Loading...
HomeMy WebLinkAbout0257 PERCIVAL DRIVE pit va./ �rrrr igh UPC 12534 No. 2-153LOR HASTINGS.MN _ .d+a.�cea.,-�,rx�-:.a.....,.,_.�..�.�,.,.,.�_,�...sw,.z,...._..._.,_,._.._..:.:=._.Y..>._.l_-��.,iw.•-. ._.�_�>r ...,.a .:....�,.: :r._.... ... _. .._. .<..,....�__ ... s.. ...�_ __.___•_ _�.�.._ — — -._ _ �_ _._.... ,.. �� - - —� �, 4: ;Z_. - _ - y.. 04 OCT 21 p,m..9: 48 OAR ��,STABLE E EARN TO CLERK To of Barnstable Zoning Board of Appeals Decision and Notice Appeal 2004-130 -Adams Section 3-1.1(3)(D), - Family Apartment Special Permit Summary: Granted with Conditions Petitioner: Christopher Adams Property Address: 257 Percival Drive,West Barnstable,MA Assessor's Map/Parcel: Map 111,Parcel 064 Zoning: Residence F Zoning District Relief Requested & Background: The subject property is a 0.85-acre lot improved with a two-story,four-bedroom single-family dwelling with a living area of approximately 2,156 sq. ft. There is also an attached 24 by 14 foot, one-car garage. The property is served by private well water and an on-site wastewater septic disposal system. According to the application and plans presented, the petitioner is proposing to demolish the existing age and-construct anew attached two-story addition measuring 28 feet by 40 feet and containing a new two-car garage; added living space of 530 sq.ft. on the first floor; and a Family Apartment of 1,142 sq.ft. on the second floor. Interior layout plans were presented showing the Family Apartment to be a�_­one�bedroo.—unit. The petitioner is requesting a Special Permit for a Family Apartment pursuant to Section 3-1.1(3)(D)of the Zoning Ordinance. The_Fanuly Apartment-is_to-be=occupied-by-the-applicai ts_siepfather and-mother; William-and=Joyce-Hickman✓ Procedural &Hearing Summary: This appeal was filed at the Town Clerk's Office and at the Office of the Zoning Board of Appeals on July 26,2004. A public hearing before the Zoning Board of Appeals was duly advertised and notice sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened September 29,2004, and continued to October 13, 2004 at which time the Board found to grant the appeal. Board Members deciding this appeal were Jeremy Gilmore, Gail Nightingale,James Hatfield,Randolph Childs and Vice Chairman Ron S Jansson. Mr. Jannson was the Acting Chairman for this appeal. William and Joyce Hickman represented the appeal before the Board. At the initial hearing the Board questioned the proposed area of the Family Apartment and expressed concerns with regards to standing as Erica E.Adams,co-owner was not cited on the application. The appeal was continued to allow resolution of those issues and provide time for the Old King's Highway Historic District Commission to review the proposed addition. At the continuance,Erica E. Adams was also present and submitted a letter authorizing the application. Detailed calculations were submitted with respect to the dwelling area and the Family Apartment. The dwelling was documented to be 2,329 sq.ft. and the apartment unit totaled 1,164 sq.ft. Public comment was requested and Mr.Robert Stahley of 44 Percival Drive expressed concerns for the number of bedrooms and the size of the proposed Family Apartment. He questioned if this proposed apartment was more of a two-family rather than a Family Apartment. Mr.Mark Dowdall of 10 Percival 1 Drive and representing the neighborhood association discussed the covenants and noted that the association and the applicants were working together to resolve any issues. Findings of Fact: At the hearing of October 13,2004,the Board unanimously made the following findings of fact: 1. Christopher Adams has applied for a Family Apartment Special Permit in accordance with Section 3- 1.1(3)(D). The apartment unit is being proposed as an addition to the existing dwelling. The property is located as shown on Assessor's Map 111,Parcel 064 addressed 257 Percival Drive,West Barnstable, MA in a Residence F Zoning District. 2. The subject property is a 0.85-acre lot improved with a two-story,four-bedroom single-family dwelling. There is also an attached 24 by 14 foot, one-car garage. The dwelling was originally constructed in 1995. The applicants are proposing to modify the existing structure and add a Family Apartment and in doing the proposed changes,the dwelling will result in a total living area of 2,329 sq.ft. and the Family Apartment would be 1,164 sq.ft. and meets the 50%limitation imposed for a Family Apartment. 3. A letter dated October 12,2004 from Ms Erica Adams has been submitted to the file which provides for proper standing in the application. 4. Testimony was given that the Old King's Highway Historic District Commission has reviewed and approved the plans for the addition. 5. The petitioner is requesting a Special Permit for a Family Apartment pursuant to Section 3-1.1(3)(D)of the Zoning Ordinance. Family Apartments are allowed in all residential zoning districts as a conditional use,provided all requirements have been met and subject to the granting of a Special Permit from the Zoning Board of Appeals. 6. The applicant and the family members have testified that they will abide by all of the Family Apartment requirements of Section 3-1.1(3)(D)of the Zoning Ordinance. The apartment unit is under the 50% area limitation and the property owner will resides in the main dwelling. 7. The application falls within a category specifically accepted in the ordinance for a grant of a Special Permit as Family Apartments are permitted in all residential Zoning Districts provided all criteria are met. 8. After evaluation of the evidence presented,the proposal fulfills the spirit and intent of the Ordinance and would not represent a substantial detriment to the public good or the neighborhood affected. Decision: Based on the findings of fact, a motion was duly made and seconded to grant the appeal with the following conditions: 1. The Family Apartment shall at all times comply with and be maintained in accordance with all restrictions of Section 3-1.1(3)(D)of the Zoning Ordinance and shall be the primary year-round residence of the family member residing therein. 2. The Family Apartment shall be developed and maintained as per plans presented to the Board and initialed and dated by the Chairman today consisting of: • A proposed plot plan of which is entitled"Plot Plan of Land Located in Cotuit Mass. Prepared for Joyce Hickman"Dated May 2, 2004, Scaled 1"=30', as drawn by Cape &Island Engineering, 2 � f • Building plans presented consisting of eight sheets showing proposed elevation and floor plans. 3. All development shall comply with any Certificate of Appropriateness issued by Old Kings Highway Historic District Commission. 4.. The Family Apartment is limited to a one-bedroom unit-not to exceed 1,164 sq.ft. as proposed as shown on development and plot plans submitted entitled"Plot Plan of Land Located in Cotuit Mass. Prepared for Joyce Hickman"last revised October 07, 2004, Scaled 1"=30', as drawn by Cape&Island Engineering, 5. The on-site septic system shall comply with all Town of Barnstable Health Division regulation and Title 5 without any variances for the Board of Health. 6. The locus shall comply with all State Building Codes and State Fire Prevention Regulations. 7. This Special Permit must be recorded at the Registry of Deeds and copies of that recording shall be submitted to the Zoning Board of Appeals file and to the Building Division at the time an application for a-liuilding_permit is made. An-occupancy permit-from-the-Building-Division-must be issued prior to the occupancy of the apartment unit. The vote was as follows: AYE: Randolph Childs,Jeremy Gilmore, Gail Nightingale,James Hatfield,Ron S. Jansson NAY: None Ordered: Family Apartment Special Permit 2004-130 is granted with conditions. This decision must be recorded at the Registry of Deeds for it to be in effect. The relief authorized by this decision must be exercised in one year. Appeals of this decision, if any, shall be made pursuant to MGL Chapter 40A, Section 17, within twenty(20)days after the date of the filing of this decision, a copy of which must be filed in the office of the Town Clerk. Ron S. Jansson,Acting Chairman Date Signed I,Linda Hutchenrider,Clerk of the Town of Barnstable,Barnstable County,Massachusetts,hereby certify that twenty(20)days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision has been filed in the offi e the Town Clerk. Signed and sealed this r f 'ay o un&rlhe pains ar pe ialties of peijury, Linda Hutchenrider,Town Clerk 3 Appeal or Permit No: 2004-130 Appeal Special Permit Status: Not Family Apt Last First Applicant: Adams Christopher Addr: k Addr2: 257 Percival Drive Village: West Barnstable MA 02668 Aff Received: Map Par: 111064 Zoning: RF J Decision: - -- - -� - -- - -� - Notes: No bldg.per.As of 11/23/05, no recorded ZBA decision(issued 10/21/04 to construct addition with family apartment). ` Close � FIE BAMSTABM _ The Town of Barnstable 9. Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner September 27, 1996 To Whom It May Concern: Please be informed that a Certificate of Occupancy has been issued for 257 PERCIVAL DRIVE,WEST BARNSTABLE,MA. The Town of Barnstable has no further interest in any performance bond for this property. If you have any questions,please feel free to contact me. Sincerely, UV� Kathleen Maloney Office Assistant i bondrele Hssessor's Office(1st floor) Map I l Lot 9(a / CPermit# ' 11201 Conservation Office(4th floor) Date Issued Board of Health(3rd floor)(8:30-9:30/1:00-2:00) 7/ 3 Fee /�°/, ? ` pA— Engineering Dept. (3rd floor) House#1o?$r1 Planning Dept.(1st floor/School Admin. Bldg.) �` tiffs BARMA NSrABLE.o �19 1 59. Definiti Approved by Planning Board 3 — / -D-I �� k �1,¢A FOMrt� TOWN OF BA STABo y a ; Building Permit Application Projiec treet Address pee__C(, oqn� �--V. g Village kNJ�S'i Owner �02S��a —Di rs C1, C� c' � �-C.. Address Telephone Permit Request I A S &A C.1-1 6 7, J <:ZL 04 Lf �3 Total 1 Story Area(include 1st arages eckd s) '4-lgrare feet OF Total 2 Story Area(total of 1st&2nd stones) ,`� square feet Estimated Project Cost $ ( ZZ© 6pb� Zoning District k-1 Flood Plain (fi Water Protection Lot Size 5,35� �r' Grandfathered ? 7��5 Zoning Board of Appeals Authorization Recorded Current Use Af ytm 1771-fiiJ Q Proposed Use EE—s.I Construction Type -D -1e- Commercial Residential Dwelling Type: Single Family t/ Two Family Multi-Family Age of Existing Structure jt1 n Basement Type: Finished Historic House Unfinished Old King's Highway Q!` V-L h I5 s Number of Baths 2, No.of Bedrooms 4 Total Room Count(not including baths) --7 First Floor Heat Type and Fuel r-f4yi iaS Central Air go Fireplaces o� Garage: Detached. Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name �'� "v1— U 2 Telephone Number Address P•� 'Eb X t�(, ! �4 S c koo License# (37-(,332 Home Improvement Contractor# Worker's Compensation# (o&-(-Z4 J 7(v7Pjt cw7,--t NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRU ION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO T;Z77(� SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLL WING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. y ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: "ROUGH`. FINAL - - GAS: s ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. t J a� q. TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID Ill 064 GEOBASE ID 36886 ADDRESS 257 PERCIVAL DRIVE PHONE { W. Barnstable ZIP - LOT 18 BLOCK LOT SIZE j DBA DEVELOPMENT DISTRICT WB PERMIT 15315 DESCRIPTION SINGLE FAMILY DWELLING '(PMT.#11701 PERMIT TYPE B000 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: _ Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: �1NE 'BOND- $:0 'CONSTRUCTION gQSTS $.00 756 CERTIFICATE OF OCCUPANCY 1 ; BARNSTABLE, MASS. OWNER HORSEFOOT, HOLDINGS C 039. Fp�A ADDRESS 24 SCHOOL ST PO BOX 186 BUILDMGG IVI I4ON � W DENNIS MA i BY 7T DATE ISSUED 05/22/1996 EXPIRATION DATE 'ts�.I i�i•I•,IG Pk:i2M::T :EL I 111 00"4 GR)BASE. Ill 36886 t-E85 - n., f i�,, PRONE �'�!Cr _V L W. Barxi--table `LIP - in BLOCK LOT SIZE DEVELOPMENT DISTRICTILs i.I`?' 11.7_01 DESCRIPTION :SINGLE FAMILY D1' r,.LING 1I�' T jI':r 3(.fL;_' TTT;,E NEV RESIDENTIAL 106paftt11ent of Health, Saf Pt} ! , LVFRETT rr�_ . JK. and Environmental Serv.ic ARCH $187.83 �1ME B%iE° I_C0 t�• �,"j,?.n A.,t l,e!. 4� „t„`t t..,'.ti.T�� i i'R�. it t:',','�. L" 't 9AM i MASS. 039. BUILDING DIVISION BY ' THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN. CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREE OP ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OFTH! PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED APPROVED PLANS MUST BE RETAINED ON JOB AND ' FOR ALL CONSTRUCTION WORK: WHERE APPLICABLE, SEPARATE .1:FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2.PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MEGH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLEPOST THIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 Z- J - �,jj 1 e°`9 1 /IV.kj 07er/AWo %L J r� • 2 2 2 �/►'I�7L� � � , 9� _. 2- YIN 9� 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 n �BOARDLTH 1ER: SITE PLAN REVIEW APPROVAL ' 'ORK SH':LL NO IROCEED .I'�ITI1� ( PERMIT l�!LL BECOME PULL AND V00 ;F CON- INSPECTIONS INDICATED ON THt I?EGTl)riii,:oF^op•T,E.; ; E ` P:;C ;" C'' WORi: : �f.: TAFI-'E.0 WITHIN SIX CARD CAN 6E A:3FANIGED FOR :1' i r.c.1D.i ;—,.;,, I is`iL'[D AS I�' i't��Fd ��:E Qr'�'?JFZ..i• ';�J� T!rt, II ;'rF:n.A!,f_,i:E_ The Town of Barnstable BARNSTABIF, • '1 � Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner June 28, 1996 Enclosed is the bond for 173 Percival Drive. The building inspector tells me that 257 and 259 Percival still need loam and seed at the street. If you have any questions,please contact Richard Stevens at this office, 8:00-9:30 a.m.or 3:00-4:30 p.m. Sin, rely, Kathy Maloney Office Assistant `oFtHe► The Town of Barnstable o� 7 BARNSfABLE.�! Department of Health Safety and Environmental Services MASS. �! t639• �0 �Eo Na Building Division 367 Main Street, Hyannis, MA 02601 s Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection [`} ��Lvv�YP P 1' Location Permit Number t l Owner Builder �6�j One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: Please call: 508-790--6227 for reeinspection. Inspected by Date s • 3�, o 66' o LOT 18 35,359 + S.F. (0.81 + AC.) I C'p ' 9p • CY A� 0' �0 R��9p9> 'pp v del JOB # 94-039-18 CERTIFIED PL 0 T PLAN PREPARED FOR LOCATION : ASES MAP 111 PAR 64 LOT 18 PERCIVAL DR Y. BARNSTABLE SCALE : 1" = 60' REEF REALTY REFERENCE : LOT 18 PLAN BOOK 413 PACE 99 �yx OF 1 HEREBY CERTIFY THAT THE STRUCTURE ��� JOHNASs9cy SHOWN ON THIS PLAN IS LOCATED ON THE o Z. N GROUND AS SHOWN HEREON. DEMAREST,JR. ►� o No.36859 Z4 DM �' oP DEMAREST - McLELLAN ENCINEERINC 24 SCHOOL STREET P. 0. BOX 463 DECEMBER 21, 1995 WEST DENNISI MA 02670 (508) 398-7710 DATE �OF�SIONAL LAND VEYOR �I I I' Ctl��IVA4-v(t, i Itta4B vin+r "T --• - -_- _ tz, aePw.,.r _ .t N.14"I 04kmPs 9aIL:4'L Ta rForir x. 9'ti''y,•R.cy '— /P��+fV� R�SI+r C1-��/A.TIoN -_rEzGzhlT_.E-LZM TIOIr l i i W.G.C. ir3 ,t Iulli�i�IlwHilIr sa.'1 un I I f•IPC'c'Oase 11' I � I I LZFT' r-L- vATIoN RJR e�ev,e.T lc, I ' 481-o x?(i=o S PlCn 1"31'a+ 96ucw4l,2. ' .. ♦^.xT1K�ofG L�Ya'(1oAis °Y"'�.u.. .'•1� 1 ° Y 51 09 ?LAN �y �x. ,11,.� size R o. T a •1�a I \ n 1 SIL.•'uitr:'6e _ �I ; J a CJL17.3 i E.Po CC.1•R G.a'�\f:L'a.T.r�i=" M V\ r u� .T•... e�rh3t lvia;o'LCjny J 1 A � ° -IuX LN'IL� � p.,;n•e-/J � lJd.� O IJN, � � �" ICIIL°KCIOL' � .NcN, "PR IZ'1 cL �lV — ?vFrA O VA M usn,n,r Gali'3b-2 = 'jiYZ�� 1J1-O N 5 v14.11gl4iJ.2 24u4 --''z• g1jS a r Wt. NfA11"xw� 4-Ag 1 r.L.. — IA-� QC- \ 1 D o rnF. 5/F' �ECoNe pL.PI-Ac1.l „ 77--c 10 La.. 4 t W ® vi Qv 4A LA el E N ry w�15 VIi,YI V -1 u 19%xze' I UE � aEff sew —lo -- ut.-T I '1 KornSn,z e A.To ewkit ON 'S�2 I+�ca of(Fore.�pu�ese•�. FT,a�PP_qa.T.o a�rSE W F �ouvD eurw ii�\ RM. O 5• P�oTrael r!¢\Cu-�v u\Tnr'.2 Y:+ Bo�TS�T(P.)w exPPArS�aM.carcftwv4ouT Vl r.Ef4TLj To co�Se.Ife11S rvp i........ .._ i I'Go. p ' __ � F'Rhr•aNv SEdroNv FL..R.�u.l 88�}6.F G�.�33(.s,F 4A�.�14v•r+�wc.k .4 La, Lo ?j, q Lo !e.11 .........., ..b 2 aF 'PLAN R 1N5ULAriyr1 SEcnc,,'\ _W.MAP4.3r^p 60 C,-G.bs512:t-,eLY ARea,v$g,46.F Pi.7o U•,039 �,R•�, ��_. n>sr_I�c3u( I.(1m4- 88hSpt f5�'to U►.osr WMu..b3�er•t 0L( �jWb� ?010 4F, - , LIvW.Ir RGA Isu S.F. U-.40 4L.oR.A(4V%- 404r, U.,A4 ... ui+c.aR Apo.• '55f.a HeT WN.ii.Pp• IBZ`18F U•,08 2040 PeP1 e+r,uE of WVW r;vRs. i_ 1'K1.1.T)w5 429c1,,c 12! -1'Va"T-l"¢,lc"o.G 211y,1o�1MP 1 2"�,1S��WPT�RS�Is�o,4 n 21�KPS��Afl,- Ev ' T` dIV^O,C. 1.>t411Ir14Fpy n-ao ear4 clti.�sTs. `ka"pvx>�. 11'r4.Ms,x, . aoll.«o,o. /C."�.'Aft n 1411 .493 Ul 4I°rS9x 18 all 4� e�t')ctnn-A"M r� 1" —� � .-.i MIN.�0�3upF4..• e�XA'ellos .. �. • yo,�e 9,.acrc•p,•Potr' Q4411^f11.1..1.1�� 2"XW"110f.. �� . •440 n.,crn..FoF 2�Q PL. T.en.egPP°�(o,v;•, crin�y�-pimp , r-V r1 • rJ/ -W cIZ"Caie.Froi. IIoWi`I 0(pfrj, :Cone,P ...... —�Ix,. -sew I 11 "'tYf'-It7w..::.1'L•42'I, 5e�n�N Mb'STF� Pav if•�; jSM.4t=cn��11 vlewlsv PFa� FIywP t. '�7LPlt,'Sfl)"�O1�S . � • rrov"u w b . i ........ .. .. .. - e i I G.s I O 4As 4 " I 1p 1 ❑�r I i � G N ( c i i i • �mo I I j (' - I C I j -PAl 12 -ten�-�-o• I __, i ''a ;r : Lo i ' � I o I I IQ : 2G o 0 z p 0 Z a I z sa I tl d o�ti m � s . , d . f — .The Commonwealth of Massachusetts Department of Industrial Accidents «' =� flNee of/nyesdoz oos 600 Washington Street Boston Mass. 02111 Workers' Compensation Insurance Affidavit Annhcant information• r..�:-.�':"'` y'�'��a • name: location: ci[v phone# I am a homeowner performing all work myself. O 1 am a sole proprietor and have no one working in any capacity �1 am*an�emplover providing workers' compensation for my a loyees working on this job. c m an meC ,pe�4x—eC--1,T- Lo. address: in,sur co. A. SU dcsi � S:x policy# CXI_5=-C_ Z :.: Lv 7 ❑ 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: city: phone# n uran i s ce co. P Y company name: ... . ....: address: city: phone#: :...::::.:..::..::::..:. insnrance co.. 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 S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this stateme be forwarded to the Office of Investigations of the DIA for coverage verification. /do hereby certi de,the pains Jan , ena/Niels of) rjury that the information provided above is true and correct Signature Date 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# :0: Do ❑check if immediate response is required contact person: phone#; _ tromed 7/95 PJA) 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", an entployee is defined as every person in the service of another under any contract of hire, express or implied, oral or'written. An emplot!er is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the fore`_oin�= 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 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. 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 n be sure to fill in the permit/license number which will be used as a reference number. The affidavits 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. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents — Office of Investlgadons 600 Washington Street , Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406,409 or 375 ..ir:•/, S' COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY OF ONE ASHBORTON PLACE C_•.i is CC g o...._G:::c'lnjl MASSACHUSETTS BOSTON,AAA 02108 �roritrociuon cJ i::i L I C E h"S E CAUTION EXPIRATION DATE C O AI S T R.• S I. "is R V I S O R 0 3/11/19 9 6 EFFECTIVE DATE •LIC-NO. FOR PROTECTION AGAINST RESTRICTION THEFT,PUT RIGHT THUMB NONE 96/30/1993 032809 PRINT IN APPROPRIATE g g BOX ON LICENSE. 6� F . ytf:FTT a BOY JR >•3 0 X 186 BLASTING OPERATORS W DENNIS MAC 02670 MUSTINCLU-DEPHOTO. j . . . PH !O.�Lk 4TNOOPRONLY) FEE: ' PAID . •-_- '•�v... 100.00 NOT vK1D UNTIL SIGNED BY LICENSEE AND OFFICIALLY AI i �:• - .. HEIGHT: D.on-SIGNATUREOFTHEcoMMLssIDNER :: :z::c�• .t'+:,!:,. "��(tJl'i�•r�•.ylU1�•'1.`�,1.i jZo.- THIS DOCUMENT MUST BE « SIGN NMtE W FULL ABOVE SIGNATURE LINE . .' ''''•�.' .�:.• CARRIEDONTHEPERSONOF TUBE Of LICFl1SEE y1'.••::i;r[e !u�,y THE HOLDER WHEN EN• D/ j, S fiKiEDNTMSOCClIDAT10N. rA ..._... ...___ �...-......+.ram—nr•.�._..�,-.—.__..... Application to 4N"EG� t tM � 9 9 dl••�t>°`N� r►w�.,.s o`wwfi�tw v�s 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: 1�5 New Building ❑ Addition ❑ Alteration Indicate type of build'ng: Jq House Garage ❑ Commercial ❑ Other 2. Exterior Painting. 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). 'b I ` CtS TYPE OR PRINT LEGIBLY DATE ADDRESS OF PROPOSED WORK t-OT- l8 `p -tV(P�L—n Q%0197 ASSESSORS MAP NO. 1� OWN yQ5-EEc0t1— } OL_.p ctS! S af:-, C9� ASSESSORS LOT NO. HOME ADDRESS �� bL �BCoL� '�<✓Nti�S� �� Q2C° TEL. NO. 3 C) _ FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). Cam, �� VM C��o(o ��_� f SVAAC tf f�o�tc L y ZG&�?� Ql v ram Dom., t� ' > 5 (/�^� / AGENT OR CONTRACTOA '`Gt --� L-ro ' TEL. NO. - �yctc� ADDRESS 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). �s w E� �C , W a N C a4` IF-H.0 %,GD Q-00 n C13L.a rl SC-- ��"t 3a\,c1c. C2-52� Pv4C-(L— Fo�,, nn FFR Signed Owner-Contractor-A t Space below line for Committee use. Received by H.D.C. Da The Certific is hereby t Date & Time rJvT 2- i9niz . Iini.s" By,. TOINNI Of WNSTABLE Approved- _ . I]- IMPORT If Certi icat Is approved, approval is subject to the 10 day appeal period provided in the Act. Disapproved ❑ 1 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 excerptions: a. Existing signs or billboards on November 27, 1974 shall have until November 27, 1977 to secure an approved Certificate of Appropriateness. b. Temporary signs for use in connection with any official celebration or parade or any charitable drive as long as they are removed within three days of the event. Certain other temporary signs that the Committee feels does not detract 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 Appropriateness. 8. Under heading of "Detailed Description of Proposed Work" give detailed data on such architectural features as: foundation, chimney, siding, roofing, roof pitch, sash and doors, window and door frames, trim, gutters —leaders, roofing and paint color.. 9. Unless application is complete and legible and all material required is supplied, application will not be accepted or acted upon. Copies of the Act establishing the Regional Histon District may be obtained at the Town Hall. i i i 3 i j �� i f r Town of Barnstable Old King's Highway Historic District Comm:ssoc: SPEC -SHEET FOUNDATION 1 ow2f=1> Cc�N C_z.e­rV_. v;i,�sr-= V.Q_rz,C:40,-k rr_(:"a,P c�crA 11 SIDING TYPE WIACM COLOR ►�i��-�u�+��-- CHIMNEY TYPE _E>Q-%cJr-_ COLOR ROOF MATERIAL COLOR PITCH -7/I Z WINDOW y�'t-r�2- �0�,��3c-� �t �WI �CZ [tiLE�,SIZE Z`� 2,4 TRIM COLOR P4 LI SPCDG DOORS AtiC) �C-�='�- COLOR lEO-zsC- CL_�, SHUTTERS \j I ►may L-- ���-�s ply GUTTERS 5c .P- S ri L--� [Nv �� `����i" DECK GARAGE DOORS�Ati�L� ��pSc, �,�� COLOR '�)EOI n'1Er t4-r 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. N � - ASSESSORS MAP: 111 PARCEL: 64 TEST ROLL' LOGS NOTES: � ,��• ,p 1. VERTICAL DATUM._ASSUMED FROM QUAD (NGU o-4 CURRENT ZONING: RF ENGINEER: DOYLE ENGINEERING 2. MUNICAPAL WATER IS NOT AVAILABLE. BUILDING SETBACKS: WITNESS: THOMAS MCKEAN, R.S. 3. SCHEDULE 40 - 4" PVC PIPE TO BE USED THROUGHOUT SEPTIC SYSTEM. F:30 S: 15' R: 15' DATE: 10-2-86 _ 4. ALL PRECAST UNITS TO CONFORM WITH AASHTO H-10 a H-20 PERCOLATION IRATE: < 2 MIN/IN LOADING SPECIFICATIONS. FLOOD ZONE: C TH-1 TH-2 5. PIPE PITCH = 114" PER FOOT,(UNLESS NOTED OTHERWISE). 97.0 6. FIRST 2' OF PIPE OUT OF D-BOX TO BE LAID LEVEL. TOP & ELX`V 7. THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE LOCUS 24• SUBSOIL 95.0 USE OF A GARBAGE DISPOSAL. , T FINE 8. ALL CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE LOCATION MAP SAND STATE OF MASS. ENVIRONMENTAL CODE (TITLE FIVE) AND LOCAL EL HEALTH REGULATIONS. LOT 18 so' 92.0 9. CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR 35,359 SF \ 3 CLEAN TO CONSTRUCTION. (0.81 AC.) MELIUM \ 3� c SAND 10. PROPOSED SEPTIC SYSTEM AND WELL LOCATION ARE IN ACCORDANCE �66 WITH MASTER PLAN ON FILE WITH BARNSTABLE HEALTH DEPT. \ tos LOCATION OF SEPTIC SYSTEM HAS BEEN REVISED SLIGHTLY FROM 144.1 MASTER PLAN BUT STILL MEETS ALL SETBACK REQUIREMENTS. \104 NO GROUNDWATER ENCOUNTERED 11. D-BOX TO BE WATER TESTED TO ENSURE LEVELNESS AND EQUAL FLOW. � � 102 108 100 SEPTIC SYSTEM DESIGN 98 FLOW ESTIMATE: .5- BEDROOMS AT 110 CAL/DAY/BEDROOM = 550 CAL/DAY SEPTIC TANK: ss . 550 GAL/DAY 1.5 DAYS = 825 GAL DR 6o 94,% :', ?! " .• , fo8 USE 1500 GALLON SEPTIC TANK .o �� o� : , 28' S BEDROOM 24' 92 % d,� p'O0 f,Yf,V: , LEACHING AREA: DWELLING GARAGE 90 , g �`�'' i f•1•�4i ►; : ' ' �` USE TWO LEACH PITS (6' x 4') WITH 2' OF STONE 24' `tiy°' ��� c , :► .: (10' EFFECTIVE DIAMETER x 4' DEEP) 84 FIDE AREA: 10 x 4 x PI = 126 SF (2.5) = 314 GAL/DAY PROPOSED DWELLING 82, ``` f os 1?OTT0Af AREA: 5 x 5 x PI = 78 SF (1.0) = 78 GAL/DAY f 80 , , - �•• :� ___� _ TOTAL CAPACITY = 392 GAL/DAY PROPOSED WELL 78 ` . ? ' TO LEACHING) 76 , 104 x 2 PITS = 786 GAL/DAY 74 - '` + + ' , ' ' ' SEPTIC SYSTEM SECTION 2" PEASTONE PROPOSED WELL ' . ` ` . , + 1 102 (LOT t7) 74 ,` ` ` � , i + i 1100 1 76 i ' 98 COVERS WITHIN 12" OF 3/4" - 1 1/2" ' ► i ► ' 100.0 OF FINISHED GRADE WASHED STONE U17LI TY CLi1STER - �, ; , ' ; ► ► ; ss TOP OF FOUNDATION 94 92 ` 80 . ' , 90 76. 8 + , 86�EDGE OF DRIVE \96.43 78 % 4' r 0 79. 0 , 84 96.68 1500 GAL ELEV. D-BOX 96.z , ELEV. SEPTIC TANK 96.37 92.0 Z97.O ELEV. ELETJ. J96.02 2 ELEV. jh L ELEV. TEE SIZES: `� INLET: 6" UP, f0" DOWN ELEV. .- 10' TWO LEACH PITS (6' x 4 BENCHMARK AT G�' EXISTING WELL OUTLET: 6" UP, 19" DOWN 2' OF STONE (10' EFF. DIAM.ITH x 4' DEEP) (H-201 CATCH BASIN ELEV.-- 75J BREAKOUT CALC.: (96.5 - 80) / 125 x 150 = 20' SITE AND SEWAGE PLAN EY: LOCATION. EXISTING CONTOUR: PERCI A PROPOSED CONTOUR: •••••-••-•••-••••••••••-•••-•• LOT 18• '•_ �� ° .�'"� r V L DRIVE EXISTING SPOT ELEVATION: 25.5 PROPOSED SPOT ELEVATION: 5 s �- WEST BARNSTABLE MA z TEST HOLE: - ` ' �`` ' PREPARED FOR: UTILITY POLE: -O- '� ' FENCE LINE: DM _ . ��.� � �` ' REEF REALTY HYDRANT: DEMARNST-McLELLAN ENGINEERING II"° �� - SCALE: 1" = 40' DATE: 3-9-95 RETAINING WALL: 24 SCHOOL STREET P.O. BOX 463 `t 1 t \ �•, - f _ WEST DENNIS, MASSACHUSETTS 02670 REFERENCE: PLAN BOOK 413 PAGE 99 M # 24 0_2=18 [THOMAS McLELLAN, P.E. JOHN Z. DEMAREST JR., P.L.S.