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Home My WebLink About0190 LOTHROP'S LANE p p C k J x I .I 6 1 �p4.CYCifp . 4 UPC 12534 � No.2®R 'garcoc� HASTINGS.MN .o 7r ,,� • r 1 /�/f' �/-f�i. I � �� _ �� I ` 1 � �� ! 2,� �� a } � � . � _ � � ��. __ _ � �� _ _ . __ �, f C i I a� 7- /V5 Z,) i r TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 110 025 010 GEOBASE ID 37068 ADDRESS 190 LOTHROP'S LANE PHONE (508)428-4090 W. Barnstable ZIP - LOT 27 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT WB PERMIT 15713 DESCRIPTION SINGLE FAMILY DWELLING (PMT.#12974) IPEhMIr TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY i CONTRACTORS: Department of Health, Safety I ARCHITECT:: - and Environmental Services TOTAL FEES: TEIE BOND $.00 , CONSTRUCTION COSTS `" $.00 756 CERTIFICATE OF OCCUPANCY gpgrAg MA83. OWNER SPRINKLE, BRAD ADDRESS 122 MINTON LANE ED M BUILD G DIVIS O WEST BARNSTABLE MA BY DATE ISSUED 06/10/1996 EXPIRATION DATE 1 (0-02s,- 010 p 11 1 f V 1 ij 1 L J J1 c I L J. Department of Health, Safety and Environmental Services 01, BARNSTABLF, MASS. 039. %,BUILDING DIVISION 'BY t THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THERE(, %ti40 CROACHMENTS ON PUBLIC PROPERTY NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPr- PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOL, 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED LJNTIL FINAL INSPEf- 2.PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NC. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN. 4.FINAL INSPECTION BEFORE OCCUPANCY. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL -tPPROVALS ;wjA11qik90001 xoo��/ 2 2— DI jo -I Cl 3 I HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT JDI 2 BOARD OF A (Z3L_�V� tit'* 7-- - is OTHER: 4.11—r- H., Af--- SITE PLAN REVIEW APPROVAL ... WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE.ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. _te#W �" /�� Parcel Q��= .D/O Permit# 1 Se 3 v Conservation Office(4th floor)(8:30-9:30/ 1:00-2:00) Date Issue �' Jo Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) Fee O?) Engineering Dept. (3rd floor) House# 1HE 1p�Mpt.. s oor BARNSTABLE. D rd 19r M°j tee$ FOMPy� TOWN OF BARNSTABLE > Building Permit Application Proje ress l 9 O /_Din r y 3' Z�qd� Village W. Ag ZA6-f}b/e_ Owner_Ak-act- Address 19Y r_AIS�%3,b/e_ )Ed — )lygAA)I.-S' Telephone Permit Request :25 tJ C YO U odC ate)/,Um4 G A/-Afl C{1 d First Floor square feet Second Floor square feet Estimated Project Cost $ /0 Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure "2d Z4 Basement Type: Finished Historic House Unfinished Old King's HighwayV Number of Baths No. of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel X Lo Central Air Fireplaces Garage: Detached Other Detached Structures: Pool -toa<, c— Attached Barn None Sheds Other Builder Information Name „ t-a cL s:�ft/A)/C/t_ Telephone Number 7715-` j 719 k Address „B gt-4s� 6!c- -j d License# 61)6& E� L4y 9 AA) IS Home Improvement Contractor# 1031�2 Worker's Compensation# ZyC/ — ,3/S — yyM k1-636 � 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 �s - 6 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY P RMIT NO. D TE ISSUED MAP/PARCEL NO. t . "DR] VILLAGE i OWNER x DATE OF INSPECTION: ` FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ' ROUGH FINAL _ PLUMBING: ROUGH FINAL ' GAS: , ' j ROUGH FINAL FINAL BUILDING v, DATE CLOSED OUT ASSOCIATION PLAN NO. t - t • . e ! i ' 1 t i F ' ' � ' 1 y TEST BY: WELLER & ASSOC. / WITNESS: r-P r aV'�E - PERC RATE: LZ Nt►�!� _ ¢O lu 4 A ice. (Nlb •� ,'� 1� DESIGN DATA o \ DAILY FLOW:(�lro'Ix Ilcl�?O� O 4P SEPTIC TANK:44o 4FO X�a+ . $:' GPO \ ` USE: l5co G�1�-, s�.•�c 'rANI� LEACHING.FACILITY: USE.a)4'x8'��c.ob.IDl CAPACITY: �¢oU ► °'� \60 \ \ t 1 I SIDEWALL: ►o'+x2-�. 74 153 ,7 BOTTOM: IZr�4ox , 7�{-�- 355, ' Z TOTAL: rJ0`I 4� i/~�� : (j"ll•'�' Tile Conunonit�ca1111 of Massachusetts w•,� `j..ii•�.�t• • , sr.,: .. � �;- Department of Judustriol Accidents • � � • ;Y � Of/Iceol/ayesl/9a1/oas 600 11 a-vhin,;;t,)Street Bust,),Alas. 02111 Workers' Compensation insurance AMdavit _ location- citj �A\ 1 1 ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working in any capacity Cyr I am an emplover providing workers' compensation for my employees working on this job. c mlL1N IA* �� Y �� • ��'�� City: '^ � _ 14`, instinince co. VNn C.... ❑ I am a sole proprietor,genera contractor,or homeowner(circle one)and have hired the contractors listed below who ha the following workers' compensation polices: comynny re • phone Ih noticy# to pre ro - -sc .:-- �:--- s.esran�...-sl�esr'e+es'r-s'�•eT�sr•' e �R�7+r01�'Y'' 7'„�` - - companv name- ciri phone#i policy# �- :Attaeh addlHonal•sheei 1Caeerssa �+ �� - '^'t r•'�"R 'Le`' Y rr ��. ..�: Failure to secure coverage as required under Station 25A of 111GL 152 can lead to the imposition of a rimitud pt aaltia of a fine up to 51300A0 aad/u. unc years'imprisonment as well as civil penalties in the form of a STOP IVORK ORDER and a.flae of S100.00 a day against me» 1 understand that s COPY of this statement may be forwarded to the Ofrce of investigations of the DIA for coverage ver+Beation. I do herehr penalties ojpetymy that the injornmtion provided above is Ime and comes Sianaturc Date ` C one# Print name MCial use oniv do not write in this area to be completed by city or town oflieial city or town: permil/Ilecuse# n8uiiding Department Ot.icensing Board check if immediate response is required �Sdeetmea's nmOfilce Oli calth Department ' contaetperson• phone#• nOlher I revered 3I75 P)AI information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for th employees. As quoted from the "law", an emplgree is defined as every person in the service ofanother under any contract of hire, express or implied. oral or written. An eynphniper is defined as an individual. partnership, association, corporation or other legal entity, or any two or me the foregoing enLa�=cd 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 tl owner of a dwei lint, house !laying not more than three apartments and who resides therein, or the occupant of the dwcllin !rouse of another who employs persons to do maintenance, construction or repair work on such dwelling he or on the ;,.,rounds or building appurtenant thereto shall not because of such employment be deemed to be an employ( MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or rencival 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. Additionallj•. 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 been presented to the contracting authority. . , �"•'T�ii. . ,.y.. •atijJ-1b..,,,�• .•. Uw:._�::1Yr. Applicants j Please `ill 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 i 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 require, to obtain a workers' compensation policy, please call the Department at the number listed below. —• r _..•....'....,.. � •� ..•...�.•....-�. _ :. ., •,,.�.:. ..,.,,:...... �-:y;,T.-•� •tom;• -:N ' ... .. .. -Sw...>: ':,..--s,•'-. . . :�:`.:'�'c"'.'.wu:�. ..may... ��1�G=:•:.: w.i�,.�.....i'a.,.r�''tS,' ... . City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom c the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Pit be sure to fill in the permit/license number which will be used as a reference number. The atjdavits may be returned 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 questio 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 r Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 ' � �.....•—---'•"+�. .s'`✓/LG V007YI)ZIYJZUICQ.LLIL 4�✓I�GC�d�LClAecw DEPARTKENT OF PUBLIC SAFETY f CONSTRUCTION SUPERVISOR LICENSE Number: --` Bgpires: Birthdate:, CS 006643 10/0811991 10/0811955 t --Restricted4oi 00 ! :-,'.BRAD E SPRIRELB .122 OFF.KINTON LR i N BARNSTABLE, NA 02668 Is legistretign ' r' af1P R V T CORP ORAtI0t1 Y IPirat'o 07/0,9I96 r�-� �: a 5 y �Sp 1ak18 Ho�e�;I�prouesent;� Trt . °"Bra. 6�K•, SP�Tn1�l8 ceM.�o :-iya nin s 4 02601 ADtiA�NISIRATOR = ��'� M` ,. The Town of Barnstable K#JK ,$ Department of Health Safety and Environmental Services Building Division 367 Main street,Hyannis MA 02601 Ralph Office: 508-790-6227 Building Commis Fare 508 775-33" For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL a 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,remo%%I, demolition. or construction of an addition to any prc cdsdug owner oc=pr ed building containing at least one but not more than four dwelling units or to stsachrres which are adjacent to such residence or building be done by registered contractors,with certain c=pdons,along with other Type of Work: 6Ya u/t Jst) �/W I'.J 6 ?6,a/ Est Cost 1 02 614 0 Address of Work: /5 9 Lo--i rOP/s •L"C, - (J) • Owner.Name: .6rdd, Date of Permit Application: I hereby certify that: Registration is not required for the follcming reason(s): Work excluded by law _ _ob wader SI,000 Building not owner-occupied Owner puffing own perm# Notice is hereby green that: OWNERS PULLING THEIR OWN PERMIT O R DEALING WITIIUNREG�COMRAGTORS 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. Date Contra mine Registration No OR n•,a Owners name ; Application to JQ`aEO��E Jt� 5P PNS,PP N$ P tG� • � ePE�N E�P�� Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a !1 9 9 6 O CERTIFICATION OF EXEMPTION Application is hereby made, in triplicate,for the issuance of a certificate of exemption under Section 6 and 7 of Chapter 470, Acts and Resolves of Massachusetts, 1973, as amended for proposed work as described below and on plans,drawings,or photo- graphs accompanying this application. TYPE OR PRINT LEGIBLY DATE `1 ADDRESS OF PROPOSED WORK p "��`S l— ASSESSORS MAP NO. OWNER ASSESSORS LOT NO. HOME ADDRESS q� �„-7 �� 01 TEL. NO.':!8 AGENT OR CONTRACTOR � �� ADDRESS T�0) pplication is for exemption of proposed exterior construction on the ground that: It will not be visible from any way or public place. ❑ (2) It is within a category declared entitled to exemption by Old King's Highway Regional Historic District Commission. (Check applicable box) • PROPOSED WORK: Describe and furnish plan of proposed work, showing location on lot,and, if an addition Is involved,show, ing location of existing building. SIGNED Space below line for Committee use. ' Owner•Co tractor-Agent „r_ R ceav�`edY k�C.� '�' The Cert'ficate is hereby�,40' Date .y Time APR 1 619% y A RAR►dS TABLEy� By ap'lN OF .u%amy Date Approved ❑ The categories of work entitled to exemption are listed on Disapproved ❑ the back of this form. EXTERIOR ARCHITECTURAL FEATURES SUITABLE FOR CERTIFICATES OF EXEMPTION FOR RESIDENTIAL USE ONLY FENCES: 1. Post and rail,split, half round or round; natural finish 2. Square rail;white or natural finish 3. Stockade;natural or gray stain finish;not forward of face of main building 4. Picket;white only (Maximum height of all fences,4 feet) HEDGES: natural, not to exceed four feet in height DECKS: constructed of wood, on single family dwellings, built after 1900, at first floor level, at the rear only, railings not to exceed 30 inches in height, not over 50%to be visible from a way;natural finish or color compatible with building involved ' BREEZEWAYS: enclosure of existing breezeways, consistent with style, material and color of house, excluding sliding glass doors facing street,way or public place FLAGPOLES: on residential property, not over 24 feet high, not less than 20 feet from way, constructed of wood, with natural finish or painted white, or of aluminum, or of fiberglas or metal painted white ARBORS AND TRELLISES: of lightweight,wooden construction, not over nine feet high ROOFS: natural cedar shingles,or asphalt shingles per approved color samples;not over five inches exposure to weather SIDING: natural cedar shingles, or wooden clapboards- natural or approved color;not over five inches exposure • to weather STORM SASH,STORM DOORS,WINDOW SCREENS, SCREEN DOORS,GUTTERS AND LEADERS: permissible if consistent with style, material and color of building LIGHT POST: permissible if consistent with style,-material and color of building AIR CONDITIONERS: portable,window units at side or rear of building STONE WALLS: construction of field or split stone, not exceeding 30 inches in height f NOTE • 1. All prior bulletins hereby superseded. 2. Conditions contained in certificates of appropriateness shall be binding regardless of any exemptions contained herein. _ 9 yp^A. • I� .I ICI �li '�y ' \ �o .a tnr�;o. ,( ;' •,� fir,'. �� ._ l L—— C ._,.I -- - 'st �J�al '�Y�1 ; � �if� ��;��• � `- �f jl ' b jkv Z g of !i 3d �lr � � � ♦aw� r � p IwI Al Q M • g N YI i N rill lift 'i fit m ■ / • C J Q N ♦ / ib "1IIICLlit 01 lilt N"" —, a I b% . 1 s lilt • a I I � 1 I�� n�� >t� a s a ils: G, a� lrJ l--I l--1 ^" a Ar �N IL lit i - n _ f I � oil . N ,� _I �aigc j I. In Il. 4 1 il lill's t . th Classic and Contemporary Series WON ' � .rv+o orn onOJvaar 11111ds M«t 9 W/ram New York •111/0 0 if 111.1�0-1100 , 111FERIHL FUUL PIA 1' 161I , 4�: r � � I I � o T �r, � 1 �� lH wC y(t`t�i fit r r r-. All- lk tall it � ♦rrr lifts i r+- -�.• a e$v fit oil �QQ .1.rs4.�%/i' 3';ba'�, �� I+y I � I 5 �� •+, ,,1; s M LM Nil ��'.� �.�'d':,''•?i�:ti°, ��V� �.i', fro �� tl ��i � ', , 1�I�I�u�i T off C)� int x „ r a ` cc sea d .. 1h, .I +( � 1 nu MI/M161/i0 IN MNII � .. — I 'Classlo and Contemporary Berle$ P41 POOL OOMPANY n. LZlatiRa 1 �� aa.o u•n aioouinoi" !0 w.a•IIo�C•.lilhlM,New Yak •1111Q 1 f�111-t00-IR00 ` �t4 �.,n ' t �^ i' W R' q J CERTIFIED PLOT PLAN FOR LOT 27 LOTHROP'S LN. WEST BARNSTABLE, MA. PLAN BOOK 418 PAGE 55 PREPARED FOR I CERTIFY THAT THE BUILDING SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN ON AND TAT IT BRAD SPRINKLE CONFORMS TOTHEHMINIMUM SETBACK REQUIREMENTS OF THE TOWN OF BARNSTABLE WHEN CONSTRUCTED. SCALE: V = 40' MARCH 5, 1996 +o�+`�*vix of y u 8TEVEN W. `� RUMBA y NOTE: THIS PROPERTY LIES IN FLOOD ZONE"C"* A 3579 Op S SVEvo� WELLER & ASSOCIATES P.O. BOX 119 YARMOUTHPORT MA. 02G75 `PER FLOOD INSURANCE RATE MAPS PREPARED BY THE ' FEDERAL EMERGENCY MANAGEMENT AGENCY. C/ As sessor's,Office(,1st floor) Map �(� Parcel o�_s f 0 Permit# g Conservation Office(4th floor)(8:30-9:30/1:00-2:00) RG Date Issued l q --q w Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) 96-;� /�G�r�'� , /� Fee - ;z 0-7) Engineering Dept. (3rd floor) House# 0 �}IKE Planning Dept oor/School Admin. Bldg.) . .- , k J� Definiti av ro by Planning Board -/ 19 1N WITH TITLE 5 TOWN OF BAR STA ONMENTAL CO DE AND •� Building Permit Application TOWN 4�EGULATI®EIS Projec ddress � QO �07��QPS L�� Village /,(/ . B/ILR f I-57'/i6L.9 Owner �� Ri b 50/ //1//L� Address 1�wM g�}SST f Telephone ' / Permit Request 'To co1c)✓7'21/CT i/ 5l/��L� Fl�-I lI L Z 1-10 JE 40 First Floor CoZ 55 square feet Second Floor / �f'O(] square feet Estimated Project Cost $ /(a�, Zoning District 9 f" Flood Plain Water Protection �D Lot Size Grandfathered ? Zoning Board of Appeals Authorization -- Recorded Current Use C l�A) T LO T- Proposed Use Construction Type (,UQQ J�S FR/`fi/u F. / Commercial Residential i( Dwelling Type: Single Family t/ Two Family Multi-Family Age of Existing Structure /U Basement Type: Finished Historic House Unfinished Ind OR9-b Old King's Highway y S Number of Baths 2 aZ No. of Bedrooms 5 ' / Total Room Count(not including baths) / First Floor `7" /' Heat Type and Fuel I S fi lk Central Air A U Fireplaces Garage: Detached Other Detached Structures: Pool Attached C;�, C R I'L Barn None - Sheds Other `/ Builder Information �1 Name �� y s 1 bg 8 o l z-f�Iy6, /4J C Telephone Number -7 7/ — 10 qU Address jo- G • 81-/ Q�;- License# aQ; 5-6 CF,Xl 7E P—V l LL-F— 10 4 Home Improvement Contractor# -----� Worker's Compensation# UI C I 1 Z&0(3 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 1�Gl�Z�9-�i�CtC(/ �iXx SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOL OWING REASON(S) FOR OFFICIAL USE ONLY I - PERMIT NO. 7—j " • • 1 DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE r OWNER DATE OF INSPECTION: = FOUNDATION FRAME s INSULATION ti FIREPLACE ` ELECTRICAL: ROUGH ,i FINAL r PLUMBING: ROUGH FINAL { GAS: ROUGO-1 5 S FINAL FINAL BUILDING RIP - � .� tl C-) ' ti DATE CLOSED OUT ASSOCIATION PLAN NO. �1NE ipy_ `The Town of Barnstable a MA .SS. � Department of Health Safety and Environmental Services 1 V MASS 16)q.�Eo ru•+' Building Division 367 Main Street, Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection Location \q6 1��a Permit Number / —t Owner 1�pc�St(� Builder 3 �s\t�4r— One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: KA� ITN, Please call: 508j-790-6227 for reeinspection. Inspected by Date COMMONWEALTH" DEPARTMENT OF PUBLIC SAFETY c I rptOpat LY OF ONE.ASH BORTON_eLACE_ l: 1{lsss0AltiltttltitsB�llg �e9 MASSACHUSETTS ( SOSTbAi;l41�i'vo^ :` '` �11_(orr�woCatl�s LICENSE : . .. EXPIRATION,DATE CONSTR. SUPERVISOR I. CAUTION 04/,19/19,96 EFFECTIVE DATE LIC-NO. i FOR PROTECTION AGAINST RESTRICTIONS o THEFT, PUT RIGHT THUMB NONE .1 n,rlr-- 06/30/1 993 005645 PRINT IN APPROPRIATE 0 '. BOX ON LICENSE. BRIAN T DACEY ° 62 F E RBR OOK LANE BLASTING OPERATORS SS ff 027-46=5956 Cc: CENTERVILL MA 02632 n MUST INCLUDE PHOTO. _ PHOTO(BLASTING OPP ONLY) F U -00 i r - NOT VAUD UN11L SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: STAMPED-OR-SIGNATURE OF MMISSIONER �1 PAID DOB: 04/19/1956 IL ! 2 1993 THIS DOCUMENT MUST 8. i « SIGN NAME IN FULL ABOVE SIGNATURE LINE CARRIEDON THE PERSON O-' IGNATURE OF UCE162E THE HOLDER WHEN I�4a I �Ia e e ` OTHERS-RIGHT THUMB PRINT GAGED IN THIS OCCUPAT1OK011 '�I� R � . ` COMMONWEALTH OF MASSACHUSETTS i «P. DErAM-NSF-N'T OF I!NTDUSTRIALACCID.UTTS 600 WASHINGTON ST= BOSTON, MASSACHUSETTS 02111 .iames-' Car-tooel: ;or-n ss'°ne WORKERS' COMPENSATION INSURANCE AFFIDAVIT 1 7. l (licensalpertniaec) . with a principal place of business/rrsidencc ac 6 3 a (Ciry/Satemp) do hereby certify, under the pains and penalties of perjury.thar. (] l am an employer providing the following workers' compensation coverage for my employees working on this job. 2L, Insurance Company Policy Number ( J 1 am a sole proprietor and have no one working for me.. ( J 1 am a sole prop6cror, ncnl contractor r homeowner (circle one) and have hired the contractors listed below who have the following wor compensation insurance policies: Name of Contractor Insuran¢ Company/Polity Number Dame of Conrrac:or Insurance Company/Policy Number Name of Contr2c:or Insurance Company/Policy Number '0 1 am a homeowner performing all the works myself NOTE .PIcasc be aware t:at wbtic borneowaen wao aflotov penow to do masnttnancr, cotutrualoo or repair-Mrk on a Cwriiinc of not more xbLn three unto to %+Mnsch the horneo,-mcr aiso resides or on the Erouacs appurtetsanI tbcrrto an: not central~' considered to be er_fliovrrs unorr the Woriccn' Competuauon Act (GL C 152.sat• 1(5)), appiieatioo by a bomeowr,er for a licences or permit may rnccacc the ieo sutus of as eropioytr under the Qoricen' Coropenution Act l uncimund :nest : c00%•of this statt-:rnt will be forwarded to the Denaranent of lndunrial Aeacena' Ofncc of 1ruumnQ tot mar Ll CS wn-1c.znon anc :nv:sjjurc to secure t�tra.Cc Is rteuircc undo: Seenon :5A of.MGi 15: can Ica c to the imposition of ai:.�L ��. ccns,sone of: line of ue to S1 500.00 and/or imprta:uorent of up to one yea Inc o er:%ii pIioes in the dorm or a Stop Wo-ic Ordc erne a fine of S 100.C-v s day I€a:ns: me. 01 �K �-56 V� v J SHEETROCK: MEL REED: (L) WORCESTER INS - CB817530 (W) COMMERCIAL UNION - CBH557387 INTERIOR TRIM: DAVID'S REMODELING: (L) COMMERCIAL UNION. - NB F821442 DAVID BIK: (L) MERCHANTS INS GRP- 8CM0278579150 (W) TRAVELERS - 176K337-8-94 OAK INSTALLER: ROBERT BUDDEN: (L) NORTHERN ASSUR. - NBF528652 PAINTING: CAMPBELL PAINTING: (L) .TRAVELERS - 1680251K4083COF (W) AMERICAN POLICY - WCC 186604 ROUSSEAU, AL (L) MERCHANTS MUTUAL - 8CM0278570179 (W) EASTERN CASUALTY - ??? GARAGE DOORS: ALL CAPE GARAGE DOOR: (L) U S F & G - BSC14667590301 (W) COMMERCIAL UNION - CBH573757 STORMS & GUTTERS: ALUMINUM PRODUCTS: (L) AETNA - MPOO21014146 (W) AETNA - JC89258880 OAK FINISHER: AMERICAN FLOORS: (L) TRAVELERS - 680 342W754-0 CARPET, VINYL & TILE: CARPET BARN: (L) VERMONT MUTUAL - SBP6507393 (W) PHOENIX INS. - 6NUB476J652794 WIRE SHELVING: CAPE. COD CLOSETS: (L) U S F & G - BSC146983441 APPLIANCES: KITCHEN APPL MART: (L) FIREMENS FUND - AZC80453098 (W) HARTFORD INS CO - 77WZNB1603 MIRRORS & SHOWER DOORS: L & M GLASS: (L) COMMERCIAL UNION - CBR409003 (W) U S F & G - 0071439933 LANDSCAPE & SPRINKLER: COY'S BROOK: (L) COMMERCIAL UNION - ABR345850 (W) CIGNA COMPANIES - C41138178 DRIVEWAYS: NORTHERN SEALCOAT: (L) MARYLAND CASUALTY- EPA18716945 (W) THE PHOENIX - UB387K530 ti y SUBCONTRACTOR'S INSURANCE ENGINEEER: BAXTER & NYE ENG: (L) FIREMENS FUND - S30MXX80564866 (W) LIBERTY MUTUAL - WC1312595563023 EXCAVATION & SEPTIC: DRISCOLL, JJ: (L) U S F & G - HGL 110093 (W) U S F & G - 7708711936 FOUNDATION: BAYSIDE FOUNDATIONS: (L) COMMERCIAL UNION - ABR406267 (W) LIBERTY MUTUAL - WC1312201785044 WELLS: DENNIS SCANNELL (L) TRAVELERS - 660873E5627COF92 (W) WAUSAU - 151300062926 CELLAR/GARAGE FLOORS: MICHAEL BROWN: (L) AETNA - MP0023672849 FRAMERS: ROBERT DORRER: (L) TRAVELERS - W680526K991TIA9 (W) AETNA - 006CO023972416C MICHAEL DUFFLEY: (L) COMMERCIAL UNION - NBF821356 (W) LIBERTY MUTUAL - WC1312492127024 ROOFER & SIDEWALL: JOHN MEE: (L) AMERICAN STATES - 01CD1486783 (W) TRAVELERS _ 6NUB448K275894 MASON: SHERMAN, WAYNE: (L) COMMERCE INS CO - N60689 (W) WAUSAU INS - TO BE ASSIGNED ELECTRICIAN: CHAVES ELECTRIC: (L) HANOVER INS. LHN2964649 (W) MISCELLANEOUS INS CO. - 0708878 91 1 PLUMB & HEAT: WHITELY PLUMBING: (L) TRAVELERS - 660365K1782COF9 (W) EASTERN CASUALTY - POLICY IN MAIL ALARM SYSTEM: BALTIC SECURITY: (L) FIRST FINANCIAL - FF0131 G400831 (W) COMMERCIAL UNION - CB0743379 CENTRAL VAC: VACUUM HOUSE: MERRIMACK MUTUAL - SBP1608045 INSULATION: MAP INSULATION: (L) AMERICAN STATES - 02CC326435-3 (W) U S F & G - 7711099932 Application to 1. 9 9 6 01*1 Old Kings Highway Regional Historic District Committee in.the Town of Barnstable for a CE:RT.LFICATE I. OF:APPRO.PRIATENESS Application-is.hereby made,'iri triplidate,.for the issuance of.a Certificate of Appropriateness under Section 6 of Ch,apter,470, Acts and'Resolves of:Massachusetts; 1973, for proposed work as described below and on plans, drawings or photographs accompanying'this.application.for.: :CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: New Building ❑--Addition ❑ Alteration Indicate type of building: E- House a Garage ❑ 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 MPRINT LEGIBLY.:: DATE ADDRESS OF-PROPOSED WORK 2� �T�1<zAy'S —�4��' ASSESSORS MAP NO. 1 I O OWNER 72>n Al> y SPn i G ASSESSORS LOT NO. "57 I y HOME ADDRESS ( ZZ I'VI t .vT-or-1 1—AP W• 3A2N TEL. NO. Zy yU%O FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). AGENT OR CONTRACTOR �'`�Y� t�� U�r—tJ cId`s S_✓tL TEL. No. s US 77/ — 16 �ZU ADDRESS I•0 - 21 2-K �`� Ce- �%� d'L lL f1'1 a1- cl7 Cc-3 �Z 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). PPROWED Signed 'ram Owner-Con tractor-Agent Space below line for-Committee use. ___._Recei,ved,b_y_H.D.Q ,--- 1l � ;. 2 li n;Date — °M 9 The if'cate-is he y Date Ti i''9- nl ; f Approved `s ] r, iMPO NT: if C ficate approved,approval is subject to the 10 day appeal period provided In the Act. Form "A-1" OLD KING'S HIGHWAY HISTORIC DISTRICT Spec Shaat Foundation Type �ay�7 C GNP Siding Type C,P b,-�RZJ mac)-DNT ► Lac; Chimney Type `��rj :> �L�C ColorZtF-n Roof MaterialpY�1�LI Color Si �L Pitch Windows `bbUE3L-�C-- Size 3ok -7 Trim Color W�� G��c Ubzt)Z — sroCcc� 6�ae`� L Doors j Cx `�,�P�1' t_ t,� `DSO.. 5CDc3 1-16t1V` Color Shutters Gutters lR1 l`�-e_. — ✓��y v✓i~� r-3L)PYL Deck ��1�sS t)�7 ✓l�cc Garage Doors Color — Notes: Fill out completely, including measurements and materials[colors to be used. Three copies of this form are required for submittal of an application, along with three copies each of the certified plot plan, landscape plan and elevation plan, when applicable. Lot 27 lie lop 0 40 Scale I " =40FT i TI tI 1111111 . I . i , ; __ : ; . , : . . .. � � . � . .�_ _ /_ . . ; � � 'i° �; -�--�' �� . ;.: ,. � ,, �,` �� '� . � - � � � ��L `�, i � .� . ��. � � , �� i � .� �\ � W °i �•., \ �- V .\\ i . ` �� i .J ��\\ U . � � i ! i �. I !i .� � i OI a -- !� -- - I - -- Q -- i � I ' i •� i � I i II i _ I ' of id ul 1 ► i a > AEr- LP ctM71 Q IL I i I I t, L±t . .......... Ul II, 4 'ri --- - r � I i C o Ls oG 3 � S Q � I I a 0 : oz .,0 • �•- II Q �I �e � � 2 J,'• 0 ,g 0 Ullfir I N 10,11 r .o,ol N Z I ?•r�an V� bi N i I d7�1�5 I S' I O dl \• Q •O I \/ �D nmov I 'a' 41 I N _ f W 0 0l I ,w.�znw--=•i=,sue-�s= - -- 2 •��I"bl� •� � .,z-,s� � Q - 7 o N 4") Or I i i 0 0. W z ! I .9 Y r d �. u _ c j ci __.. i LO ' C N b — a b c bi d I ,IIll� r CO, Ii L ot i � wiEl o I ' I I 1 j ,0;0) I I I •o'�gL i .tiz ' ; � ' a — r ° II �9 < i CO ..•�•.� eI •�•�� a of I i-----. ----- ' — — -- -- — — — -- .—I I I -' N LA rul a, x I I i o a I ; IP a IL � 'r— L d � 3 oil. I- _ f- i nco � q • .i Fir -.-.-IE1 —I I , W C r-5 I I ; LJI � � I ' Jo p o 117 J w �FL I p a L IL Z ;'i 42Z4� 2' . I I VN� I Di. L Lj W)c �a II I i c0 EEL i I a 2U o1 r j �:. n 1: ,q ' r1.10 O �I, d J I U- P.Y1 CL J a � �ro W rr .� IL r HAW r :(()I T t � I t TEST HOLE LOG DATE: 'Dr5r_ M, 19915 TEST BY: WELLEI2 & ASSOC. WTTNEsS: pp 1A4=y 17- Ne;� C� PERC RATE: <2 HI►J'Io, J E -�y 4- ?� V -_ •• ��, �'; h- � S �p`{� ,yam`` -yet ��,. 'ram 't J� �:1 \. \ � II.I�Y• r�N�N'- { ��f SC.o c� o\b \ DESIGN DATA sE1IcTAONWtt�44o 4Bm�j,t _ � �� USE: I500 sr• ''FA01c� ..�� LEACHING FACILITY: ,,, \5 ,v \� ` 1 .` USD+,:C�c)4'xb iaHiv�c�e.1. r� s. 4 °� O \0� 4\ CAPACITY: .4oUrJ� 5 I� '� SIDE'WALL: BOTTOM:_�Z TOTAL: OJ sm _�_�.,-=-"-_- __ram_,__-�-�__�_,_. _: "-. ., .: _ -"-' ---- _ - ��i•/ tip' ,�� - 5T,0e, PIPE r O BE LAD) 2".LAYER OF 3/8"PEASTONE LEVEL FOR 2' OUT OF OV];R 3/4"-1 1/2" WASHED DISTRIBUTION BOX TU`'E ALL AROUND TOP OF F�OU". Cad EL. 47iC1� q 1,p0 I eel 80.i7 <ur G ��..1� I 06 V B .50 ALL POPE TO BE 4" DIA.SCH 40 PVC gr -Bo3(-ro I;i RAISE ALL, APPLICABLE .\IAKHOLE 5L� ?� 4- LA*'(P� r-f �t,_ COVERS TO WITHLN 6" OF FINISH CRADE THIS SYSTEM IS NOT DESIGNMI) FOR THE USE OF A GARBAGE DISPOSAL SCALE: 1"=10, 3Fshy r; wc, GENERAL NOTES s °r^'``'^ 1. CONTRACTOR TO BE RESPONSIBLE FOR THE SITE—SEWAGE PLAN � r!7ciz•. ce LOCATION OF ALL UTILITIES,ABOVE AND FOR T-��c, `4i�o �� UNDER GROUND,PRIOR TO ANY CONSTRUCTION L�{Rc�s t.�►- 1�J s'� �r:)1�� GFr��S 27 OR EXCAVATION. '�►� k 41 a ?AG 5E 5 )Q_ 2. INSTALLATION OF SEPTIC SYSTEM TO BE IN ..PREPARED FOR ' `� COMPLIANCE WITH 310 CMR 15.00: TITLE V. 3. T141S PLAN IS NOT TO BE USED FOR PROPERTY LINE DETERMINATION. nF SCALE: I , 4c7 DATE: t) G, '-/1995 WELLER & �*ia j ASSOCIATES ,i P. O. BOX 119 YARMOUTHPORT, MA. 02675 �`�e�'V�r►a� (508) 362-8131 APPROVED BY: