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2455 MEETINGHOUSE WAY/RTE 149
V 1 1 oxftw NO. 1521/3 ORA MADE IN u.SA 0 ESSELTE :a�.a,..: -sue r� ... �._�. •+. :^ •. - _ r � - _ - _ - - �.—.r.++-.1 0-...� art r S pe g} 54, 11 t o i I Ln For delivery information visit our website at www.usps.como m Postage $ r� Certified Fee M ReturnReceipt Fee V VJ`Postmark O (Endorsement Required) Cj ON I Here Restricted Delivery Fee OIS Q (Endorsement Required) O Iti Total Postage&Fees $ \p r—1 Sent To a �S- �n 4 M b°hee(,Apt No.; Ve r- or PO Box No. y0 i4 (/QQ y S;! ZIP+4 -------- L .esi f City,State, PS Form Q- :i0 August 2006 See Reverse for Instructions 'Certified Mail ProwWas: • 0.A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Maile or Priority Mail(& ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Retum Receipt Requested'.To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery° ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT: Save this receipt and present it when making an inquiry PS Form 3800,August 2006(Reverse)PSN 7530-02-000.9047 iU.S. Postal 0 RECEIPT CERT ,,)FIEQ MAIL Domestic Mail Only -° m m or delivery /+ m 0FFICIAL USE Ir Q' Certified Mail Fee $ .,slv�202122�� Extra Services&Fees(check box,add ree as apprdpnate) rq ❑Return Receipt(hard top» $ �� O ❑Return Receipt(electronic) $ -� � a O []Certifled Mall Restricted Delivery $/�^�. j.,'Postmark Here 't1�Q []Adult Signature Required $ m ❑Adult Signature Restricted Delivery O Postage , ��. V m '� b r i Total Postage and Fees t7 �A � Se ,. �c1 �wv O c " �---�----------- Sliest andApt.No.,or PlU bFo IUo. g, 1yry'S�tafe ZIP+-a-- G.......................... iY� Oo2 6 rv0 Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic retum receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this L delivery. USPS&posbnarked Certified Mail receipt to the- ■A record of delivery pncluding the recipient's retail associate. rn i signature)that is retained by the Postal Service' Restricted delivery service,which provides m for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent m Important Reminders: Adult signature service,which requires the 4■You may purchase Certified Mail service with signee to be at least 21 years of age(not '1? First-Class Mail,First-Class Package Service°, available at retail). -C or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavallable for requires the signee io be at least 21 years of age, International mail. f essee specified I ■Insurance coverage Is not available for purchase by name,o to the addrovides ressee's o the authorized agent 3 with Certified Mail service.However,the purchase (not available at retail). M of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is Insurance coverage automatically included with accepted as legal proof of mailing,it should bear certain Priority Mail items. `, l USPS postmark If you would like a postmadc on frl 1 •For an additional fee,and with a proper this Certified Mail receipt,please present your 1 i endorsement on the mailpiece,yo`may request Certified Mail item at a Post Office-for F� the following services: postmarking.it you don't need a postmark on this -Return receipt service,which provides a record Certified Mall receipt,detach the barcoded portion u of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply h You can request a hardce _py return receipt or an appropriate postage,and deposit the mailpiece.q electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return.D., .:, p r• `.'s-��. `;�Z'.•u'% Receipt attach PS Form 3811 to your mailpiece; IMPORTANt:Save this receipt for your records. Ps Form 3600,April 2ou fa a e)PSN 7530-02-000.9047 \ •i n S+ `• • • • . • . ■ 7W92:7 Complete items 1,2,and 3. A ■ Print your name and address on the reverse X 0 Agent . so that we can return the card to you. ❑Addressee ■ Attach this card to the back of the mailpiece, B. eivecyby(Printed Nam) C. Date of Delivery or on the front if space permits. `/ 1. Article Addressed to: D. Is delivery a r ss different from item 1? ❑Yes / If YES,enter delivery address below: ❑No o�S/S r,6 I1')e e- n f ltdds e U, l LJ yBainS/-C'6le•/ �aloloW II I'lllll IIII ICI I III I III I II I I I II II III I I II I I III 3. Service Type El Priority Mail Express® ❑Adult Signature El Registered MaiITM ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted 434ertified Mail® elivery 9590 9402 3630 7305 4656 06 ❑Certified Mail Restricted Delivery etum Receipt for ❑Collect on Delivery erchandise 2. Article Number(Transfer from Service lab eQ ❑Collect on Delivery Restricted Delivery ❑Signature Confirmation'" ,i-Isured Mail i ; { ❑Signature Confirmation „ .FU iu ..17 3 0 '.0 0 01 4 9 9 3 t.. 3 3 4 6 1", J 1sured Mail Restricted Delivery` Restricted Delivery 1 tIver$500) PS Form 38111 July 2015 PSN MO-02-000-9053;I,', -,Domestic Return Receipt First=Cl2ss Mail I Postage u&Fees Paid USPS I t-n". Pe mi No.G-10 ; I 9590 9402 3630 7305 4656 06 I United States •-Sender:Please print your name,address,and ZIP+4®in this box* Postal Service t' WN OF BARNSTABLE BUILDING DIVISION 200 MAIN ST. HYANNIS, MA 02601 � M I Postal Service'" CERTIFIED O . ■ Inj Domestic Mail Only co For delivery information,visit our website at www.usps.comiO. � tLl u) Certified Mail Fee (` $ `ciS "n Extra Services&Fees(check box,add fee as eppro det� ❑Return Receipt(herdwp» �. , • (a.' ate, O $ c O ❑Return Receipt(electronic) $ nt iH l C('?ctSn Postmark ❑Certmed Mail Restrict ed Delivery $ ht Coe r3 ❑Adult Signature Required $ Wig I ❑Adult Signature Restricted Delivery$ (a O Postage O $ a I� Total Postage and Fees I I- S tTo o �_e_� .�_.L�� �n--------------------------- reef an Apt.Xi or tad Box o. Ciry State ZI + -- - - - ----- ------------------------PS Form 3800,April - Q' 2015rr rr,• Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this- delivery. USPSO-postmarked Certified Mail receipt to the ■A record of delivery(including the recipient's - retail associate. signature)that is retained by the Postal Service- Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent Important Reminders. Adult signature service,which requires the , ■You may purchase Certified Mail service with signee to be at least 21 years of age(not 1 First-Class Mail®,First-Class Package Service°, available at retail). or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is not available for requires the signee to be at least 21 years of age International mall. and provides delivery to the addressee specified •Insurance coverage is not avallIpble for purchase by name,or to the addressee's authorized agent with Certified M ver,the purchase (not available at retail). of Certified Mail service does not change the o To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on ■For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail Rem at a Post Office'for the following services: postmarking.If you don't need a postmark on this Return receipt service,which provides a record Certified Mall receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label;affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return.,., , , r. ,1 ,�\ Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records. PS Form 3800,April 2015(Reverse)PSN 7530-02-000-9047 COMPLETE • • DELIVERY rK omplete items 1;�;:;�nd 3. A. Signat rint.your nee�d address on the reverse X Agent that we c.'return the card to you. O Addressee tach this card to the back of the mailpiece, B• eceived by Printed Na e) C. Date of Delivery on the front if space permits. 1. Article Addressed to: - ' D. Is delivery address different from item 1? 0 Yes ' G&n i e -7 4-C es 11 e �etJ 1`01 If YES,enter delivery address below: p No 62r-n svLk le- , M19�a�6� II I IIIIII IIII III I III I III I II I I I II II III II I III III 3. Service Type ❑Priority Mail ail r s® M❑Adult Signature ❑Registered aiIT"' ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted 9590 9402 3630 7305 4656 13 o cceewneedd Mail Restricted Delivery ,b�etu Receipt for ❑collect on.Delivery ``MMerchandise _2._Article Number(T/anSfel from Sen/iCe label) :_ ❑Collect on Delivery Restricted Delivery ❑Signature ConfinnatlonTM L °`i+''ed Mail Matl Restrictei Fehvery I l7 Signature 11 Restricted Delivery confirmation 701-7' 1,10GO U070b '67'S7-'21912 (� .i$5oo> �:x .r tat �s PS Form 3811,July 2015 PSN 7530-02-000-90531 j _ �'' `xfsiD 5�jc'�}�e atrl ieceipt First=Class Mail Postage&Fees Paid USPS Permit No.G-10 9590 9402 3630 7305 4656 13 United States •Sender:Please print your name,address,and ZIP+4®in this box* Postal Service TOWN OF BARN LB BUILDING DIVISION 200 MAIN ST. HYANNIS,MA 02601 �r�.r:rr,�Ir1 ,r,�Iilr�E,ril,,;i,►i,>>;,a1yil�l,jl,:+JjjlLi!„rllli �a Town of Barnstable _ ,�� .... w . . Building r gTA Post This Card So That it is Visible:From the Street'-Approved Plans Must be Retained on Job and this`Card Must be Kept M Posted Until Final Inspection Has-Been Made: .; G Permit . w. .. c llj Where a Certificate of Occupancy,is Required,such'Building shall Not be Occupied until a'FinaI Inspection has been made. ' Permit No. B-19-2202 Applicant Name: JOHN J. LEITNER Approvals Date issued: 07/12/2019 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 01/12/2020 Foundation: Commercial Map/Lot: 155-017 Zoning District: WBVBD Sheathing: Location: 2455 MEETINGHOUSE WAY/RTE 149,WEST Contractor Name-.-,.,10HN J. LEITNER Framing: 1 Owner on Record: BARNSTABLE,TOWN OF(LOMB) Contractor License: CS-058106 2 Address: PO BOX 159 -- "-� Est. Project Cost: $500.00 Chimney: WEST BARNSTABLE, MA 02668 } Permit Feb: $ 160.00 Description: Construct 8'x8'ceiling with 2x4's 16" O.C.,inside of 2000 room Insulation: ; Fee Paid: $ 160.00 Project Review Req: Date: - 7/12/2019 Final: Plumbing/Gas Rough Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Final Gas: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: f 1.Foundation or Footing Service: 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installedm - 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: O Application Number.......... a......... ..... ..... ...... ...... ............ 'Ism MASEL Permit Fee...... 1....Q'..................Other Fee:....................... s639. Total Fee Paid................................ .. BUIDIN.0 DEFF. TOWN OF BARNSTABLE Permit Approval by... 122019 UP................on...... ........... MN OF BARNSTP BLE BUILDING PERNUT Map.............. ,cel..........iO ......................... ........................P APPLICATION Section 1 — Owner's information and Project Location Project Address-.2 115:5- M&YIY 6kJ AY Village YeAJ-S 7A_ -3 LE Owners Name /--),q lu , �L_ At) D I�s L ( L= vr,I xf Owners Legal Address_2_4,5_!T-3 City W 2, Ak#.)57;4 R_ cc— State WA -zip 'C>-Z(,Q6r9 Owners Cell # 54)8 3 b E-mail J P-0 cc WN Section 2 — Use of Structure Use Group— F-1 Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling F_ Section 3 — Type of Permit ❑ New Construction E] Move/Relocate E] Accessory Structure E] Change of use ❑ Demo/(entire structure) El Finish Basement El Family/Amnesty El Fire Alarm Rebuild D Deck . Apartment El Sprinkler System Fj Addition ❑ Retaining wall Fj Solar Renovation ❑ Pool El Insulation Other—Specify Section 4 - Work Description 621VS-faile-f 'y Y a x- Last undated: 11/15/2018 Application Number........ .. ........................................ Section 5—Detail - i C6st of Proposed Construction yV Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind'Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design i Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors `i ❑ Plumbing ❑ Gas ❑ Fire Suppression i ❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom Water Supply El Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site i Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: 1 /t 0701 /.9,, S 5��, -L 414 El am using a crane ❑ Yes No � Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland,coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage # of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed j Side Yard Required Proposed 1 Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No i Last updated: 11/15/2018 Application Number........................................... Section 9- Construction Supervisor Name Ul'1 y Lk4oj C2 Telephone Numbero2- Address S tZ./6 AAZ /QAI de City ` �2 M61A State YY1 A Zip 73 License Number LS"6 0 License Type (:� S Expiration Date O Contractors Email 'S-L dwct4 C-0 AcAST:Ne'( Cell # S V `I,).l a I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts Stat Building Cod . I understand the construction inspection procedures,specific inspections and documentation ed by 80 CMR and a To of Barnstable.Attach a copy of your license. Signature Date 1C? Section 10—Home Improvement Contractor � p i Name Telephone Number Address City State Zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date l� Print Name J04 Al Z GI� °kr— Telephone Number E-mail permit to: Z e i-�/ycz CO h'►C4.S i v1/E Last updated: 11/15/2018 Section 12 —Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site.Plan Review(if required) ❑ Fire Department: : ❑ Conservation" ❑ For commercial work,please take your plans directly to the fire department for approval, Section 13 — Owner's Authorization i I, D C�ti r.e.L Qe V1ile as Owner of the subject property hereby r— authorize to act on MY-behalf, in all matters relative to work authorized by this building permit application for: (Address of job) 717 fj 13 Signature of v ner Print Name Last updated: 11/15/2018 Comr?�onwealfh of Massachusetts j Division of PrRoegul;t ons and Standards 0' Board of Building ervisor Construction Sup p410412020 Expires: CS-058106 t i JOHN J.LEITNER 16 SKYLINE DRIVE Mk WEST YARMOUT'I 1, Commissioner vi l�� o✓z L-bwele c t 5 •/ v 1 Qk The Commonwealth of Massachusets Department of IndustridAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.m ass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plnmbers Applicant Information l Please Print Legibly Name(BusinessIOMwdzation/Individual): J y k AJ L—e 4,oyc 1z Address: L 5' 5 K,/Iliv(f 1,7/Z1 VkC- City/State/Zip: C11Z"uu - 1 )47,4 4a7 67,?Phone#: ��-- Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with- 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.X I am a sole proprietor or partner- wed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity.actt3'• employees and have workers' 9. ❑Building addition [No workers'comp.inarrance comp.insurance.: required.] 5. ❑ ❑ We are a corporation and its 10. Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insumce required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work 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 subcontractors 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 isproviding workers'compensation insurance for my employees. Below is thepolley and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: 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 c der a pains and Wallies ofperjury that the information provided ab a is and correct Date: Phone#' 2 Ojflcial use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityrrown Clerk 4.EIectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone M I Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person'iri the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct bur7diugs in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLQ or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be 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 required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the peumittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents OrJ�ce of Investigations 600 Washington Sheet Boston,MA 02111 - Tel.#617-n7-4900 ext 406 or 1-877-MASSAFB Revised 4-24-07 Fax#617-727-7749 www.mam.gov/dia HEr Printed On:7/15/2019 i Complaint Call Report I 639Mm 2455 MEETINGHOUSE WAY/RTE 149, WEST Case# C-19-539 BARNSTABLE ---------------- Case#: C-19-539 Address: 2455 MEETINGHOUSE Date: 7/2/2019 WAY/RTE 149, WEST BARNSTABLE Owner Info: Property Info: BARNSTABLE, TOWN OF MBL: (LOMB) PO BOX 159 155-017 WEST MA 02668 BARNSTABLE Owner Notified?: Complaint Details: Type of Complaint Classification of Complaint Method of Complaint Building Code, Medium Priority Dept Referral Complaint Summary: Village store is on Lombard Trust property. Donna (Health)found and documented significant renovations inside without the benefit of the required permits. Action History: Action Taken Date Description Fee Inspector Close Case 7/15/2019 owner has received $0.00 bowerse Building permit B-19- 2202 No violation exist Inspector Assigned to Complaint: bowerse Filed by: andersor Comments: Comment Date Commenter Comment 7/2/2019 andersor Called David Anthony to confirm that the town owns the building and to check and see if the tenant had David's approval for any of the work. He was unavailable but Theresa Santos will get back to me on 7/3/19. 7/3/2019 andersor Ed posted stop work order 7/2/19. Jeff L. re-posted a new stop work order in a visible location on 7/3119 citing work w/o permits. 7/3/2019 sheas see more pictures on c-19-540 Date: 7/15/2019 Town of Barnstable r Town of Barnstable Inspectional Services BARNSrAB[.E. ' Brian Florence,CBO NAB& a t639• `0m Building Commissioner DM s 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us INSPECTION REPORT Address : 2455 MEETINGHOUSE WAY/RTE 149, WEST Case # C-19-539 BARNSTABLE Inspection Type : Commercial Building Code Inspector: bowerse ..._..............__...-......................................._.........._............._......__.... - .._-...._......................................-.........................._..........---.................._.......---............... Description Date Unit Status Comment It shall be unlawful to construct, 07/02/2019 FAIL Working without permit i ;reconstruct, alter, repair, remove or � I demolish a building or structure; or to change the use or occupancy of a I j building or structure... regulated by g 1780 CMR without first filing an 'application with the building official i and obtaining the required permit. I Inspection Type : Violation Inspector: bowerse Description Date Unit Status Comment Violation 07/15/2019 PASS contractor came in and pulled permit B-19- i i 2202 ; complaint should be closed Inspection Type : Violation Inspector: bowerse Description Date _ Unit Status Comment 'Violation 07/05/2019 � FAIL Sent violation letter out 7-5-19 certified mail copy attached I Town of]Barnstable Building ]Department Services Brian Florence, CBQ ,�DST Building Commissioner BARNSTABLE 200 Main Street; Hyannis, MA 02601575 16J9.301d www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Notice of Building Code Violation(s) and Order to Cease, Desist and Abate: Daniel and Leslie Devlin 2455 Meetinghouse way and all persons having notice of this order: As property owner or tenant of the property located at 2455 Meetinghouse,West Barnstable,MA, Assessors Map 155 Parcel 017 and known as commercial structure,you are hereby notified that you are in violation of 780 CMR,the Massachusetts State Building Code Chapter 1 Section R105.1,and are ORDERED this date 7/5/2019 to: CEASE AND DESIST all functions associated with the following violation(s)on or at the above mentioned premises: Summary of Violation: On 7/5/2019 1 received creditable evidence&testimony of a violation of 780 CMR of the Massachusetts State Building Code Chapter 1 Section R105.1 Specifically, Working without a permit. Summary of Action to Abate Violation: In order to abate this violation and to avoid further enforcement action by this office,commence immediately upon receipt of this notice the following action: Obtain building permit And, if aggrieved by this notice and order;to show cause as to why you should not be required abate the violation in this notice,you may file a Notice of Appeal(specifying the grounds thereof) with the State Building Code Appeals Board within(45)days of the receipt of this order and in accordance with MGL c. 143 § 100. If,at the expiration of the time allowed,action to abate this violation has not commenced,further action as the law requires may be taken. By Order, Edwin Bowers Local Inspector Town of Barnstable Building Department Services Brian Florence, CBO Building Commissioner BAMSTABLE 200 Main Street, Hyannis, MA 02601 .=r @M3�• •w 1609-7014 www.town.barnstable.ma.us 55 Office: 508-862-4038 Fax: 508-790-6230 Notice of Building Code Violation(s) and Order to Cease, Desist and Abate: Daniel J. and Leslie Devlin and all persons having notice of this order: As property owner or tenant of the property located at 2455 Meetinghouse Way, West Barnstable, MA, Assessors Map 155 Parcel 017 and known as commercial structure,you are hereby notified that you are in violation of 780 CMR,the Massachusetts State Building Code Chapter 1 Section 111, and are ORDERED this date 12/20/2018 to: CEASE AND DESIST all functions associated with the following violation(s)on or at the above mentioned premises: Summary of Violation: On 7/2/2019 1 received creditable evidence&testimony of a violation of 780 CMR of the Massachusetts State Building Code Chapter 1 Section 105.1 Specifically, It shall be unlawful to construct, reconstruct, alter, repair, remove or demolish a building or structure; or to change the use or occupancy of a building or structure; or to install or alter any equipment for which provision is made or the installation of which is regulated by 780 CMR without first filing an application with the building official and obtaining the required permit. Summary of Action to Abate Violation: In order to abate this violation and to avoid further enforcement action by this office, commence immediately upon receipt of this notice the following action: obtain a Building permit as required by 780 CMR And, if aggrieved by this notice and order;to show cause as to why you should not be required abate the violation in this notice,you may file a Notice of Appeal (specifying the grounds thereof) with the State Building Code Appeals Board within (45)days of the receipt of this order and in accordance with MGL c. 143 § 100. If, at the expiration of the time allowed, action to abate this violation has not commenced, further action as the law requires may be taken. By Order, Edwin Bowers Local Inspector I I F NE, Complaint Call Report Printed On:7/2/2019 KSrABL rf ,,0�a 2455 MEETINGHOUSE WAY/RTE 149, WEST BARNSTABLE Case# C-19-539 Case#: C-19-539 Address: 2455 MEETINGHOUSE Date: 7/2/2019 WAY/RTE 149,WEST BARNSTABLE Owner Info: Property Info: BARNSTABLE, TOWN OF MBL: (LOMB) PO BOX 159 155-017 WEST MA 02668 BARNSTABLE Owner Notified?: Complaint Details: Type of Complaint Classification of Complaint Method of Complaint Building Code Medium Priority Dept Referral Complaint Summary: Village store is on Lombard Trust property. Donna(Health)found and documented significant renovations inside without the benefit of the required permits. Action History: Action Taken Date Description Fee Inspector Inspector Assigned to Complaint: bowerse Filed by: andersor Comments: Comment Date Commenter Comment 7/2/2019 andersor Called David Anthony to confirm that the town owns the building and to check and see if the tenant had David's approval for any of the work. He was unavailable but Theresa Santos will get back to me on 713/19. Date: 7/2/2019 Town of Barnstable .� � � ;� :� n �„ P __ �� �� .�� - - - - �� - r `� � � �: � ,�;� , - -� `"�.+�' .-_ • :ill , f�, . Y _w ! .ti r � � t J t�7v -`' ` uj �o co uM s a t • 1 i i i 1 1 k .r r A� 4?7-11' t rt=. k 1 LU lJ CIO C: t•_ c.^ r�.. `�. / /��f. r - G u.a �' .. �� U LLS �s f ca {y' } t..t„, ..a'""° t ""°==z, �� �, ,. � :` �� ._ ;, r a Pam,,,,, '�""' .. �,- ,� ,• .•, � - n1 � , r ., 4� .. ♦ ..: � _ 1 R h � :: _, -, .. _y�� ..,� . .-.r- - - -- i �; ,""d+ `� � :, - o _ � � ,� ?f .�- k � .,,...e.:`f- _ .;. ..�x�. ,�� � :�,! 1, s:- ^t,.� �+ ;,� "+ � 4' _... ice,.- .. LLJ a C1 _..8 ca r'', Ln 0-. etc C, ("�i U.. - — a - �T _.,n! ,. �,� 4,. ';�� .--,,..�„�, ,j �. ., ,� - n..���`� i_. _,. - - �� w cn r . I C . i_ 11. F .dam r :.• I .�3a��-u.e4x..�naaaYr� 0 rJ LLJ —1 re.4 F, i_- l r a � x w „ x r _ �;�,•r � sa�,Wi. -�". as -; r. --.:.. ' y ,CC ` it 4 } 'tlsr,� w cr] _ c� a _ � Cr I f i Iris — w Mi C� - -��\ : « >2 \ . .../\�\�2%m» � - - ����\\© - z» . » ........... r : - r - `»z cU -.j rl", cn r,-. CC C .; Lt.- f CD C� » 2 .1 \, . \ � - &�~?2 �\�f LU __A �t i-- LP, U. s Ir a �,• YY 4w: a rd T _ r I i I No � . � � � a t r t i i 1 I I 1 L.LS I i � LLJ ram. __.r r-:' �a PC Rom. . �i I � W Y�_ j : Rio 1 i di s ' i4 I Ii i I i I I LU rc; ,� �. ,� {� � -��� p{, 1� '1 �� �r. � a ., ., ��-�;_. , �`�q '- y c� g' L cra i a, � a sir *� �'�$r"c�T+,�" .i�� a. � i u a� e � :_mot. � �Sc""au.:`i�?' "' a,a. ` � tip' "�' �, '�°`k;'dv -.r,, _ LU __j co is—= f�,-1 Ln i Ma r Anderson, Robin From: Miorandi, Donna Sent: Tuesday, July 02, 2019 4:33 PM To: Anderson, Robin Subject: Operator of Old Village store Dan Devlin phone number is 508-367-9892 Donna i 1 s WA 'N OF BARNSTABLE BUILDING PERMIT APPLICATION Map �S Parcel Application # Health Division ,�� - Date Issued Conservation Division Application F Planning Dept. Permit Fe e � � d Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address ��J� � ����► 1�� `� Village Owner Address Telephone �- EPermif-Request—=:r C. �1 �e�,('}. `V\A' �. is o i 2 Q aci -{- Q fad-FYnt ff+ 0 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay R P�jecQaluatiEn: ) Construction Type �►� d@� �U1�c� Flnm� Lot Size Grandfathered: ❑Yes JXNo If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes XNo On Old King's Highway: ❑Yes V'No Basement Type: ❑ Full Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing_0 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: 4Yes No Fireplaces: Existing New Existing wood/coal stove: ❑Yes No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ r Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: + -, Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ s -, 3 1 :. Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION rn (BUILDER OR HOMEOWNER) Name Telephone Number Address —A-"6 License # C-5 Wh, QiS k% Home Improvement Contractor# Email n Worker's Compensation # ()49 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# _ DATE ISSUED MAP/PARCEL NO. ' ' ` . ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION / a FRAME ��7 /3 7 �+�►Y' ' ~ INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING'( )f/k 6w-it DATE CLOSED OUT ASSOCIATION PLAN NO. F ' x Town of Barnstable Building Department Brian Florence, CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.toivn.barnstable.ma.us Pre-application for Business Certificate Date 11n hq Map /0—Parcel V Applicant Information Applicants Name I_ / q Applicants Address o2'7�S� � J�fa 11 S,L/�/T Email Address Telephone Number `7�c9 367 ��J�o2, Listed� Unlisted ❑ Business Information New Business? ----------------------------------------, Yes No Business is a registered corporation? -------------------------- es No If yes Name of Corporation Does business operate under-the registered corporate name? Yes Is the business a sole proprietorship or home occupation? --------- Yes No If yes thennaa Home Occupation Registration is required-See Building Division Staff Name of Business /i{�C�/ V/LL r-�G-L �'�'>ro&i=. n F ! rZ4aA J5'�,/� / Business Address Type of Business �- — U r Building Commissioner Office Use Only Cond' s --) 0;( 4,6 Building Commissioner Date /a 10 Clerk Office Use Only ..mow �,:_��: ,...t, �,. �, 's �' �'. �,iK,. �"r ;��a-, �"�M1^�° ,�. -- .� ��� �� _v _`. b'"' ��+.� �S��,w � � _ :4 �y � �� � � � of � ,� ;•, ,.� .tf�,��}:�� °{p �`. •�r�'�. �` ,�, �'.:.. -:' '� ��t � �"y,�. C RY {s. ,� a '.`y'> ,1��, �' � ` s � � �, y 1 � g M �� �, �a'i l ®�. k` � J ` 4 '' ;4� ��� U� 9 � s,.. ��,,.. t �,�. �.� `�� r,•:s .Sk � �` � � Mckechnie, Robert From: Matthew Eldredge <mseldredge3@gmail.com> Sent: Monday, November 06, 2017 1:43 PM To: Mckechnie, Robert Subject: Old village store Attachments: 2017102695144711jpg; 2017102695144743jpg; 2017102695144751jpg; 2017102695144757jpg; 2017102695144808jpg; 2017102695144815jpg; 2017102695144823jpg; 2017102695144832jpg Hi Bob, attached are the remaining pictures from the crawl space under the village store/apartment. Thanks, Matt Eldredge I 1 n`r `la �l� r ��r U a N �F - 9 Ilt{I+r i 1 p� �I r.:M1 1 t� •T. ._f s4r t t' x . DI l yy� J CC t z op FTHETp�y� Town of Barnstable BAMSTABIZ 2 200 Main Street Tel.(508)862-4038 T�A 1� `0ya IfOMA�' INSPECTION REPORT Permit: Addition/Alteration - Commercial Use: Date: 1/13/2016 12:00 AM Inspector : Permit Number : B-2015-04434 Name: BARNSTABLE, TOWN OF (LOMB) Address: 2455 MEETINGHOUSE WAY/RTE 149, WEST BARNSTABLE Unit No. Inspection Type Inspection Item Status Comment Building Frame A - Inspection Results PASS RMCK: NEED MORE NAIL PLATES, PENETRATIONS NOT FOAMED Custom Status: Conditionally Approved Inspection Overall Comment: Overall Inspection Status: Re-Inspection Date: Date: 1/26/2016 11:58 AM Inspector : mckechnr Permit Number : B-2015-04434 Name: BARNSTABLE, TOWN OF (LOMB) Address: 2455 MEETINGHOUSE WAY/RTE 149, WEST BARNSTABLE Unit No. Inspection Type Inspection Item Status Comment Building Insulation A- Inspection Results PASS Fiberglass Batts in walls, Demilec Heatlok in attic rafter bays Certification in file Inspection Overall Comment: Overall Inspection Status: Not Reviewed Re-Inspection Date: Inspector Signature Owner Signature Total Score: 100 *1HETp Town of Barnstable A 200 Main Street Tel.(508)862-4038 �AM &t639. �0�p rf INSPECTION REPORT Date: 4/1/2016 12:34 PM Inspector : mckechnr Permit Number : B-2015-04434 Name: BARNSTABLE, TOWN OF (LOMB) Address: 2455 MEETINGHOUSE WAY/RTE 149, WEST BARNSTABLE Unit No. Inspection Type Inspection Item Status Comment Building Final A- Inspection Results NIC Need Fire sign off, OK with fire sign off and insulation in crawl space Building Final B -Cellar/Basement NIC Not done Insulation Building Final B - Final Plumbing, NIC Fire not signed off Electrical, Fire, and Gas Complete Building Final B - Heat Detectors in PASS Heat detectors connecting store fire alarm and apt Garage Building Final B - Insulation in Attic- PASS Eve access and pull down stairway Building Final B - Interior Doors where PASS required Building Final B - Kitchen and Bath PASS Flooring in place Inspection Overall Comment: Overall Inspection Status: Not Reviewed Re-Inspection Date: Date: 6/19/2017 12:29 PM Inspector : mckechnr Permit Number : B-2015-04434 Name: BARNSTABLE, TOWN OF (LOMB) Address: 2455 MEETINGHOUSE WAY/RTE 149, WEST BARNSTABLE Unit No. Inspection Type Inspection Item Status Comment Building Final A- Inspection Results NIC Fire separation not complete, need more fire foam in fire wall. Inspection Overall Comment: Overall Inspection Status: Not Reviewed Re-Inspection Date: Inspector Signature Owner Signature Total Score: 100 1 � _ `pFtHE fpky Barnstable Old Kings Highway Historic District Committee BAMSTABLL p; 200 Main Street, Hyannis, MA 02601, TEL: 508-862-4787 Fax 508-862-4784 MAM a 1639.9�prEp MPt s�0� APPLICATION, CERTIFICATE OF APPROPRIATENESS Application is hereby made,with five(5)complete sets,for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,Acts and Resolves of Massachusetts, 1973,for proposed work as described below and on plans,drawings,or photographs accompanying this application for: Check all categories that apply; 1. Building construction: ❑ New ❑ Addition EZ Alteration 2. Type of Building: ❑ House ❑ Garage/barn ❑ Shed ❑ Commercial M Other 3. Exterior Painting,roof ❑ new roof ❑ color/material change, of trim, siding,window, door 4. Sim : ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 5. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Retaining wall ❑ Tennis court ❑ Other 6. Pool ❑ Swimming ❑ Other man-made pool ❑ Solar panels ❑ Other Type or Print Legibly: Date / ) 5 NOTE All applications must be signed by the current owner ( r Owner(print): Les I!.e- De y I I n Telephone#: Address of Proposed Work: U s U- ,- WC, village W, acti r 65+61$ Map Lot# 15 5 Mailing Address(if differe Owner's Signature Description of Proposed Work: Give particulars of work to be done: A 4 ( r,G P k 4e `Ifs r Q G J J Agent or Contractor ``(print): � �� 1�e d g�- Telephone#: 5 � - I 3 9 /\ a V Address: L�V ��/�� S7</Ce�' w. ar S-�rN6�e Contractor/Agent'signature: ���� For committee use only. This Certificate is hereby APPROVED/DENIED Date ,tle Mem ers signatures t�� T11 WIBNT R APPROVED Z015 Town of Barnstable Old Ding's Highway 1 Q:IBoards and Commissions101d Kings HighwaylOKHApplicationslOKH 2O11 Cert Appropriatecn®ess dock CERTIFICATE OF APPROPRIATENESS SPEC SKEET Please submit 5 copies Foundation Type: (Max. 12"exposed)(material-brick/cement,other) Siding Type: Clapboard_ shingle_ other Material: red cedar white cedar other Color: Chimney Material: Color: Roof Material: (make&style) Color: Roof Pitch(s): (7/12 minimum)' (speck on plans for new buildings, major additions) Window and door trim material: wood other material,specify Size of cornerboards size of casings(1 X 4 min.) color Rakes Ist member 2nd member Depth of overhang Window: (make/model) material color (Provide window schedule on plan for new buildings, major additions) Window grills (please check all that apply_. true divided lights_ exterior glued grills_ grills between glass_removable interior_ None }k Door style and make: I1-�P �/���rSP� 30 material r I b 6 r Icss Color: Garagz Door,Style Size of opening Material Color Shutter Type/Style/Material: Color: A !V D Gutter Type/Material: Color: 'MA5 AU Deck material: wood other material,specify Color: n of Barnstable Old Kio m ttee Skylight,type/make/model/: material Color: Size: Sign size: Type/Materials: Color: ��''cEMD Fence Type max 6' ) S le material:al: Color: Retaining wall: Material: NGEMENT Lighting, freestanding on building illuminating sign OTHER INFORMATION: THE ATTACHED CHECK LIST MUST BE COMPLETED AND SUBMITTED Please provide samples of paint colors,manufacturers brochure of windows,doors,garage door,fences,lamp posts etc Signed: (plan preparer) Print Name Q:lBoards and Commissions101d Kings HighwaylOKHApplicationsl0KH2O11 Cert Appropriateness.doc 2 Town of Barnstable Geographic Information System August 10,2015 168028 1660 0881 0906 165024 #975 • 155034 165021 go No 155039. 02481 166026 #2606 166014 # 166021 09999 p #166026 166022 �nAr 02482 166033 1124115 t 55043 . . . . . . . . . . #2489 . P{. • .... . . . . . . . . . . . . . . . . . . . . . . 02463 #2461 16536 / #2481 156050 02449 165048A00 170027 00 #48 165017 46 166018 02456 #68 165028 165027 166037 02464 02472 #24 155038 #2439* 166020 #2429 # fi24 166018A01 #2414* ,0 165029 .y ®• 02464 166030 155019 #2416 166040 � #2401 #2377 55031 #241_2 0 80 Feet �� DISCLAIMERS:This map Is for planning purposes only. It is not adequate for legal Map:155 Parcel:017 r N boundary delemOnadon or regulatory Interpretation. Enlargements beyond a scale of Owner.BARNSTABLE,TOWN OF(LOMB) Total Assessed value:$348900 Selected Parcel 1'=100'may not meet established map accuracy standards.The parcel Ones on this map E are only graphic representations of Assessor's tax parcels.They are not true property Co-Owner:%BARNSTABLE,TOWN OF Acreage:0.30 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location 2455 MEETINGHOUSE WAYlRTE + such as building locations. 149 Buffer WI/I 1 1-13 a � s terra'm ae - q ,a Szza z a °3 3 s s d a „a r 4� � f n .. ..i s i" r\ +\ 1 a „ s wG `: \ «�« w �m , � > � \ — •`s^�,�f�`c:� ��r�-2. t e�.r yr�iw .�'��...y�'^'���� sp�f`� �k r ..�� �.�y �. �^ 1_ — f i T•y.. i f 'iy'SS 77-7-7 i_ r Y n w OF b i� �wwrww9w.� } e � w �- a' �•ii y,�4'C� � tea- i� �� - tee.r f' b E . 1�0 AA p TR S F •tit 4'� ENTRY b00RS' Entry Door Heights I tp p RO " ED I AUG 2 6 2015 Town of Barnstable Old King's Highway Custom-size doors are available in 1/8-(3)increiW..ittee ©AEHIDxx68 ©AEHIDxx80 0 AEHIDxx68AP/PA ©AEHIDxx8OAP/PA Available in custom designed panels,see page 192.Stationary single(S)and stationary AEODxx68 AEODxx80 AEODxx68AP/PA AEODxx8OAP/PA two panel(SS)doors are also available(i.e.AEHID2068S or AEOD4068SS). Rectangular Inswing Entry Door Dimensions and Specifications _ t _ �_. .� Door Dimension_- -_Mln.R-ough Opening Clear Opening Maximums"- Doar Overall Do Number Width Height Width Height Clear Opening 90'Width Full Width )i] Height Vent Area Inches/ Inches/(mm) Inches/(mm) I Inches/(mm) Sq.Ft./(mz) Inches/(mm) Inches/(mmI 4 Inches/(mm) _ Sq.Ft./W) Sq.Ft./(m2) 2068 2511/,; (652) 82' (2083) 263/,; (665) 821/i (2096) 12.56 (1.17) 200/,i (529) 221/e (581) 791/,' (2008) 12.56 (1.17) 14.63 (1.36) I.2668 31 11/,; (805) 82- (2083) 323/,i (818) 82 yi (2096) 15.85 (1.47) 26 i3/,' (681) 28% (733) 7911i (2008) 15.85 (1.47) 18.04 (1.68) i 2868 t 33 1i/,; (856) 82- (2083) 34 3/,; (868) 82 yi (2096) 16.95 (1.57) 28 D/,; (732) 30 T/e (784) 79�/,; (2008) 16.95 (1.57) 19.18 (1.78) 3068 ', 3711/,; (957) 82- (2083) 383/2 (970) 821/i (2096) 19.15 (1.78) 32-/,; (833) 347/; (886) 791/,; (2008) 19.15 (1.78) 21.46 (1.99) 13668 4311/,; (1110) 82- (2083) 443/,i (1122) 821/2' (2096) 22.44 (2.08) 38u/u' (986) 40% (1038) 791/u (2008) 22.44 (2.08) 24.88 (2.31) .2080 - j 25 (652) 95' (2413) 263/,; (665) 95% (2426) 14.62 (1.36) 20-/,i (529) 22 T/; (581) 92 y,; (2338) 14.62 (1.36) 16.95 (1.57) 2680 ! 31 11/,; (805) 95' (2413) 32 3/,i (818) 95 T/i (2426) 18.46 (1.71) 26-&- (681) 28 7/i (733) 92 (2338) 18.46 (1.71) 20.90 (1.94) i 2880 33 11/,; (856) 95' (2413) 34 3/u' (868) 95 yi (2426) 19.74 (1.83) 28 D/,; (732) 30% (784) 92 y; (2338) 19.74 (1.83) 22.22 (2.06) '3080 37 11/u (957) 95- (2413) 38 3/0 (970) 95% (2426) 22.30 (2.07) 32 13/u (833) 34 T/; (886) 92 If,; (2338) 22.30 (2.07) 24.86 (2.31) 3680 4311/; (1110) 95' (2413) 443/0 (1122) 951/2' (2426) 26.13 (2.43) 38u/,; (986) 401/; (1038) 92 2338 /u E ) 26.13 (2.43) 28.82 (2.68) i 4068AP/PA 503/4' (1289) 82' (2083) 511/; (1302) 82 1/i (2096) 26.32 (2.45) 43 u/,; (1113) 47-/,; (1218) 79 i/,; (2008) 26.32 (2.45) 28.90 (2.68) �4068AP/PA' 503/' (1289) 82' (2083) 511/; (1302) 821/i (2096) 12.59 (1.17) 207/; (530) 22% (593) 797/,i (2008) 12.59 (1.17) 28.90 (2.68) (5068AP/PA I 623/; (1594) 82' (2083) 631/' (1607) 821/i (2096) 32.91 (3.06) 55% (1418) 59% (1522) 79 y; (2008) 32.91 (3.06) 35.73 (3.32) 5068AP/PA• 623/' (1594) 82' (2083) 631/' (1607) - 821/i (2096) 15.89 (1.48) 26%' (683) 28%- (735) 79t/,; (2008) 15.89 (1.48) 35.73 (3.32) I:5468AP/PA 663/.' (1695) 82- (2083) 671/' (1708) 821/; (2096) 35.10 (3.26) 5913/i (1519) 63% (1624) 793/,i (2008) 35.10 (3.26) 38.01 (3.53) t 5468AP/PA- 663/.' (1695) 82- (2083) 671/' (1708) 821/i (2096) 16.99 (1.58) 28T/; (733) 3013/,; (786) 791/,; (2008) 16.99 (1.58) 38.01 (3.53) 6068AP/PA 743/.' (1899) 82' (2083) 751/; (1911) 821/1' (2096) 39.50 (3.67) 67-/,i (1722) 7111/,; (1827) 793/,i (2008) 39.50 (3.67) 42.57 (3.95) t_6068AP/PA' 743/.' (1899) 82- (2083) 751/' (1911) 821/2' (2096) 19.18 (1.78) 32% (835) 3413/,; (887) 791/,; (2008) 19.18 (1.78) 42.57 (3.95) 17068AP/PA 86 3/.' (2203) 82' (2083) 87% (2216) 82% (2096) 46.09 (4.28) 79-& (2027) 83% (2132) 79 3/; (2008) 46.09 (4.28) 49.40 (4.59) 7068AP/PA' ' 863/4' (2203) 82- (2083) 871/' (2216) 82 1/i (2096) 22.48 (2.09) 381/e' (987) 40 a/,i (1040) 79 3/,; (2008) 22.48 (2.09) 49.40 (4.59) y 4080AP/PA , 503/,' (1289) 95' (2413) 511/' (1302) 95% (2426) 30.65 (2.85) 4313/,; (1113) 4713/,; (1218) 92 3/,; (2338) 30.65 (2.85) 33.48 (3.11) �4080AP/PA' ' `. 50%' (1289) 95' (2413) 511/' (1302) 951/3' (2426) 14.66 (1.36) 207/.- (530) 2215/,i (583) 921/,; (2338) 14.66 (1.36) 33.48 (3.11) {•5080AP/PA 623/4' (1594) 95' (2413) 631/' (1607) 951/i (2426) 38.32 (3.56) 55-/,; (1418) 59% (1522) 92 3/; (2338) 38.32 (3.56) 41.40 (3.85) ):5080AP/PA- 621/.' (1594) 95' (2413) 631/' (1607) 951/2- (2426) 18.50 (1.72) 261/; (683) 2813/,; (735) 92%,; (2338) 18.50 (1.72) 41.40 (3.85) -5480AP/PA ( 66 3/' (1695) 95' (2413) 671/' (1708) 95 1/; (2426) 40.88 (3.80) 59 u/,y (1519) 63-/,; (1624) 92 yu (2338) 40.88 (3.80) 44.04 (4.09) j.5480AP/PA- 66% (1695) 95' (2413) 671/' (1708) 951/2' (2426) 19.78 (1.84) 287/; (733) 30i3/,; (786) 923/,; (2338) 19.78 (1.84) 44.04 (4,09) 6080AP/PA - 743/4' (1899) 95' (2413) 751/' (1911) 95% (2426) 45.99 (4.27) 67 L1/,;(1722) 7115/,; (1827) 921/,; (2338) 45.99 (4.27) 49,31 (4.58) j 6080AP/PA' S 743/4' (1899) 95' (2413) 751/' (1911) 951/2' (2426) 22.34 (2.08) 32%- (835) 3413/,; (887) 921/,, (2338) 22.34 (2.08) 49.31 (4.58) 7080AP/PA 863/4' (2203) 95- (2413) 871/,' (2216) 951/1' (2426) 53.66 (4.99) 7913/u (2027) 83-/,; (2132) 921/u (2338) 53.66 (4.99) 57.23 (5.32) 1 7080AP/PA` 863/4' (2203) 95- (2413) 871/' (2216) 951/1' (2426) 26.17 (2.43) 387/i (987) 40% (1040) 921/u (2338) 26.17 (2.43) 57.23 (5.32) •To complete door Identification,add AEHID to'Door Number'listed in table(i.e.AEHID3068 orAEHID4080PA). •'Door Dimension'always refers to outside frame to frame dimension. •*Minimum Rough Opening'dimensions may need to be Increased to allow for use of building wraps,flashing,sill panning,brackets,fasteners or other Items. *Passive panel in closed position. Rectangular Outswing Entry Door Dimensions and Specifications 11 Door Dimension "�� MIn.RoughOper_iing _ � ClearOpeningMaximums�Y �] !t Door Height p in g r j gh' 3 Overall Door Number Width Hei t Width Height Clear Open 90'Width I Full Width 1 Height- Vent Area Inches/mm Inches(mm) Inches/(mm) Inches/(mm Sq.Ft./(m) inches/(mm Inches/(mm) i Inches/(mm .FL m) Sq.Ft./(m) 12068 25U& (652) 82' (2083) 263/,; (665) 821/i (2096) 12.68 (1.18) 21% (537) 231/v' (586) 793/u (2011) 12.58 (1.17) 14.63 (1.36) 2668 3111/; (805) 82' (2083) 323/,; (818) 821/i (2096) 15.98 (1.48) 271/; (689) 291/; (738) 793/4' (2011) 15.82 (1.47) 18.04 (1.68) 1,2868` 3311/ (856) 82' (2083) 343/,; (868) 821/i (2096) 17.08 (1.59) 2911, (740) 311/,; (789) 793/,; (2011) 16.89 (1.57) 19.18 (1.78) 3068 371y; (957) 82' (2083) 383/,; (970) 823/i (2096) 19.28 (1.79) 331/e (841) 351/u' (891) 793& (2011) 19.00 (1.77) 21.46 (1.99) 13668' ( 4311/,; (1110) 82' (2083) 443/u (1122) 821/2' (2096) 22.58 (2.10) 39% (994) 411/,; (1043) 793/,; (2011) 22.13 (2.06) 24.88 (2.31) }'2080 ' - j 2511/„ (652) 95' (2413) 263/u (665) 951/i (2426) 14.76 (1.37) 211/; (537) 231/,i (586) 923/,i (2342) 14.66 (1.36) 16.95 (1.57) 2690 - i 3111/,; (805) 95- (2413) 323/,; (818) 951/i (2426) 18.61 (1.73) 271/; (689) 291/,; (738) 923/,; (2342) 18.45 (1.71) 20.90 (1.94) 28a0. 3311/,; (856) 95- (2413) 343/Y (868) 951/i (2426) 19.89 (1.85) 291/; (740) 311/; (789) 923/,. (2342) 19.69 (1.83) 22.22 (2.06) 3080 - 37 t1/,; (957) 95' 2413 38 3 1 1 1 a ( ) /u' (970) 95/; (2426) 22.45 (2.09) 33/; (841) 35/u' (891) 92/,; (2342) 22.17 (2.06) 24.86 (2.31) continued on next page 2013-2014 400/200 Series Product Guide Page 1 of 2 Andersen. Rectangular Outswing Entry Door Dimensions and Specifications(continued) Door Dimension Min.Rough Opening l Clear Opening Maximums Door ( I Overall Door Number Width Height Width Height I ClearOpening 90'Width Full Width Height Vent Area Inches/(mm) Inches/(mm) Inches/(mm) Inches/(mm) Sq.Ft./(m2) Inches/(mm) Inches/(mm) i Inches/(mm) Sq.Ft./(m2) Sq.Ft.%(m=) . 3680 'P 43 ri/u (1110) 95- (2413) 44 r/u (1122) 95 r/i (2426) 26.29 (2.44) 39% (994) 41 ym' (1043) 923/m' (2342) 25.84 (2.40) 28.82 (2.68) 4068AP/PA 503/4' (1289) 82- (2083) 511/4' (1302) 821/e (2096) 26.46 (2.46) 441/ (1122) 48% (1222) 793/,' (2011) 25.73 (2.39) 28.90 (2.68). ` 4068AP/PA•. 503/4' (1289) 82- (2083) 511/,' (1302) 821/= (2096) 12.65 (1.18) 21• (533) 23- (584) 793/,e (2011) 12.28 (1.14) 28.90 (2.68) 1.5068AP/PA 623/4' (1594) 82- (2083) 631/4' (1607) 821/2' (2096) 33.06 (3.07) 563/,; (1427) 60% (1527) 793/,e (2011) 32.38 (3.01) 35.73 (3.32). 5068AP/PA• ' 621/,' (1594) 82- (2083) 631/4' (1607) 82y= (2096) 15.95 (1.48) 27- (686) 29- (737) 7931W (2011) 15.60 (1.45) 35.73 (3.32) 5468AP/PA 663/e (1695) 82- (2083) 67%' (1708) 821/i (2096) 35.26 (3.28) 603/u' (1529) 641/e (1629) 793/u (2011) 34.43 (3.20) 38.01 (3.53) 5468AP/PA' :1. 663/,' (1695) 82" (2083) 671/,' (1708) 82yi (2096) 17.05 (1.58) 29- (737) . 31- (787) 7931W (2011) 16.63 (1.54) 38.01 (3.53) 6068AP/PA 743/4' (1899) 82' (2083) 751/4' (1911) 823/2' (2096) 39.66 (3.68) 6831W (1732) 721/e (1932) 793/e (2011) 38.48 (3.57) 42.57 (3.95) 6068AP/PA• -a 743/4' (1899) 82 (2083) 751/,' (1911) 82 yi (2096) 19.25 (1.79) 33' (838) 35' (889) 793/,e (2011) 18.65 (1.73) 42.57 (3.95) '..7068AP/PA 863/4' (2203) 82' (2083) 871/4' (2216) 821/2 (2096) 46.26 (4.30) 803/u (2037) 84%' (2137) 7931W (2011) 44.37 (4.12) 49.40 (4.59) � 7068AP/PA`. 863/4' (2203) 82- (2083) 871/4' (2216) 821/; (2096) 22.55 (2.09) 39' (991) 41- (1041) 7931,e (2011) 21.60 (2.01) 49.40 (4.59) 4080AP/PA 503/4' (1289) 95- (2413) 511/4' (1302) 951/; (2426) 30.81 (2.86) 443/,: (1122) 481/e (1222) 9231W (2342) 30.08 (2.79) 33.48 (3.11) 4080AP/PA' 503/,' (1289) 95- (2413) 511/4' (1302) 951/2' (2426) 14.72 (1.37) 21' (533) 23- (584) 923/,e (2342) 14.36 (1.33) 33.48 (3.11) 5080AP/PA ,; 623/4' (1594) 95- (2413) 631/,' (1607) 951/i (2426) 38.49 (3.58) 563/u (1427) 601/,' (1527) 923/,e (2342) 37.80 (3.51) 41.40 (3.85) 5080AP/PA- 623/,' (1594) 95- (2413) 631/4' (1607) 951/2' (2426) 18.57 (1.73) 27- (686) 29- (737) 923&- (2342) 18.22 (1.69) 41.40 (3.85) 5480AP/PA r. 663/4' (1695) 95- (2413) 671/4' (1708) 951/1' (2426) 41.05 (3.81) 603/u (1529) 64ye (1629) 923/u' (2342) 40.22 (3.74) 44.04 (4.09) 5480AP/PA' 663/4' (1695) 95' (2413) 671/4' (1708) 95%- (2426) 19.85 (1.84) 29' (737) 31- (787) 923/,e (2342) 19.43 (1.81) 44.04 (4.09) 6080AP/PA 743/4' (1899) 95' (2413) 751/4' (1911) 951/, (2426) 46.17 (4.29) 683/,e (1732) 721/a (1832) 923/,e (2342) 44.99 (4.18) 49.31 (4.58) . 6080AP/PA• 743/4' (1899) 95- (2413) 751/,' (1911) 951/2' (2426) 22.41 (2.08) 33- (838) 35- (889) 923/,e (2342) 21.81 (2.03) 49.31 (4.58) 7080AP/PA` 863/4' (2203) 95- (2413) 871/,' (2216) 951/,' (2426) 53.86 (5.00) 803/,e (2037) 841/,' (2137) 923/,e (2342) 51.96 (4.83) 57.23 (5.32) 7080AP/PA• ! 863/,' (2203) 95- (2413) 871/,' (2216) 951/; (2426) 26.25 (2.44) 39 (991)' 41- (1041) 923/u' (2342) 25.30 (2.35) 57.23 (5.32) •To complete door identification,add AEOD to'Door Number'listed in table(i.e.AE003068 orAEOD4080PA). •'Door Dimension'always refers to outside frame to frame dimension. •'Minimum Rough Opening'dimensions may need to be Increased to allow for use of building wraps,flashing,sill panning,brackets,fasteners or other items. •Dimensions in parentheses are in millimeters or square meters. 'Passive panel in closed position. Direct-Set Rectangular Entry Door Sidelight Dimensions Direct-Set&Sash-Set Rectangular Entry Door Sidelights and Specifications Sidelight Dimensions ! Min.Rough Opening (. Overall Sidelight ° Glass ---- ---- g Sidelight Number Width Height I Width Height Area M Area Inches/(mm) I Inches/(mm) = Inches/(mm) Inches/(mm) Sq.Ft./(m2) 1 Sq.Ft./(m2) AESLD0868 91s/le (252) 82' (2083) 161/,8 (418) 821/{ (2096) 3.77 (0.35) 5.66 (0.53) AESLO1068 1513/,e (405) 82' (2083) 161/,e (418) 82 ye (2096) 7.03 (0.65) 9.08 (0.84) AESLD2068 ;251ye (652) 82- (2083) 263/,e (665) 821/; (2096) 12.32 (1.14) 14.63 (1.36) Li AESLD3068 3711/vi (957) 82' (2083) 383/,e (970) 82 ye (2096) 18.84 (1.75) 21.46 (1.99) AESLOO980 915/; (252) 95" (2413) to i/.' (265) 951/,' (2426) 4.40 (0.41) 6.56 (0.61) ©AESLDxx68 ©AESLDxx80 ©AESLlxx68 ©AESLIxx80 AESLDxx68 AESLOxx80 AESLO1080 15 u/,e (405) 95- (2413) 16 yu' (418) 95 yi (2426) 8.19 (0.76) 10.51 (0.98) AESLD2080 25111e (652) 95" (2413) 261/,e (665) 95 y; (2426) 14.37 (1.33) 16.95 (1.57) Direct-set(AESLD),sash-set inswing(AESLI)and sash-set outswing AESL.D3080 13711/,e (957) 95" (2413) 383/,e (970) 951/= (2426) 21.97 (2.04) 24.86 (2.31) •Sidelight Dimension always refers to outside frame to frame dimension. (AESLO)entry door sidelights Shown.Dimensions and Specifications •'Minimum Rough opening'dimensions may need to be Increased to allow for use of building wraps,flashing,sill Shown Or s et idelights,contact your Andersen supplier for panning,brackets,fasteners or other items. ,�� •Dimensions in parentheses are in millimeters or square meters. d li'ot dimensions and specifications. Order Designation Description 1�11 p 6 Zp15 Viewed from the exterior. AEG a tr,stabte Torn 0' B�Irtghwa' OEd cLommtttee 17 AEHID 3168 A L 17 AEHID 3168 A R 17 AEHID 6480 A P L R Flanking unit Door Active Left Flanking unit Door Active Right Flanking unit Door Passive Right width rough opg. panel hinged width rough opg. panel hinged width rough opg. panel hinged Andersen Entry Andersen Entry Andersen Entry Active Left Hinged Inswing Door Hinged Inswing Door Hinged Inswing Door panel hinged Inswing entry doors(AEHID)shown above,for outswing entry doors use AEOD.Outswing entry doors open outward to the exterior. 2013-2014 4001200 Series Product Guide Page 2 of 2 a�w ?.2,-5 S1 ATH 6'-1 "x � - v BEDROOM e�R �R 12-T'X 10'-b" o Fire Wall m (see attached) KITCHEN g �� 10'-4"x"1'-4" i- Existing 6reo�d steel door (:V to a `fi 90 N 101-�" LIVING 20'-1"x v � a LIVING AREA b"12sgR 7bWON SON Proposed UP • r Deli area 260 2b66 Existing storage area 0 Existing framing is 2x4 2WDH SON DECK UP Dell area Existing i storage area Existing $ Existing framing is 2x4 i i i DECK I u ' _. .% �"�tC�t'IItStFlOY '�i Q��Cf55[FE�iiG4�S _ frce Er��adio�s . �HA MI www.r�assgo�drrt WCWkeuce Cunipensatian Jusmn anc$Affida-wit S ersfCau arsMecfridz s(Pbamhers AvvHcantIIIfornY.a 6M Please Frm Le A r�6 CZ-DA\,4- AreFwn an emgIn.I'ee a=ktU7appmpriafr-bmc r ype�� L El am a emplaper vita 4 ❑ I araa. s1 ccnfmctar aad I emiployees{Ea audforpart:ime).* hz ehiredlEm 6- ❑Nero consEmc� El I am a sole prapsietar orpartner- listed oaf the attar5ed sheet ❑gesmdeling sbip aad have no empiopees Them- have g- ❑DemoEfiba VnAdng forme in any capacity eaapinpem and have woai=' [90 orlo.5'Comp;m- m ra_nce .CQm 7.II1SDial�:.I ❑BIIS�FIIg ad i4� We am a cmpara6baaad ifr 10-0 kcal repaim or additions 3_❑ hmue termed facer 1 Lo Plumbing mpaim yr adc2ions myseM PC Wodme comp- right afemmpfieaperMGr_ e regnired.]t c.15Z¢I(4� adtiee have no L-❑$nafr$paas emplay-M[15Iar wodm& 13-0€per !AZT sagbrCmff tort cheds bc¢WR=Lltzlm M cari'm se&mbguwsh�ffierwm&CS*mmpmcdion i Mmmmwnum vrimsabmittsIffullva meyamrlabigsHlvdc�d6,enhaeom eca rsmasisnb�a�ic�3seitmar sar3c ffiafchecktbisbar, Iattrit aa:cdmna�shyshbvrbxgth2n�of�e ohsmdsmte nraattimse 7aave ex�xIcgEGS Iftht sob-cns�aa�h-ct empru�rh�gmmY gs:rvcTe�-tved�`tomg.po-�ccym�brz • lam an smpioyer that ispra•►&&.g ararlters'caaspszu�id trtsrtraacs of m� ia�erak B�Iaar is$ae p� c}*rrad}ob rr� InsvMce Compar<yI`Fame_ Ion Sim Addresr_ CitgJ'Staf�Tp= Ai#acI=a copy of the irarke&conmpensztiau p aRcy decUFatioa gage(showing fhe po&eg r€mabrr xrad a - to f. Faaluca to secure cavezage as s e3and�Secimm Sly o€MUL c. 152 caa lmd to the imposh-=orrr mrual PMMIEM of a fins up to$I,50U 0a andfor=L-y ari ns mil as eira pcmd m- fire farm of t STOP CORK O$Dh$and a aTV to�250-DG a day against fhe viohtaL Br-advised that a copy of ibis stai==t nmybe eS tar The Office of Invesfigatims of ffie DIA ft insu rnmmvemgeve ost • 1`da frsreblr eer.tt�p ntsdet drs}�s tt�'Fsaa.$�r nrrezaad�iaaa pro•vidca£aka�e g trsce taaci'exact SiEmeom- D,,,.-- ry 15k l5 Off=- a1 Lase utrij; Da Ad Irriia in tins•areq,ta.be cawtpzd by city or form afficiaL Cify or Town Peradt :cease# fssming A n Grity(adrele on* - L B aard of$csItic..�..$�Td�Ileltar��t',��LylFogca Qt2ir �IIedncal Insge�oF �.�a""""'"� �pF . 6.Other Cc�tct Ixenan: Phase#: 6 - r OWice of Consumer Affairs & Business Regulation- Mass.Gov Page 1 of 1 y�b� The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) Consumer Affairs and Business Regulation =4 Home Consumer Rights and Resources Home Improvement Contracting Home Improvement Contractor Registration Lookup To search by registration number, enter the registration number in the textbox below and click the 'Search' button. Search by Registration Number 153262 Search To search by other fields, enter the search criteria in the fields below and click the 'Search Registrants' button. For the State field, use the two character state abbreviation such as "MA "for Massachusetts and "RI" for Rhode Island. All search fields allow partial text so the search will look for any values that begin with what was entered. For example, if you enter"Fr" in the City/Town field and "MA" in the State field then the search will return records for Framingham, Franklin, and Freetown which all begin with "Fr" and are located in Massachusetts. To return less information'enter in more criteria. For instance, entering in a state of "MA" will return a large number of records but entering in a state of "MA" and a city/town of "Medford" will lower the results. Search by Registrant's company's name Search by Registrant's last name City/Town �r State �� Zip code Search Registrants Click on the registration number to view complaint history. You can also view arbitration and Guaranty Fund history. The list is current as of Sunday, July 5, 2015. Search Results REGISTRANT RESPONSIBLE REGISTRATION ADDRESS EXPIRATION STATUS NAME INDIVIDUAL NUMBER DATE ELDREDGE&SONS ELDREDGE, 153262 P.O. BOX 572 11/13/2016 Current CONSTRUCTION INC STEPHEN W. BARNSTABLE, MA 02668 https:Hservices.oca.state.ma.us/hic/licenseelist.aspx 7/6/2015 Q fice of Consumer Affairs & Business Regulation - Mass-Gov Page 1 of 1 The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) � Consumer Affairs and Business Regulations 4" Home Consumer Rights and Resources Home Improvement Contracting HIC Registration Complaints Registration# 153262 Home Improvement Contractor Registrant ELDREDGE & SONS CONSTRUCTION INC Registration Home Page Name STEPHEN ELDREDGE Address P.O. BOX 572 City, State Zip W. BARNSTABLE, MA 02668 Expiration Date 11/13/2016 Complaints Details No complaints found for this registrant. You can also view arbitration and Guaranty Fund history. Back To Search https:Hservices.oca.state.ma.us/hic/licdetails.aspx?txtSearchLN=54538 7/6/2015 i FORM 153 The Commonwealth of Massachusetts DIA Use Only =Zl_\ Department of Industrial Accidents C%n r 7� Office of Investigations -Dept. 153 1 Congress Street,Suite 100,Boston,Massachusetts 02114-2017 6, http://www.mass.gov/dia Invest./SWO)D#: AFFIDAVIT OF EXEMPTION FOR CERTAIN CORPORATE OFFICERS OR DIRECTORS Chapter 169 of the Acts of 2002 amended M.G.L. c. 152, §1(4) by adding the following paragraph: "This chapter shall be elective for an officer or director of a corporation who owns at least 25 percent of the issued and outstanding stock of the corporation.Notwithstanding section 46,these provisions shall apply only if the corporate officer provides the commissioner of industrial accidents with a written waiver of his rights under this chapter. Said commissioner shall promulgate regulations to carry out the purpose of this paragraph. Violations of this paragraph shall subject the corporation to the penalties set forth in section 25C." Pursuant to M.G.L. c. 152, §1(4) as amended, I/We the undersigned officers of: ELDREDGE &SONS CONSTRUCTON, INC. 140 CEDAR ST. P.O. BOX 572 W. BARNSTABLE, MA 02668 (Name of Corporation and Address) each holding at least 25% of the issued and outstanding stock in said corporation, do hereby invoke the right to be exempt from the provisions of M.G.L. c. 152, §25A and therefore are not required to carry a workers' compensation policy covering the undersigned corporate officer(s) or director(s). I/We the undersigned do also waive any and all rights to make claims for benefits as defined in M.G.L. c. 152 for any injuries that may be sustained while in the employ of the above-named corporation. Further, I/we the undersigned do understand that, should the above-named corporation hire or have in its employ any employee(s) in addition to the undersigned corporate officer(s) or director(s), said corporation is required to obtain workers' compensation coverage for the employee(s) as prescribed by M.G.L. c. 152, §25A. I/We the undersigned have read and understand the statements and obligations as delineated above and I/we have checked the appropriate box below my/our name(s) indicating my/our desire to be exempt or not to be exempt from the provisions of M.G.L. c. 152. Signed under the pains and penalties of perjury: STEPEN ELDREDGE -PRESIDENT 07/16/2013 Signature Print Name&Title Date(mm/dd/yyyy) ❑✓ I wish to exercise my right of exemption or ❑ I wish NOT to exercise my right of exemption Signature Print Name&Title Date(mm/dd/yyyy) ❑ I wish to exercise my right of exemption or ❑ I wish NOT to exercise my right of exemption Signature Print Name&Title Date(mm/dd/yyyy) ❑ I wish to exercise my right of exemption or ❑ I wish NOT to exercise my right of exemption Signature Print Name&Title Date(mm/dd/yyyy) ❑ I wish to exercise my right of exemption or ❑ I wish NOT to exercise my right of exemption Note:ALL ELIGIBLE CORPORATE OFFICERS MUST SIGN. THERE CAN BE NO MORE THAN 4 SIGNATURES. Instructions on back. Form 153—7/2010 oFViE r Y� ti �• sexxsxear� * . ��,��' Townof Barnstable Regulatory Services Richard V. Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street; Hyannis,MA 02601 www.towu.b arnstable_ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Coinplete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behal� in all matters relative to work authorized by this building permit application for- q) (Addre of job) J S tare of Owner D to Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. OLP 0 F-0 TOW 005 BAQ)o 67AAYA-7 �am ts M P-:0 7ac-,57.) &,Ii��G w �lv. OFUIIA). 46th3 P �t QAWPFII.ES\F0RWJ.S\buiIding pcmh forms\EXFRESS.doc Revised 061313 V,4D av,(-Olel D4UI,0 V. AVTkaA ��is .Massachusetis-Departrnentof Pucaic Safety. -Board of BuildingRegu)Ans and'Standards Construction Superr•i,ni License: CS-0643Is STEPHEN B ELD?aDG I ; PO BOX 572/140 CEWARrST W BARNSTABLE 1"1022 J��fi�+ r7tl?if3t�Gz.�; Commissioner 041.0812016• . I Massachusetts Department of Environmental Protection 1 eDEP Transaction Copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: ELDSONS Transaction ID: 774514 Document: AQ 06 -Construction/Demolition Notification Size of File: 88.78K Status of Transaction: In Process Date and Time Created: 9/23/2015:10:53:49 AM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. C) -fin J 03 .. CD r �� m Massachusetts Department of Environmental Protection Bureau of Waste Prevention •Air Quality BWP AQ 06 s Notification Prior to Construction or Demolition r This is a revision to an existing form. Project ID for existing form to be revised: I r This job is being conducted under a Blanket Permit MassDEP assigned Blanket Authorization ID: r This job is being conducted under a Non Traditional Abatement Work Practice Permit. MassDEP assigned Non Traditional Work Practice Authorization ID: G None of the above conditions apply,generate a new form. Revised: 11/13/2013 Page I of Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Air Quality ' 100229031 BWP AQ 06 Notification Prior to Construction or Demolition Asbestos Project Number# A. Applicability A Construction or Demolition operation of an industrial, commercial, or institutional building, or residential building with 20 or more units is regulated by the Department of Environmental Protection (MassDEP), Bureau of Waste Prevention,Air Quality Division, under Regulations 310 CMR 7.09. Notification of Construction or Demolition operations is required under 310 CMR 7.09(2)ten(10)working days prior to any work being performed. The following information is required pursuant to 310 CMR 7.09. Is this a fee exempt notification(city, town, district, municipal housing authority, state facility, owneroccupied residential property of four units or less)? Is this a fee exempt notification(city,town,district,municipal housing authority,state facility,owner-occupied residential property of four units or less)? FI Yes No Type of Notification: r Revision of an Existing Form Cancellation of Project Instructions: 1.Blanket Permit Project Approval,if applicable: Approval ID# 1.All sections of this 2.Non-Traditional Asbestos Abatement Work Practice Approval,if applicable: form must be completed in order to Approval ID# comply with the B. General Project Description Department of p Environmental 1.Facility Information: Protection notification LESLIE DEVLIN 2455 MEETINGHOUSE WAY requirements of 310 CMR 7.09. Name of facility Street Address BARNSTABLE MA 026680000 6178163450 2.Submit Original CityfTown State Zip Code Telephone Form To: Commonwealth of WEST BARNSTABLE OWNER Massachusetts Facility Contact Person Contact Person Title P.O.Box 4062 LESWDEVLIN@GMIAL.COM Boston,MA 02211 Facility Contact Person Telephone Facility Contact Person Email Facility Size: 440 1 Square Feet Number of Floors Was the facility built prior to 1980? Yes r_J No Describe the current or prior use of the facility: RESTAURANT Is the facility a residential facility? El Yes F No If yes,how many units? 2.Facility Owner: LESLIE DEVLIN 2455 MEETINGHOUSE WAY Facility Owner Name Address WEST BARNSTABLE MA 026680000 6178163450 City/Town State Zip Code Telephone WEST BARNSTABLE 02668 On-Site Manager/Owner Representative Address LESLIE DEVLIN MA 02668 6178163450 Cityfrown State Zip Code Telephone Revised:03/17/2014 Page 1 o: --........ > Massachusetts Department of Environmental Protection r33ureau of Waste Prevention • Air Quality BWP AQ 06 1100229031 Notification Prior to Construction or Demolition Asbestos Project Number# B.General Project Description(continued) 3. General Contractor: STEPHEN ELDREDGE 140 CEDAR STREET Name Address WEST BARNSTABLE MA 026680000 5087372392 City/Town State Zip Code Telephone STEPHEN ELDREDGE 5087372392 General Contractor's On-site Manager/Foreman Telephone General C. General Construction or Demolition Description Statement:If asbestos is found 1.Construction or demolition contractor: during a Construction or Demolition STEPHENELDREDGE 140 CEDAR STREET operation,all Contractor Name Address responsible parties must comply with 310 WEST BARNSTABLE MA 026680000 5087372392 CMR 7.00,7.09,7.15, City/Town State Zip Code Telephone and Chapter 21 E of STEPHEN ELDREDGE 5077372392 the General Laws of the Commonwealth. Construction and Demolition On-site Manager Telephone This would include, but would not bw 2.Licensed Contractor Supervisor: limited to,filing an asbestos removal STEPHEN ELDREDGE CS-064359 notification with the Department and/or a Supervisor Name License Number notice of release/threat of 3.Is the entire facility to be demolished? E Yes F No release of a hazardous 4.Describe the area(s)to be demolished: substance to the Department,if INTERIOR EXISTING ...��� applicable. MassDEP Use Only 5.If this a construction project,describe the building(s)or addition(s)to be constructed: Date Received NOTAPPLICABLE 1 6. If this is a demolition or renovation project,were the structure(s)surveyed for the presence of Asbestos-Containing Material(ACM)? Yes r1 No 7. Was asbestos containing material(ACM)found? r Yes r No If a survey was conducted,who conducted the survey? AIR SAFE INC AC000464 Name Department of Labor Standards Certification Number I Revised:03/17/2014 Page 2 o: "MOW Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Air Quality BWP AQ 06 1100229031 Notification Prior to Construction or Demolition Asbestos Project Number# C.General Construction or Demolition Description(continued) The Asbestos Abatement Notification Number for this address is: This project rj Construction r Demolition is: 12/1/2015 3/31/2016 Project Start Date(MM/DD/YYYY) Project End Date(MM/DDNYYY) 8. For demolition and construction projects, indicate dust suppression techniques to be used Seeding r Wetting r Covering r) Paving Shrouding [7 Other-Specify: 9.For Emergency Demolition Operations,who is the MassDEP official who evaluated the emergency? Name of MassDEP Official Title Date of Authorization(MM/DD/YYYY) MassDEP Waiver Number D. Certification "I certify that I have personally STEPHENELDREDGE examined the foregoing and am Print Name familiar with the information r contained in this document and Authorized Signature all attachments and that, based CONSTRUCTION SUPERVISOR on my inquiry of those onfritle individuals immediately LESLIEDEV responsible for obtaining the LESLIEDEVLIN information, I believe that the Representing' information is true, accurate, and complete. I am aware that there Date(MM/DD/YYYY) are significant penalties for submitting false information, including possible fines and P.E.# imprisonment. The undersigned hereby states, under the penalties of perjury,that I am aware that this permit application or notification shall not be deemed valid unless payment of the applicable fee is made." Revised:03/17/2014 Page 3 o: I 2�1ah BROWN LINDQUIST FENUCCIO & RABER ARCHITECTS, IMC. November 13, 20.15 Mr. Robert McKechnie Building Inspector, Town of Barnstable, West Barnstable Village 200 Main Street Hyannis, MA 02601 Re: Alterations to Existing Mercantile Use Building at 2455 Meetinghouse Wy, West Barnstable-Old Village Store Mr. McKechnie, We have reviewed the documents for the renovation of the existing building at 2455 Meetinghouse Way (Old Village Store) in West Barnstable upon request from Stephen Eldredge on behalf of the Owners of the Old Village.Store. The documents were prepared by Stephen Eldredge and the scope of work is limited to the renovation of a rear portion of-the Old Village Store into a single residential unit. BLF& R Architects has provided Mr. Eldredge with a formal code review letter (refer to enclosure.). The following conclusions were made based upon our understanding of the 8th edition of the Mass State Building Code/IBC 2009 and its associated Massachusetts Amendments. The Massachusetts Amendments refers to the International Existing Building Code (IEBC 2009) for the renovation of Existing Buildings: The Old Village Store is currently a Mercantile-M Use. • The proposed renovation to the rear portion of the Building is considered a Change of Occupancy per IEBC. • The Change of Occupancy per IEBC to residential use requires the installation of a NFPA 13R sprinkler system. • The required installation of'the sprinkler system is limited to the "work area", only if the work area is separated from the remainder of the building byfire resistive construction per IBC requirements. The entire building is not required to.be sprinklered. • The building area does not exceed.the 7,500 gsf required by M.G.L. c. 148 § 26G. Therefore a sprinkler system is not required per M.G.L. c. 148 § 26G. • It is our understanding,that the Town of Barnstable has adopted M.G.L: C. 148 § 261. All three criteria applicable to the General Law; 203 WILLOW'STREET SUITE A PH 508-362-8382 YARMOUTHPORT MA 02675 FAX 508-362-2828 W W W.CAPEARCHITECTS.COM Occupied for residential use, and 2). 4 or more dwelling units,.and 3). Substantial rehabilitation to the building so as to constitute the equivalent of new construction, do not apply to the scope of this particular-project. The building is not being substantially rehabilitated, a small portion'of the building is being renovated for the new use of a single dwelling unit. Upon completion of the renovation the building will have a single residential unit. Therefore a sprinkler system is not required per M.G.L. c. 148 § 261. • Chapter 3 of the IEBC allows the Building.Official-to waive requirements of the Code for building with Changes in Occupancy if the proposed use is less hazardous than the existing use. The Proposed R-3 Residential Use is less hazardous than the Existing.Mercantile Use, as outlined in the attached Code Review Letter:. In conclusion,based on the criteria in the Building Codes, associated Massachusetts Amendments, and applicable State of MA General Laws a sprinkler system is only required in the area of the new residential unit. However, the Owner is requesting that the Building Official waive the requirement for a Sprinkler System in that area of the building. A code required 2-Hour Fire Rated Partition..will be installed between the R-3 Residential and M Mercantile Uses, a 2-Hour Rated Partition is allowable as a separation between the two use groups in a Non-Sprinklered`Building. Please feel free to contact our office with any additional questions. Maria Raber, Project Architect Cc: Mr.Tom Perry, Building'Commissioner Mr.Stephen Eldredge, Contractor Encl: Code Review Letterto Stephen Eldredge Diagram of required fire-rated construction locations. UL U334-Assembly Information M.G.L. c. 148§ 26G M.G.L. c. 148.§:261 203 WILLOW STREET SUITE A PH 508-362-8382 YARMOUTHPORT MA 02675 FAX 508-362-2828 W W W.CAPEARtHITECTS.COM i I Notes -- Windows to match existing 7/17/2015 USG Design Studio I UL U334-Fire Resistant Assembly,Fire Rated Assembly,Fire Rated Detail u DESIGN STUDIO of 1 s'I Iit it it it it It it I t I� 1J �,I11� �1 �1 � ��1d � rti d�.V� d6 � 1 � � r1d � r �r9J1 R is R2 c, R• Rc }a 9a as as {4 .a . as 4 as to nJ Rc �B�re�—+!=-��a��r' r '''r=�e�+=R Ewe �'� �' i" '• UL U334 Interior Partitions -Wood Stud (Loadbearing) Fire Rating 2 hour �- STC 58 Sound Test USG-810219 System Thickness 6-1/2" Detailed Description Quick Description Gypsum Board - Two layers of 5/8 in. gypsum board applied vertically or horizontally. • SHEETROCK Brand FIRECODE C Core Gypsum Panel - 5/8" Resilient Channel - 1/2 in. deep resilient furring channels, min 25 gauge corrosion- protected steel, spaced vertically a max of 24 in. OC Wood Studs - Nom. 2 by 4 in. wood studs spaced 16 in. OC max, effectively firestopped Batts and Blankets - 2 in. mineral wool batt insulation Gypsum Board -Two layers of 5/8 in. gypsum board applied vertically or horizontally. SHEETROCK Brand FIRECODE C Core Gypsum Panel - 5/8" For more information, visit U334 Gr httpJAA ww.usgdesignstudio.com/assembly.asp'id=920600&assemblyCategory=921052 1/1 Legend Parcels , t � A� - 9 rd• A, Y �.. 'T Boundary i 55 039• .� R n a(road Tracks � , J 4248�1 Buildings Approx.Building 52 wid0315 Painted Line . k ;.: .•: � Parking lots '`.^�.�`. '`�.: + ;, <•. ..` '�.,,.,ti �" _ 91 Paved 155022 ~ �� 1. �J'` J, 155026 Unpaved #2465 E f' i 43 #2452�,� Driveways 0 Paved R '�'sr`. :Unpaved 1 / a � +i � � Roads 1. k y: � �.:%'ri.' 0 Paved Road Unpaved Road ,,. ✓• _ , 'a r'y ? �.i°�,.<s. e +j t - Bridge i55035 - � .� '�'� i�+ � �'` �` ®Paved Median A 155050 Streams #2449 / , 1�55027. Marsh J< f #2463 x z 3r f. '� M Water Bodies a ` tit3 #2472 1r• . 3 k '. r #2455 iUN z d%� t f , #2464 ,i + x + \. f Yz ' a , X. Ijr.. i l� tax #2439 �. 155029 1550 4 } JG 15501BA01,. MOO r Map printed on: 9/28/2o18 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit' adequate for legal boundary determination or representations of Assessor's tax parcels.They are Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent .367Main Street,Hyannis,MA 026oi O 83 167 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 5o8-862-4624 reflect current conditions,and may contain such as building locations. Approx.Scale: i inch= 83 feet Q' cartographic errors or omissions. gis@town.barnstable.ma.us COMPLETE ■ Complete items 1.,2,and 3.Also complete. A.KSignatureitem 4 if Restricted Delivery is desired. �, ❑Agent a- P*�rt our name and address on the reverse X � � ❑Addressee Y so that we can return the card to you. Received by rinted Na g QN of Delivery ■ Attach this card to the back of the mailpiece, �� ` �� or or.4he front if space permits. D. Is delivery address di t fro m 12<' 1. Article Addressed to: * �" If YES,enter deliver ad ress;beli too N Sip�,vh e/o%o�s2_ G P� A0/x - 3. Service Type ❑Certified Mail® ❑Priority Mail Express- � ❑Registered , ❑Return Receipt for Merchandise ❑Insured Mail ❑Collect on Delivery 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number,1 1 11 , 7'O 1'412,Q 0. 0 0 1' 0358` (Transfer from sen4ce labeq , j PS Form 3811,July 2013. Domestic Return Receipt ri, First-Class Mail Postage&Fees Paid USPS Permit No.G-% • Sender: Please print your name,address, and ZIP+4®in this box* TMAIN OF BARNSTABLE ;l ^"C 1 ST0WN0F BAD VISI BN B BUILDING 200 MAIN ST 1NNIS, MA 02601 DIVISION I � l��t�llllrl�,l,�i�11111 1111itI1�"'111111"1�1'1'��1�"!1'11i'�1� � � 1 ■ Complete items 1;2,and 3.Also complete. A Signature item 4 if Restricted Delivery Is desired. 0. Print your name and address on the reverse ��; � O Agent so that we can return the card to you. I]Addressee ■ Attach this card to the back of the mailpiece, Received.by rioted N iQ� of Deliver) or on the front if space permits. 1. Article Addressed to: D. Is delivery address di fro m 101 SAP en E���e ` IT YES,enter deliye ad ress bel�i pc am Sev;ate ` \l eel 89920 % 3. Service Type. ❑Certified Mail® Q priority Mail Express- El Registered Return Receipt for Merchandise ❑Insured Mail ❑Collect on Delivery 4. Restricted Delivery?'(Extra Fee) p Yes 2. Article Number( 7 014 1200 0001 0358 5 6 4 7 Transfer from service labeQ i PS Form 3811,July 2013. Domestic Return Receipt t a sr i J i' i_ i ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application 4A Health'Division BUILDING DeP7; Date Issued I I Conservation Division Application Fee ' Planning Dept. MAR 102016 Permit Fee 6 tu CA Date Definitive Plan Approved by Planning Board TOWN OF BARNSTRiA E Ole R .i Historic - OKH _ Preservation / HyannisAIt�� D Project /S,tret Address Z� Village Owner Li /- —V � Address Telephone Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation"se� Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size . Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION - - (BUILDER OR HOMEOWNER) �I 4► r Name L� � ��"�l 7`` Telephone Number / 7 Address J01r License # Home Improvement Contractor# 10 Email �, 5/b(iAAZ: Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE i 4 s t. FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL N0. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION c FRAME INSULATION y FIREPLACE ELECTRICAL: ROUGH FINAL r. PLUMBING: ROUGH t FINAL { GAS: ROUGH FINAL T FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN`NO. The Commonfved&ofHassachmses Aepwament of1kdrrstr a-dAcddmtY - lzce a� skg�Yotrs ' 60fO Wasl i€tg;fojwStreet Boston MA a2 www.ma-mgmAd=- W-a.rkem,CctmperlsafwuInsma-3:aceAffidav&]Bml&rslC,�antraciorsfMectncmns/Plumbers Afwgamt aiian PteaseFrmt Name 93akix slOrga i vith�: S ��i� e:OillS% Ciylsiatl7sp_ Phane 5r0 Are you an earployer?Chet he appropriate bor: _ rype of project(re$au-eq: L ElI am a employer with 4�* t conixacEar and i & ❑Nesr ccmstn�iaa employees{ ili andlorpart-ime)* e&i eatb, 7�I am a sole prupnetar or partner- Itsfed a6 the afiached sheet 7- ❑Remodel g ship and have,no employees use sub-corthmciars have g- ❑Demolition worlang fof mein any capacity: employees and have workers' 9_ ❑BuArFmg additian [No W orke a comp:inrarrxnFe Comp_mmr ttnw rmireA-] 5_❑ We are a corporaficuand its 10-0 Electrical repairs crc additions 3_❑ I am a hemea%mer doing all work officers bwm eaerrised their 1 L-❑Plumbing repairs or additions myseM LNo worms'gyp_ right ofeszemption per MGL. 12 ]R-Dofrepairs i mn-ante�njred,I T c.154§1(4),and we hati*e no employees-[No wodoem 13-E]odmr cam-m=ance required-] sages thut checks box-;I n�rt slso fll a�tt secfiunbeIac�ch,��a H �o�Cea'conmens va go Hnmeawnes o submit this affid:af ind-rrs aley am damg iff vro&and dies hmE wide coa sadt tCbnt3Lch= maaditim sheetsbtrcriagtirEnsme Thesoh-comerActortandsmtevched*Cocnatthasg have employees IfthesmTa-contrashweempIayee%they=.stpwvidet;3rwarps'comp.policy mrmbes_ lam azz ernprioyer thatispmid&g warlrers'congMUYdivn inrctr=-ce for my emproyem HeiatF is thCPQUC}r du 11 j0b x&N irtfatYrtmliatt. Insurance CompanyName: A 1 PoEu#or sel€ins-Z.ic- "��� — 7�,E�� FxpLatins Date: D /� Job Sine Addfess: o��s'.�/d'1/`'����aI,�K� �. CifgfStafslTsp: �i�� Attach a copy of the:markers'cohapensat 4m poI'iep declaration page(sh vrhtg the:policy auurber•and cqxirztio-n date). Failure to secure•cove age as under Seck=SA o€AML c. 152 can lead to the imposition of criminal pmalfies of a fine up to$1,500:Oa anNar ow-yearimprisonment,as wen as tirrl penalties in the faffi of a STOP WORK ORDER and a fide ofup to$250-00 a day against the violator_ Be advised the a cry of this statement maybe forwarded to the Office of Itrrestigations of the DIA for insmmnce coverage verifica6an_ I&herebycarltfy:�. � " sartrr snafus of �formofiarnpratu&dabavecstrue¢ncfcvrrsct Simature- Date: Phone#- g � d•ffW&I use anf}. Da nat wri5s in this arerti ta.be campleW by city or tarn ofeiaL City or Town.: PerruitUcense i€ Fsvu Anthor4(circle oae)c L Baard of Health 2.BuWmg Department 3_Cityfrdwa Clerk 4.Eledrical Enspector S.Flumbmg k,xtor 6.Otherr Contact Person: Phone#_ 6 Information and Instructions Massachusetts aeneral Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pu mantto this statute;an employee is defined as"...every person in the service of mother under any contract ofhire, express or implied, oral or written" An employe-is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employcr,-or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority_" Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their cerc*ncate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)wzihno employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of industrial Accidents for confirmation ofinsurance 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 peamit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Of acials Please be sine that the affidavit is completes 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 tD fill in the permit/license number which will be used as a reference number. In addition,as applicant that must submit multiple pernrit/license applications in any given year,need only submif one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses A new affidavit must be filled out each year.Where a home owner or citizen is ob+a'_ning a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would lice to thank you in advance foryour cooperation and shouldyou have any questions, please do not hesitate to give us a call The Department's address,telephone and fax number- The CommnwWa of Massachuaats Depaztme�nt of industrial A.ccidems O.-Mce of lavestigatims ��F�ashingtoa�Stroe� . Roston.IAA 02111 Tel,A 617 727-4 at 4-06 or I 477-MASSAFE Revised 4-24-07 Fax#t: 617 727-7749 www go:vfdia r $Ag2ISZA331 yF s 9$ � ,. Town of Barnstable ''rEc n►a�'' . Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder ILslle- �e-1110 ,as Owner of the sub ,p J property hereby authorize_/� S ��� to act on my behalf, in all matters relative to work authorized by this building permit application for: (Addy s of Job) Signature of Owner ate Dvxz Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPF]LESIFORMS\building permit fnrmslEXPRESS.doc Revised 061313 Mass. Corporations, external master page Page 1 of 2 William Francis Galvin Secretary of Commonwealth ofMassachusetts Corporations Division Business Entity Summary ID Number: 001153957 Request certificate New search Summary for: OLD VILLAGE STORE OF WEST BARNSTABLE, LLC The exact name of the Domestic Limited Liability Company (LLC): OLD VILLAGE STORE OF WEST BARNSTABLE, LLC Entity type: Domestic Limited Liability Company (LLC) Identification Number: 001153957 Date of Organization in Massachusetts: 12-08-2014 Last date certain: The location or address where the records are maintained (A PO box is not a valid location or address): Address: 2455 MEETINGHOUSE WAY City or town, State, Zip code, WEST BARNSTABLE, MA 02668 USA Country: The name and address of the Resident Agent: Name: DANIEL J. DEVLIN Address: 24 LORETTA RD. City or town, State, Zip code, WALTHAM, MA 02451 USA Country: The name and business address of each Manager: I Title Individual name Address MANAGER DANIEL J. DEVLIN 2455 MEETINGHOUSE WAY WEST BARNSTABLE, MA 02668 USA MANAGER LESLIE W. DEVLIN 2455 MEETINGHOUSE WAY WEST BARNSTABLE, MA 02668 USA In addition to the manager(s), the name and business address of the person(s) authorized to execute documents to be filed with the Corporations Division: Title Individual name Address SOC SIGNATORY DANIEL J DEVLIN 2455 MEETINGHOUSE WAY WEST BARNSTABLE, MA 02668 USA SOC SIGNATORY LESLIE W. DEVLIN 2455 MEETINGHOUSE WAY WEST BARNSTABLE, MA 02668 USA http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEfN=001153957&... 3/10/2016 Mass. Corporations, external master page Page 2 of 2 The name and business address of the person(s) authorized to execute, acknowledge, deliver, and record any recordable instrument purporting to affect an interest in real property: Title Individual name Address REAL PROPERTY DANIEL J. DEVLIN 2455 MEETINGHOUSE WAY WEST BARNSTABLE, MA 02668 USA REAL PROPERTY LESLIE W. DEVLIN 2455 MEETINGHOUSE WAY WEST BARNSTABLE, MA 02668 ❑ ❑Confidential ❑Merger ❑ Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS Annual Report Annual Report - Professional Articles of Entity Conversion Certificate of Amendment y' View filings Comments or notes associated with this business entity: v r- New search http://corp.sec.state.ma.us/Corp Web/CorpSearch/CorpSummary.aspx?FEIN=001153957&... 3/10/2016 - i �/e -�arnr�tauuea�l� a�✓�aaaac`uraelta ' Office of Consumer Affairs&.B siness Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration:, gv11076 Type: i Office of Consumer Affairs and Business Regulation Expiration: -1412,6/,2016 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 C STOPHER A7HUTTO:N-_ a i CHRISTOPHER HUTTO'IJ; - i PO BOX 395/7 TITO? BREWSTER, MA 0263.�� �•-,__�� Undersecretary of valid without signature ®� Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-054813 - "- Construction Supervisor CHRISTOPHER A HUTTON PO BOX 395/7 . TITOS LANE BREWSTER MA 02631 ^"^ CA-- Expiration: Commissioner 11/20/2017 I .4 a HEATLOK *: - - . - Company Name 90 5 Phone Number f Applicator Name Installation Date ! �� �e 2rJ i Jobsite Address l A-Side Lot #'s Permit Number B-Side Lot #'s ApproximateLocation of Insulation Thickness Total R-Value Walls Attic CoatingInturnescent -. Location .- - ate www.Demilec.com law, DEMILEC N0. SIAM 9c Io 910 alsvismg �0 KAM H E AT LO K n DEMILEC TECHNICAL DATA Heatlok"'is a two component,closed cell,spray applied,rigid polyurethane foam system.This product uses recycled plastic materials,rapidly renewable soy oils,and the blowing agent has zero ozone depleting potential.Heatlok complies with the intent of the International Code Council's residential and commercial building codes and is commonly used as a thermal insulation,air barrier,vapor retarder and water resistive barrier in above grade,below grade,interior and exterior applications. ASTM D 1622 Density 2.1 Ib/ft' 33.6 kg/m3 ASTM C 518 Aged Thermal Resistance(R-value @ 1 inch) 7.4 ftzh°F/BTU 1.3 Kmz/W See ESR 3210,Table 1 for additional R-value information ASTM E 283 Air Leakage @ 75 Pa @ 1" < 0.02 L/sm' ASTM E 2178 Air Permeance @ 75 Pa @ 1" < 0.02 L/sm' Water Vapor Permeance @ 1.2" ASTM E 96 Qualifies as a Class II vapor barrier per IBC Section 202 < 1 perm < 57.2 ng/Pa•s•mZ ASTM D 1621 Compressive Strength 28.7 psi 198 kPa ASTM D 1623 Tensile Strength 46.2 psi 319 kPa ASTM D 2126 Dimensional Stability @ 158°F(70°C)97%R.H. (%volume change) (168 hrs,sample without any substrate)L/W/T -1.37/-0.42/+0.27 CA Spec 01350 VOC Emissions Standard Compliant ASTM C 1338 Fungi Resistance No fungal growth ASTM D 2856 Closed Cell Content -90% t. F. Surface Burning Characteristics,4"thick Class I ASTM E 84 Flame Spread Index 20 Smoke Developed 00 Ignition Barrier-Compliant with 2006,2009&2012 IBC and IRC,and ICC-ES AC-377 NFPA 286 Appendix X,for use in attics and crawl spaces without a prescriptive ignition barrier,thermal Pass barrier or intumescent coating. NFPA 286 Thermal Barrier-Compliant with the 2006,2009&2012 IBC and IRC,as an interior finish Pass without a 15 minute thermal barrier with Blazelok'"TBX at 11 mils dry film thickness. ASTM D 1929 Ignition Properties(spontaneous ignition temperature) 932°F(500°C) Polyols Containing Recycled and Renewable Content -40% Renewable Content 13.5% Pre-Consumer Recycled Content In Progress Post-Consumer Recycled Content In Progress Total Recycled Content In Progress Cream Time Gel Time Tack Free Time End of Rise 0-1 seconds 2-4 seconds 3-5 seconds 4-6 seconds 3315 E.Division Street,Arlington,TX 76011 Heatlok Technical Data Sheet Phone(817)640-4900,Toll Free(877)336-4532 Last Revision 5-5-15 Fax(817)633-2000.Info@Demilec.com,www.Demilec.com Page 1 of 2 Message Page 1 of 1 Mckechnie, Robert To: airnail@verizon.net Subject: 2455 Meetinghouse Way, WB Application Hi Steve, Just a heads up. I am working on this application but need to speak to Tom Perry about whether or not the property will require sprinkling. I will have an answer next week and will let you know. Thanks for your patience, Robert McKechnie Local Inspector Building Department Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4033 10/1/2015 Town of Barnstable Regulatory Services Richard V. Scali,Director • Building Division BARNSTABI,E s�errsTesi.E . . 10W 1639. ,��' Thomas Perry, CBO 1639.2014 Building Commissioner 575 200 Main Street, Hyannis, MA 02601 www.town.barnstable.maxs I Office: 508-862-4038 Fax: 508-790-6230 October 7, 2015 Stephen Eldredge Re: 2455 Meetinghouse Way 140 Cedar Street West Barnstable, MA 02668 P.O. Box 572 Map: 155 Parcel: 017 West Barnstable, MA 02668 Steve, This letter is in response to application number 201504434 for converting storage space into an apartment at the subject property. Unfortunately, the application is not approved at this time for the following reason: 1.) A conversion from storage to an apartment in an existing commercial structure triggers the installation of a fire sprinkling system in part or the whole building. This system would have to be designed by a Fire Sprinkler Engineer and reviewed and approved by the West Barnstable Fire Department. You can appeal this decision to the State Building Code Appeals Board per The Massachusetts State Building Code 780 CMR 113 or 780 CMR R112 and MGL c143. Please feel free to contact me if you have any questions. Respectfully, '00,0`! Robert McKechnie Local Inspector 508-862-4033 I i Page 1 of 1 Mckechnie, Robert i From: Maria raber[Maria@capearchitects.com] Sent: Friday, November 13, 2015 10:54 AM To: Mckechnie, Robert Cc: airnail@verizon.net Subject: 2455 Meetinghouse Way_Old Village Store Good Morning, We've completed the Code Review Letter for the Old Village Store Project. As we discussed on the phone,the area being renovated into a residence is a Change of Use,and does require a Sprinkler System. However, the Prescriptive Compliance Method allows the Building Official to waive code requirements in a building where there is a Change in Occupancy, and the new use is less hazardous than the existing. We have cited sections of the code indicating that the new use is less hazardous as part of the Code Review. We have requested on behalf of the Owner that the Sprinkler System requirement be waived based on the Code provision in Chapter 3 of the IEBC. I would be happy to meet with you on site if you would like to review. Please let me know if you have any questions, Thank you, Maria Raber Maria Raber Brown Lindquist Fenuccio& Raber Architects Inc. 203 Willow Street, Suite A, Yarmouthport, MA 02675 Tel: 508.362.8382 Fax: 508.362.2828 Cell:781.258.6940 maria(a)capearchitects.com www.capearchitects.com m on faceb9Q The information contained in this e-mail is confidential and privileged, intended for the sole use of the addressee. Unauthorized use, distribution, copying or disclosure of this information is prohibited. If you are not the addressee and have inadvertently received this communication, please contact the sender at(508) 362-8283. `j Please consider the environment before printing this e-mail 11/13/2015 7 Old Village Store 11/11/15 2455 Meetinghouse Way West Barnstable, MA I i i .9 tit l SAL .9l/fii�.9 --a .ZJIo-.41 � waaai �aau Q z Lu;� Y b o n X Q I' LU .ZJLb.4 New R-3 Residential Use I F (Single Residential Unit) ® o 10 pL.J q X .L-.b Continuous 2 Hr. Fire Rated Partition to extend — from crawl space below ground floor level to underside of roof deck in attic per IBC Section 707.5 - Refer to UL U334 Assembly attached. rn Existing M - Mercantile Use -to remain Mercantile Use S BXLJV.U334-Fire Resistance Ratings-ANSI/UL 263 77, U` ONLINE CERTIFICATIONS DIRECTORY Home Quick Guide Contact Us UL.com d Design No. U334 BXUV.U334 Fire Resistance Ratings -ANSI/UL 263 Page Bottom Design/System/Construction/Assembly Usage Disclaimer Authorities Having Jurisdiction should be consulted in all cases as to the particular requirements covering the installation and use of UL Certified products, equipment, system, devices, and materials. . Authorities Having Jurisdiction should be consulted before construction. Fire resistance assemblies and products are developed by the design submitter and have been investigated by UL for compliance with applicable requirements.The published information cannot always address every construction nuance encountered in the field. When field issues arise, it is recommended the first contact for assistance be the technical service staff provided by the product manufacturer noted for the design. Users of fire resistance assemblies are advised to consult the general Guide Information for each product category and each group of assemblies.The Guide Information includes specifics concerning alternate materials and alternate methods of construction. . Only products which bear UL's Mark are considered Certified. BXUV - Fire Resistance Ratings-ANSI/UL 263 BXUV7 - Fire Resistance Ratings- CAN/ULC-51O1 Certified for Canada See General Information for Fire-resistance Ratings -ANSI/UL 263 See General Information for Fire Resistance Ratings - CAN/ULC-5101 Certified for Canaria Design No. U334 August 28, 2015 Bearing Wall Rating — 2 HR. STC Rating-62 (See Item 7) This design was evaluated using a load design method other than the Limit States Design Method (e.g.,Working Stress Design Method). For jurisdictions employing the Limit States Design Method, such as Canada,a load restriction factor shall be used —See Guide BXUV or BXUV7 * Indicates such products shall bear the UL or cUL Certification Mark for jurisdictions employing the UL or cUL Certification (such as Canada), respectively. VATf111tllCtdSOfitlYtNli1M . ....LY L�n'.®yJiw�ei...<..••_mt.'.'y- ..:Cr• r./'.� ' _ -•Frr. .r% �� ..-ate, - - _ .w .i.� -•w.,.... .�+1-. —./�. ^rim. e ' 1. Wood Studs— Nom 2 by 4 in., spaced 16 in. OC. Studs cross braced at mid-height and effectively fire stopped at top and bottom of wall. Ll http://database.ul.com/...SUUL+263&objid=1074330327&cfgid=1073741824&version=versionless&parent_id=1073984818&sequence=l[11/12/2015 12:54:57 PM] BXfJV.U334-Fire Resistance Ratings-ANSI/UL 263 2. Resilient Channel — 25 MSG gals steel, nom 2-1/2 in. wide by 1/2 in. deep. Resilient channels placed perpendicular to studs, spaced vertically max 24 in. OC, flange portion attached to each intersecting stud with 1 in. long Type S steel screws. 2A. Steel Framing Members(Optional, Not Shown)* —As an alternate to Item 2,furring channels and resilient sound isolation clip as described below: a. Furring Channels— Formed of No. 25 MSG gals steel. 2-9/16 in. or 2-23/32 in. wide by 7/8 in. deep, spaced 24 in. OC perpendicular to studs. Channels secured to studs as described in Item b. Ends of adjoining channels are overlapped 6 in. and tied together with double strand of No. 18 SWG galv steel wire near each end of overlap. As an alternate, ends of adjoining channels may be overlapped 6 in. and secured together with two self- tapping #6 framing screws, min. 7/16 in. long at the midpoint of the overlap, with one screw on each flange of the channel. i b. Steel Framing Members* — Resilient sound isolation clip used to attach furring channels (Item a)to studs (Item 1). Clips spaced 48 in. OC:, and secured to studs with No. 8 x 2-1/2 in. coarse drywall screw through the center grommet. Furring channels are friction fitted into clips. RSIC-1 clip for use with 2-9/16 in. wide furring channels. RSIC-1 (2.75) clip for use with 2-23/32 in. wide furring channels. PAC INTERNATIONAL L L C —Types RSIC-1, RSIC-1 (2.75). i 2B. Steel Framing Members* — (Optional, Not Shown) - Furring channels and Steel Framing Members as described below: a. Furring Channels— Formed of No. 25 MSG galv steel. 2-3/8 in. wide by 7/8 in. deep, spaced 24 in. OC perpendicular to studs. Channels secured to studs as described in Item b. Ends of adjoining channels are overlapped 6 in. and tied together with double strand of No. 18 SWG galv steel wire near each end of overlap. As an alternate, ends of adjoining channels may be overlapped 6 in. and secured together with two self-tapping #6 framing screws, min. 7/16 in. long at the midpoint of the overlap, with one screw on each flange of the channel. Gypsum board attached to furring channels as described in Item 3. b. Steel Framing Members* — Used to attach furring channels (Item 5Aa)to studs. Clips spaced 48 in. OC. Genie clips secured to studs with No. 8 x 1-1/2 in. coarse drywall screw through the center hole. Furring channels are friction fitted into clips. PLITEQ INC—Type Genie Clip s� 2C. Steel Framing Members— (Optional, Not Shown)* — Furring channels and resilient sound isolation clip as ; described below: a. Furring Channels— Formed of No. 25 MSG galv steel. Spaced 24 in. OC perpendicular to studs. Channels secured to studs as described in Item b. Ends of adjoining channels overlapped 6 in. and secured together with four self-tapping No. 8x1/2 Self Drilling screws (2 per side 1 in. and 4 in. from overlap edge). Gypsum board attached to furring channels s as described in Item 3. Side joint furring channels shall be attached to studs with RESILMOUNT Sound Isolation Clips -Type A237R located approximately 2 in. from each end of length of channel. Both Gypsum Boards at side joints fastened into channel with screws spaced 8 in. OC,approximately 1/2 in. from joint edge. b. Steel Framing Members* — Resilient sound isolation clip used to attach furring channels (Item 2Ca)to studs. Clips spaced 16 in. OC., and secured to studs with No. 10 x 2-1/2 in. coarse drywall screw through the center hole. Furring channels are friction fitted into clips. STUDCO BUILDING SYSTEMS— RESILMOUNT Sound Isolation Clips -Type A237R 3. Gypsum Board* — 5/8 in. thick,4 ft wide. Attached to furring channels: base layer with 1 in. long Type S steel screws spaced max 24 in. OC,face layer with 1-5/8 in. long Type S steel screws spaced max 12 in. OC. Attached to wood studs: base layer with 1-7/8 in. long 6d coated nails spaced max 14 in. OC, face layer with 2- 3/8 in. long 8d coated nails spaced max 7 in. OC. Base layers installed vertically. Face layers installed s horizontally with butt joints offset 16 in. from base layers. r: iAMERICAN GYPSUM CO —Types AG-C t_ CERTAINTEED GYPSUM INC—Type C. http://database.ul.com/...SI/UL+263&objid=1074330327&cfgid=1073741824&version=versionless&parent_id=1073984818&sequence=l[11/12/2015 12:54:57 PM] BXUV.U334-Fin;Resistance Ratings-ANSI/UL 263 CGC INC—Types C, IP-X2, IPC-AR. CONTINENTAL BUILDING PRODUCTS OPERATING CO, L L C—Type LGFC-C/A. GEORGIA-PACIFIC GYPSUM L L C—Types 5, DAPC,TG-C. i NATIONAL GYPSUM CO—Types eXP-C, FSK-C, FSW-C, FSW-G. L i PABCO BUILDING PRODUCTS L L C, DBA PABCO GYPSUM —Type C or PG-C. PANEL REY S A—Type PRC THAI GYPSUM PRODUCTS PCL—Type C. UNITED STATES GYPSUM CO —Types C, IP-X2, IPC-AR. ' r, USG BORAL ZAWAWI DRYWALL L L C SFZ —Type C USG MEXICO S A DE C V—Types C, IP-X2, IPC-AR. 4. Batts and Blankets* — Nom 2 in. thick mineral wool insulation, 96 in. long, cut to 15 in. widths, friction fitted between studs in wall cavity. ROXUL INC —Type AFB THERMAFIBER INC —Type SAFE. s 4A.. Batts and Blankets* — Glass fiber insulation.The cavities formed by the studs friction fit with R-19 ' ` unfaced fiberglass insulation batts measuring 6-1/4 in. thick and 15-1/4 in. wide. See Batts and Blankets* (BZJZ) category for names of Classified Companies. 5. Joint Tape and Compound —Vinyl,dry or premixed joint compound, applied to joints, screw heads, and nail heads(two applications); paper tape embedded in first layer of compound over all joints. 6. Caulking and Sealants— (not shown, optional)A bead of acoustical sealant applied around the partition perimeter for sound control 7. STC Rating —The STC Rating of the wall assembly is 62 when it is constructed as described by Items 1 through 5, except: a. Item 2A, above— Steel Framing Members* Shall be used to attach wallboard to studs on either the acoustical source or receiving side of the wall assembly. b. Item 4a above— Batts and Blankets* As described above, fiberglass insulation shall be used. c. Item 6,above—Caulking and Sealants (not shown)A bead of acoustical sealant shall be applied around the partition perimeter for sound control. 8. Wall and Partition Facings and Accessories* — (Optional, Not shown) — Nominal 1/2 in. thick,4 ft wide panels,for optional use as an additional layer on one or both sides of the assembly. Panels attached in accordance with manufacturer's recommendations. When the QR-500 or QR-510 panel is installed between the wood framing and the UL Classified gypsum board,the required UL Classified gypsum board layer(s) is/are to be installed as indicated as to fastener type and spacing, except that the required fastener length shall be http://database.ul.com/...SLUL+263&objid=1074330327&cfgid=1073741824&version=versionless&parent_id=1073984818&sequence=l[ll/12/2015 12:54:57 PM] BXUV.U334-Fire Resistance Ratings-ANSVUL 263 increased by a minimum of 1/2 in. Not evaluated or intended as a substitute for the required layer(s)of UL Classified Gypsum Board. PASCO BUILDING PRODUCTS L L C,DB'A PASCO GYPSUM —Type QuietRock QR-500 and QR-510 i *Indicates such products shall bear the UL or cUL Certification Mark for jurisdictions employing the UL or cUL Certification (such as Canada), respectively. Last Updated on 2015-08-28 i Questions? Print this oaoe Terms of Use Page Too ©2015 UL LLC The appearance of a company's name or product in this database does not in itself assure that products so identified have been manufactured under UL's Follow-Up Service. Only those products bearing the UL Mark should be considered to be Certified and covered under UL's Follow-Up Service. Always look for the Mark on the product. UL permits the reproduction of the material contained in the Online Certification Directory subject to the following conditions: 1.The Guide Information,Assemblies, Constructions, Designs, Systems, and/or Certifications (files) must be presented in their entirety and in a non-misleading manner, without any manipulation of the data (or drawings). 2.The statement"Reprinted from the Online Certifications Directory with permission from UL" must appear adjacent to the extracted material. In addition,the reprinted material must include a copyright notice in the following format: "© 2015 UL LLC". 4 t I is i y. http://database.ul.com/...SLIUL+263&objid=1074330327&cfgid=1073741824&version ersionless&parent_id=1073984818&sequence=l[11/12/2015 12:54:57 PM] i I • 11'-9 1/16" o ATH 6'-1 "x 11'- n a >b a� BEDROOMR �R d�R X Fire Wall m (see attached) KITCHEN i- 10'-4"x T-4" 2-hour Existing fire rated steel door -v soee � b _ N 10,-T' LIVING 20'-1"x 13'-T, 4 Proposed 20'-T UP r.° Deli area \ Existing storage area 8 Existing framing is 2x4 a 2WVHLI, 9pyp DECK -U P Deli area Existing z storage area Existing Existing framing is 2x4 DECK u i Notes . T -- Windows to match existing 7/17/2015 USG Design Studio i UL U334-Fire Resistant Assembly,Fire Rated Assembly,Fire Rated Detail u� �0- DESIG1 SMD10 Home > System Selector > UL U334 Fire Rated System Design - UL U334 1/2�� imnnnnn 1 1n1 !! r4 r• ,v v. .s .. .r .r ry av r. +e .. sY no ry .v r.} IIIIIII1IIIIIAIII111 11011111111111.11J1' G t. 3 G i t .. .. 1- . .. .. .. Y• :. t. .. ..r 1 i i it it it it it it I — It UL U334 Interior Partitions - Wood Stud (Loadbearing) Fire Rating STC/Sound Test System Thickness 2 hour 58 dB 6-1 /2" : Sound Test: USG- ; 810219 Detail Description - Gypsum Board -Two layers of 5/8 in. gypsum board applied vertically or horizontally. - SHEETROCK Brand FIRECODE C Core Gypsum Panel - 5/8" ' - Resilient Channel - 1/2 in. deep resilient furring channels, min 25 gauge corrosion- protected steel, spaced vertically a max of 24 in. OC - Wood Studs - Nom. 2 by 4 in. wood studs spaced 16 in. OC max, effectively firestopped - Batts and Blankets- 2 in. mineral wool batt insulation - Gypsum Board - Two layers of 5/8 in. gypsum board applied vertically or horizontally. - SHEETROCK Brand FIRECODE C Core Gypsum Panel - 5/8" United States Gypsum Company : 550 W. Adams, Chicago, IL. 60661 :www.usgdesignstudio.com Reference URL: http://www.usgdesignstudio.com/assembly.asp? id=920600&assemblyCategory=921052 httpJN,rww.usgdesigrr.tudio.com/print-assembly.asp?id=9206008assemblyCategory=921052 1/1 Town of Barnstable RARYSTARLE. • Regulatory Services , MASS g t6}9. �e Building Division p�EO MPy� 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax:. 508-790-6230 �„�,� I Inspection Correction Notice Type of Inspection � 'vl Location a�S.S *C�71A16/6229 (44 Permit Number Owner l) Builder One notice to remain on job site,one notice on file in Building Department. The following items need correcting: GT6 14 p I s © �-t To O Please call: 508-862-4-@&8=FmYre on. Inspected by C Date J" r �? -Commaawealth of Massachusetts Sheet Metal Permit M Parcel Q 1- ap / Date: ? ` 1 � Permit# CO— 7 s S . Estimated Job Cost:.$ 2016 Permit_F=S p` Plans Submitted: YES .No Rlus iievtewed: YES NO Business License .-3 �7 Applicant License# �Ati 3 Business Information: ) Property Owner/.Job..Location.Iniform.idon:. p Name: V' c��.�Li �, t 2 L�'A7 Name: O L me.—,( r VL�oQe (21 C'V-1l AcJR Street: �—.Z l�� (�,/I . . ._ _I . Cit)/Toovn wiC City�I'ov�ti: U J�57 � Telephone: - = 4 u L6 Telephone: Photo I.D.required/Copy of Photo.I.D. attached: YES NO 0 srar initial i J 1/M-1-unrestricted.license ' dwelliu s.3-stories or less and commercial up-to to 104,000 sq.. fl /.2-stories or less .J-2/M-2-restncted to g i Coesidential-.1-2 family Multi-family Condo/Townhouses Othermmercial: Offi_cee Retail Industrial Educational i _ Fire.I?ept_Appro_v_al iz 0 6 Institutional_ Other v Square Footage:'under 10,000-sq. ft. over 10,000 sq.ft. Number of Stories: Sheet metal workto be completed:- New Work: Renovation: 6� t / HV- AC V Metal Watershed Roofing. Kitchen Exhaust System Metal-Chimney/Vents Air-Balancing Provide detailed description of work to be done: .INSURANCE COVERAGE: 1 have a current Ilabilitv.insurance popFy or its.equivalent which meets the requirements of M.G:L Ch.112 Yes&.114o ❑ If you have checked yam,:indicate the -of coverage:by checking the appropriate box.below: - A liability insurance plficy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:-']am:aware that the licensee does.-not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my-'signature on'this-permk appllcatlon'. -this requirement. I Check One Only I -Owner. ❑ Agent ❑ ' • 1 Signature of Owner or•Owner-s Agent t By checking this.box❑,I hereby certify that all of the details and infonnationd have submitted('or entered)regarding this application are true.and accurate to the best of:my knowledge and'.thafall sheet metal work and lnstaliations.performed'undeF the pe It issued,for-this.applicatdn will be In compliance with all pertinent provisibri of the Massachusetts Building Code and Chapter 112 of the Gene Laws. Duct Inspection requiered prior to-insulatiori installation:YES NO Progress.Inspections .I . Date Comments • � . F�nalIns�,ection Data Comments Type of-License: 3y ❑ Master ride ❑Master-Restricted 3ity/Town ❑Joumeypelsotr. Signature of Licensee .❑Joumeyperson-Restricted Ucense.Nurritier %e ❑ QhEeck at www.mass.d0_yldal nspector signature of Permit Approval i The Ct7Mlz OnYMMI a afmassachusrl �e�hx�t��'�`ardustrst��Ecid'exrts E Wwa ofLMMt4 iens 600 Wmkington meet Aastrxt%,MA 02M "-Fv.rma=goP1dia Warkersa Carapensatiam.Insurance Affidavit:E.uiTdersfcontra:cturs/EtectricianslPlvm'lers rrI%rtlII## frtn PleaseFrinf I.e�ihlhi Na=tsudnatsrcirmim a�_ Address d—�'l �'JZe�ele�C�� �D�1 J c-i �ll� cityfsta : Cxg,1okc-(q Phom Are you employer?Check the appropriate ba= Type of gr• ject(rega reds- L am a employer With 4- ❑I sixes goal contractor and I 6- ❑Neat constcisction. employees{full andlorpart-time)* have bired-the sub-r s ,�,,,/ 1❑ I am a sole proprietor ar partner- listed on the attached sheet 7 � ship.and haste no employees Them sub-contractors have g_ ❑Demolifion -forking for me is-my capacity enaplayees and have workers' 9- ❑Building addition [Nu worIcecs' comp.n,�T,�*,�a comp.insu,a,�1 1 5-❑ re We a a coeporaticnandifr 10-0�lethical repairs cr additions 3_❑ I T-r homeovs�er doing all vvarlt offirzrs have e=cised their IL❑Plumbing repairs or additions. myself. [No Racks'Damp- of es-empfion ger b�fGI. 12-❑Roof repaics, re�;rea l l c-154 §1(4),and we hum no � emplayees-[IslawoTk=, 13-El Other V. . comp_MSMW=r5qIIIred'] "tinymF tb=tchecks box W1mast also fall out the sectiaabelVffdUTW %dUdramiss'camprmMfiWpobcgiafrarnfiue_ �Snmffiwnas aim subffit this a$idrnit i trey 8Le r1aRlg S1I�TaL3C sad tbea lore DEC cOQTIBC[DLS mnS�SRbO}I[s CSC A�1d.8L'ZL m�a�surFi �trnl�cma thst check this bax must stlacbed ax a�di6ansI s�shascin�tL'e nee of�e spoors mdstste uhrltie[GCAai Mesa 5sve empivyeas Ifvasub-contmctwsharemmpIoyee-%thegm aprovidetheirwn&-e&comp.palCYnumber- lam arz employer thrd'is pm4dbxg workers'concgmns t&n inaurrutce for my eMPinyeea BeTvty is fhepalic}'rrndlob�il>; irribrrr�mtian. ,( Tnsviance CompauylFame: ��CCJV'cJ� PoEry#or Seff-ias-Lim# 4o(�S A 1 ( �(� C7 cJ Fxpisatinn.Date: Job SiteAAd=;1C- �YVlee : S ►sue UZ Cibrst WT.P: v c A-Rach a copy of the workers'corapencatian policy declaration page(showing thepaficy i€amher•and ccpnr-lion date). Failure to secme•cavi?rage as repiredunder Sectiora SA of MGL r- 152 can lead to the imposition of criminal pcmiIties of a fine up to$1,50D_00 and/or one-yearimpri as well as civil penalfies m fe form of a STOP WORK ORDMand a fins ofup to,$250.00 a dry against the violator- Be advised that a copy of this stet maybe forwarded to the Office of InverEi tions of the DIA for inetrxn_ce coverage vmr r=ion_ I dii hereby cads;fp urrd�r tics ©andponnafttas n!'per� $�a uc fnrx:•triiaa prauidRd r�hvve Es hu`e anr!correct , 5�atare- 1%•'.�����ti %�"l� )_'hone 9- ©gEci4d use only, Do nat write in t[ s area,to be campfe#ed by city ar town afficia cL City or Town: # ]suing Authority(circle oae)c . L Baard of Health 2.Biding M-par[ment 3;MpTi awn Clerk 4.Electrical Inspector 5.P-i-ombing Inspe'aar .6.Other Conbtct Person: Phone#: 6 ]Information an.d Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant•to this statute, an employee is defined as".._every person in the service of mother under any contract of hire, express or implied, oral or written_" An anproyer is deleted as"m individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,-or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states th2t"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 arty applicant who has not produced acceptable evidence of compliance with the insurance-coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insura„m, requirements of this chapter have been presented to the contracting authority-" Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone numbers)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance- If an LLC or LLP does have employees, a policy i required.. Be advised that this affidavit 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 required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and priated 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 Permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple pernit(license applitations in any given year,need only submif one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof.that.a valid affidavit is on file fnr future permits or licenses. A new affidavit must be frilled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial veutu re (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavZt The Office.of Tnvestigations would like to thank you in advance for your cooperation and shouldyou have any questions, please do not hesitate to give us a call The Department's address,telephone and fax number. The COMM—QnN Tth of M ssachimu ,tls Depaztmmt of Iadustaaj AGcjdee s Office of Zawstigat om 600 WaAmatou Stye $ostoli,IAA G211 I Tel,A 617 727-49-00 Qxt 4-06 or I-9 MASSAFE Revised 4-24-07 Fax#617-727-7-749 wwwaaa..ss govIdz'a iSIRE. Town of Barnstable l .11IMarA 3M s Regulatory Services n A Thomas F.Geaer,Director �1639� ` ill Building Division Tom Perry,Building:Commissioner 200-lain Street Hymun s,MA 02601. .www.towmbarnstable:ma.us Office: 508-862-4038 Fax: 5.08-790-6230 Property Owner Must Complete and.Sign This Section If Using A Builder I, �S21,z� ,as Owner of the subjectpropetty herebg authorize � je �� to-act.on ray beh4 in.all matters..relative.to work authorized by this building:pemiif -(Add6s of job) *,*Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized. til all final'inspections are performed and accepted. Signature of Owner Signature-of Applicant L_pLld, ���% - tzgwff L-YY1 Print Name Print Name o� Da Q:FORMS:OWNERPERMSSIONPOOL9 A4CC>R00® CERTIFICATE OF LIABILITY INSURANCE 2/17/220 6 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS-NO Ril~►�UQ0b1 TIDE•iCERT!EICAV-.WO.L,9ER_.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. h IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WANED,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 endorsement(s). CONTACT PRODUCER NAME: USI INSURANCE SERVICES LLC PHONE (877)463-2723 F �:866 828 2424 {A/C flQ 12 GILL STREET,STE.5500 ADDRESS: Certificate@hanOVer.Com WOBURN,MA 01801 INS S AFFORDING COVERAGE i NAIC N INSURER A: AQmenca Financial Benefit i 41840 INSURED INSURER B: Citizens Ins Co Of America 31534 FRANK W.KELLEY INSURER C: DBA FRANK KELLY PLUMBING INSURER O: 24 FREDERICKSBURG AVE INSURER E: !! HARWICH MA 02645 INSURER F: I COVERAGES CERTIFICATE NUMBER: 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 SUEhh.POLdCIESbJlMLSt"..O'M M,AY HAS QiGN REDUCED BNa.9AID CLAIMS. INSR ADOL4SU3R1 (( POLICY EFF tt POLICY EXP LTR TYPE OF INSURANCE ! POLICY NUMBER ! MMMU i M?AMD LIMITS GENERAL LIABILITY I I i I EACH OCCURRENCE S 1 I f DAMAGE -N _ f COMMERCIAL GENERAL LIABILITY r��I PREMISES(Eaawmence S ;� 1 } 1 CLAIMS-MADE :J OCCUR { MEDEXP(Any one Person) S ! i i! I PERSONAL SADVINJURY S ! j i GENERAL AGGREGATE S GEN AGGREGATE LIMIT APPLIES PER: 1 I ` PRODUCTS-COMP/OP AGG S L i POLICY E1 PRO-JFrTI LOC I I I S AUTOMOBILE LIABILITY F!F-j ( I Ea accidDnSWGLEUMl7 S ANY AUTO 1 ' i BODILY INJURY(Per Person) S 1,000,000 i 11/1512015 11/15/2016 YI AIx ALL OWNED X SCHEDULED I AWN 9794655 04 BOl)IL NJURY{P attident) $ 1.000,000. AU$09 - NOALF OS�--ED n l 1 1 PROPERTY DAMAGE S HIRED Auros i X NONawNEo I I Per accident) 1.000.000 AUTOS 1 i S UMBRELLA LIAB f OCCUR i EACH OCCURRENCE S EXCESS UAB I CLAIMS-MADE i AGGREGATE S DED RETENTIONS I I is WORKERS COMPENSATION I i V C STTORY 'TU-AITS OTH-I AND EMPLOYERS LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE YIN ❑ NIA WBS A791a8700 .11D.112016.-1 Q1/01/2017 E.L.EACH ACCIDENT5�0,000 OFFICERAEMBER EXCLUDED? 1! 1 (Mandatory in NH) 1 E.L DISEASE-EA EMPLOY_ S 500,000 If yes,describe under I i ! E.L.DISEASE-POLICY UMIT I s 500,000 {IF-1 ` f I DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION Town Of Bamstable 367 Main St SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Hyannis,MA 02601 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 1 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 0..� ONWtXb... .. ICI illipi USETI:.g ' • • - • BOAIRD OF SHEET. METAL `wQRKER ISSUES THE FOLLOWft:GfCENSE ::.. <<> ; AS A MASTER UNREST ::<f:,R;AfftlN. W KELI.EY l aj `Y 24 FREOEIYfCKSBURG k(AR.W{CH "'A"A 02645 2134 , 736.3 02 8 39291 i Home Energy Raters LLc info @EnergyCodeHe/p.com 888-503- 2233 i Duct Leakage Test Address- 2445 Meetinghouse Rd W. Barnstable, MA Date — March 2, 2016 ; Contractor— Frank Kelly Conditioned floor area = 620 Sq Ft. Total Leakage-Includes Air Handler/Furnace To comply with the 2012 IECC Energy Code in this home the Maximum duct leakage CFM < 24 CFM (620/100 x4 = 24.8) Duct leakage tested = 23 CFM The duct leakage tested at this residence complies with the 2OtVECC Code Test Mode - Pressurization Test Pressure = - 25.0 Pascals Equipment - Series B Minneapolis Duct Blaster Duct Leakage as Percentage of Floor area = 3.70 % Contact our office with any questions, i Sean Davis Home Energy Raters LLC } t Parcel Detail Page 1 of 3 SARNSTAW-L krA� y$o 1639. tail • _ -. - `�-..�•fib'�{'ems:' Logged In As: Parcel De lC7I I Friday,October 16 2015 Parcel Lookup Parcel Info Parcel ID 155-017 ( Developer Lot Location 12455 MEETINGHOUSE WAY/RTE 149 I Pri Frontage Sec Road ( Sec Frontage Village IWEST BARNSTABLE I Fire District I W BARNSTABLE Town sewer exists at this address I No I Road Index 1013 Asbuilt Septic Scan: Interactive , �t 155017_1 Maps . Owner Info Owner IBARNSTABLE,TOWN OF (LOMB) I Co-owner J%BARNSTABLE,TOWN OF(LOMB) Streets C/O OLD VILLAGE STORE W BARN I Street2 2455 MEETINGHOUSE WAY City IWEST BARNSTABLE I State rM—A1 Zip rO-26681 Country I —� Land Info Acres 10.30 I use STORE-MSRY FRM zoning[W—BVBD I Nghbd C105 Topography Level I Road Paved Utilities I Location I • Construction Info Building 1 of 1 Year 1881 I Root Gable/Hip I Wood Shingle Built Struct Wall all Living 3319 —I Roof Asph/F GIs/Cmp I Type AC Area Cover Central t BAS 2 25 1 ' Style Store I wall nt Wall Brd/WOOd I Rooms Bed 00 _ 31 Model Commercial I Flo Pine/Soft WooInt d I Rooms Bath 0 Full-0 Half I 7 Grade Average �I Heat Hot Air I Total _I SAS Type Rooms Stories I I Heat Gas Found Stone Ftgs Fuel ation 6 ' 9B 7. Gross 3839 —I . III MO' Area Permit History http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=10373 10/16/2015 Parcel Detail Page 2 of 3 Issue Date Purpose Permit# Amount Insp Date Comments 9/4/2003 New Roof 71308 $6,000 8/18/2004 12:00:00 AM 5/1/1995 Repair Work B37754 $900 1/15/1996 12:00:00 AM WB REPAIR Visit History Date Who Purpose 11/17/2014 12:00:00 AM Jeff Rudziak In Office Review 5/18/2006 12:00:00 AM Jeff Rudziak Mea+Corrected Listing 8/18/2004 12:00:00 AM Paul Talbot Bldg Permit Completed Sales History Line Sale Date Owner Book/Page Sale Price 1 4/24/2008 BARNSTABLE,TOWN OF(LOMB) 22857/158 $225,000 2 3/15/1993 SOLES, SHARON E TR 8466/148 $1 3 10/15/1989 ROGERS, ELIZABETH P 6921/260 $210,000 4 3/9/1972 TROCCHI, JOHN&MARTHA 1614/205 $1 5 3/11/2015 BARNSTABLE,TOWN OF(LOMB) 28732/42 1 $350,000 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2015 $217,300 $4,200 $3,600 $123,800 $348,900 2 2014 $221,200 $0 $3,900 $123,800 $348,900 3 2013 $221,000 $0 $4,100 $123,800 $348,900 4 2012 $190,100 $0 $3,200 $123,800 $317,100 5 2011 $193,300 $0 $0 $123,800 $317,100 6 2010 $214,000 $0 $0 $123,800 $337,800 7 2009 $196,900 $0 $0 $112,600 $309,500 8 2008 $196,900 $0 $0 $112,600 $309,500 10 2007 $303,100 $0 $0 $112,600 $415,700 11 2006 $262,000 $0 $0 $112,600 $374,600 12 2005 $238,600 $0 $0 $87,100 $325,700 13 2004 $222,700 $0 $0 $87,100 $309,800 14 2003 $115,200 $0 $0 $81,700 $196,900 15 2002 $115,200 $0 $0 $81,700 $196,900 16 2001 $115,200 $0 $0 $81,700 $196,900 17 2000 $111,500 $0 $0 $79,400 $190,900 18 1999 $111,500 $0 $0 $79,400 $190,900 19 1998 $111,500 $0 $0 $79,400 $190,900 20 1997 $121,700 $0 $0 $0 $121,700 21 1996 $121,700 $0 $0 $0 $121,700 22 1995 $121,700 $0 $0 $0 $121,700 23 1994 $110,100 $0 $0 $0 $110,100 24 1993 $110,100 $0 $0 $0 $110,100 25 1992 $122,400 $0 $0 $0 $122,400 26 1991 $169,900 $0 $0 $0 $169,900 27 1990 $169,900 $0 $0 $0 $169,900 28 1989 $169,900 $0 $0 $0 $169,900 29 1988 $146,700 $0 $0 $0 $146,700 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=10373 10/16/2015 .•171, . i 11+ :�•,.- t �.. �,• � ; �(xrM A fR7f `na. t I nil ,-,U.M, 14 r � t ■ f .. - � ,}tea s }: f �- •rs �� i i Town of Barnstable �FTHE ht Regulatory Services Richard V. Scali,Director AAAA Building Division BARNSTABI,E .unors uus•os'[imui•rmutw^cwF ��� Thomas Perry, CBO � Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstabIe.ma.us Office: 508-862-4038 Fax: 508-790-6230 October 7, 2015 Stephen Eldredge Re: 2455 Meetinghouse Way, 140 Cedar Street West Barnstable, MA 02668i P.O. Box 572 Map: 155 Parcel: 017 West Barnstable, MA 02668 Steve, This letter is in response to application number 201504434 for converting storage space into an apartment at the subject property. Unfortunately, the application is not approved at this time for the following reason: 1.) A conversion from storage to an apartment in an existing commercial structure triggers the installation of a fire sprinkling system in part or the whole building. This system would have to be designed by a Fire Sprinkler Engineer and reviewed and approved by the West Barnstable Fire Department. You can appeal this decision to the State Building Code Appeals Board per The Massachusetts State Building Code 780 CMR 113 or 780 CMR R112 and MGL c143. Please feel free to contact me if you have any questions. Respectfully, Robert McKechnie Local Inspector 508-862-4033 Building Detail Page 1 of 1 lHi BARNSTALlLE. r5le ease Logged In As: Building Detail Tuesday,August 4 2015 Parcel Lookup Parcel Detail Building 1 of 1 22 10 1 BAS 21 10 j 1525 K S-ro rt fKc6 ��y� / 6" (J GoNTgINr..— iDX;Zo � 7 9 - �ct�rQs �x i� D BAS 8 T3 7 18 4 3 5BAS2 8 56 18 Code Description Gross Area Effective Area Living Area BAS First Floor 3319 3319 3319 WDK Wood Deck 436 0 0 FOP Open Porch 84 0 0 Extra Features Code Description Units Unit Price Year Built Value Comments FOP Open Porch-roof-ceiling 84.00 47.85 1985 $3,000 Out Buildings Code Description Units Unit Price Year Built Value Comments WDCK Wood Decking w/railings 436.00 16.91 1981 $2,300 PAV1 PAVING-ASPHALT 2000.00 4.01 1999 $5,500 014 Vt(-& a Ef�s http://issgl2/intranet/propdataBuildingDetail.aspx?PID=10373&BID=10767&N=1&NN=1QE) ►O ii 1ERK INK:rys 'A� E. Mns�. TOWN OF BARNSTABLE '82. APR 30 PM 3 44 Zoning Board of. Appeals . Deed duly recorded in the Property Owner County Registry of Deeds in Book _ Villag_e_Store) Page rw ._ _, __Registry _..... _M Petitioner District of the Land Court Certificate No. _....__..__..... ..._...__ __._ Book . _______._ Page _ Appeal No. ....__.....1.9. 2��J_._......__._...__...._ _ ................ /_AP.r l...i._ 2.7........ __ ___..._ 1982 FACTS and DECISION Petitioner filed petition on ._AP.rLL5 19 82 requesting a variance-permit for premises at _.Meet..i.tl.gll.aws&._Wa.Y....._.._._....___..._...._._._.., in the village (Street) of .._Ws.tn....�ar�sxab.l _._____ ___.._, adjoining premises of (see attached list) Locus under consideration: Barnstable Assessor's Map no. _._...._..1.55_ lot no. Petition for Special Permit: (N Application for Variance: ❑ made under See. of the Town of Barnstable Zoning by-laws and Sec. Chapter 40A., Mass. Gen. Laws for the purpose of Spec,ia,l Permit to a1*1ow_ins_tallation of coffee shoo________ _.._.-i,n ex,!_stins country_ store .bui Locus is presently zoned in.___ !.>>.a9.e Bus.i nes_s._B,,.,zon..i ng-.d.i s.t r i_ct. Notice of this hearing was given by mail. postage prepaid, to all persons deemed affected and by publishing in Barnstable Patriot newspaper published in Town of Barnstable a copy of which is attached to the record of these proceedings filed with Town Clerk. A public hearing by the Board of Appeals of the Town of Barnstable was held at the Town Office Building, Hyannis, ?Mass., a-t 15........._-MW P.M. __-, Ap r i 1 22__._..__.__._ ._.____ 19 82 , upon said petition under Loping by-laws. Present at the hearing were the followipg members: ,Frank P. Con.gd.._ on_�_� _._._....t..u.ke....P.....:..L.a.l_1y--_ ___ __Richard_ _._BoY..-----.._. ...._ _........ .... ......._...._...... .. Chairman z < 7 C' Xurn rri X rnn} zj� o rnC- rn ;x7 rn o m`y -- -� m m ry c A" sr-? 8/>Z- Assessor's map and 'lot number ......... ,) ZO o�THETo ewage Permit number .... _ ........ L V* t A T1 f UL 5 • ENVIRONMENTAL COa House number '..............�.... .., ... ......... ..... ................. '�rnea LE, S TOWN REGU ATI®111. o6aY'a�e�' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO '.�'. ..� ......... TYPE OF CONSTRUCTION .......vti.P:QD` .....:............................................................................:. TO THE INSPECTOR OF BUILDINGS: ' The undersigned hereby applies for a permit according to the following information: Location .... ..............:..................................................:....:........:..:....................:............... Proposed Use ..... 4.4-.A . ............U.-O.�a.rL..... ....���C'-ts�: .� Zoning District ........................................................................Fire District ......... .�`. v�`��'1��'1 .1 ........................... Name of Owner ..... ...Zcx ?��................Address ........ ........ ZAAV ?.4. Name of Builder* Address ........ ............ ... . ....... .. ..... a` .............�... t, ................�� Name of Architect .... ........................Address ................................... ................................ .................... Number of Rooms .....�y ����.� ...5.`. ? j :. ' .'"�.-Foundation .... ....................................................... Exterior .......#1 .... ......:. ............ %. ? ..N .... .... .`.5. +..Roofing ........... 1\� �i Floors .............\X.,,!ZR 5�-�Li,;.°�nteriar ....4� ..: ................. Heating A� '��fl e2....... . ........... g c�� ............ ............Plumbin ................ i�........................................................... Fireplace ............. ........................................................Approximate Cost . /:�..17 Div Definitive Plan Approved by Planning Board _----------_______-----------19 . Area .lY...... .. ..... .4................ . Diagram of Lot and Building with Dimensions Fee /d. ............................................. 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 of Barnstable regarding the above construction. Name .. ... ..... . ROGERS, ELIZABETH .74 No 24.072.... Permit for REMODEL .. ....... .................................... Coffee Shop/ Commercial ....................... Location .1..... ...... ...................... West Barnstable ............................................................................... Owner Elizabeth..Rq�g!�.�.��......... . .......................... ............. Type of Construction ....... a.m.e...................... .................... Plot ........................ Lot ................................ May 21i 82 , Permit Granted ........................................19 Date,of,Inspection .......19 Date Completed ....................:. .....19 '01 Assessor's map and lot number . �- , TNETO� SW\ age Permit number ......`.... ....... .::...: Z EARNSTAXLE, i House number ..:......;.............-.................................................... vo rasa O 039. 9� ED YPY of. TOWN OF BARNSTABLE BUILDING INSPECTOR a APPLICATION FOR PERMIT TO ...��:........:... ..� . ....... ......... .... ........ ......... ........ TYPEOF CONSTRUCTION ...........:......................................................................................................................... .......... .."...................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....................................................................................................................................................................................... Proposed Use ........ ......... ...................................... \ c Zoning District �'. .. :.....Fire District ......... ......................... Name of Owner ..... ((� . . ..::...............Address ........L ... Name of Builder. .. :. .. .............. . � o r> _ �.� _>..............Address .........: Q. Nameof Architect ..................................................................Address .................................................................................... Number of Rooms :. a. . ..Foundation ... ...... `.. ................ Exterior .('.. : ...... ....:.: :................................... .......... ....:. ............ .........:........................... FIOOfS :...... .....: ......................... Interior .... ......a. ........ ........^. ....b..... � .. .J.......... a Heating ...............................Plumbing ..........:.....:,;.:................,............................................ t �> 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 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .....: � ���� ....................................................... J ROGERS, ELIZABETH A=155-17 •r •24072 REMODEL No .�.............. Permit for .................................... Coffee Shop/ Commercial .................. . .... ................................ ���5.5....rneefi nyhous Location Rte 14 9 ` ................... West Barnstable ............................................................................... Owner Elizabeth..Ro ers f ............... ...... ................... .......... Type of Construction ..Frame I ............................... Plot ..................... ..... Lot ............... ............... Permit Granted...........Ma 21 8 2 ' .....'......... 19 . :... ._::. �.:{.................:� F Date of Inspection .'......19 Date Completed 44 5 � do (I JS r61 � '---Assessor's Office(Ist floor) Map Lot 0 P rmit tonscrvation Office(4th floor .. r3 /� — � S' Date Issued / /Board of Health Ord floor '` .�1-2 lave /EnQinccrinQ Dept.(3rd floor) House# 7 .�-f� yti°4 • ' �;' S •ArtNB'rA j i6 o_ard 19 ��'� (Applications r essed� - 0 a.m.& 1:00-2:00',p.m.) SEPTIC S MUST BE IOVSTALLED IN COMPLIANCE t fief WITH TITLE 5 TOWN OF BARNSTABL"VIRONMENTAL CODE AND TOWN REGULATIONS Pj Building.Permit Application' Project Street ' .-Qr✓ CiliSC. / Village W eLtIl 01- 5 i'- 6 `-c Fire District . _ A zc, Owncr Address' Telephone Permit Rcqucst: Re/,7--t-` .� 0'e- vC /fie nG C C��,2 Zoning District Z/1�3 Flood Plain / � _Water Protection ✓�//� Lot Size , 3 3 Grandfathered % S Zoning,Board of ApMils Authorization Recorded _ Current Use %�a46 / Proposed Use �4 Construction Type ��G ,25f if in Existing Information Dwelling Type: Single Family Two family lr� Multi_family Age of structure /9 F�10 Basement type A y s 7F Historic House c9 Finished �� S Old King's Hig_hwav ��(� Unfinished Number of Baths No. of Bedrooms Total Room Count(not includinbaths) First:Floor le c `_ Heat Type and Fuel a fl Central Air X s _ Fireplaces Garage: Detached A J Other Detached Structures: _ Pool Attached vvti� _ Barn _ None Sheds Other Builder Information Name &Z, (' o/Lr d Telephone number Address_11�i "" �� li S'� License# 0 0$9 0 ' /`�r �—•"�— '�/ ��r 7 / _ i iui,li:i.�i ii`C:iiiC.ii_l..Uiiii i;t,.:V ii -�® / et i Worker's Compensation # ?0 20 NEW CONSTRUCTION OR ADDITIO14S REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS NVELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Ye A,, f Project Cost Fee ems-v SIGNATURE G� / C/ DATE, BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) _ BPERM T 5/15/95 —3-7--* 155.017 2455 Meetinghouse Way/Route 149, W. Barnstable Owner: Elizabeth Rogers �tME Sign TOWN OF BARNSTABLE Permit * BARNSTABLE, • MASS. 1639. �ArFD MA'S A` Permit Number: Application Ref: 201203399 20070759 Issue Date: 06/08/12 Applicant: TOWN OF BARNSTABLE (LOMB) Proposed Use: RETAIL & SERVICE STORE SMALL Permit Type: SIGN PERMIT Permit Fee $ 50.00 Location 2455 MEETINGHOUSE WAY/RTE 149 Map Parcel 155017 Town WEST BARNSTABLE Zoning District WBVB Contractor PROPERTY OWNER Remarks REPL EXIST 12 SQ ROOF- WEST VILLAGE PASTA& CHEESE SHOPPE 3 SQ - FROMAGE A TROIS BOTH SIGNS GOLD ON BLACK Owner: TOWN OF BARNSTABLE (LOMB) Address: C/O SCHOFIELD, ALFRED P 2455 MEETINGHOUSE WAY WEST BARNSTABLE, MA 02668 Issued By: p POST THIS CARD SO THAT IS VISIBLE FROM TAE STREET "ofTHE, Town of Barnstable TO N Or- BARNSTABt.0 ti Regulatory Services 1012 g --5 Pi1 3 17 . yBARNMASI IE�, Thomas F. Geiler, Director 16 ;Ay lb Building Division Tom Perry, Building Commissioner ���� i 'F 200 Main Street, Hyannis, MA 02601 01 www.town.barnstable.ma.usv' Office: 508-862-403 8 Fax: 508-790-623 0 Permit# Building Official approving _ Application for Sign Permit ApplicwiL VA4 fZi�j 4-A4b(j Z _Assessors No. Doing Business As:j— �rjf Telephone No.-?73!ILL/( — 2?C � Sign Location Street/Road: _(►my5�e, 6 Zoning District: Old Kings HighwayP Yes/No Hyannis Historic DistrictP Yes/No Property 0 er None: Telephoile:TT,T�-'�`7q9 (C• Address:- Sign Contractor 0012- ow*% Name: �7� i Telephone: �� Mailing Address: � J� {yS 1 2— qDescription Please follow die cover directions. You must have:ui accurate rent ition of sign with dimensions ,,u)d location. Is the sign to be electrified? Yes (Note.Il',cs, a wirvjg permit is•required) = 1 tt . Width of building face ft. x 10= _x .10=0 _3 3 35611. Check one Reface existing sigor New Total Sq. Ft. of proposed sign (s) c �j Ilyou Ila ve additional S"gns plcase attich a sheet listing earl] one with dimensions If refacing an existing sign please provide a picture of the existing sign with dimensions. I hereby certify that I am the owner or that I have die audiority ol'tic owlier to make this applim6on, dial the information is correct and that die use aiul construction si;ill conform to dic pro6sions of §240-59 through §240-89 of die Town of B, ]stable/ ning( r roan Signature of Owner/Authorized Agent: ate ?.d t .r Sep-23 09:56 AM RBC Wealth 'Management :508=420-5981 1/1 Barnstable Old Kings Highway Historic District Committee = 200 Main Street,Hyannis.MA O'...601,TEL 508-862-4787 Fax 508-862-4784 X= i6sp . APPLICATION, CERTM4 CATE, OP APPROPRUTENTM Application is hereby made.with four(4)complete sets.for the issuance of a Cmtirtcate of Appropriateness under Sectian 6 of Chapter 470.Acts and Resolves of Massachtuetts.1973.for proposed work as dwmbcd below and on plain dratviogs.or photographs accompanying this applimdun for. Check all categories thou apply; 1. ]Building construction: ❑ New ❑A,a ion ❑Alteration 2. Type of Building: ❑IIouse ❑Garage/barn ❑Shed ❑ Commercial ❑Other I Exterior Painting,roof ❑ new roof ❑color/material change,of trim,siding,window,door Ski n: New Signs'` Existing Sign epainting Misting Sign 5. Structure: ❑I-ence ❑ wall ❑Flagpole ❑Retaining wall ❑Tenths court ❑ Other 6. Pool ❑Swimming ❑ Other man-made pool ❑ SoIar panels ❑ Other Type or Print Legibly: Dater NOrR AUgpp5=doas mrvr hesfgrrrd by d.rarrrar mmtr Owner(print): AtaizA ama) Telephones r ��/ ,,�// Addretia of Proposed MorkE f t�v5n W 19ilage9*1map Lot p 3(Mailing Address(if diff A 2r- Nemec y S��taF�e'"`7 6 A&0,2e S7 ttber's5ignaturc- YO _ Description of Proposed Worl.. Give particulars of work to be dune: Agent or Contractor(lrrint): C_ C� j Address: Contrx;tor/Agent'signutun: For committee use only. This Certificate is hereby APPROVED/DMNEED D au"%slPuLurcS _. _- 49 RECEIVED 9.10 1 -MAY 0 3 2012 GROWTH MANAGEMENT AppFIOVED QV-Afrand a affftJ& ut�rHlyh+�,*0V1Appltw"v\0K11 D lfTZ011 C rMrmgr=,=DWTda Old Kings Hig tI y Commtttee CERTIFICATE OF APPROPRIATENESS SPEC SHEET Please ubmit 5 Copies Foundation Type: (Max. 12"exposed)(material-brick/cement,other) Siding Type: Clapboard shingle_ other Material: red cedar white cedar other Color. Chimney Material: Color: Roof Material: (make&style) Color: Roof Pitch(s): (7/12 minimum) (Sp e ify on platys for new buildings, major additions) Window and door trim material: wood other erial,specify Size of cornerboards size of cas' s(1 X 4 min.) color Rakes Ist member 2nd member Depth of overhang Window: (makelmodel) aterial color MAY 232012 (Provide window schedule on plan for ne buildings,.major additions) Town of Barnstable Old King's Highway Window grills(please check all t apply_. Committee true divided lights_ ex 'or glued grills._ grills between glass_removable.interior None Door style and make: material Color: Garage Door,Style Size of opening Material Color Shutter Type/S e/Material: Color: Gutter T el Material: Color: Dec material: wood other material, specify Color. Skylight,type/make/modelh material Color: Size: i Sign size: X t Type/Matenals: Color: L,/Cii iz Fence Type(max 6' )/Style material: Color: Retaining wall: Material: Lighting,freestanding on building illuminating sign OTHER INFORMATION: RECETFD THE ATTACHED CHECK LIST MUST BE COMPLETED AND SUBMITTED MAY 0 3 2012 Please provide samples of paint colors,manufacturers brochure of windows,doors, arage door,fences,lamp posts etc OWTN Signed: (plan preparer) Print Name Q;\Boardr and CommissionAOld Kings HighwaiAOKHApplications\OKH DRAFT 2011 Cert Appropriateness DRAFT.doc 2 APPROVED 61S IGN MAY 2 32012 Diagram of sign,showing graphics,size,design and height of post,color and materials. t�ipec sheet. Town of Barnstable Site Plan on a GIS map or mortgage survey,OR photographs OR to-scale sketch of builA ft4 way showing location of proposed sign;and any tree to be removed near a freestanding sign. Fee according to schedule. 6. SOLAR PANELS Drawing of location of panels on house showing roof and panel dimensions. Site plan showing location of building on property. (Assessors map may be submitted) RECEIVED Height of solar panel above the roof. Color of panels MAY 0 3 2012 Finish(matt or glossy) 7. FOR LIST OF ABUTTERS: PLEASE SEE OKH STAFF GROWTH MANAGEMENT SIGNED (plan preparer) Print Date:,�� Tel.Phone no's: '� q=!f y0"9-7 !/ NOTE l The Old Kings Highway Historic District Committee MAY DENY INCOMPLETE APPLICATIONS ATTENDANCE AT MEETINGS. If the applicant or his/her representative is not present during the hearing is scheduled,the application may be either CONTINUED OR DENIED APPEAL PERIOD APPROVED PLANS PLAN PICK UP There is a ten(10)day appeal period,plus a 4 day waiting period for approved plans from the date the decision is filed with Town Clerk. This is necessary for each Certificate of Appropriateness and/or Certificate for Demolition issued by the Old King's Highway Committee. Plans approved by the Old King's I-lighway Historic District Committee may be picked up at Growth Management,Regulatory Division,200 Main Street,Hyannis,after expiration of the 14 day"wait"period. If the 14ei day falls on a Saturday,your plans will be available the afternoon of the following business day. DENIALS Applications that are denied may be appealed to the Old Kings Highway Regional Historic District Commission within 10 days of the filing of the decision with the Town Clerk. For more information,see the Bulletin of the Old Kings Highway District Commission. BUILDING PERMITS,OTHER AGENCY CONTACTS In most instances,before commencing work,a Building Permit is required. The Building Division will require a certified plot plan for new construction and/or demolition. Commercial work may require Site Plan approval. Demolitions: the applicant should check with the Building Division as to conformance with Zoning requirements. Other Regulatory Agencies at 200 Main St,Hyannis MA 02601: Building Division 508-862-4038 Conservation Division 508-862-4093 Health Division 508-862-4644 QUESTIONS ABOUT YOUR APPLICATION? PLEASE CALL THE BARNSTABLE OLD KINGS HIGHWAY OFFICE AT 508 8624787 5 Q:\Boards and Commissions101d Kings lfighway\OKH Appheations\OKH DRAFT 2011 Cen Appropriateness DRAFT doc Town of Barnstable Geographic Information System May 4,2012 15So27 0 905 40 15so2a • 0976 156023 00 155039 02481 • 155034 00 165026 166014 02600 098 166021 >:9999 #15502S 156022 165043 ® '� 2482 156os3 02466 P 02469 1155049 r P{� a9.9s 662445 1 8 3481 165048Ao0 048 68 10 0 88 155027 156029 02472 165037 02464 024 166058 0a439* �s 16660 »2az9 10 >. 155D10AD1 02A15 t# 165029 'CO. 02464 16501E 165030 156M F 62401 02416 02377 15,5031 , ;v 0 71 Feet • 0 a400 DISCLAIMERS:This map Is for planning purposes only. It is not adequate for lapel Map:155 Parcel:017 Q boundary determination or regulatory interpretation. Enlargements beyond a state of Owner.TOWN OF BARNSTABLE(LOMB) Total Assessed Value:$317100 Selected Parcel are only may not meet establentati shed map occurs t standards. The parcel ones on per map ��e,ROUTE 149 MARKETPLACE. Acreage:0.30 acres Abutters 1b E are only graphic represamaUons of Assessor's tax parcels.They are not true property boundaries and do not represent accurate relationships to physical features on the map Location:2455 MEETINGHOUSE WAY/RTE !� such as building locations. 149 Buffer > fi .' tit'` .,1�` y •�� i#LS �::., +e�7 {:+f� Y. v ; 4 .,*.• f'�• � �Lam`_. -�•_� T"aS��•w� � _.t' ._ .,,.,. � � f h M1�+4 • '^1 M in oil THE WEST VILLAGE PASTA & CHEESE SHOPPE i 12 sq. ft. - •��� .. d99%&vA& D1ffE Monday,April 30 2012 CLIENT° West Village Pasta CONVCT- Kathleen Kadilk PHONE wmm IFUNA)VIE. westvill2 APPROVED BY. EA IM EWEEPTPPFQISE�RO.CM�1t'�(Vmr�mA 02001 z ■ • • ■ t ■ • z ■ •' RECEMD MAY U 3 2012 ►w� ��5 l +Y `���( aROWT ppP ROVES P�,AY 2 3 2012 . >e o O\Nn ns�+� nwav Comm Fromage , Trois - 10"�x-48"r-(-3 3 sq.•ft:) _ 4. '� 0 y 41�� Li t't�' • r� 111 --�-+- _ Oa .l►t�y -r�. r ti i DATE Monday,April 30,2012 CUENT- West Vllla a Cheese CONVtCr- Kathleen Kadlik PHONE FILENAME froma a APPROVED BY. 1M ENTERPME RD,HYMM MA 02601 ® •:• . •••• . • . . � �t►�ry(� . . •- 50"15-3431 a • �'$i• ••, 5/16 carriage bolt 3/4" MDO PLYWOOD 3/8" GALV LAGS RECEIVED APPROVEt/2sox 1 ,1/2 " X 1/8 1' mAY 0 3 2012 GROWTH NIAi`��1c�Er�IENT MAY 2 3 2012 �� Town.of Barnstable Old Kings Highway Committee 5/16 carriage bolt 3/4" MDO PLYWOOD 3/8" GALV LAGS 11/2" X 1 1/2 " X 1/8 " ANGLE IRON �q► �'��Q/ 4 n hursda , Ma 03,2012 CLIENT: West Villa e CT: Kathleen PHONE:ME: roofwest APPROVED BY. 103 EME1:FME M HYANNA MA MW THE ABOVE • PROPERTY OF CAPE ISLANDS 508-815-3431 • • DESIGNS • • • • •- • • - .00 L I I Fromage a Trois ARTISANAL e FRESH e HIANDCRAFTED It nal + a � maim — — 1 pr1130,2012 CUENT- West Village Cheese i • • PHONE: 1 NAPPROVED-BY, S _ THE ABOVE DESIGN IS THE PROPERTY OF CAPE AND ISLANDS SIGNS AND MAY NOT BE DUPLICATED OR 1 USED WITHOUT EXPRESS WRITTEN CONSENT. CHARGE FOR DESIGNS USED WITHOUT PERMISSION: 5500.00 i i I i _ -fir... _ �'�•t � F ��}�;�� THE WEST VILLAGE ,� ►�4. PASTA & CHEESE SHOPPE , .'hlffl nl � T HE WEST VILLAGE PASTA & CHEESE SHOPPE DArE-Monday,April 30,2012 CLIENT West Village Pasta CXDN-RCT-. Kathleen Kadlik PHONE- SIGNSFILENAMF- westv!112 APPROVED BY. �{ " ill ' 1 •1 THE ABOVE DESIGN IS THE PROPERTY OF CAPE AND ISLANDS SIGNS AND MAY NOT BE DUPLICATED OR 1 USED WITHOUT EXPRESS WRITTEN CONSENT. CHARGE FOR DESIGNS USED WITHOUT PERMISSION: S500.00 r �. ;fig '� y �^�; �r • ,�'4���#'��% � �',�', � :�� rQ THE OLD VILLAGE STORE Yummy coons 1. a� TOWN OF BARNSTABLE ' SIGN PERMIT PARCEL ID 155 017 GEOBASE ID 25451 ADDRESS 2455 MEETINGHOUSE WAY RQU PHONE W. Barnstable ZIP - LOT BLOCK LOT SIZE IDBA DEVELOPMENT DISTRICT. WB PERMIT 21404 DESCRIPTION CRANBERRY CROSSING (6 SQ.FT. ) ( PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $25.00 BOND $.00 �1ME CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHERE BARMABLE4 ; MAS& OWNER SOLES, SHARON E TRSi639' ADDRESS MEETINGHOUSE TRUST ,�� EDIN1�►�� 566 AIRLINE ROAD RR 3 r� SO DENNIS MA B LDING D' VIES ON-� DATE ISSUED 02/28/1997 EXPIRATION DATE �` The Town of Barnstable T Safe and Environmental Services -11M 9 7 e artiment of HealthSafety 1 Department p Building Division fa54' 6 �►� 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Application for Sign Permit nn Assessors No. �•�-S G/ Applicant: '1 i tJ n A ( I��)o rV Doing Business As• ��Cs � i Telephone Sign Location Street/Road: 4 Zoning District: Old JKings Highway? (ONO Property Owner _ - Name: 5�1��^nN I— �PS Telephone: Address: Village: 1 k), Rn a n id k Sign Contractor Telephone: Name: , Address: Village:— Description Please draw a diagram of lot showing location of buildings and eldsting signs with dimensions, ` location and size of the new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? Yes (Note.Ifyes, a wir74PW7ZZ&is required! I hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the k provisions of Section 4.3 of the Town of Bas le Zoning Ordinance. rn Signature of Owner/Authorized Agent:4zld-z Z'e �' Date• Le a Permit Fee: Size: Sign Permit was approved: Disapproved: Signature of Building Official: Date: 17 C' v` IA) b 'eeV- 6.Cp VI'`I I ' � 4 r0-0 U , CRANOB- yY `7/.fit, id9 crass 40 7 Yf-d 0 7--�40 TOWN OF BARNSTABLE HEALTH INSPECTOR'S /�' a •> OFFICE HOURS: Item No. In the space below describe all violations checked. Page of BOARD OF HEALTH 8:00-9:30 A.M. F 367 MAIN STREET MON.-FRI. P) HYANNIS,MA 02601 790-6265 FOOD ESTABLISHMENT INSPECTION REPORT Establishment Name Date o 0 Time: Address Ib In Out Telephone Type of Establishment or Purpose 1 Food Service Routine Owners Name Retail Food Follow-up Residential Kitchen Complaint -- Person in Charge Mobile Unit investigation Temporary Food Service Other Inspectors Name Icaterer 0 Based on an inspection today756 ttems dredced below Indicate the vi ted provslons d 105 CMR 590.000.Each item is followed by the applicable section of the Massachusetts regulation.Noncritical violations are marked under column'N'and critical violations are ma6d under column'C'.Descriptions of each ftem appear on the back of this form. Each violation checked requires an explanation on the narrative page(s).This report serves as official notice of violated provisions and official notice tocorect said violations. Food N C WT Sanitary Facilities N C WT 1. Food Supply .002 4 29. Water Source .015 4 2. Food Containers .002 1 30. Sewerage .016 4 Food Protection 31. Cross Connections .017 4 3. PHF Temperatures .004 4 32. Toilets/Handwashing .018&.019 4 4. Facilities,Hot&Cold Storage .004 2 33. Insects/Rodents .021 4 5. PHF Re-service .006 4 34. Plumbing .017 1 6. Spoiled/Damaged Foods .003 1 35. Toilet Rooms v .018 2 7. Food Protected .003 4 36. Handwashing Areas .019 2 B. Food Thermometers .004 2 37. Garbage/Refuse .020 2 9. Cross Contamination .005 2 38. Outside Disposal .021 1 10. PHF's thawed,cooked&cooled 005 2 39. Outer Openings .021 2 , 11. Food Handling .005 2 40. Pesticide/Rodenticide Application .021 1 12. Dispensing Utensils .006 1 Physical facilities Personnel 41. Floors .022 2 13. Employee Infections .008 4 42. Walls,Ceiling .022 2 i 14. Employee Hygiene .009 4 43. Lighting .023 1 15. Employee Clothing .006 1 44. Ventilation .024 2 Equipment&Utensils 45. Dressing Rooms .025 1 "FOOD 16. Equipment/Utensil Clean&Sanitized .013 2 Other 17. Food Contact Surfaces .013 1 46. Toxics .026 4 18. Non-Food Contact Surfaces .013 1 47. Premises .027 1 ' 19. Food Contact Surfaces Clean .013 1 48. Living Areas .027 1 20. Non-Food Contact Surfaces Clean .013 1 49. Linen .027 1 21. Wiping Cloths .013 1 50. Pets .027 1 Discussion with Management 22. Dish/Warewashing Facilities .013 1 51. Bulk Foods .031 1 23 Pre-Scraped, Soaked .013 1 52. Salad Bars .032 1 , 24. Wash/Rince Water .013 1 25. Thermometers/rest Kits 013 1 No.of 13 Critical Items Violated 26. Equipment/Utensil Storage .014 1 These items require immediate attention. 17 27. Single Service Articles .014 1 28. Single Seixvice Re-Use .012 1 t SCORE r s Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered? Y N x3 c #Seats Observeo%"' Frozen Desert Machines: Outside Dining Y N Self Service Wait Service Provided Variance Granted Y N Variance Letter Posted Y N Inspected by eceived by i I i i �`�� �� �� ' .y ..., 4, .�:, 't, �� .�. i�, _ tr .�. �. M,, i�•- � � �` � _ :; �' ��, ��� j;�+ 1� _ � �„ L • � ��. �� .'� � � „�. • �� � "� C f-»i ....�+'�.� � �� � ���P � •� _,,,,,- ` �1 �f;h•i rY � ` ', �p+�ty''.�'—_ ". art y�'��f ` { � \.��`l! _r. fy a ��~ ,..— r, I �t� ,�,1� " �� yam- 1 .n _ � 1 . `��, m I1 `�� <��VC, ��,� - 1 ' :�' , � ►ate✓� �+.��,.'. _ `�. -. AA 1 � ' f / ( , J......_.b� , � QUERY PERMITS : QUERY END QUERY PERMITS PENTAMATION----------------------------------------------------------- 02/03/98 PERMIT NUMBER 747 PARCEL ID 155 017 2455 MEETINGHOUSE WAY/R PERMIT TYPE BREMOD RESIDENTIAL ALT/CONV DESCRIPTION 37754 REPAIR DECK CONTRACTOR PERMIT FEE 0 . 00 VARIANCE STATUS C COMPLETED CONSTRUCTION TYPE 753 GROUP TYPE APPLICATION 05/11/1995 EXPIRATION VALUATION 900 . 00 DATE ISSUED 05/15/1995 COMPLETED 08/04/1995 DEPARTMENT-----STATUS---DATE-----DEPARTMENT-----STATUS---DATE---- (N) EXT/ (P) REVIOUS/ (C) ONTRACTORS/ PR(0) PERTY/ (I)NSPECTIONS/ (H) ISTORY/ (F) EES/ (A) RCHITECTS/ (V) IOLATION/ (E) XIT i QUERY PERMITS : QUERY END QUERY PERMITS PENTAMATION----------------------------------------------------------- 02/03/98 PERMIT NUMBER 23702 PARCEL ID 155 017 2455 MEETINGHOUSE WAY/R PERMIT TYPE BGASA GAS PERMIT ALT/ADDITION DESCRIPTION 1 VENTED RM. HTR. CONTRACTOR PERMIT FEE 20 . 00 VARIANCE STATUS A ACTIVE CONSTRUCTION TYPE 753 GROUP TYPE APPLICATION 06/12/1997 EXPIRATION VALUATION 0 . 00 DATE ISSUED 06/12/1997 COMPLETED DEPARTMENT-----STATUS---DATE-----DEPARTMENT-----STATUS---DATE---- (N) EXT/ (P) REVIOUS/ (C) ONTRACTORS/ PR(0) PERTY/ (I)NSPECTIONS/ (H) ISTORY/ (F) EES/ (A) RCHITECTS/ (V) IOLATION/ (E) XIT QUERY PERMITS : QUERY END QUERY PERMITS PENTAMATION----------------------------------------------------------- 02/03/98 PERMIT NUMBER 21404 PARCEL ID 155 017 2455 MEETINGHOUSE WAY/R PERMIT TYPE BSIGN SIGN PERMIT DESCRIPTION CRANBERRY CROSSING (6 SQ. FT. ) CONTRACTOR PERMIT FEE 25 . 00 VARIANCE STATUS Q APPROVED CONSTRUCTION TYPE 753 GROUP TYPE APPLICATION 02/28/1997 EXPIRATION VALUATION 0 . 00 DATE ISSUED 02/28/1997 COMPLETED DEPARTMENT-----STATUS---DATE-----DEPARTMENT-----STATUS---DATE---- (N) EXT/ (P) REVIOUS/ (C) ONTRACTORS/ PR(0) PERTY/ (I) NSPECTIONS/ (H) ISTORY/ (F) EES/ (A) RCHITECTS/ (V) IOLATION/ (E) XIT QUERY PROPERTY: QUERY END QUERY PROPERTY PENTAMATION----------------------------------------------------------- 02/03/98 PARCEL ID 155 017 GEO ID 25451 LOT/BLOCK DBA PROPERTY ADDRESS OWNER SOLES (24551 �MEETINGHOUSE_WAYI%ROUE SHARON E TRS MEETINGHOUSE TRUST W BARNSTABLE 620 CEDAR ST W BARNSTABLE MA 02668 PHONE DISTRICT WB DEVELOPMENT STATUS C ASSESSOR' S CODE CAPACITY(NOTES) ZONING DIST/ZOC VB-B SEWER SYSTEM FLOOD PLN/ELEV. WATER SYSTEM OKH? Y ## BEDROOMS ZBA DECISION FAMILY APT LOT SIZE 13068 OPER/MGR NAME WET LANDS MULT ADDRESS USE 325 PROTECT DIST (N).EXT / (P) REVIOUS / NO (T) ES / PER (M) ITS / (V) IOLATIONS / (G) EOBASE / (E) XIT This value is not among the valid possibilities -i Pj Certified,Mai1#7005.1160 0000'0191 2205 Town of Barnstable 210A P N 2 3 ► : 3 Regulatory Services Thomas F. Geiler, Director ___�-- Public Health Division ,'�:Z)[0*N Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 August 22, 2006 Sharon E. Soles, Trust Meetinghouse Trust 9 Shannon Way Brentwood,NH 03833 � O� THE NOTICE TO ABATE VIOLATIONS OF 310 CMR: 15.000 THE STATE ENVIRONMENTAL CODE TITLE V: MINIMUM REOUIREMENTS FOR THE SUBSURFACE DISPOSAL OF SANITARY SEWAGE AND VIOLATIONS OF THE 1999 FEDERAL FOOD CODE AND VIOLATIONS OF THE STATE PLUMBING CODE,248 CMR 10.00. The business owned by you, known-as Old Village Store and your tenant doing business as CUP Village-Restaurant-&Pizza;located-at 2455 Mee inghouse Way_,West-Barnstab;le, was inspected on August 18 & 21, 2006 by Donna Z. Miorandi, R.S., Health Inspector for the Town of Barnstable, because of an complaint of raw sewage under the building. The following violations of the Federal Food Code and the State Environmental Code were observed: FEDERAL FOOD CODE 5-402.13: Conveying Sewage. There was a discharge of wastewater effluent directly to the surface of the ground. According to the plumber, there is approximately three to four feet deep of raw sewage on the ground within the crawl space below the restaurant. Sewage shall be conveyed to the point of disposal through an approved sanitary sewage system or other system, including use of sewage transport vehicles, waste retention tanks, pumps, pipes, hoses and connections that are constructed, maintained, and operated according to law. 310 CMR 15.222( 10): Building Sewers. Portions of the building sewer are PVC and must be cast iron. All building sewers shall be constructed in accordance with the State Plumbing Code, 248 CMR 10.00. QA0rder letters\,Sewage violations\2455 Meetinghouse Way.doc f 310 CMR 15.229(3): Placement and Accessibility of Septic Tank. A dumpster was located on top of one of the components of the septic system with no lid provided to that particular septic system component. Septic tanks shall be accessible for inspection and maintenance. No structures shall be located directly upon or above the septic tank access locations which interfere with performance, access, inspection,pumping, or repair. 310 CMR 15.230 (7): Grease Traps. Grease trap covers could not be located. Grease traps shall be provided with a minimum 20-inch diameter manhole frame and cover to grade over the inlet and outlet tees. - 310 CMR 15.351(1)& (2): System Pumping and Routine Maintenance. Town records indicate there are no documented pumpings of the onsite septic tank or grease trap since November 2004. The operator of the restaurant did not have any recent pumping records available for the health inspector during her inspections. Whenever a system component is pumped, the system pumper shall submit to the local Approving Authority within 14 days from the pumping date. Grease traps shall be inspected monthly by the owner/operator and shall be cleaned by a licensed septage hauler whenever the level of grease is 25% of the effective depth of the trap, or at least every three months, whichever is sooner. The owner/operator shall keep all inspection and pumping records. 310 CMR 15.303 (a)(2): Systems Failing to Protect Public Health and Safety and the Environment . There was a discharge of effluent directly to the surface of the ground or to surface water of the Commonwealth. According to the plumber, there is approximately three to four feet deep of raw sewage on the ground within the crawl space below the restaurant. FEDERAL FOOD CODE 5-402.12: Grease Trap. The onsite grease trap was not easily accessible for cleaning. You are directed to correct all of the above listed violations prior to re-opening the food establishments at this site. You may request a hearing before the Board of Health if written petition requesting same is received within ten(10) days after the date the order is served. PER ORDER OF BOARD OF HEALTH 4 as McKean, R.S. Director of Public Health Town of Barnstable Cc: Thomas Perry, Building Commissioner Evangelos Theodorou, Old Village Restaurant &Pizza Michael Rogers,P.O. Box 772, West Barnstable, MA 02668 Thomas Geiler, Director of Regulatory Services QAOrder letters\Sewage violations\2455 Meetinghouse Way.doc HERBERT D. STRINGER TELEPHONE: 775-1120 TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. July 5, 1963 Registry of Motor Vehicles 100 Vt zhua Street Boston .14, mm o Dear Sire T hrEi cep that t' '�i1 solr � thin 'A croa D vBr, 41 � :pe ttdd this area. Vell tru3$-you, - Ba3.3rUng pec�or' i led.�l_r 5 1 J � �ee r N \ CAPE COD, MASSACHUSETTS PLEASE REPLY TO: - 241 Captain Lijah Road Centerville, MA 02632 June 24, 1982 Town of Barnstable Board of Health Department Town Building 367 Main Street Hyannis, MA 02601 Gentlemen: This will confirm the fact that Mr. Ron Gifford of the Health Department confirmed to our Mr. William Mitchell, registered engineer, that the new septic system installed in the rear of the Village Store on Route 149 in West Barnstable is faulty in that it has been installed on property that is rented by our -. club from the Parker limbard Trust. This means that it is undoubtedly also not in accordance with the dimensional requirements of Chapter V of the Sanitary Code. I By this l::tter we are asking that you take the necessary steps, through your permitter ccitrols, to see that this condition is corrected and that the system is properly located on the store's property before an occupancy permit is issued. Very truly yours, CAPE COD MODEL RAILROAD CLUB E4 Edward C. Gibbons President mlp os Daluz of Barnstable Building Inspector CAPE COO CENTRAL _.T9V4 OF BARNSTABLE BAR_W 4674 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager w Address of Offender MV/MB Reg.# Village/State/Ziip/ Business Name /E4f Otb V1c j.,,6,4,-, 9-7.0;41 E '7�� am/pm, on 7 0 ID Business Address � /�� r^V6h�Z/ A. / �v ``•/J /�` �/ W Signature .of Enforcing -Officer Village/State/Zip Location of Offense7Y1�. ��/ .�,.- Enforcing Dept/Division Offense p74`- Y '�1 Facts oar? This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. TOWN OF BARNSTABLE BAR-W Ordinance or Regulation WARNING NOTICE Name of Offender/Manager Address of Offender MV/MB Reg.# f Village/State/Zip / �- Business Name 4,1 r S ( �am/pm on t�' 20 Business Address a�s, ' //�F�Tj�6� �f' W/ �2.-T 11 e" /���// r Signature .of Enforcing Officer Village/State/Zip A4r7 4"-f7"4we-: "1 Location of Offense k��6 � ly / Enforcing Dept/Division Offense � /� .. L! ��C Facts I This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./RFG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. TOWN OF BARNSTABLE BAR-WNyO 3014 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager " Address of Offender MV/MB Reg.# Village/State/Zip Business Name -7:�tG e9c_d (��� h� 1[,�k',r9at,7 f� am,1 pm� on20/0 Business Address I . Signature .of Enforcing Officer Village/State/Zip `" a'a` i�. '�✓��t�! Location of Offense ell 0 1- b //(IC Enforcing Dept/Division Offense .) f�o_b / -s 7-rr y t Facts This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. , YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall)and 200 Main Street Offices at the Licensing counter. • �v- DATE: G;-i - %6 Fill in please: x�X 4r': i f ck . � APPLICANTS YOUR.NAME: BUSINESS YOUR HOME ADDRESS: l3f KE7�LCrfc2� i�7 -rd '3 ''1 Gt)h ttszn�i/4 i �_c� r��ls4 c�'Z�,G�6 k« ' TELEPHONE # Home Telephone Number: NAME OF NEW BUSINES 'r (< C 4- TYPE OF BUSINESS IS THIS A-HOME OCCUPATION? YES N Have you been given approval from the building division? YES NO ADDRESS OF BUSINESS_a?Y6S L;3 MAP/PARCEL NUMBER I When starting a new business there are several things you must do in order to.be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING CO ONER'S OFFICE This individ al a ee.n i rm of,any permit re nts that pertain to this type of business. 4�21"A A thorized atu COMMENTS: O 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature" COMMENTS: -- 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature"" COMMENTS: TOWN OF BARNSTABLE BAR-yNG. 3015 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager Address of Offender MV/MB Reg.# Village/State/Zip � / Business NameULt c. ^2-e pm on "� 201 Business Address��✓�� T/A�{: /CF ,,/�„ ,� ��--'�--1 ��e �� / Signature .of Enforcing Officer Village/State/Zip Location of Offense < E [p i GA /ir,L, Enforcing Dept/Division Offense Facts 7' �Efo 44 i'!/1 rr S'(:,ti ' &z AW-AKM6 /0 7' This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are It to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD/REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. n � � � � � � - a � �� �, j � � � � � � �' YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. ; - DATE: Fill in please: �a tt ft i �X APPLICANT'S YOUR NAME/S: Atoh4 BUSINESS YOUR HOME ADDRESS: 4D%ffAlox 0aS.37 V c"-[3 ` TELEPHONE # Home Telephone Number 33 -11,Y6-a? F r n ' NAME OF CORPORATION I NAME OF.NEW BUSINESS' TYPE OF BUSINESS COVE;ES IS THIS:A HOME OCCUPATION? YE$. NO ADDRESS OF BUSINESS MAP/PARCEL NUMBER': f � Q,�7 (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth-I Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in Chis town. vs' � 1. BUILDING COMMISSIONER'S OFFICE ti = This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: it771 � rr- 2. BOARD OF HEALTH This individual nf;g r d rpiit r i is pertain to this type of business. orize ign e*COMM ��� M,, (> ¢ r p I 3. CONSUMER AFF 1 (!. SING AUTHORITY) °� This individual has been informe of the 'censing requirements that pertain to this type of business. Au orized Signature** COMMENTS: YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. L/I Lr LE r DATE: 5-(3-2-0( � Fill in please: APPLICANT'S YOUR NAME/S: AVIV H. R6USS4:E�0 BUSINESS YOUR HOME ADDRESS: lo6 H& /V W-1 j ttF 5�i-q,a-b-153( w, 4Riv s,—+��( r l 0�Co� TELEPHONE # Home Telephone Number 50Fs-�f Z- U 4(0 is <,#WOO esuOr: NAME OF CORPORATION:`: _. ._ NAME OF N;EW BUSINESS R60,550W 1Rt1iVr1n&, 's EQFAZ/N TYPE OF BUSINESS rev OV � . LcCoPA-n 5rAL171Nq. IS THIS A HOME OCCUPATION? YES NO ADDRESS OF BUSINESSc146J.. M2tTiN tI GODS uay W-Z;A&US1tL MAP/PARCEL NUMBER V � D (Assess,ing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMIVIISSIdNER'S OFF CE This individual has enlinforrnfdd f any pe,(mit requirements that pertain to this type of business. X . r horized Signature* COMMENTS: 1 i i' t � I !1 tl it 2. BOARD OF ILLTH MUST COMPLY WITH ALL This individual has i beerl�ji f���eA of the permit requirements that pertain to this type of business. WARMUSMATERIALSREC�"IMNS Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual h infor ed of the licensing requirements that pertain to this type of business. Aut one Signature* COMMENTS: Commonwealth of Massachusetts ✓ Executive Office of Energy &Environmental Affairs Department of Environmental Protection Southeast Regional Office•20 Riverside Drive, Lakeville MA 02347 .508-946-2700 DEVAL L PATRICK MAEVE VALLELY BARTLEfT Governor Secretary DAVID W.CASH Commissioner October 1,2014 Mr. Al Schofield RE: BARNSTABLE—Pubic Water Supply Old Village Store Old Village Store 2455 Meetinghouse Way PWS ID#: 4020016 Route 149 Sanitary Survey West Barnstable,MA 02668 Dear Mr. Schofield: Please find attached the following information: Sanitary Survey Report for a survey performed at the Old Village Store,Barnstable, MA on July 15,2014. Please note that the signature on this cover letter indicates fonnal issuance of the attached document. If you have any questions regarding this document, please contact Isabel Collins at 508-946-2726 or Isabel.Collinsna,state.ma.us. Sinter yY, Richard J. Rondeau, Chief Drinking Water Program Bureau of Resource Protection R/IC , ecc: Certified Operator: Donald Rugg: drugg@sarianco.com `� Marisa Picone-Devine'mdevine@sarianco.com Barnstable Planning Board Barnstable Board of Health E: cc: Barnstable Board of Selectmen 4 Barnstable Town Manager ra. Barnstable Building Inspector C Y:\DWPArchive\SERO\Bamstable-4020016-SanitarySurvey-2014-10-01 P:\ic\ss\ss20l4\Bamstable-4020016 This information is available in alternate format Call Michelle Waters-Ekanem,Diversity Director,at 617-292-5751.TDD#1-866-539-7622 or 1-617-574-6868 MassDEP Website:www.mass.gov/dep . Printed on Recycled Paper Old Village Store Barnstable 4020016 July 15,2014 Public Water System Sanitary Survey CITY: Barnstable MID: 4020016 Pws NAME: Old Village Store Survey Date: July 15, 2014 Re ortDate: October 1, 2014 Surveyor: Isabel Collins Affiliation: DEP. Person Interviewed: Donald Rugg Title: Certified Operator Person Interviewed: Marisa Picone-Devine Title: Certified Operator Person Interviewed: Title: PUBLIC WATER SUPPLIERS: Attached is a Sanitary Survey Report for the above referenced sanitary survey site visit. At the end of the report is a Water System Compliance Plan which consists of the following (checked items only): ❑ Table A - Summary of violations and Notice of Noncompliance (if violations were observed during the survey) ® Table B — Summary of deficiencies and required corrective actions ® Table C—Recommendations ® Water supplier response and certification. Within 30 days of receipt of this inspection report, you must complete and submit the response form if your system has TABLE A—Violations and/or TABLE B-Deficiencies. Attach a copy of each completed table listing the date that the corrective action was or will be taken by your system and all other applicable documentation. (310 CMR 22.04(12)) 1 Old Village Store Barnstable 4020016 July 15,.2014 SYSTEM DESCRIPTION: r ; The,Old Village' Store is a general store. It is. classified.as a transient non-community water. system: :A 30=gallon Amtrol hydropneumatic tank provides both storage and pressure to the distribution system. The water is not treated., . ADMINISTRATION General-System Information Is this correct? Yes ® No ❑ °` -'+.�' Po mF .�'d'�c• ' �' r�.;+a'Er Seas on Stets �� � wa, 'rra.i#`+si< ,rr•s .<z s -:ups' ��. cxt. -t-7----- 'as p - =PWS,D PWS Season Season Populationr5ervedlPopulationService � #Distrbutionz - ,n I4020016 NC 101 1231 . 250I 100; 1 0 . Facility Address. Is this correct? Yes ® No ❑ "F,. F xS .✓e. 5 L3 .3 r r w,�i'�a ' rPWS FacilityAddess � �s��£ �. Y xrfaM the z ub ra,.�.2. `*.sf^•.xa,r h FhrNNIss:a - �. 0 1 �� ' "`" Address �� sy �# y �� *�w,� k € VJ�� 3 " Name Address M ' }may s Zrp� Entail. Phone# Fax# � Co l merits v _ •• Town --- • . a:. F y4xC nMrF+F � a�:.� OLD 2445. ROUTE WEST. :026680000 (508) SYSTEM RE- VILLAGE MEETINGHOUSE 149- BARN-STABLE 362-3701 _.OPENED.IN STORE WAY - 2008 Mailing Address: . Is this correct? Yes No ❑ ~ '��^ °'sass,"° va � �� �—x� r - 2ra �� a ' „ PWSEMailing�Address� � £�= - r ya k OLD VILLAGE STORE 2455 MEETINGHOUSE WAY ROUTE 149'WEST-BARNSTABLE'';MA 026680000 . Contact Information Is this correct? Yes ® No ❑ I £sn s a; x 1 k < x -'.k.. a s' Z.' rc a & - � "� r ga PWSContact.Information£ � � j ° r ",_ y f H -> -: c'�+ ��'� azw,.y • S 2. SC.-.`ZS� �yTn .f 4..•,3f.4� Ge GR R$Lx h 'f�-.f�"^ ..•X 'iA k k M;. PWSID#'First MI = Last Addressfi yWork� omen IPr�a=n Addr `� r Town State t Zit �:ry. ' SSx (2� .� x_, 100. ,.. , hone#Contact 4020016MLSCHOFIELD 2445: WEST MA .026680000i5083623701 Y MEETINGHOUSE; BARNSTABLEI - WAY Comments.• ,. None . 2 Old Village Store Barnstable 4020016 July 15,2014 Certified Operator Information: Is this correct? Yes No ❑ PINSID# g-%rSt MI'TLast �;:, Address Town St t Zip nlNork�Phone# d Fps 4020016 DONALD F RUGGL90 CEDAR TREE NK RD MARSTONS MILLS.:MA 02648 5088887262 5088888313 OPer�ator tnaformaton �03 ' 3 �Pos,t,o L,cense Gr deb L,ceiases#` Pr,m0 era01 PWSID# F,rstfMlrLast ,k`.%,:e,•;sH.r_.r. ,,�'rx<:.�,..:'=-r:ry-s_ tc�::_.s...,-..g,...�nr ��'�u*:__.....�nr..�.s,UE-.-.:.w vfi�� L.�,.�.r iw.+� ��kc3cs:wsw� 4020016 DONALD:F RUGG DW OPERATOR 4D/3T 1195/2961 Y _ _.- -- - 4020016 MARISA ;A PICONE DEVINE ;DW OPERATOR 1T/3D 4738/2593/5549 N ,�� SystemDistrib:ut,onClass¢r � rx ,aru a tr, t ,F �PWSID# Drsbut�on lass PopulationSerued 4020016 VSS 2501 Does the PWS have a certified operator? (Verify that primary operator listed yes ® No ❑ in WQTS is correct PWS operator) Are operator grades appropriate for system size and/or treatment type? Yes ® No ❑ Does the system have the correct staffing levels for the system size and grade? Yes ® No ❑ Is certified operator or a.backup operator available for emergencies? Yes ® No ❑ Comments: None OPERATION AND MAINTENANCE: Is there an adequate spare parts inventory? Yes ❑ No Is there an O & M Manual? Yes ❑ No Z Is there a preventative maintenance program? - Yes ® No ❑ Are operational.records.collected appropriately? Yes ® No ❑ Are records properly maintained and available for review? Yes ® No ❑ Frequency of master meter readings? . Daily ❑ Monthly ® Other ❑ Frequency of distribution meter readings N/A How frequently are meters calibrated? Not done e . 'The Department recommends that source.meters be calibrated on an annual basis. Are emergency telephone numbers posted? Yes .Z No ❑ Is all critical infrastructure'locked? Yes ® No ❑ Does the PWS have available an emergency response plan prepared in accordance with.the provisions of3.10 CMR22j04(13)? Yes Z No ❑ Who performs.emergency repairs? . (Systems without dedicated staff) Contractor Comments: Contractor has spare parts and 0&M Manual. 3 Old Village Store Barnstable 4020016 July 15,2014 TREATMENT - GENERAL: Treatment listed Unapproved treatment No Treatment ® above is correct ❑ installed ❑ • Unapproved treatment is subject to MassDEP permit requirements If a sediment filter is being.utilized how often is the filter replaced? N/A For sources without permanent disinfection: Is an emergency chemical injection port available? Yes z No ❑ N/A ❑ Are there any unprotected bypasses in the treatment process that could result in contamination of finished water?. Yes ❑ No ❑ N/A Is information from the manufacturer available for reference? Yes ❑ No ❑ N/A Is chemical storage, containment, and safety equipment adequate? Yes ❑ No ❑ N/A Is equipment properly maintained? Yes ❑ No ❑ N/A Are alarms tested and adequate? Yes ❑ No ❑ N/A Z Are chemical treatment forms submitted monthly as required? Yes ❑ No ❑ N/A Are they completed properly? Yes ❑ No ❑ N/A Is operator familiar with the treatment system and its operation? Yes ❑ No ❑ N/A Is the treatment system providing 4-Log inactivation treatment? Yes ❑. No Has the system experienced a loss of membrane integrity? Yes ❑ No ❑ N/A Comments: 4-Log not required at this time. SAMPLING: 41 TC mpleFrequencyt � ��� � �PWSID NOBACTERIi45AMRLES BACTERIA SAMFLEFRE NO A1IVINTERBACTS%�MPLE b' x 'WINTER. BACTSAMPLE 4020016 1 QUARTER 1'QUARTER Does the.system have an approved Total.Coliform Sampling Plan? Yes ® No ❑ Have changes been made to the system (population, configuration, storage tanks, etc.) such that the coliform sample plan does not comply. with 310 CMR 22.05? Yes ❑ No Is the system taking the correct number of bacteria samples? Yes ® No ❑ Is the system using appropriate coliform sample sites? Yes ® No ❑ Is the system using appropriate source sample sites? Yes ® No ❑ Are raw water sample taps available for all sources? Yes No ❑ Comments: None. 4 Old Village Store Barnstable 4020016 - July 15,2014 STORAGE: Maintenance and Condition geankTabl'e1 � ��-�.«_.ss._. --g �r•"^.'n" `"} °`�:'`-•,'+,... .,'111 ast1 `StfuC.Ural•a*: ' torage�Sank re j �z � `. tt PWSIQ# Na ev �� StocageType ate : Capacity(GALza) lnspectiony CleaneIntegn ay -- � � �� �pateUn - INDafe �5Condit!on' 4020016 30 GALLONS HYDROPNEUMATIC STEEL 30 GALLONS N/A N/A POOR MTROL TANK STORAGE TANK AMTROL TANK _............. .. .....:._. ._.._.._._..__. __ . _ • MassDEP recommends storage tanks be inspected and cleaned every 5 years. Protection and Safety 7'YaEffil- w y 5" ".cry.•'•" tt" "mr'T'r"s". ••,—' �, . •w.3"` _1y�` -" - .y Storage,Tank°1Tab1e2Atmospher � `xi,s�'9_ 7r�,: k '.#z'�t •°� - '�'- allAIj rl ;�TOPe .0 ver�ed= � H4gh LowX Pa S ORAG M a i „ vVenfed.. ,Sample- �. �LeYeiz,.,,,a € + Protectedtfr�om as w.>`. "-, PWSID TANK , Overflow Lo`eked '�a'Sened. Ta ,, Repave .from Renced? �. ' @ontroliloodi >SOft � .-� ,�s t ,�Q�) .,. .��^...S„a ` G' i`?s .' 4� - z:.' •a'nx .r"S 7 5,.� g � � .,..„�4x%?.::�'�g��'� • 4020021 ITANK#1 /A Y/N /A YIN /A. N/A Y Y /A j The storage tanks have nearby injection ports to allow emergency disinfection. 'Yes ❑ . No N The storage tanks are adequately protected against vandalism. Yes N No ❑ MAre there any holes or failures.in the tank roof or structure? Yes ❑ No (2)Have any tanks been identified as subject to flooding or run-off? Yes ❑ No N (3)Are all the tanks protected from unauthorized:entry? - Yes N No ❑ . (4)IS proper screening in place on all overflow pipes and vents? N/A N Yes ❑ No ❑ Comments: The pressure tank is In poor condition, the.MassDEP recommends it be �e laced: PUMPING STATIONS: " '"�5"'v ,WPum in Stations ' k ;x� " � =� n z..I'�t__<mJ+�r,....r.�.v1:.ir..-_v�^rs. �:,_�: .�i.. :.MP-+'�s,�s`xr.:�::.'•a._'�'..v^'S.n"�:��'`:.�_ ,"�yv'�5 P S D P�mpc$Stn #ofLocation4 Function'Wx G ft�j( Emergj Motor ,Motor TCE hr rs. Named Pumps rcxuw "� 1Typea. s�:Power? H ...3u� pe �� BL7TM EOD 402001611WELL#1 f 1 MEETINGHOUSE:YEAR IR 6 N 1`SUBMERSIBLiACTIVE PUMPING - WAY ROUND STATIONj. ] Are all pump stations recorded in WQTS? Yes.N _ No El Is',there flooding or standing water in the pump house? Yes ❑ No N =Does the,air/water relief valve discharge have an air gap? Unknown ® Yes ❑ - No ❑ .e r Are,ther&.any open floor"drains'in the facility? Yes ❑ No N, Are pump stations adequately maintained? Yes ❑ No N Comments: None. 5 Old Village Store Barnstable 4020016 July 15,2014 DISTRIBUTION/TRANSMISSION Has the system submitted a distribution map to MassDEP Yes ❑ No Are valve locations known or identified? Yes ® No ❑ How many distribution systems are there? 1 Is adequate pressure being maintained? (20-60 psi) Yes ® No ❑ The distribution system has 0 dead ends which are flushed List distribution system weaknesses or problems None Date of last leak detection survey: Daily Percent of system surveyed?: 100% Are distribution valves exercised regularly? Yes ❑ Frequency? N/A No ❑ Is there a hydrant maintenance program?N/A Yes ❑ No ❑ Is there an adequate flushing program?N/A Yes ❑ No ❑ • The Department recommends that the distribution system be flushed twice a year. Comments: Pressure gauge needs to be replaced, old and rusted, difficult to read.-See Table B- Deficiencies. CROSS-CONNECTIONS / BACKFLOWPREVENTION: Connectlonrc Status 7 - � '�. .1.. h.'. PVYSfD# Does System.Have Approved Cross.Gonnemon Plan?;Was X=Conn Surrey Conducted; 4020016;Y ,Y NTNC & TNC only: Was a cross-connection survey conducted by a Massachusetts Yes ® No ❑ N/A ❑ Certified Cross-connection Surveyor? Surveyor Name: Donald Rugg Surveyor Certification#: 4243 Date of last system-wide survey 12/13/2013 Did the cross-connection survey reveal any unprotected cross- Yes ❑ No ® N/A ❑ connection(s)?If yes, have all cross-connections been eliminated or properly protected? Yes ❑ No ❑ Have testable backflow prevention devices, if present, been yes ❑ No ❑ N/A tested in accordance with the frequency stated in 310 CMR 22.22(14)(d)? Are there Hose Bib vacuum breakers on all threaded faucets? Yes ❑ No ❑ N/A 6 Old Village Store Barnstable 4020016 July 15,2014 s Comments: There are no outside faucets. SOURCES: Sollarce Type and Co:nsumptlon, „�. �, t w r a ' ° ," %Furth z % + %Purch� Max Monthly r Demand(� Ma, al PWS1 Sources i YEAR ti�Y k� Groundl Ground SURFACE, Surface _ Demand:(MG) DemandF(MG)` 4020016 1 100 0 0 02013 0.014 0.00018 0.0004641 Groundwater Sources: Well Construction Information Is this correct? Yes ❑ No ❑ Ground Water CeS77, Soumob Source.Name Location Availabiiity ell'Type DepthlPump Setting JComrhents 4020016701G WELL#1 IRTE 149 ACTIVE DRIVEN -1 80: UNKNOWN 1 Well Inspection Well inspection Checklist Source ID ear Installed Casing height(ft) In Pit(Y/N)?, .Well House?.Vent Screened?Sedsonal?l Candition? 4020016-01G I i UK 1Y IN I IN JUNABLE TO VIEW1 Are all wells in use approved and recorded in WQTS? Yes ® No ❑ Are all of the wells listed on the sampling schedule? Yes ® No ❑ Are manifolded wells reflected accurately on the schedule? Yes ❑ No ❑ N/A *Is the wellhead damaged in a manner that would make the source susceptible to contamination Yes ❑ No ❑ *Are there unprotected openings in the well cap or casing? Yes ❑ No ❑ *Is the wellhead, cap, and/or vent subject to flooding? Yes ❑ No ❑ Are all wells > 100 ft from the nearest surface water? (NC systems) Yes ® No ❑ Is the quantity of water supply adequate? Yes ® No ❑ Do any sources run dry? Yes ❑ No If yes, during which periods and how is it handled? Comments: *Well in pit under heavy cement cover, surveyor was unable to view. The April 2001 Sanitary Survey recommended to extend the well casing at least 18 inches above ground. The September 2009 Sanitary Survey Report listed the lack of action on the 2001 'recommendation as a deficiency under the 4.20.4 Guidelines. Presently, the wellhead-is still enclosed in the concrete it.—See Table B — Deficiencies. 7 Old Village Store Barnstable 4020016' July 15,2014 Source Protection: 6 SWAP Database Information OMIT - jc- � l ".S.3'f'.E�'"A '}4�4G?'3Y3 -'•-r 1 '�.1 ��5i.1 Hi 5 f� �� �T Sou ce D ffAPP owed Vo ume W�PA? ZgRe k'I§. terminal on Is Zo e i " w Zone I(ft) n(a , Pollution Sources 0245 110/GD ° {ftl �aMethgd � OwnecJ?° 4020016-01G 999.36 100 7 142Z TITLE 5 RATE N BUILDING, ROAD,PARKING Is there excessive use of fertilizers or chemicals in Zone I? Yes ❑ No Are there any known or potential,sources of pollution observed in the Zone I or IWPA (other than those listed above)? Yes ❑ No Is there an awareness of threats and an attempt to minimize them? Yes Z No ❑ Is protection area posted? Yes ❑ No Are source water protection measures adequate? Yes ❑ No Comments: None OTHER ISSUES OBSERVED: None PRIOR OUTSTANDING ACTIONS- Enforcement Actions: None Inspection Actions: V' RIfig, ion DEP SINSx:_' �"., � � � <gcUon� AcLonCoriplete* PWSID# k � p ;Correct�ve,Action M MDaten. ,ti.Staff.r= TYPe [ nrri-: a; ;� � � �_ Deadline Date_ 4020016 9/24/2009'TARDIEU SAN ;EXTEND TOP OF WELL CASING 18 INCHES ABOVE 3/22/2010 Statement of Zone I Compliance ®Please note that you lack ownership or control of the required 100 ft Zone I protective radius around the following well(s): 4020016-01G If you plan to modify or expand this source or to replace any wells,, you,must notify DEP (in accordance with 310 CMR 22.21(3)(b), 310 CMR 22.04(1) and 22.21(10)(a)). At the time of such notification of a proposed modification or expansion, DEP may require you to comply with the Zone I requirement. ®You are hereby notified that: the. following well(s): 4020016-01G are in non-conformance with the MassDEP's requirement (310.CMR 22.21(1)(b)(5)) that Zone I activities .be limited to those directly related to the provision of public water or will have no significant adverse impact on water quality (as. specified in Policy 94-03A). To the extent possible, efforts should be made to reduce or eliminate the impacts-of non-conforming uses within the Zone I. Pursuant to 310 CMR 22.04(1) and 22.21(a), you must notify the DEP if you.plan to modify or expand your source or to replace any wells.. At the time of such notification of.a proposed modification, expansion, or replacement, DEP may require. you to comply with the Zone I requirement that all Zone I activities be limited to those directly related to water supply or will have no significant impact on water quality. Non-Conforming activities documented within the Zone I: BUILDING, ROAD,PARKING 8 Old Village Store Barnstable 4020016 July 15,2014 SUMMARY OF FINDINGS Table A—Violations Please note that this document is also a Notice of Noncompliance(NON) pursuant to M.G.L. c.21A, §16 and 310 C.M.R. 5.00. Within 30 days of receipt of the NON and inspection report,you must fill-in the corrected date(s)and submit this form to MassDEP and the attached SANITARY SURVEY COMPLIANCE PLAN RESPONSE FORM,including all applicable attachments. If the time required to complete the correction is greater than 3 months,submit quarterly progress reports and provide an anticipated completion date. GWR Significant Action Due' Date T/F/M Citation TABLE A-CORRECTIVEACTION Complete by Deficiency Date 'PWS . 1. T 2. Table B -Deficiencies MassDEP has made note of several items that do not reflect good water system practice and, if left unresolved,could lead to problems that are more serious. Some of these items may be potential violations, and are summarized below. Due to the item's severity or importance MassDEP has included a required course of action with a compliance date. GWR ,.Date.: T/F/M Citation TABLE B.-CORRECTIVE Action Due ACTION - Significant _ Date Complete:by DeficiencyPWS 1. T/F 310 CMR A buried or below grade wellhead that cannot be inspected is Y November 22.26 considered to be a well subject to flooding. Extend the top of the well 28,2014 casing at least 18"above ground. 2. T/F 310 CMR Replace broken pressure gauge. N October 22.04 28,2014 3. Table C -Recommendations MassDEP has made note of items with a recommended course of action, summarized in Table C. It is strongly encouraged to follow the recommended actions in order to improve ability to provide a safe supply of drinking water. Failure to do so could eventually lead to violations of the regulations. T/F/M TABLE'C-RECOMMENDATIONS 1. T Pressure tank needs to be upgraded. 2. T Calibrate meter 3. *Groundwater Rule Significant Deficiencies: The EPA, as part of the Groundwater Rule, required states to identify specific Significant Deficiencies that are related to the potential for fecal contamination of the water system. Significant deficiencies, when identified at a PWS that is subject to the Groundwater Rule, are regulated under the treatment technique requirements of the GWR. A PWS has 120 days to correct any significant deficiencies after notification from the state of their existence. If the deficiencies cannot be corrected within 90 days, then the PWS must enter into a MassDEP-approved correction action plan, with intermediate timelines for compliance. Failure to have an approved corrective action plan in place within 120 days or to comply with the timelines contained within the corrective action plan, constitutes a treatment technique violation, as detailed in 310 CMR 22.26(4). If a system fails to correct any identified significant deficiencies, then the PWS will be required to provide an alternate source of water, eliminate the source of contamination, or provide treatment that reliably achieves at least 4-log inactivation of viruses. 9 Old Village Store Barnstable • 4620016 July 15,2014 SANITARY SURVEY COMPLIANCE PLAN RESPONSE FORM for TABLE A & B Within 30 days of receipt of this inspection report, you must complete and submit this response form if your system has TABLE A —Violations and/or TABLE B-Deficiencies. Attach a copy of the completed tables listing the date that the corrective action was or will be taken by your system and all other applicable documentation. (310 CMR 22.04(12)) Please note that violations listed in TABLE A of the Compliance Plan are also a Notice of Noncompliance (NON) pursuant to M.G.L. c.21A, §16 and 310 C.M.R. 5.00 and may require the submission of quarterly written progress reports on the identified violations. The following corrective actions listed in the Sanitary Survey Compliance Plan(s) TABLE A and/or B has been taken by the public water system. (Please check all that apply). ❑ My system has taken ALL of the corrective actions listed within the timeframes specified in the Sanitary Survey Compliance Plan(s). • For each item, I have listed the completion date of the corrective action within each table. • I have attached copies of supporting documentation as required. ❑ My system has taken SOME BUT NOT ALL of the corrective actions listed within the timeframes specified in the Sanitary Survey Compliance Plan(s). My system HAS NOT complied with ALL of the requirements set forth in the Sanitary Survey Compliance Plan(s). • For each item, I have listed the actual or anticipated completion date of the corrective action within each table. • 1 have attached copies of supporting documentation as required. • 1 have attached a revised corrective action schedule establishing timelines for my system to address outstanding items and I will submit a written progress report each quarter (every 3 months) until all items have been addressed, at which time written documentation of completion shall be submitted to the Department. I understand that my system may be subject to further enforcement action. ❑ My system is UNABLE to comply with some or all of the corrective actions within the timeframes specified in the Sanitary Survey Compliance Plan(s). I understand that my system may be subject to further enforcement action. • An explanation is attached. I hereby acknowledge receipt of the inspection findings and compliance plan table(s)of the sanitary survey conducted by the Department of Environmental Protection's Drinking Water Program. I certify that under penalty of law I am the person authorized to fill out this form and the information contained herein is true, accurate and complete to the best of my knowledge and belief. Water Commissioner, Owner, Owner Representative or Other Responsible Party: Signature: Date: Print Name: Title: Return this form, a copy of each Compliance Plan Table and all attachments to: DEP-BRP Drinking Water Program,20 Riverside Drive,Lakeville,MA 02347 Attn: Isabel Collins 10 o � c� z w � v �� ,,p r � � Town of Bar SW Post This Card So That it is Visible From the Street=Approved Plans` M°S& Posted'Until Final Inspection Has,Been Made.. 163p Faraa�'' Whee a Certific rate of.Occupanq is Required,such Building shall Not Permit No. B-18-3626 Applicant Name: Date Issued: 10/31/2018 Current Use: Permit Type: Building-Sign Expiration Date: 0 Location: 790 IYANNOUGH ROAD/RTE132,HYANNIS _ Map/Lot: 311-092 Owner on Record: BARNSTABLE,TOWN OF(ARP) Con Address: C/O WS ASSET MANAGEMENT INC I Con CHESTNUT HILL, MA 02467 Description: 4 signs total for BANK OF AMERICA i 4 SIGNS 12 SQ FT EACH Project Review Req: TOWN OF BARNSTABLE INSPECTION WORKSHEET Chose CERTIFICATE NO: CANCELLED: Q MAP: 155 DBA: I&LD VILLAGE RESTAURANT, INC. PARCEL: 017 NAME/MANAGER: ISUSAN STOCKDALE STREET: 12455 MEETINGHOUSE WAY, UNIT#4 VILLAGE: JWBARNSTABLE STATE: MA ZIP: 02668- SEQ NO: 1❑ BUSINESS TYPE: IRESTAURANT CONSTRUCTION TYPE: STORYI: CAPACITY: USE1: B Capacity Under 50: O STORY2: CAPACITY: USE2: STORY3: CAPACITY: USE3: Outside Seating: ❑ BY PLACE OF ASSEMBY OR STRUCTURE CAP1: 8 LOC1: SEATS OUTSIDE CAPS: LOC8: CAP2: 12 LOC2: DINING ROOM CAP9: LOC9: CAP3: 4 LOC3: STOOLS AT COUNTER CAP10: LOC10: CAP4: 16 LOC4: MAXIUM INTERIOR SEATING CAPACITY CAP 11: LOC11: CAPS: L005: CAP12: LOC12: CAPE: LOC6: CAP13: LOC13: CAPT. LOCI: CAP14: LOC14: INSPECTION: DATE ISSUED: EXPIRATION: E 0 P 1int Thls Screen 0 05/19/2011 0 0 PrinrCertlfjcate of Inspection �'; COMMENTS: 2014.11.20 11:19 JHS Capital Advisors 5084205981 >> 508 790 4555 P 1/2 -ri.ra c 5=7j 1i, 1 G.y �`��� ��:a: �•'fir•t ���'�y ... M v y Fi) li U � � 0 m z XEI WdT�, :OT OT02 12 Aow MAIN STREET - RT. 6A 12' SHELVING FIRE EXIT 4x4 m 'N v DRY IW- PW CE W W END DISPLAY aA CY_ W FEE REAL ESTATE OFFICE 0�' 4x4 W V O 4' 4' CV a 8'-2' END DISPLAY SAND SIW `v N 4x4 C] �' W H � •44 2'X8' 4x4 Q w FORA ICE v U o1-2-LL- F'CORALLU RE W o AKE Iq" s. CARTS a 17' SHELVING iO SIDE FIRE T Q 4 ENTRY 04 16x6� �6x6 ' t jyyr a 4x4 aR O m W,OR 4x4 S RVIG COUNTER 30•DR W IY 2 DR. ICE N '" � LL! - 3a oR �Lu co CREA 10 Q! ® GATE 4 p? I v ,I $ ff u jllll�to "�..•l V IS D. e ■4x4 W IN Ip (YI L! ICE C WEAM (E) ©� HOB j—AIRI wo-o HANDLER �V"- IXVEL FLOOR L--- *44 ---=—YOx 0 llif (� RAMP DONN LL sd 17R WSTAIRS TO 161" DAIR BASEMENT 32 24 BAT44 LL �� L? FIRE EXI Q e •e� OFFICE N pp��g�N� Rq�p T01 SE REPAIRED vP 3Q t RE-SURFACED O MOP SINK ` 4x4 �ry �c9+ O9 O 41 PARTITION beEA�RI N RE ODELED �' 0�'P -j RECEIVING RE ROOM 4 '8• >L ' O� � � � (DRY STORAGE) ` 4x4 la" B. 8' LO sus TABLE H/w MEAT CASE ;��'�. Q M,N SHELVING PREP SINK �� �q w 3' (Q MEAT DOOR , FIRE EXIT PREP w MEAT RACKS GATE de F111 4x4■ 3 -- PIZZA PREPARED LAIGOPENIN4 OVEN FOOD STORAGE 9p CASE FOOD q 4x4 GRILL PREP PHONE In r------------- 6FT I� �jELI 4 f FINAL FOOD PREP CABINETS I DELI I RODUCE f TO BE DETERMINED ON-SITE MEAT Gpq6EIR -------------� In IL n> IS -O STORAGE 32 DOOR 25' SHELVING GATE 15 SHELVING H> FIRE EXIT Iq' B. FIRE EXIT iq" B. 3' com W-W WINDWV sa 31 WINDOW REAR OF BUILDING BARNSTABLE GENERAL STORE PROPOSED CONDITIONS FLAN 11 -30- 11 SCALE 1/8" I' .»• t \ jeiEpyt D.DaLu2 Building Commimontr TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS,MASS.0260t TELEPHONEi 775-1120 EXT.107 November 17,1982 J ' Mr.Martin Flynn Board of Selectmen Hyannis,Mass. Dear Mr,Flynn? Lt^es-f \oc>^7^ 1,personally,visited Mrs.Parris at her business known as the West Barnstable Trading Post.We had a long conversation concerning her business and the area. In addition,Buddy Martin (Building Assistant) is in that area daily and he has also stopped and spoken to Mrs.Parris on numerous occastions. Parris in in the Village Business District, following is permitted: In this district the Retail store,professional or business offices,bank, personal service store or shop. Since she sells merchandise she would fall within the retail category, and I understand that "barter"also falls within the same category. Therefore,the use appears to be legal under our zoning. The question of the yard appearance is,I believe,the area of concern. Mrs.Parris made it very clear that she lives very simply and that she has done all she could in keeping the area in her life style.During our discussion she said she would agree to an 8'section of fence to conceal where the children play and to complete the shingling on the south side facing the street. This question of appearance is the one area that has caused heartburn, particularly when "compliance"is non-negotiable. I had asked Jeff Parker to review Mrs.Parris's lease,and I believe I was informed that the questions raised were not relevant to the lease. Mrs.Parris also mentioned that her attorney advised her that she is not in violation of her deed. As I stated.Buddy Martin has that area of enforcement and he informs me that the area conforms to the limits of our enforcement. Peace, ;eph D.DaLuz lilding Inspector Board of Selectmen New Town Hal 1 South Street Hyannis,MA 02601 Gent 1emen; August 30,1982 ,eWNs/ The Trust Fund Advisory Committee had its usual monthly meeting on August 18th and on that occassion and at the prior monthly meeting the Committee has been advised of serious problems regarding the property at Lombard Farm leased to Elizabeth G.Parr is—property known as the West Barnstable Trading Post. A nearby neighbor has indicated that conditions there have not improved, but rather have disintegrated.Generally the complaint being that the property is not properly maintained and it is simply a mess. There are conditions to the lease,and it is alleged that these conditions have not been met. The Committee unanimously asked me to write to you to request your intervention in this matter;specifically,that you ask the Building Inspector to visit the premises and advise Mrs.Parr is that her-lease is being reviewed for possible violations and that he report his findings to you. The Trust Fund Committee would,of course,appreciate being advised of his report to you. FPC:tm Kindest regards. 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