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HomeMy WebLinkAbout0005 LANCASTER WAY a I NO. 1521/3 ORA I of Tie Town of Barnstable Building sxsrws�t t Most This.Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept ,Posted Until Final Inspection Has Been Made. Permit ;Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-18-1260 Applicant Name: Russell Cazeault Approvals Date Issued: 04/27/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 10/27/2018 Foundation: Location: 5 LANCASTER WAY,WEST BARNSTABLE Map/Lot 110-004-008 Zoning District: RF Sheathing: I Owner on Record: JENNEY,STEVEN R&KENNEDY, EILEEN M Contractor Name: PAUL J.CAZEAULT&SONS, INC. Framing: 1 Address: 5 LANCASTER WAY Contractor License: 103714 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $10,000.00 Chimney: Description: Remove the existing shingle roof on the whole house and install Permit Fee: $51.00 Insulation: new asphalt shingles. ' Fee Paid: $51.00 Project Review Req: Date: ;' 4/27/2018 Final: Plumbing/Gas Rough Plumbing: _...- - Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. --.----- ___ _ Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work:' Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable RECEIPT rw �ste. 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-18-1260 Date Recieved: 4/25/2018 Job Location: 5 LANCASTER WAY,WEST BARNSTABLE ��v Permit For: Building-Siding/Windows/Roof/Doors ` Contractor's Name: PAUL J. CAZEAULT&SONS, INC. State Lic. No: 103714 Address: 1031 MAIN ST, OSTERVILLE, MA 02658 Applicant Phone: (508)428-1177 (Home)Owner's Name: JENNEY,STEVEN R& KENNEDY, Phone: (508)771-3110 EILEEN M (Home)Owner's Address: 5 LANCASTER WAY, WEST BARNSTABLE,MA 02668 Work Description: Remove the existing shingle roof on the whole house and install new asphalt shingles. a ZE U —T° Total Value Of Work To Be Performed: $10,000.00 Cn t� Structure Size: 0.00 0.00 0.091 rn -o Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Russell Cazeault 4/25/2018 (508)428-1177 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $10,000.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $51.00 4/25/2018 $51.00 XXXX-}XXX-XXXX- Credit Card 0985 ......................................................................._..........................................................................................................................................................................................._........................................................ Total Permit Fee Paid: $51.00 THIS ISI,NOT A,PERMIT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION t f Map 110 Parcel UOq 00% Application # 3��7� Health Division Date Issued tck Conservation Division Application Fee s Planning Dept. Permit Fee oZ Date Definitive.Plan Approved by Planning Board V � Historic - OKH Preservation/ Hyannis Project Street Address S •�-4�1('A.S�� GVaY Village PeS_� aarnS4 L le . Owner �i ten Keane !,p �"Jf��0JC %Address s (�ncas�cr Way/ Telephone 77`I— 368 — 0901 oe S69-237- Y8 73 Permit Request :X V54nll 1,79eaund PQQ a 40 0001— X "C.)6 /I0 n!'Aev rr?C-C -algtckChet,,, G• le_ Qce✓ alvo'f Square feet: 1 st floor: existing/ALproposed N 4 2nd floor: existing 102Y proposed � * Total new CD Zoning District Flood Plain Groundwater Overlay - o •- Project Valuation ZOX600 Construction Type Ved AromCIVih71 Lmetr b 4 ac � � Lot Size - Grandfathered: Ell ®'I�lo If yes, attach-supporting' documentation. Dwelling Type: Single Family UK' Two Family ❑ Multi-Family (# units) Age of Existing Structure 14 yr-s Historic House: ❑Yes QlI o On Old King's'Highway:-z Ore-1 VOINo Basement Type: ❑ Full ❑ Crawl l�lkout ❑ Other ° '_ Basement Finished Area(sq.ft.) 13 Basement Unfinished Area (sq.ft) 2 4 2- Number of Baths: Full: existing 3 new D Half: existing / new Number of Bedrooms: S existing 0 new Total Room Count (not including baths): existing /0 new First Floor Room Count s Heat Type and Fuel: 806as ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes Mlo Fireplaces: Existing / New Existing wood/coal stove: des ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ®'new size160413arn: ❑ existing ❑ new size_ Attached garage: 21boxisting ❑ new size _Shed: ❑ existing ❑ new size — Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION / (BUILDER OR HOMEOWNER) Name CI <cA KCnAe!� * Ofieveh�/cn Me y Telephone Number Address n C4Steri &,-tky License # W e& T' 1'11olv^ S4ftS12:::!0tC- Home Improvement Contractor# S�ed/ TS lQ��c /�! Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO AIIA SIGNATUR DATE s FOR OFFICIAL USE ONLY 1�4 f APPLICATION# f' DATE ISSUED . 1 MAP/PARCEL NO. ' ADDRESS VILLAGE OWNER ' DATE OF INSPECTION: FOUNDATION L Ol (b FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL I ' r PLUMBING: ROUGH FINAL r GAS: ROUGH FINAL FINAL BUILDING I .. . DATE CLOSED OUT F k ASSOCIATION PLAN NO,. r The Commonwealth of Massachusetts ^; Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 c www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): edeeia Ka, neay C6, 6I/e JV_aAS/ Address: f a ncros4er Wo►Y City/State/Zip: W.BXW AS4y.66- Phone#: $Ck-t3?—q S 13 Are you an employer?Check the appropriatVI : Type of project(required): 1.El am a employer with 4. 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. 1 7. ❑ 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 5. ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I I.[] Plumbing repairs or additions myself [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] t_ employees. [No workers' 13.Vther �mJ.- comp.insurance required.] - *Any applicant that checks box#I 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 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. Insurance Company Name: Policy#or Self-ins. Lic.#: 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi under the pa' and na of perj at the information provided above its true and correct Si afore: Date: Phone Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual, partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more.than three apartments and who.reside.s,therein, or the occupant of the dwelling house of anotlaer�who entiploys':pegsons toTdo mambtAafic!o `cipnstni`ehonoi repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such empigyment be deemed to be ari employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold:the is$uance or renewal of a licenseior`perait to 6))r'ate a'biusiness or to construct buildings in'ttie cbrt nl0htveaCftt'for any- applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(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 coiiftiaYation of insti rance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that-the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. , The Department's address,telephone and fax number: ' ► The.Commonwealth-of Massachw Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 Qr 1-977,MASSAFE Revised 5-26-05 Fax# 617-727-7749 www.mas&.gov/dia THE Town of Barnstable �pf Ypy o ReLyulato'ry Services Thomas F, Geiler, Director MASS.tbSp. Building Division '��� PrFD µA't� Tom Perry, Building Commissioner 200 Maid-Street,_Hyannis, MA.02661 x-wv.town.barnstoble.ma.us Office: 508-862-4039 Fax: 508-790-6230 H07S,17—OWWER LICENSE EXEMPTION Please Print DATE: !OB LOCAMN: number //�� � --I street village "HOMEOWNER": �loea /vm4wly name home phone# work phone# CURRENT MArLING ADDRESS: kxsl� ttr4J -2 city/town rtatc zip code T c current exemption for"homeowners" was extended to include owner-occupied dwe.11inu 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. DEFTNMON OF HOMEOWNER Persons) who owns a parcel. 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 constrgcts 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) 711c:undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, rules and regulations. The undersigned "homeowner"certifies that.he/she understands the Town of Barnstable Building Department m;n;rn insp ction proce ures and requirements that he/sbe will comply with said procedures and re ignatvrc of meowner 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 pcmrit is required shall be exempt from the provisions of this section,(Seetiun 109.1.1 -Licensing of construction Supervisors);provided tha t if the homeowner atgages a person(s)for hire to do such work, that such Homeowner shall act as supervisor." )Jany homeowncrs who use this exemption are;unaware that they arc assuming the responnbilities of a supervisor(see Appendix Q, Rulcs&Rcg{la dons for Licensing Construction Supcn•isors,Scction 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 againsl the unlicensed person as it would with a licensed Supervisor. The hodreowner acting as Supervisor is uldTmte)y resppnstb)e. To ensure that the homeowner is fully aware of his/her responn'bilitics,many communities require,as part of the permit application, that the homcowncr certify that he/she understands the responnbiliocs of a Supervisor. On the last page of this issue is a form currently used by seyeral towns. You may care t amend and adopt such a form/certification for use in your community. THE Town of Barnstable Regulatory Services Y.AFWSTABL2;, v ' Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma,us Office: 508-862-4039 Fax: 508-790-6230 op-erzty.�C qmer MUS t ,, Complete and Sign This,,Section If Using A`MV :X , r � d. Y c \a'Jd ,f .0,. ilr J.4�°]1•.:h'i as Owner of the s.ubject.property hereby authorize to act on my behalf, in all matters .relative to work authorized by this building permit application for. (Addxess of job) signature of Owner - Date Prtut Name If Property Owner is applying forperm�tplease complete the Homeowners License Exemption Form on 'the reverse side, 05/09/2011 09:24 5087781789 NORTHWOODINSURANCE PAGE 01 r^~+1 OP ID: KG DATE(MMVDWYYYY) CERTIFICATE OF LIABILITY INSURANCE 05/09/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed, If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this Certificate does not Confer rights to the Certificate holder in lieu of such endorsemen S. PRODUCER yy 508-771-1632 CONTACT AME CT 540 Main Street Suite 9.Inc 508-393-2955HOME�g __ Fax Hyannis,MA 02601 ADDRESS: -.--• �-------'_...._.....—tAIC.Nol: �.�sTOMeR1De:SHELI-1•._ _ _____ _ _ INSURERS)AFFORDING COVERAGE _I NAIC k INSURED Shell Island Pools,Inc. INSURER A:ACE AMERICAN INSURANCE CO Fred Scherer INSURCR13: 121 Cammett Rd. INSURER C: Marstons Mills,MA 02648 -- -- - — ..-..__------•-----.._....._ INSURER D: INSURER F: INSURER F: COVERAGES CERTIFICATE NUMBER; REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN9R-.—.—........--- ........ ....-. .. ---__.__...-PiiEF�. ••isOLl�°Yt(XF�t - -- --•• --• -- LTR' TYPE OF INSURANCE JbA&wyD POLICY NUMBER MMIDDry Y MWDDIYYrYJI LIMITS GENERAL LIABILITY t EACH OCCURRENCE I S nJA O RENTED COMMERCIAL GENERAL LIA91LIP ( PREMISES(Ee oay?gv l ' S --_ r—� t- -�CLAiM5-MADE I I OCCUR L MSD EXP(Any One person) i.S.•-. .. _..-.------•— ' I I PERSONAL&ADV INJURY $ I GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP POLICY LOC AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT S — (Ea accident) I ANY AUTO BODILY INJURY(Per person) S I ALL OWNED AUTOS j BODILY INJURY(Per acddant) S SCHEDULED AUTOS 1 j PROPERTY DAMAGE , (Per smident) S _ HIRED AUTOS I I NON-OWNED AUTOS � S UMBRELLA LIAR 7! OCC0fAC EHOCCURE-I!EXCESS LIARCLAIN}`,_MADE ; AGGREGATE S _ DEDUCTIBLE —. ----• -- f —— RETENTION S $ WORKERS COMPENSATION WE,STA•TU- OTH- AND EMPLOYERS'LIABILITY Y 1 N ER A ANY PROFRIETOR1PARTNEF1MCVTNE CERT WILL FOLLOW FRO 04/22/11 04122l12 E.L.EACH ACCIDENT S $00,00 OMFQf �En NH)EXCLUDED? .NIA W/IN 5 DAYS I E.L.DISEASE-EA EMPLOYEE 8 5000 i U lee,dew1be Undar r 500000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 S r i I DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarka Schedule,If more apacc is required) CERTIFICATE HOLDER CANCELLATION TOWNBAR sHOUL.P ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 230 Main Street Hyannis,MA 02601 AUT14ORt2ED REPRESENTATIVE 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD ' A •-4 N \ N O \ x C N a _d PQ DAPr-2 Manual 1222De:LaWLA It 5114M9 12A2 PM Page 1 —�— U) N;t) •sIL SAFErV TIPS �6. INSTALLATION OF OPTJONAL SCREEN rIr• KIT REA "S DOOR ALARM Whanthe s-VCA b0beryh 10W.lhed SIBtm horn rll Chtparoeevaty -Supervise children at a�bleak CONNECTING ODOR AEAwa to SESOR aWRnes I a9COn�U1M means R Is time t0 Inalsl a raw baosrt(Battery IFB le -Never peamll swimming alone.Never leave 9 child alone,even ME SENSOR APES A mAANl11LL FOR�NSTAILR E TEDTO THE MDRInstallationInstructions "louAmalely 1 yeah Tett)ar door alarm*oft by Opening Ile Thor to answer the Telephone. T��+���RFE F6iWHEMLY CONNECTED To TF¢MDR � and RIOMhg the 0111111 to9alyd. -Always remalre the entire solar cover tram o pool before A"Alk CONNE07 BOTH BENSORVAREDCOMN ILL OFROMTKDOOROJIM MODEL DAVT-2 TD TIESENSOR SWIM"ONTHE DOOR FRAME,WHEN LPETHE SUPPLIEDSwimming. JUMPER WAOS TO CONNECT TO TIE SOAEEN DOOR SENSOR&Wm:9 _ MEETS UL 2017 IVAR• 4bannember lhat sloonol and Water Betefy do not MIX. (SEE DIAGRAM BEUUW4 TE TWO BENSORS WDLID BE HOOKED UPIN - --- __ r,� �• •Have your peel area lanced and the pate tacked m prevent PARELLEL V• M FWR OTHER, a-� LTl Ynsurdfodred tllby LD life pool,and IRslall a gaae alarm. .THE PLASifo COVERS ONTNE SESOR SYATC/ED a SENSOR (5F1 PODLGl1ARD h soli■Ifn a Ilrita9 wansgroN»var dafP.rss h pawls -Lack and secure all doors Ih The house TAtdch permit easy KWOEr MUST BE REMOti7D SORE INSTALLATIONend vDnkrtenNlp war ono year hom data at pumhssB.Q�ettiln pm01 d eGa@9s to Te pool,and inslell B door Smarm. •SVWTCHM DO ONTIE FRAME SYTHE DOOR LISTED C* pmrlfays).If Poolg,"d ldmtil6 a derecl,p�Cdl our Customer •Have a respenable adult teach sWlmming and waRY Safely to •MAGNETS rb ONTRE DOORITSELF-SEE PICTURE INNI&NUAL �Serdce Oepari ern el l-WO.24Z-7163.Unauttlonted mWmB Ml notbe yewcfilldren- e=PNENT KFEDED accepted.Raper mpat[s Sly erlecred when the unit is refured oo the •Maintain clean,dear water In the pool .A.ONE DOOR ALAR14 AND 2 MOLINTM n[REMman,eri . Wh our wabshe at swRpaDF rdoom m 111 oN yallC •Do nol aw4n dur)ng electrical Storms_ RL ONE SET OF SENSOR SM70HAND SENSOR MAGNET AND 4 SCREH6waTU"regi*110n WtollTelbn •Do not permit boldles, glass, or sharp ob)ects to be used FOR DOOR FRAME A DDOR,ONESETOFSENSOR3VATGMANOE AMANMe1.ET•JUMPER"RESaround(he pool. AND 4SCREWSAsk your pool dealer how Vou can lrrprWe your pooll _FOR SCREEN DOOR FRAMEANDSCPIDN DOORSafely-11neyWill be9lSdtoassistYOU- IF YOUHAVEANrallESTIONSCALLUSAT1N3aorda7r4w•Above all: remember that Commm sense, awarenes9, end MMOODR SCRGINDOORcaution will allow you to enjoy your pool. DOOFtALARTI gure 1 I �PBMINDUSTRIES,INC. bPA_eox Ter �D PASSTHRU IMPORTANT CSR 5NOFrrH 1754664 OIL RN4TffiS poolgudrd" D • uAmH , r `• c 00 f! MAMti ® The product Fray Dean dnFaMd to aid In U9 defection o1 uwa Ted O • AIMPm HDPDI IntruslemB Yrlo urouperdaad mea- F'ODUIUARD DAPT,2 IS A co P13rA 3miciraIES,ANC, co 0o guard www.poolguHrd.com tMEs SAFETY ALARIuS SYSTEM AHDIVDTALIFESAVk1DDEVICE, n N MADE IN USA BhoddtetsedInccn?Avlbnwth Ina adetfeWilmertarrentyInwo O � , REV.W9 Figures ��r;� and&Wd nm alfencleAsnngsmelyprroetwes. -1 -� I F 'TJ O O N • a N N O x N a d I PG DAFT-2 Manuel 122200:Layaul t 5114M 12:42 PN L I Page 2 �— I �' c-[- A.DelemhFe rho bed location.The door alarm must be Installed at local OPERATING - ppp• Paolg�d rd' CD INSTALLING THE 91f BATTERY 1F,.r.Z, 54'aborm Iha tt[whnV of the dos: 4. ' - a Wih a pond(mark 2 spuls 2la'apart aerfcalb'(W 6 down)where TTe POOITILNRD DOOR ALARM aces My delay modes wfhldh allow hl rwh► cn Ito&term wll be mmrhmd.Thane 2 marls arc where fro 2 larger A.Borrows,ter assarblY strew'from the beat at ft dos alarm and supplied sc awv-wit be hearted into the well to hung the door alarm the user to r[)dt and crater draos d wd hot[Me alamh shwndhg,Tlhsaa N ree'auagempoonec.lSmFyllhm2) G Insert the 2largeesu(fAedmm"IrM the well anftZm mLo— (" . amerylalhedbaw � 5 CI D.Rll damn the battery timing end Iseml the 9v battery(He fgune 2) abed 642'(not Irdhdrg Me heed of Tlla screw)of the scnew from A. FIRST DELAY MODE When the door Ic opened the alarm NOTE:If She battery,epdng is not In the oo[mct posllon under The Che oukcretkely goes!de the Mat delay mode"0 96m you 7 tre".tho a�mn wil nol go beck oogelhar. w�L seeorda stW lte door b apened err push Me pass fru ewlldh.If the D.Hang The door alarm on Me rnoW Bd screw and pill downward uml i G.alto Uy 9r battery b hlVelbd,1M LED all flash orhar awry 10 pass Ilea awikh In not pushed wthh 7 eamnde the alarm wll sound �•. Ile bat the am positioned h Me steal end d the hanger hol:a h the secorrd9.When the alarm sounds fs L®RII flesh orrar etrry with Uw door open a cbea[.L Ts,silence Me darts dale the doer at � ' off E.R�lupurchased the DPTIDtfM.Screen Door Kh see section 6. than p[sh the pass tW SRlt1L Y fi D. mbla 11e door alarm r.1Rr the oceonbty serotc NOTE:Once �a 5 6 SEQOND DELAY►ODE:When Me dear is opened end Me pass tau the be"Is Insaellsd Me alarm may sand ecclJenmly u9hl the (� ) SMA"Is pushed wbh 7 seconds,lhb puts fie Boor alarm In the Persons are connected propyM 3. INSTALLING DOOR l' seoord delay anode vfiklh allows you 14 neoade to gG II'M h lte doa and clwe It When the door h closed within 14 netande,the 2. IRSTALLING•a a -t 1 A.The Dear Alarm tomes with are esns swldh and one senor alarm wll he alarm reset n Ily dock's not nosed wAthh 14 t q< AISd1EDH0uT RWEME RM magnet;re ace Me corers tom hash of time perb by using your seoorde,the PJerm sell sound. ''/ NTnt RBADre Rfefrrrat /�IAJ Vow ued DocrAlenn Isdesi nerd lobe halalledwith22'dthe Rngernal cranial trial to mcilli Ile cwm(rocs the botlornside and IN h»out�PooL wtTa[ 9 Figure 4 srsat waiHTBADMRECfhSt sensor swidh ter Me sereor wins oanneelbn.To mmrt Be door a4lm eadhgnanfesarsor. 9 lwliai PLAf71CWVEa `r1 an wall neA m door: S.goes whose hem an Ides lx nrr6m Is sensor rtoanel to theFT a lurrbn5r Ntun goes on Use door end Ifs eerear bwtkh k usuely mourned m the X y�Iwastia+[nr door frame. OUT k O_bdetal framed dome rrey,reed a alme between the sencas and Ma KNoCK u UfE 2 a dSwr tshq a amail place of wood a dotHe sided loam tape. FI g Boos a The Swam must be Irelolod parallel beach dhar wllh a spacirg ` \iavanals between them or uppradm6itely34'.The sertsme can be mounted -� O Hodmr�tya lkrer�F/as long as lhay rerielth parallel. E.Loosen @e two terminab on ty sensor swlkh by lowering The ® p 00 ,awMsuNosr �� Amsews then pleas ehder m end comhp horn M alarm a door ala 4r.TE AlASma cr Fea[yurprak b co -- between each of Iha leemhek.It doeadt me let w4idh wire goes to tMpe ProW Your Fanbh co �. w*k h mrml h se'd.Replace Plas Cmra. Alt[rAfsrStldwudL TV rtbm:rMacoserforlhy herhecrstlaclhmasnollad(htnplaceOecatrea WWw.poolguacd.com Lo of the sensor wlrea,rmhwm de WmIc ul tram the side of the sensor t_J"l xraa+,nE switchcwm(see 1"4) -�- I F •-v 0 0 w ' N If 6 frJ� ti - � s r / ` ,x Ak- LOT 7 30,169 + S.F. w (0.69 ±AC.) m , JOB # 93-025 CERTIFIED PLOT PLAN PREPARED FOR LOCATION : ASES MAP UO PAR 4-8 REEF REALTY LANCASTER WAY WEST BARNSTABLE scALE : 1" = 40' OF Gf AS REFERENCE : LOT 7 PLAN BOOK 454 PAGE 96Z.N N` I HEREBY CERTIFY THAT THE STRUCTURE �EhiAaEST,Jn. �; SHOWN ON THIS PLAN IS LOCATED ON THE �o� Nlo.36559 GROUND AS SHOWN HEREON. � a� DEMAREST—McLELI.AN ENGINEERING 24 SCHOOL STREET P.O. BOX 463 JANUARY 13, 1998 WEST DENNIS, MA. 02670-0463 (508) 398-7710 DATE P#&4NAL LAND SURVTYOR I & All 1-14 ,144411 It t9ttl4lill Nimperial FROM A TD: I-R��. a ,a,0 c , M NUFAC URG 9R �. POOLS N1 118'-1 1/A" N A,7+ �1.., -Air'4 ra 6'3• 9R 92 40' 1 A"• N2 1 •II N' I CENTER LIGHT LIGHT 3'1 1/2" P 17'-0 3M" P 10'•!1 A l� I'I' I A January 2010 N U PANEL OPTION Pf 13'A" Pf 10'-ttl fii 1. C 9R T R Q 22' 26'-0 1/4" Q 31'-/1 2 1' 1 w in 3'11/2• 3'-T S 3/A' R 11'•10 A /! h R1 30'.51/4" R1 11.-10• fit 7-Lagoon N s 38'•83/4• s 2a-2ur s 18' x 37' x 29' Ri ht FFa 2g•$" r 2,'�1,/A U r 7'.,• 4l-1(U 38'•6 1/7." 38'-10 3/4" TT ill 9 4 PART DESCRIPTION PART# z 9 OR 9'RADIUS PLAIN PANEL-87 04170 4 4 14 1 1 1 B r>+�"9R 6'3• A 9'RADIUS SKIMMER PANEL-6'3" 04172 2 2 121 1 6'3• T 9R 9'RADIUS RETURN PANEL-6'3" 04176 2 2 121 R9 8'3" 9'RADIUS PLAIN PANEL-3'93/4• 04175 1 1 1 4' , 38.,,• 9'RADIUS PLAIN PANEL-3.1 1/2" 04173 1 1 1 33"-1 8'RADIUS PLAIN PANEL-63" 04162 3 1 rxyi 1 MINpdIIM r t V RADIUS RETURN PANEL-6'3" 04167 1 1 9R ^� PREPA1117D 3'-4" g.3• , RS' ' "Locmlon of point®on tforroM 8'RADIUSPLAINPANEL-4'2" 04441 2 $ heweloremobpopm 6 r ANSMS1, 2'(h3 8'RADIUS PLAIN PANEL-2'3" 04184 2 P1 9R standard.. 10'REV.RADIUS PANEL-6'3" 04301 1 1 1 10'REV.RADIUS PANEL-521/4• 04300 2 2 2 38'-11" E P 4 " 6'3• q.1 " 8'REVERSE RADIUS PANEL_63" 04165 2 2 2 R1 R q.10 r �gN1 4'-1-6'—I 14' ADJUSTABLE A-FRAME 05188 8 8 10 9R 4 0�• __33,,2 4'q 3,-2 • R11' T BACK BOTTOM SLOPE 8'R x 14'W STEEL STAIR 04010 1 TO 3/4" 4'-A 3'"2j" WALL PAD 8'RADIUS STEP-N-REST 07418RSNR 1 1'-ej- 2' 4'-T NUT&BOLT PAK-75 pcs PAK45 3 3 3 N2 R14' 5' ORR NUT 8 BOLT PAK-100 pos PAK-100 IORR 2 q'S 6'3• R8' ALL DIMENSIONS ARE Fit 9'RADIUS LIGHT PANEL-8'3• 04444 3'-.,1• 5'2 1/4" 5'4 8RR R10' S 6,2 6-3• SF—FRIX FORM 01'AII 10RR 11.. 1�" 5'2 1/4" 7'73 2' 8' ,11,,,, Q� 8R OR I 9'-52 2' 11'-4- V3" 6'3 9R 3'11/2• /S 12-q" 8-1j"g 6R 6-4' t 9'-11" 2'3" 9' 9R F 12' G R8, 6'3" G OR RB' 13'-f)" J�, DIVING PERMITTED ONLY FROM6'3•DESIGNATED DIVING AREA. R9' ' 13'-91"1.Pour 2500 P.S.I.concrete fooling around entire perimeter,minimum 8"deep. 8R 2.Back ell with clean earth,free al mote and debris. 9R r-10j" 3.3'wide concrete deck la to be poured at least 3"thbknesa and a ebpe g•3• Jof Y.•to 1'away from the pool. D 1ORR23 4.All inside pool dimensions are to be finished dimensions. 9R OR gR C gR 6.Finished bottom Is to be 2"minimum of suitable material or undisturbed earth. 8'3" 6'3• 87 4'2• 6.A safety line,with buoys,Is to be permanently attached IV to the 8'RADIUS PLASTIC Shallow side of the point of first slope change. R10' STEP OPTION 7.Construction Drawing: Different methods and precautions may be dictated by various ground conditions. This Is to be determined by and Is the responsib!!Ity of the contractor who Is not an agent of the Manufacturer the component parts. 9.I on Is to be done In accordance with all federal,state and local —A-FRAME BRACE K building codes,as well as A.N.S.1./N.S.P.I.suggested standards. The bottom oonllpuretlon shown conforms with curtent NSPI/ANSI eueyesw minirnum standards for poste approved for use wIth manufactured dMV equipment.tt dNbe equipment M Installed,folbw the equipment manufecturees installation•use and safety immotions. Volume: 22100 gal 83650 L Perimeter: 111'-7" 34.01 m Surface Area: 729.26 ft 2 / 67.73 rn lob 1HF IOky Barnstable Old Kings Highway Historic District Committee O� 200 Main Street, Hyannis,MA 02601, TEL: 508-862-4787 Fax 508-862-4784 y !(ASS u .°rfo M ►`ee APPLICATION, CERTIFICATE OF APPROPRIATENESS Application is hereby made,with four(4)complete sets,for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,Acts and Resolves of Massachusetts, 1973,for proposed work as described below and on plans,drawings,or photographs accompanying this application for: Check all categories that ap�pl ; 1. Building construction: ❑ New ❑ Addition Lit Alteration 2. Type of Building: House ❑ Garage/barn ❑ Shed ❑ Commercial ❑ Other 3. Exterior Painting,roof ❑ new roof• color/material change, of trim, siding, window,door 4. Sig_: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 1 5. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Retaining wall ❑ tennis court ❑ Other 6. Pool Vswimming ❑ Other man-made pool Type or Print Legibly: _ Date: Address/of proposed work: House# Street:������s��`l Gy )/ Village '✓I J _ �• Assessors Map Lot# Description of Proposed Work: Give particulars of work to be done: �A/JV/i �y L . �,vs i4�C,1Ai.tVc? 1-6 IL n d pvCi Agent or Contractor(print): Telephone#: Address: Contractor/Agent' signature: NOTE AU applications must be signpd by the current owner Owner(print): �6E s2_.� 6 by Telephone#: Owners mailing address: �— CA S/�� G�� - .4 X) S )/ Owner's signature: - Ar committee u only. Tte7 rtificate is here APPROVE /DENIED ECEIVED Date i atures APR 0 7 2011 TOWN OF BARNSTABLE , FIISTORIC PRESERVATIO A conditions of a royal: -�� ,AI^�=�=�=oar—� 1 --------------- CA Documents and SettingsldecollikV ocal Settings Memporary Internet Files10LK110KH Cert Appropriateness 07.doc r Town of Barnstable Old King's Highway Regional Historic District Committee CERTIFICATE OF APPROPRIATENESS SPEC SHEET Please submit 4 COilieS Foundation Type: (Max. 18"exposed)(material-brick/cement,other) Siding Type dae-6oa,.ck material: G- c>c>cA Color: 4(e,CC,,1jv11:k 6eiK_ Chimney Material: Color: Roof Material: (make&style) Color: Trim material a)CCA i SC Color: 6 I eej/e-r b eiq-e- Roof Pitch:(7/12 minimum) Window: (make/model) material color Size(s): Door style and make: (QT r%eA material Color: T� 1r rl 6:tc k Garage Door,Style Size Material Color Shutter Type/Material- Color: Gutter Type/Mater�1. ECr-1%j Mj Color: � � Decks: material APR Size Color: TOWN OF BAR Skylight,type/make"SIOAIC PRESERVATION material Color: Size: Sign size: Type/Materials: Color: Fence Type(max 6' )Style Chair► Li^L— material: Viny ( Color: A LCc4L.-I Retaining wall: Material: Lighting,freestanding on building illuminating sign Please provide samples of paint colors and manufacturers brochure of style of windows,doors,garage door, fences,lamp posts etc ADDITIONAL I FOR/MATION: 31 ����►�, T Q'G S{QIV'� C:I N�iI �/'t�'I � fc•l.Q '�'O �P_ �� �. Signed: ( lan preparer) print name tel. no. '7z/ . , - • e9 ation of application: Street �^ Street /-)�CJC'�5 %c T� Gc�✓�1.� Village �� n--/ -4 e CC 2 C:(Documents and SettingsldecolliklLocal Settings Memporary Internet Files IOLK110KH Cert Appropriateness 07.doc i Town fB n * i �' "a �FTHE T ow o Barnstable Permtt# Regulatory Services o�� fee 6 months from issue date BARNSTABLE, v MASS. Richard V.Scali,Director Opt �e �A 39. �m 'FOM°�A Building Division�o/�' SFP 3 0 Paul Roma,Building Commissione y0 1016' 200 Main Street,Hyannis,MA 02601 oe www.town.barnstable.ma.us Office: 508-862-403 8 'dac�:�3'08-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY _ Not Valid without Red X-Press Imprint _ Map/parcel Number Property Address Jr `-ctr7Cc4S-t ey WOL 7 0 Residential Value of Work$ �.5, 000 a Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address S*eye.rt �e+znty 57 WC4,y SJa" Contractor's Name Telephone Number S50SS 7 37-M-0 Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor R-I am the Homeowner ❑ I have Worker's Compensation Insurance i Insurance Company Name I Workman's Comp.Policy# 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 $o.-na- 4-' - 1gr sl,%�-% Ies Replacement Windows/doors/sliders./U-Value a 30 (maximum.32)#of windows 1 2- S4Me_ 5+2-G #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 req SIGNATURE: QAWPFILESTORMS\building permit fo XPRESS.d e 06/20/16 ?lie Commornveafth of Massachusetts Depar&nerit of 1"nd-mteid Acciderrtr �► - Offize of.£mvestigations. . 600 Washingi fflf Street Boston,? A 02LT1 wFvn 1i=go91dia N[turkers' Cumpensat on Insurance Affidavit:B•mlderslContractorsJEIectricianslPlEmbers Applicant Infarmaian Please Print Iy -Name(Hus�esslDtganizaEion/fnd Cinal} �+w c n �en✓l-P-4 CitylState1Zig ked IO-Waca Pl�aa� ✓oFf'7 3?- Y 4 Z O Are you an employer?.Check the appropriate box: Type of project(required}: 1.❑ I am a employer with 4- ❑I am a general contractor and I p * have Hired the sub-con ractors 6- ❑New consf cEiorz • employees(full an-Nor part-time_ 2.❑ I am a sole prqprietar or . listed on the attached sheet. ?- ❑REmodeling. sliFp and have no employees. These su -confractors have 8_ ❑Demolition . woAdgg, forme in any capacity- employees and have workers' 9. .❑Building addition [No wodoz& comp.insurance comp.insurance-1 required.] 5- ❑ ale are a corporatifln and its 1�❑Electrical repairs or additions 3 I am a homeowner doing all work of have exercised their 1L❑Plumbing repairs or additions Xmyself[No workers'comp. right of eaemp&n per MGL L-❑Roof repairs inm ancerequired]i c.152, §1M andwe have no A employees-[Na workers' 13-❑Otheret'i comp.insurance required_] r 4te- 6 A11y appiic d5at checlsbaa#1 nmst also fMci t the section belaw shorning then v;oaexs'c®pensafiaaparicy imjmmaaon_ #Homeowners Who sabmit this Kfid=rd fmx rating they axe doing zUwoax and dim bim auutside contmctarsxrm submit a new aSdzzit'h airline such rCautlscinsiffia[cbeckthis boat mast attached=additional sheet showing the name of the sab-contxrcto-a and state whether ornotthose entitieshav employees.Ifthesub-caahactars have employee%theymustpmridetheir zrodces'-comp.ponunizober. I grit ani ennipZo}�er f7eat isprmzdurg>varkers'eonrpenesafiart irnsrira>zce fur sty enrpFv}'ees Beloav is Yite policy,and job site information. Insurance CompanyNtratm: "Policy 4 or Self-ins.Iic_w'.- FxpirationDafe: Job Site Addre= Cityl5tatelztp: Attach a•copy of the workers'compensation policy declaration page(showing the policy,mrmber and expiration date). Failure to secure coverage as required under Section 25A o€MC L c-157 can lead to the imposition of criminal penalties of a fine up io$1,50a 0 andlor one-y6irimprisor:ment,as well as civil penalt ies Ja 1he form of a STOP WORK ORDERand a fne of up-to$250-00 a day aggaind the violator_ Be advised that a copy of this statement=ay,be farwarded to the Office of lavestigations of the DIA for insurance coverage verification- I do if r-e,&y certify ru 'is and penalties efpe�ntrp tJnatflte informatiouprmirW abatis is true and correct Sitmature: Date Phase ik b�-717- 620 O,Okial use aryl}: Da not write in f ds area,to be campleetetd by dtp artown g rciet City or Town: PerffitUcense# Issuing Antharity(Circle one): L Board of Health 2.IuTdmg Department 3.[S.tylTown.Clerk 4.Electrical Inspector 5.Plumbing Inspector b.Other Contact Person: Phow#: - ----- -- - - - - - 6 -formation and Instructions M&�cetfs General Laws chapter 152 mgm-m all employerss-to F¢M&WOII as'compensation for then-employees. Pmsuantto this statrde,an=V&yrPis defined as.`�.e=ypersonin the seavicc of another imder any contact ofhae, express or implied,oral or wrif[=[L" An Mayer is de-fined as-an jaffiVidnal,parinershiP,association;corporation or other legal entity, or any two or more of the foregoing a ngagEa ia a joint mterpase,and inchzding the legal represeatatives of a deceased employer,or the receiver or trustee of an individnal,partnership,association or other legal entity,employing employees. However the owner of a.dweIIing house having not more than three apartments and who resides therein,or the occaparit of the - dw M g house of another who employs persons to do mai of enan ce,consdt-nt.on or repay work on such dwelling house or on the grounds or building app thereto shall notbecause of su h employment be deemed to be an employer." MGL cbaptrr 152,§25C(6)also states that every state or local licensing agency shall wiflihoId the issuance or renewal of a hcen e.or permit to operate a business or to construct buul6h3gs in the commonwealth for any applicantwho has not produced acceptable evidence of compUanc:ewith the hLsTwance_coverageregmdred-" Additionally,MCM cbaptnr 152,§25C(7)states¢Neither the eo*TTm? wealtT,r nor ray OR—political subdivisions shall enter into any contract forthe performance Ofpnbhc workuahI acceptable evidence of compliance with the it c C� e. requn emus of this chapter have Been presented to the confi arfing authority." r Applicants Please f M out the woocers'compensation affidavit completely,by checl g ae boxes'Eat apply to you-sitnation and,if necessary,srippIy sub-contractor(s)or(s)nam e(s), address(es)and phone nomber(s) along with thrir certificates) of insmance. Limited Liability Companies(LLC)or Limited Liabf7ity'Partnersbips(LLP)?eithno employees other than the members or partners,are not mqui d.to carry workers' compensation insurance If an LLC or LLP does have empIoyees, a policy isrupfied. Be advised that this a$ida�may besnbmiffedto the Deparfinentof Industrial Accidents for confsmahon ofinSC1.TaLlcB coverage-- Also be sure to sign and date the affidarit--The affidaVi-should be mtrmmed to the city or town that the application for the peunit or license is being requested not the D epartmeat of fi1d stag Accidents..Should you have any questions regarding the law or ifyou ate regmred to obtain a workers' compensation policy,please call the Department at the number listed below Self-fimrrd companies should enter their s elf-fi sorance license number on the appropriate line. City or Town Officials t Please be sure that the affidavit is complete and primed legibly. The Department has provided a space at the,bottom of the affidavit for you to fill out m the event the Office ofInvestigatio ns has to confect you regrading the applicant. P leas e b e sure to fill i a the pemmWlicense number which will be used as a reference somber. In-addition,an applicant that must submit multiple pemut/license applications in any given year,need only submit one affidav3t mddicafmg current policy inr rr ation(if nwes-sary)and under`job Site Q_daess"tie applicant should write"sII locations in (city or town)--A copy of the-affidavit that has b ea officially stamped or marked by thi city or town maybe provided to the applicant as-proc fthat a valid affidavit is on file for furore permifr or licenses- A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a liceose or permit not related to any business or commercial ve u e (i e. a dog license or peumrt to bum leaves eft_)said person is NOT u�Ed to complete this affidavit: The Office of Investigations would lilm to t>iank you in advance for your cooperation and shonld your have any questions, please do not hesifa tc to give us a call. The Department's address,telephone and fax munber the CG=M0nWm *of A&ssachusettR Degar�n�of 1zid1 Accldent� . • �Q=4�ashmgEan . Baston.,MA(2111 i Tf,-L 4 617 -4900 cat 4-06 w I-977-MASS,� Fax 9 617727 7M revised 4-24-07 g1d I Town of Barnstable Regulatory Services ` MAM`'m'$' ` Richard V. Scali,Director. 1659. Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us .—Office: 508-862-4038! _..._______- _ Fax: 508-790-6230 -- Property Owner Must Complete and Sign This Section If Using A Builder I as Owner of the subject property > l P Pay hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) **Pool fences and ala.rsns 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 QTORMS:OWNERPERMISSIONPOOLS Town of Barnstable Regulatory Services oFtME Richard V.Scali,Director 4 Building Division BARNS'ABM ' Paul Roma,Building Commissioner � MAss. � 039. 200 Main Street, Hyannis,MA 02601 Areo www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION DATE: I 1 3 � 6 Please Print [ / �0 JOB LOCATION: 5— Z!ICAS4 — number street village ..HOMEOWNER": ay w 5bir — 7 3 7—YC20 6Z5 Y-?71 —3//O 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. DEFDYITION 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 undersi a `homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedur equirements and that he/she will comply with said procedures and requirements. Signature olodntV 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 this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 06/20/16 i Town of Barnstable Regulatory Services eA E MAS& Thomas F.Geiler,Director 1DrFo�,,prA Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 August 10, 2012 Eileen Kennedy& Steven Jenney 5 Lancaster Way West Barnstable, Ma. 02668 Dear Property Owners, As you may recall, permit application number 201102387 was issued to construct a pool and requires successful completion of all required inspections before use. The following items must be brought into compliance and successfully pass inspection before pool use is authorized: 1) Final electric inspection required. 2) Barrier must be installed in accordance with 780 CMR. Thank you for your immediate attention in this matter. Respectfully, Gey OVe . Lauzon Local Inspector jeffrey.lauzon@town.bamstable.ma.us a,town.barnstable.ma.us (508) 862-4034 A cPeCnr'c r4.-lip. ^ Y r i v Parcel Permit# Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) 4 S, F4) Date Issued l� ' Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) : l —/037 Fee _ 5�`� ,ao `Engineering Dept. (3rd floor) House# 95 yS�t"e Planning Dept.(1st floor/School Admin. Bldg.) AA U RNSTABLE,�` Definitive Plan Approved by Planning Board ,Tv/V t i 19 Y� /°/aB1y7 D��,,T e 9. 0pe, ce 1 TOWN OF BARNSTABLE Building Permit Application Project Street Address .cam Village Owner Address C3 \2)(A Telephone 'Z>C19 ?jy ciD Permit Request ' e7�S��� ��„ �� e•�cu.J, �,L,r C' r �� '�- ��-r n First Floor / `�`j�S square feet Seconds Floor QL l square feet Estimated Project Cost $ 1 Q o , oco. 00 Zoning District .Flood Plain Water Protection Lot Size 2P-4 1 to Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use N a C,C w -\- \OA.— Proposed Use Construction Type Lo p o _ Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished `Old King's Highway Number of Baths No. of Bedrooms 'Total Room Count(not including baths) / First Floor Heat Type and Fuel V Cgo S Central Air NA& Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Telephone Number Address - License# o 2- Oct 'M`, oaca¢ )o Home Improvement Contractor# Worker's Compensation#'\c.�9 SS Ct a(o q 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 SIGNATURE DATE d_ BUILDING PERMIT DE IE 0 E FOL ING REASON(S) a, FOR OFFICIAL USE ONLY. PE IT NO. D ISSUED M /PARCEL NO. � x . �•t+ ,f d RESS VILLAGE OWNER ga�- DATE OF INSPECTION: FOUNDATION G FRAME L INSULATION OniD�� FIREPLACE Y ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL - GAS: ROUGH FINAL , FINAL BUILDING a DATE CLOSED OUT E . ASSOCIATION PLAN NO. N • l� y� ti s �X x� tip'Cb Al � ti 71-T o~ LOT 7 17 ,vs� 30,169 + S.F. rn (0.69 ± AC.) cc �o NE • P. JOB ## 93-025 CERTIFIED PLOT PLAN PREPARED FOR :. LOCATION : ASES MAP 110 PAR 4-8 REEF REALTY LANCASTER WAY WEST BARNSTABLE SCALE : 1" = 40' P�Z k OF A9gss9 REFERENCE : LOT 7 PLAN BOOK 454 PAGE-96JOZ N cyGN I HEREBY CERTIFY THAT THE STRUCTURE DEMAREST,JR. SHOWN ON THIS PLAN IS LOCATED ON THE o No.36859 GROUND AS SHOWN HEREON. P ® �No SuV�4 DEMAREST—McLELLAN ENGINEERING 24 SCHOOL STREET P.O. BOX 463 JANUARY 13, 1998 WEST DENNIS, MA. 02670-0463 (508) 398-7710 DATE PR E 'I NAL LAND SU V YOR ASSESSORS MAP: 110 4 PARcdL 4 B TEST HOLE LOGS NOTES: y .�S3 1.VERTICAL DATUM: ASSUMED FROM QUAD(NCVD+/-) CURRENT ZONINC.' RF ENGINEER THOMAS MCLELLAN-P.E. P.MUNICAPAL WATER IS NOT AVAILABLE. " BUILDING SETBACKS.- WITNESS:!_ERRY DUNNING 3.SCHEDULE 40-!•PVC PIPE TO BE USED THROUGHOUT SEPTIC SYSTEM. BICA'yT,�,h F.-2z--S: fS, 'k 15'_ DATE:9-9-93 4 ALL PRECAST UNITS TO CONFORM WITH AASHTO H-f0&H-20 PERCOLATION RATE:<P MIN/IN LOADING SPECIFICATIONS iacvs-� FLOOD ZONE: C TH-1 esE TN-2 5.PIPE PITCH-1/4'PER FOOT,(UNLESS NOTED OTHERIISEJ st.ev 6.FIRST 2'OF PIPE OUT OF D-BOX TO BE LAID LEVEL rov s 7.THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE r SUBSOIL 4ISE OF A GARBAGE DISPOSAL ,4 SFINE IL2 H.ALL CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE LOCATION MAP / Gl 83 SAND BOB STATE OF MASS.ENVIRONMENTAL CODE(TITLE FIVE)AND LOCAL I �4 HEALTH REGULATIONS LOT 3P. y6�P PROPOSrD FELL Y CLEAN 9.CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR - •.`�,;',, (OHB± ,�6 40 AIN[ TO CONSTRUCTION.AC.) S BP-_ AND .i.\. N f0.DESIGN ENGINEER TO INSPECT AND CERTIFY SUITABLE SOIL COND(TIONS ' fat 73Z TO A DEPTH OF 4•BELOW LEACH PIS'AT TIME OF CONSTRUCTION. IOW µ ft.D-BOX TO BE WATER TESTED TO ENSURE LEVELNESS AND EQUAL F 90_ 'iD ---' 89 f2.SEPTIC SYSTEM AND WELL LOCATION ARE IN ACCORDANCE WITH MASTER NO CRR/NDFAfLR FNCTAMFRED PLAN(REVISED 5-2-93)ON FILE WITH BARNSTABLE HEALTH DEPT. FP (CRWNDFATRR ON f.OT e d ELEVr 481) 89 SEPTIC SYSTEM DESIGN so I �d `• ``� `� '---_--___ `_ •. BB VALE--COT ® �' .' �' a6 FLOW ESTIMATE: c\ 5-BEDROOMS AT 110 CAL/DAY/BEDROOM=550 CAL/DAY \ a 12 05FCa as-----1 -' SEPTIC TANK: ra-t 4 550 GAL/DAY•IS DAYS-825 CAL PROPOSFD rl•� a+,e , 0 84' USE 1500 GALLON SEPTIC TANK 5 Br�M zle _ `0.�• `.V,, 0�''6 '� 1 � LEACHING AREA rs t ts4F cF -' __ _ _-'-�'• g�Q�)�-O�• 'O. eL Q USE 2 LEACH PITS(S'z 4')WITH 3'OF STONE Ps• .. 02 EFFECTIVE DIAMETER s AV DEEP) �w SlDE AREA 12 s 4 s PI=f51 SF (26)=37 CAL/DAY PROPOSED DWELLING B07TOM AREA a s B s PI-fIs SF (1D)- Ifs CAL/DAY TOTAL CAPACITY 490 CAL/DAY s 2 PITS=980 CAL/DAY SEPTIC SYSTEM SECTION YPEASIONE t CATCH BASIN 880 COVERS WlTHlN 12' WASHED STONE i TOP OF POUNDATIFV OF FINISHED GRADE OF 78� %O BENCHMARK AT ddd CATCH SAW . ELFVv 790 G-$ 73.8 LANE 78s2 1500 GAL ELEV. D-Box 78.1s ; 4"ELM PAD-� i ��a.'9f-' ELEV. SEPTIC TANS ELEV. 72A \\�y EpIT gY 79A ELEV. ELEV. TEE SIZES. 76P g 7t a CQQ (UNDER INLET:6'UP,f0'DOWN ELEV. �— 1P 7� / OUTLET:G'UP,19'DOWN ONE LEACH PIT 71 (6•s 4')WlTR '7`'J BASEMENT) S.OF STONE(12 EFP.DIAM.s C DEEP)(H-20) �C R\ BREAKOUT CALC: 783-73B 49 z 150-14 `BENCAMIRK d ( )/ Ty p CAVCB BASIN El",7PB SITE AN SEWAGE PLAN KEY: APPROVED BY, DATE: EXISTING CONTOUR LOCATION- PROPOSED ——-- i PROPOSED CONTOUR ••.•........•• EXISTING SPOT ELEVATION: 26S �,OT Y LANCASTER WAY PROPOSED SPOT ELEVATION:25 TEST HOLM' WEST AARNs7•AB MA UTILITY POLE:-0- PREPARED FOR FENCE LINE:HYDRANT DM REEF REA•TY:b RETAINING WALL. ® DZ AREST-McLFLLAN ENGINEERING SCALE: t-30 DATE. 3-1B_95. 24 SCHOOL STREET P.O.BOX Ass DM WEST DENNIS,MISSACHUstrls 02e70 THOMAS MCLELLAN,PX. ✓OHN Z.DEMAREST✓R,Pis. REVISED. PLAN BOOK 054 PACE 96 REVISED:10-2-97 - ---------- ---_ L,.b � A�PrInL•(hl„YMLIis ofuC aaJrvcK/3L� pm,�,� mPcl.l; T�"P� _ v to�col all t yp4(o __�'"�✓f 4-`�'4 aJar =.l L+.IE Ora• .k��,�` •Y ;J-GY��•5Y4" Arr(X..- .l FNfWJW L/1Ep +'' - _�d_O_H—�=_' ___._?I_(IG,Y_.iv'._� ol — ( 5Y',K A�trH4_L� a�� (J AE✓��3 rtK�-'6 IMa1Jr: R.cY',.I,. �.,aa>:� a� �� u'� J �sftr_'V)NrWllr f,Of{; ocrp—+l G�SUM�.mn• J �G G to L�� ---_(r.Q.Fj.l+y�hl f.�.�c JG_y,}Ipr.7 s,✓� Gd-�vNl c�I�A. �•r'a�'.�»o (J._Ga. trZ'GJ Np,aIJ(�•oP, nrJ(X'r'7r rI—G�'��e'or'in, s.�nrl.a. ,NFL � � Go PrfFOL��YwdFlr. - ---- - �11 veWx 97xt� G+,O rtY Va G 5ty.t.t(rI�L!tilx�uLi-- .. __.. -- --•---- ---.._.. t n�,.r, ((yr-.lf�;1I + , R•TO A 7'73�r G'-b3'e-' Sti,q LYL_4 P��IfL I�4tlxrirf �'—�yi. xic:� ewe, F G'u r G' J Ld wcr:, CCafc4 FiRL L=✓�(_/(a'- .� 1G Mid rIfL✓lief rJ. ///•9UrY� �/r 0_ -� (� L':^`"r L+'-✓Yr+ _.�f-.u23,�r�1 Oxs>L �—L Y�,�ID'c+ci. i a' �/� �s'GG yNk'r!o'-1' I�Ylr�-VP- (71 fGL0 � _ t.,�.f�6'u.a. �xb'Yi fly{.I "1Qi4QG � ;.ru r4'o•c. _. f ,ar.l' ._^..TT .y.,._.�,. - �'_.',yc" %' ° I Ff..cYL wn�� O�y I �. '�7-tr,[a�rLt 'llr lln':' a ) U}vro rcrc�-F�Nlo. JF (`.Lrt',.1; i�4`'(Oq�K ail=:EII- .�,�`•u r'+�'�oicR G�a-t Io,v4,o ev le frrh. 9 _._ L►,�R�c�arx>H•=o ,r ,.� --�•h:.n,hl-r�l�rl��c�, src�- �' _._ __ _ . .__. _._..._ _ --------\ cnw> j 'o _ -- — Lam" � �y ,III tir �Gv�l P�l•Jr, LvrF rrlr s�rla�'^c.S„cv� ,• � �rJn�-tb^�. 5Z r�Jll,nlrlG �IU�1 Ni_ICIJ ------- - i GLGI• I.�iLMr^,--(; fL�DG Il^.o+3 A J5.72y J_.4D r'100 Pv(�lctiY/.. I Q71=A�?t M(F'� ft'�!1 LJ• .arP 1'Fr7�•i-f _!/'J G�---1.54_- Gam® �A� LoZ�j I.BTT A4 [,S GG3 �Jrxlv.¢pJelL ZtIU.s%kcOL. I N/ALL RaL J'•�JJ P-'G6a'1' 11 �33 Gv/A�LL7li '(U'Chli G,t7 Ifo 2Z7L . a tiU Z x i d Irfi toy _.-- ---- ---- -�rllt=tltll-Il -u��l � L r =IIII Ilfl- J'f 7=to (�.JFrA Go+�. Perot 0 �q"�411+ro u.la Fa-a- A.r•�I�I� I-�I.01� 5Pf-�i, ��IUI�'I� 17 rDJGK A«a mho �f`r --W rf�K C�...,aY IR 9 I6°�J�(�'�krFo ��yurdrR - W /BJ xrM It GtMrrYiY)u/R 41 et Pm (pRwN a14 1(o�i' P.O.awe--," ��-J1 �f�o1�1T `t✓I�UATI Off _ LEFT SIDE ELCVP.TI DN FlA h�rR LJ,nrl � -ronNtleJiJC,tc7 9 9� I UPI LD Prt,wi. JR71 —..— � } j J/ �` _.. _ -• II II wa!Jn�u.g 1� 0 KEAK ELEVATION Iz1 HT_S16E:ELEUA-f ION: AMEK H OtX)l N rz s sFEc.HOME A o ��on I I I 6�y�'� fmJFrl�to,IG. f k-6 I I 1 S) i (o n�fai mXA 1 . IL— ro fit Iro'fwf.Gi� fovy-eo ert ww fo tu'xlfo' 4•G�b Myi�7 U ra n ——— J raKw �r�. fwf.lc I T GXIfKliCiJ IPA� - _ jii Ii i II �i I A b�% �u.N�p°frG cA1L. AW ' ot I 7=1C7a 9�toa 19—tOt I I ' I 1 p >o E oRoP GwrnGl-�tar� -14 ---- I I _4 EN vP G" I I 1 I Ems. r.a..rd0. o'-oe p I s — of Nu��a rb✓�(uJ.1(�r.�t _ v b=G"O.U. p.,l✓ 7=J'FH+M � GoRdeti irl P•T.?.r(o91H- /,I�a J— Q° R•iNtl r-t n. e - -?�M�K Hot-•DINc�S SPED. HoM� loll&Iq 72 FOUND,471ON FL,4, l %4 ti O ®' 0 W-0 i a , _ © i O � I J�1clJG �� S O O O AMliL4 PN'ri V Cl —F • =MIX, o oo � p _—--- v�Jvrio © �nri94e a+k. �Y k_ rI�L2 rxnaanrt _ PA r of — O O+ ., L_-� •I �ro/� �"n.,:b' •God. o.oaol i U O 2'-ft' IT� S''o" _ v' d-o' _ ro'•G" A'�o' %10" e" AMEK HOLDINGS �. oME F R--,T FL(:::)OIZ A ' o Io o- o- - -- _ -- -- •tz in \W�-, m�01 B'Qy I 9 a AMEK HDlD1NGS S�EG.L- - "OM5 10 16/M TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 110 004 008 GEOBASE ID 42082 ADDRESS 5 LANCASTER WAY PHONE W BARNSTABLE ZIP - LOT 7 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT WB PERMIT 32640 DESCRIPTION SINGLE FAMILY RESIDENCE (#27219) ' PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety 9 ARCHITECTS: and Environmental Services TOTAL FEES: tME BOND $.00 ' CONSTRUCTION COSTS $.00 i 753 MISC. NOT CODED ELSEWHERE + BARNSI'ABLF, * 9 MASS. 1639. ED MA'S u BUILD I ISO BY _ DATE ISSUED 08/10/�_998 EKPIRATION DATE—,„ _ _ Department of Health, S ` and Environmental Servi .�L e { FAM HOME DETACtlCD 1 FiliVir_TL F: •,: 'F � + BARNSfABLE, MAS& 3g3gm BUILDING DIVISION BY CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENT ITS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STRE =SAS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE 0 ' S NOT RELEASE THE APPLICANT FROM THE CONDITIONS.OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. )F FOUR CALL INSPECTIONS REQUIRED + ONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARA (IONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED F 0 COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND ME ' fO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. ' ION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 3PECTION BEFORE OCCUPANCY. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVAL$' ca i!v tJ 2 f -6; 2 Vw F- I HEATING IINN�SP C ION APPROVALS ENGINEERING DEPARTMENT 2 J(ry 7 9 OF JHHIA LT THER: SITE PLAN REVIEW PROVALA WORK SHALL NOT PROCEED UN L PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON T 'THE INSPECTOR HAS APPROVED HE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR 1 VARIOUS STAGES OF CONSTRUC MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFI T TED• - O.N.- ,. .-.- ••- .,. mm: •t. tr.� i t�t ty BUILDING � r a I t • t , r r . i, , i r , 1 4 i 7 f • r 1 f1. r� t• , •. .� --.. .� w.. i_. _. � .. .. _. _ �--� - .L ... _ram DEPARM31 Of PUBLIC SAFETY CONSTJI 'alks SUPERVISOR Licissis Expirest '• `.."r:::::.:;;'.: `::; :;.,:' BOY JR RETT I DENNIS-, NA 02670 MTR n - E a 0 0 D'c_ armicnt of hidustria/.-lccidetit.v j16. MiCe o//nvesti9ations 600 If alrintttn Street Boston. lfas's. 02111 `- Workers' Compensation Insurance Affidavit MegsT PR le�thlv"` nn 1.���C�' loc•ttion 4—D�� �GLV�Gu��� LADSLR4 y cit` A 7 sV�A�G�a�Q.� nhonr 41—ato (o I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any:apacity pl am an employer providing workers' compensation fo-my employees working on this job. hone#: insurance co. \ \C "�\r �C.��_l�e�\�c� polio,#__TC CC ISS9 2p)( ls- �,...:_......ate.:._.__._._._.__... . I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the followin_workers' compensation polices: company name: address: phone#: insurance co. pnlic,# company name: address: city: phnne#: insurance co. nolic,# .\tiacti'additional sficet if rice! sary ::r _ 4, T�_M•::•- -- :_ - - `�� w'�u .:�7:_:r:c�—j ,.v"=... �:,-t.i:'�.:w w : ..fir_. :.^. Failure to secure coverage as required under section?iA of iNICL 1_=can lead to the imposition of criminal penalties of a fine up to SI i00.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this suuemcnt may he fanrardcd to the Officc of Investigations of the DIA for coverage,criftcation. I do hereby certirVi der Tins nu ralties of perjurt•tha.the information provided ahove is true and correct. Sianaturc Date 16:ao _ ( D Print name _ Phone R 2 , y--,'ziO2o rye- official[INC only do not write in this area to he completed by:in or town official k: a. 2.. cih•or town: permidliccnsc# r•It3uilding Department , r• QLiccnsing Board C; ❑check if immedi:Ue response is required ❑Selectmen's office u' Qllealth Department (; contact person: phone#: FlOthcr - .t Information and Instructions iViassaClluSCtts General Laws chapter 152 section 25 requires all employers to provide workers compensation fir their employees. As quoted from the "law", an empinree is defined as every person in the service of another under any contract of•hirc, express or implied, oral or written. An emplurer is defined as an individual, partnership. association, corporation or other legal entity, or any two or more of the foregoin,, en-aged in a joint enterprise, and including the legal representatives of a deceased employer, or the rccciyer or trustee of an individual • partnership, association or other legal entity, employing employees. However the owner of a dwelling house hawing not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to he an employer. NiGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any.of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial .Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of industrial Accidents. Should you have any questions regarding the "law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. —.-,,.-,�.-..,.....-..�-..rye->,�---•-•..__..,.:...,�,�:..,�.-:.-n--..-�, f - - City or Towns Please be sure that the affidavit is complete and printed legibly. Tile Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, Ma. 02111 fax r: (617) 727-7749 phone r: (617) 727-4900 ext. 406, 409 or 373 Application to ,pN•,�,. ,N 1997 236 O'p Ppp� •pt M�yt�� 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 buildingsaXoEse arage- ❑ Commercial ❑ Other 2. Exterior Painting: (� 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). /\ TYPE OR PRINT LEGIBLY J1 DAT MAP N 0 ADDRESS OF PROPOSED WORK SSESSOR S 0 OWNER �D O C-- ' ASSESSORS LOT NO. 8 HOME ADDRESS TEL. NO. FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). AGENT OR CONTRACTOR ��� E'rw\�� TEL. NO. ` �C� 10 ADDRESS 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). _\ � iU Signed 4-4'10" O er-Co rector-Agent Space below line for Committee use. '424W • Recei�ye I bV-,H:DC._ D 5 U Date - The Certific to is �;�� 4Lr - � T.®CTime ` 21997 1 4 /`• �t�o� c -� /� Tr y�;�O r �, E•+ G�ACY �1�7�+KA Approved ❑ 'IMPORTANT: If Certificate is approved, approval is subject t e to day appeal period provided in the Act. Disapproved ❑ Town of Barnstable _ Old King's Highway Historic District Committee SPEC SHEET FOUNDATION ��� CCU�C,re• Q-,�,o��'.��.-ems SIDING TYPE(2 ��S�`�o-a�� Cy�os S\�wu(�.COLOR CHIMNEY TYPE' COLOR�o� ROOF MATERIAL �ST���\"z S"�, COLOR PITCH WINDOWh SIZE TRIM COLOR DOORS COLOR ��'��� �y.e SHUTTERS ���jph.� �� 1 COLOR GUTTERS � ��� ��\J "QV\ \ C �20•c�,�� DECK GARAGE DOOR3��,�����c�,�� S�-a-� COLOR L\10 5 ra ` SIGNS \C\\ C1- COLORS FENCE � . COLOR NOTES: Fill out completely, including measurements and material a/colors to be used. Three copies of this form are required for submittal of an application, along with three copies each of the plot plan, landscape .plan and elevation plans, when applicable. Plot plan need not be "Certified" except for new homes, but should show all structures on the lot to scale. SPECSHT •....,.._... _... __ _ _ �,._,.._�._..._..,. _.,._,......_...................._._.._.............__:..:..............___................ ...... _ f i Town of Barnstable-Planning Department Old King's Highway Historic District Committee 1 MEMORANDUM TO: Building Commissioner FROM: Gwendolyn Brown, OKH Secretary DATE : June 11, 1998 SUBJ: Modification to Prior Approved Plan A minor modification has been approved by the OKH Committee to a prior approved plan for the applicant (s) named below. The modification is briefly summarized and I have attached backup -material for your records.. Applicant (s) Amek Holdings of Cape Cod Map# 110, Parcel 004-008 Address of proposed Work #5 Lancaster Way W. Barnstable, MA 02668 Meeting Date Approved by OKH October.:22, 1997 Minor Modification to change the colors of Clapboards and garage to. Oriel Gray-SW2095, and the Trim to Gazebo White-SW2221, and the Doors to Georgetown-SW2155, and Shutters to Victorian-SW2017. Chairman June 10, 1998 Date If you should have any questions, please do not hesitate to contact me at ext . 790-6285 . MEMOsc ASSESSORS MAP. NOTES. = ` PARCEL: 4-8 i'L ST :HOLE LOGS 1. VERTICAL .DATUM:. ASSUMED FROM QUAD CNGVD ENGINEER. THD:alA5 M'cLELLAN, P.E. NOT `AVAILABLE.- 5• � ZONING: RF 2. MiTNICAPAL WATER IS ;.. CURRENT WITNESS. JERRY DUNNING 40 - 4„ PVC PIPE TO BE USED THROUGHOUT'SEPTIC SYSTEM. BUILDING'SETBACKS. 3. SCHEDULE - -20 DATE. 9 93 T UNITS TO CONFORM WITH.AASHTO H 10 & H r F: S: 15 R. 15 4. .4LL PRECAST •` STR �_ PERCOLATION RATE: < 2 MIN/IN LOADING SPECIFICATIONS. .� - W SE - E PITCH 1 _4 PER FOOT UNLESS NOTED OTHER I LOCUS FLOO D ZONE: C TH 1 TX 2 5 PIP �_ � ( ) 85S _.. �i 6. FIRST 2' OF PIPE OUT OF D BOX TO BE LAID .LEVEL. ELEV. TO ACCOMODATE THE 94 TOP ar 7. THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED 2 SUBSOIL 83 5 o USE OF A GARBAGE DISPOSAL. '�•4 SILTY B. ALL CONSTRUCTION-DETAILS ARE TO BE IN CONFORMANCE WITH THE . FINE / \ 60" SAND STATE OF MASS. ENVIRONMENTAL CODE (TITLE FIVE) AND LOCAL 93 80S LOCATION MAP Gl HEALTH REGULATIONS. 4 \ Z CLEAN UTILITIES PRIOR � � , 9. CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILIT 0 LOT" 7 . PROPOSED HELL MEDIUM 3O 69 + S.F. y�' \ -FINE TO CONSTRUCTION. ,1 _ �� o \ 0.69 -�- AC. t� 'S SAND ( _ ) y sz _ _ CERTIFY SUITABLE SOIL CONDITIONS yd y 10. DESIGN ENGINEER TO INSPECT AND I TO A DEPTH OF 4' BELOW LEACH PIT AT: TIME OF CONSTRUCTION. _ 144 73 5 1 11. D-BOX TO BE WATER TESTED TO ENSURE LEVELNESS AND EQUAL FLOW. _ \ 94 90 s � , � � _ _ 12. SEPTIC SYSTEM AND WELL LOCATION ARE IN ACCORDANCE WITH MASTER _ 93 PLAN (REVISED 5-2-93) ON FILE WITH BARNSTABLE HEALTH DEPT. _ _ � \ �'• / NO GROUNDIIATER ENCOUNTERED _ \ \ ' 92 (GROUNDWATER ON LOT 5 AT ELEV.= 48-1) 89 , / -91 - - _ SEPTIC SYSTEM DESIGN \ \' .' • 89 IIALK--OUT _ - - W>ESTIMATE:FLOW E T DECK 110 DAY 1x /4 BEDROOMS AT GAL/DAY f BEDROOM 550 GAL/ g 16, 6' rl 23'8 41 - _ , �, '8S / SEPTIC TAN ,� �' SSA GAL/DAY * 1.5 DAYS = 825 GAL PROPOSED ' fs , , ,, 5 BEDROOM 24 85 -9g ` . ," , 8 4 USE GALLON SEPTIC TANK DWELLING, .��_ 30' D1I GARAGE LEACHING AREA: s' Q" 16' 4' 24' 5 p / '"-82 24 83 - _ \: o cQ G USE 2 LEACH PITS (6 x 4) WITH 3' OF STONE 82. , - �' � ' \ ` , ` 80 (12 EFFECTIVE DIAMETER x 4DFEP) 7A \ r , PROPOSED DWELLING 79 SIDE AREA 12 x 4 x PI = 151 SF (2.5) - 377 GAL/DAY 'BOTTOM AREA: 6 x 6 x PI =113 SF (1.0) - 113 GAL/DAY TOTAL CAPACITY' _ 490 GAL/DAY. 7e x 2 PITS 980 GAL/DAY 80 , \ SEPTIC SYSTEM SECTION 2" PEASTONE � \ co 76. 5 OF3 4" - 1 1 2" 79 �' , ``-CATCH BASIN COVERS WITHIN 12" WASHED STONE � 77 � 88.0 \ \ , 6g , 1 TOP OF FOUNDATION OF FINISHED GRADE r q0• 76' \ BENCHMARK AT 78 ` / \ - CATCH BASIN 0 _ - 5 ELEV.- 76.0 78.62 ELEV. D-BOX \ •, \ ' � � �' ' �� � � 1500 GAL 78.14 8 73. a Alm ELEV. 69` s L - SEPTIC TANK ELEV. 72.0 4x4 ELEC. PAD \ ' ' �'�' y4 ELEV. Y 3 3 g' 79.0 TEE SIZES: 76.0 •---- =- r r r r ./ ELEV. INLET. 6 UP, 10 DOWN / 72. 8 coC „ , (UNDE,O OUTLET 6" UP, 19 DOWN ONE LEACH PIT (6 x 4)) WITH 77 . 3' OF STONE 12' EFF. DIAM. x 4' DEEP) (H--20) 76 / , BASEMENT) ' BREAKOUT CALC: (78.3 -- 73.8)/49 x 150 = 14' 75 / BENCHMARK AT 74 -!� CATCH BASIN 73. 0 ELEV.= 729 SITE AND SEWAGE PLAN APPROVED BY: DATE: KEY: L OCA TION EXISTING CONTOUR. PRO POSED CONTOUR. OF LOT 7 LANCASTER WAY �` ''AAS „ EXISTING ;SPOT ELEVATION 25.5 �: . ; W EST BARNST ABLE MA PROPOSED SPOT ELEVATION. 25 -+ TEST HOLE: ,.. PREPARED FOR. UTILITY POLE. ••-a- . FENCE LINE: . DM tr REEF REALTY HYDRANT. -6 SCALE:. . � - 30' DATE. 3-18-95 ' DEMAREST-McLELLAN ENGINEERING RETAINING WALL. � ��� 24-SCHOOL STREET P.O. Box 463 REFERENCE: PLAN BOOK 454 PAGE 96 WEST DENNIS, MASSACHUSETTS 02670 P.E. OH Z. DEMAREST JR. P.L.S. REVISED: 10-2-97 D1b1 A 93-025 rnsF2L7) _ _ _ __ THOMAS McLELLAN, ' J NLl REVI