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0240 MAIN ST./RTE 6A(W.BARN.)
%J S UPC 12543 • No.53LOR NASTINQS. UN Ila ♦AA� � 1 TA �C=1N.*,G SIL L Le-6 K 1-1 T i-ACC» ///�'�/ T d /� Imo'! -,. J:�O r.J�t ► .��i.i t.,,: FD.e,, -L I SCALE 0-' -Z 47� =- G._74= 1�o-rE PLAn/ 2EF&.2E A/C E pj _j _ ��- �j"T. �C.�'JvO(.�:—'S -ram raJ� �....I� � ��✓ �F"'. t � +-+ jI{I �i1� ��Cr��•_ ;i t��'C.t�� r �1EeE0y FY TA-IA T Tl,�6 EX1S7-- i �r'i FOUNDAT/OA./ LOCLiT/ON 150,2.2.2E .45 SNOWAI AND_7_z�_*�)-z __COA1,r'OZ, f W/TN THE SU/LD/ti'G .5E7_3AC-ZV69U/.eLM6V7 OF THE TO"VIV OF uasTa� �aaTta:.;3c,. l5't4 ------ -------------- 12 rc 't uz✓,yoQ - - �c'.csT� 1" �>J t snt A� �- �U .�_��:=-t•*: CQQ Lt/ELL { T.a YL02 CO,�� 42 Assessor's map and lot number ................/..........:..:..:. S'EMC SYSTEM MUST BE `t INSTALLED IN COMPLIANCE WITH ARTICLE II STATE Sewage Permit number ............. g X....................:............... SANITARY CODE AND TOWN R��V4Tl9t�s� - F7NEtp�` TOWN. . 0f BARNST.ABLE fps �•w ' Z BAWSTADLE, MA8 163 . q 0 M a'. BUILDING INSPECTOR 'E• PY Bulld .' ��f / / �1 APPLICATION FOR PERMIT TO .:........................ .............1J...�.................................G7........................... T' TYPEi OF CONSTRUCTION ..................Fr.ske........................................................................................................ March 12 ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersignedhereby applies for a permit according to the following information: Location Route 6A, West Barnstable .............:. ..................................................................................................................................................................... Proposed Use ..., Single family dwelling Residential West Barnstable ZoningDistrict .......................................... . .... .....................Fire District .............................................................................. •Name of Owner l Richard Burch Address .•Route 6A, West Barnstable ............................ ..................................................................... Name of Builder Chest-nutHomes Inc. ..Address Piccadilly Sq. , Rt. 6A� Yarmouth Port Name of Architect .....Rankin Associates •••Address Pembroke, Massachusetts Ran.k.i.n...As.soc.i.at.e.s................ ......................................... .................. Number of Rooms .....Flve..................................................Foundation .......32.....X...38.................................................. Exterior . -;Board and batting ...Roofin Red cedar shingles .. ......................... g ............ .. Floors Carpeting............................................Interior Card?eting......................... ..................... i Heating .Electric Plumbing ..........9PPP!e?........ 01............................. ................................................................... Fireplace None..........................................................Approximate Cost ..$1.I 00.Q..........................................:..... Definitive Plan Approved by Planning Board -----------___-__------------19________. Area 1. f 0........... Diagram of Lot and Building with Dimensions Fee ...... SUBJECT TO APPROVAL OF BOARD OF HEALTH i I - i i - I I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. -O fs v p G Y ' Name . 8,rok -Richard 16 add o s' e No ........� 9... Permit for ........... 1utiC 1 - 1 1 2 sto add' faldly..dualling......... ?'Y n• .. ........ O //'' / pY1 4Test B Owner .........R�Gkla7C ..BLIx'C ........................... Type of Construction frame............:.:. ............... . ..... ..................................... ........... ; f Plot ............................ Lot .................... � Permit Granted March 18 74 ........ .....................19 Date of Inspection G ..[J . L/...... ... . ..®l Date Completed . .......19 I y, PERMIT REFUSED ..................:.................................... .... 19 y .... .............................................................. S 3 ...................................................................... ........................................... .................. ........ i Approved .......................:......................:. 19 �. Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 `o 7::1 2/15/16 ' ' 00 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permit#201508962 TO: Building Inspector(s), This affidavit is to certify that all work completed for 240 Main Street,West Barnstable has been inspected by a third party Certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, i { William McCluskey 1 i �L I I I DEC 2 8 2015 w TOWN OF BARNSTABLE BUILD,IN( 'PEE IT AF#t,T4ff�A Ii N Map r 3 L1 Parcel 608 Application # 20 :� Health Division Date Issued. Conservation Division Application Fee C Planning Dept. Permit'Fee —7 ©� l Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis 1' Project Street Address oAo -1 'Olt it y e,� Village_ W Q-s+- e, Owner 5-E-�e�l e y Address Telephone SOV 36 3 0 5 0 Permit Request OIJ �' 3 C e l lw d o 5, Ao t�+c �' �/� , P� a A R ' 19 �rlgrJ 4r, �ajtm,044— lot; Z se., I 44, A 411ry o n,. 0.aJ I ' rico4fiJ, 6a�r► . Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District I Flood Plain Groundwater Overlay Project Valuation d0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family 0 Multi-Family(# units) Age of Existing Stricture Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: i Full ❑ Crawl ❑Walkout ❑ Other Basement Finished)Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: (Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: 1 existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of A,peals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes No If yes, site plan review# Current Use I Proposed Use APPLICANT INFORMATION 1 _(BUILDER OR HOMEOWNER) ` Name. �II�Rn+ a I'G�` k6 e- Telephone Number 5'&R 399 0396 Address �'fl I v.n����c�n A irel License # --C L 0 c�- s• �"r"�'� �} �a 6 d Y Home Improvement Contractor# l 33 Email I Worker's Compensation # W w C ?13 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO ��rn►a u,� �. SIGNATURE I DATE L 3 A FOR OFFICIAL USE ONLY APPLICATION # o DATE ISSUED ; MAP/PARCEL NO. , R • { i ADDRESS VILLAGE OWNER" DATE OF INSPECTION: FOUNDATION FRAME INSULATION ' FIREPLACE ELECTRICAL: ROUGH FINAL s PLUMBING: ROUGH FINAL r GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ?� ASSOCIATION PLAN. NO. • CIX The Commonwealth of Massachusetts Department of IndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual):Cape Save Inc Address:7-D Huntington Avenue City/State/Zip:South Yarmouth, MA 02664 Phone#:508-398-0398 Are you an employer?Check the appropriate box: Type of project(required): 1.❑✓ I am a employer with 20 employees(full and/or part-time).* 7. ❑New construction 2. I am a sole proprietor or partnership and have no employees working for me in ❑ 8. E]Remodeling any capacity.[No workers'comp.insurance required.] 3.�1 am a homeowner doing all work myself[No workers'co insurance ]t 9. ❑Demolition comp. required. 10 Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that at]contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs Or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These subcontractors have employees and have workers'comp.insurance.: 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[E]Other Insulation 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and 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'compensadon insurance for my employees. Below is the policy and job site information. Insurance Company Name:Wesco Insurance Company Policy#or Self-ins.Lic.#:WWC3136274 Expiration Date:04/09/2016 Job Site Address: 240 Main Street City/State/Zip: West Barnstable Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.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 th pains and penalties ofperjury that the information provided above is true and correct Signature: Date: 12/23/15 Phone#:508-398-0398 Official use only. Do not write in this area,to be completed by city or town official, City or Torun; Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: A�a CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODIYYYY) 10/14/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such andorsement s. PRODUCER CONTACT NAME: Colleen Crowley Risk Strategies Company PHc No E : (781)986-4400 AC No: (781)963-4420 15 Pacella Park Drive IWEss:ccrowley@risk-strategies.com Suite 240 INSURER(S)AFFORDING COVERAGE NAICi Randolph MA 02368 INSURERA:Selective Ins. of America INSURED INSURER Allmerica Financial Alliance Ins Cc 10212 Cape Save, Inc INsuRERc:Wesco Insurance Company 7 D Huntington Ave INSURER D: INSURER E: South Yarmouth MA 02664 INSURERF: COVERAGES CERTIFICATE NUMBER:CL15101402127 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTTRR TYPE OF INSURANCE POLICY NUMBER 7MPMOILD' POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 RFNTF A CLAIMS-MADE X�OCCUR PREMISES GETOE.occurrence $ 100,000 81994480 20/16/2016 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN1.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY� ECT a LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ MBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident $ 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ AUT OWNED X SCHEDULED AiMA46796600 11/6/2015 11/6/2016 BODILY INJURY(Per accident) $ X HIRED AUTOS X AUTOS NON-OWNED PR PERTYDAMAGE $ AUTOS Per ecddent X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 A7 EXCESS LIAO CLAIMS-MADE AGGREGATE $ 1,000,000 DED I I RETENTION Bil B1994480 10/16/2015 10/16/2016 $ WORKERS COMPENSATION Officers Included for X STATUTE ERH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/E)(ECUTIVE YIN Coverage E.L.EACH ACCIDENT $ 500,000 C OFFICER/MEMBER EXCLUDED? N❑NIA (Mandatory In NH) WWC3136274 4/9/2015 4/51/2016 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yyees,describe under OESCR{PTnN OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500 GOO DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addltionat Remarks Schedule,may be attached If more apace Is requlrod) National Grid Corporate Services LLC d/b/a National Grid, Action Inc, Colonial Gas Company and NStar Electric are all included as Additional Insureds with respects to the General Liability coverage of Named Insured as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Housing Assistance Corporation THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 460 West Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE Michael Christian/CLC O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(201401) HOME OWNER WEATHERIZATION WORK PERMIT: PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER. I hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation on the property located at: ILA 54- The weatherization work done will be based on programmatic priorities and availability of funding and it may include all.or some of the following measures: Weather stripping; air sealing; attic &basement insulation; exterior wall insulation; ventilation measures In consideration of the weatherization work to be done'at my home I agree to the following: 1. 1 give permission to Housing Assistance Corporation the property with such equipment land materials as may be necessary to perform weatherization. 2. The Housing Assistance Corporation reserves the right to'inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5)years after the weatherization work is completed. I have lead' the provisions of this agreement and give my consent. Home Owner(signature) Home Owner email: Date: Agent:(Signature) Date:' Weatherization Co ractors: Adam T Inc Cape Save All Cape Energy Frontier Energy Solutions Alternative Weatherization Lohr Home Improvement Building Science Construction Resolution Energy Cape Cod Insulation Tupper Construction i �. r�te ��O Yl2-gin��?tuea�C� o�Ci��x.J1C�'�C�12Gli1P�J Office of Consumer Affairs and Business Regulation .; 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration - = Registration: 171380 Type: Corporation Expiration: 3/14/2016 Tr# 249649 CAPE SAVE INC. _ WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 --- - - t Update Address and return card.Mark reason for change. sCA 1 c 20kt-05n1 Address Renewal ❑ Employment Lost Card • Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: •171380 Type: Office of Consumer Affairs and Business Regulation Expiration:;,3H-,4I2016, Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE SAVE INC. j WILLIAM McCLUSKEYt 7-D HUNTINGTON AVENUE SOUTH YARMOUTH,MA 02664 Undersecretary Not vali Uhout signature Massachusetts -Department of Public Safety ` Board of Building Regulations and Standards VOihtrucdani Suner-visor'ariecialty License: CSSL402776 W11LLIAM J MC CtU 37 NAUSET ROAD West Yarmouth NlA Expiration Commissioner 06/28/2017 i Town of Barnstable Regulatory Services TOVRI Or .,: tiSTABLE t Thomas F.Geiler,Director lr MASS' Building Division 2 39 639. ► Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT# ( Iv > FEE: $ SHED REGISTRATION 200 square feet or less I D �Gt�1� �✓ " '�—1 v VAS � �CC/,v(S �l��2 Location of shed(address)) Village � 3GZ- -3(_)_� o Property owner's name Telephone number f° x1y � LI cY� Size of Shed Map/Parcel# � A8� l( Signature Date H ain Street Waterfront Historic District? 2 Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:304:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE I COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A i PLOT PLAN i Q-forms-shedreg: ! . REV:05201 I -�j�'v ✓ Town of Barnstable Old King's Highway Historic Distract Committee NAM 200.Main Street, Hyannis, Massachusetts 02601 ` (508) 862-4787 Fax (508) 862-4784 CERTIFICATE OF EXEMPTION Application is hereby made,with four(4)complete sets,for the issuance of a Certificate of Exemption under Section 6,and 7 of Chapter 470,Acts and Resolves of Massachusetts, 1973,as amended,for proposed work as described below and on plans,drawings,or photographs accompanying this application: �©1 I Date c Address of Proposed work, Assessor's Map and lot# House# 940 Street Village: This application is for an exemption of the proposed construction on the grounds that work: Will not be visible from any way or public place Q� Is within a category declared exempt by the Old Kings Highway Regional Historic District Commission ❑ Other II__ I Description of Proposed Work: 1.�� Z SV` Sr �rJ LA,A A,f SEP 2 8 2011 Town of Barnstable Old King's Highway Committee Agent or contractor(please print): Tel.no. Address Owner(please print): z l Tel no. g -�- Z _^ e) Owners mailing address: �. P71D K Signed,Owner/Contractor/Agent v For Committee Use Only This Certific is hereb Ap ove Date: ' _ Committee Members Signa I • Any conditions of approval: C:(Documents and SetlingsldecolhkVLocal SettingslTemporary Internet Files10LK110KHExemption Form 07.doc r .Ais j _ A AL A AL AL }- N 0 z MARSH AL _. AL 0 PARCEL AL AL f AL O e,f APPROVED c �• SEP 28 2011 ss t Town of Barnstable Y' Old King's Highway R PA R CEL Committee 5 10 V•�F'"d fi i.{.. s �= GRAPHIC 8C 80_ 0 40 8� H. has^ _ L' •=vx eY.: °':aM1.r#i t ~''�T' ..•-mow:. SEP 2 8 2011 1 inch .�: i • �,r. • �: ti � -,/t � fry � r�.-' :� y - ''_ ~�• y, t i t• W a , �T • � y. �E.. N '7.` � � h .air. �'I - W 14, Irar" a ! " I i 4( L t , i