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0229 MAIN ST./RTE 6A(W.BARN.)
U" _ NO. 152113ORA i y P t .{ 4 v �. a (�n 0 9 :�� yyyy ��� �x a r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map /�S __.-. -Marcel Permit# /�9s, Health Division �b y4ily Date Issued Conservation Division oMgLa3 Application Fee N6 aVV i Tax Collector Permit Fei� - °�° A� Treasurer SEPTIC:SYSTEM MUST EE INSTALLED IN COMPLIANC4 Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE ANL TOWN REGULAI- ONS Historic-OKH Preservation/Hyannis Project Street Address 2`�� 9,6-1, 7 Village �,f, &"S 4f- Owner 25422 L-4E. t-�Wic/ Address Telephone r� ~Permit Request 22) c o d Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District MFlood )Plain Groundwater Overlay Project Valuation N "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 i Historic House: ❑Yes QNo 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 3 new Total Room Count(not including baths): existing new�� — First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil Electric Cl Other Central Air: ❑Yes �No Fireplaces: Existing New Existing wood/coal stove: DYes ❑ No 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 O Appeal# Recorded❑ Commercial ❑Yes Q No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Number Address lee, _7J /©WA11kQNfr_ License# l A-12 �CaU �(.4 _ e0Z1Q&,4 ✓`Home Improvement Contractor# ✓Worker's Compensation# _CS DJ/7O�/ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO aA16TAAg ,c- SIGNATURE DATE FOR OFFICIAL USE ONLY ) a G PERMIT NO. DATE,4SSUED MAP/JPARCEL,NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION ` FRAME INSULATION FIREPLACE �j ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 20 The Commonwealth of Massachusetts = - Department of Industrial Accidents Office of/ayesti9ations r� 600 Washington Street G Boston,Mass. 02111 Workers' Co ��%tion��c� %�%�//////%%%%/%%%%�%%%%%%%�%%%%%%/%�%%%%��% name '7/ Ar1/1 n , location lid Z n �OitL� 0�25> �aD hone# ❑ I am a homeo performing all w rk myself. am a sole rietor and have no one worki>1 in ca achy /am//a/1",%///////O /%%%%% %%% / %/%////%%���%%/% 1 rovi workers' compensation for my employees.working,on this job. ::::::::::::}:}r:;.r:.>:.r;:.:;.r:.r:.}:;}::;:$:::>:F:;>;:::>:;:»;:::$::;$;:::;:: I am an em oyer ...................... nam-any.EOmD t<. {.:'4y.�.:::v:::....::•.::•.:?.:.::•;$:4i%:}:f,+r}!:r:v::•,y.:•}:?.:.}}:4:Lrr}}{•i$rY:::::::?•i::4}�Y.4;4}:•}:••i}i:vY.:......•• ::::::........ :. !ti::':{;::i=''';!is�F:{:•.}$}$:vr}rr$F$:�::�:::tititi:$F$:;•is�}}r:4ir;{{{.};i":r'ii:{;:.;?:;4r:{4:•}i}.}•:{::;:4::;nrr:}... •::;•i:}r:} :•:'.:}.err:}:Y.J:::•.�:}::::::•.v::::•,::4:,:::::.�:..:::`%:::':: .::::::.. ... ........ �• ....... ... .........................::::x::r:v::•:w::-wv:;::.•••.};::........:.:..�:4rY�i:r.;::.�';':.....:..�i:}}ri:•:. :ittl SS L 4'4Y {� ��.?�;y':$;:;}"•;:}..$:;'�,:;$�.is � .: �.�.. ..... ...::.phone•#...�� .:::.: .....:..:.........:.::::..... r<7 ........... tl" :A::.r Y}. ..... �•'••:�:'�•�•$$::?{;,{ ::F:;:}{Ci{ :v';i'�:y:i5.;:4{.�,v'$Y�r1.�?:�$$}:.i i. . �:.;'::Y'{i:;:�i::�:'?.'!l ::•i:! :<{•�'::::�:< iirr •?:. ® I am a sole proprieto eneral contractor, r homeowner(circle one) and have hired the contractors listed below who have thefollowing workers' comp.e..n...s..a..t..i.o...n....p..o...li...c..e..s..: ::::::::...................:.....::.:.:.:':.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.;.:..:.:.:.:.:.:.:.:.:.:.:.:.:;.:.:.:.:.:.:.:.:.:. $ .,...,4 ..:.......... :. :•: � .. :.:{L$!;{;J.;rri{J$:v$FF:v$F$F$:.i:.;.;;,$.;:i::�v$$j$:O:!•} :i$$F$$$:Cii:}:}::•}}:•:?•:i:•rtiK{J�{:$F$$$$$ism$.'•$:::F;{r:i:{$$$$i;i:;:;:^:;:;:'}:•r;{$;.•v.4:�k�ti:f:Y',$i:$: 'm p n Y r.. :$::'L$:;::; $Syy;tiN+rye•{.?;:}:F :: �r�• r .. ...:.:.:....... :YY :a �t77 N a { Y: $: F:j:tr:$r$$:v?4::$$$r::$?$:::{i.$F{?:<?i?<::�F{:�;:;�:y;:y'r:•:j$r? .x l { J '}}K:4•}rY}}}r}:• jj �•O p�tfranCe:Ca:r. .............. .......... ............... :::::::.}'4:4}}::•:..;... .......±r:•}i:•ri::::::::::;}::::::•:J:{::::::::::::::::::ii.:;:.r•::.r::is i:........:: k,;v.,.:.::. :::tit•:,:,::•:r::::. .........:.. .:.:::.::y:.:':::.,::•{•:::r::vi•: '•,.•.�.;. v; }$$$$i:{ir}:4:•r:r'}fri:v:{;•i:•r•i:!4r}r:+�$$'^{:,}}::;.;:. •}:;•:}};{:v}Y}i:;tiv:ii:v:}:•:::•.':':':'::'F::::.. ........ :•::v- .... .•::•::::.w::{J:•.:... - .:•..... ........... :. ::.::: r:.r'+•r+rrrr;.}v:{3:{$:iwi$r:.::}riri::4:{:{?•Y•Y:;:'Fr:•i:4:{{4:4::{v;•,i•:F:r:ri�:..:•$:... iC AUX ampsnyn �\ ..�"' }.................... ::::Jaw•{•::'k >? �s ,�j• '. z•.........:.... .................... t.l i` .wnwi�....................::::nv:::::n�.::4;.}}}}rr}:•:':::r:�Y.:r}::i:::::::::::::::::::._::.::.:.....:.:n�:::::.::::n::.n.................. ::•:::v::i•}:i:•:;:hY:::r:i::•}::Y:v;..•w::.�::::::::w:...n�v:;.....:.::v:::::.�:•.::• -.y:w::•.:::::.�.::...:. FWh=to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of crb ninal penalties of a fine nP to$1,500.00 and/or one years,imprisonment as well as civfi penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify the pains and penalties of perjury that the information provided above is ;Z� correct /Si�� Date Print Phone# offlc al use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ► ❑checkif irnmedlate response is required ❑Selecbnen's Office . } ❑Health Department contact person: phone#; ❑Other (revised 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. - a r - .An employer is defined as an individual,partnership, association;corporation or other legal'entity;or any two or more of �ttie`foregoing'eiigaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. .However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. ; MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. r Applicants , Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and-phone numbers along with a certificate 'of insurance as all affidavits maybe Fp Ym8 submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and VW 2_ 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. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the penmitllicense number which will be used as a reference number. The affidavits may be retnrh io the Department by mail or FAX unless other arrangements have been made. I The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Me of Invesugations 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 0,F1METp Town of Barnstable Regulatory Services ` ■ARNszaBM Thomas F.Geiler,Director y Mass. g 39.�p Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: l -go-avc AF/ Del_ Estimated Cost 00 Address of Work: 224 A[, zdz Al ` &zz l Owner's Name: 1&9XIC itl i(L Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY /i ereby appl for a permit as the agent of the owner: to Contractor Name Registration No. OR Date Owner's Name Q:fomvs:homeaffidav I 09-15=2003 14:45 From-TAYLOR DUANE BARTON GILMAN(LLP 6174825350 T-581 P-002/002 F-812 Town of Barnstable : Regulatory Services Thomas F.Gefter,Director Building Division Tom Perry, Building Commissioner 200 MaW Sawt, Hyannis,MA 02601 Office: 50"62.4038 Pax: 508-79U230 Property Owner Must Complete and Sign This Section If Using,A. Buildex j 1, ��►�rt �� r" �' U r �Q=,as Owner of the subject pxopextp AA I � hereby authorize y i d /krs ka.1A _ - to act on my behalf, in all matte=xelati ve to work suthofized by this building permir application for: arys (Address of Job) /5- 0 tore o ex ate j pit Name 0;FoRMWWNMW,RMMSI0N ' ✓fie �nariviiuriuuea�i a�✓Glauac�acweCla BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 061704 Birthdate: 07/30/1967 Expires: 07/30/2005 r. no: 14190 `s P Res DAVID J MARSHALL 182 OLD TOWNHOUSE RD S YARMOUTH, MA 02664 Administrator = t ,. n Board of Building Repulations is s- One Ashburton P ace, m 1301 r. Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR L Birthdate: 07/30/1967 Number: CS 06170 xpires: 07/30/2005 Restricted To: 00 DAVID J MARSHALL 182 OLD TOWNHOUSE RD S YARMOUTH, MA 02664 Tr. no: 14190 Keep top for receipt and change of address notification. TOM CLERK BARNSTAB!E MASS. Application to ®Yb Rin '0 i bWay Region al �io 0rit Miotritt GAIT mitt Ef 2M I R 2: 05 In the Town of Barnstable o C � d CERTIFICATE OF APPROPRIATENESS <' -? C � fl _ lication is hereby made, with four complete sets, for the issuance of a Certificate of Appropriatene s under=28ecti6n Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described.belo and 60 plats, ✓ings, or photographs accompanying this application for o w o rz ECK CATEGORIES THAT APPLY: :xterior building construction: ,� .� New ❑ Addition Alteration ,ldicate type of building: R House ❑ Garage ❑ Commercial El Other :xterior Painting: ❑ signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign structure: ❑ Fence ❑ Wall ❑ Flagpole ❑Other PE OR PRINT LEGIBLY: DATE )RESS OF PROPOSED WORK Zj (p MAIA Sr ASSESSOR'S MAP NO. 13 'NER 1IEtJ/JI rIFR AAD 3CHAJ 30I-CI✓ ASSESSOR'S LOT NO. NE ADDRESS 8 � � .5� riT� i 6 12? TELEPHONE NO. .L NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any lic street orway. (Attach additional sheet if necessary.) �oNA-t.� u� Nr�f�c1� boo ��4c��r r�,P�- . � �'fF�y�nl T o�J�� ®o s �>.�iJ z►a.6Gg Ago w t.E TK 41A 14 5 i S 3 o►770 ENT OR CONTRACTOR 7;&/l�> TELEPHONE NO. —3 74- S/b DRESS 18A © b y M1 -1, AM ©A110-7" SCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please ude locations of proposed signs. Ir Signed —V Owner-Contractor-Agent r Committee Use Only This Certificate is hereby APPROVED- Date 1� Approved nie Com ittee Members' Signature . i Iry l� NOD 66 135 ov"Yo ''• 1 '3NI dV d V SIAV 65' �l sMm3m A o Y TYr16Nvvs •,.6 . 71LL do M0119v10 3 violin 03vv 3vd 1. \ 7v,)f,j jJ / ot -ell i od / Q — �• �seo'i •. H 1-fa— ; . .. :o. M O""dA OL'E P b• d ' ?o L.CMbI 1 ,' •au � s .� r.. .6 Town of Barnstable Old King's Highway Historic District Committee SPEC SHEET :)UNDATION IDING TYPE tq/� COLOR HIMNEY TYPE AA COLOR OOF MATERIAL �I�CIiir / �COLOR ITCH INDOWS #UDF ,6;'\) COLOR &X1 iF, SIZE p?YXz/4o FY e,61 ' - RIM COLOR . tj 4l rCi OORS COLORS HUTTERS dA COLORS UTTERS �`�/iZ COLORS ELKS to A MATERIALS ARAGE DOORS /v COLORS KYLIGHTS /V4 SIZE COLORS IGNS COLORS 'ENCE COLOR OTES: 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, 0 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3 Parcel �o t Applicationo OS Health Division Date Issued O Conservation Division X( L-/ Application Fee : Planning Dept Permit Fee. Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis o Project Street Address a Q , Moan SW-eF:4- 9c,&4e— (oA Village rns4-a61e F YYl A Owner J-hY, +- Ter)" ► eA- 13(A v IC — Address;,2e!9 b0ca n <i�t. Telephoned Permit Request cervy6 4- 4-n renaird da,w.c-nea C9lirnneus En bnd i 01+ aah l eAAA(Aear�^C per ✓ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay 0 Project Valuation 1500n•p Construction Type rnas m� . Lot Size 3 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family ((## nits) Age of Existing Structure Historic House: ❑Yes O'No On Old King's Highway: eYes ❑ No Basement Type: ❑ Full ❑ Crawl 0 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: ❑ Gas ❑Oil ❑ Electric ❑ Other F� Central Air: ❑Yes ❑ No Fireplaces: Existing_ZNew Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size Pool: ❑ existing 0 new size _ Barre existing❑ now size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Oth�; o � o n Zoning Board of Appeals Author' ation ❑ Appeal # Recorded ❑ o Commercial ❑Yes o If yes, site plan review# a Current Use 1 delV!6&I Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name nrici, A -a,Bn aw, Telephone Number Address A31 oAa�yi "arnAe- a-Y License # Cr.S - 313 Mai [A :-WO, W 1 . Home Improvement Contractor# 149 '49 h O aL-1 Worker's Compensation # hlPA w 0,a(oY,1S I to ' IQ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO cas / u r,. �,-A Chi SIGNATURE DATE h Jam/ FOR OFFICIAL USE ONLY "f 4APPLICATION# DATE ISSUED '2 a r MAP./PARCEL NO.- _ ADDRESS VILLAGE :t ". OWNER DATE OF INSPECTION: 11 FOUNDATION - FRAME INSULATION:: FIREPLACE 4 � Wo0 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL .,GAS: , -ROUGH ti' FINAL J -FINAL BUILDING ' (� = s 4 3 DATE CLOSED OUT ASSOCIATION PLAN NO. r s The Commonwealth of Massachusetts Y— Department of Industrial Accidents. Office of Investigations 600 Washington Street t Boston, MA 02111 yy www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electl-icians/Plumbel-s Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: ty AA Vk 1 ti City/State/Zip: fJ . MnAPhone #: �' -{3���3� n Are you employer?•Check the appropriate box: Type of project(required): 4. ❑ am a general eral contractor and I 1. am a employer with �` 6. ❑New construction employees(frill and/or part-tiri�e).* have hired the sub-contractors.. 2.❑ I am a sole proprietor-or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for mein any capacity. employees and have workers' 9 ❑ Building addition No workers' comp. insurance comp. insurance.# 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] 3.❑ I am a bomeowner.doing all work officers have exercised their 1 LE]Plumbing repairs or additions myself [No workers' comp: right of exemption per MGL 12.0 Roof repairs required] t c. 152, §1(4), and we have no insurance re q ] employees. [No workers' 13.0 Other comp. insurance required.] 'Any applicant that checks box 4) must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site informatiot>_ '� Insurance Company Name: f�L 1 C.L_ �✓1 S l (7 — Policy#or Self-ins. Lic. M LJCPr^2(u5_I 6 — t ca Expiration Date: q o26 Job Site Address: .2c2-9 O ' �ia'Yl�e,_City/State/Zip: Attach a copy of the workers compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP.WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I.do hereby certify under e pai and penalties ofperjury that the information provided above is trice and correct. Si nature: Date: 0 Phone M U Official ctse only. Do not write in this area, to be completed by city or town offtciaL City or Town: Permit/License# 77] [Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Cleric 4. Electrical Inspector 5. Plumbing Inspector 6. Other. Contact Person: Phone#: >' WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY 0 INFORMATION PAGE NCCI Carrier Code #33391 Policy No. WCA 0268516-12 Issued By Acadia Insurance Company Previous Policy WCA 0268516 - 11 290 Donald J. Lynch Boulevard Marlborough, Massachusetts 01752 1. NAMED INSURED AND ADDRESS AGENCY NAME AND ADDRESS 07401 LaBarge Engineering and Contracting, (508) 791-2241 Inc. Sullivan Insurance Group, Inc. 237 Main Street Ten Chestnut Street,- Suite 1010 Route 28 Worcester, MA 01608-2804 West Harwich, MA 02671 F.E.I.N. 043552990 U.I.A.N. Bureau File No. 0262586 State: MA Entity of Insured: Corporation `LOCATIONS See Attached Schedule of Locations POLICY PERIOD 2. The Policy Period is from 09/26/2010 to 09/26/2011 12:01 AM Standard mailing address. Time at the insured's COVERAGES 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 500,000 each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ 500,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: ALL STATES EXCEPT ND, OH, WA, WY AND STATES DESIGNATED IN ITEM 3A OF THE INFORMATION PAGE. D. This policy includes these endorsements and schedules: SEE SCHEDULE OF ENDORSEMENTS This policy is: X Direct Bill 9 Pay Plan Agent Billed I I WC 00 00 01A Page 1 Original 1 4 � THE t Town of Barnstable Regulatory Services LIRT(6TAS[.� p uAas �, Thomas F. Geiler,Director ��EDbMF�}gym Building Division Tom Perry, Buildiog Commissioner 200 Main Strect, Hyannis, MA 02601 www.town.barnstable.ma.us Mice: 508-862-4039 Fax: 509-790-623( Property Owner Must Complete and Sign.This Section If Usirz_g A Builder I, `1 <)In n k ✓Le— , as Owner of the subject property hereby authorize - to act on my behalf; in all a tiers relative to work authorized by this building permit application for. (Address ofJob) 0 ature of Owner Date /�-- Print Narne If Property Owner is applying for permit please complete. the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WMEPPERMISSION Town of Barnstable Regulatory Sez�vices uttrrsr.�s Thomas F. Geiler, Director - t.s, . A. Building Division rEDA� Tom Perry, Building Commissioner 200 Maid-Strect,_Hyannis, MA.02601 ww'sv.to wn.b arnstab 1 e.ma-us Office: 508-862-403 8 Fax: 509-790-15230 HOKEOVNER LICENSE EXE IPT10N Please Print DA TE: JOB LOCATION: number street vi l l age -HOMEOWNER".* nasnc home phone# work phone# CURRENT MAILING ADDRESS: city/town sfato ap code 7bc =eat exemption for"homeowners"was extended to include owner-occupied dwellinKS of six units or less and to allow homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor- DEFTNTTION OR HONIBOW ER Person(s) who owns a parcel of land on which he/she resides or intends to reside,,on which there is, or is intended to be, a one or two-family dwelling, attached or'detached siructures accessory to such use and/or farm structures. A person who constrycts more than one home e in a two-year period shall not be considered a bomowner. Such "homeowner"shall submit to the Building Of5cial on a form acceptable to the Budding Official, that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"horna-owncr"aS=r-s responsibility'for compliance with the State Building Code and otber applicable codes, bylaws, rules and rcgula.tions. The undersigned "homeowner" certifies that.he/she understands the Town of Barnstable Building Department n:1j imum.inspection procedures and requirements and that he/sbc will comply with-said procedures and requirements. Signatisre of Homeowner A.pproval of Building 015cial Note: Thrce-family dweIlings containing 3 5,000 cubic feet or larger willrbc,rcquirt<d to comply wiih.,the State Building Codc Section 127.0 Construction Control. HOMEOWNER'S EXE) Y=ON .The Code states that: "Any homeownerperfomsing work for which a building permit is rcquircd shall be exempt from the provisians of this section•(Secrian )o9.).) -Lica ring of construction Supervisors);provided that if the homeoz5mer argages a p=on(s)for hire to do such work, that such Homeowner shall act as supc-visar." Many homcownm who use this cxmnptian arc unaware that they art assuming the responsrbilitics of a supervisor(see Appendix Q, Rules&Regulations for Licensing Consbvetion Supervisorr,Section 2.15) This lack of awanaress often results in serious problems,particularly when the homeowner hires unlicarsed perrons In this ease,our Board eannol procood against the unlicensed person as it wouJd with a licensed Supervisor. The horfreowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware ofhivbcrrtsponsibi)itics, many communities require, as part of the permit application, that the horncownr_r certify that hdshe unden:tands the mcloonsib0itiu of a Supervisor. Do the last page of this issue is a form eurrcnt)y used by tcvct dl towns. You may care I amend and adopt such a form/ccrrifi=.6an for use in your community. Q:forms:home.c9c^Zp t INlassachusetts- Department of Public Safety' Board of Building Re!-ulations and Standards Construction Supervisor License License: CS 68313 Restricted to: 00 -� TODD A LABARGE 237 MAIN ST/RT 283 W HARWICH, MA 02671 ^:4 � �--�--!� Expiration: 2r//2012 ('uuunisiuner Tr#: 15072 I Restricted to: 00 00- Unrestricted 1G-1 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Refer to: WWW.Mass.Gov/DPS 1 I J 1 TLC T7dYIYI)LOOLL(/P.CL�iL d�✓!/LGbJCLC�LfIdC�b . _ — Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration:_ °•149496 . 10 Park Plaza-Suite 5170 = Expiratiion-=;]1.93(2012 Tr# 291587 ., Boston,MA 02116 Type.:; P ivate Co( .6�ation LABARGE ENG.INEBRIN0w---G=,QaNTRACTING INC TODD LABARGE:,:v_;-A. 237 MAIN ST- W HARWICH,MA 02d7'i.� ' Undersecretary Not valid without signature I 1 1 ' I 1 i ........... 1 I 1 i 3 - O l Lo (Q53 The Town of Barnstable dU Pemi t# Massachusetts Date BARMAIRZ NAa& SOLID FUEL STOVE PERMIT i nis constitutes an oniaat stove permit auer inspection anu approval oy the ounuing inspector. Owner �N /� � Telephone no. Address of Property 49L.9 (y\C \ 7)4-, Village 14,1 . 0pf n x1- Location and Stove Type y r n ry e , 0 Date: Bu lding Inspector The solid fuel burning stove at the above locat' n passed li failed: inspection. aw- r The Town of Barnstable Permit# 5 Massachusetts Date I s NAB& SOLID FUEL STOVE PERMIT minas. �039. �.� p act Fee —� pus constitutes an official stove permit after inspection and approval by the building inspector. Owner �� ti� 9 �� h 56 n Telephone no. Address of Property Q3\ g", IL Village �' c Location and Stove Type Lo tA 1 UE w Aa,µ.EIZ_ Date:_ Qg*' cam. Bu ding Inspector The solid fuel burning stove at the above loca on passed: failed: inspection. ywood r .A TDAM CLERK Application to Pisstorit Miitrict Committee 2M JIUN 12 % Mh own of Barnstable C t CERTIFICATE OF APPROPRIATENESSco alcation is hereby made, with four complete sets, for the issuance of a Certificate of Appropriateness nder S2ction F Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described.below z nd on plpns,— Nings, or photographs accompanying this application for. o co r ECK CATEGORIES THAT APPLY: o rn xterior building construction: 0 New ❑ Addition Alteration ndicate type of building: House ❑ Garage ❑ Commercial ❑ Other Exterior Painting: ❑ Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other PE OR PRINT LEGIBLY: DATE DRESS OF PROPOSED WORK low 5l-' ASSESSOR'S MAP NO. /3 INER '1"�i�tJI rF R AAJb SCHM Bokke. ASSESSOR'S LOT NO. ME ADDRESS 6A51r I 2 TELEPHONE NO. _.'66 LL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any flic street orway. (Attach additional sheet if necessary.) WkZ VJ AIICROL66 „200 W.MAJ6f cy,P► - 8 :�F EAI T 045Y ®0 5- v IRAJ LV6Cg W 1 �.� S MAIN 5f I 6 - Es - 3 �= �s i L -'i 5QCW 0)770 ENT OR CONTRACTOR !7/�IIJ� yl1( L�� TELEPHONE NO. SJe DRESS I 04h ABC f y. M(r0-1, AlA C6 SCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please lude locations of proposed signs. -t- . Signed Owner-Contractor-Agent —Z A& h r Committee Use Only This Certificate is hereby Ppnx/pn 4(6§ 11653 ro d e i Committee Members' Signatures: i� fh dy O • � O y r � v Z v S 1 .1" 9_2 To 1{j.' I ly 77O•�C !! —23pp -I N v I.IbAG / 23-?- Q ° /� A. F I.oeAC- to I_ c 1.OLAC �A,f' 1 �� Y V� � i %JN \ h/ ve / �1 / ♦ / 1 " •� k I.ZOAC. 1 T_.. PII[VARED UNOEII ! 0111lCTS7N Or THE A 9ARNSTAMA E o1 ASSESSONS 2 1 AVIS A1R INC. 1 rASSA SET S CON N AL •.' It A Town of Barnstable Old King's Highway Historic District Committee SPEC SHEET 'OUNDATION TIDING TYPE to h- COLOR 'HIMNEY TYPE COLOR :OOF MATERIAL �'��ri� IGV� fi 3a✓`tilJ COLOR bmiWe4 090P )ITCH N tlNDows �E �� COLOR WA4 I Fi SIZE_p��,�'��o ►V C�� 'RIM COLOR . U) l�l )OORS COLORS SHUTTERS COLORS 7UTTERS �'`�/rl COLORS )ELKS A A MATERIALS ,ARAGE DOORS AA COLORS 3.KYLIGHTS SIZE COLORS SIGNS A '"-'.-' COLORS COLORS ?ENCE COLOR COTES: 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 plane, when applicable. �T Town of Barnstable *Permit# 6 7 /7 9 � � � Expires 6 months om issu�,d�te 5 Regulatory Services Fee - 0(J SEP 2 7 .200 g rY . Thomas F.Geiler,Director TOWN OF BARNSTABLE Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERIMT APPLICATION - RESIDENTIAL ONLY Not Valid'without Red X-Press Imprint I,} Map/parcel Number I 4/1/3q Property Address [Residential Value of Workp�!20 o,-J Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address )c)k �, ,3 1 c- `-e--- S o C( L,-) Telephone Number Contractor's Name ( 0 D� M� �j�a.�.g.�n Q eP Home Improvement Contractor License#(if applicable) �7 Construction Supervisor's License#(if applicable) C) s S 0 C ❑Workman's Compensation Insurance Chec one: 6,41 am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side replacement Windows. U-Value Qt\�+o('S0n(maximum 44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvem Contractors License is required. SIGNATURE: Q:Forms:expmtrg Revise071405 �men 27 05 01 : 24p Dumont Morris & Burke, PC 16172277025 p. 1 ■0% ■so ■ 0■ Town of Barnstable Regulatory Services Thomas F.Geller,Director t°'° Building Division Tom Perry, Building Commissioner 200 Main Straet, Hyanuie,MA 02601 www.town.barnstable.ma.us Office: 508-862.4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, `/oho Z)• Bar kl ,as Owner of the subject property I' hereby authorize � ��r�� to act on my behalf, in all matters relative to work authorized by this building permit applicadon for: A i.3o (Address of job) "?/Z--7 45� Signature of Owner Date Print None i Q:PORM S:OWNW 6PJ,0S10N d M 'ON WO08MOHS N3S830NV/A31d3HS Wdlo: l S001 'It 'd3S Application:to: y N' �E ,ate ffPPJ Old Kings Highway RegionafH1Stq ,c District Committee in the Town of Barnstable for a CERTIFICATION.OF EXEMPTION Application is hereby made, in triplicate,for the issuance of a-certificate of exemption under Section 6 and 7 of Chapter 470, Acts and Resolves of Massachusetts, 1973, as amended for proposed work as described below and on plans,drawings,or photo- graphs accompanying this application. . TYPE OR PRINT LEGIBLY DATE -7- 2LC)O ADDRESS OF PROPOSED WORK o�a9 ��A ASSESSORS MAP NO. OWNER Jati.,� ,,�` ASSESSORS LOT NO. HOME ADDRESS 5�.,^^Q TEL. NO. AGENT OR CONTRACTOR 4!A ec �` yaq� �a — OAK y A ADDRESS 7-7 11 c)nj�H,J .7C.�,-� I TEL. N0. !SOB' This application is for exemption of proposed exterior construction on the ground that: ❑ (1) it will not be visible from any way id' 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 I ing location of existing building. i Gam" �Q C,uN� ����C 1�„�cJ�^► ()i.i'T.a- l .'�Qa.�.e ..1C)�•Q, O�G�`�.o/'� tJ�l'"1 .��'"`.r""` Gv�^^��h'�� S NED %'• ��� Space below line for Committee use. . Owner-Contractor-Agent Received by H.D.C. The Certificate is hereby Date Time J&y By Date Approved ❑ The categories of work entitled to exemption are listed on Disapproved ❑ the back of this form. ' r I � WINDOWS-DOORS � NFRC Andersen®� t kaGliding Patio Door National Fenestration Vinyl-Clad Wood Frame Rating Council® Dual-Pane Low-E Glazing with Argon Product Type: Sliding Patio Door with Frame ENERGY PERFORMANCE RATINGS U-Factor(U.S./I-P) Solar Heat Gain Coefficient 031 034 ADDITIONAL PERFORMANCE RATINGS ; Visible Transmittance Air Leakage (U.S./I-P) V'O 6 Manufacturer stipulates that these ratings conform to applicable NFRC procedures for determining whole product performance.NFRC ratings are determined for a fixed set of environmental conditions and a specific product size. NFRC does not recommend any product and does not warrant the suitability of any- product fonany specific use.'`Consult manufacturer's literature for other product performance Informatlom www.nfrc.org ENERGY STAR®Qualified w in All 50 States DESIGN PRESSURE(P5F) 1 Single DP40 SLT-C40 51"x 96" WIN�� RAMCIA„� 2 Panel DP25 SGD-LC25 96"X.96" www.wdma.cam 2 Panel Upgrade DP40 SGD-LC40 96"x 63" Perma-Shleld`Gliding Patio Door Tested to ANSI/AAMA/NWWDA 101/I.S.2-97 or NAFS-02orAAMA/WDMA/CSA101/I.S.2/A440-05 Manufacturer stipulates conformance to the applicable standards ; Meets or exceeds M.E.C.,C.E.C.,&I.E.C.C.Air Infiltration Requirements WDMA Hallmark Certification Program , Rea 8/05 Pane 4780730 Z. Uoa�vnzo�uueall� o�/�aaaac�ivaeQ2 BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 055029 Birthdate ;0611:4/1964 -z... Expires:O6/14"/2006 Tr.no: 2903.0 Restricted: 00. TODD R MACDONALD PO BOX 544 G YARMOUTHPORT,'MA-02675 Commissioner _— jj� Two 48355222 t` " , ,. �2Jb09�061, Gsf MGT AV I {.-M R•CJ 26 FRANC,ISAOAD, HARWIC 0 f-02645-2304� ZM License or registration valid for individul use only before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston,Ma.02108 Not valid without signature .•✓�ie '(�omvrna�uue�a�,/�aaaacfu�aeda Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 111795 Expiration: 10/7/2005 Type: .Individual TODD R.MacDONALD TODD MacDONALD 17 WAGON RD. YARMOUTH;MA 02675 Administrator n Assessors map and lot num _ .......... ..1...... .... THE SewagSewage T e Permit numbe / .... . ... ....... . Z BA STABLE, i House number ........................Z. .9...................................... q rhea �p i639. J 0 MP-1 a' TORN OF BARNSTABLE BUILDIH.G INSPECTOR APPLICATION FOR PERMIT TO .: .I. .........�� ..1"!.... ..................................................... TYPE OF CONSTRUCTION ..............woo ............f.::.� ................................................................... . ............L1.. �.1.....................19. TO THE INSPECTOR OF BUILDINGS: -• The undersigned hereby applies for a permit according to the following information: �L2 �t ►rt 57� laJ. �v�reS�A��� t-,, Location (. )................. ....................................I............................. ..�.......................................................... Proposed Use CA✓C. 61 A(�(n .......................................................................... .................................................................., ZoningDistrict ........................................................................Fire District .............................................................................. -Name of Owner ........ Kv.....(,.I..... Y. t79! �ress .....22" .........r'�ALet....S..i.�....lN.i..l l.fc•NYl�6k C-LF It Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................`........... ...................................Address ...............................:....................................I............... Number of Rooms (............................................Foundation .............GFq....�F�..............E........................................ u Exterior .............w9t�!4............f lr. ..u.......................:........Roofing ...................tvO.?0.....S.N!rt�............................. Floors �•G=•e1G .......................Interior ................ ...voa� .............................................................. ..................................................................... Heating ..................................................:................................Plumbing .......... Fireplace ..............................................................................Approximate Cost ........................�.��`................................. m Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area .......... ... . .......,;................... Diagram of Lot and Building with Dimensions . Fee ... ...... .................... SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town rns bl r g ing t above construction. Name ..................... .......................................:.......... Construction Supervisor's License ....( � .?.5�............. , ,, JOHNSONr KENNETH & LOUGHNANE, CHRISTINE M. No ...24965. . . . Permit for :.Build. . ...Garage.. .. . .. .... ..... .. .... ..... ............ Acc.essory. . . ...to. ...Dw. 11i......ng .................. ..... .... .. .... .. .. .. .. ....e........ Location 2.29 Main Street .. .................................................. West Barnstable ............................................................. Owner Kenneth Johnson, &„Chriq.tine M. Loughnane -•Type of Construction ..Frame......................... Plot ............................ Lot ................................ Permit Granted 19 8 3 April 19, Date of Inspection ................................:...19 Date Completed ..........16x ................19 i V o . 42 ra I v CIA ' .I c nGti� .rt/ter- Tf/y5 �T /S .voT i SIMOWn/ OA/ • N,a 2,4 iznS �s,�-p s CERTIFIED PLOT PLAN LOCATION WIST,C3fil?�.sT.9.el.6. .!`'�ISS.. SCALE . .�.�/-.6�. DATE -3. 98 PLAN REFERENCE a� ip . . . . . . . . . . .p. . . . . � I CERTIFY THAT THE G'.. . r,. � .b6`' -SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS'SHOWN HEREON AND THAT IT CONFORIiS TO THE SETBACK REOUIREMENTS OF THE- TOWN OF . . . . . . . WHEN CONSTRUCTED. ! �G�•c.6?i! 8. S�fr�/So DATE �w�.. •3 ��8/ /�/y PETITIONER; REGISTERED .LAND SURV OR Application to PON 5<PepMOV<N 0P OPEP,p5<�pP`pNs Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, iri triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on .plans; drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: Building ❑ Addition ❑ Alteration Indicate type of building: ❑ House 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 OR PRINT LEGIBLY DATE ADDRESS OF PROPOSED WORK 22OI MA f-I `3T ",, W. 6NQ-t5-661LF ASSESSORS MAP NO. 13Y OWNER M- Lw(nttNArtE- ASSESSORS LOT NO. HOME ADDRESS 66rnr, A5 P,(3ou6E TEL. NO. 3(222 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necess'ary). �PrriE �Ocllrl ,200 t-�lwrll`� S f• , W. `�PtM'tS7o48CF' �'Tirvc-rt � r�a��r f�c-Y , z-�co s��i� S7. ,, 1N• t5��r�57a�3� f,Cr)At,ie: 69Il,00--f } 25�1 MAJri 57. t,.1. 6Ar1r-f'VWLC AGENT OR CONTRACTOR TEL. NO. n762 3�0 9 ADDRESS CAMG, r 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). 'fbin-&t- CA-e— Ch a&ACic 'jjO st= Tye - C; K Ct - C-t 'A ('�rL� C(,?-+QLcf TG A,V SLAG) wl C M NAZI t (.e7-0A1t-1YH ra(2Le5 S IIp Gam+-�-5 �e o°>=� �0�4 1—It-Wok/5 J ptr-w� 6lz°u"-c T(�tr•^ AS �- �T1i�rF� Of��.ir1G 5., Signed ��� f�� O � -Contractor-Agent S I li r COE-MI- use. �- Recei • A NSTABLE Date The Certificate is hereby Date -Yb C/fz11 Time �w A.gatl, By APR 1 Ion Approved IMPORTANT: If Certificate is approved, approval is subject to the 10 day appeal period provided in the Act. Disapproved ❑ ADDITIONAL INFORMATION FOR MAKING AND ILIING AN APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS The four categories for which a Certificate of Appropriateness is required are: (application for demolition or removal is-a separate form). 1. EXTERIOR BUILDING CONSTRUCTION (new or existing buildings): An application is required for any exterior of a building to be erected or altered including windows, doors, siding, roof, light etc., that will be visible from any public street, way or public place. The following scale drawings are required in duplicate with application: plot plan (if addition — show existing buildings in outline), floor plan and elevations. Also required are snap shots of existing buildings, where additions or alterations are to be made. No plot plan is required for addition or alteration which does not touch the ground. 2. EXTERIOR PAINTING: An application is required for any portion .of a building, structure or sign to be painted that is visible from a public street, way or public place. Color samples must be attached to these applications. An application is not required when repainting existing colors, changing to white, or using colors approved by the Town Historic District Committee. 3. SIGNS OR BILLBOARDS: An application is required for any sign or billboard to be erected within the District, with the following exceptions: a. Existing signs or billboards on November 27, 1974 shall have until November 27,'1977 to secure an.approved Certificate of Appropriateness. b. Temporary signs for use in connection with any official celebration or parade or any charitable drive as long as they are removed within three days of the event. Certain other temporary signs that the Committee feels does not detract from the Act may be allowed with the prior permission of the Committee. c. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they are erected or displayed. d. A single sign of not more than 1 square foot in area showing the name, occupation 6r address of the occupant of the premises on which they are erected or displayed in a residential zone. 4. STRUCTURE: An application is required to'build or alter any structure within the District which is defined by.the Act as a combination of materials other than a building, sign or billboard, but including stone walls, flagpoles, hedges, gates, fences, etc. GENERAL REQUIREMENTS . 5. Work on projects requiring approval shall not be started until the Certificate of Appropriateness has been filed with the Town Clerk by the Committee. Approval is subject to the 10 day appeal period provided in the Act. 6. No changes shall be made from the original approved specifications without advance approval of the Commission on an amended application"filed with the Committee:' 7. A separate application must be filed with each project requiring a Certificate of Appropriateness. 8. Under heading of "Detailed Description of Proposed Work" give detailed data on such architectural features as: foundation, chimney, siding, roofing, roof pitch, sash and doors, window and door frames, trim, gutters—leaders, roofing and paint color. 9. Unless application is complete and legible and all material required is supplied, application will not be accepted or acted upon. Copies of the Act establishing the Regional Historic District may be obtained at the Town Hall. I RA .� .. 4. v ... .. Assessor's map and lot number .... THE G y� Sewage Permit numb. ...... .. ....... . 1 B9B39TSBLE. i House number .......? 163 s• e� 0 Yp-f a` TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ............ 7lJ..l' .........� ....................................................... TYPE OF CONSTRUCTION ............W.P2a............E-` M.C.................. .............................................. // .19 .... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit.,according to the following information: 22� t Ir1 57• 1�v. CS�K�S�A>��� i--jAr ( �y �7 b Location ...............................................................)........................................................ �. .................... �. Proposed Use (-A Ut A R- G'l— ............ ............... ............................................................................................................ Zoning District .................Fire District ..............................-. ....................................................... ................................................ y-eHHt;-r g Jo►10 Gt �A 22�1 t.. Marc S�, by, 9A�5T,-0 - Nameof Owner ....... k}.....1`f�.(r1.1.................� ..... ....... ddress .................................................. .............. L ti Nameof Builder ........................... .....................................Address .................................................................................... Nameof Architect .................5...`.... ....................................Address ........;........................................................................... Number of Rooms ....................�.............................................Foundation ............ . .......................................... . W000 51AtriUu; W000 Sl�lrt�<< Exterior ....................................................................................Roofing ............................................................................:....... L Floors ..........Lt'�..�..........................................Interior .......................�'"000.............................................. ..a Heating ..................................................................................Plumbing ..................................:.........-�� ................................... ...............................................:........A Approximate Cost Fireplace pp ......................�........................................... ........................ Definitive Plan Approved by Planning Board __________________________ 76.0 19 - -. Area ................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH o OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of tWTownrnstable r garding the. above construction. Name .. ..... ... ............................. .................. •. Construction Supervisor's License ... . ....?................... jbHNSON, KENNETH & 'LOUGHNANE, CHRISTINE A=134-16v' 24965 Build Garage No ................. Permit for .................................... Accessory to Dwelling ............................................................................... Location ...229...Main........St...r.....ee...t ..... ...................... West Barnstable ............................................................................... -Owner ..Kenneth...Johnson. ....&....Ch.r.is.t.ine Loughnane .. .... ....... .. .. ....... ....... . .... .. .... .. Type of Construction Frame ...................................... ................................................................................ Plot ............................. Lot ................................ April 19, 8 3-' Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 18y s I . � r 2 -7 1V1,5 ���� 7 1S NEST i of z ell r( O too ' 9 60 J /, ° �/ � , , �1:. [ 1 , / � • ,60 ,l ,� o q; 2 to alv, .77 A4 ® ) A�A� Now- R6tiAT�oNS $A.S�'D oN 0 c9 CERTIFIED PLOT PLAN LOCATION WrJT,8A??!�! 8.4� SCALE . . / .��Lo ' . . DATE S4v-6�•?7/S$v u� PLAN REFERENCE cr% EU`JV R' 15 , � EyF �. 14AvD 2z_ZO�4m /n✓ 8C. Z8Z No F(j ISTV I CERTIFY THAT THE ... . ... ....... .. ...... ` SHOWN ON THIS P ON THE GROUND AS SHOWN HER � IT CONFORMS TO THE SETBACK TS OF THE TOWN OF I'/, W4Z4CP &-TcrX . . . . . . . . . . . . WHEN CONSTRUCTED. IV&" —5691AL.'a DATE . . . . . .. . . . PETITIONER: Sot�Th/ CA�COr-/A/A.1 Z99Lo REGISTERED LAND SURVEYOR SHEET Z of Z TOP OF FOUNDATION CONCRETE COVER CONCRETE COVERS •'! 4"CAST IRON 12"MAX. 12"MAX. PIPE (OR 4"ORANGEBURG(OR EQUIV.) T EQUIV.)- MIN. PIPE- MIN. I LEACH ° PITCH 1/4"PER. PITCH 1/4"PER.FT PIT PRECAST ° LEACHING NVERT Q EL.9?�40... INV�F RT INVERT o Q•e PIT OR SEPTIC TANK EL••X7,oZ DIST. EL 9L.�8 : .• w ':' EQUIV. ,.o INVERT BOX e; EL.17.�9.. �000 GAL. INVE�T� INVERT '•' v°~ 0' :;�: 3/4"TOII& .� EL4. -.... EL.*!... U. WASHED w STONE W DIA. o. •' , i �' /o' DIA.—►{ ivo.v6 i PROF 1 LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE PRELIMINARY t S01'L LOG WITNESSED BY : DATE u.I.y79 TIME E. !Y.,'RA P Cr .w'e� BOARD OF'HEALTH TEST HOLE # TEST NOLE�S 7VOAf s E. !irdZ4-V !, !�G. ENGINEER ELEV. .777-27, /oZ,Q.o ELEV./oZ.Bo S e s DESIGN DATA ' CoArE NUMBER OF BEDROOMS 34) 3 Sot TOTAL ESTIMATED FLOW 33o GALLONS/DAY CQiewEZ BOTTOM LEACHING AREA 78.Sv SO.FT. /PIT i -- 79 SR"'a SIDE LEACHING AREA . . . -SO.FT./ PIT .She�iES GARBAGE DISPOSAL !�o^�G-. .(50% AREA INCREASE) TOTAL LEACHING AREA . 447 c v . SO.FT SAwiD ` / ,1 N PERCOLATION RATE .Z7.5-6c. �'`-W Ivcq MIN/INCH .04 LEACHING AREA PER PERCOLATION RATE .4T 79.. SQ.FT. !Vo. .WATER ENCOUNTERED 1 piT NUMBER OF LEACHING PITS . . . . 4 . APPROVED . . . . ! . . . . . . . BOARD OF HEALTH a< N GyA2�,SIDES. = lSG !�Sv�S7a�uF f eR P/T .DATE. . . THOMAS E.XELUY'Cci. . . . . . . . .. ENGINEERS—SURVEYORS AGENT OR INSPECTOR 346 LONG POND DRIV SOUTH YA.RMOUTH,MASS. 02664 '1��OF MSS o� THOMAS y 'y ED',A E /J i ELLEY �i o K y W O No 2;10� /1 4Yi1 TE�`6���. sS1ONAL PETITIONER SouTl� CAJZoGi!�A Z59Zn �e� 'a � ^ X 4) / X �o AV i „3 A, CERTIFIED PLOT. '.PLAN LOCATION SCALE . .�.���.6Q. . . . DATE PLAN REFERENCE •�;��! �-'' � .� .., ,Tjc.Dl�i,SH �. i''IA�T7��4 ,S, Cf�2T�,� . . . e4 I 'kbl, ti�spy.�;. i r j"f,�" ! . . . . . . . . . . . • . ... . . . . . . . . . I CERTIFY THAT THE ��.?�S?7!>!G.. . .���NAAT7nr✓..: SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF eey. �. �/Ez �v�C �� LE . . . . WHEN CONSTRUCTED. , /GTdnJ /yE T3Lg�vp ` DATE 4Vv PETITIONER: Sv Th/ 0gr.0G/NA Z99Zo J REGISTERED LAND SURV OR. Sl"f 1-. d.X /2C A ssor's map and lot numb ..1.��.0....................... �� V ,� SEPTIC SYSTEM E Sewage Permit number .. .............................................3 i` INSTALLED IN C / 22 10 a WITH TIT TAP 1 . House number ..... �................ ......................... ...:.................... ENVIRONMENTAL. LIP \e I TOWN REGU a TOWN OF _BARNSTAB'LE. BUILDING INSPECTOR APPLICATION -FOR PERMIT TO ..... L. .....1..... ...-� � `.............��. .C... ................. TYPE OF CONSTRUCTION ..........................�1 .��.t! .... /?` L�� ...... .... ... L L.�/►� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..W .. :........ .14. "" Y�.CL,a� .LQ, ........................................................:............................................................ ProposedUse !'T.Lc ( '...............................................:......................................................^.......................................... Zoning District; ................ ..Fire District )... Fr l-e I .. nc Name of Owne dress .:.T ... . .. Name of Builder (,1,).1 .. (,.,..............AddressQia�..�(�� .TZQ� • :��- � Name of Architect 7.1 c5 Y.1'.. ,..IJ�.L.4.►?'i 2..................Add ressm.I.1.1tx:1.. .not.-.... .... .Rm+00.� Numberof Rooms .... .............................................................Foundation .VtiT Q,[ ,.....:.................................................... Exterior �Y..51rz ..............................................Roofing ... Floors . �................11Ja.�........O.........................................Interior .fir. ...1 ..`...................................................... . . l HeatingQO. .. .... . e 1. ................................Plumbing .... .................................................... Fireplace ... .....................................................Approximate Cost. Q Definitive Plan Approved by Planning Board -----------_______-----------19 . Area ::: .... ` id, Q Diagram of Lot and Building with Dimensions L 3 .l Fee .............. ... 1 SUBJECT TO APPROVAL OF BOARD OF HEALTH / ' T oypl 1 ^ , ti 0 � � I hereby agree to conform to all the Rules and Regulations of the T gr b regarding the above construction. Name .. .................... E� tW ttIP, ,7F F`REY VIVIA —U-R KEN JOHNSON & HRISTINE LOUGHNANE 1*o Permit for , One 1/2 Story ..2 2 4 6 5.. ................ J Single Family Dwelling _r . ............................................................................. 229 MA'I cc Location ............ ........................................ West Barnstable ............................................................................... Owner J.effre. y...M... ... ... & Vivia. . . .n...Urig. . Welch .. .... .......... .. . .. ..... .. . .. .. .. .... .. Frame Type,of Construction .......................................... ................................................................................ Plot ...:........................ Lot ................................ Permit Granted .......Atlgust...2.9.,.......19 80 _ Date of Inspection �� .. :- 19�l "Dote Competed .. ................1 :. 3.19� PERMIT REFUSED - ..... 19 m ,, ....,. . :...... ........................................................ a....Qr.....:ar. .:.................................................. .................................................... a- �- M � .5. . .................................................. ® ix4 ' AP-0r 2 ea Q...— ...................................... 19 . .................................................... .............................................................................:. TOWN OF BARNSTABLE Permit No. _2 }6 Building Inspector Cash -- — �` OCCUPANCY PERMIT Bond "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Ken Johnson & Christina �.Aaahrane r, 'ti- R irn-,t-_nh1 229 Route b A ?est Barnstable Wiring Inspector �� `� _ Inspection date Plumbing Inspector 1/<,.�J� ! `, Inspection date Gas Inspector Inspection date "Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. 19 Building Inspector Assessor's map and lot numbe, I-Al!.1.71.66........................ i OfTNETO Sewage Permit number ......................................................... /47 '1 Z 13AW TABLE, House number ............ .......................................................... 163 0 M TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ........I...........................7...... ........................ ........................................ ............. TYPE OF CONSTRUCTION ...................................... ..7.................i.......................................... ........... ........................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .. . ............................................... . ... ....... .. ..... ........................................................................ ProposedUse ................................................................................................................................................ Zoning District ..........................................................Fire District ................................... lAddress i, Name of Owner—A., ....... ....... Name of Builder ..............Address Address ....................... .... ..... . Name of Architect .... .... .. _?!A- . . ....�.A..�,.,.. ��A.. ................ .... ......... ..Address)�31�1�,.M Numberof Rooms ............................................................Foundation ........................................................... Exterior ....... ... ..... ..............................................Roofing ..K.,��,............................................ Floors ...................................................Interior . ..................................................... Heating . .......... ....... .. ..... ................................Plumbing ................................................................................... Fireplace . .........................................................................Approximate Cost ................................................. Definitive Plan Approved by Planning Board ---------------—--—-----------19--------- Area ....... ................ Diagram of Lot and Building with Dimensions Fee .............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH t." vA A, I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ................ ............... ....................... t(a West Barnstable ----'---------------------- Ovvner —J�ff K.e.y'M......&...Vivian..Ur-ig[ Welch . Type of Construction .F x r/p, Permit ^ - Granted ' - Date of Date o|e�e6 . - ' ` PE MIT ' ____—,_—'—,-------.---- lV . ` .----------..�--. ........ . ' . —_ . — ` ' ' ............ .--. —� � ---- ..k—'�------ . . . Approved ................................................. l9 _ - ^ ` . ' ---------------...--.--".--- . ` --------^----------^—^^^^--'''' ' ' ' ~ - � ---- ii • I i j it i it Y � . I j { I � ) I I €li ! , I j ! I. 1 e I : i et'S1 i- � t rn n �� l il' Iis ti lE 14 , .'I I t ; �- C is � , •i ; I � , i jll i f I I I. t I i I • 17i 't 1� 1 Y 1 f I l t , is , ! yy r t Y ,J 1 { t• , f 'I ti � � t i lII� : I, • l � I I I i •I d.. _ tif�- _ o�� 3h I n. I gip. w . .. �'. :R. . , f �PAar I Ins . .._ � s r { It Mill 5 1 C 235 1 t • 04 ' i i.rf I`r L° I5 - T 4J �x ski nt =1,--T L1 4 to n G2�5 Y I� 3d !I' i ,I G yy E, t 9 S ' ' ' I , , : I. - '; ��, 't� .1 ag s} .I � � � r •i �"' ��i �. d tl ` [i i � P - C$t z' i I 1 ,$ 6 �3 1!!1� t j• � � i � , � i' 7 I'{r ( { tt tR • �. tj L .E >av - rr� 11 APPROVED BY: °i { aR is n. A AWN bV v s h' l y � �• t i l . . 2 DATE: 'pRAWINO NUMBER I.. ' .• � tli�fi � .qua f e F, a ! � C' �3 $t� _ 'i>.- _...I � � r , - ' � A�+1[F 4�i' 'F� t,y3,= t3 �¢ Y W Y __ ___ ___._.� b�> - '�t._—__v—cam..—��.__. -.�.,.__....w...�_.�«..w.a-.. �.+• w• �t } � d r : v 4 « .. v I i I 1 y i I it �t 1-7 Al I SCALE: tooh APPROVED BY: DRAWN BY l DATE:�7 DRAWING NUMBER I 1w4<2 64 �,r _t��►► ,� i2 �r ol ------------------- I �o�T I _ i i 1 i i a w i { SCALE: .d " APPROVED BY: DRAWN BY DATE: !� i DRAWING NUMBER ,-•lit Se- I 1 1 q r t x r's� _ naq • -31 i I 1 1 i ► s (1 :1 { I ._... ll l r �! eu I'S�in ' 1. {I d 1 + , J , l I, p r ' �Sz l''STt �uaoal.. 5h In I a _. .. ,: ; � . • ,_ , � � - - �� ,L.� i h I, . 1 1 ;, • g ! I � .C� d ,p f errs Ilf I : I I 9 Fs Ilrt . . to th ; i , I , ti ��; ;,1' �: ; ; ;,_yq C�.St , 't: �,is�t n u1 h I�-�. ,1 ,� ���� 1 L. 6 v ii' ' Y , i ` xr * I - �� _*kin ins ;, ,. i ' �' �J .�• � •1.1 '.. �. ,id: M �. r, ' �' ICJ. i _ X�A04 L1 Z G and LL,' 1;0 t { 1 . 44 _ I ' - - , r �1. 1 j. 7 �:• # �r i •{f i b n D. . t � Il. n t it APPROVED BY. '? I �I I "� d r ALE: (I WNBV K �. ATE: -. j!n t.- j f i 1 li 71" i �I T� � I - FI6 ' WINO NUMBER It 6f k's t to yt pis IT y ,l t b p} r S