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0096 LOMBARD AVENUE
r h J O ff 96 LON�k,8X A\4 N V® ��•\) 152 1/3 ORA � � 10% �Ila t+ Sign TOWN OF BARNSTABLE Permit * BARNSTABLE. • MASS Permit Number: Application Ref: 201006138 20070537 Issue Date: 11/10/10 Applicant: MCNAMARA, CHRISTOPHER TR Proposed Use: BLDING, HRDWARE, FARM, STORAGE Permit Type: SIGN PERMIT Permit Fee $ 50.00 Location 96 LOMBARD AVENUE Map Parcel 155014 Town WEST BARNSTABLE Zoning District RF Contractor PROPERTY OWNER Remarks BEACON SALES 3 SQ DISPLAYED ON MAIL POST Owner: MCNAMARA, CHRISTOPHER TR Address: 492 DEPOT ST HARWICH, MA 02668 Issued By: PC . .............................. ........ ....... ....... .. .. . :;: :<< :'>>`:: P ST HI ARD. THAT..Y ISIB:LE..FR M.T IE.S.T ET':<:: >:>'' ,: '< :'::><' :.;:' ........................ .::::. .:.:.................... .::.:::::: 0:::.... . T S C. : . SO..: .: .... ...:. :.5.:. ..:.:. O:: ::. ..:...::..:.::..:::. 1 'S 1 TOWN OF 9 M"STABLE r"-C 9 t"D'V -9 PMI 2: 19 OfIHFTp� Town of Barnstable Regulatory Ser t��Cq aarwsraehe' + y Thomas F. Geiler, Director Huss. a 0 1% Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, JMA 02601 www.town.barns table.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit # Building Official approving____________ Application for Sign Permit Applicaut: vCdbl�__�/�v Co. -----e--------------------Assessoh-s No.-- Doing Business As:--4Ak-4l�A-_�& >w- --------Telephone Sign Location / Street/Road: -- Zoni)g District:—_-_____ Old Kings HighwayP Yes/No Hyannis Historic D]StrictP Yes/No Property Owner ;�� �9 rTelephone:_ -y31 Address:--- P- _�L ---------[----------Village: ----- Sign Contractor ---------------Telephone:------------- Mruling Address:--_ __ __ ----- ----------- Description ------ Please follovv die cover directions. You must have an accurate rendition ol'51g» with dimensions and location. Is the sign to be electrified? Yes/ )c Note. II yes, ,i pr�ri»g permjtis required) Width of building face ----------ft. x 10 Check ohe Reface existing sign---- or New_!� Total S Ft. of proposed sign 3 q• P P � Cs) -----�- II you h,c ve,I(jdjtroj),q/sig»s ple,7se;rttIcL,7 sheet Lsti»g ewh OJl e rndi (Jj 1nCJJs/OI)S If refacing an existing sign please provide a picture of the existing sign with dimensions. l hereby certify that I am die ovvner or drat I have the authority of die owner to make dhis application, that die information is correct rind that die use and onstruction shall conform to die provisions'of' §240-59 dhrough §2.40-89 of the Towu of Bann e Zoning di lice. Signature of Ovvner/Authorized Ag -- Date '''vuw r I-TAr1 c '10 OCT -6 P :42 °F' Er°'`y Barnstable Old Kings Highway Historic District Committee -- °; 200 Main Street, Hyannis, MA 02601;TEL: 508-862-4787 Fax 508-862-4784 y MnSS 039. `EDM"�� APPLICATION, CERTIFICATE OF APPROPRIATENESS Application is hereby made, with four(4)complete sets, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings, or photographs accompanying this application for: Check all categories that apply; 1. Building construction: ❑ New ❑ Addition ❑ Alteration 2. Type of Building: ❑ House ❑ Crarage/bam ❑ Shed ❑ Commercial ❑ Other 3. Exterior Painting, roof ❑ new roof ❑ color/material change, of trim, siding, window, door 4. Sign : 7.� New Sign ❑ Existing Sign ❑ Repainting Existing Sign 5. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Retaining wall ❑ tennis court ❑ Other 6. Pool ❑ swimming ❑ Other man-made pool Type or Print Legibly: Date: Address of proposed work: House# Street:q6_koynt o A✓� Village W Assessors Map Lot# Description of Proposed Work: Give particulars of work to be done: U, NIA w S�1 •v '� .tiR�vl� Qgen)r Contractor(p ' Telephone#: ©S 614?" U8/ Address: G4 �16 �uls As On 61,g �o a'l+ G a Contractor/Agent' signature: NOTE All applications must be signed by the current owner Owner(print): Telephone#: Owners mailing address: r`a,!,,_4% may Owner's signature: �� 1R�. aid For committee use only. This Certificate is hereby APPROVED/DENTED Date t O Members signatures p C @ L Atli 3 0 Any c nditions of a I: HISTORIC PRESERVATION 1 Q:IGMD-Groupsl0id Kings High way10KHNewAppIOKHCerl Approprinteness 07.doc Town of Barnstable Old King's Highway Regional Historic District Committee CERTIFICATE OF APPROPRIATENESS SPEC SHEET Please submit 4 copies Foundation Type: (Max. 18"exposed) (material-brick/cement, other) Siding Type material: Color: ' Chimney Material: Color: Roof Material: (make & style) Color: Trim material I nil Color: Roof Pitch: (7/12 minimum) Window: (make/model) rTrk�t6e�aI color TOWN O Size(s): HISTORIC PRESERVATION Door style and make: material Color: Garage Door, Style Size Material Color Shutter Type/Material: Color: Gutter Type/Material: Color: Decks: material Size Color: Skylight, type/make/model/: material Color: Size: y Sign size: d Y Type/Materials: AtAm„AIA-i Color: ��Q� t" ey Fence Type (max 6' ) Style , material: Color: 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 INFORMATION: Signed: (plan preparer) print name tel.no. Location of application: Street no. Street Village 2 I 492 North Hinrs,- August 27,2010 Beacon Sales Attn: Lionel Lw-ive 48 Lombard Ave West Barnstable,MA 02668 Dear-Lionel: This letter is to serve as refierence as to v, C.rS$, i)'::'rI<::, andc=r:. Lombard Ave, We,t Barnstable,providin;x : ,: „ ,i.Gsi io hst:i11.a at t',.zi location. If you have any quer:,tio►rs,.please cor.a@;.,i rc, ! Sincerely, Chris McNamara Trustee ---------------- • GC� � D �IC� D • . . ...... ... .... . . . .. . ALO 3 8 TOWN OF BARNSTABLE HISTORIC PRESERVATION i * Y 1'4- 2- t ��w_ .��rr'�—.,t �, �'r, , � �..- }•..-fit, i 4 _ BEACON_: - ,y ♦M_ _ \ � yam,. _ � ,� � r cid y ✓ 1 P .' .Y ;y,. {4 r s ': . . "r..L• Ph r, � � � n� � h -� ►�'���r' .,a,. - - - ♦s"!'' -'yam;+k. v � a? w � w C- i - �W k 49 , e w { o t s s �d — 0 03/12/2009 • TM u �M F' k � J 2 s �t"Eti Town of Barnstable Building Department - 200 Main Street BARNSMBLE� # Hyannis, MA 02601 ' MASS. (508) 1639. 862-4038 9� ACED MA'S� 3 Certificate of Occupancy Application Number: 20061722 CO Number: 20060131 Parcel ID: 155014 CO Issue Date: 10117106 Location: 96 LOMBARD AVEIST Zoning Classification: RESIDENCE F DISTRICT I Owner: MCNAMARA, CHRISTOPHER TR Proposed Use: INDJCOMM 492 DEPOT ST HARWICH, MA 02668 Village: WEST BARNSTABLE Gen Contractor: JOSEPH R FINNEMORE Permit Type: CC00 CERTIFICATE OF OCCUPANCY COMM Comments: WHOLESALE AND STORAGE ONLY. NO RETAIL. /7 ld4 Building 0�/artment Signature Date Signed r� TOWN OF BARNSTABLE Milding Application Ref: 20061722* BARNSTABLE, +` Issue Date: 07/27/06 Permit 9 MASS. 1639• A Applicant: JOSEPH R FINNEMORE Permit Number: B 20060755 Proposed Use: IND/COMM Expiration Date: 01/24/07 [Location 96 LOMBARD AVE/ST Zoning District RF Permit Type: COMMERCIAL ADDITION ALTERATION Map Parcel 155014 Permit Fee$ 810.00 Contractor JOSEPH R FINNEMORE Village WEST BARNSTABLE App Fee$ 100.00 License Num 055665 Est Construction Cost$ 100,000 r— Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND INTERIOR PARTITIONS IN WAREHOUSE THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: MCNAMARA, CHRISTOPHER TR BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 492 DEPOT ST INSPECTION HAS BEEN MADE. HARWICH, MA 02668 Application Entered by: NL Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY. ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLY 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 FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: I. FOUNDATION OR FOOTINGS. 2. ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE.APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). BUILDING INSPECTION APPROVALS PLUMBING IN'SP,EE`CCTION APPROVALS ELECTRICAL INSPECTION APPROVALS U'V �e VS 9/"' )Q S U c y / g y A G c� 2 2¢IN 2r� CG��� 3 1 Heating Inspection Approvals Engineering"Dept Fire Dept /'� 2 Board of Health 06( W/dA ' • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application# Health Division �' .':"_ 2 Conservation Division Permit# Tax Collector 'i`i;.- V� '-l--Date Issued l.0 Treasurer Application Fee w Planning Dept. �g Permit Fee Date Definitive Plan Approved by Planning Board Q lot Historic-OKH Preservation/Hyannis Project Street Address Village t�• ,�yJ �"�A Owner Address 1�at �i- Telephone r5 `2-� �-~•� Permit Request sta)y \a Square feet: 1st floor:existing proposedN%'� 2nd floor:existing proposed Total new Zoning District /� Flood Plain Groundwater Overlay i Project Valuation V 06 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: A Gas Cl Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: 4,oning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial XYes ❑No If yes, site plan review# Current Use Proposed Use w Orr\ tt BUILDER INFORMATION Name �o S?:f Vg-- Telephone Number Address C-c���e sn� �r-ctt� License# C7S'ste�oS Home Improvement Contractor# 100 ZZZ Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. -r ,.PATE ISSUED { MAP/PARCEL NO. ADDRESS Ir VILLAGE s OWNER DATE OF INSPECTION: : } i FOUNDATION FRAME INSULATION _r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL , .{ GAS: ROUGH FINAL ' >. FINAL BUILDING Y• ' . 1. DATE CLOSED OUT j a ASSOCIATION PLAN NO. � �4J �\ 1/tG IiVI/tli�Vi•irGwiai• vJ ♦•�wuu».............. \ Department oflndustrialAccidents Office of Investigations 600 Washington Street Boston, MA 02111 i www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/]Electricians/Plulubers Applicant Information Please Print Legibly Name (Susiuess/organization/Individual): Address: City/State/Zip: .VM Phone#: AVII u an employer? Check the-appropriate bog: Type of project(required): 1, am a employer with 7!�> — 4. ❑ I am a general contractor and I 6. Md construction employees(fall and/or part-time).* have hired the sub-coutractorslisted on the attached sheet $ eling 2.❑ I am a sole proprietor or partner- • ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp,insurance. g, El Building addition o workers' Comp.insurance 5, ❑ We are a corporation and its [N l t).❑ Blectrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs o. additions myself.(No workers' comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.) t . 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 andthen hire outside contractors must submit anew aff davit indicating such lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy inforn2ati in. I am an employer that is providing workers'compensation insurance for.my employees. Below is the policy andjob site information. Insurance Company Name: �2� � y OZ�J�2�'t�R ��S CIO Policy#or Self-ins.Lic. #: io'E>t0 0 V% — `3 a-'3C.0Q.—t—CSC,Expiration Date: 0 _O t —O- Job Site Address: O NN • City/State/Zip: \N•`CK 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify nder the pains and penalties of perjury that the information provided above is true and correct Si ature: /eZ"'' Date: v Phone#: F only. Do not write in this area,to be completed by city or town officialn: Permit/License# hority(circle one): Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Insper-ter LL _ 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 resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or.on the grounds or building appurtenant thereto shall not because of such employment-be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s) of inswance. 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 sore 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 contactyou regarding the applicant . Please be sure to fill in the permittlicense number which will be used as a reference member. In addition,an applicant that nnist submit multiple permitllicense 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 an file for future permits or licenses. Anew affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would hike to thank you i a advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. r 617-727-4900 ext 406'or 1-877-MASSAF'E Fax#617-727-7749 Revised 5-26-05 www.mass.gov/'m'a Town of Barnstable Regulatory Services 9XAg Thomas F.Geiler,Director �'�FD►AA��',m , Building Division. Torn Perry, Building Commissioner 200 Main Street, ljyamnis,I AU b2601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Scction. If Using A Builder M9 AMA2A ,as.Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. CAV (Address of Job) (J O Signature of Owner Da e �`2�S�COP�1t. \y`—\VAtJ�ta2A Print Narm Q:FORMS:O WNERPERMI.S SIGN COMMERCIAL-BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $150.00 Alterations/Renovations <igQ;Dp/ Building Permit Amendment $50.00 FEE VALUE WORKSHEET NEW BUILDINGS square feet x$140.00/sq:foot= x.0081= ALTERATIONSMENOVATIONS OF EXISTING SPACE square feet X$96/sq.foot= ti�301 ct-.2"`O X-.0081= STORAGE BUILDINGS ONLY square feet X$32.00/sq.foot'= X.0081 Commprojcost Rev:063004 _�� ✓�re a��r��zoouae e o ,f uadaaeiZ BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 055665 ,= Birthdate• �`54 xpir as:05112/2008 \ Tr.no: 25474 ;�truotion=CS. stricted: 00 JOSEPH R FINNEM RE 4 e� 34 COCHESET PATH. 3 W YARMOUTH, 0267 Commissioner -------------- 77 ✓�ze'!°noo�vnzoowrea� o�./�aaaacliueall Board of Building Regulations and Standards — HOME IMPROVEMENT CONTRACTOR Registration: 100222 Expiration: 6/12/2008 Type: Individual JOSEPH R.FINNEMORE Joseph Finnemore 34 Cocheset Path ,,,�Gr.�.. W Yarmouth,MA 02673 Deputy Administrad r NOTICE NOTICE W TO a TO EMPLOYEES EMPLOYEES 5-4 The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 — http://www.mass.gov/dia As required by Massachusetts General Law, Chapter 152, Sections 21, 22&30,this will give you notice that I (we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: HARTFORD UNDERWRITERS INSURANCE COMPANY NAME OF INSURANCE COMPANY ONE TOWER SQUARE HARTFORD, CT 061.83 ADDRESS OF INSURANCE COMPANY (6S60UB-1323C97-1 -06) 01 -01 -06 TO 01--01-07 POLICY NUMBER EFFECTIVE DATES BRYDEN & SULLIVAN INS 485 ROUTE 134 PO BOX 1497 SOUTH DENNIS MA 02660 NAME OF INSURANCE AGENT. ADDRESS PHONE# JOSEPH FINNEMORE HOUSEWRIGHT 34 COCHE.SET PATH LLC WEST YARMOUTH MA 02673 _ EMPLOYER ADDRESS EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital aid medical services in accordance with .the' provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the' injured employee. The employee may select his or her own physician. The reasonable cost,of the services �— provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS 014587 W20PIG02 TO BE POSTED BY EMPLOYER . ...: ': i '.: i::' :> `' `::....' -.-..isi:i`.::fi:i:i:i::i:ir:E%;:..;<;:..�::::;::;::;::;::;:;:.:;;^ i:%;?:`%:::i::i TE MM DD a ( YY) 1. ® ::: ':,, /1 III ..:GERT :F17E:::O. .: [ :S. J:R ►N. .E:.::.::.::.:..::...::. :::::::::::::::::.:.:::::::::::::.::::::::::::::::::. :.::.::.:.::.::.::.::.:::. .:: ::.::: .: PRODUCER [:ALTER HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION NLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE BRYDEN & SULLIVAN INS OLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 485 ROUTE 134 THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO BOX 1497 COMPANIES AFFORDING COVERAGE SOUTH DENNIS MA 02660 COMPANY 75BKG A HARTFORD UNDERWRITERS INSURANCE COMPANY INSURED COMPANY _. .-_J.O.S.EP_H_F_I.NNEMORE_HOU.S.E.WR.I.GH-T------ B LLC COMPANY 34 COCHESET PATH C WEST YARMOUTH MA 02673 COMPANY D . C.:...EFillt�lwS............................:.::.:::::::.:. :................................................................:.:::..::. ...... ::::::.:.:.::.:........................................................::.....::::::::...:....................................... THIS IS:T::::::......................................................................................................................................................................................................................................................................... 0 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM\DD\YY) DATE(MM\DD\YY) GENERAL LIABILITY GENERAL AGGREGATE S COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. g CLAIMS MADE a OCCUR. PERSONAL&ADV.INJURY $ OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE S FIRE DAMAGE(Any one fire) S MED.EXPENSE(Any one person) $ AUTOMOBILE LIABILITY COMBINED SINGLE S ANY AUTO LIMIT ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) S HIRED ALTOS BODILY INJURY NON-OWNED AUTOS (Per Accident) $ PROPERTY DAMAGE $ GARAGE LIABILITY ALTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE S UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND A EMPLOYER'S LIABILITY (UB-1323C97-1-06) 01-01-06 01-01-07 STATUTORY LIMITS THE PROPRIETOR/ EACH ACCIDENT S PARTNERS/EXECUTIVE INCL DISEASE-POLICY LIMIT $ OFFICERS ARE: FX I EXCL DISEASE-EACH EMPLOYEE S 100,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. :C RTI ICAT ::>:z:::>:.;: .::>:;:><:::>::»::::»> ><:::::::::::>::>::>::>::.................::>:>::; :::::::::::::`><::<::::::::::::::::>::;.:,:.. :,:,,:.;::, .:.,._::::::>::>::::>::::>::>::::>:::::>:::>:::> ::>::::>::::::>:::;<:::::»:::>;>:i<;::>:::<:>:::::»:.... :<:>:<:>::::>::::>:::<:. >::>:::::::>::::>::;<:><> :...:E:MOt.�ER::::::::::..........................................::.............................::::::::.:::..::. .::::::.:::::::::......................................::. :::.::::::::::.:............::...:......................:.:::::.::.::::::::::.:.:::::::::::.:.....................................................CAIrICELLATION..::::::. .:.....................................................:.:::::::.:::..:::::::::::::.::::::.... ..................................................:..:::::::::::::::::::.::.::::::::.::::::::::::.:::. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE MCNAMARA REALTY TRUST LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR 492 DEPOT ST LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. HARWICH MA 02645 AUTHORIZED REPRESENTATIVE .. : ::: ........ t........ ..................................................................::.;:.;:.;:.;...;:.:;::;.;:.;: .;:.;;:.;:.;:.;:.; OAC PORA 1AN:<�:993.. app�Od�[� WEST BARNSTABLE FIRE DEPARTMENT Front of Building (facing yard) NSA) window(s.).; window(s) ......-....... _ ' door manager 0 office _ door door ---- 2' — --- --- door counter a Cr Y /1 L. 0 0 0 warehouse Lreak -E doI door o door "oor �tll�ty �--->> �loset office office mechanical ) door do r 12' 12' 12' room 12' door � t Iz-,v F- 48 Lombard Realty Trust 492 Depot Street North Harwich, MA 02645 MATERIALS TO BE USED AT 96 LOMBARD AVE PROJECT 2 x 4 framing Sheet rock walls Drop ceiling Carpet/tile flooring Solid core doors FUZ(— NDC)C1L S S C'v.�� Insulation as necessary I i YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town(which you must do by M.G.L-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL,367 Main Street,Hyannis,MA 02601 (Town Hall) DATE: to d(I'101, Fill in please: � APPLICANT'S YOUR NAME: beoA cearl BUSINESS YOUR HOME ADDRESS: moo-3eigowl. TELEPHONE # Home Telephone Number NAME OF NEW 81161NE5 . �-� 16 THIS:A HQNI QCOURATI4N:�. Y€S -- .:.- Have you been-glVi3n approval from the'b 'Idir�a.divielon? 'YES NO_ ADDRESBL�F I UBIN>ESS 9lo Lbw MAPfRAROEi::NUMBER S" CS1 When'starting a new business.there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST-GO TO 200 Main St.--_(corner of Yarmouth Rd.&Main Street) to make sure you have the appropriate'permits and licenses required to legally operate your business in this town. 1. BUILDING COM ER'S OFFI This individu (h b n ir10 d ny permit requirements that pertain to this type of business.. ut orized ature** : COMMENTS: , r k 2..BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of'business. , Authorized Signature**.' COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. ti Authorized Signature* COMMENTS: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Pare �� } Permit# �h zt 0 S� • Map oo Health Division o2 16 0 (o —�!� -ER-aPt v gprr . Date Issued 46W& Conservation Division Fee JJ Tax Collector Application Fee G� Treasurer Planning Dept. Checked in By _ Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis No ��c S�,► �ucv►�IU�1- Project Street Address `--�M�N-4-Q '�-Ve - Village Owner �� t.�,,,,bc�n QV--4 Address cARZ- "D-Pcn Telephone S� -� ► i Permit Request c� iii rn Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Valuation Zoning District Flood Plain Groundwater OveClay !�2 Construction Type of Size •ZLk We e Grandfathered: R'Yes ❑No If yes, attach supporting documentation. welling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) - Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new `5;0tal Room Count(not including baths): existing new First Floor Room Count ZHeat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No V Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size' Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yeG,site plan review# Current Use- Proposed U BUILDER INFORMATION Name �t,1, C•y���ll Telephone Number Address �`} ��t'paNessc-'c� ptvQ - License# CS Oy7R0` ��A RS1'FPe2 0 U_-Lw`AA Home Improvement Contractor# �`NZIM `4v Q\P�- \Yz0' .Worker's Compensation#' PCs 1s �� t `a'c �jCC-C 1�:k1C- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE � �� .— DATE 2- t' \O�Ob FOR OFFICIAL USE ONLY 4 a PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER r µ " DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL .. u FINAL BUILDING DATECLOSED OUT ASSOCIATION PLAN NO. I BUILDER INFORMATION Name �A `�—�2y Telephone Number , `�' 3 Address �� � License# C-S 04:::"7c>vo l �A 1yi`fiP2Q , �o. O�` i Home Improvement Contractor# 11\,, n _ l a����Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE LLe) BUILDER INFORMATION Name --DAo Telephone Number — 4\3 Address �`� ��gnc�N�sse �v� License# LS 0<o71C�U 1 \v`kswp-g—Q a �A 0 Home Improvement Contractor# \y\P� c��RrL U LvtertE '1WGc� `.1'� Workeri s Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 'Z—x co SIGNATURE ((—,)LjVqL3 DATE 3II 6I Db 4f The Commonwealth of Massachusetts Department of Industrial Accidents Office.ofInvestigations- ' ' 600 Washington Street Boston,MA 02111 °,M s••'. www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): ���1�laCl. J 1Cw1Qjty Address: 1-9 o.>J s c e T Qv City/State/Zip: VA trio,IF I_— Phone#: Are y an employer? Check the-appropriate box:. Type of project(required): I am a employer with O�' . . 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors Remodeling '.El am a sole proprietor or partner- listed on the attached sheet x ❑ g 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.❑ Electrical repairs or.additions ❑ I am a homeowner doing all work right of exemption perMGL 11.❑ Plumbing repairs oradditions myself.'[No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.]t employees. [No workers' comp.insurance required.] 1 Other�cri�� � any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infomaatiou: �• Homeowners who submit this affidavit-indicating they.are doing all work and then hire outside contractors must submit a new affidavit indicating such: :ontractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. am an employer that is providing workers'compensation insurance for my employees.'Below is the policy and job site formation. . 1swance Company Name: )licy#or Self-ins.Lie. #: 'T t3 V> Expiration Date: Cv�?-4r�7 ib.Site Address: Oth Lo►�t�t�cva �1 v i3 City/State/Zip: W ttach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). tilure to.secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ie up to$.1,500•.06 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a.fine up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of vestigations of the DIA for insurance coverage verification. to hereby certify unAr the pains an naldes erjury that the information provided above is true and correct atare:.Of ( 1 p Date: 3 b tone#: '7 7`f 36c5 .O Z l.S 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 vlassachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. ?ursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, ;xpress or implied,oral or written." An employer is defined as-`:an?udiYiauaL...Partpership,,association,Corporation or other legal entity,or any two or more :)f 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. Howeyer:tlie owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the ersons to do maintenance, construction or repair woik`on such dwelling house dwelling house of another who employs p or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence-of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es) and phone numbers)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 urance coverage. Also be sure to sign and date the affidavit. The affidavit should Accidents for confirmation of ins 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.. Se ur lf-insed 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 legubly. 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 permi0icense 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 thata.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 orpermit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit_ The Office'of Investigations would like to thank you in.advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and.fax number: The Commonwealth of Massachusetts . Department of Industrial.Accidents Office 9f'Investigations 600-Washington Street . . Boston,MA 0211 L. Tel. #617-727-4900 ext 406 or-1-877-MASSAFE Fax#617-727-7749 Revised 5-26.05 www.mass.gov/d.i.a MAR-15-2006 15:02 MORSE INSURANCE AGENCY 15087489579 P.01 ACOR& CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDJYYYY) 3/15 2006 PRODUCER (508)238-0056 FAX (508)230-8367 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Morse Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 285 Washington Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. North Easton Village Shoppes North Easton MA 02356 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:NGM Insurance Company Daniel J McCarthy INSURER B:Libert Mutual Insurance 44 Popponesset Avenue INSURERC: INSURER D: Mash Dee MA 02649 INSURERE: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADIr POLICY EFFECTIVE POLICY EXPIRATION RD TYPE OF INSURANCE POLICY NUMBER DATE MMIDD DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PARE GE T EaR nce $ 50,000 A CLAIMS MADE 7X OCCUR TBD 3/8/2006 3/8/2007 MED EXP(Any one neon) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 X POLICY EEC LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) $ HIRED AUTOS BODILY INJURY NON-OWNEDAUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE IJABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN FA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE RETENTION $ $ B WORKERS COMPENSATION AND TORY L M ER EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBEtEXCLUDED? Issued By Company 3/8/2006 3/8/2007 E.L.DISEASE-EA EMPLOYEE$ 500,000 If yes,describe under SPECIAL PROVISIONS below E-L DISEASE•POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION (508)430-1846 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE McNamara Bros. , Inc. EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Chris 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT 492 Depot Street FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE North Harwich, MA 02645 INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE __ Barbara Morse CPC ACORD 25(2001/08) 0 ACORD CORPORATION 1988 INS025(oionos AMS VMP Ine.rAM1477.ardf. , MAR-15-2006 15:03 MORSE INSURANCE AGENCY 15087489579 P.02 MASSACHUSETTS ASSIGNED RISK POOL REQUEST FOR CERTIFICATE OF INSURANCE Use this form to request a Certificate of Insurance from an Assigned Risk Pool Carrier. Please provide all of the requested information, including the facsimile number(s) of the person or persons to whom the Certificate of Insurance should be issued. If this form is fully and accurately completed, the Certificate of Insurance will be issued and distributed by facsimile to each fax number provided below,within two(2)business days of the carrier's receipt. This Form may be mailed or faxed to the Assigned Risk Pool Carrier. To obtain each carrier's contact information refer to the Certificates of Insurance section located in the Producer Community section of the Bureau's website (www.wcribma.org). I. Name, address, telephone number and facsimile number of the INSURED: Name: UlAtJ1 f,.11 -( . . Mailing Address:APOl z© NLSSF-T AYE. 1�c�,I�S1,�� MIA d y Q Physical Address: 'SA Phone: 0 14- %b 8- 112),%S Fax: 2. Name, address, telephone number and facsimile number of the CERTIFICATE HOLDER: °... .. Name: M AMVkI?A 1JC08. 1'NC. i Mailing Address: W q2k 6 y� Physical Address: SIA M L Phone: $- y 3 d - a.o xo Fax: A- y 30- ) $ LA 6 3. Name, address, contact person, telephone number and facsimile number of the PRODUCER: Name: M D Mailing Address: & t) 1JST tJ Contact Person: t)WA Phone: D DSO Fax: 4. Policy Number, Policy Effective Date and Policy Expiration Date If a Certificate of Insurance is needed for more than one policy term, provide the Policy Number, Effective Date and Expiration Date for each policy term. CIA), If the policy has not yet been issued, you must attach a copy of the Notice of Assignment. Policy Number: _T p Effective Date: Expiration Date: 3 -8- 0 7 S. List any special requests for optional coverages/endorsements(see Page 2 for listing of coverages available in the pool and the conditions of availability) or additional information(including changes In exposure not yet reported to the carrier) that will assist the carrier In the issuance of the Certificate of Insurance NOTE. An additional Insured(s) shall not be listed on any Certificate of Insurance unless such additional Insured(s)is a named Insured on the policy. i .ems- of T Town of Barnstable Regulatory Services sAx SS. Thomas F.Geiler,Director .au► �fo►'���`e� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Ovcrner 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 application for: (Address of Job) I 2.11 W U6 Signature of bwner Date Print Name Q:FORMS:0VINERPERML4 SION t � ,.y �•, • :c.':�:` -C;drrtiliii>¢5 oner.� .,� . 126-d 100/l00•d Zti6-1 9011 UP $09 HEN Vd- dJ MY61:01 90OZ-21-83J MCNAMARA BROS., INC. =� Landscaping & Hydroseeding 492 Depot Street N. Harwich, MA 02645 February 17, 2006 Town of Barnstable Attn: Paul Roma 200 Main Street Hyannis, MA 02601 Dear Paul: As you requested I am enclosing this note to remind you this project is located at the old "Barnstable County Supply" facility in West Barnstable. It consists of new roofing, siding, doors and windows. If you have any questions, please call me at(508) 430-2020. Thank you for your assistance with this process. Sincerely, GL . Chris McNamara McNamara Bros., Inc. S eape coal Since 1955 (508) 430-2020 - (800) 441-4727 - Fax (508)430-1846 i �v.. oa "OCR FRONT ELEVATION _ LEFT SIDE ELEVATION DESIGNEDIDRAWN BY ALTERATIONS FOR: DRAWING TITLE: �7 THOMAS A. MOORE DESIGN COMPANYSCALE : PROJ. NO. BLDG. 1 P.O. BOX 2124 26 WAMPUM DRIVE 48 LOMBARD REALTY TRUST EXTERIOR ELEVATIONS 1/4° = i'-o° 25-497 DWG. NO. BREWSTER, MA. (508) 896-6403 -. 48 LOMBARD AVE. BARNSTABLE, MA. - DATE : DRWN. BY : A• 8/27/2005 T.A.M. TYPICAL NEW CUPOLA -_- METAL CAP TYPICAL NEW METAL RWPING I TYPICAL NEW , METAL 5101NG ao 00 a0 RIGHT 51 DE:ELEVATION TYPICAL'FLYING RAW .. rv.C:...'r TRIM L�1....�. 12 eF15T.1 - - _ ! OOUBLC1 ., 5 !L! I i IL '�'�� TYPICA L CIS;. F— FRONT ELEVATION REAR ELEVATION TYPICAL NEw METAL RCOFUIG- TWILLS NEW METAL SIDING "III���JIIIII oa LEFT 51 DE ELEVATION DESIGNED/DRAWN BY: LE:DRAWING TIT SCALE : PROJ. NO. THOMAS A. MOORE DESIGN COMPANY ALTERATIONS FOR; EXTERIOR ELEVATIONS 1/411 = 1I-011 25-497 B G. NO. P.O. BOX 2124 26 WAMPUM DRIVE 48 LOMBARD REALTY TRUST BUILDING #5 DWG. No_ : DATE : DRWN. BY : Al BREWSTER, MA. (508) 896-6403 48 LOMBARD AVE. BARNSTABLE, MA. 8/25/2005 T.A.M. _ TYPICAL NEW CUPOLA TYPICAL'IELV METAL ROO•1• I i i ©© i 1 i i RIGHT SIDE ELEVATION F.CAL•r:Yu:c RArp' Z pJM E>'15T.r- I t I n I 00 FRONT ELEVATION REAR ELEVATION I TYpICPI NS-1 METAL ROOr1•IG TYPICAL NEV/ METAL SIDING LEFT SIDE ELEVATION DESIGNED/DRAWN BY ALTERATIONS FOR. DRAWING TITLE: SCALE : PROJ. NO. BLDG. THOMAS A. MOORE DESIGN COMPANY EXTERIOR ELEVATIONS 1/4" _ 1'-0" 25-497 6 P.O. BOX 2124 26 WAMPUM DRIVE 48 LOMBARD REALTY TRUST BUILDING #6 DWG. NO. BREWSTER, MA. (508) 896-6403 DATE : DRWN. BY 48 LOMBARD AVE. BARNSTABLE, MA, 8/25/2005 T.A.M. Al r Tilt-Wash Double-Hung Windows Standard Options Features 1' FRAME � Exterior outer COLOR HARDWARE frame members are i O ® r covered with apre- � formed rigid vinyl ' Exterior Color PVC cladding, t; option minimizing U SASH topcor complete yourecify a unit clor order:White, maintenance 0; .> Sandtone,Terratone�or O r and providing &Keeper— f. r. :;; Forest Green. an attractive )r�;';K coal with a Flexacron®finish Classic Series'"Hardware t. "`p' U is electrostatically applied to ;appearance. �, Y PP� The standard cam-o Prefinished Interior peraled lock/ • { Andersen®tilt- - penetrate all exterior surfaces Andersen 400 Series tilt-wash keeper is made of engineered wash windows * _ "_ for maximum protection and a composite resin for smooth --. lustrous finish. windows are available with a operation and long life.The are available in pretinished white interior. four neutral colors. tiroY', © Wood sash members are hardware finish on units with Specify White,Sandtone, .' treated with a water-repellent a prefinished white interior is Terratone®or Forest wood preservative for long-last- PATTERNED GLASS white.Slone color is standard on Green color. r ing protection and performance. Patterned glass options are units with clear pine interiors. 0 For exceptionally long-lasting Interior surfaces are unfinished available.See page 7 for clear pine.Low-maintenance �s.�— performance,sill members are more details. ' constructed with a wood core and a pretinished while interiors are Fibrex•composite material exterior. ® Weatherstripping throughout also available. j Sill ends are protectjd and sealed the unit provides a long-lasting, GLASS Stor 11E ATCH * fI with weather-resistant covers. energy-efficient,weather-repellent O O R t seal.For the top and bottom rails, 0 A glazing bead and Tilt-wash double-hung i ® Natural wood stops are made an encased foam material is used. silicone provide superior _• windows are available Optional Luck&Keeper— of treated,clear pine that can be The head jamb liner and sill have a wealhedightness and durability. with Stormwalch'" Estate"Hardwai e* finished to match the interior d6cor. rigid vinyl rib that the weatherstrip. protection.For a co of the On white prefinished interior units g y0 High-Performance"Low-E copy Optional accessories(field ping material conipresses against. and Ili Andersen Coastal Product Guide, applied)include an Estate the stops arc white PVC. gh-Performance Sun" see the Andersen supplier i At the check rail,compressible vinyl pplier nearest you. lock/keeper design,and a 0 A facto p y Low-E glass deliver optimum ry-appfied rigid vinyl bulb material is used.Side in jamb insulating performance.High- selection of fills in a variety anchoring flange on the head,sill liners use leaf type wealherstrip- GRILLES of finish options:bright brass, and side of the outer frame helps Performance Low-E tempered I ping with foam inserts. and high-Performance Son antique brass,polished chrome ' secure the unit to the structure. Low-E tempered See Woodwiight section starling and oil rubbed bronze. Unique block and tackle counter porod glass also r i ® An extruded rigid patented balances feature sized-to-the-unit, on page 55 for divided light available.(Glass option must .k: vinyl jamb liner and fin provide rust-resistant springs that require be specified.) patterns.Please note,till-wash a protective seal against the no adjustment.Glass-reinforced units with high-profile exterior outer frame members.Exclusive nylon balancer shoes provide grilles include a unique exterior patented slide wash assists make smooth,reliable sash operation. glazing bead to accommodate it easy to lilt the sash into wash To prevent accidental release when grille depth. j mode position. in wash mode,they automatically I lock into position with a patented i stainless steel retainer clip. i � Vps ' i AUG 3 0 2005 '. TOWN OF BARNSTABLE HISTORIC PRESERVATION 'Rarecror.'�5 q•egittj,,o rrjdemrrt or Per,r^A9Y7iix Ire nnio wpnrelaly. Learn more online at 64 andersenwindows.com f �:,. y*iYf'{iLiFY•,n!:aF r wYv. i_'!a 6a. +rY.• 1r. F i r I� ' Accessories FRAME HARDWARE Traditional Contemporary I Sash lift* Finger Lifts* �/ +SA_ Classic Series Hardware Classic Series'"Hardware Shown in stone finish. Shown in white finish. Ezteitsion Jamhs" Pine Slonl" Also available in white. Also available in stone. Basic jamb width is 4-1/2" A clear pine stool is available (114).Pine extension jambs and really for finishing.The ty— 110 f ��t are available fur the following, till wash stool is available Contemporary ®--7-{�� wall thicknesses: for 4-9116"(116)and 6-9/16" Sash Lifts* •5-1/4"(133) (167)wall thicknesses.In Estate'"Hardware addition,a high inside sill •G-9/1G"(167) g 1 { Shown in bright brass finish. 1 �c r, •1 I/8"(l01) slop is available as an upgrade -- — --- s, Also available in anli oe for Andersen's lilt-wash units, Classic Series'"Hardware q 'the side and head extension allowing the windows to achieve brass,polished chrome and x jambs are re-drilled in the Shown in white finish. oil rubbed bronze. 1 1} 1 P design pressure 50 performance. '., following width: Specify pine sill stop and Also available in stone. •6 9/16"(167) Sash lift packages.Use of this 1 f ,�t ome sizes may he pine veneer. package will subtract 5/8"(16) ®a Q is �t from clear opening height. 4.,= flanges are reversible to CAUTION: �JP accommodate the following DP50 upgrade not available for Estate`"Hardware •Painting and staining may 11•', wall thicknesses: TW34 and TW38 unit widths or Shown in bright brass finish. cause damage to rigid vinyl. •4 1!2"(114) the 72 and 76 heights. Also available in antique •Products in Sandtone or Terratone° I�) brass, olished chrome and color may be painted any color lighter �;. OII rubbed bronze. GLASS than Teuatone using quality oil-base or latex paint.Submit color samples Andersen®Art Class to Andersen for approval when to r1 . V Available for tilt wash transom painting While.Submit color samples I,r' (, ? r,J to Andersen for approval when units.Andersen art glass panels painting Sandtone or Terratone f'r` come in eleven original patterns, any color darker than Terratone. ! including four Frank Lloyd •Do not paint Forest Green exteriors. tc Wright°series designs.See •Creosole-based stains should not �t y tf page 127 for complete details come in contact with Andersen r on Andersen art glass. products. •Do not paint wealhefstripping. •Abrasive cleaners or solutions containing corrosive solvents should f not be used on Andersen products. i'`?- •For vinyl painting instructions and ii preparation.contact your Andersen 1� y supplier. 2 g � t 0 •Andersen does not warrant J;� the adhesion of paint to vinyl. `t;'•,; e 0 6 3 01��g for More Information � ,a P p9�-E See pages 6-10 for more about: ,Rz- R�,, •Sold separately. OF gP�S��kP Glass Options ? Grilles Insect Screens Installation Accessories FY Irt ;; 65 itr' ..k Table of Basic Unit Sizes Scale 1/8"= 1'-0"(1:96) Unit Dimension V-9 5/8" 2'-1 5/8" 2'-5 5/8" 2'-7 5/8" 2'-9 5/8' 2'-11 5/8" 3'-1 5/8" 3'-5 5/8" 3'-9 5/8' (549) (651) (752) (803) (854) (905) (956) (1057) (1159) t _ _ _ 1 r. rir api/a 2 2 t/e• 2,61/s° 2,-8 t/8" —2'-101/8"r 3'0 t/s" 3�_2 t/a" _ .3 6 t/e" .._ 3'-10 1/8" C3Ro{ugh_Opening? (562) - (664) - . (765) (816) (867) (917) (968) (1070) (1172) Unobstructed Glass- 15" 19" 23" 25" 27" 29' 31" 35" 39" (381) (483) 1 (584) 1 (635) (686) t (737) (787) (889) (991) _a a wl n Cal, ® ® IND RO ®®l TW18210 TW20210 TW24210 TW26210 7W28210 TW210210 TW30210 TW34210 TW38210 E91N [0210 r 7W1832 TW2032 TW2432 7W2632 TW2832II TW21032 TW3032 TW3432 T%V3832 0 t .i! ad p�,•`� n � � Ir It�j� 1��-1���—j �j�T1 t s; 4 TW1836 TW2036 TW2436 TW2636 1AV2836 10 TW3036 TW3436 TYV3836 1✓'. _ n � r� �i � ro I1f II�II�JIF��JII `• r r -y TVd18310 TW20310 TW24310 TW2 --6310 7W28310 TW2.t0310 TW30310 7W34310 7Vd33310 � �a+ 1•� N — � II—I}—II—II �L � LLJJ__. _ ,, t' f •rr tTN — TW1842 TW2042 7IV2442 TW2642 TW2842 TW21042 TW3042 TVd3442 TbY3842 t " re Fd-= --- P—J] Iff] IF-161 --� PLU P19 �I---__r _ T1' d1846 M2046 TV12446 TT412646 PN2346 TV121046 TW3046 0 TW3446• TW3846 ,Y, #ti TW18410 TW20410 TW24410 MGM TW28410 TW210410 lIV30410 TIV34410 TW38410• BAR ERVA 10 s v s I I I I W�titS t �0 ��? 7 7, ID -- - — N1S�UR 4 11V1852 TIV2052 TW2452 TW2652 TTV2852 TW21052 1W3052 TY13452 5 TW3852• 11 wo Thcse 5'-9"hci tt! n —_— IITI 1I�I — — — — gl _ Units with •5 RF, „I� t �I units are"coda+e'I f •^ vv `!;- � .. — III JJJ — IIWII—�IfII—LII1I J—IIIII _—— _ --_ — — — — Etttt���i 11 1 equalsash style"units,and eights ale Iry Thelopas escripton.00 v have unequal sash. dIi ^4 ..•�..,. i 3�^' •n °i — — — shunter than um Contact dealer" bottom sash. for lead bmei, y` { tT TW1856 7W2056 TW2456 TW2656 PN2856 TW21056 TW3056# TW3456 4 TW3856# . n _ ^ Unobsbucted glass height is for single ^v- t � � � N+ � � sash only. +y S 4 e'0 4 `.°7 W — • flieso units main or extend Ilia following r `D � ./1 —_—— dimensions:Clear Openable Area of 5.7 " ft sq. .,Clear Openable Width of 20'and ' (( Clear Openable Height of 24" ' TW18510 TW20510 TW24510• TW26510• TW28510• TW2105100 TW30510• TW34510• TW38510• 'Unit Dimension-always refers to auLside Irame to frame dimension. Dimensions in parentheses are in ° ® ® ® ® millimeters. o�p When ordering.be sure to specify color desired:White.Sandtone.Tenatone° or Forest Green. 1 •tf iF� — Td�: TW1862 TW2062 TW2462• TW2662• TW2862• TW21062- TW3062• TW3462• TW3862 66 �" 7 ARA A."INDUSTRIAL The pre-painted steel doors for industrial and commercial use offer all the advantages of a standard garage door, plus a higher insulation factor than products in the same category. G-5000 Windows Features Steel coating f Sealed thermal glass are inserted 1 26-gauge hot-galvanized steel with woodgrain finish on both Hot-galvanized steel(G-60,Z-180) into an expanded PVC frame sides of the door. with five coats of protective finish which is cast without joints and applied in the factory provides d 2 Rustproof baked-on polyester paint. Can be repainted.guaranteed for 10 years against effective rustproofing and any glass sealing defect.Window 3 1 3/4 in. (44.5 mm)insulated door with high-pressure injected preserves the door's beautiful frames are offered in White, appearance for years.Given the polyurethane foam ensuring a high thermal-resistance rating Brown. Desert Sand or Claystone. of R-16.04(k=0.357 W/m2KY and the solidity of a composite high quality of the finish,these - -- -R— material. doors require little maintenance and no additional protection. - 4 Solid mechanical overlap joint:increases the weathertightness of the door and prevents delamination. 5 Thermal break between the interior and exterior faces of each section. �—��- Baked-on paint v ii Primer 6 Flexible tubular bottom weatherstripping ensuring the weathertightness of the threshold .r galvanization Full vision window sections - (service-station type)are composed 7 14-gauge reinforcement plates placed in the interior of the ~� Steel of glass sections• inserted into door where hinges and handles are attached. —c-so galvanization clear anodized or white pre-painted d__— T Primer alumimium extrusion.Several types 8 Wood end blocks provide a thermal break with the exterior of glass(tempered.tinted.etc.) of the door.Steel end caps are available as an option. are available.Contact our 9 Door weight: 1.90 lbs/ftz(9.3 kg ml) customer service department. 10 13-gauge or 14-gauge.2 in. (51 mm)commercial tracks (for doors of less than 140 it'(13 ml)or 12-gauge 3 in. (76 mm) D E C E pn --_ industrial tracks.Torsion spring.Sturdy galvanized steel suited V to the door's usage.Springs from 25.000 to 200,000 cycles (optional)are recommended for high usage doors. AUG 3 0 2005 s TOWN OF BARNSTABLE HISTORIC PRESERVATION AVC211111bia a9lzras 9balimtf C19t3rMcil 91®5b run Vis i9 sedtions (service station) Widths: Size of the windows: 21 in. x 13 in. (533 x 330 mm) from 5'to 29'6",in V increments 26 in. x 13 in. (660 x 330 mm) from 1.5 m to 9.0 m in 25 mm 30 in.x 13 in. (762 x 330 mm) Number of units per section increments Width of the doors: 8' 9' 10' 12' 14' 16' 18' 24' 28' 96 to 122 in.(2 438 to 3 099 mm) - 3 Heights: 21 in.windows: 3 4 4 5 6 7 8 11 15 123 to 150 in.(3 124 to 3 810 mm) - 4 from 6'to 24'.in 3"increments 26 in.windows: 2 3 3 4 5 6 6 9 10 151 to 184 in. (3 835 to 4 674 mm)- 5 from 1.8 to 7.3 m. in 76 mm increments 30 in.windows: 2 2 3 4 4 5 6 7 9 185 to 216 in.(4 699 to 5 486 mm)- 6 1 py;yam� y t r. 1 Product warranty QQ`�N j� PVC Top weather stripping made of a flexible flap of 2 1/2'(65 mm)offered 3 Gf RAGA I ( Solid interlocking joint with double as an option Garaga Inc.guarantees its product for 10 years against any „I 1 contact intersection moulding perforation of steel due to rust. 10 years on the wood end blocks against cracking and rot,5 years against delamination I� of the steel from the polyurethane foam and one year on other components. Some restrictions apply. Contact our customer service department or a Garaga dealer.The Garaga products are sold and installed by a network of garage door specialists throughout Canada and the United States. L 14-gauge steel reinforcement plates for hinges and handles Panel intersection 26-gauge.G-60 galvanized steel/ 14-gauge steel anchor plates (0.016 in.or 0.40 mm) / Full hinge(13-gauge) High-pressure Solid interlocking joint with double 0 injected weatherstripping contact(thermal break) j polyurethane foam ���-- Double end wood blocks Wood blocks(pine)provide a thermal break between the exterior and the interior side of the door. Furthermore,the end hinges attach to the wood in the door with large screws and offer a better hold than a self tapping screw in a 16-gauge steel end cap.Thus. it is the ideal combination for a high usage garage door. Double wood end blocks are installed for doors that exceed 12 ft.2 in.(3.7 m)in width. Garaga guarantees the effectiveness of its wood end blocks for 10 years ly D E EA E against cracking or deterioration and all other defects. ✓ _�` with normal use of the doors.This guarantee applies AUG 3 O 005 also for uses such as:car-wash.wood driers and j vegetable warehouses. '�y TOWN OF BARNSTA HISTORIC P S N Colours available While Metro Brown Desert Sand Claystone (GIC-3953) (OC-228) (OC-5142) (OC-5977) / r•t t - � Flexible bottom weatherstripping that ensures the weathertightness of the threshold. Colours may differ slightly from reality. A y,;1 lv Specifications Product Weatherthightness The doors are the G-5000 model,as manufactured by Garaga Inc. The bottom weatherstripping consists of a PVC spacer and a semi- The panels are roll formed and electronically high-pressure circular EPDM rubber tubing. injected with polyurethane.Overall thickness: 1 3/4 in.(44.5 mm). Intersection moulding is a flexible yet rigid PVC and is found at the Metal intersection of each panel.This type of weatherstripping will provide an efficient thermal barrier as well as double weathertightness Both sides of the door, are 26 gauge galvanized steel sheets. in in accordance with the following standards: when submitted to accordance with A.S.TM.A.642, has G-60 coating with a thickness a pressure of 0.075 kPa which is equivalent to winds of 25 m/h of 0.016 in.(0.40 mm). The galvanized steel sheet G-60 has a (40 km/h),the air infiltration rating as measured using standard zinc coating (or Z-180. 180 gr/m') accordance with standard ASTM E-283 shall be of 0.033 litre/second per meter of joint ASTM A.525-M.The polyester paint finish conforms with standard between the door sections. ASTM D.1005 and has a thickness of 1.0 mils.The surface of the steel sheet is woodgrain with fivedecorative horizontal grooves. On the exterior side of the jambs and lintel,weatherstripping is made up of an aluminium spacer as well as a double-edged strip Insulation of arctic vinyl. High-pressure CFC'free. polyurethane foam is injected between Options the walls of each panel. It's density is 2.3 lbs/in.' (40.4 kg/m') with a thermal resistance factor of R:16.04 (k= 0.357 W/m'K). ' 16-gauge galvanized steel end caps The insulation is in accordance with standards ONGC 51-GP-21 M • Flexible weatherstripping on top and 51.26-M86. • Exhaust ports of 4 in. (102 mm)in diameter. Windload Hardware The sections and the tracks are designed to meet or exceed the . Tracks of 2 or 3 in. (51 or 76 mm), are mounted with steel industry standard for windload (DASMA). (Note: for high wind conti-nuous vertical angle or with steel brackets. situations.consult our engineering service) • 13-gauge galvanized steel hinges and 10-ballbearing rollers. Reinforcements Double hinges and rollers available as an option. 14-gauge steel reinforcement plates are inserted within the door • 22-gauge horizontal struts available for larger doors. panels to provide proper fastening for such hardware accessories . Torsion type spring available: 10,000 to 200.000 cycles. as the hinges. handles and plate for the garage door operator. • Options available: Fender guard («Z)) style), track guard Panel ends («L» style), chain hoist. pusher springs. tension bridge A block of dry pine (grade #4) is inserted at both ends of each reinforcement, safety bottom brackets, flanged bearing and insulated garage door section for the fastening of the end hinges. rubber rollers. Windows Electric operators Regular: • Technical documentation available on demand. Double thermopane windows with a total thickness of 1 in. (25.4 mm). sealed-in aluminium Intercept spacer. Assembled Our"Construction Specifications"booklet outlines comprehen- units are inserted in a moulded PVC frame(White.Brown,Desert sive technical data about Garaga garage doors. Sand or Claystone). These specifications are available on request or you can find Full vision: them on our Web site www.garaga.com. Double pane sealed,total thickness of 5/8 in.(16 mm),sealed-in aluminium spacers. The windows are Inserted in alumimium n„ tubular extrusions (anodized or white) 0.063 in. (1.6 mm), and D U fixed with rigid PVC mouldings and brackets. AUG 3 0 2005 TOWN OF BARNSTABLE Garaga has established a permanent research program for all of its products.As a result of this ongoing quest for improvetmeHISTORiCsPREGER"TMO g rage doors are subject to change without notice. Garaga Inc.also makes a complete line of residential garage doors. i 1 7 Application to 01b Ring's 3b[gf)bJdP Regionat �q gtDr[C All$trict Committee In the Town of Barnstable CERTIFICATE OF APPROPRIATENESS e-- U; M Apoiication is hereby made, with four ceamgleto-sets, for the issuance of Q Certificate. of Appropriateneszo under�40iarr-J G of Chapter 470, Arts and Resolves of Massachusetts, 1973, for proposed work as described below and on ,plans-o drawings, or photographs accompanying this application for: CHH'GR CATEGORIES THAT APPLY,. rl - ❑ New ❑ Addition Alteration tv 1. Exterior building construction: ' . -� Indicate type of building: ❑ House ❑ Garage '2. Exterior Painting: ❑ Commercial El Other 3. Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 4. Stfucture: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other f r I'1(PE € R PRINT LEGIBLY: DATE �J� �5�1u 5- a ADDRESS OF PROPOSED WORK ASSESSOR'S MAP NO. '�J V 'C"L cJ OWNER � Ae-� k-T.-::, 1?,V Ste" ASSESSOR'S LOT NO. G HOME ADDRESS ``�c� � c A�(L.,a\lr�L M4�. TELEPHONE NO. "56?02c3 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any public street or way. (Attach additional sheet if necessary.) AGENT OR CONTRACTOR `\UA�nK&P,.� TELEPHONE NO. ADDRESS DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please include locations of prroposed signs. hN0 W\Qc 3Ll < Signed Owner-Contractor-Agent For Committee Use Only Arr 1h y vk i -w — This Certificate is hereby �a Dateq\lq�NAI D � ,LU Approve /Denid e I AUG 2 5 2005 + om ittee Mem rs' Signature U _ TOWN OF BARNSTABLE HISTORIC PRESERVATION s f i Town of Birnstable Old King's Highway Historic District Committee SPEC SHEET FOUNDATIONlS�\�J6 SIDING TYPE Me.-cA�_ COLOR CHIMNEY TYPE COLOR ROOF MATERIAL 1``Q-V(I L— COLOR tLcr.G1.� PITCH WINDOWS !y1ltJUl cam COLOR WA`X` - SIZE V �ahLe S z TRIM COLOR DOORS COLORS VJ \�cC; 1 1�1 U SHUTTERS COLORS C�<Z,G�1.1 AUGf25 "1005 LI )`I GUTTERS COLORS �'�,�.Q.1J HIS�TORI�C P ESNRVATTION DECKS MATERIALS GARAGE DOORS COLORS SKYLIGHTS SIZE COLORS SIGNS COLORS FENCE COLOR NOTES: Fill out completely, including measurements and materials/colors to be used. Four copies of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plans, when applicable. SPECSHT Revised 11/98 Engineering Dept. (3rd floor) Map Parcel -Permit# House# Date Issued Board of Health(3rd floor),(8:15 -9:30/1:00-4:30) Fee -,ao ,jG Conservation Office(4th floor)(8:30-9:30/1:00-2:00) � Planning Dept. (1st floor/School Admin. Bldg.) pFINE Definitive /Plan Approved b P�l`a ingBoard 19 D/ �" `, • ARM � TOWN OF BARNSTABLE Building Permit Application Project Street Address T M Village_y . &A612D� Owner .Qix,c Address /O 77 H&5wr ST &M A0 41Q Telephone / —8 OD- 8 i rD-TAI e Permit Request mid 6 G First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ _ � 4)eO,.00 Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No .Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other ,Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Flooi Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) " ❑Other(size) Zoning Board of A eals Authorization ❑ Appeal# Recorded❑ Commercial Yes ❑No If yes, site plan review# - Current Use eo yl,/ Proposed Use Builder Information Name Telephone Number 7 7S-77&3 Address P D. ���// License# tY.riv4 T���'19 D d'i/�g Home Improvement Contractor# Worker's Compensation NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLO ING REASON(S) ,Ik; . f' .. , r FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER o . DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH • FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING " o DATE CLOSED OUT ASSOCIATION PLAN NO. . 'I j kyTRAT10N iJ '"BHOME I P o §OVTTFN on � �✓b.`a_,car nO eau3c 1�F� rt f i One Ashburton ,'lace 1301 Boston, Massachusetts 02108 _ Ya t4PROVEMEiVT 'C0N.Tf2ACT"3;a -�' — -Registration 10�t91£i Expiration 00 Eype - D'BA T� HOME IMPROVEMENT CONTRACTOR Registration 108918" , THEODORE L. HITCHCOCK ; � " Type - D6A _ . (" iration 08/27/38 �zP 4 1HEOCORE L . HITCHCOCK PO BOX 211/55 LISA Ltd , , C K W BARNSTABLE MA 02668 THEODORE ! ;:HITCHCOCK THEODORE L.fHITCHCOCK �� OX 2.11/55 LISA LN Eye-, ST49LE MA 02668 �.. AC^AR'4STRATCR • /—y J J The Town of Barnstable HAM Department of Health Safety and Environmental Services Building Division 367 Main Saves,Hymb MA 0?601 • Ofce: 508-790-M7 F c: 509-790-WO SSW Building Comtnissio, For am=use only Permit no._ Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements• Type of Work: 11& 10 pl—or t.Cost 0, / f-2 AddressofWork: l'S/9 �t /�/n�is?1 r+ . .►+n r�/.�-�[� Owner's Name Date of Permit Application: TT 9 " I hereby certify that: Registration is not required for the following reasoa(s): Work excluded by law _Job under 51,M Building not ownw-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: • log / Da Contractor Name Registration Na.. OR M The Commonwealth of Massffcj useas { 9 _ t H .'. Department of Industrial Accidents �" 0/ll�d Ol/I19tsllB��fllots a .; '• a 600 Washington Street • ~ Boston,Mass 02111 Workers' Compensation Insurancc,AftidavitAs QM2tion Pie • 4, o- ,° ` � ` ,J i _axe • • e • O �I rJtJJ'l-am a homeowner performing all work myself. 1 am a sole proprietor and halve no one working in any capacity I am an employer prop iding workers' compensation for my employees working on this job. 4 Eomnam•nam //)�D ✓},I O �/���/�'Ji�J �j Address- PD M11lCS3=co. (�!/1/a/.�OJ.oi ._. '7' I am a sole proprietor. general contractor, or horneowner(circle octal and have hirfd the contractars listed below who hse the following worker;' compensation polices: gd�rt'ss: . f mi�'.� $ a e��. ."aF � r, 1*fb•'e �Y c'.'`� '1'f" `fit�Sfl� �tl�Y� ! '� �st -r ."�' r _�t.: -� e�""J +, ���. FJailure to secure covcrsge as rewired under 5tetian 25.4 of hYGL 15�ts®lEaJ9 to tb¢i itioaJ alcn^es�be sat uaataata al t2va aJp to 1104 AWAY01 oa.e years'imprisormettt as w•¢!1 as cis•il ptF�ntt;ea in t!•Je fosasJ of JJ S'TOf''rV©€�'��)�1@ st��>}Ie�:sJ!ii',ttt?:�1 a�aq e�ga:t.r�t�J:, t GLfit�`ei'Jsd4s�tt m3 Jf cogJy or then statenteot osay ue Porxarded to 4he!wl`I'iiee�i @nreatlgatioas of the l)l�.f2ar etsaersl�:z rco�sft;atcJs. 1(10-hercLY M^rif)'"nrdee titz pains and pettaides of perjury that the inforr.�601,pr oti:V:0 4ove sr tlnmr and CO-Irem Signature Print name / 10A_ 1oly phone 9 2a otricial use only do not+►rite in this area to be completed by city or Iowa otilcial , city or town: _ _ permit lieease N r'►litll(dipg Department ClUceetsiog ward ®check if immediate response is required ()gelecrrsen's®Rice [313e$1 h Mpartment contact person: phone 0 Irevned 1.95 PJAI 991.70' Chain/ink fan'Ce Chom/ink Fence x x--x—z—x—x--x—x —c—x—x—z—x—x——z�x—x—x—x—x—x—x—x—x x=x—x—x—xr—z—x—x----x—x—x—x—x-�+ ��x z /Tz / x7—x x 7—x Jr x z z x xJ i i 44i -- — — — — — _ _ — — -- — — rop ` I r / I / — 7777777777,777 i /ice i Overhang (rjpkd) Green House ii ii/ /ii/i / /i/i �ii /✓i� \ moo + Grace/ Dfive Bulld/ng 8 Benchmark Corner Of Concrete \ + Pad EI.=46.9 O9 \ \+ N L // /� // / /46' L------ \F�fn�fPq Pod Hoop Houses x I J / L FOP ` \ Ji f--x—x--z—x—x—z—x—x—z— .—�..x x \ \— — — \ z + Utility Pole / 1 48—/ Lx-Lx—.�_ L _f / i ,\'1il.. �...��.. \+ I 1 i 'i \ \\ Lot Area awl,,_ �-- � \ 1 ;S� / " x�x x—x—x—x.-._x—z` —x �i, � �� \C�n�`\ \\ \ t i/,,, / \ / Choinlink Fence ,Ir, �!� + I o�dent s d f 87,040t Sq. Ft. ' a P guNdln9 5 \ \ �� pf \t Or I 2.00± Acres + Electric •, ,,, "% I ,0,, Lot Area �- �, s- \, Transformers +� Underg�oLird II \fi\ w 1QQOp' yrcEJec a \ \ tric 359 067f S Ft. O \ ' Or q• rl! ••. �„ Co + 6 E , a as // �aaa + a u ` �j�`L � 8.24t Acres ,tl�•'*T '\L + Uti/ity Pole 0 %P \ Bundln9 6 :;/:\ //• ' � 1 \�} � � f J�Elec. Manhole 1� pad � ,,low 63�s. 9uddin9LOCUS Elea \ Transformer Tel. Riser) VQ' th ;� utility Pole \ \ ZONING SUMMARY _,_._...__--..._... � ��\ E_E \ arch 46.56' \+ :% % =i - �E—'� c \ a/ �h 7.49• ' +\+ / o i 0 Underground \ l Conn s.� a / Electric E\ Loading , I �O ZONING DISTRICT: VB—B BUSINESS DISTRICT Cr 11 Dock I MIN. LOT SIZE 43,560 S.F. x�x MIN. LOT FRONTAGE 160' LOCUS MAP MIN. LOT WIDTH — N 16 .25' x�x�x�x_x \ ) SCALE 1"=2000't MIN. FRONT SETBACK 40, �°,' �x MIN. SIDE SETBACK 30' !- / ASSESSORS MAP 155 PARCELS 14 & 48 MIN. REAR SETBACK 30' ro / I MAX. BUILDING HEIGHT 30 0 LOCUS IS WITHIN FEMA FLOOD ZONE C AS SHOWN ON ,C COMMUNITY PANEL #250001 0011 D DATED 7/2/1992 ZONING DISTRICT: RF RESIDENTIAL DISTRICT MIN. LOT SIZE 87,120 S.F.* a� / OWNER OF RECORD MIN. LOT FRONTAGE 150' MIN. LOT WIDTH — - c W F I LOMBARD REALTY TRUST MIN. FRONT SETBACK 30 CHISTOPHER McNAMARA TRUSTEE ' 492 DEPOT STREET MIN. SIDE SETBACK 15 , HARWICH, MA 02645 MIN. REAR SETBACK 15' / °pOp" % \ /° ° sned� MAX. BUILDING HEIGHT 30' - �' „Q gib *SITE IS LOCATED WITHIN THE RESOURCE REFERENCES e I PROTECTION OVERLAY DISTRICT. / DEED BOOK 12675 PAGE 121 " PLAN BOOK 200 PAGE 35 OX 1 Fish o L I I Pond DANIEL A. J'N EXISTING CO" ODITI V NS Drain manholes _ ,I WM A PLAN OF LAND ` \\ f140980 utility Pole Z r 3 IN Catch Basin DATE DANIEL A. OJALA, P.L.S. Drain Monl®� �p WEST BARNSTABLE MA PREPARED FOR off 508-362-4541 faX 508-362-988o NOTES: I 48 LOMBARD REALTY TRUST 1. THE PROPERTY LANES SHOY�'N HEREON HAVE BEEN down cape en lneerin Inc. E COMPILED P bo- b°�, FROM PLANS OF RECORD AND ON—THE—GROUND SURVEY, BUT DATE: DECEMBER 13, 2005 DO NOT REPRESENT A FULL PERIMETER SURVEY BY THIS CIVIL ENGINEERS OFFICE. LAND SURVEYORS Scale:1"=40' 2. ELEVATIONS ARE NGVD29 f.SSUMED FROM G.I.S. SPOT GRADES. 939 main st. yarmouthport, ma 02675 0 20 40 60 80 100 FEET 3. ALL UTILITY LOCATIONS SHOWN ARE APPROXIMATE ONLY AND SHALL BE VERIFIED AND MARKED PRIOR TO ANY EXCAVATION. DCE #05-250 05-250 BASE.DWG ,4 T'�:-^�.`„'�."""';,R w ; ,.. .•. r: �+'T. `'..r .,. �.'-t is. > ,1.� i r y ,k 4 ,y' -rr• - ti i, t, `i t c a ,r• k 1- �•i v L 1 M �; 1 � •i'a A 1. 1• k •F .> '• •J.• Y' R- •1' l i.. .e h' I" ,r i 7 1 i r. r' s♦ { Y .i Y,•a•' ,tip 9: 1 +S t. a , .wr t a T. T L nYi Y C t t' L { i Ir ,• t i , r r 4i• , t `Y t4 �c T r2 ` , a t ,L R - y k 3. a ; r i 4 t, •1 a. V .♦ , ,. ... .�...,,.:. ..n.... .. ... .. ,....,: .. '.. . ... ,�: it _ h J f: .H ✓ ». • ,,.. t . :,. .^ ..-, l .- . : .,... ,..:,:: .. :c r..., fir:, 1 , .: .. .,•_ _.. ..._ .r.... 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