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0163 PERCIVAL DRIVE
7 r . o } 4 P a NO.152113 ORA N MAM w use►. i$F ESSELTE . � � f V . � _ ._ . �, Town of Barnstable P erm Regulatory Services o� Dl SHE Toy, Thomas F. Geiler, Director Building Division " s MASS. ' Tom Perry, Building Commissioner 0:59. ��� 200 Main Street, Hyannis, MA 02601 www.town.ba rnsta ble.ma.us Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner. J c l M E S MACS(f2� Phone: 5 )7 Install at: 63 Village: V-1i 5F L3 2"5rlpqCo!�-L Map/Parcel: I l 00O 10 12- 31 Date: 1 2 /t ' 1 / Stove A. New Used B. Type: �adi t/Circulating C. Manufacturer: V 6?1J10N1__ (A5r)Ak3 Lab. No. L)L_ 149 Z D. Model No.: 11Vfi/L�)� Chimney v —a A. New Existin (If existing, please note date of last cleaning ca � B. Flue Size 13 13 i w ; o C. Are other appliances attached to Flue? D. Pre-fab Type and Ma acturer ,. E. Masonry.: in nlined �. E,; I-Iea rth 00 A. Materials: 511 C� B. Sub Floor Construction: i Q()V-c>pj? v, Installer Name: 56M G.5 /INV✓2p� Address: I l0 3 p`t/LCt� i D2 Phone: 50T 44Y55 Y Location of Installation: D) 3 pact Urw D/C H.I.0 Registration# Construction Supervisor# OR check eHomeownerinstallin licens required APPLICANTS SIGNATURE APPROVED BY: /�✓Zw� ! ii oZ cc Please make checks payable to the Town o Barnstable *This constitutes on.of cial stove permit after inspection, photographed, and approved by the Building Inspector Q:forms:stove The Commonwealth of Massachusetts \ Department of Industrial Accidents Office of Investigations • 600 Washington Street. Boston,M4 02111' h wWV-mass.gov/dia Workers} Compensation InsurAnce Affddvit: Builders/Contractors/Eleetricians/Plumbers Applicant Information Please Print Le ' ly Name(Business/Organization/Individual): , �A e— S .mAc/t2;- •Aadress: l b 3 42.Eiv� ����� •. . , City/State/Zip: IkA S'r �DI�YWIvW✓_ Phone.#: �g Y5_� Are you an employer? Check the appropriate box: :Type of project(required):. [2. I am a employer with 4. ❑ I am a general contractor and Iemployees (full and/or part-time).* , have hired the sub-contractors 6. ElNew construction❑ I am a'sole proprietor or partner- ' listed on the'attached sheet 7. ❑Remodeling ship and have no-employees These sub-contractors have g, ❑Demolition working for me in any capacity, employees and have workers' (No workers', comp,insurance comp. insurance. $ 9. ❑Budding addition re ' ed] 5. ❑ We are a corporation and its 10.❑•Blectrical repairs or additions officers have exercised their 3. am a homeowner doing ill-work . 11.❑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, insurance required] *Any applicant that checks box#1 must also fill o.ut 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 Sub-contractors and state whether ornot those entities have employees. If the sub-contractors have employees,they must providt:their workers'comp.policy number. ------------ I am an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: 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 tip 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 Invest', lions of th for insurance coverage verification.. I do hereb ertify and the pains-and penalties ofperjury that the information provided above is true and correct. Si a e: Date: �Z'•1 /tt Phone#: Official use only. Do not write in this area, tb be completed by city or town offzciaL City or Town:' Permit/License# Issuing Authority(circle one): .-I.Board of Health 2,Building Department 3. City/ToSvn.Clerk 4.Electrical Inspector 5,Plumbing Inspector 6. Other r of Tt•+e r� Town of Barnstable " Regulatory Services BAJUVS7r,BLF, Thomas F. Geiler,Director Miss. =6s9. ,�� Building Division Tom Perry,Building Commissioner 200 Maiu•Streei, Hyannis,MA 02601 vcww.town_barnstable_ma_us i Office: 50 8-962-403 9 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE- IZI � � It JOB LOCATION: 1� O v�I V�4`, DA I V JC l,j[ s ')� 04,1 AIJ number street v village H EW " OMONER": d �/ n amc home phone# work phone# CUR F-NI'MAILING ADDRESS: CIS S At-,O O Z-5--3 7 city/town state rip 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_ DEFIN.CI'ION 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 constrgcts more than one home in a two-year period shall not be considered a bomeoamer. Such "homeowner' shall submit to the Building Official on a form acceptable to the Building Official, that be/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' meownee'certifies that.he/she understands the Town of Barnstable Building Department minimum* dctio procedures and requirements and that he/she will comply with said procedures and r ents. Signature of H town 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 scction.(Sectian 109.1.1 -Liccnsiflg of.conshvction Supervisors);provided that if the homeowner argages a peson(s)for hire to do such work,that s-u`ch Homeowner shall act as supervisor. 4-any homeowners who use this excrrrptiorr are unaware that they are assuming the responsibilities of a supervisor(see'Appcndix Q. R.ulcs&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness bftcn results in serious problems,particularly when the homcowncr hires unliccnscd persons. In.this case,our Board cannot proceed against the unlicensed person'as it wrould with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her iesponsibilitics,many communities require,as part of the permit application, that.the bomcovrner certify that hc/shc understands the resp=mbilitics of a Supervisor. On the last page of this issue is a form currently used by several towns. You may can t amend and adopt such a fomdccrtification for use in your community, n•f rr An rt[XCMDt zT � Town of Barnstable 0 Regulatory Services v� 1r 6 a� `erg Thomas F. Geiler,Director �rEow Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstab l e.ma,us Office: 508-862-4038 Fax: 509-790-6230 Property OwrierMust Complete and Sign This Section If Using- A Builder as Owner of the subject•property hereby authorize to act on my behalf, in all n-Atters relative to work authorized by this building permit application for. (Address of Job) . Signature'of Owner Date Print Name If Prope , . Owner is:applying.for pem-lit please complete.the . Homeowners License Exemption Form on 'the re de. n•cnoA�o.nn nrcn n.-.;............ . �oFt►,t ram, Town of Barnstable *Permit -y *Permit# Erpires 6 m �Ihs jroni fss dale ,. Regulatory Services Fee ]3tAAV3LlBLli, 1 1619- �� Thomas F. Geiler, Director � Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barns table.ma.us Office: 508-862-403 8 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 508-790-6230 a Not Valid rvl/hon!Red X-Press tmprinl Map/parcel Number ,16 �� t Property Address Cx/ I lU residential Value of Work �( e 0._ Minimum fee of$35.00 for work under$6000.00 Owner's Name c@ Address Im "l� � ��e-c f�� ► , IN ,.�G � , Contractor's Name t 1 c 0 Telephone Number_ Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) MAN,` v ` t]s•-y•!uw bi' W ti-,7y i!a y IiP d�9 N . Workman's Compensation Insurance Check one: u'I(I ❑ I am a sole proprietor ❑ I am the Homeowner MOAN' OF BARN.S")T:ABLE J2-1—�ave Worker's Compensation Insurance Insurance Company Name re %�r� Workman's Comp.Policy# ,A13— — ` 1 L b(-P M l7�(p Copy of Insurance Compliance Certificate must accompany each permit. Permit Request (check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to I�,a t � ;JCS ❑Re-roof(ht rricane nailed)(not stripping. Going over existing layers ofr000 ❑ Re-side ❑ Replacement Windows/doors Isliders. U-Valu #of doors e (maximum .35)#of windows •Where required: Issuance of this permit does not exempt compliance iriih other town department regulations,i.e.Historic,Conservation,ctc. *Note Owner Prope Owner must sign.Property Owner Letter of Permission. A copy o r ire the Home Improvement Contractors License & Construction Supervisors License is e SIGNAT i R . QAWPFILESIFO bi' in permit formslEXPRESS.doc ACORD. CERTIFICATE OF LIABILITY M SURANCE 12lOCflMO TMCER7W4KM5MMASAMUMOFMORKU=49LVmooanqMgofaoHMUpoN7HECEffMWATEMLOOL T= CERfFMAXOOE9NOfAPF9OAIIYELYORNEBAMELYAEEftOMMORALIMMM0dEERAB£AFfOROOBY7HEPOiJ mBELOW. TUBCBn=MOPfffUlRJtNCEDOESBOfCOZSIRBLEACONiRACfBEiREEATRE SSOEIIE: RBpTtESWA7WE OR PRODUCER.AIM THECB iERO1BF8 BIPORX4W.,Utls bcWw aanAGMTH BAL 6spoayoos)mmtbgwWW &IF Ci1RMjRW vmmub tD"w tmmaemdoa atD�poleY.eerNinpo&tesmsyneV�eeertdeodo rent A ppyda dwsmtom d f tho troy to ELett at engs}- PROMPOER COMACT NAR& P FAXWIIIJAD�PAW�OIl�.4 AL3CY (AlC Kci ft0: FAX 4W FALMOUIB ROAD Sam ADORE FRODUM C01M.MA 0285 CUSIVNERIDO: TINHW 9AEiORD9KiCOtrERAGB LEA ENs1� MUMMA: 7RAMKj==WrASSEM=ff TLE ICRCIDCS CONS7RUCrM SERVICES WC E C: 55 LISA LANE BTSURE R D: WESTBARNSTABi$MA M668 LNEAmm1w 84URER p cavaRam CERnRCAlEXUMBER: TWSTOCERnFYTigffMMPa CMS(WDEERLMMUMM68DWRMme®i66=rolMMUND di®ABOYEFDRIMPO REFV taDNUMBk� aLBA1P ANr Rismawaffiffy decomm OpopimcmannomommsO g�cryo BE 1 B s�sD ®�s DAeL i ec � a�aDr Paws i11'89{QodIdAY WE81 W �i BED BfPAIDoidMCIA M ow Fourv"FemE po1mewom L7R 7YpEOFE C9�lLYD PQIlC4EGte�$t (� LlaTB GENERAL LJABi M C0UMEP0aG80BiA UA88liY EACH OCCURRENCE CLAM MADE occwL GENL.ADGREBATELUSTAFPL05PM PamoNAL86ADVI am ; POLY PRQLECP LAC GEMMALAGUMME PRODUTIS-OMrJOPAee $ AUTONKIBOXILIABLm ANYAUTO COMBINEDSPIGIE ALLCMNEDAUTOS uwwae°ctaao S SCHEOULEAUMS BODLLYNAERY ; FL9L®kUIOB BDMYYVgjtw S NON4DWfODAUiDs PPROPERFYDANWM $ ' (Petacidem UMBRB]AUAB 00= A A29S41ADE A ADEMETWE C S H6TwoN S - - S WORKERSCOMPENSAIRMAND wi'rsv0vKwLLwm cum EhMANERBLUB&M To i T-td Tummo IV14MH F-LEAD}LAt f $ foam EMUMM N ELDSEASE-EA®1PLOYM$ 10gp00 nym "tmo� ELORMASE-POUCYUMW $ B00,000 LnaioFa�na�oa,,, . DE9CPJFiLONOF yaw .TMMOACMAOFYFRIORCEERWATEMnMIDMECUanWMMRUMA.FFECMWVWJMSCMeODUERAM C.ERTfl3CATE HOLDEER CANCEUAMN MIRDANYOF7HEABOVEDEMOOMPOUMBECAMC8 ADBE+ORE 'ME WUUUM DATE7HERBW.HdTUETLLDLBE GEUVEM LLi ACCO - LPONTdl�POI/L,7P AUFNIORMEO REPRESEWO rE t I ClB& ACt:1:fl 2s( } 19SUMACORDCORPORNI M-AB NghtS resav>L The Commonwealth of Massachusetts _� n Department of Industrial Accidents Office of Investigations 600 Washington Street 4 Boston,MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information l �, Please Print Legibly Name(Busincss/Organization/Individual): 4— L� kL oe-x Co�51 T, ., 'l Address: City/State/Zip L P one#: Are you an employer°!Check the appropriate boa: Type of project(required): 1.[�I am a employer with 4_ ❑ I am a general contractor and I employees(full and/or art-time). have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance t 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 I LEI Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL I Z�A�oof repairs insurance required.] t c. 152,§1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] °tiny 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. +Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. tribe sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'conWensatum insurance for my employees. Belaw is die policy and job site information. ,"4 ,� Insurance Company Name: y-��� `� rcc� A Y t"mrJr Policy#or Self-ins.Lic.#: U M Date: Job Site Address: �? �` � Jal �✓ City/State/Zip: 02 i.&V 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 t the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigati9ngof the DIA forlTurance coverage verification. I do her by certify under- enatties of perjury that the information provided a ove is true and correct Si Phone-4: Ifial use oni o not urste in this area,to be completed by city or tmsn official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I ��HET Town of ]Barnstable Regulatory Services ^B Thomas F. Geiler,Director 019. �`0� Building Division Tom Perry,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 Usine A Builder L M , as Owner of the subject property hereby authorize ' LUG C-0 C"r— to act on my behalf, in all matters relative to work authorized by this building permit application for JCJ (Address of Job) m Signa - of Owner ate J �d" Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. O:FORMS:OWNERPERMISSION Town of Barnstable a FTHE Tp� . o Regulatory Services Thomas F. Geiler,Director BARNSTABLE, LASS . 9� 1639. � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 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:reside'§orintends 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 not 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•larg'er 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 dQ 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 unlicensed 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,as part of the permit application, that the homeowner certify that helshe 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 fomJcertification for use in your community. Q:\WPF.ILFS\FOPMS\homeexempLDOC I &WMWMW 40/d Office of Consumer Affairs and2USiness Regulation 10 Park Plaza- Suite 5170 Boston,Massacbisetts 02116 Home Improvement 6�gtor Registration ---—, Registration: 16M7 Type: Private Corporation T {z Expiration: 4/6t2012 Tr# 2954M TL HITCHCOCK CONSTRUCTION S � THEODORE HITCHCOCK :U� ; 55 LISA LANE WEST BARSTABLE, MA 02668 Update Address and return card..Mark reason for change. Address Ej Renewal Employment Lost Card DPS-CAI 0 50M4gD/-G101216 Consumer ���� License or on valid for individul use Office of Consumer Affairs&B ess Regulation registration only HOME'IMPROVEMENT CONTRACTOR before the expiration date. Hfound return to: Registration:-, 65507 Type: U�ce of Consumer A&6 and Business Regulation � Expiration: 012 Private Corporation 10 Park Plaza-Suite 5170 f— Boston,MA 02116 VTLTCHCOCKCOjW-T9tJG=R'SERVICE INC. THEODORE HITCH�� 55 LISA LANE 1 _�„ WEST BARSTABLF," Underse�ctary Not €: Massachusetts-Department Of PubiiC•SafCt Board of Building Re_ulatiuns and Standards Construction Sup'--" Asc-SpL-cl31ty L-Merse License: CS SL 9cR28 Restricted to: RF.WS TED HITCHCOCK " 55 LISA LANE WEST BARNSTABLE,MA 02668 ~ ' Expiration: 6/1/2M2 f o m aksif"wr Tr#: .1 T Town of Barnstable 1 \\o 0E ro Regulatory Services d -� Thomas F.Geiler,DirectorBARNSTABLL Q 9� MASS. �0 Building Division `G- ��fD MA'S Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www,town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-623( PERMIT# �`7G FEE: $ SHED REGISTRATION 120 square feet or less Water Location of shed(address) Village Property owner's name Telephone number � Jx12 Div 00 01Z Size of Shed Map/Parcel 114le -7 Si ture Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature is required) .-- Sign off hours for Conservation 8:00-9:30&3:30-4:30 V 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 ACCO M �B� A PLOT PLAN IUZ Q-forms-shedreg 9 ail REV:042506 \' Application:to: OPaANS,'P4�`'t PP EPas t ng's Highway Regional Historic District Committee r' in the Town of Barnstable for a V CERTIFICATION.OF EXEMPTION Application is hereby made, in triplicate,for the issuance of a certificate of exemption .under Section 6 and 7 of Chapter 470, Acts and .Resolves of Massachusetts, 1973, as amended for proposed work as described below and on plans, drawings, or photo- graphs accompanying this application. . TYPE OR PRINT LEGIBLY DATE /'�3 Z AD DRESS.OF PROPOSED WORK `� FM-tVt9L , Wa SeN ASSESSORS MAP NO. OWNER 1J�M1 - rar2bq ASSESSORS LOT NO, HOME ADDRESS -7 1menml LIZ TEL. NO. 5U���`' AGENT OR CONTRACTOR WXUI_1�tM 04N yMj ADDRESS � Pt TEL• N0, This application is for exemption of proposed exterior construction on the ground that: ❑ (1) It will not be visible from any way or public place. ❑ (2) It is within a category declared entitled to exemption by Old King's Highway Regional Historic District Commission. (Check applicable box) PROPOSED WORK:. Describe and furnish plan of proposed work, showing location on lot,and, if an addition is Involved,show ing location of existing building. 6 e.112-) Z��z Prrlrff ►Zuor As-PH61-. ;��- ��� Hsu s C) - . .. - C�AF90Al;1> ON Fad-N-I 5'VtM .ES VAJ >TDFS (r_1 MT(Woe ftvcl c_) C�t�r ao�r�h p�a�N � 7►� 'IN itoU5C j w2j>0 vJ 5 1 QGo� SIGNED Space below line for Committee use. . Ovine Contractor•Agent R r .ie v�by�.[ C The Certificate is hereby v sn U AY rm 3 2007 TOV'JtI,.t'2 1QNSlfi f i . ,ar,-— E?I Date lSTO 1lON Approved ❑ The categories of work entitled to exemption are listed on Disapproved ❑ the back of this form. X J�M�'S X dr XE'RRY 4. MACURDr TY3 :'� BARNSTAIBP.g ` • wAA I PE'RCl L AL URI bL9' r g� �he►"�'4 � t t L• =, PAULLot A. 40 •°0••••ue a Neoo��� .. 83 fl.GOl� P�eA'f' ?lean ue fir ! hcre0l certify' dent tfiu marrt�tl� inayec•f►on plan was jelroparad for* ---_ Bank Ltae Only ---ial flood Aarard ions I PLAA' � EF. _ 4p•?iSa9- TA� csofiui, vl !tb• Der.ld/ty •Aotrn does lo., wttAi/� s special g0 FT a fhr toeat.on of th'a dt7..illt'j/ doer -. .. conform to the loco: aonin, by, jvq to a set ..3'C��f9 1 _ --- tf fM t/Ali lotro/n�/ee'nla,lx>e snlortamiot act oaf tndrr y%droptoi nsisnvrl���AC4h v00Ae�Sse 7 �28te. !43 •it•!gp `?flrtsL.�TfT 77w 'e/yt fetAet) M laze I lion w.• "ovelod Hy too eoi ,notrtes•at •nd or. yMewnon «•Ir Aa a�fw/ fid parw t a pteenswrrwr.rune to /r .ay e+rrt .,tsar way �t n.tel pa�Y bA.r 1d! "�° �Orprns Aarrart+erloa d toy OeerAP kN ha. dnnsne/oru. 1kav" or hml eco +w Cod a r.d !w nearer naptaeo .of a.re�e ail b Jons /brP wnor 1n'"Me Y Amete properly "0MtMf�P.lJfl6 d OYrwlIAYn W"p .• .hm" )OOPSAte mito pr nilw�..� rn.!' re/Ys•I 7dM�.�ret i�•� as1 /rINA td.AAWV*JMJ0 INDUSMY R.�9 MARSMYS A JILS. a.4 ���618 PifU 3V 4M i I I i _.._......._.._................ -.. . ..._............ . ...... --- ---..._................ ----- -- ---- j _ --- -- _... . --... I�z/I2rcl� 1 _........... _...__... ............. . ... ... ......_.._.. .._.-_.............. ...._.........._ 13 ' I 1 I _.....r.... 1 _... -._....- ---- `._......._.....__... ............._`............ I t; M KOZO l i i r r ........---- - ------.- ; ------------- La . � r I i ---- Town of Barnstable eZ d CF fME "o Regulatory Services S Thomas F.Geiler,Director • anxNsenBLF4 • ' s�0� Building Division ld� lows V1 En MA+ Tom Perry,Building Commissioner Per FN—Ople 200 Main Street, Hyannis,MA 02601 n0 www.town.barnstable.ma.us M I U - Of -5_8-86-2-4038 Fax: 5l08-790-6231 ohe CLPERMIT# FEE: $SHED REGISTRATION 120 square feet or less (e3 P�iXciVA -- DOm4 was, 3AZr-J5rrotl(A-7- Location of shed(address) Village -T ei r�5 1,C�22 d�-1��y >�1 �O`� Z S IRS 5F Property owner's name Telephone number Size of Shed Map/Parcel# Signatur Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 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. i THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:042506 . . p�h'CITI 4p 00, ;o v 59. 99, 4 N K cv �C S14isD 0 4� ti tea' o o � w ti H. ti LOT 31 35,097 + S.F. (0.81 + AC.) 168 00, JOB # 94-309-31 CERTIFIED PLOT PLAN PREPARED FOR LOCATION : ASES MAP 110 PAR 1-12 PERCIVAL DRIVE W. BARNSTABLE SCALE : 1" = 60' REEF REALTY REFERENCE : LOT 31 PLAN BOOK 413 PACE 99 OF I HEREBY CERTIFY THA T THE STRUCTURE JOMcyG SHOWN ON THIS PLAN IS LOCATED ON THE o Z GROUND AS SHOWN HEREON. DE °� 0 No.36859 ig DEMAREST - McLELLAN ENGINEERING 24 SCHOOL STREET P. 0. BOX 463 DECEMBER 12, 1995 WEST DENNIS, MA 02670 (508) 398-7710 DATE OFE ZONAL LAND WVEYOR r Town of Barnstable °F1NET° Regulatory ServicesT01if�q U gARaSTABLE o� sTnB . 1 Thomas F.Geiler,Direct02004 JUN 10 AM 9: 4 3 HAMMASS, �0� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 01 V 1 S 10N www.town.barnstable.ma.us Office: 508-862-4038 `J % Fax: 508-790-6230 3 PERMIT# FEE: $ SHED REGISTRATION 120 square feet or less I (o.3 F13aCI utq L C.F, 12. c��� 3�Ns� Location of shed(address) Village -5 � �y M11Cv1,73`7 Property owner's name Telephone number C) Size of Shed Map/Parcel# w Si gna Date Hyannis Main Street Waterfront Historic District? /Old King's Highway Historic District Commission jurisdiction? (� 1plo/ 7-C, Conservation Commission(signature is required) S. pX60 d 5�0' J,-17MM W e-/-ZA* PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE Cskb�M RAY 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 � Application to: Old Kings Highway Regional'.His ""' District Committee in the Town of Barnstable for a CERTIFICATION.OF EXEMPTION Application is hereby made, in triplicate,for the issuance of a certificate of exemption under Section 6 and 7-of-Chapter 470, Acts and Resolves of Massachusetts, 1973, as amended for proposed work as described below and on plans,drawings, or photo- graphs accompanying this application. . TYPE OR PRINT LEGIBLY DATE ' ADDRESS OF PROPOSED WORK 1 (03 EeEC"/0-� d 2 V, ASSESSORS MAP NO. OWNER �� +Q S 2' u ASSESSORS LOT NO. HOME ADDRESS � ��. ��rc-�.�c�fi ��- �.l2 s-c- 2aZk-0 TEL. NO. :�Qpc;) AGENT OR CONTRACTOR. • s .ADDRESS. TEL. NO. 3C04 This application is for exemption of proposed exterior construction on the ground that: ❑ (1) It will not be visible from any way or public place. (2) It is within a category declared entitled to exemption by Old King's.Highway Regional Historic District Commission. (Check applicable box) PROPOSED WORK: Describe and furnish plan of proposed work,showing location on lot,and, if an addition is involved,show• ing location of existing building. SIG Space below line for Committee use. . Owner-Contractor-Agent Received by H.D.C. The Certificate is hereby Date Time By Date D �nnrnvcrl n The ratannrias of wnrk antitlarl to ovomntlnn ara lietarl nn S " A ZA TO MA T6 fi MATC 4(Jv5F coLo►2 i �PQoX RDOF P irC,14, 4 5 TP M Pli iNT S MA'rCla- 14bu5lZ- 1 _ 1 _ ZL='LL2N -z4,LLTCj APPLICANT ✓AMES K & KERRY A. MACURDY 7'O W_IV.- BARNSTABL �0 CIO I'FRCI I AL DRI LE :: o•� gY'�F, o i 0?Ok Stiff' I -s5 O'E60.00- N�'D Vj �e(A OAJ G b vol ao 6 O 31 lid PAUL J, rn AHEW _ s4735 4.9'E ftsa 00 -s n 'Qt kQ Ito ` OPE'v , 't�ttetnute41"t FLOOD P.k/1'F,l,. JUUI 0017C FLOOD TUNE „C __ DATED 8,179.'85 Plan is For I hereby certify that`. this r.�urtgane inspecUrr, p:att ties prepared for, Bank Use Only _C�f_ C_'__rt9QRTC-SCE' COMPA, _ ?-'--'------_ __ — -- _ 4131'99 The location of the, building shown does :.__ fall w7thin a special flood hazard zone PLAN RAF _ _.__. The location of the dwelling does __ _ conform to the local zoning by-la q /n effect i 5'Ca1t' 1'" = _50 FT at the time of construction with respect to horizontal dimensional setback re uiremen-y or is exempt from violation enforce-inert action unJer AJass Ceneral Lows Ch. 40A -Sec. 7 Date. 11j_t'��02 PLEAS't' N01T The structures on ibis i'nspectloil were located by tape not msdrument and are approximate only An actual surrey is necessary for a arp,aia& d&ttririnab0fj of the burldinB location and encroarlmenti, if any exist, &I fiber way arrwss properly lines. This inDpoction must not ZIP usr,d for recording purposes or for use in preparing derd descriptions and must not be used for varrem-e or building plan purposes. This ins•�nctr�n must not be used to loc•dte property fines Verification of burldinB locations, properly line dimensions, fences or lot configuration car, on// Uc ae•Cuu/l.'lr r/�cJ by pu ev.:u.o�c iaot.w+.c..! .a u..•.y .rhich may ro//oot d.11eronr inlarmaii.v /Ain whit /c chnwn .,avian Thix infneehofi is not to be 6svd fur any purposes other then n7ortg&de. Yankee Survey accepts no responsibifitc for darrages�r/esulting J>onr said rrliance. - 1 I�lI].[J IL �~U �'�LJ� Y CU: •ti�~`.�TIJ�`�1 Y'I i C� t'A.Y. 6C6 0 SOX 265, 40 INDUSTRY RD, MARSTONS HELLS, MA 0,D4B PHONE-508—4.38--0055 34373 LM s�-� c/59s— I/ao�v 9 p �x p i rem I�-f2Vn t T ����� � . . . _ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map10 / L Parcel 0 1 2 Permit# Health Division big: �2a)3 -03� ` � *� � a/�/0� Date Issued a' � -° � Conservation Division 7 s s �� s'�e U 11;,e" ln4eV Y Application Fee Tax Collector " p v m o IA 3A Permit Fee b ( �. Lo Ploy' PLAa b Treasurer M eQe,*A e w Planning Dept. _ Date Definitive Plan Approved by Planning Board �f R Historic-OKH Preservation/Hyannis Project Street Address 1 G 3 P F2C 1 V6 L_ 2 IV Village W %�S 1 -8X NSt/1 L F mt 0 Z( G f Owner J 4M 6✓5 I Krr�G� /k� AQX 1� �Address S/4 10 Telephone 5Q9 � - 1 116 Permit Request I3U1Lb 1 ,G ' '-k Z 7 ' "DmoO R S}-ISvk HOMF Square feet: 1st floor: existing proposed 2nd.floor: existing o u 4-proposed Total new 2 ISZ Zoning District Flood Plain Ci Groundwater Overlay Project Valuation /.�� Construction Type vjoc�I Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting.documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure S Historic House: ❑Yes On Old King's Highway: Yes ',O No Basement Type: �ll ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 1 F Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 7, w 2 'y Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new e First Floor Room Count _ j Heat Type and Fuel: gas ❑Oil ❑ Electric ❑Other p g I New� Existing wood/coal stove: ❑Yes Central Air: es El No Fireplaces: Existing Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existingkn-ew size 7-0Y Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use -t-n BUILDER INFORMATION A q Name _.1�'IV�IS N1� Telephone Number Address I �� 1 42C l Vl �) 2_ License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTIO RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Z 1 0 FOR OFFICIAL USE ONLY v PERMIT NO. DATE ISSUED MAP/PARCEL NO. • ADDRESS VILLAGE o OWNER-,, a , DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL „f FINAL BUILDING DATE CLOSED dUT ASSOCIATION PLANNO. oFtHE, , Town of Barnstable Regulatory Services 13 SrABLs, Thomas F.Geiler,Director Building Division QED MA'S Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: 'o T ? ADD YrT" Estimated Cost Address of Work: b� �'�"` ( -F Owner's Name: 'SI�M�S - � f'1ACVo/. Date of Application: Z t Io o I hereby certify that: Registration is not required for the following reason(s): FWork excluded by law ❑Job Under$1,000 ❑Buil ' g not owner-occupied CSOwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name Q:forms:homeaffidav The Commonwealth of Massachusetts _ - Department of Industrial Accidents 600 Washington Street ` Boston,Mass. 02111 ' Workers' Compensation Insurance Affidavit'-General�slnesses / sole• ' ' .: OCV PP. 2 hone 83 Aworte location fa address e, Retail❑Restaurant/Bar/EafmgEstablishment tm a sole proprietor and have no one Business Typ 'orlsing in any capacity. ❑Office[]Sales(including Real Estate,Antos etc.) I am an em to er with em l es(full& art time. ❑Other / "MIN �an egm I //'�/////G�y/�lr��/////% � //o/////Dens/o/n//fo/r/�yy//�//gyp es worldn�on this job; � I am an employer providing v{�k ,. /,•,. .,.;'G.• }•V."Y�L::� s•1' .� °� 'r' ,� -t', :�•,.; rl. .play;:'�f"•� ' •''' cam anv 'eme: y. bone#-•:. `' city: r ` j : e' ,. L•. 't. '.(� �:n. 5 ' ' :i%.i4' :�I: '�.. t•t;lF. Oi1C.'•iF' ' .} .So • • ..:..: <'•, . :a . / •�• ^ ` / // . . etor and have hired the independent contractors listed below who have the following workers' I am a sole props - polices--co, iiion . ,r,.•• am C: 1�w.f y•i. •\li�•t •.�._� ' •:1:•,~• ''1�•,!,t •:5,. �I.i, �.l.', C0m56II tliji'rl:''�'•i: fir:•': ::f'"\f'��, ''' r�r't,'r t• rt /t!:�: le tit +r'i'r.•`I'„•'`r riv ntiJr:• ''7 .,.• 'Ol1C r# •.)^.''' Y• 'S 1-•' ' /r ������/� insiu°ence co. �~ : _ �. /./ / // l •Q I,e,`•' .55;.�iti•-tr,.a• ',:mot• . ' /• >, :(�.•.i': com on. us •hone#i:. :1;' `j,;r,,... •v. ' ,'.. '�.4., '"t. .. •�,p"''• t `� ii ^~r:�• :u''t1.1 . ' ` ;:11• •'r.'i'�,' ',r .1' r,•� . •'•'"'.'•: •. •r'l �. r .�i, ,� :�'.\!'.•%C .1�t••-• •i: 0 1CV'lur'. 'i�:. .' °� _ .• • fiisure'nce'ho. ,,:••.,,:•:. . � y - ithe FI 1 to secw a coverage as required under 3e"cti�o> e f�Mf 8 SOP'WOR1fi ORDER ead a Fine of 0.00 e� SBin?�m AIIa 'tand thatp one years'imprleonment as well w civil f 0 the copy of�statement may b to the Otfice of Investigations of the DlAfor coverage verlRcation: I do hereby certi under the pal and penalties of perjury that the Information provided.above is tr dcor Date ){){ Si attire � Phone# Print ulna ofrieial we only do not wrtte in thb area to be completed by city or town official ` permltlllcense ft ❑Buildtng Department city or tows: (3ucensiag Board Qselectmen's Ofr'ice ❑check if immedfata respoese is requited Q$ealthDepartmeut , • phone R; ❑other contaetperson: (revleed aept.10M) e RIESIDENTIAL BUILDING PERNUT FEES APPLICATION FEE , New Buildings $100.00 Residential Addition $50.00 Alterations/Renovations $50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= '3 (f 6 x.0041= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0041= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft. x.0041= Ste' ACCESSORY STRUCTURE>120.sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf-1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS i Open Porch x$30.00= (number) . Deck x$30.00= (number) Fireplace/Chimney x$25.00= ' (number) . Inground Swimming Pool $60.00 - — Above Ground Swimming Pool $25.00. Relocation/Moving $150.00 (plus above if applicable) Permit Fee i Projcost Rev:063004 EQ.L 2LAM F APPLICA,,VT.- J4MES h: & KERRY A. M-.4!'URBY TO WN. BARX3TABLE 40.00, PERC'I PAL DRIVE' U !s336 iY FEB 2005 Of BARNSTABLE CO ERVATION �-S5l Zl 20'E 6'0.UO�. • ,f o g � o �0 sue. vol .32 40 D 0 r 11,4LtfACr A. k4E FITHEW = 1'40.-32098 v •'2V es• 16B.0D• Q`'`� pP� y SP�gCE FLOOD PyNF,L-• 250001_0015C FLOOD zOA'F' _C DATED 8,%1.9/85 l hereb,v certify that this mortgage inspection plan was prepared for., Blau is For Bank Use Only G 4C_MORTGAGE COMPANY M- The location of the building shown does ADZ-_ fali within a special flood hazard zone. PLAN REF. = 413/9,9— The location of the dwelling does _ - conform to the local zoning by-laws in effect Scale 1" = 50 FT at the time of construction. with respect to horizontal dirnensional setback requirements ----- or is, exempt from vinlation enforcement action under dfass. General Laws CA 40A -.Sec. 7 I Date: 111 23�02 PLEASE NOTE: The structures on this inspection were located by tape not instrument and are approximate only. An actual survey is necessary for precise determination of the building location and encroachments if any exist, either way across property lines This inspection must not be used for recording purposes or for use m preparing deed des•cnpt:ons and must not be used for variance or building plan purposes. This irsf>ectior. must not be used to locate property lines 6'erification of building locations, properly line dimensions. fences or lot configuration can uiuy Le• a--pil11—d uy aie scrurnto instrumend sur`ry which mar ro!loet difY—nt information fhar, what is shown by reran This inspection is not to b� used for any purposes �other jthhan mortgage. TYankee Sur:ev accepts no responsibility for damages /�resulting from said reliance. I TA1 Vjl i JAL S /R IT 1 7 C01 YTti UL 1 2A-L VT��J FAX 508-420-5553 O BO,Y" ?J5, 40 IIVDUST-RY RD, MARSTONS MILLS, MA 02648 PHONE.-508-428-0055 34373 LM Permit Number MECcheck Compliance Report Checked By/Date Massachusetts Energy Code MECcheck Software Version 3.4 Release 1 Data filename:Macurdy.mck TITLE: Garage Familyroom Addition CITY:Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family,Detached HEATING SYSTEM TYPE:Other(Non-Electric Resistance) DATE: 11/03/04 DATE OF PLANS: 11/3/04 PROJECT INFORMATION: Jim Macurdy 163 Percival drive West Barnstable,MA COMPANY INFORMATION: Kenneth Sadler Associates P.O. Box 1149 Hyannis,MA 02601 508.790.3922 CS#039020 NOTES: Calculation are for Familyroom only COMPLIANCE: Passes Maximum UA=85 Your Home=67 21.2%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1: Flat Ceiling or Scissor Truss 384 38.0 0.0 12 Wall 1: Wood Frame, 16"o.c. 124 15.0 0.0 8 Window 1:Wood Frame:Double Pane with Low-E 14 0.320 4 Wall 2:Wood Frame, 16"o.c. 195 15.0 0.0 14 Window 2:Wood Frame:Double Pane with Low-E 14 0.320 4 Wall 3: Wood Frame, 16"o.c. 124 15.0 0.0 8 Window 3:Wood Frame:Double Pane with Low-E 14 0.320 4 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 384 30.0 0.0 13 COMPLIANCE STATEMENT`. The proposed building design described here is consistent with the building plans, specifications,and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in MECcheck Version 3.4 Release 1 and to comply with the mandatory requirements listed in the MECcheck Inspection Checklist. The heating load for this building,and the cooling load if appropriate,has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer �� _- %�;��� g Datel MECcheck Inspection Checklist Massachusetts Energy Code MECcheck Software Version 3.4 Release 1 DATE: 11/03/04 TITLE:Garage Familyroom Addition Bldg. I Dept. I Use I I I Ceilings: [ ] I 1. Ceiling 1: Flat Ceiling or Scissor Truss,R-38.0 cavity insulation I Comments: I I Above-Grade Walls: [ ] 1 1. Wall 1: Wood Frame, 16"o.c.,R-15.0 cavity insulation I Comments: [ ] 1 2. Wall 2: Wood Frame, 16"o.c.,R-15.0 cavity insulation I Comments: [ ] 1 3. Wall 3: Wood Frame, 16"o.c.,R-15.0 cavity insulation I Comments: I I Floors: [ ] 1 1. Floor 1: All-Wood Joist/Truss:Over Unconditioned Space,R-30.0 cavity insulation I Comments: I Air Leakage: [ ] I Joints,penetrations,and all other such openings in the building envelope that are sources of air I leakage must be sealed. [ ] I When installed in the building envelope,recessed lighting fixtures I shall meet one of the following requirements: I 1. Type IC rated,manufactured with no penetrations between the inside of the recessed fixture I and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 1 2. Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cfm(0.944 1 L/s)air movement from the the conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. I Vapor Retarder: [ ] I Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. I I Materials Identification: [ ] I Materials and equipment must be identified so that compliance can be determined. [ ] I Manufacturer manuals for all installed heating and cooling equipment and service water heating I equipment must be provided. [ ] I Insulation R-values and glazing U-factors must be clearly marked on the building plans or specifications. I I Duct Insulation: [ ] I Ducts shall be insulated per Table J4.4.7.1. I Duct Construction: [ ] I All accessible joints,seams,and connections of supply and return ductwork located outside I conditioned space,including stud bays or joist cavities/spaces used to transport air,shall be sealed I 1' using mastic and fibrous backing tape installed according to the manufacturer's installation I instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. [ ] I The HVAC system must provide a means for balancing air and water systems. I I Temperature Controls: [ ] I Thermostats are required for each separate HVAC system. A manual or automatic means to I partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. I I Heating and Cooling Equipment Sizing: [ ] I Rated output capacity of the heating/cooling system is not greater than 125%of the design load as I specified in Sections 780CMR 1310 and J4.4. I I Circulating Hot Rater Systems: [ ] I Insulate circulating hot water pipes to the levels in Table 1. I I Swimming Pools: [ ] I All heated swimming pools must have an on/off heater switch and require a cover unless over 20% I of the heating energy is from non-depletable sources. Pool pumps require a time clock. I Heating and Cooling Piping Insulation: [ ] I HVAC piping conveying fluids above 120°F or chilled fluids below 55'F must be insulated to the I levels in Table 2. r I Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pine Sizes Heated Water Non-Circulatine Runouts Circulatine Mains and Runouts Temperature(F1 Up to 1" Up to 1.25" 1.5" to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Pipine System Types Ran a 2"Runouts 1"and Less 1.25"to 2" 2.5"to 4" Heating Systems Low PressurelTemperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD(Building Department Use Only) i i �Op1HE tp� Town of Barnstable Regulatory Services ��. .. .... .:..., lY t = sAxtvsTAar,E; M � °� .. , ::�._...•...,:,,.�.; �.h_o1m�,s:F;::O.eiler,�D'-.ec or: -. ....�__..__ . _ ..,.,... _. ... -� -... . . .... MASS, 39• i6 ,•� :: Building Division'-Tom Perry;`B'u"ildmg Corimnussoner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 =- Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 2—I I .1 ff JOB LOCATION:_ I b 3 ftctuPrc L✓n 1 number street village /p, "HOMEOWNER": A(yy? y-l)name Q (� home phone# work phone# ► "CURRENT MAILING ADDRESS: (� V �5 51tMtNico- . A--I— 2 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 slot 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 l09.1.1) 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 Toym of Barnstable Building Department mspe on procedures and requirements and that he/she will comply with said procedures and re ements. Signature 6meoviier 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 unlicensed 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,as 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. Q:forms:homeexempt BC CALC® 20.03 DESIGN REPORT - US Thursday, February 03,2005 10:24 Double 1 3/4" x 16" VERSA-LAM® 3100 SP File Name: Jim Macurdy.BCC: RB01 -Job Name: Jim Macurdy Description: Structural Ridge in new family room, Address: 163 Percival Drive Specifier: City;State,Zip: Barnstable,Ma Designer: Bill Campbell Customer: Company: Shepley Wood Products Code reports: ICBO 5512, NER 629 Misc: 12 ' L 1 Standard Load-30 psf 1 15 psf Tributary 12-00-00 B0 B1 3240 Ibs LL 3240 Ibs LL 2286 Ibs DL 2286 Ibs DL Total Horizontal Length-16-00-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur. S Standard Load Unf.Area Left . 00-00-00 16-00-00 Live 30 psf 12-00-00 115% Member Type: Roof Beam Dead 15 psf 12-00-00 90% Number of Spans: 1 1 -Ceiling, Unf.Area Left 00-00-00 16-00-00 Live 5 psf 09-00-00 100% Left Cantilever: NoDead 10 psf 09-00-00 90% Right Cantilever: No Controls Summary Slope: 0/12 Control Type Value %Allowable Duration Load Case Span Location Tributary: 12-00-00 Moment -22104 ft-Ibs 51.4% 115% 3 1 -Internal Neg. Moment '0 ft-Ibs n/a 100% End Shear 4605 Ibs 37.0% 115% 3 1 -Left Total Load Defl. U450(0.426") 40.0% 3 1 Live Load: 30 psf Live Load Defl. U768(0.25") 31.2% 3 1 Dead Load: 15 psf Max Defl. 0.426" 42.6% 3 1 Partition Load: 0 psf Duration: 115 Notes Disclosure Design meets Code minimum(U180)Total load deflection criteria. Design meets Code.minimum(U240)Live load deflection criteria. The completeness and accuracy of Design meets arbitrary(1")Maximum load deflection criteria: the input must be verified by anyone Minimum bearing length for BO is 1-7/8". who would rely on the output as Minimum bearing length for B1 is 1-7/8". evidence of suitability for a . Member Slope=0,consider drainage. particular application. The output Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing above is based upon building code-accepted design properties Connection Diagram and analysis methods. Installationof Consult project design professional of record or BOISE technical representative for connection design products must be in accordance engineered wood Bolts are assumed to be Grade 5 or higher. pr Member has no side loads. with the current Installation Guide and the applicable building codes. Connectors are: 1/2 in.Staggered Through Bolt To obtain an Installation Guide or if you have any questions,please call a=2„ (800)232-0788 before beginning b=2 1/2 bl I d�I product installation. c=6" —�— =: �, BC',CALC®, BC d 24' a FRAMER®, BCI®, -- BC RIM BOARD- BC OSB.RIM BOARD- BOISE GLULAM-, VERSA-LAM®,VERSA-RIM®, VERSA-RIM PLUS®, C VERSA-STRAND rm, VERSA-STUD®,ALLJOISTO and AJSTm are trademarks of _ Boise Cascade Corporation. �� e I Pagel of 1 BOISE, BC CALC®2003 DESIGN REPORT - US Thursday, February 03,2005 10:24 Double 1 "3/4" x 14" VERSA=LAM® 3100 SP File Name: Jim Macurdy.BCC: RB01 Job Name: Jim Macurdy A Description: Structural Ridge in new family room Address: 163 Percival Drive Specifier: City,State,Zip: Barnstable, Ma Designer: Bill Campbell Customer: Company: Shepley Wood Products Code reports: ICBO 5512, NER 629 Misc: 1__1° 12 1 . Standard Load-30 psf 115 psf Tributary 12-00-00 ,pg f. `` .i�f��' - erg�"� � zr .,�'rb` iv K�"•`y � ' •,� zr ", Fen - ,.�: >,- a & ,a.Kw.r ''n�` 5 r .rJ, rs..+r .W '` Ak AL BO B1 3240 Ibs ILL 3240 Ibs ILL 2270 Ibs DL 2270 Ibs DL Total Horizontal Length-16-00-00 ,General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur. S Standard Load Unf.Area Left 00-00-00 16-00-00 Live 30 psf 12-00-00 115% Member Type: Roof Beam Dead 15 psf 12-00-00 90% Number of Spans: 1 1 Ceiling Unf.Area Left 00-00-00 16-00-00 Live 5 psf 09-00-00 100% Left Cantilever: No Dead 10 psf 09-00-00 90% Right Cantilever: No Controls Summary Slope: 0/12 Control Type Value %Allowable Duration . Load Case Span Location . Tributary: 12-00-00 Moment 22041 ft-Ibs 66.0% 115% 3 1 -Internal Neg. Moment 0 ft-Ibs n/a 100% End Shear 4707 Ibs• 43.2% 115% 3 1 -Left Total Load Defl. U303(0.635") 59.5% 3. 1 Live Load: 30 psf Live Load Defl. U515(0.373") 46.6% 3 1 Dead Load: 15 psf Max Defl. 0.635" 63.5% 3 1 Partition Load: 0 psf Duration: 115 Notes Disclosure Design meets Code minimum(U180)Total load deflection criteria. Design meets Code minimum_(U240)Live load deflection criteria. The completeness and accuracy of Design meets arbitrary(1")Maximum load deflection criteria. the input must be verified by anyone Minimum bearing length for BO is 1-7/8". who would rely on the output as Minimum bearing length for 61 is 1-7/8". evidence of suitability for a Member Slope=0,consider drainage. particular application. The output Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing above is based.upon building code-accepted design properties Connection Diagram and analysis methods. Installation Consult project design professional of record or BOISE technical representative for connection design of BOISE engineered wood Bolts are assumed to be Grade.5 or higher. products must be in accordance Member has no side loads. with the current Installation Guide and the applicable building codes. Connectors are: 1/2 in.Staggered Through Bolt To obtain an Installation Guide or if you have any questions, please call a=2„ I b- I d (800)232-0788 before beginning b=2-1/2" product installation. c=5„ _! = " BC CAL d 24 aC®, BC FRAMER®, BCIO, —i —� BC RIM BOARD rm, BC OSB RIM . BOARD rm, BOISE GLULAMTm, VERSA-LAM®,VERSA-RIM®, VERSA-RIM PLUS®, " C VERSA-STRANDTm VERSA-STUD®,ALLJOISTO and AJSTm+are trademarks of Boise Cascade Corporation. j Page,1 of 1 , ftpHill e 3e� --------------- -------- ]-<-(-�-------- - - c i i i _---____--y I ,I . - p FOuND N ATI& PL-AN10 $-Y g _.e.e.. q PIphT FLooF--FLAN SMOKE DETECTORS REVIEWED g BARNS7ABLE BUILDING DEPT. DATE I I I I FIRE DEPARTMENT DATEE �di € BOTH SIGHAi URES ARE REQUIRED FOR PERMITTING J r4.t rv..P4n �t31�ooF F��rge P->r+N P...,rr.m.rr.• A 1 00 i 0 / w o E / E � � � a � All � ri ir oa J � 3� r------------------------- �p1�eA.�et.ev,u.TlaN / 1 P. �oNT e�.ev�.TloN 0 it _� a f° p ------------ ---------------, A 00 8r 933 t�Z(6}app� s c a �/f•AIA r.1.J Jr.Muy �' t P4 LW.fMP•ve C ` Y a a b z z ILr,.WL..LPL,.r1..•1.... : t'KAr.1./Ju.iMry - fr♦W.I.fW.•.6•,a nNO.4.nLW+:p.90 s/.•NAr.IJ r4 oWl„r >. •P4 m.u1.1L...p.fl /t r•r.M.N6M. -� . �/.�PUCAING yGGTioN'n• � 7�3�§$6ij t a�.w iiz•.i-o $ a .- pRAPIMB MB II . Cauildvy 4.cF'vn•A• P A400 • Application to 01b Rinq'o -Jkligbtuap 3.egiDnar 3�igtoric �Eliitritt Corr mittee CD In the Town of Barnstable CERTIFICATE OF APPROPRIATENESS Application is hereby made,with four 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 pla_6s, drawings, or photographs accompanying this application for. ry, — J CHECK CATEGORIES THAT APPLY: j I I.,Exterior building construction: ❑ New XAddition ❑ Alteration Indicate type of building: ❑ House ❑ Garage ❑ Commercial 0 Other 2. Exterior Painting: ❑ �, 3. Signs or Billboards: ❑ New Sign 0 Existing Sign ❑ Repainting Existing Sign — 4. Structure: ❑ Fence ❑ Wail ❑ Flagpole ❑ Other C� a TYPE o•R PRINT LEGIBLY: DATE ADDRESS OF PROPOSED WORK I �!J J t" r 4CIV I L Y ASSESSOR'S MAP NO. i O d / . OWNER M �,5 Vag- MACV O( ASSESSOR'S LOT NO. HOME ADDRESS )G3 _ Y t0VA(— (L VJ V l"► TELEPHONE NO. -. 3b`I' 14 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any public street or way. (Attach additional sheet if necessary.) �fi� IJ u-4 K Ne- I S 9 PIC-"JAL, ",PZ w� :bW7+ c9 0 2 T I +v 2 �sT �0J 02G +CH- 1-71 P 6tr_1 V4 L. PYL AGENT OR CONTRACTOR _AM 6;S MACV�-I�� TELEPHONE NO. ADDRESS 5 2M r, DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please include locations of proposed signs. Ty 1LD A- Z c/ Y2- &Pff46c-- ©N w�s T S 1 b4 6-F hoM Fr -SOT I*S i3r.0i 5W_'Z7;> A1-11> &DPI-POIJ WILL- f, , W/.,0`� �,.� + �j « M S i��� L�u�� — N1/�TVRf/�t 5 W i is (r��u- T3►�� '/1�� St1M6 1)- .6N A . Signed Owne-Contractor-Agent For Committee Use Only App This Certificate is hereby Date • w pproved/De led I Jell, mmittee Members' atur ; r i +n Town of'Barnstable W Old King's Highway Historic District Committee SPEC SHEET FOMMATION_ K3 l� ( WA LL SIDING TYPE CLOW✓ 14r COLOR CHIMNEY TYPE V 1 ► I� y l- `� IS COLOR ROOF MATERIAL Q' .U`IV� COLORR YA, _ I PITCH (y ouUi WINDOWS COLOR TRIM COLOR V �'T I Ir/ f /b ,6 45, 42W DOORS [�l�f r"'I V°' W WJ COLORS V 41 lei OI`- I.1� bW 1 ?U Awi� SHUTTERS NV C' �-� - COLORS GUTTERS NI I 1`�✓ COLORS DECKS ���✓ MATERIALS GARAGE DOORS COLORS SKYLIGHTS NV tr�✓ SIZE COLORS SIGNS IN COLORS FENCE PO COLOR COLOR NOTES: Fill out completely, including measurements and materials/colors to be used. Your copies of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plans, when applicable. J SPECSHT F4,PPLICANT` J_4MES h: & KERRY A. i1.,CURDY TOWN- BAPNSTABLE PERCYPAL DRIVE' a3°p6,� `-S512f 20'E 60.00-. ri 130 3� l�l lam. 1 v OF PAUL rM A. kq r,!THEWGo Q098 �Q S4735 49'�, 168.00, SPACE FLOOD PANEL- 250001—0015C FLOOD LOA'E` ..G DATED 8/%9/85 l herckv certify that this rnor•teage inspection plan was prepared for- Plan is For Bank Use Only GAf4C MORTGAGE COMPANY The location of the building shown does I=__ fali within a special flood'hazard zone. iPLAN REF. The location of the dwelling does ------ conform to the local zoning by-laws in effect (Scale 1 " = _50 F7 at the time of construction with respect to horizontal dimensional setback requirements• ------ or is exempt from violation enforcement action under Mass. General Laws CA 40A -.Sec. 7 Date. PLEASE NOTE The structures on this inspection were located by tape nol instrument and are approximate only. An actual survey is necessary for a precise determination of the building location and encroachments if any exist, either way across property lines This inspection must not be used for recording purposes or.for use /n preparing deed descriptions and must not be used for variance or building plan purposes. This irspecaor. must not ba used to locate property lines. Nn-ification of building locations, property line dimensions. fences or lot configuration can urely be• —...urnyiivi—I by ar. >ri:urnto in>lrumen! :u y which mar rrflaot different information than. what i.c shown herenn This inspection is not to b� used for any purposes �other than Lmortgage. TYankee Sur:e•y accepts no responsibility for damages /resulting from said reliance. L t31 YjI1�1�, tJ�C /1� V,� ��IAT UL .7 1 AT ITS FAX 508-420-5553 D BOX 265, 40 INDUSTRY RD, MARSTONS MILLS, M4 00648 PHONE.'508-428-0055 34373 LM sQ,$E- BC CALC® 2003 DESIGN REPORT - US Thursday, February 03,2005 10:21 Single 5 1/ " 8" RSA-LAM(g) 3080 DF File Nam 4fJimacurd CC: F601 Job Name: Jim Macurdy Description: Floor Beam under new family Room Address: 163 Percival Drive Specifier: City,State,Zi : Barnstable, Ma Designer: Bill Campbell Customer: Company: Shepley Wood Products Code reports: ICBO 5663, NER 442 Misc: Standard Load-40 psf 110 psf Tributary 12-00-001 1 1 1 1 1 p ���s�,�✓�� f . a�.r i. ,.�, ,,1`�;�����' � �,z,`c dEY.�z.,¢��� �,� . '��zS.��..Sv_ A€F�..,%S�n�ra.�� xn �� �Y ��,�.�'tl^r�t.uS�"es. BO 131 3840 Ibs LL 3840 Ibs LL 1088 Ibs DL 1088 Ibs DL Total Horizontal Length-16-00-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur. S Standard Load Unf.Area Left 00-00-00 16-00-00 Live 40 psf 12-00-00 100% Member Type: Floor Beam Dead 10 psf 12-00-00 90% Number of Spans: 1 Left Cantilever: No Controls Summary Right Cantilever: No Control Type Value %Allowable Duration Load Case Span Location Moment 19713 ft-Ibs 62.2% 100% 2 1 -.Internal Slope: 0 Neg.Moment 0 ft-Ibs n/a 100% Tributary: 12-0 00-00 End Shear 4319 Ibs 36:5% 100% 2 1 -Left Total load Defl. U310(0.62") 77.5% 2 1 Live Load Defl. U397(0.483") 90.6% 2 1 Max Defl. 0.62"-- 62.0% 2 1 Live Load: 40 psf Dead Load: 10 psf Notes Partition Load: 0 psf Design meets Code minimum(U240)Total load deflection criteria. Duration: 100 Design meets Code minimum(U360)1ive load deflection criteria. Disclosure Design meets arbitrary(1")Maximum load deflection criteria. Minimum bearing length for BO is 1-1/2". The completeness and accuracy of Minimum bearing length for 131 is,1-1/2". the input must be verified by anyone Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing who would rely on the output as evidence of suitability for a particular application. The output above is based upon building code-accepted design properties and analysis methods. Installation of BOISE engineered wood products must be in accordance with the current Installation Guide and the applicable building codes. To obtain an Installation Guide or if you have any questions,please call (800)232-0788 before beginning product installation. BC CALC®, BC FRAMER®, BCIG, BC RIM BOARD-, BC OSB RIM BOARD M, BOISE GLULAMTTM VERSA-LAM@,VERSA-RIM@, VERSA-RIM PLUS@, VERSA-STRAND-, VERSA-STUD@,ALLJOIST@ and AJSTm are trademarks of Boise Cascade Corporation. Page 1 of 1 BOiSE- BC CALC® 2003 DESIGN REPORT - US Thursday, February 03,2005 10:21 Single 5 1/4" " VERSA-LAM(g) 3080 DF File Name: Jim Macurdy.BCC: FB01 Job Name: im Macurdy Description: Floor Beam under new family Room Address: 163 Percival Drive Specifier: City State, : Barnstable, Ma Designer: Bill Campbell Customer: Company: Shepley Wood Products Code reports: ICBO 5663, NER 442 Misc: Standard Load-.40 psf 110 psf Tributary)2-00-00 Ak BO 131 3840 Ibs LL 3840 Ibs LL 1111 Ibs DL 1111 Ibs DL Total Horizontal Length-16-00-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur. S Standard Load Unf.Area Left 00-00-00 16-00-00 Live 40 psf 12-00-00 100% Member Type: Floor Beam Dead 10 psf 12-00-00 90% Number of Spans: 1 Left Cantilever: No Controls Summary Right Cantilever: No Control Type Value %Allowable Duration Load Case Span Location Moment 19804 ft-Ibs 45.8% 100% 2 1 -Internal Slope: 0/12 Neg.Moment 0 ft-Ibs n/a 100% Tributary: 12-00-00 End Shear 4229 Ibs 30.3% 100% 2 1 -Left Total Load Defl. U505(0.38") 47.5% 2 1 Live Load Defl. U651 (0.295") 55.3% 2 1 Max Defl. 0.38" 38.0% 2. 1 Live Load: 40 psf Dead Load: 10 psf Notes Partition Load: 0 psf Design meets Code minimum(U240)Total load deflection criteria. Duration: 100 Design meets Code minimum(U360)Live load deflection criteria. Disclosure Design meets arbitrary(1")Maximum load deflection criteria. Minimum bearing length for BO is 1-1/2". The completeness and accuracy of Minimum bearing length for 61 is 1-1/2". the input must be verified by anyone Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing who would rely on the output as evidence of suitability for a ' particular application. The output above is based upon building code-accepted design properties and analysis methods. Installation of BOISE engineered wood products must be in accordance with the current Installation Guide and the applicable building codes. To obtain an Installation Guide or if you have any questions,please call (800)232-0788 before beginning product installation. BC CALC®, BC FRAMERG, BCIS, BC RIM BOARDTm, BC OSB RIM BOARD-, BOISE GLULAM-, VERSA-LAMS,VERSA-RIMS, VERSA-RIM PLUSG, VERSA-STRAND-, VERSA-STUDS,ALLJOISTG and AJSTm are trademarks of Boise Cascade Corporation. Page 1 of 1 ppEa..E �p Application to (199 5 171 �PpE IN "Its I P,�0. Old Kings Highway Regional Historic District Committee .._ . in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, id triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application.for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: ( New Building ❑ Addition . ' ❑ Alteration Indicate type of building: [House EDGarage ❑ Commercial ❑ Other 2. Exterior Painting: ®� 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY DATE 2_L4" CIS ADDRESS OF PROPOSED WORKS 3L QC0 ry JJ bt—I.WZ, ASSESSORS MAP NO.- 1 OWNER V1orS� �cao� CICKIIL4 S '5 i C-CPam_ �GQ ASSESSORS LOT NO. t a— HOME ADDRESS P'd'`3aac�Sl� i S-� EIZ &f\ CL(0 t,6 TEL. NO. ^�>J �d FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). f ( ' ` f � Q � a►�5 _ 'tee r S•e..�� _ M o`di c►rW S a�C•C• 1%O � JU K ��L , � 1 sf �'J e-(n r�I ���� a Z L�-� AGENT OR CONTRACTOR,�l�-� TEL. N0. nn ADDRESS T•O NAAwi.S 4�� 6Z.6 sb 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). ( g 4 (AS OV)--f,- Car dr I-V� K_VQ4,e-Ar- . . A #1 NIN I A 111�, r'ic F . ... Signed 2E _ . G :;.. : .. . .. . . •: Owner-Contractor-4genj Space below line for Committee use. Received by H.D.C. Date The Certific a is hereby ��"f" Date y �9J TimeJb By • Approved ❑ IMPORTANT: If Certificate is approved,approval is subje to the 10 day appeal period provided in the Act. Disapproved ❑ +•� r' 'F, .. .,.:4;'1' .._ i ..�M'..„ ..Hl Kri"./.f-9.-". ..:.h'-.'il.':.. ... i':f.': .Y.w t.s....r wn...i,.n4.. T+T.!.' ._w.'✓+.....+mm[.avin...�tv.,...e..u-.......A.....-......-....-.�.-..�-- ADDITIONAL INFORMATION FOR MAKING AND FILING AN APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS The four categories for which a Certificate of Appropriateness is required are: (application for demolition or removal is a separate form). 1. EXTERIOR BUILDING CONSTRUCTION (new or existing buildings): An application is required for any exterior of a building to be erected or altered including windows, doors,.siding, roof, light etc., that will be visible from any public street, way or public place. The following scale drawings are required in duplicate with application: 'plot plan (if addition — show existing buildings in outline), floor plan and elevations. Also required are snap shots of existing buildings, where additions or alterations are to be made. No plot plan is required for addition or alteration which does not touch the ground. 2. EXTERIOR PAINTING: An application is required for any portion of a building, structure or sign to be painted that is visible from a public street, way or public place. Color samples must be attached to these applications. An application is not required when repainting existing colors, changing to white, or using colors approved by the Town Historic District Committee. 3. SIGNS OR BILLBOARDS: An application is required for any sign or billboard to be erected.within the District, with the following exceptions: a. Existing signs or billboards on November 27, 1974 shall have until November 27, 1977 to secure an approved Certificate of Appropriateness. b. T'emporary signs for use in connection with any official celebration or parade or any charitable.drive as long as they are removed within three days of the event. Certain other temporary signs that the Committee feels does not detract from the Act may be allowed with the prior permission of the Committee. c. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they are erected or displayed. d. A single sign of not more than 1 square foot in area showing the name, occupation or address of the occupant of the premises on which they are erected or displayed in a residential zone. .4. STRUCTURE: An application is required to build or alter any structure within the District which is,defined by the Act as a combination of materials other than a building, sign or billboard, but including stone walls,flagpoles, hedges,gates, fences, etc. GENERAL REQUIREMENTS 5. Work on projects requiring approval shall not be started until the Certificate of Appropriateness has been filed with the Town Clerk by the Committee. Approval is subject to the 10 day appeal 'period provided in the Act. 6. No changes shall be made from the original approved specifications without advance approval of the Commission on an amended application filed with the Committee. 7. A separate application must be filed with each project requiring a Certificate of Appropria eness. .8. Under heading of "Detailed Description of Proposed Work" give detailed data on such architectural features as: foundation. "ihiriiii-e'y". 'siding,-'roofing, roof pitch, sash and doors, window and door frames, trim, gutters —leaders, roofing and paint color. 9. Unless application is complete and legible and all material required i.s supplied,application.ation will not be accepted or acted upon. Copies of the Act establishing the Regional Historic'District may be obtained at the Town Hall. Town of Barnstable 014 King's Highway Historic District Comm.. SPEC•'-SHEET 11 6 .1 r FOUNDATION C QeA r-t5 SIDING TYPE az&6 �6-_F4,5 COLOR--Favcv CHIMNEY TYPE— COLOR K e4 ROOF MATERIAL ICA COLOR V�"JLC- PITCH - WINDOW \LtAK_=c SIZE L(17-+ TRIM COLOR C_(_sC,_ ea, DOORS T COLOR CX4 L&O c- SHUTTERS GUTTERS VV\_ I DECK— GARAGE DOORS jWa_SCV,,C- _ COLOR' r V NOTES: Fill out completely,, including measurements and materials/colors to be used. Three copies of this form are required for submittal of an application, along with three copies each of the Plot plan,, landscape plan and ';' . elevation plans, when applicable. Plot plan need not be "Certified", but should .. show all structures on the lot to scale. i p��'CIII �L DD 4p 00, �b fib. a. 59. 99, 44 K cv �C 82 yo �Y. 0 o =s w �k LOT 31 35,097 + S.F. (0.81 '68 00 . JOB # 94-309-31 CERTIFIED PLOT PLAN PREPARED FOR � LOCATION : ASES MAP 110 PAR 1-12 PERCIVAL DRIVE W. BARNSTABLE SCALE : 1" - 60' REEF REALTY REFERENCE : LOT 31 PLAN BOOK 413 PACE 99 �N OF MASs9 I HEREBY CERTIFY THAT THE STRUCTURE JOHN cy SHOWN ON THIS PLAN IS LOCATED ON TIC' o L GN GROUND AS SHOWN HEREON. D gr JL v No.3W59 ig DEMAREST - McLELLAN ENGINEERING 24 SCHOOL .STREET P. O. BOX 463 DECEMBER 12, 1995 WEST DENNIS, MA 02670 (508) 398-7710 DATE 0FE IONAL LAND VEYOR 4•F "mor I �T!� P1eK.uv � � N.Onpasra.g�� - . ell, 12p F. 6. o�•�»,.4. : . ._.-.. -- � env«I+w.r. ___ r 1r `;- I yKwn' = 4�I w!! cappgreu oo — —. 94*otZOO46.os aR..2•►.r forT vc. ut71 ECG(,MrI S. .�_ ..:; J ROAIT E'LLVATIOLI --� - -- �' ti ud -- __• , � • ' µo. eraM'�t. s 1ox'1=o Pi+an. � �`. T- - W.E.G. 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I �rwl. � - r 1 1 13� P N I llc� PAN U • �prncsv oN,v�oP Txe TouNvknol{ g �. ;. N�epcC.00 7'tir+PI✓�tL• f To Wg ? po�-nv To�►re pvr•1.w I Z-4Z u �(Fo.Tif�. P07 nON��i.s.uY�o TIrC gouNv�crlvW �.�.11 ouNDi.T1oN QL.rnt�• �.. msA 1 LJu k¢l, a,Y Ih 6upeD rN TMI.FIRy/ "lox Wo 4 lo60.Go,.ON-L+ ff4A .u►Ioer- ' Ft•.oalrFroR NMa.. .oua• •. o rrro.�o n ..v i _ r -- !` ,�1 v_ J � � �� _�� } � . . t � � � . ___ -. � - TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 110 001 012 GEOBASE ID 36847 ADDRESS 163 PERCIVAL DRIVE PHONE W. Barnstable ZIP - LOT 31 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT WB PERMIT 15621 DESCRIPTION SINGLE FAMILY DWELLING (PMT.010758) PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: BOND $.00 , CONSTRUCTION COSTS - $:00 - 756 CERTIFICATE OF OCCUPANCY BARNSTABLE. *' MASS. OWNER HORSEFOOT, HOLDINGS C 039. A�� ADDRESS 24 SCHOOL ST ED M/'I► PO BOX 186 l` BUILD �G DIVISION W DENNIS MA �' BY IC,�L, ,----- DATE ISSUED 06/05/1996 EXPIRATION DATE Assessor's Office 1 t floor Ma Lot dO • 0 / ��� Permit# Conservation Dffic844th floor C. 4: �{ � Date Issued Board of Health Ord floor Engineering Dept. (Ord floor) House# j411 � Planning Dept. 1st floor/School Admin. Bld . -- �o - MRNBrAUS. _ Definitive Plan Approved by Planning Board Dim ^-S✓'�`' �� 19 `� ���b' 'b� 4.".lam {(Applications processed 8:30-9:30 a.m.& 1:00-2:00 p.m.) ( , 0 k 4" f 4c . �` .C5 bier r 65 4A- p w.J or Q.pgid►l, � tom', TOWN. OF BARNSTABLE J Building Permit Application Project rcet Addres -7EYLC,L V SAC►- h w-t V ls villag 00w- r%N-1 r a� Fire District Owncr - � �' ,�- �Ye�r1�e 1�1C��p C�- Address '70 736k l ti.\ 16e7N AV 1S,�Jl�+'�C�(o•�t� Telephone SD8 --SR 0 Permit Request: 7-b Ce ,4 p.k�w s L*A "t c-y 1^1 C7 -2 o 8?A'd -u , Zoning District Flood Plain C- Water Protection Lot Size 35, b9-1 g41 Grandfathered 6S Zoning Board of Appeals Authorization Recorded Current Use V Ox r4-t rr Proposed Use (LE S rtDG,.XT[ mac! Construction Type LZMC.7D 9-14Wl / EaistinQ Information Dwelling Type: Single Family ✓ Two family Multi-family Age of structure r-4eW Basement type urz-&0 t C<� Historic House P40 Finished Old King's Highway 91 ?moo qcj Unfinished H CW,r=; L Number of Baths ,5 No. of Bedrooms Total Room Count(not including baths) '42 —] First Floor Heat Type and Fuel by C ty S Central Air N.© Fireplaces yes CI Garage: Detached Other Detached Structures: Pool Attached (bV- . CA1L Barn None Sheds \ Other CID K t+1 Builder Information Name E,,-zo TI— W , 1Gy Telephone number JSn�Address fR o .�J x1 _ 2 5QeHoe`S'`'t" License# '0377-8Sn Home Improvement Contractor# Worker's Compensation # CLCo-C Z4-S-76-7s,l Cb4A} NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Proie t Cost 41 110 ot r-- Fee R- 41 SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOW G REASON(S) BPERM T FOR OFFICE USE ONLY ' to K� y ADDRESS VILLAGE =c OWNER 9� DATE OF INSPECTION: FOUNDATION 12 FRAME INSULATION FIREPLACE I" _- ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUII,DING: 1�• � � r�;�� r DATE CLOSED OUT: ASSOCIATE PLAN NO. O ,^�V� ,� t - r .�._. =�..-.'�r.::._ _�1........s �1ra..-� i.....:..,,,...��Yr,yc.a,:r i:1i. —:--•- . —..,..- _. � (��'��jy • _ i .�tk. >�} jJ�TABLE.• l;�� ?�� '1 = � t .'`' ,. 'x •4•� y .f't(: { { ,+J)t a-"��:'► '- � . PARCEL ID l0 `001. Oar _ `, r tf t ,'�a`t r36847, ADDRESS 163 .PERCTV� ,{f,^{•�� �* • . " :PHONE t, W. Barnatabl: �?�,y 1 ,, r - { -ZIP '.; LOT 31 • ,r. 4 '1t"'#,�,w �• LOT SIZE DIM .a ' . „�. , : yFMRrI' , y- DISTRICT WB ' PERMIT 10758 DESICR�P'TION .CONSTRUCT SINGS$AMMOME W/GARAGE & DECK `. PERMIT TYPE BUILD TITLE NEW ,RES/COMM Bhp merit of Health; Safet3 . CONTRACTORS: BOY, EVERETT W. JR. r. _; and Environmental Services ARCHITECTS: 1 .* ., .� TOTAL FEES: $1g7.83 { �1ME BOND $.00 CONSTRUCTION COSTS •$110,000.00 �i► 101 SINGLE FAM HOME DETACHED � 1 PRIVATE P 039. OWNER HORSEFOOT, HOLDINGS•>,C �, { ADDRESS_ 24 SCHOOL ST PO BOX 186 W DENNIS MA -BUILD I ` DATE ISSUED 10/05/1995 'EXPIRATION DATE BY ' THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, ER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. f` MINIMUM OF FOUR CALL INSPECTIONS REQUIRED ;' s i ( FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND; WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION r• • PERMITS ARE,REQUIRED FOR • i'. 2.PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A'•CERTIFICATE OF OCCU;_ ELECTRICAL,PLUMBING AND MECH- 't; (READY TO LATH). .z PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE - ANICAL INSTALLATIONS. 3.INSULATION. = OCCUPIED UNTIL FINAL _INSPECTION HAS BEEN MADE - . 4.FINAL INSPECTION BEFORE OCCUPANCY.' Y POST THIS CARD SO IT IS V1z"j"IBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS •ELECTRICAL INSPECTION APPROVALS ilo 3 Me� �� 1 HEATING INSPECTION APPROVALS • ENGINEERING DEPARTMENT . 2� _ , : , • BOARD OF HEAA� �h OTHER: SITE N REVIEW APPROVALA o7 ,•' f�� ! S -l7 -�-�' WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVEDTHE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. 508-790-6227 ' HE 1p� The Town of Barnstable BARNSTABLE. ' Department of Health Safety and Environmental Services MASS. i639• �0 Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection Location �3 \l t v �/� Permit Number . r j Owner C) 0 Builder ! One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: r u n �tn k u i Please call: 508-790-6227 Qfor reeinspection. Inspected by Date To Date Time WM, OU WE R UT M � of Phone Area Code Number Extension TELEPHONED PLEASE CALL CALLED TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU URGENT RETURNED YOUR C L Message 6 Operator AMPAD Z3-021-200 SETS �j EFFICIENCY® 23-42i 400 SETS CARBONLESS 711 To ;{ Date �/ Time WHILE YOU WE R OUT M of. Phone Area Code Number Extension TELEPHONED PLEASE CALL CALLED TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU URGENT R�ETUR/>NEED YOUR C L .Message --.z p GV . Operator AMPAD 23-021-200 SETS EFFICIENCYe 23421-400 SETS CMBONtFSS .The Commonwealth of Massachusetts Department of Industrial Accidents gz �.. ofl/ce of/nvesi/gat/ons 600 Washington Street Boston, Mass. 02111 g2r1.a��'•' "—' Workers' Compensation Insurance Affidavit Applicant information' �rReF,•�:. .w.:::r' _`. _:aa.._:_:` name: location: Cite phone# I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. comompanynampe: address: city SST J�Nf- UZcc lV phone#• SC7�-3���30 1��.._ �. insurance co, oolicv# W(0 —�1 ���� I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name- address: _ . i phone 4. insurance co company name: address: city phone#• � prance co policy Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one years'imprisonme well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statemen may be forwarded to he Office of investigations of the D1A for coverage verification. 1 do hereby certij de the pains a d enaltie of rjury that the information provided above is true and correct Signature ate Print name Phone# official use only do not write in this area to be completed by city or town official city or town: - permit/license# nBuilding Department OLicensing Board O check if immediate response is required OSelectmen's Office 0I-fealth Department contact person: phone#; 00ther (rc,.sed 3/71 PIA) i Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", ad employee is defined as every person in 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 fore-oin�ur 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 section 25 also states that every,state or local licensing agency shall withhold the issuance or t renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance,coverage required. Additionally, neither the commonwealth_nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the "law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. :K.'nT'?:Rt.'�'`C+Y'�c.71=Wt.�'�M�,i�?s'.t���~ r .. .<'F Y:..... _. -.: •e e _ City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permitAicense number which will be used as a reference number. The aff davits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. r ' .fL.i't:<j1.'f' The Department's address, telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents — Office of Investigations 600 Washington Street Boston, Ma. 02111 fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 ... .. :•H;.w ' COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY OF ONE ASHBORTON PLACE L �•v iC CC��C " MASSACHUSETTS BOSTON,AAA 02108 c'!i.'.;;l;cy�co•fO!/CVOCLfIOa� EXPIRATION DATE C O N S T 14. $ i^L E R V I S 0 R CAUTION RESRICT�IONS9 9 6 EFFECTIVE DATE r UC-NO. FOR PROTECTION AGAINST THEFT,PUT RIGHT THUMB NONE /+/3()/1 9?3 0 3 2 8 0 4 PRINT IN APPROPRIATE ' 0 6 BOX ON UCENSE EVE-f'.ETT W BOY JR :t,= }3 0 X i 86 a BLASTING OPERATORS SS :0:z3-42-4928 Z W DENNIS MA. 02670 Z MUST INCLUDE PHOTO. PHDTO(BLASTING OPR ONLY) FEE: pATD -- _ 100.0() NOT VALID UNTIL SIGNED 8V LICENSEE AND ociICU1LLV .. _ ' %i r - - S PED•OR-SIGNATURE OF THE COMMISSIONER HEIGHT: DOB: Uri 9 1993 03/17 /1454 J ' ale•,•�(f;(•,.;F;'•'S•'nGe.o.�: '• �. T:,t��••-- « SIGN NAME W FULL ABOVE SIGNATURE LINE fi•� • %��,•%.i "i�i.,•yti1l: •�•r�.;I,11,���..;�)rJL' THIS DOCUMENT MUST BE TUAE OF LICENSEE �Y) r%`:�:�'t`I�1�11'�,\�>'-?•: d/I Iif 7 CARRIEOONTHEPERSONOF •iL(-. �°!v�M':i.''.^•.,)y}y,/n��.//�w�4'. THE HOLDER WHEN EN- �lj; l •-,,�x� T, GAGED W THISOCCUPATION. ISS%NER . .• _ v Application to ®YET Rittg'o 3�igbbjap Regional 9�isstDr(c Aliotritt Committee - ca In the Town of Barnstable E C E E �-' c= CERTIFICATE OF APPROPRIATENES MAR 1 8 2004 R Application is hereby made,with four complete sets, for the issuance of a Certificate o "W� 4"q Se tion 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as describeF ,ns, c -) drawings, or photographs accompanying this application for. 1`71 cn CHECK CATEGORIES THAT APPLY: 1. Exterior building construction: ❑ New ❑ Addition ❑ Alteration Indicate type of building: ElHouse A Garage El Commercial Other NEW t>F- 2. Exterior Painting. 3. Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign --. 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other C: TYPE OR PRINT LEGIBLY: DATE_ / cR. ADDRESS OF PROPOSED WORK`I V3 pERCIVAL N W, BAQN ASSESSOR'S MAP NO. 110 OWNERS AMCS � Kr(-A'J MACYRD'A ASSESSOR'S LOT NO. 001 F N IZ HOME ADDRESS I�3 ���/�L D2i�� TELEPHONE NO. J�'Dy 2 g�Z 3 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, Including those of adjacent property owners across any public street or way. (Attach additional sheet if necessary.) ND� 14S8DI-rc-W 173 P��✓At- �2�V� w�sr BA2NSTq-B�- 02 ` Sv--,Vir4 K QEo f2 cl5 I p PrgLiV4L fzIv� y N- E ivAL- Qi✓f r e KS C90 55 iiVe RS56(. h) Po i3o r7 sf 5TqJ3LC, ftW? AGENT OR CONTRACTOR --AAM i'.S MAIW Del TELEPHONE NO. SO$ Z�4SSS ADDRESS SAM I DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please Include locations of proposed signs. 13u 1LD 4 'DETA C-4 p Z + .NJ L 4 Z C49 WooD �94m r Coti rTAur-roiJ - CLAP130AAP -("PT— 7O MAJ-Clf kdvsJ:i, PaMOuG F--ti5r1PV 10 X I � 16CK P—. -PLACE. WIn4- 14 xZO — D>:,GV— Ta �{qvE MF�1tOC�RN'� Dl;c�c�1JCr Signed WNr tibrier-t3ontractor-AEfent For Committee Use Only r This Certificate is hereby V14 ate S -V d o Committee Members' Signatures: i ' E # M2 Town of Bsrnstable LS ' Old King's Highway Historic District Committee &'AR 8 ?004 SPEC SHEET H SOWN BARNSTA LE � RESF FOUNDATION � CONC(L�TF fxo5 i yiALL 41 5'-,+3 �,,n SIDING TYPE6LhP0Q6 D f00 0fiVkrz.- COLOR CLA®1 QW V MAT-Cif k1"' CHIMNEY TYPE N COLOR ROOF MATERIAL /"15� _COLOR PITCH WINDOWSApD6500\61L 5iM i I. LLOR P R IT SIZE 5Ef P6 TRIM COLOR �rl TC1-� DOORS I"�V�r1 I'�� COLORS W4 I 1 FI- SHUTTERS COLORS GUTTERS /7LuM COLORS DECKS �M SST' MATERIALS r)eAM fr—,- MA 10006 GARAGE DOORS YA ALUM COLORS w H SKYLIGHTS SIZE COLORS SIGNS t" A I COLORS FENCE N COLOR NOTES: Fill out completely, including measurements and materials/colors to be used. Four copies of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plans, when applicable. SPECM Revised 11198 y` A RTGACTE _1L=_'yTJ0N LLAN .Q Ri�fICANT- JAMES K. & KERRY A. M_4 CURD}" TO WX BARN, LE f PEW[17AL DRIVE _h'4153�6'%�' _ Afq�' 1 8 ?0 TO 04 p��pRESNSTABLE eti��r�,sT � ER�ATION -551 l:20'�4 60.00_ \ S� r \S y do �4 2 Vol Tr. r3- l � vol Q9Q `a S S�TtSR�`� C9p 1 cif vol s • PAUL • yG�i �:4'rIAiTHEW ; = NC.-32098 Qom; - . S4 y 95 4g '••,Ct`� 168..00' 0/y S �. I-- FLOOD PANEL. 250001_Ot715C FLOOD ZOA'E _C_—_ DATED t3,�19;85 I herebv certifv that this fno.rtga�;e inspection plan was prepared for., Plan is For _ Bank Use Only GMAC MORTGAGE COMPANY — The location of the building shown does .�QZ fall within a special flood hazard zone. PLAN REF = _4131199--- The location of the dwelling does ------- conform to the local zoning by-laws i.a effect Scale I FT at the time of construction with respect to horizontal dimensional setback requirements -- or is exempt from violation enforcement action under Mass General Laws CA 40A --Sec. 7. I Date: p46ASE NOTE: the structures on this inspection were located by tape not instrument and are approximate only. An actual survey is necessary for a precise., determination of the building location and encroachments, if any exist, either way across property lines This inspection must not be used for recording purposes or for use in preparing deed descriptions and must not be used for variance or building plan purposes. This inspection must not be used to locate property lines. Verification of building locations, properly line dimensions. fences or lot configuration can only Lr aecumplW,h d 8v au accurate instrument survey which moy rWaet different information than what is shown horenn This inspection is not o be used for any purposes other than mortgage. Yankee .Survey accepts no responsibility for damages resulting, from said reliance. . FAX 50B-420-5553)' NK�E UF I A Y CONSULTANTS O BOX .265, 40 INDUSTRY" RD, AMRSTONS MILLS, MA 02648 PHONE.-508-4e8-0055 34373 LM f Landscape Plan For: Old Kings highway Committee X OF BA. �31 RES ABLE ERV Location: 163 Percival drive West Barnstable "'� P ATION Proposed Work: Build a 24x24 detached two car garage and replace 1Ox14 deck with 14x20 1.Remove trees in the general area of the proposed garage and deck 2.Pow 24x24 foundation 3. Rough grade disturbed areas 4.Extend existing driveway to front of proposed garage 5.Loam and Seed rough graded areas ASSESSORS MAP: »0 PROPO M iaLL PARCEL, 1-12 (1s7 To IJACM Prr) ' (ISZ To AM=ZNG - 7.LrACBING ARaA) CURRENT ZONING: RE BUILDING SETBACKS: yy tJ77LTlY : :1i. sf 1.., .9. 7� y' 1 / { �:a ter'+%"r•v'.: 4�,,:,.r,t f,; 9 FLOOD ZONE: :. r ;�.. __ ! 4 g9, ; aDJS Olr PAV.Is, '.'� .70 ffi11RS dT 3t# --:; CATCB BASIN C] 'LOCATION 1(AP :;:.. -, ) t ) ! p 1 r': SA LOT '31 ,• .35,097 f S.F. •� �� � �� �� ) � ) f j 1 1 �i \ � � • .'. PROPOSSD LaACBING 1 AC.) AMA (LOT 32) / t ) ` 1 + �� co, SA co ON Ilk -''� '�.• :'-' . \ \ S` may:~ •}. '?.,. 1 1 i ♦\ ;y:��;:, �;`� \\ \ \ \ 1 1 1 i •.i ! ; ') PROPOSM WELL \ \ LOT 30 " : \ \ + •1� }._ f ) \ t .055'TO MACH PIT) 414 yIr ' • •, , sib.; .♦` \ ♦ � \\ 1tA 'f�,l' \ \ \\ \ \ ♦ is •:;: . ...:;...• •,fir.•5��,:v;[•�,•Rt•„:,. r \\ \\ \ \ \ PREplO�TS LOCdTIOT OF .e% ♦ \ \ \ \ \ \ \ PROPOSED W= (Saa : . '♦. ♦ \ \ \ \ \ \ \ \ > MAT LOCATION FRONT 01' LOT) DOSS NOT WT Ol YA.S:rZJ? ; 1•• ' �.♦ �.� ♦ \ \ \ \ \ \ \ \ \ \ \ PLANS .. . . . Ao At ! J J \ \ 6`j 46> SS 6. S • \\ \\ \ 1` ) ! cif - .. 1 1 1 KEY: + 1 1 EXISTING CONTOUR: \ 1 \ vo PROPOSED CONTOUR: EXISTING SPOT ELEVATION: 25.5 s se PROPOSED SPOT ELEVATION: 25 TEST HOLE: UTILITY POLE: -O- DM FENCE LINE: .. .. .. :: r` , HYDRANT. -� DZMARasT-Yc JUAN axclxaA. 24 SCBOOL i. . RETAINING WALL: WaST DSNIITIS, YASSdC$llSET7" I� _ -- N ASSESSORS MAP., 110 PROPOSED WELL TEST HOLE LOGS NOTES. PARCEL: 1-12 - (193' TO LEACH PIT) 250 TO ABUTTING v �oG LEACHING AREA) f. VERTICAL DATUM: ASSU1uED FROM LJjl�(NGVD +�,) t r CURRENT ZONING: RF ENGINEER: DOYLE ENGINEERING 2. MUNICAPAL WATER 1S NOT AVAILABLE. 4� BUILDING SETBACKS: �� UTILITY WITNESS: JERRY DUNNING 3. SCHEDULE 40 - 4" PVC PIPE TO BE USED THROUGHOUT SEPTIC SYSTEM. kfc F: 30' S: 15' R: 15' > � CLUSTER DATE: 5-8-87 4. ALL PRECAST UNITS TO CONFORM WITH AASHTO H-10 & H-20 e PERCOLATION RATE: < 2 MINIIN LOADING SPECIFICATIONS. ZONE: C ;i '?�`� �s ► , TH-1 TH-2 TH-3 1 1 64 5. PIPE PITCH = 4" PER FOOT,(UNLESS NOTED OTHERWISE). q FLOOD . g9' y EDGE OF PAVE 66.0 64.0 60D 6. FIRST 2' OF PIPE OUT OF D-BOX TO BE LAID LEVEL. ss 61B s9 I ` TOP & ELEV TOP & ELF TOP & ELEV 7. THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE I I SUBSOIL SUBSOIL SUBSOIL 'c��',�,�. LOCUS ► , ' I I , I ` BENCIDARK AT 36" sso 36" 61D 36" 57D USE OF A GARBAGE DISPOSAL. '�'�,p_ 1 ► I ► I t CATCH BASIN o�- CLAY CLAY 8. ALL CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE '°�C 1 I I I I +► ELEV. - 76.7 '� 62.0 54' S9S 54' SSS ► I 1 ' I ► ' I ® CLAYEY SILTY SILTY STATE OF MASS. ENVIRONMENTAL CODE (TITLE FIVE) AND LOCAL ► I i I o SAND SAND SAND r I ► I � HEALTH REGULATIONS. .00ATION MAP / I I 1 WITH WITH WITH L0P 31 ' , � ► ► ' 1 , ' ` , "� 132- BOULL"Rs 55D 132- COBBLES SsD 132- COBBLES 49D 9. CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR '5,097 f S.F. PROPOSED LEACHING ► I 1 �/ ' 1 I �, TO CONSTRUCTION. / COARSE- MEDIUM MEDIUM(0.81 + AC.) AREA (LOT 32) , ► N ► i �}9 MEDIUM -COARSE -COARSE , ►l , ��, i 1 i 49• � � ,� �� � s�ANHr SAND SAND 10. PROPOSED SEPTIC SYSTEM LOCATION IS IN ACCORDANCE WITH MASTER �� PLAN ON FILE WITH BARNSTABLE HEALTH DEPT. PROPOSED WELL GRAVEL Ise' 4s o LOCATION HAS BEEN REVISED FROM MASTER PLAN BUT STILL MEETS ALL �.�, ' , / ' 1 �, sz.o 1ss" so o SETBACK REQUIREMENTS. , ' ► , /► �,( I , i ` �' \ r 11. DESIGN ENGINEER TO INSPECT AND CERTIFY SUITABLE SOIL CONDITIONS ,, �� ►/ ► i ; 1 1 1 �` \\ ,� NO GROUNDWATER ENCOUNTERED TO A DEPTH OF 4' BELOW LEACH PIT AT TIME OF CONSTRUCTION. ma`s �: ► t _ ► � �, I \ \ �.. : :.�.. ...�......., I i ♦�� SEPTIC SYSTEM DESIGN 1 s y ♦ ryo I �s : ► }��4 •I �� '� /1 ♦ ♦ `\ FLOW ESTIMATE: s ,r O ► • \ BEDROOMS AT 110 CAL/DAY/BEDROOM = 440 GAL/DAY ` � ` ♦ �0� I I !' E ` � T °Q`S`�j 1 \�G ♦ ` ♦ \j 34• ♦ 1 1 G ..++,�l,C . I 6 ♦ \ \ .. •��f� 1 ► ♦ SEPTIC TANK: a ♦ POSED ...... ` 'O c I • ► ' �� �40 GAL/DAY * 1.5 DAYS = D2 GAL 4 B BEDROOM �\ ��..• �\ 'o' 1 ' ♦ USE 1500 GALLON SEPTIC TANK 26' DUELLING PROPOSED WELL ` r , I' •. , , LOT 30 LEACHING AREA: \ \ I 1 I 1 ♦ ► (155' TO LEACH PIT) _ DECK USE TWO LEACH PITS (6' x 49 WITH 2' OF STONE s? ♦ s� ' ` lA \\ �\ ` ` ` � ` �\ ass (10' EFFECTIVE DIAMETER x 4' DEEP) PROPOSED DWELLING A SIDE AREA.- 10 x 4 x PI = 126 SF (2.5) = 314 GAL/DAY c ♦ . �� ` \ \ ♦ BOTTOM AREA: 5 x 5 x PI = 78 SF (1.0) = 78 GALI DAY TH�1 ` ` TOTAL CAPACITY =3392 GALIDAY PREVIOUS LOCATION OF x 2 PITS = 786 GAL/DAY` ♦ � \ s' � \ � ` PROPOSED WELL (SEE ♦ ♦ ` `. ♦ \ \ ` \ \ \ NEW LOCATION FRONT OF LOT) s, , , , , • , , , ? (NEW LOCATION DOES NOT SEPTIC SYSTEM SECTION 2" PEASTONE ♦ ♦ ♦ ♦ `\ ` ` \ ` \ \\ ` \ ` AFFECT LAY OUT OF MASTER \ COVERS WITHIN 12" OF 314- _ 's� \ � ♦ \ \\ � ` \\ i TH-2 ` ` �\ � \` `\ `\ �� OF FINISHED GRADE WASHED STONE ♦ \ \ \ ` ♦` \\ \\ \ TH-3` 1 ` ` \ \ \S.9 74.0 TOP OF FOUNDATION \ \ 6.b, V ♦ ♦ ♦ \1 ` I \ ` \ ` 63.39 4, a o 63.64 1500 GAL ELEV. D-BOX 62.72 69 ELEV. SEPTIC TANK 62.89 ELEV 51.0 . ELEV. � z�ELEV. TEE SIZES: ` 10, ELEV. ` \ ♦ ` ` i I ' ► 64.0 INLET: 6" UP, 1O" DOWN -- ELEV. OUTLET: 6" UP, 19 DOWN TWO LEACH PITS 6' x 4' WITH \ I I I I 2' OF STONE (1O' EFF. DIAM. x 4' DEEP) (H-20) 1 i 1 I I I 6,' SITE AND SEWAGE PLAN ► I I 1 ' I �`� I 1 1 1 KEY. L 0 CA TION.'LOT 31 PERCIVAL DRIVE EXISTING CONTOUR: — ,�, � j �►+� t w �� s PROPOSED CONTOUR: •.'•'•'•••"'..•.••..'•"'•••' o y WEST BARNSTABLE MA c a EXISTING SPOT ELEVATION: 25.5 :.` .` `�= ' a° PROPOSED SPOT ELEVATION: 25 ` . :k I !�� ao TEST HOLE: - 0 �; _ ,., � .v_ 1 ; PREPARED FOR UTILITY POLE: -O- REEF REALTY FENCE LINE: r-a , ' ' ► "' (' , HYDRANT: -6 DEMAREST-McLELLAN ENGINEERING r �- SCALE: f" = 30' DATE: 3-7-95 '7 i J l � i - -?— RETAINING WALL: 24 SCHOOL STREET P.O. BOX 463 REV: 9-7-95 ( REFERENCE: PLAN BOOK 413 PAGE 99 )M # ,Q�y�31 HEST DENNIS, JIlASSACHUSETTS 02670 THOMAS McLELLAN, r.E. JOHN . DEMAREST JR., P.L.S.