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HomeMy WebLinkAbout0241 PERCIVAL DRIVE 1 o � OxibrcF NO.152113 ORA ManE w usa ESSEUE L_� ' .. • - ��a� �I �y _.. ,., - --- �- - -� r-.J.�---_-^—SS.^',^.�y�•!-^_...�___�as�e..�-_.::_ .�...r!,�,rn.,,�.'--_ __..� -ram � ,...^*n.�-.W�-.Z.:.r"_%._....rti:u'r`_ PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HY @1S, MA 02601 DATE'S 03/26/07 TIME 14:17 ----- -----=-----TOTALS------------------ PERMIT $ PAID : 25.00 AMT .TENDERED: 25.00 AMT APPLIED: 25.00 CHANGE: - .00 - APPLICATION'NUMBER: 200701760 PAYMENT�METH: CHECK 2 PAYMENT(REF: 179 Town of Barnstable *Permit# bb Expires 6 months from issue date Regulatory Services Feed JThomas F.Geiler,Director ]Building Division I PERM Tom Perry,CBO, Building Commissioner X-P E 200 Main Street,Hyannis,MA 02601 MAR 2 .0jR www.town.barnstable.ma.us Office: 508-862-4038 TOWN OWYAT�$4E EXPRESS PERNIIT APFLICATION - RESIDENTIAL ONLY Not Valid without Red X--Press Imprint[ap/parcelNumber 1b �o a�Jo7 roperty Address i 2C+✓✓-1 i_ �+ v i ti O� G A �c residential Value of Work /.-'O 6. Minimum fee of$25.00 for work under$.6000.00, iwner's Name&Address (,Fl iZt t Ty �l-1 c�IZ �. C0 ontractor's Name Z�- Telephone Number r [ome Improvement Contractor License#(if applicable) Licerzse#�-(�appiieahiej .. . ._.. ]Workman's Compensation Insurance Check one: ❑�a sole proprietor LK I am the Homeowner ❑ I have Worker's Compensation Insurance zsurance CompanyName I /r4 t2'J✓g (Lec)l + L�2�rti `rI L A L� i Vorkman's Comp.Policy# :opy of Insurance Compliance Certificate must be on file. ermit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to < ❑Re-roof(not stripping. Going over existing-layers of roof) i YRe-side a�+ ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property er must s' Property Owner Letter of Permission. A c y f Home r ve Contractors License is required. ,IGNATURE: Al I:Forms:expmtrg .evise061306 The Commonwealth ofMiusachusetts * Department of Industrial Accidents Office of Investigations ' 600 Washington Street . Boston,MA 02111, ' www.mass.gov/dia ' Workers}Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers• Applicant Information Please Print Le ' 1 Name(Business/Organiiatio dividual : Address: `IM City/State/Zip: C __�)I�.VQ ."A, Q hone.#� Are you an employer?,Check the appropriate box: general contractor and I :Type of pioject(required):, 1;❑ 4. I am a I am a employer with ❑ g employees{frill and./or part 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.andhave no employees These sub-contractors have g• Demolition: 'working for me in any capacity. employees and have workers' 9. M Building addition . [NE orkers' comp,insurance comp, insurance, ' ed] 5: [] We area corporation and its 10.❑•Blectrical repairs or additions 3: I homeownez doing a71 work officers have exercised their 11-❑Plumbing repairs.or additions ' myself (No workers' comp, right of exemption per MGL 12.E]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 nut the section below showing their workers'compensation policy information• t Horneowners,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 addidimal-sheet showing thename of the Sub-contractors and state whether arnotthose entities have employees. If the sub-contractors have employees,they must provide theif workers'camp.policy number. ram 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'(showingfhe policy number and expiration date): Failure•to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK.ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the.Office of Investigations of the 1)IA for insurance coverage verification, 1do hereby certi under the pains-andpenalties ofperjury that the information provided above is true and correct. Si afore: Date: 02 Phone#: C ��1�8� 3�f2o� -03 Official use only. Do not write in this area, tb be completed by city or town official. i City or Town: ' Permit/License# Issuing Authority(circle one) A.Board of Health 2.Building Department 3, City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector .6. Other •. Contact Person: Phone#: Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees- Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hue, express or implied, oral or written." An employer is defined as "an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a-deceased employer, or the receiver or trustee-of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to'operate a business or to construct buildings in the commonwealth for any applicant who has not produced�acceptable evidence of compliance with the insurance coverage required." . Additionally,MGL chapter152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public-.work until acceptable evideme,of complianece Qyi#htlie insurance requirements of this chapter have been presented•to the contracting authority.'t Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-confractor(s)name(s),address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies*(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members•or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that ibis affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit.or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law-or if you are required to obtain a workers,' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their . self-insurance license number on the appropriate-line. City or Towp Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all•locations in (city• 'or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be felled out each year.Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (i.e. a dog license or permit to bum leaves-etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for.your cooperation and should youbave.any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number:; The COMMODWWthi of aMch=tts DePutment of IndusWal Accidents Of."of Investzgwaolm Eton,MA 02111 Tel. 617-727-4W ext 406 or 1'977-MAS.SAFE Fax 4 617-727-7749 Revised 11-22-06. www.ma=g6v./dia Of1/1E� Town'of Barnstable ti Regulatory Services • RAIRN rABM Thomas F. Geiler,Director asess. Eo1 .,p`0� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-403 8 Fax: 508-79076230 Property Owner Must Complete and Sign This Section If Using A Builder L s Owner of the subject property hetebp authorize to act on m7 behalf, in all mattets relative to work authorize/bthis building pertnit application for: (Address of Job) l � Signature of Owner Date Print Name Q:FORMS:OWNERPERMISSION Application to J-,- 3[gigbivap 3.egiottat �)isstoric Misstrict Committee In the Town of Barnstable CERTIFICATE OF APPROPRIATENESS 2010 OV 2.2 PM 3: 23. 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 plans, drawings, or photographs accompanying this application for. DIV1510N o ..4-Co CHECK CATEGORIES THAT APPLY: oD El New El u Alteration 1. Exterior building construction: N r J e of building. 15House ❑ Garage ❑ Commercial Other -� Indicate typ G: �� 3og2O ;� S�\i� c�. 0 s1•,'> i� C� (s-z!j ;�z 2. Exterior Painting: 3. Signs or Billboards: . ❑ New Sign ❑ Existing Sign . ❑ Repainting Existing Sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other TYPE OR PRINT LEGIBLY: nn DATE ADDRESS OF PROPOSED WORK 241 r„� �`'J2. G�. A>z� ASSESSOR'S MAP NO. 110 OWNER_ ( " r� ,��`' ��E '2 L3• C© X ASSESSOR'S LOT NO. 00 i -602 HOME ADDRESS 5 t-A TELEPHONE NO.7114 f19H : i1Jot FULL NAMES AND ADDRESSES additional OFs ABUTTING OWNERS, including those of adjacent property owners across any public street or vvaY• ( r e� necessary.) '1 ►ZeJ�'�Ar�uEy M L-1 9 -z' -S—i Vat PA A v A t, Cn g AGENT OR CONTRACTOR TELEPHONE NO. ADDRESS ' DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please include locations of proposed signs. ►.4vJ G2 C-T3 CAA l7 - 3o.A ZO (A,1 oZC'? C: Z % "A e- 6--AI ;-1 � � V�� (s��� ��� � c Cv �o :Z� • Signed OL& -rV Owner-Co tractor-Agent For Committee Use Only This Certificate is hereby Date ApprovsdJD nied Comm,temberTatur Town of Barnstable Old King's Highway Historic District Committee SPEC SHEET FOUNDATION C.DhI C r2L-�� C IZ ►`� SIDING TYPE L/I '� � `� ��` COLOR S�W06-� vac CHIMNEY TYPE �>21 L IG COLOR i31zIGK ROOF MATERIAL ,&14 'S!11�1 C�L-ir COLOR . o PITCH A &x WINDOWS COLOR LW H i i t5 SIZE S -,q. N' TRIM COLOR W 1 J►3 1 I�AC�CCOLORS DOORS - SHUTTERS JVIa n� COLORS GUTTERS AL J tj I � � � COLORS •DECKS I MATERIALS GARAGE DOORS ( COLORS u t-t t 1 C COLORS SIZE �// SKYLIGHTS � SIGNS COLORS FENCE �Jl A COLOR T NOTES: Fill out completely, including measurements and materials/colors to be used. Four copies of form1z' j— are required for submittal of an application, along with Four copies of the plot plan, lands plan and elevation plans, when applicable. SPECSHT Revised 11/98 Town of Barnstable Regulatory Services BA NSrABI.E. : Thomas F.Geiler,Director a 9 .0�� Building Division p�fD MAC A 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 �y Please Print DATE: 3— �(��, JOB LOCATION: e \ V/� �� W. /��Z ►y��"V�LC numb`ern /��street (� village n "HOMEOWNER": Coo 650 V) 3(OD Q —O J I�! name pp home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall 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. T'lo W V Signature of omen r 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 �ar A.M g- &803 Assessor's Office(1st floor) Map //n /-a Permit# " .�73 1 . r Conservation Office Oth floor � -%� !� --! Date Issued ��;L9.s-- , Board of Health 3rd floor • ' Engineering Dept. Ord floor House# a 'Plannin 'De t. 1st floor/School Admin.Bldg.): ,t�l/1t14�G /V - P Pvp M MUST BE Definitive Plan Approved by Planning Board 19COMPLUINCE (Applications processed 8:30-9:30 a.m.&1:00-2:OO p.m.) H TITLE 5 �• 5 a 3 / s M ENVIRONMENTAL CODE AND • -liN REGULATIONS �. TOWN OF BARNSTABLE Building Permit Application Project Street Address Lof �I I��et c C vice( ^i u� s'� ' 22rec 6le Village (a)�s- t'�ia�r\s-Eeih IP- Fire District (hvncr Address i�D •` nx 187(Q 1 t9 A w'h�5 Telephone 39N f Permit Request: �'r,r,S'�-r uc���o�, r sf to p-Lo 5:r�t�I p �m �\j (APe l ►�4 Zoning District = 1Z F Flood Plain Water Protection Lot Size _ �'. i J11 5.►= Grandfathered Zoning Board of Appeals Authorization \ Recorded ` Current Use vac 1 re. Proposed Use ��S i GQ e n`��`c4 i 1 �r m i �v Construction Type 1 pno�, 1=P,p-m►- Eaistina Information Dwelling Type: Single Family ✓ Two family Multi-family Age of structure )�I.0 Basement type �iuccr�-� Cam!c-,e Historic House Finished Old Kinp s Highway /-!I -9_5' Unfinished Number offBaths No. of Bedrooms .3 Total Room Count not including baths First Floor Heat Type and Fuel F1+U) G 0-S Central Air Fireplaces OAF— Garage: Detached Other Detached Structures: Pool Attached ✓ )w o Cfae- Barn None Sheds Other Builder Information Name F vec-r ff' I A 9 • Mn Tr • Telephone number 39H- :1101 Address �•D• `a3ox tWO License# �.� Go P1 14. tn.7h Home Im rovement Contractor# Worker's Compensation # f, -I',59-4 C-A- 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 Project Cost //G+trnn Fee l 8-?•'� -e/ SIGNATURE DATE 3--9� BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) �� Z�l�-� z S-i-a►-7 `6D6 ���. . S-7,6 BPERM T 2-0SU p !!i FOR OFFICE USE ONLY o ADDRESS VILLAGE 6J . OWNER DATE OF INSPECTION: FOUNDATION d, FRAME �v2! WSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING: DATE CLOSED OU-f' ASSOCIATE PLAN NO. 0. ,tee 72 i? , Com.monwea&. o f MaijacLi-effi 2eaarb"nt 01 j'Ju,f�iaC—Acidenf3 a 600 W,,jA1ryt0n eef James J.Campbell (/)olton, Maijacltaiette 0211.1 , Commissioner Workers' Compensation Insurance.Affiidavit I' . .E�erett W. Boy, Jr. (I censee/penniccee) with a principal place of business at: 24 School Street, P.O.Box 186, West Dennis, Massachusetts 02670 (City/sate/zip) do hereby certify under the pains and penalties of perjury, that: 1 am an employer providing workers' -compensation coverage for my employees working on this job. Aetna WC# 006-C-23219584CAA Insurance Company Policy Number () 1 am a sole proprietor and have no one working for me in any capacity. () 1 am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: _ Contractor Insurance Company/Policy Number Contractor Insurance Corripany/Policy Number Contractor Insurance Company/Policy Number () I am a homeowner performing all the work myself. I understand that a copy of this statement will be forwarded to the Office of Investigations of the DIA for coverage verification and that failure co secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties consisting of a.fine of up to S.1,5.00.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of s 100.00 a day against me. Signed this �/� day of 19 � I 1 Li nsee/Permittee Building Department Licensing Board Selectmens Office Health Department 405, 409,..373... _.. TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, - ` Ca6AlVIO VM"tFI DEPARTMENT OF PUBLIC SAFtsTY OF ONEASNBORT'ONFLACE f^"'• Lcce2r:•; E?ccrrre�t M53ACMIiS B O21OBOSTON.MA �' °rc+rc�oocrroA L I C E"E CAUTION EXPIiiATIOPI DATEC 0•I S T It S LLA E R V I S O R FOR PROTECTION AGAINST J 996 EFFECTIVE DATE UC fIO. THEFT.PUT RIGHT mums NUKE ;16J30/1993 0328©4 PRtN(TINAPPROPRIATE R g BOX ON LICENSE- A5 P hVERETT :) BOY JR 9 H 0 X 1 U6 BLASTING OPERATORS SS At .033-42-4926 W 0ENNLS MA, 02670 MUST INCLUDE PHOTO. Twvro »m opa Nan E' D All) V V� NOTwjoLwvLWuntOBYUGtr.F�YewU(filCtlY.v a �C'�11dY . . { •- eLPf.0-0A-3W,0,,MTUWRlE OF TN6 CCAMO SSONEA HEIGHT:Doi 1993 03J71J1S54 ��� 9TNEL OE EfG(p4[[ F9THC NOLOETI WHEN EN- ,1 T fV .nM • Hovr r�� Aer Zr KAAaY� —_.- — - --• gym• � GO __ I� � � [Follo 11 - Zt,`�IL7�ystR,vp, ...vu�-.ywa�v,.�+/a� en.a Lr.�r op•u -- _:- • _-... �ro'Y .'f�Dof.�t - ferle.FPa+r ytLl' /r1r�'Lpf I I I� ldr�ia•wT"0E �TypE l'G°�j.ld prr-w"L+aa.rLod4n. LEf7 1=L�l.4TIaN YE�eILp _�j[vl•!T F�..2vA'�1ohi Yty'=1'-0 -�-(��� ELE�/.^.TbM Ye=1-o -2o'-o,croLc, P.T.lic.nec� -- - vu r.aO¢ wmti rxt 6ka:_4m_4Lj be Op 1p R�v"C — 21 5SC.11 low* 19!2j1 ��o _•_I �I�-�— - _ _ - 14 Q © O i 141N''.�LB\l.4TION:..Yd'-1b .5 .O. - vn .r 1 Jy b e sue. Lr. . 8'.oXLL I YV3G1O Tl IU. pK o L•x� I vo oo `_ate c N bFiRePr- 2S r r nyn _ �2 I S M S E "+r.d+ r7o vo Oo 2 der[t ® V2^X9"sn.,puvF Wle-r4"a9r41 vo n I _ pn ® Ql LOL`e Sr)WIM ft TCtV e-likde. N 1rtl Zo A Lq 4L © vrl 9R F f F�w.l eN.vveK roavym 1yH1 a -LHS'-F e- 'I1+0 Wv,.Fo:!<S) Ot e�9. qY a FL.ovge 4,ze Ito. x 1 (4 2 A k r')(FAN 01 J I 'V.R. ... vd+, 41 x K I 9rR`P.rN 4 v.W 2 ' 110 .41 - I 55-t Z!X 41 � I gE17��•3 —_ —_ v vEL1T�c u; 9 8 y wllx Yy . -- 14-oxlro'cNp� ll�xll` ram,�Y 1„1 I � l o.r1.TR.MU 2 ^ 2 � 3" X 1!lob 21 r on Ilxr3 ,_o a zb'-o.K_28i•O Q4�p E 2 , .rx. 9 011 ,wror®n o ww cr•DU 7xo u.c.�.uerr bT LI pelcr K, ',EcnoM -E/..l2I I I1t.-.. SSld:.L:'"ksslT.eLY�•�-Y*e6e's.F':_:-:__�': .Slo„'�..t2S:=_�►_(ool.ys).�*tC•4t)rs9(4.)rS7Gts) wGlt`�.�C\—=..gym-k'--u'••►¢ I 9 limo r.w.of ,E uvue 4 vys—14 S?'VI 5F. u-.es °f r.. L"xlon u / 9�P.4:Rl5w. -Fi-�io -942t F4•INS. _ 0 1 19�+c ISM o .l*lE1So�PIT ggfwr+��j}�.� r e .. 1C1��d'h'S L1;'13�FCH. t .._.y�conf vrNry $gaPx.1,�e(w+o j a - 4 sn. WM (east 1) Q i T y 4� 22. - ;EOF der+ °MsnO�lO etvVR.., fw-..IgG3Ji r~ E � e y 8 iH. — rc. I -f L x Jl xx 12 careUt t oiunwo aa.a NA p r_+w+pnev -L�r z -k�Ga'1154 l00� O �p � � u caw—. 11yUF9°fOtic.. I o Co s° w, o L- Gi_o i I I dJ `r .Uq E�cIAVs�TE YJ oyuu q f�T°�vft 4-4 ( .p c."' y{ �dn ion.. I 1.�.•s r�tr+gr- I I uv gee. — 2'}I'o Gd-o o.n °Mwwo MU/u e r.. #'9 • Application to (�A 00, �.. t N� � Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in 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: C&New Building ❑ Addition ❑ Alteration Indicate type of building: [S House ❑ Garage ❑ Commercial ❑ Other Z 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 /-9 —q ADDRESS OF PROPOSED WORK LA Jl PeCLUO.1 �)fi Ue ASSESSORS MAP NO. Z/0 OWNER 1�-r—S -t061 N-dlcti` ASSESSORS LOT NO. HOME ADDRESS P-c • A x IQ-(, t)' b;,e,\r\ TEL. NO. 3911`3,020 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheen if necessary). CF(� TnF �•V 9'SC7X ��1�_. W t_���VV� )/1114" (:�r•�n� ;k S • �- �-o 1 i r � m��' as 9 U-�e c i ya D r, l l� c n . inw g' J�C.`('��ctcr� 930 c�ciuej %r 11). AGENT OR CONTRACTOR "i� 4 L`W TEL. NO. '39H — \ 0?Oc/ ADDRESS} ISS(' Lo I- 691Q.76 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). i 0-r, 0--� c— f) +e w 31� x Z61 wocc� -�,Ly,\e. 3 beAccexn (ILP-e lv -,+k et.'t"6ch FC` O�GiCAq C_ arJ Ss -�c ra-A e4 ll6ces e be t1 D O D Signe Owner-Contractor-Agent Space below line for Committee use. R'ec egiv Dae (:er ' ca is hereb Date 49994 Time Tad�;,, By.fir_ Approved ❑ IMPORTANT: If Certificate is approved, approva sub'ect to the a ap I period provided in the Act. Disapproved ❑ ' • u tii OLD RING'S HIGHWAY HISTORIC DISTRICT SPEC SHEET FOUNDATION ! C lec�<-s SIDING TYPE ;�k,l �w�la CcCLI_n Dcrc(s COLOR S'�� G rc CHIMNEY TYPE �T��. COLOR ROOF MATERIAL S*),a I T -L.,, Jos COLOR ;�r�°Y►i. r- i."Gs,^rV PITCH /n2 WINDOW `�c 4�� E I-�u ►,o� c ;�'In cis; l�S SIZE TRIM COLOR �L� � DOORS t�ir , cQ S w p COLOR SHUTTERS �? n.i �� �r�c �s .b I u r? a GUTTERS S'Pr.mVe 5-5 1,1 m 1 r\i, vM DECK SSu GARAGE DOORS ma ,: e COLORu1c, ;s: Fill out completely, including measurements and water'ials/colors to be used. Three copies of this h7� , form are required for submittal of an application, along with three copies each of the plot plan, Seaport Gray- landscape plan and elevation plans, when applicable. Plot plan need not be "Certified", but should show all structures on the lot to scale. aDDDO D . Ptd,lri, 1;hw i 157. 00' y. LOT 21 1+ 35,141 ± S.F. (0.81 ± AC.) i LOT 20 pRoposE ECK LOT 22 16'+ CAR DfYEL D NG� h M SKETCH PLAN o� PREPARED FOR: �o REEF REALTY LOCATION : ASES SHT 110 PAR 1-2 PERCIVAL LANE WEST BARNSTABLE REFERENCE : LOT 21 PLAN BOOK �- 1 �P�AGE 99 SCALE . " _ ;G! DATE DECEMBER 14, 1994 �u P'•S•�,�e���3 �c; A=50. 00' 12114194 R=190. 91' DATE OFE S ONAL LAND 5qVEYOR p ERCIVAL DRIVE DEMAREST—McLELLAN ENGINEERING 24 SCHOOL STREET P.O. BOX 463 WEST DENNIS, MA. 02670 �Sq 00, ' LOT 21 35,141 + S.F. (0.81 ± AC.) LOT 20 �X ,n0G,k Nro ADO LOT 22 9� JOB #94-039-21 CERTIFIED PLOT PLAN PREPARED FOR LOCATION : ASES MAP 110 PAR 1-2 PERCIVAL DRIVE WEST BARNSTABLE REEF REALTY SCALE : 1" _ 40' /r ^� REFERENCE : LOT 21 PLAN BOOK 421 PAGE 57 OFMA �� q�y 1 HEREBY CERTIFY THAT THE STRUCTURE z JOHNZ. G SHOWN ON THIS PLAN IS LOCATED ON THE DEMAREST,JR. , GROUND AS SHOWN HEREON. v gip,36859 n P DM �NoSO DEMAREST — McLELLAN ENCINEERING 24 SCHOOL STREET P. 0. BOX 463 . MARCH 15, 1995 WEST DENNIS, MA .02670 (508) 398-7710 DATE OF SIONAL LANDS VEYOR '..i6n.�...,.►�.;.le+"K•,J-.+. rM .,—' '.•.�':.•a;�.r.l+r. ..--ti:.. :,.•..`T:+l.^-_`.�':.•.�:w�,�..i., : S .-.. vo Y+ ♦ -. TOWN OF BARNSTABLE permit No. .- ...., BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ,67V• HYANNIS.MASS.02601 Bond �., J CERTIFICATE OF USE AND OCCUPANCY issued to Horsefoot Holdings Address 241 Percival Drive (Lot 21) West Barnstable, MA USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. May 4 95 ... ... ......... ...... ..... 19................. ........ .. t���.,. .......... Building Inspector ; _ N / ASSESSORS MAP. 110 NOTES: PARCEL. 1-2 TEST HOLE LOGS CURRENT ZONING: R ENGINEER: DOYLE ENGINEERING 1. VERTICAL DATUM: ASSUMED FROM QUAD (NGVD ff- �� • ,� DATE: 9-16-86�-9 BUILDING SETBACKS: WITNESS: THOMAS MCKE'AM, R.S. 2. MUNICAPAL WATER IS NOT AVAILABLE. 3. SCHEDULE 40 - 4" PVC PIPE TO BE USED THROUGHOUT SEPTIC SYSTEM. F: 30' S: 15' R:��' PERCOLATION RATE: < 2 MINIIN 4. ALL PRECAST UNITS TO CONFORM WITH AASHTO H-10 & H-20 LOADING SPECIFICATIONS. FLOOD ZONE: C TH-1 TH-2 5. PIPE PITCH = 1,,14" PER FOOT(UNLESS NOTED OTHERWISE). 6. FIRST 2' OF PIPE OUT OF D-BOX TO BE LAID LEVEL. TOP & ELEV VLOCUS SUBSOIL 7. THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE le 101s USE OF A GARBAGE DISPOSAL. ` c CLAY S. ALL CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE LOCATION MAP 4e" 99D STATE OF MASS. ENVIRONMENTAL CODE (TITLE FIVE) AND LOCAL \ FINE-' HEALTH REGULATIONS. LOT 21 \• MEDIUM 9. CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR 35,141 SF (+/-) \ SAND TO CONSTRUCTION. WITH COBBas 10. PROPOSED SEPTIC SYSTEM AND WELL LOCATIONS ARE IN ACCORDANCE WITH MASTER PLAN, ON FILE WITH THE BARNSTABLE HEALTH DEPT. 144" 91.0 1Sq OD' NO GROUIVDIIATER ENCOUNTERED 9 ,g zoT SEPTIC SYSTEM DESIGN _ g � N - _ _ _ _ _ - FLOW ESTIMATE: sonDEFELLIAV ,, , - _ _ _ - BEDROOMS AT 110 GAL/DAY/BEDROOM =-, Q GAL/DAY 24' BEDR28' SEPTIC TANK. GAR 330 GAL/DAY * 1.5 DAYS = 495 GAL2414 2z 6 _ USE 1000 GALLON SEPTIC TANK - - - - - - \\ ' \\ '�, PROPOSED DWELLING LEACHING AREA: _ - _ _ _ _ _ - ' \ , \ *'\\ � T �`���- e _USE ONE LEACH PIT (6' x 49 WITH 3.0' OF STONE _ -,06 (12' EFFECTIVE DIAMETER x 4' DEEP) > _ SIDE AREA: 12 x PI x 4 = 151 SF (2.5) = 377 GAL/DAY g, gg - - _ ` , :'•. _ BOTTOM AREA: 6 x 6 x PI = 113 SF (1.0) = 113 GAL/DAY TOTAL CAPACITY = 490 GAL/DAY • , .......... gti , • RETAINING WALL t SEPTIC SYSTEM SECTION. 2" PEASTONE -WELL \ \\ `\! _ 9� COVERS WITHIN 12" - OF 3/4" - 1 1/2" 6 , 1 ►it / 107.0 OF FINISHED GRADE WASHED STONE TOP OF FOUNDATION it,\0 I PROPOSED WELL 6► ' �� ,'- 21 FROM LEACH PIT A = 50.00' R = 90.91', . \,103.41n DGE OF 0g - o AVE - _ _ ' �` 103.66 1000 GAL ELEV. D-BOX 103.18 4 0 EXISTING WELL ELEV. 99.08 'L 104.0 SEPTIC TANK 103.35 ELEV, r ;ELEV. A e\�,, g UTILITY CLUSTER •�'� ELEV. TEE SIZES. ELEV. 103.08 3' 3' INLET: 6" UP, 10" DOWN ELEV. 12' OUTLET: 6" UP, 19" DOWN ONE LEACH PIT (6' x 4') WITH ELEC. MANHOLE 3' OF STONE (12' EFF. DAM. x 4' DEEP) (H-20) BREACKOUT CALC: (103.6 - 100)/60 x 150 = 9' BENCHMARK AT CATCH BASIN ELEV- 90.0 SITE AND SEWAGE PLAN EY: EXISTING CONTOUR: LOCATION.' PROPOSED CONTOUR: ........................•••••• EXISTING SPOT ELEVATION: 25 LOT 21 PERCIVAL DRIVE .5 PROPOSED SPOT ELEVATION:F2_5_1 WEST BARNST ABLE MA TEST HOLE: - - UTILITY POLE: -O- PREPARED FOR: FENCE LINE: Im - HYDRANT: �, REEF REALTY RETAINING WALL: ® DEMAREST-McLELLAN ENGINEERING lh n. iY►j �,�,..._ -,- SCALE: 1= 40' DATE: 12-14-94 24 SCHOOL STREET P.O. BOX 463 � -Y ti WEST DENNIS, MASSACHUSETTS 02670 REFERENCE: PLAN BOOK: 421, PAGE: 57 T HOMAS McLELLAN, P.E.IFJOHN Z. DEMAREST JR., P.L.S.