 ? S� NO GROUND'IIdTa'R•aNCOUNTLrRED OF 4' BELOW LEACH PIT AT TIME OF CONSTRUCTION. 1 { 1 { 1 (SITE TO110GAIP Y SHOWS NO I { 1 6'6 EXISTING WELL GROUNDWATER AT ELEV.- 34) `P,r I ' ' co ' BENCHMARK AT SEPTIC SYSTEM DESIGN { CATCH BASIN ELEV a 805 50'FECK I5cr yi♦ ♦ . II II ' / /I , 'I {I I 1I II I ` y$aLIr o pG) FLOW ESTIMATE: PROPOSED A�8I UTILITY CLUSTER BEDROOMS AT110 GAL DAY BEDROOM =, GAL DAY 5 BEDROOM z4' 26' DWELLING DWI rj ' ' . ' ' 1 I , , ` is sA PROPOSED WELL SEPTIC TANK: CAR ' ' '�' ' I ` `� \ �� ' (.EACH PROPOSED ,'5Q_GAL/DAY * 1.5 DAYS = 825 GAL s6' ,�- I , , 1 ,' USE 1500 GALLON SEPTIC TANK PROPOSED DWELLING TH-z LEACHING AREA: USE TWO LEACH PITS (6' x 4'J WITH 3 0' OF STONE j , I 112' EFFECTIVE DIAMETER x 4' DEEP) 7 y so - ' ' '66 :i' 68 •.. % ti°` /o 1s �e 490 so SIDE AREA. 12 x Pi x 4 = 151 SF (2.5) = 377 CAL/DAY BOTTOM AREA: 6 x 6 x PI = 113 SF (1.0) = 113 GAL/DAY -' / �♦ /' / IRoN E TOTAL CAPACITY. - 490 GAL%DAY D x 2 PITS = 980 CAL/DAY - 1 e SEPTIC SYSTEM SECTION z" PEASTONE � . ' � � ' � � � � � _ - - 4 58F� �' I OF3/4" - 1 1/2- cavERs WITHIN 12' ' ' ' • ' • , _-s r - T•�`'�eo - - - 78.0 of FINISHED GRADE WASHED STONE TOP OF FOUNDATION y UTILITY op' � I / 90 7 CLUSTER 8 o �.......... 80 EDGE OF PAVE \,68.43 60.83 4. o ' ,' /' ♦ I eo 68.68 1500 GAL ELEV. D-BOX ELEV. LP-1. 47.5 ELEV. SEPTIC TANK 61.0 ELEV. 43S PROPOSED WELL ELEV. LP-1. 51S �—.. ♦ i 69.0 LP-2. 47S 3' ELEV.-(UNDER TEE SIZES: ' PROPERTY LINE INLET: 6" UP, 10" DOWN ELEV. .---- f2' --► (WORK LIMIT LINE) BASEMENT OUTLET: 6" UP, 19" DOWN TWO LEACH PITS (6' x 4') WITH / 3' OF STONE (12' EFF. DIAM. x 4' DEEP) (H-20) � 76. o BE STAKED FLOOR) of �g�• �e BREACKOUT CALC: (52 46)/46 x 150 = 20' 15a�y�1 HIND) �/ 65 �.�_ BREACKOUT CALC: (48 - 38)/63 x 150 = 24' TO 1% SITE AND SEWAGE PLAN 0000 LOCATION.• ? EDGE OF WETLAND LOT 39A IRONSIDE DRIVE pie WEST BARNSTABLE, MA = ' PREPARED FOR ti I EDGE OF DITCH ' REEF REALTY >>r > DEMAREST-McLELLAN ENGINEERING ��`�L-�• It 1 �,r- SCALE: 1" = 30' DATE: 11-12-94 24 SCHOOL STREET P.O.,BOX 463 HEST DENNIS, MASSACHUSETTS 02670L REFERENCE: PLAN BOOK. 421, PAGE. 57 REV: 11-28-94 DM 94-039-39 �' '• �S el THOMAS McLELLAN, P.E. L OHN Z. DEMAREST JR., P.L.S. REV: 4-12-95 REV: 3-20-95