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HomeMy WebLinkAbout0010 PERCIVAL DRIVE E - 0 0 n v i Oidbrcr NO.182113 ORA WIO�N U EMIjE • • o o -�+ "' -.,� .. .. _., �.__ ..� t __-...,a.,_....dr r.":h"..'�"".�-..,,� _ „.,ram q,r� _ �.�..a.rL..�..+w:�...i._ � ...-�.•.e..M....� _ _ __ - 'a-e,.�-,�.f��..w.+"irr'�. _ _ Town of Barnstable Building t Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept "'"� Posted Until Final Inspection Has Been Made. Permit 463P �� 3 Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-20-1614 Applicant Name: William McCluskey Approvals Date Issued: 06/30/2020 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 12/30/2020 Foundation: Location: 10 PERCIVAL DRIVE,WEST BARNSTABLE Map/Lot: 111-057 Zoning District: RF Sheathing: Owner on Record: DOWDALL,MARK D&LYNNE A Contractor Name: WILLIAM J MCCLUSKEY Framing: 1 Contractor License: CSSL-102776 Address: 10 PERCIVAL DRIVE � 2 WEST BARNSTABLE, MA 02668 =the Est. Project Cost: $2,900.00 Chimney: Description: Add R-38 fiberglass, R-33 cellulose,and R-10 rigid insulatioPermit Fee: $85.00attic.Air seal the attic plane with expanding foam.Genera Insulation: weatherization. Fee Paid: $85.00 Date: 6/30/2020 Final: Project Review Req: 10 Gy�_lazr? -- Plumbing/Gas Rough Plumbing: \Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within7six months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in with the local zo�ling by-laws and codes. 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 Final Gas: work until the completion of the same. I Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: j 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: i 0?0 IQ 0 7 (o Town of Barnstable *Permit# Expires 6 months fran issue dale Regulatory Services Fee ',3,�S� MASS. 'Thomas F.Geiler,Director 163 V/�opRESS PERMIT ' 9 ArfD MA'l Building Division I. Tom Perry,CBO, Building Commissioner DEC 3 200 Main Street,Hyannis,MA 02601 www.town.barmtable.ma.us Office: 508-862-4038 TOWN BLE EXPRESS PERNUT APPLICATION RESIDENTIAL ONLY 1 J, Not Valid without Red X Press Imprint Map/parcel Number / Property.Address w . Residential Value of Work l,sI—y eT Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address,j p Contractor's Name Number �J r.- Home Improvement Contractor License#(if applicable) `?O 65 7 Construction Supervisor's License#(if applicable) �/ 31-0 Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner �I have Worker's Compensation Insurance Insurance Company NX� i��,l� Workman's Comp.Policy# ly�-1J G j®� `7 V 2© /. 62 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricad.nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side A #of doors replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and.inspections required. Separate Electrical&Fire Permits required. - *Where required: Issuance of this permit does not exempt compliance with other town department_regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter.of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is equired. SIGNATURE: QAWPFILES\FORMS\building permit formsEXPRESS.doc ?die Commonwealth of Massachusetts Deparhnent of Industrial Accidents OfiTce of Investigations 600 Washington Street Boston,.AM 02111 . wrcwv.massgov/dia Workers' Ctampensation Insurance Affidavit: BmlderslCantractorslEdectric anslPlnmbers. icant Information Pease Print Legiblv, Name(BusinessMmanizafi=hv ividoa1): Address_ City/State/Zip Phoneme Are au an employer?Check the appropriate box: Type of project(required): I am a employer with 4 ❑ I am a general []and i 6- ❑New construction employees(full audlorpart-time}* ha're the sub-contactors . listed on the attached sheet. 7.-0-Remodeling 2.❑ I am a sole proprietor or partues- These sub-contractorshave g- ❑Demolition ship and have no employees woddng for me in any capacity- employees and have vvctrkers' 9 ❑Building addition [No workers'comp.insurance comp.insu aural 5. ❑ We are a corporation.and its 10.❑Electrical repairs or additions required.]3..❑ I.am a homeowner doing all work officers have exercised dwir 11.0 Plumbing repairs or additions . myself [No workers'camp- right of exemption per bIGL 12.❑Roof repairs insurance required.]r c. 152, §1(4),and we have no - o workers' 13.❑Other employees- . IN comp.insurance required.), *Any apphcant that check box Ai mast also fill mat the sectian below showing the¢wodsens'compensation policy information— I Homeownen who submit this affidavit indicating they are doing all wed and then him outside con=mrs¢ 'submit a new affidavit indicating such. tContracrors that check this boat iowt attached an additional sheet showing the name of the s:6-camdractws and stare whether,or not those entities have employees. If the subtontractom have®ployees,theyamst.pravide their viurkeW comp.policy number. lain are emplo;,et that is ptmjiding workers'co.trrperrsation insurance for wry amployee& Be1ow is the polig-and job site. information. n �� 2.e�Insurance Company Name: � Policy#or.Self ins.Uc:#: F-xpiratian Date: / —��- Job Site Address: City/State/Zip- Attach a copy of the workers'compensation policy declaration page(showing the policy cumber and expiration date). Failure to secure coverage as required under Section 23A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 1,500-Oa 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 stitement may be forwarded to the Office of Investigations.of the,DIA for insurance cooperage verification- ' I do hereby certi the ' s and pmattiss ofpedwy that the infot mid asn provided above is bus and correct Si Date: z, - Phone official use only. Do not write in this area,to be completed by city or town officiat City or Town: PermitlLicense# Issuing Authority(circle one): 1..Board.of Health 2.Building Department 3.City(Fown Clerk 4.Electrical Fnspertor rs:Plumbing Inspector 6.Other r' rr, _ 1. s ration valid for individul Use to:. -...�---•" '.... e d return ~" License or r g iration date. If foun Regulation . ,1 at, before the v er Affairs and Business p ° ;aeff ss g office of Consu Suite 51�0 tjr airsY T CONTRACTOR. Type. 1 10 Parkplaza- Otfice%IMPROVEMEN A 02116 t1pN►E 120659 .Boston,M !''z OBA " Registration y{Lg12014 Expiration-' tur N R ISES= l i• e s.0 LL E,TE P ali d w►thout sign I 1'j Not v Rp tpN '`-7� Undersecretary '• ;��Via,:>, 59 FREE ORT, YARMOUTHP.• _ Massachusetts- Department pf Puhlic SOON 4, Board (if Buildin�u Re'aulations and Snind:irds Construction Supervisor License One-and Two-Family Dwellings License: CS 71507 s + DAVID J LINNELL JR 59 FREEBOARD LN YARMOUTHPORT, MA 02675 - Expiration: 8/11/2013 Tr#: 2398 ('ommissioner - a ALICR Inc INSURERS AFFORDING COVERAGE NAIC 9 INSURER A: A,E.I.C. . INSURER B: ell Ente INSURER C: 59 Freeboard Lane' INsuRER o: Yarm0u-`.1' ;02675, INSURER E HAVE BEEN COVERAGES THE POLICIES OF,IN S OR CONDITIO BELOWN OF ANY CONTRACTUOR OTHER DOCUMENTAWfTH RE ECTTO WHICH THIS CERTIFICATE MADY BE ISSUEDOR NMAY ANY,REQUIREMENT, PERTAINt�THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES_AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. T In t IMiTs TYPE OF INSURANCE POLICY NUMBER D •LTR'1 EACH OCCURRENCE 5 GENERAL LIABILITY.ri S .; 60MMERCIAL GENERAL LIABILITYPREMISES a e0nce do ia CLAIMS MADE � OCCUR MED FXP(Any one Verson) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE S PRODUCTS-COMPIOP AGG S GEML AGGREGATE LIMIT APPLIES PER: POLICY PROJECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S (Es n6denl) ANY AUTO ALL OWNED AUTOS BODILY INJURY g (Per person) SCHEDULED AUTOS HIRED AUTOS IPOer lecdder�i)INJURY S --1 NON-OWNED AUTOS ° SRCR (Pu eaE-dtlTMetf AMAGE O S AUTO ONLY-EA ACCIDE T GARAGE LIABILITY ANY AUTO OTHER THAN EA AFC S AUTO ONLY: AOG S EXCE39/UMBRELIA LIABILITY EACH OCCbRRENCE S `n OCCUR F1 CLAIMS MADE AGGREGAf E S ft- I 11T $ I— , J S DEDUCTIBLE - S RETENTION S WORKERS COMPENSATION AND TO LIIIM S ER EMPLOYERS LIABILITY WCC5007447012012 8/112012 8/1/2013 E.L.EACH ACCIDENTANY s 100,000• A OFmCERIMEMBER EXCLUDED? 100,DOD EL DISEASE-EAF,YPLOfEE $ If yea,describe undor E.L.OISEABE-POLICY LIMIT S 5pD,000 SPECIAL PROVISIONS balwv OTHER Osrid Linnell is covarad by the workers compensation po5Cy. i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION IITown of BaMStable .DATE THEREOF,THE ISSUING INSURER WILLEmEAVORTOMAIL 15 DAYS WRITTEN i Building Department NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 200 Main Street iMPOBE NO OBLIGATION OR LIAMLITf OF ANY KIND UPON THE INSURM ITS AGENTS OR Hyannis, MA-02601 REPPEbFJdTATiVES- AUTHORW--D REPRESENTATIVE 'AGORD 25(2001108) 0 ACORD CORPORATION 1988 1 c+ i 639: ,�� Town of Barnstable prEp Mp'l A Regulatory Services Thomas F.Geiler,Director Building Division' Thomas Perry,CBO. Building Commissioner 200 Main Street,' Hyannis,MA 02601 www.town.barnstable:ma.us Office: 508-862-4038 'Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize- JI?ris�ril� _�� to act'on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the'Homeowners License Exemption Form on,the reverse.side. : . Q:\WPFILES.\FORMS\buildingppnnitforTns\EXPRESS.doc : °F1I Teti Town of Barnstable ' Regulatory Services. * 1AMSPABLE, " Thomas F. Geiler, Director MASS. 16 n3iwt°`� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office:. 508-86240 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: . number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall riot be considered a homeowner. Such"homeowner"shall submit to the Building Official-on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned "homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and.requirements and that he/she will comply with said procedures.and requirements. Signature of Homeowner Approval of Building Official' Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109,1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unIicensed.person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,M part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several,towns. You may care t amend and adopt such a form/certification for use in your community. Town of:VBa $,t-a�1�LE CF THE Tp� do Regul� vices Thomas F.Geiler,ureAt • BAMSTABM - M6 39. �0� Building Division ArFO MA'S A Tom Perr B rdi ; ginner i y° 't�;r�Ps�oz6o-i� . 200 Main Street, Hyannis, www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT# g FEE: $ UU SHED REGISTRATION 120 square feet or less 1 D Nc O-C-►V CA . $r- l.J do—r rls+z,,-b Ie, Location of shed(address) Village . Property owner's name Telephone number /-C. © i( f2 1l► Size of Shed Map/Par el# 1 S - �o -o! ' Signature Date - Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? 1g-�r as Conservation Commission(signature is required) ° PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 r - ;-Appiica�ion to: - - ID Old K ng s 4igh�ay 1 e io 'al"•Hisi District Committee in the Town of BarnstaWi for a _ CERTI ICATION.OF EXEMPTION Application is hereby made, in triplicate,for the issuance-of a certificate of exemption under Section 6 and 7 of Chapter 470, Acts and Resolves of Massachusetts, 1973, as amender) for proposed work as described below and on plans, drawings,or photo= graphs accompanying this application. i I TYPE OR PRINT LEGIBLY DATE �Q �� ADDRESS OF PROPOSED WORK �Sk�/f/ a� SESSORS MAP NO. zz/ as OWN E R.��?.��d/d/!J/� j .. ASSESSORS LOT NO. ��_•_,. HOME ADDRESS ,l/1��iPC/1114 NO. (10 ,_,�,� AGENT OR CONTRACTOR ITS/2 2,9 a ADD R ESS• ka/0(ali Tiy /�,rf�,l.,,fN�t//S /�� TEL. NO.SQA '�,rC - r This application is for exemption of proposed exterior construction on the ground that: ❑ ) It will not be visible from any way or public Pjace. 4 `2) It is within a category declared entitled to exemption by Old King's Highway Regional Historic District Commission. (Check applicable box) PROPOSED WORK: Describe and furnish plan of proposed work,showing location on lot, and, if an addition Is involved,show.* ing location of existing building, d. ,z e-A 6wu e�- -7 EZ ,Z�✓ST/�'L C �� -x l� c.J,I�C-� G✓ /T/7' /��u�3��T'C.��v I r Tff �&tL j� �1CNED Owner-Contractor-Agent en Space beloline or Committee use. c.l IL 9 t j i Received by H:D.C. The Certificate is hereby Date -1 Time By Date Approved ❑ The categories of-work entitled to exemption are listed on Disapproved ❑ ' the back of this form. i 1V ASSESSORS MAP. 111PARCEL: 57 _ i y j/ `v�.-�. CURRENT ZOV I NG: RF BUILDING SETBACKS: F: 30' S: 15'--R: FLOOD ZONE: C BENCHMARK AT CA?'Ce'I BASIN LOCUS I, ELEVATI0N = 88.2 LOCATION MAP � 8 ol-" /9° 35,251. ---- . ' r 98 100102 \\ , A�q , /\ 106 < 9,3- 7 98 94 o J 108 UTILITY �� �t �WPROPOSED- / 1 WEI \ j + 84 1 86— 88— TII-1 / 90— i LOT 12 104 / 106 1.0i / KEY: 0' _ + no CONTOUR: 4ssessga's office(1st Floor): Assessor's map and lot num ` ) 'S 7 G Ow11_ .1 .0� Conservation(4th Floor): Board of HealtFi(3rd flo � '_ • Sewage Permit number H!:: � TIC SY� MUST s�y�i Engineering Department(3rd floor): ; / 'INS IALLED IN COMPLIAN i610' House number 1 ! Qr \►G'`i,! w °Y1r D,efinttive Planning Plan Approved by Board /O 19 t WITH TITLE 5 . _ VIR®MMENTAL CODE. AND APPLICATIONS PROCESSED 8:30-9:30 A.M."and 1:00-2:00 P.M.only TOWN ' O;F BAR STABLE BUILDING 'INSPECTOR APPLICATION FOR PERMIT TO1 ,0 �` ���%N/G / Y(Nyr'G�j ,TYPE OF CONSTRUCTION 1 r t EL 19 G� TO THE INSPECTOR OF BUILDINGS: ; The undersigned hereby applies for a permit according to the following information: Location Proposed Use Zoning District- �`'� - Fire District Name of Owner 60&ZA�1rA13Wjy Address A9� 02,11IX 196 pp''// ``,, p��� 24 SCKOOL fir; Name of Buildera6wra/fW A/� � tTAddress�O,adX ft lft�b&Wai S, MASS Name of Architect Address ,' Number of Rooms Foundation�lp7/� D� (, Ale, AQAI a//Vir f Exterior G -S Roofing � � �� '5kel 6l6g Floors U r i��� 1-0 6! Interior � !( ,/J c e1,, ` %> i � P�-at�r Heating t� l� /V��Uy ����(vll 1 Plumbing ' ///SM If p4 `''I PJ I N�'- Fireplace f'` ���'V �4drf0� Approximate Cost 4C%,� e a Diagram of Lot and Building with Dimensions Fee A;f�"J_o i OCCUPANCY PERMITS REOUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstabl egardi g the above construction. Nam Construction Supervisor's License 05, ^01i BQY, EVERETT JR. , .No 3fi96-3 Permit For BUILD DWELLING Location 10 Percival Drive , A O.51�1 Owner Everett Boy Type of Construction Plot Lot Permit Granted July 22, 19, 94 Date of Inspection: Frame. ,19� Insulation •19 k S Fireplace 19 Date Completed ' 19 r r•" i wo COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY OF ONE ASHBORTON PLACE "acerrenf MASSACHUSETTS BOSTON,AAA 02108 -c t'"r"ro"U017 LICENSE CAUTION EXPIRATION DATE L O N S T K. S V E R V I S O R 0 3/11/119 9 6 EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST RESTRICTION THEFT, PUT RIGHT THUMB NONE o r)6/30/1993 032809 o PRINT IN APPROPRIATE 6'� BOX ON LICENSE. �' o I-- ZETT a BOY JR � H 0 X 186 BLASTING OPERATORS z W DENNIS MA 02670 m Z MUST INCLUDE PHOTO. m PHOTO(BLAISTING OPR ONLY) FEE: n NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY PAID HEIGHT: sT PED-OR•SIGNATURE Of THE COMMISSIONER JUN 9 1993 c•,i i,">;,i:E,;;�!�1":',%ir'L�111`'1;�,';�J; THIS DOCUMENT MUST BE « SIGN NAME IN FULL ABOVE SIGNATURE LINE ldr...' CARRIEDON THE PERSON OF "'RE OF LICENSEE 1 THE HOLDER WHEN EN- • _ :3 ��RI�F{f�T)41gM�,•FAIIR• GAGEDINTHISOCCUPATION. �ISSIONER • • 5 �ti �ti c� ti� N 1 w�wo� �O ell x� LOT 11 35,258 + S.F. (0.81 ± AC.) w� 2y > >j LOT 12 o° / JOB # 94-039-11 CERTIFIED PL 0T PLAN PREPARED FOR LOCATION : LOT 11 PERCIVAL DRIVE WEST BARNSTABLE SCALE : 1" = 50' REEF REAL T Y REFERENCE : PLAN BOOK 413 PACE 99 NON OF 4t4 I HEREBY CERTIFY THAT THE STRUCTURE �� JOHN qcy SHOWN ON THIS PLAN IS LOCATED ON THE a� L GN CROWD AS SHOWN HEREON. o DEMAREST,JR. ra No.36859 co DM osu �PQ DEMAREST - McLELLAN ENCINEERINC 24 SCHOOL STREET P. O. BOX 463 JULY 22, 1994 WEST DENNIS, MA 02670 (508) 398-7710 DATE PR ESSIONAL LA URVEYOR i ;r O TH•O F �W-SACHUS DEPARTIVf ENT OF .USI�?Ari►ACCiDENI� ' 600 WASHINGTON STREET .fames J Catwoei: BOSTON, MASSACHUSETTS 02111 ornn:ssrone: WORKERS' COMPENSATIONINSURANCIr WMAVIT =_Y . .. el Viornsee/permimee) 3 ' with a principal place of business/tt:sidence at: (QCYS - do hereby certify,under the pains and ties of � - penal perjury.that± • _ .. . [ 1 am an emplovtr providingthe following workers'eom g pcnsatfon coverage for my employers working on this job. G- 5S� 9 lnsuran z�Z•�cc Company Policy Number C [I 1 am a sole proprietor and have no one working for me [] I am a sole proprietor.general co,ntrac ror or homeowner(cirde one)and have hired the contractors listed below who have the following workers'compensation insurance policies: Name of Contractor Insurance Company/Policy Number Name of Contrctor lnsurancc Company/Policy Number N1amc of Contnaor Ins=nee Company/Policy Number 0 I :m 2 homeowner performing all the wort;myself. Nom.Please be aware that-bile bomcowocrs wCo employ persons to co caintenaace.construction or repair wvrl;on a dwcisjnc of not more 6zc t•rcc units in waicb tie bor_•cowncr also resit-cs or on t c prouncs appurtenant thereto arc cot Generally considered to be c r=Dlovcrs vacrr 6c iz:'orLcra' Cotzoc.satioo Ac(CL C 15'_.sec- 1(5)).application by a borncowocr for a license or permit may ericeCec tie lcfal gurus of a.n err lover under 6c Coders'Corpcosation Act_ 1 L^CC. cz:%*C. t_S s—c-mcL wIL rw�CCG [O L: be fo _"-cr.;of:r.t cs::i:�Acadcnts' Ofiia orinsuran� for covcr:Cc -c - : c c�::cc un6 c- G: c:-. cC - sec :c c,vc.—r rc c:Scccc: ic:c to t•.c UM PO.-Mon nJ cr.:i6= ^p n o. c^:::i. p =�="'c of.J::c c: t tc S i S�G.GG�.cror J:n_-rt:o::-=.t of��to Cap vc�a..c c. Dcr._::iu i:I 6c form of:Stop Work Ordc::.ac a [Inc of S 100.00:pay a -ins:nc. Sicncd this 19 da.•or COMMONWEALTH OF 4W ACHUSr�M V�— f JEPARTMFNT OF L►TDUSTR2AMi►ACCIDENT� ' 600 WASHINGTON STREET jarnes.' CamoDei: BOSTON, MASSACHUSEITS 02111 �ornrrussione: WORKERS' COMPENSATION INSURANCEAFFIDAVIT-:. _ 't,, %1< -T GUI (licensee/permittee) f � r with a principal place of busincss/rrsidence ar- -714• _ s' i :. i� �x 1. do hereby certify,under the pains and penalties of that: Pules', ( I-am em lover providing the following 'p p g flowing workers compensation coverage for my em y ploees working on this • job. Insurance Company Policy Numbs G (� 1 am a sole proprietor and have no one working for me (] I am a sole proprietor,general contractor or homeowncr(circle one)and have hired the contractors listed below who have the following workers'compensation insurance policies: •- Name of Contractor Insurance Company/Poliey Number Name of Contraaor' Insurance Company/Policy Number Dame of Contractor Insurance Company/Policy Number 0 I :m a homeowner performing all the work;myself. NOTT.Plcau be aware t52t while botaeowoers wbo eroplov persons to&caintenanee.construction or repairworl;on a dwcliint of not moret5an t�rec t eiu is which the homeowner also resieu or oa i:c Frouncs appurtenant thereto arc cot rcaeralh• considered to be emnlo' tzacur tie�Orlctrs' Cort:ocasation Act(Cl- C 152.scc;. 10)),applieatioa by a borneowoer for a license or permit mayvid ecnec tie Ic=al suers cram ert:ploytr under the'Workers"Compensation Act 1 t ndc^;:nd t: . c�c, c:r. : ,wiL bc {orWz:,ccc to :. D -cr.r o:.r.cus;:::.'Acadcncs' Ofncc orinsu=cc for corcrarc scc:::c crvc.—sc rcct:::cc t race:SccZ,c:? G_ 'c=c:-.tc:c r per.Ju . ' to i�pos:t:on o. cri rinJ CC.^.=J=c-c o%:%::c c%t:n tc 5 i SrG.GO:,r.&or ir::cri.or.:-:.-tor c^ to enc yc:.:�.d c•::�cn-:ics i� the form of:Stop t`%'ori;Ordc::.:d: fine of S 100.00:day a€:ins:nc. � ' Signed this dat•or 19 �•��' ear'""`�►►`, `" Application to ' S►-hS�►�' S w � � 0.0�t dP• ��S/t .M Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a 1&1 4 0 7 6 CERTIFICATE OF APPROPRIATENESS Application is hereby made, iri triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 11 Exterior Building Construction: U New Building ❑ Addition Q .Alteration Indicate type of building: C4 House ® Garage ❑ Commercial ❑ Other 2 Exterior Painting: ] .3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: Q Fence ❑ Wall Q Flagpole ❑.Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY / DATE Mile 3: JP 9 y ADDRESS OF PROPOSED WORK .1�,L��PJ �- �� ��1�I_ ASSESSORS MAP NO. OWNER X_�.K_� U�. �21/� � ASSESSORS LOT NO. HOME ADDRESS ✓V d,2L,�EL NO. FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). Seo AGENT OR CONTRACTOR (�, ?,T 1 �T1, TEL. NO. ADDRESSZ/ S:TLVA 4 �Z DETAILED DESCRIPTION OF PROPOSED WORK: ,,Give all particulars of work to be done(see No. 8,other side), including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach`additional sheet, if necessary). ri- - 1 ��`�'f/p"tv''i :yl: :,f-. D � 4:.i'. •�38. •^.. .. :.!"'.� ,.�_-"Y? 't-: i 't':F: r:„�^, _. . Signed !jy -.s .'•� •_ _ - Owner-Contractor-A t staace below line for Committee use. Received by H.D.C. _ Date°� n The C c a is hereby �"TfJte Ume r. L__4 ��ez � am I 1 0 182 -�By a � TOWN OF BARNSTABLE )t' bQdW_N 'S° HWAY IMPORTANT • If Certificate is approved, approval is subject to the 10 day appeal period provided in the Act. ADDITIONAL INFORMATION FOR MAKING AND FILING AN APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS The four categories for which a Certificate of Appropriateness is required are: (application for demolition or removal is a separate form). 1. EXTERIOR BUILDING CONSTRUCTION (new or existing buildings): An application is required for any exterior of z building to be erected or altered including windows, doors, siding, roof, light etc., that will be visible from any public street way or public place. The following scale drawings are required in duplicate with application: plot plan (if addition — shov existing buildings in outline), floor plan and elevations. Also required are snap shots of existing buildings, where additions o alterations are to be made. No plot plan is required for addition or.alteration which does not touch the ground. 2. EXTERIOR PAINTING: An application is required for any portion of a building, structure or sign to be painted that visible from a public street, way or public place. Color samples must be attached to.these applications. An application is nc required when repainting existing colors, changing to white,or using colors approved by the Town Historic District CommitteE 3. SIGNS OR BILLBOARDS: An application is required for any sign or billboard to be erected within the District, with & following exceptions: a. Existing signs or billboards on November 27. 1974 shall have until November 27, 1977 to secure an approved Certifica- of Approornateness. b. Temporary signs for use in connection with any official celebration or parade or any charitable drive as long as they a removed within three days of the event. Certain other temporary signs that the Committee feels does not detract fro the Act may be allowed with the prior permission of the Committee. c. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they erected or displayed. d. A single sign of not more than 1 square foot in area showing the name, occupation or addiess of the occupant of t premises on which they are erected or displayed in a residential zone. 4. STRUCTURE: An application is required to build or alter any structure within the District which is defined by the Act a c6mbination of materials other than a building, sign or billboard, but including stone walls, flagpoles,hedges, gates, fences, e GENERAL REQUIREMENTS '~ WS. Work on projects requiring approval shall not be started until the Certificate of Appropriateness has been filed with the To ,=1.-c:r,.Clerk by the Committee. Approval is subject to the'10 day.appeal period provided in•the Act.-'.- .A. No changes shall be made from the original*approved ,specifications without advance approval of the Commission on amended application filed with the Committee. 7. A separate application must be filed with each project requiring a Certificate of Appropriateness. } 8. Under heading of "Detailed Description of Proposed Work" give detailed data on such architectural features as: foundat; "'chimney, sidrng;`roof�ng,roof pitch sash and doors, window and door frames, trim, gutters —leaders, roofing and paint cc 9. Unless application is complete and legible and all material required is supplied, application will~not be accepted or acted ul Copies of the Act establishing the Regional Historic District may be obtained at the Town Hall. i John M. Kelly 410 High Street W. Barnstable, Ma. 02668 James Leo Boyle 5 Village Drive E. Sandwich, Ma. 02537 Joseph & Carol Henderson 159 Starlight Drive Marstons Mills, Ma. 02668 Anthony S. & Helen Baudanza Box 683 44 Percival Drive W. Barnstable, Ma. 02668 David L. & Joan Lamachia P.O. Box 230 W. Barnstable, Ma. 02668 Steven & Pamela Shakin 18 Old County Way E. Sandwich, Ma. 02537 Weeks Crossing Comm. Assoc. P. O. Box 560 Mashpee, Ma. 02649 Celtic Blue Silver Mist OLD K I;N 'µ H I CHWAY H I TOR_I_G O I.STR I,CT SPEC SHEET FOUNOATION ou 2E. CAE PLc L-,CE a e- 0,4,,P C®�on: sip v �M►�r SIDING TYPt. lv+.� Cc-gin �1 COLOR v�-c SIDS T CHIMNEY TYPE e COLORS ROOF MATERIAL COLOR__�EvtT PITCH WINDOWS_ jLiVVCO SIZE TRIM COLOR IT-rc, DOORSCOLOR SHUTTERS I YWi C_ GUTTERS DECK 4 GARAGE DOORS*�, — W- l�� ►qsa N tT COLOR �I�U'(/�' �15--� Notes : F111 out Como IeteIy. Including me.a.surements ano ` materials/colors to be used. Three copies of this form are required for - sut✓mittol of an application. along with three copies each of the plot plan. landscaoe. p.Lan and elevation plan: . when app l i cable. 'Plot plan need not be "CertiFieci" . but shout a _ncw all structures on the lot to scale-. " N ASSESSORS MAP:L PARCEL: �Z_ TEST HOLE LOGS NOTES: 31 4 1.VERTICAL DATUM: ASSUMED FROM WAD(NCVD+/-) CURRENT ZONING:RI' ENGINEER: DO}'LE ENCINCERINC 2.MUNrCAPAL WATER IS NOT AVAILABLE. R c� BUILDING SETBACKS: WITNESS: THOMAS MCK£AN S.SCHEDULE 40-4"PVC PIPE TO BE USED THROUCHOUr SEPTIC SYSTEM. F: 30' S:15 pt16 DATE: 9-30-86 4.ALL PRECAST UNITS TO CONFORM WITH AASHTO H-10 A H-ZO 'V4p PERCOLATION RATE:<2 MIN/IN LOADING SPECIFICATIONS. O FLOOD ZONE:— TX-1 TH-2 5.PIPE PITCH-1jt-PER FOOT. 6.FIRST 2.OF PIPE OUT OF D-.BOX TO BE LAID LEVEL g BEXCRMARE AT CATCH BASIN TOP d £ 7.THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE c4 /ALvs ELEVATION-eaz N Sr sueI /03O USE OF A GARBAGE DISPOSAL �t PIIKET B.ALL CONSTRUCTION DETAILS ARE TO BE IN'CONFORMANCE WITH THE LOCATION MAP a SAND STATE OF MASS.ENVIRONMENTAL CODE(TITLE FIVE)AND LOCAL HEALTH REGULATIONS. LOT 11 - N ///���0 9.CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR 35258±S.F. !� ' 9• �O TO CONSTRUCTION. (OBI±AC.) urmUAf 10.DESIGN ENGINEER TO INSPECT AND CERTIFY SU/TABLESOIL CONDITIONS �1 'a, SAND TO A DEPTH OF 6 BELOW LEACH PIT AT TIME OF CONSTRUCTION: 0 , ' AND - - / 1 GRAVEL 89O 11.PROPOSED SEPTIC SYSTEM AND WELL LOCATIONS ARE IN ACCORDANCE WITH MASTER PLAN ON FILE WITH TIlE BARNSTABLE'HEALTH DEPT' /100102 so, NO GROUNDWATER ENCOUNTERED V / SEPTIC SYSTEM DESIGN 4 FLOW ESTIMATE: x zA Wt 1 ' ® -0-BEDROOMS AT 111E GAL/DAY/BEDROOM=2MCAL/DAY PROPOSED. GARAGE •'9DEDRDOM 2! gee ` \ SEPTIC TANK: D7ELLNa I 1 330 CAL/DAY•1.5 DAYS-495 CAL TI.-1010 04 USE 1000 GALLON SEPTIC TANK /p 67 6 / DECK 4� // I- LEACHING AREA: L ' WALK OUT A' � \ USE ONE LEACH PIT(6 z 4)WITH 3.0'OF STONE !H - _ _ 5 �` /�, ♦ : \: \ (12'EFFECTIVE DIAMETER s 4'DEEP) -------------- PROPOSED.DWELLING - - _ _ `\��061. g I \ \ SIDE AREA- 12 z 4 z PI-151 SF (ZS)-Q_CAL/DAY UTIL1tT Be- �qq \ 1 I \ \ BOTTOM AREA 6 z 6 z PI-113 SF (1.0)-113 CAL/DAY Cl/fSTER _ <yg�)` \ .\. \ I: 1 \ TOTAL CAPACITY-490 CAL/DAY \. PROPOSED •�' `� \. ;0 I ;. \ WELL I SEPTIC SYSTEM SECTION rPEASTONE \. . 1 10110 HASHED STONE 88- ' i/ / // /, / /, dQ 1 I / /� TOP OF FOUNDATION am— it / nE � 98� ' " I 1 1000 CAL ELEV. D-BOX 96Bt c.. LOT 12 - - 1 I mQ ELEV. SEPTIC TANK 968/ ELEV. " ELEV. ELEV. TEE SIZES: ELEV. 96.44 S - 104 , /I nE INLET:6'UP.10"DOWN ELEV. 1P OUTLET:6"UP,19"DOWN .ONE LEACH PIT(6's a'1 W,ITH 106 _/ S OF STONE•(12'.eFF.DRRAM: : . loft' BREAKOur CALc.t(97-,86),/ SITE AND. SEWAGE P-LAN KEY: EXIST/NO CONTOUR: -- 00 LOCATION.' PROPOSED CONTOu2' •""""""' EXISTING SPOT ELEVATION: 255 rnr �I DVDrIVAI DR1VF.. PROPOSED SPhOT ELEvATrmaj WEST BARNSTABLE, MA TESTHOLE:Y UTILITY POLE:-0- PREPARED FOR FENCE — HYDRANT.N- DM REEF REALTY RETAINING WALL- // DEMAR£ST-MCLELLAN ENGINEERING SCALE: 1"-30' DATE: 5-25-9d IA SCHOOL STREET PA.BOX A69 DM 9.4-099-11 WEST DENNIS.MASSACHUSETTS 02670 REFERENCE: PLAN BOOK W3 PACE 99 THONAS McLELLAN.P.£. lOHN Z.DEMAREST IR PIS. i ' FLAN yo . . 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L---� ofe� s'We -� 16 f PfuN _ unwm iv IL 1�--9'�`�(�uu('�v I a eo11GFvH.NIIUY-4'La+aPfG9 -_ -of�P F°F oHv .. uv.-f�rrseK LinL�--- . FoU1.Ir�R(Ivrl RAN -4d-c7A ZoocP .4 M7 cAoNV.L..N'VA`(04 NT ctti ..-:'.:.... "cuc ��I •rr�wm w ow...n an oMww nwa 4 4 i • 1�'BARNSTABLE, MASS ACNUSETTS r � � . 057 LD INU IRAN, �. A ,ICANT ' � T+C4[.-`. liG%.� `L .'•_L; DATE - t9 . _qo f®®� -.;,• ;r.'__ T'.A'O.DRESS _ � PERMIT NO. i a 3 PERMIT TO -%l:_-- INOJ (STRE�E T1 .1. .• .:J:.: '.�: y_ —�� (TYPE OF IMPROVEME NT)J (�) STORY - ICONT R'S IICENSEI ,..�:_ .�c�_ CivJi,',i • rl NUMBER OF AT (LOCATION) (P OPOSED US"E) sDWELLING UNITS 1.'J i�C.��]_yi3,i Jr Iot . LA ZONING BETWEEN DISTRICT SUBDIVISION (CROSS STREET) LOTS!BLOCK LOT ( ��SIZE BUILDING IS TO BE -FT. WIDE BY - FT. LONG BY " f FT. IN HEIGHT AND SHALL CONFORM IN TO TYPE i CONSTRUCTION USE GROUP BASEMENT WALLS OR FOUNDATION REMARKS: Sewage 94`357 . (TYPE) AREA OR VOLUME 'I 7 sq.(CUBIC/.SODARE FEET) ESTIMATED COST $ 135, 0 0{J PERMIT �6p• 5� OWNER .l:VE3rL�L 1T. BOY, Jr ADDRESS ..4 JC lltly J C, h 1.S t elinI S BUILDING BY y THIS PERMIT CONVEYS NO RIGHT TO PERMANENTLY. ENCROACHMENTS OCCUPY ANY PROVED BY THE ON PUBLIC PROPERTY, ALLEY OR SIDEWALK FROM THE DEPARTMENTHEJURISDICTION.IPON• STREET OR ALLEYNOT SPECIFICALLY P OR ANY PART THEREOF. OF ANY E PUBLIC WORKS. THEISSUANCE OGRADES AS WELL A PERMITTED UNDER THE BUILDING EITHER CODE, MUST BE AP- ILY OR APPLICABLE SUBDIVISION RESTRICTIONS. S DEPTH AND LOCATION OF P OF THIS PERMIT GOES NOT PUBLIC SEWERS MAY EUOBTAINED MINIMUM OF THREE CALL RELEASE THE APPLICANT FROM THE CONDITIONS INSPECTIONS REQUIRED FOR -APPROVED P ALL CONSTRUCTION WORK: PLANS MUST BE RETAINED ON 108 AND THIS WHERE APPLICABLE SEPARATE I. FOUNDATIONS OR FOOTINGCARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN �• PRIOR TO COvERING ST URAL S. MADE. WHERE A CERTIFICATE PERMITS ARE RE MEMBERS(READY T QUIRED OF OCCUPANCY IS R ELECTRICAL, PLUMBING REQUIRED FOR 3. FINAL INSPECTION NG BEFORE FINAL INSPECT DN HILDIAS BEEN E- MECHANICAL INSTALLATIONS.ID OCCUPANCY. NG SHALL MADE. BE OCCUPIED UNTIL MADE. POST THIS CARD SO IT IS VISIBLE FRO _ .�BUILDING iiVSPECTION APPROVALS M STREET R E E T I PLUMBING INSPECTION APPROVALS C'( ` ELECTRICAL INSPECTION APPROVALS �`.�.�._.,�,,,� � Ill �}vG, ��� l� �2✓I 7--=�%�� � --- JY// 2 _ I HEATING PECTION APPROVALS C' 5 IL f ENGINEERING DEPARTMENT 2 1 tO;4�OF HEALTH THER lw' dJ_ n o �� • SITE PLAN R VIEW PROVAL • I I i I K SHALL NOT PROCEED UNTIL THE INSPEC- P HAS APPROVED THE VgRlO'JI PERMIT N;LL BECOME NULL AND V 7RUCT10N. J�STAGE-G.' ' WORK IS NO1' '>(ART VOID IF CONSTRUCTION P, T I�; ED WITH?N SIX MONTHS OF SATE THE INSPECTIONS INDICATED ON THIS CARD CAN BE L�R�II 'S UED AS NOTED ABOVE ARRANGED FOR A'r TELEPHONE OR WRITTEN NOTIfIC.4TIn!J. � I *M�>, TOWN OF BARNSTABLE Permit No.. ..36-q-Q3..... BUILDING DEPARTMENT , I """ ! TOWN OFFICE BUILDING Cash .Y• 6yV•t X au+� HYANNIS.MASS.02601 Borid ..... ......... CERTIFICATE OF USE AND OCCUPANCY Issued to Everett Boy, Jr. Address �• 10 Percival Drive West Barnstable, MA USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE 1 BUILDING CODE. Sept. 22, .. . ..... , t9..9.4............. .. .. ... .. . .......... ... y� Bui ding Inspector ; f a. A FF TOWN OF BARNSTABLE Permit No. ...3b.-63,-,. BUILDING DEPARTMENT Cash TOWN OFFICE BUILDING .YL }639 ` HYANNIS.MASS.02601 Bond CERTIFICATE OF USE AIYD OCCUPANCY Issued to Everett Boy, Jr. - Address f' 10 Percival Drive West Barnstable, MA USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE+WITH SECTION 119.0 OF THE MASSACHU.SETTS STATE p BUILDING CODE. Sept. 22, 94 ... ...... . ... .. .. .... . .... 19................. . ....... .:��/ .. ................ Buis ling Inspector ; }