HomeMy WebLinkAbout2416 MEETINGHOUSE WAY/RTE 149 1
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UPC 12534
No.22
HASTINGS. MN
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SIGNEO UI ivefSal" 48003
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Assessor's map and lot number .. - C�.... ��
..... OFINETO
SEPTIC SYSTEM MUS
Sewage Permit number .......4-ne-!....:............................... INSTALLED IN COMPLI �
WITH TIT,. BAkXSTODLE, i
House number ENVIRO y0 N a
P,1ft,,�! �; O•FpYP9-
TOWN OF � BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ��.1�./.. . ..........f .. X...���........ ....e. ...........................:..........
TYPE OF CONSTRUCTION ........ .......
..... . a f.....a..7...........,92.F.0.
'TO THE INSPECTOR OF BUILDINGS:
The undersigned ,hereby applies for a permit according to the following information:
Location ....!!.!.�r��' 1.�I�. .�?.4! .�'-.......was? W�'- ..... .✓?.. 4-:.eGl/.�..............
GJ.�. ...............
ProposedUse .......�.TP...C..,P.q..e...........................................//..............................................................................................
Zoning District .'...�4�.5...........!.! �. Fire istrict �' .T a1. r �?...c5.�...a-.lR..t!�,.....
.... ..........................:........ ..... .... ........... .........
I OX 3 m
Name of Owner ki
.. :I........................` 5.S ......................Address
Name of Builder ..............................Address Y...� 5 .1'J..T.....I.�xl>".5..,... �'II.. e.C..V.I..//C-
Nameof Architect ..................................................................Address ....................................................................................
Number of Rooms ....1............................................................Foundation ..70..h..A.:5.......................................................
Exierior ...... .......................................................:....Roofing ....... .......................................................
Floors .....�Pa..p.rj...........................................................:",•.....Interior ....................................................................................
Heating /L7a. vi.�'................................................................Plumbing N017�
...... ................................................................................
Fireplace ........................................Approximate Cost ....
Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area ......../..7c"./...s ..: .
Diagram of Lot and Building with Dimensions Fee .......... ..................... .d,
SUBJECT TO APPROVAL OF BOARD OF HEALTH
00*01
1 ;2,
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name .. .....� ............
NILSSON, EVALD H.
22226..-� Build
No ................. Fermit for ...................�:X:alrie....
Storage Shed
....................................
Location ..24.lA.'Me t ngho xse Way ,
West Barnstable
...............................................................................
Owner EVald H. Nilsson
..................................................................
Type of Construction Frame
................................................................................
Plot ............................ Lot ................................
Permit Granted ................May...2.9.........19 80
Date of Insp c� tion"....................Z9.19 00
............
Date Completed .... ... .1 '�
19 ,
M i PERMIT REFUSED
tNR1.N�. ... .& ....................................... 19
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..cam. . .......................................................
:. . ..............................................................
...............................................................
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Approved ................................................ 19
• ...............................................................................
e
...............................................................................
Assessor's map and lot number(( ... , ...... � fTNero�o ..
Sewage Permit number ....... 1.t?.-*4:...................................... ro
Z DAUSTADLE, i
House number ruse
pow 1639. 00
t 'Fp YPY a`
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION-FOR PERMIT TO . ......... .......... ..x.................�`� <. .......................................
TYPEOF CONSTRUCTION ........ ..........................................................:.....................................
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a�permit
according to the following information:
/ J ..r,
........ ...Location ram ..... S
ProposedUse ....... �.r:.. ...........................................................................................................................................
-.7
.... .•.,. .............................................................Fire District ...u,�.�"5...........�:...0 .r..'?.......�...... �.............
Zoning District �� - 7 ,5 rt /
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Name of Owner d� ��J I( ,1 S 5 �,?'?.................Address o /5!...��jl'.r`'.!�;.!2 �?,G. ,`,r -a
.. . ..............
.... ..... .
Name of Builder ..............................Address .r?
Nameof Architect ..................................................................Address ....................................................................................
Numberof Rooms .... .........:..................................................Foundation .71.... .............................:.............:...:.......
Exierior
Floors .5�................................................................Interior ....................................................................................I
Heating .... _ .....................................:.Plumbing ..Nan.j�-............................. :...:....:...:..::..:............
Fireplace .................................................................Approximate Cost .... ...........................................................I.....................Q................L............I
Definitive Plan Approved by Planning Board -----------_------_-----------19 . Area // s?
Diagram of Lot and Building with Dimensions Fee �� -Q
.......... .y .�..................... '.....
SUBJECT TO APPROVAL OF BOARD OF HEALTH
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction. e q
Name .:: .............. �:' .. �° �t/......
�-
No .-2��2��6. �v .�loi /A=155-
Shad���.~ .2l�
Location .24���-D�eetioob����_����.......
_____���ot..D��]� ��-------.�
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Ovvne, ']I��ld^.B.�_0.ils.s�n________
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Type of Construction ...Tlr!�kMg.......................... �
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) Map 4T Parcel 3 Permit#
Conservation Office(4th floor)(8:30- 9:30/1:00-r2:00) Z. *tip. Date Issued
Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) - /1l . Fee' _Y Lf�";� 5-,
Engineering Dept. (3rd,floor) House# L(�n F'1_I
IKE
4 BARNSTABLE. '
e y anm ,.A` 19M6
Fo Na+'
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TOWN OYBA�RNSTABLE
q Building'Permit ApplicationProject SR.lvWy {
Village kz f // ,9rw5 Gee
.Owner �/q I Cli. /�°6e�� 1 S-S041 Address ��e_
,Telephone
Permit Request 0044is In a-c n/7 ArA e
;First Floor square feet
r "
Second Floor square feet
c
.. *timated Project Cost $ /,3
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 l j t T'5V Basement Type: Finished
Historic House Unfinished
Old King's Highway
k mber of Baths No.of Bedrooms
tal Room Count(not including baths) First Floor
at Type and Fuel Central Air Fireplaces
rage: Detached Other Detached Structures: Pool
Attached Barn
None Sheds
Other
Builder Information
Name &c,1qe V /9hI e-l) Telephone Number� 37e) 63
Address /0S� 1�dyS e d.4u e )-a. License# D5/S 3 3 8 �
Ce'7 a,Gu &, ��; d�G 3�' Home Improvement Contractor# //d 77
Worker's Compensation# 2:r_ 7bw36 a JD/
r
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 Tz/ 1f/�lay�
SIGNATURE DATE
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
FOR OFFICIAL USE ONLYf
P MIT NO. -
{I
DATE ISSUED
SP/PARCEL NO. i
ADDRESS VILLAGE
OWNER
s ,
DATE OF INSPECTION:
AA - a6
FOUNDATION
FRAME C! L� • "6G `���
4
f i i
INSULATION _
FIREPLACE
ELECTRICAL`: ROUGH -FINAL r
PLUMBING: ROUGH FINAL -
GAS: ROUGH FINAL -
- E
FINAL BUILDING
DATE CLOSED OUT -
ASSOCIATION PLAN NO.
i '
F The Coin nonivealth of Massachusetts
Departni nt of Industrial Accidents
600 11'asbinglon Street
� Boston.A1as-s. 02111
Workers' Compensation insurance ARdavit
dRolic��T .—�..-- ... Please PRIIV'i'`Te tbly - �'.•.' . . . .
/ �.ni tnformaii�n � �.rsire�
419,
S6� `3?o6
�.� ��...,- •./�o �/I�l s,. nhonc C
❑ I am a homeowner perforn> ing all work myself
it am a sole proprietor and have no one workin_ in any capacity
❑ I am an emplover providing workers' compensation for my employees working on this job.
address:
citt. nhonc#- -
noun•!t '
❑ I am a sole proprietor, neral contractor r homeowner(circle one)and have hired the contractors listed below who
the following workers' compensation po ' es:
comrany n Ci/ •�/ ! h 2/
7� 3 68
U 24 fl,- nAry 0
✓ m ant na e•
sits nhonc Ih
noller#
:Atiaeh additlonai'sheei ff neeeuarY
Failure io secnrc covet age as required under Section 3A of D1GL 1S2 no tad to the imposition of criminal penalties of s fine np to S1300.00 aoc
une 1 cars'imprisonment as�vcll as civil penalties in the form of a STOP WORK ORDER and a line ofM00.00 a day agaian me. I understand tb:
MY of this statement may be forwarded to the Once of investigations of the D1A for eorerage nTiffation.
!do lterebt•c ifj•ura/cr r/ic pains as purallics of eryurr that the injornmtion pnn7dtd above is true and cvrrnt
isnature'��l/
Q� tau a'4 ,d
fP •nt name 6e o one# 7 S
oMciai•use onir do not write in this area to be completed by city or town official
cite•or to permit/lleease# riguilding Department
Ot.icensing hoard
check if immediate response is required C3Sdectmen's O
Otinith Department
nt
contact person:
phone N• nOther�_
Information and Instructions '
a,
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for
employees. As quoted from the "law", an entplt uvee is defined as every person in the service of another under aruv
contract of hire, express or implied. oral or%vritten.
An etnplure►r is defined as an individual. partnership. association. corporation or other legal entity, or any two or n
the foregoina, engaged in a joint enterprise, and including the legal representatives of a deceased employer. or the
recciver or trustee of an individual , partnership, association or other legal entity, employing employees. However
owner of a dweilinL house havim, not more than three apartments and who resides therein. or the occupant of tite
dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling
or on the ,rounds or building appurtenant thereto shall not because of such employment be deemed to be an empic
MGL chatter i52 section 25 also states that even• 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 chaps:
been presented to the contracting authority.
Applicants
Please "I in the workers' compensation affidavit completely, by checking the boa that applies to your situation an
supplying-company names. address and phone numbers as all affidavits may be submitted to the Department of
Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The
affidavit should be returned to the city or town that the application for the permit or license is being requested.
not the Department of Industrial Accidents. Should you have any questions regarding the "law"or if you are requi
to obtain a workers' compensation policy, please call the Department at the number listed below.
r .•w+..+•►.. ..•.�►..r..-��• ..,w:� �. ':'..�:.:.:tK.�•�—`".'.': �in+l�.• 'r...: a7ri'Ss'i"•'.
Ctn• or,ro«-ns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottorr
the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. F
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returns
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 quest
please do not hesitate to ;,give us a call.
'The Department's address. telephone and fax number.
The Commonwealth Of Massachusetts f
Department of Industrial Accidents r•
Office of Investigations
600 «'ashington Street
Boston,Ma. 02111
fax #: (617) 727-7749
nhnne #- (617) 727--1900 est. 406, 409 or 375
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MPROVEMENT, -ONTRACTOR ;:
,Y 1;
�sr R gi t'rationi112971.�j`
. fxpiratiod � +•
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�c�•,do����%?�'105.:HORSESHOE LN�.�� -�',��,:.. .
� ,;§anMuus�`T° �� CENTERVILLE MA 02632 ��� -r
•' _ _._._.___-✓fie L€arrvnza�zurea a�✓�aQaac�ivaea
DBPARTHRIT Of PUBLIC SAFETY
CONSTRUCTION SUPERVISOR LICENSE
Nuabers Expires:
Restricted Toi 1G
. .MICHAEL J DANGBLO r'
_ vwr 105 HORSESHOE LAMB Z
CENTENYILLE, HA 02632
f .The Town of Barnstable
• ' Services
,� s Department of Health Safety and Eavzronmental
Budding Division
367 Main Street,HYaaais MA 0=1
gahph Crosses
Off= sos79o-6227 Budding COMM
F= 508-775 3344
For office use onhY
Permit no.
Date AFFIDAVIT
HOME MOROVEMEHT CONTRACrORLAW
SUPPLEMENT TO PERMIT APPLICATION
ction,alterations;rencyz an,���ou,conversion,
MGL c I42A requires that the"tecanstrug owner ed
improvement,.rcmO%%l. demoIitian, or oonstzuaron of an addition tom which' ���
building containing at least one but not more than four dwelLag�units
certain C=cs fang with other
to such residence or building be done by registered tractors.
/
� Cast
✓-Type of Work:�� /" � NY/� e- -
/Address of Work: ee -P
�Oa,•ner.Nam� a-
/Date of Permit Application:-
-I hereby certify that:
Regisuation is not required for the following rrason(S):
Work cxduded by law
Job under SLOW
Building not oama-O=aPicd
putting own permit
Notice is hereby gh=tlx: CONTRACTORS
OWNERS PULLING'THEIR OWN PERMIT OR DEALING DO NOEHA ACCESS TO THE
FOR APPLICABLE HOME RAPROVEMEN
ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c I42A
SIGNED UNDER PENALTIES OF PERSURY
I hcrcby apply for a permit as the agent of the owner.
Date ntra�rase
Registration No.
OR
i r Application to r,
`� 9 9 6 0 6.7
. � , SPPpt +p NS°`'�`� Old Kings Highway Regional Historic District Committee
in the Town of Barnstable fora
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: jS New 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 &!911- /a. /796
1(0 IV BARN.
ADDRESS OF PROPOSED WORK 2 V#W A le,627NC ASSESSORS MAP NO. ISE
OWNER Ev 4,Zug as T//A_ NljL ss'om ASSESSORS'LOT NO. 0.30
HOME ADDRESS AV1Y1Y,6kr/A/6MVgC1r A)4,6. W, /74i sr-ABAETEL. NO.
FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public
street or way. (Attach additional.sheet-if necessary).
Sze 67TAG�IFD
I
AGENT OR CONTRACTOR �RM�S y �oN�Rry TEL. NO. �S� 36a-3e27
ADDRESS I Hoxi.yi or—k Doe. W , 819ANSTi9,84.5'
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).
CON S i R U GT/o Av CIF AX�'AJ 619446 F�c.g Ti aN /�Tj�Cl7�1b
Ar-"'
0Dl�7DD -
Signed -
Owner- ontractor-Agent
Space below line for Committee use.
Date I The Certificate is hereby Da
6 �
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;Ti APR '
ZB;y,�a�,OF gAR�+.7
Ti1a,=LE f
Ir
Approved IMPORTANT: J.f.,Certif.icate is.approved,_app.r_oval is Subject t. the-10_day appeal period
provided in the Act.
Disapproved ❑
ADDITIONAL INFORMATION FOR MAKING AND FILING 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 fromaYa`:
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 `, t......
erected or displayed.
d. A single sign of not more than 1 square foot in area showing the name, occupation or 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.
A
Copies of the Act establishing the Regional Historic District may be obtained at the Town Hall.
i
Town of Barnstable
Old King's Highway Historic District Committee
�re-Y
SPEC SHEET
FOUNDATION PO L) Z) N CR,1! 7"
s
SIDING TYPE V j;V1j-y, C/j1o,8o ,<b COLOR
CHIMNEY TYPE_ COLOR.
ROOF MATERIAL F)ax 2&./; ,$L/psP9t1A ' COLOR�Mp//�
PITCH t� /g 14/1/L� /k
WINDOW Dou oA,6— lloA)6 SIZEX
TRIM COLOR �j/2�q V
DOORS ��� � G� r COLOR R.4 4,C
SHUTTERS V O i )F
GUTTERS
DECK
GARAGE DOORSZ0 x 7 D,N. / X 6 Ls,Fp�/O"J�i¢ COLOR_�j� �
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 plot plan,
landscape plan and elevation plans, when
D applicable. Plot plan' need not be "Certified
but should show all structures on the lot to
D ��+ scale.
SPECSHT