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0259 PERCIVAL DRIVE
35 al?(,� i . 0 ti i r a ® NO. 152113 ORA MACE N USA O WEIn Lb _, '�� - Z �� `� � z I �.... 2 � � �'c�� .. 7 i .^ � � � � 1 'S s � .. �_� C�(�=� t i . ' -� i i Town of Barnstable Building BAmsrsm& Post This Card So That it is Visible.From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept Posted Until Final Inspection Has Been Made. Permit 'moo Ma+• Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-20-2113 Applicant Name: PETER VOLLMER Approvals Date Issued: 08/21/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 02/21/2021 Foundation: Location: 259 PERCIVAL DRIVE,WEST BARNSTABLE Map/Lot: 111-063 Zoning District: RF Sheathing: Owner on Record: FULLAM, KEVIN C&MARISA L Contractor Name: MARK VOLLMER Framing: 1 Address: 259 PERCIVAL DRIVE Contractor License: 109558 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $ 10,000.00 Chimney: Description: replace windows on front of the house with new harvey double Permit Fee: $51.00 hung windows, replace clapboard siding on front of house with new Insulation: hardie board clap board Fee Paid:. $51.00 Final: Date: 8/21/2020 Project Review Req: Plumbing/Gas Rough Plumbing: \Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within si months after,issuance. All work authorized by this permit shall conform to the approved application and the�approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and st uctures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. 1 .1 Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing InspectionL �/ Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Person tracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). � Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: c� F ' TOWN OF BARNSTABLE BUILDING'PERMIT APPLICATION Map I I Parcel W BUILDING ®E Application # y OIL)PT Health Division 'Date Issued Conservation Division NOY 0 72016 Application Fee Planning Dept. TOWN OF BARNSTAgCEermif Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address.2s al P&a4ZAAa 0& Village 14, 6ehhd� Owner k4.� Address Telephone tv t'Z 311 .C1` 7 Permit Request -64 4A7 Am /,AL. Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District. Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family do' Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ,Ao On Old King's Highway: ❑Yes C?ilo Basement Type: IrFull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing ! new Half: existing new Number of Bedrooms: 3� existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: 2 Gas ❑ Oil ❑ Electric Q.Other Central Air: 0 Yes eNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes Flo Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: existing ❑ new size _Shed: ❑ existing ❑ new size — Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes MIN o If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION { M . (BUILDER OR HOMEOWNER) Name L .. Telephone Number -77Li c?Q'3 96,27 Address 60 EW License # .0`a 5. T3 a %. � •, .. Y '�t (��.Oo'1 ) Home Improvement Contractor# i R`7 Email i e Llzb 13 /9 9 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Ij�f�v - FOR OFFICIAL USE ONLY APPLICATION # ; DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER :DATE OF INSPECTION: J fj FOUNDATION ; ► FRAME TNSULATION f ' FIREPLACE _ ELECTRICAL: ROUGH FINAL - PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE-CLOSED OUT w ASSOCIATION PLAN NO. 4, 1 17ae ConirriorriveaIt&ojfMassachuseits Dqw,arrerzt o,f rndrisft ialAcciderrts Office o•f 1westigations { 600 Washington Street _.:__ Boston,CIA 07111 a ~ swi-nmas.govIdia Markers' Campensatian Insurance Affidavit:BuildersiContradursJEIectricians/Plumbers Applicant Inf6rmation Please Print Le.6bly Name(BusiIIe�DiganizationlIadis�dnal)� -r�,� A.ddress:loa � City/Sta-&Zip: Mon e' I 3 416 2 Are an employer?Cheekthe appropriate bolt Type of project(required),: 1.LJ I am a employer with. `f 4 ❑I am a general contractor and I employees(full and/or part-time)-* Have hired subcontractors 6_ nsfrtion 2.❑ I am a sole pruprieta r orpartnes- listed on the attached sheet. 7. �Zo:iing, ship and have no employees. These sob-conractors have 8. ❑Demolition wodring for mein any capact3 employees and have wodcers' [No a-orloars'comp.insurance comp.insuranmi g- ❑Building addition required-] 5. ❑ We area corporation and its 10-❑Electrical repairs or additions 3.❑ I am.a homeoum-er doing all work officers have exercised their 11.❑Plumbing repairs or additions tgsel$[No workers'comp- right of exemption per MGL 12.❑Roof repairs inc=ce required.]Y c.152,§1(4h and we have no employees.[No workers' 13.0 Other comp.insurance required.] 'tiny appBc=tdwtcheclrsbox R Est also fM out the section berow shuwbg their vnm kern'compensatianpolieyinformaFimi Homeowners wbo submit this affidm ii indicating thv_y are doing all'wat and thEM hire outside contractors must submit a new affidavit kdic=.—sacFL fContractorsthat chectthis box mast attached anadditinml sheet shouingthenuneof the sub•couttwtnzs.aad statewhethes ornattbose entitkshave employees.I€the sub-contrscturshive employLeg,they must provide their nrorkers'camp.policy number. I am nit sutpin}�crr float is prmddurg workers'con�erisatia�t insttrarrce frxr rri}*¢naploj�ees Helots is ifte policy lMd job site in,formaiiom Insurance Company Name: Policy or Self-ins.Lin ?lk�$ �'73�04�(Q. E_rpiratioaDate: ay Job Site Addre4s aS`� p t,�c t,�,� Q�r • City/State 2Tp: 1,(>' Attach a copy of the corkers'compensationpolicy 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 51,500:00 andror one-year imprisonment,as w&as civil penalties.in the farm of a STOP WORK ORDERand a fine of up to MOM a day against the violator. Be ad%rised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage,.w fication. I do hereby ccrfifir under tha pours and penahYes ofpeduq,fliatflre informirgoupratbd abmw is barb mid carrrect Sitsratirre: Date l L J,�. Phone '77 / 99 3 %g 7 Offs al use anty. Do ttot ayrite in tli&area,to be winpL-ted by city ortonrn officzat City or Tomm: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/-own Clerk 4.Electrical Fnspeetor S.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Maccar]YrTsetts General Laws chapter 152 regoaes all employers to Provide workers'compensation for their employees. pmm=t•m this statu-,an employee is defined as."-.every person in the service of another under may contract of hire, expre-ss or implied,oral or " An errrplayEr is defined as"an mdividnal,partnership,association,corporation or other Iegal entity,or any two or more of the foregoing engaged m a joint ent zprise,and including tine legal representafives of a deceased employer,or the receiver or trustee of an individnal,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 - dweIImg house of another who employs persons to do maintenance,contraction or repay Work on such dwelling house or on the grotmds or building apptn tthereto shall not becanse of sash 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 Ithe commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required_" Additionally,M(M chapter 152,§25C(7)states¢Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insur ce.. requirements of this chapter have been presented to the contacting au&6 ity." ` 1 • Applicants Please fill ott the workers'compensation affidavit completely,by checl the boxes that apply to your,situation and,if necessary,supply sub-contractors)name(s), address(es)and phone numbers) along with their cerffficate(s)of in cr„-a„ce. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or parfneas,are not requi e .to cant'workers' compensation msor mce. If an LLC or LLP does have employees,a policy is rmpir-ed. Be advised that this afddayh maybe submitted to the Department of Industrial Accidents for conformation of irmarance coverage. Also be sure to sign and date+he affidavit The affidavit should be retuned to the city or town that the application for the permit or license is being requested,not the Deparment of Inri ast ial'11 ccidents. Shouldyou have any questions regarding the law or ifyou are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-iIlSlln'ed companies should enter their self-insurance license number an the appropriate line. City or Town Officials Please be s=that the affidavit is complete and priated legilAy. The Department has provided a space at the bottom of tha 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 pen�itllicrose number which will be used as a reference number. Iu addition,an applicant that must submit multiple pem&license applinatiow in any given year,need only submit one affidavit indicating current policy iI l = 3ation(if necessary)and under"Job Site Address"the applicant should write"all locations m (city or town)."A copy of the•affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavitmust be filled out each year.Where a homeowner,or citizen is obtaining a license or pennitnot related to any business or commercial ventUre (ie. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit Th Office of Offic of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Departmenfs address,tElephone and fax number. 'I1�e CGMMMwealth-of Massachusetts ' Departaimt Qf I utdal Accidents , Q-dice of Xn�es�g�tio-� - FQQ-WashinvQn Ste'et BQstau�MA G2I 11 Tcl,#617-727-4900 cxt 4-06 ar 1-977MA.SSAFE Fax#617-727-774-9 Revised 4-24-07 W� maw�Qvf din AWC Guide to Wood Consfrudiorr in Hj;--Jr end Areas:110 mph J-Ytnd Zone Massachusetts CheckUst for COIIlpa*nc2 (780 CNIR 5301•?1,1)1 C.brsk - ' Camplianca 1.1 SCOPE. Wind Speed{3 se¢ 110 mph Wind Exposure Category----_.__ Wind Exposure Category...............-Engineering Required For Entire Project....................................._C 1.2 APPLICABILITY -Number of Stories(a roof which exceeds 8 in.i2 slope shall be considerad a story) stories 5 2 stories Roof Pitch .- - ------—_- --.__.._...-(Fig 2) ----. - __--- s 12:12 Mean Roof Height _ --•- --------• --- -- .—(Fig 2)____-___.__.-_._-•____-_It _<•33' Building Width,W_, _.-_---... ----.---__.(Fig 3)__------ -- Building Length,L _.____.__._-----•__--- -(Fig 3)— Building Aspect Ratio(UW) -__---------_ __...----.-.-__(Fig 4}_- ------.___---. c 3:1 Nominal Height of Tallest Dpening2 _-.-__.___ __(Fig 4)___- 1-3 FRAMING CONNECTIONS General compliance with framing connedians_... _._.:-(Table 2)__ ----__--_____..____�__:__-._ 2.1 FOUNDATION ' Foundation Walls meeting requirements of TBD CMR 54M.1 Concre-----------------------................................_.....---•-•----•.....------•---...---•-••-•-------..._..._.._...--- Concra a Masonry._.....___._.__ ----_.._-----____---.__._-- 22 ANCHORAGE TO FOUNDATIDN1.3 5/8'Anchor Bolts=imbedded or 518'Proprietary Mechanical Anchors as an alternative in concrete only Bolt Spaciig-general -------------------------..........---:.(Table 4). _.r..__-_.__ in. Bolt Spacing from endTomt of plate --_-_-_---(Fig 5)-�_ _.._ in.<_T-1 V. Bolt Embedment-concrete..___.-�� __ Fi - - ' _in.>_7' Bolt Embedment-masonry_...._...N�._-• ---_(Fig 5)-- _--t-----•-----_--- •rrL>_15' Plats;Washer___.-.__ ____._._—-__ -_-._(Fi9 5)_____ .____- -->_3'x 3'x W 3.1 FLOORS - Floorframing member spans checkad ------ (per 78D CMR Chapter 55) Maxirnum Floor Opening Dimension-----._T_�— Full Height Wall Studs at Floor Openings less than 2'from Fdrior Wall(Fig 6)....................................... MbLdmum Floor Joist Setbacks Supporting Loadbearthg Walls or Shearwall____(Fg 7)--_-----_-----•----- _____-.—ft 5 d Maximum CanSlevened Floor Joists Supporting lbadbearing Wass or Shearwall--- (Fig 8)_ ..____---- _------- •FloorBracing at Fsdwalls-..... _._.._._. .-----.�..-�Fi9 9)-.___ --._.-: ._. _ -----• Floor Sheathing Type -(pef780 CMR-Chapter 55) - Floor Sheathing Thiclmess (per 7B0 CMR Chapter 55)__________r__ in_ Floor Sheathing Fastening___._...__.___.-____.-___=._(Table 2)_ d nails at in edge!_in field , 4A WALLS - Wail Height Loadbearing walls____-M_____--_.__ (Fig 10 and Table 5)___. ____ It 510' Non-Loadbearing wails-- -_ (Fig 10 and Table 5)--.._. .____It'S 2[r Wall Stud Spacing __ --(Fig 10 and Table 5)_�.__-_h 5 247 D.C. Wag Story Offsets (Figs 71£8)_. ......__._.__._ —It 5 d ' 4.2 1_?CI-E J Old WALLS' Wood Studs Laadbearimg•vralls 5)......._............ __.2x Non-Loadbearing walls -•-•--:(fables) — — Gable End Wall Bracing t Full Height Endwall Studs-_______:____-_.-..__.(Fig i D)_--. WSP Affic Floor Length ft;'W!3 _ Gypsum CeEng Length(if WSP not used)-- -----:(Fig 11) _--_$;-I 0.9W _ and 2 x4 Continuous Lateral Brace 6 fit o_c-_ i 11 _ � (Fig �................................ _ or 1 x 3 aelling furring strips 16'spacing•min.writtt 2 x 4 blocking @ 4 ft.spacing in end joist or truss bays Double Tep Plats Sptice Length r.__----- -(Fig 13.and Table 6)----_--- -- ft — _ SpCtcr Connection(no:of 16d common naJls)- ff WC Guide fo Wood Cotrsiructian itt l iglr Wtrzd Areas. IIO ftrpk TYr-trd Zone Massachusetts Checklist for Compliance(7so civzRs3ol.z1.1)i Loadbearing Wall Conne l5ons - Lateral(no.of 16d common naffs)_-____- -(Tables 7)_ --_--- Non-L•oadbearing Wall Connections 1,-AE!ra1(no.of 15d common Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans -.____w_.-_ _-_....-- (Table 9).._�_. _ft_in._s ill _ _ _ able 9 • Si!(Plate Spans •_ --.--.(Table )-----.----------- _ Full Height Studs (no. of sf ids)____________(Table 9)......Non-Load.Bearing Wail Openings(record largest opening but check all openings for compliance to Table 9) 5 51Z' Header Spans.._._--- ---._-__(fable )---_______-____.._ft'_in• Siff Plate Spans..___^_- -- __--(Table 9)..,_ FLA Height Studs(no.of studs)._r.-- -(Table 9)._-._-__ ---_-_-.Y-_____-._ ExteriorWall Sheathing to Resist Uprdt and Shear Simultaneousiy4 - Minimum Building Dimension,W Nominal Height of Tallest Opening? .................. ------ ---.-._-.-------_.._.__5 6B' Sheathing (note 4) _.-_—.�-----_---- Edge Nail Spacing� ,_--(fable 10 or note 4 if less)-------.-_-_.__ in_ Field Nail Spacing____---(Table Shear Connection (no-of 16d common nails)(Table Percent Full--Height-Sheathing.-------_..(Table 10)__.-_-_-____.____•---_---_._.._°� 5%Additional Sheathing for Will with Opening>-6'8"(Design Concepts)-__._.__.__. Maximum Building Dimension,L - Nominal Height of Tallest OpeningZ_.._-------------------------------------------------------,=.__--5 SIB- ` Sheathing Type._-- __--_-_..___(note 4)-----_._______- -------_----- Edge Nail Spacing (Table 11 or note 4 if less)__--____._------ in. Feld Nail Spacing_-•-•-- ---_- _-._-_(Table 11)_____--Y_______.-_-_-- .-•- in. Shear Connection(no. of 16d common nails)(Table 11)---.--_-�_._____--._�_..___.____. Percent Fu&Height Sheathing- --..(fable 11)_______-_ -__% 5%Additional Sheathing for Wall wrlh'Opening>TB'(Design Concepts)_...-_-.-_ _-- Wall Cladding _ Rated for Wind Speed? 5.1 ROOFS_ Roof framing member-spans checked?_-__._.. .(For Rags use AWC Span Tool,see BBRS Website) Roof Overhang -------------------_ ----..__-_-------.(Figure 19)----------. ft s smaller of 2:or L13 Truss or Rafter Connectiond at L.oadbearing Walls = Proprietary Connectors Upfdt._-_--------•-----r--•(fable 12)_-- ---._..._._._._____Ll= plf Lateral �-_.----____..... ----_(Table plf 12)___-._--- S-- ' Ptf Ridge Strap Connections,if collar ties not used per page 21._, (Table 13).__----- ___ ___ _.T= plf Gable Rake Outlooker------.-_--..--:_.__..__..------(Figure 20),---•--__-_ft_<smaller of 2'or L12 Truss or Rafter Connections at Non-LoadbebAng Walls Proprietary Connecions Upf fft_ .-____- __ (Table 14)_--_-__.__-- -__U= lb. Lateral (no-of 16d common nails)-_(Table 14)--------------------------------------L= . lb. Roof Sheathing Type-__—:_ ___-- -(per7B0 CMR Chapters SB and 59)............. Roof'Sheathing Thickness_-...._ ._ --_ _--- --_-__-- -- _in__711S*WISP Roof Sheathing Fast>?rning-_--__-- ---.-•---- (Table 2) Notes- -1. • This checklist shall be met in its entirety,excluding the specific exception noted in 2, to comply with the r>:quirements of TBD CMR5301.2.1.1 item 1. If the checklist is met in ifs entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a Str:el Straps per Figwm 5 b. 2D Gage Straps per figure 11 c. Uprn't Straps per Figure 14 d_ All Straps per Figure 17 e, Comer Stud Hold Downs per Figure laa and Figure lab 2 'Exception:Opening heights ofup•tn a ft_shad be permitted when 5%is added to the percent fu"eight sheathing - nequirernerits shown in Tables 1 D and 11. 3_ The botbm sill plate in exterior walls shall be a minimum 2 in-nominal.thiclmess pressure fisted#2-gr2ide. -• AFVC Grcide fo Wood Corrcfr-acdbrr in H4gh 13,indArerrs_ IID mph ff,"hudZone Massachusetts Checklist for Compliance(7so cl�iRs3.ot?!:l)1 4. a• From Tables 10 and 11 and location of wall sheathing and BWding Aspect Ratio,determine Percent FuA Height Sheathing and Mail Spacing requirements b. Wood Structural Panels shall be minimum thiftess of 711 r and be installed as follows: i_ Panels shall be installed With strength axis parallel to studs. I All horizontal joints shall occur over and be nailed to framing. uL Dn single stD•ry constnJciion,panels shall be attached ID bottom plates and top member of the double top Plate. _ iv. Dn two story construction,upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first fioorframing. v. Horizontal nafl spacing at double top plates, band joists,and girders shall-be a double row of Bd staggered 9 3 inches on center per figures below:Vertical and fttzontal NarTng for Panel Attachment 5_ Glazing prDtecfion:a)'new house or horizontal addition—required if ppledIs 1 mule or closer to shop:(generally,south of Rte.28 or north of'Rte 6) b)vertical addition—not required uriless there is extensive renovation to the first floor c)replacementwiridows—needs energy conservation compriahce only(chap 93) 6•Wood Frame Construction Manual (WFCM).for 110 MPH, Exposure B maybe obtainedfrorn the American Wood Council, . (AWC)webstte i WrIEN EfisIDG�FF¢SSMDA . F}'ira?iBZG paEad I'vaZ . AT' ---�--t • .. a ' t - it it � a. u �� VC t It i t o i ! r [. i It It r r Q t r t 11 tt-1 t trTr 11 1 t [ a {[{[ t '•~G ii i iQ t'� ! i _ a it �It t m n it X 4 r 't tr Z a ! i dF r rl ii ii t 1 r fr FRA14MLmaABERSII II pi 1 t IDSE it ii � ttr 1 1 E 316t It u n t l t t E rt. - - • ' •x BSI � _ --�� --- - - « ' STAG•.LERE? Mari i~ua_�kr 11uL PATTERN � PANEL t — — �•} PANS—IDC:E MUMEUMLEDGE5PACVMnEPU- See Da[Fil on Next Page Vertical and HDT¢orTlal HalingDetail • far Panel Attachment � Vertigi and Norizan�l Nailing - for Panel Attachment ef' rgyy Town of Barnstable Regulatory Services ' ! RlS2'INR-PIAT4 s 4 MASS. '$ Richud V.Scan,Director Bu&hg Division TomPerry,Em'Idmg Conssioner 200 Main Street,Hyaoxis,MA 02601 www.townb a—stable_ma_IIs Office: 509-862-4038 Fa= 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder ,as Qwner of the subject P1OPuty herby authorize to act on my bd a.1£, in all m tbm m atim to work authoared bythis budding permit application for. (Address of Job) Pool fences and ala are the responsibility of the applicant Pools are not to be filled or utfized before fence is installed and all final ' inspections.are pedormed and accepted. Signa = of Owner Signature of Applicant Print Name Print Name Bate . QFoxntis:owr�$a�smr�oors - ' Town of Barnstable Regulatory Services oft r � B,irhard V.ScaH,Dirmfor , t .m. x Rc r_ awr: Tom Perry,BjaUmg Co�n77��:oner $ _ M �a 200 Main&met Hyannis,MA 02601 prm wwwtowMbzM.5tahleMa-us Office: 50 8-862-403 8 Fes: 508-790-623 0 • B:0IMWrEa LTCXNsg fox DAZE: . JOB LOCAn0K-- s namn - ham phoao# woziCphonc . T CURRENT MA ING ADM ESS: city/ta�en - rip ro& The eur=t exemption for`jLomeownerf Was extmdedto include owner-O99Mied dweIImes of six emits or Less and to alloW homeowners to engage an.individual for hn-ewho does notpossess a.licrose,ptoyided that the owner acts as supervisor_ luondrrON OBHOMFOWNEB. P m:son(s)who owns a parcel of land on which helshe resides or figruds to reside, on which tb=is,or is intended to be,a one or two- f=ay dwelling,. welling,afiacbed or detached stroctores accessory to such use and/or farm structures. A person who con tracts more than one . ne m "shIlsbttohBZgOfficial on a fog home is atwo-yearpeaod shall mtbe considm-rAahomcow h . m mm table to the Bur7dmg Official,that he/she shall be responsible for all such wow Rerf coned mmdeTthe bmldma peffitt (Section �P 109.L1) The undersigned`.`homeowner"acsamcs responsinffity for cauipliance whhthe S[ate.BuT-Min Code and other applicable codes, bylaws,rules andreg-ElTar;ons _ 'Ibe umd=lgmed`homaownm"certifies thathe/she understands the Town ofBamstabIc BtvZdmg Depart n=tT=Trn=inspection procedures andrequirementsandthathe/shewiilcomplywhit said proce&=andret emetds- Signatum ofHomeowncr Approval ofBm7dmgOfficial Note_ Three--family dweIlmgs containing 35,000 cubic feet or larger wMbe required to comply with the State Bml ing Code Seddon 127.0 Constrac n.C &CL • 33:01=WNMIS EXEMraON The Code gtatns that: I"y homeowner performing work for which a burZding permit is required shall be exempt from the provisions of this section(Section 109-U-Licensing of constxndioa Supervisors);provided that if the homeowner engages a person(;)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are aSs=Tng the responsibrTrties of a supervisor (see Appendix Q,Rules&Regulations for Limning Construcf:on Supervisors,Section 2.15) This Lack of awareness often results in serious problems,poxfm larly Whea ffie homeowner hires mfficensed persons In this case,our Board cannot .proceed ag-adost the unlicensed person as it would with a Tioensed Supervisor_ The homeowner acting as Supervisor is uItimatelp responsible. To eusure that the homeowner is fay aware of his/her respousibrTiti'es,many communities require,as part of the permit:application, that the homwwner certify that helshe understands the responsIbMes of a Supervisor. Da the lastpage of this issue is a form carreadiy used by sei,=l towns. Yoa may caret amend and adopt such a form/ce*fTicat ion for use in your communI y. pc:=hfM=)E3=3.1ba R cvisrd 061313 . - I I @ ® G. n Nw�s�y..�s . rsoKr PC. 1'FI'S^R Pill ' •. -R14HT 1=�L�/.4TIoN -'° ���' -MIFLL_Sl r x - j R;-2, IZFT Cl-CvAcTIoN - SmAr- et.cwpoN r .ul.: a �O MrIgMD n 01Yw n b •-,�,.� •• �TC�Io� E1.evA7"1oA1e �q{•'w�� :'.•���,'. • I..or n� p�R•u.cir oc. , -r ,.� 'OItE 11.0. X Stag -#Cu.LtBr. 7if'FT . I G rd' 11 }•:. c yuu: LoG 17;9�i�er MO.� �L, `o mm+-15 � .: 2 r��F BfA'eL.�, eic,+:1 r6•ll Evo C 4l-i.�31i. L'-7S��' J LT -•!a •:f 1 elr�r Lo aMT ; v_;i .pars _ 17_ l'l Iz 11'Xlo• V ,, I1Al .. - I Nc+l. Sze fS.c. '_ 'r; CiA: ® •.. _ap © `:�::i' i - 6 1 u• _ - psN.� u' �- N � •r~Z-�� VA. 3 ctl.r.'ILL a-•2+24 _ 'q u�t°,c4•dY/ •.$iQ _ 1 p �'� :c'i�':�� . Uxhewr fib-2 ' 4c JiTl2 '• 8L Ip Ib�II'� + •1�B14n A�syn 1 $ql O ITu1t:11 _fD © E OIL Z' tt•w�p .rYj (fINJ al `0 To G 1 i xtic.afi µ�TL': 4TL._ I:hlr se6 7 I A LAN 1/1 P�t%.¢.oN s,,i�L.tiw(�+r. 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'�G �,���v IH TtF iacicpclo�. �i[ryr r� Wat_..., e wrro t. �,;:.:.„ I Owens Corning Basement Finishing Systems of New England Fullam,Marisa&Kevin t 259 Percival Dr Contractor I Agent Authorization From West Barnstable,MA 02668 631-317-5177 - :- 631-220-6810- - — -- - L A QLAII0^ authorize Owens Corning Basement'Finishing Systems of Boston to sign the building permit application on my behalf,to perform the work at: Home Owners Signature: Ol�' '� Date: - 196411 b e Project Manager Signature: Date: 60 Shawmut Road • Canton,MA 02021 • Phone: 781-821-0060 • Fax: 781-821-8552 • www.ocboston.com Massachusetts -Department of-Public Safety "Board of Buiiding Regulations and Standards C M15tTucdon Sul em-isor . License: CS-075131 EDWARD T.ALLN 30 STORMY FM-1 G Dedham MA 02026 3 Expiration Commissioner 02/27/2017 Office of Consumer Affairs And Business Regulation 10 Park Plaza - Suite 51.70 Boston, M sachusetts 02116 Home Improve ontractor Registration . Registration: 137943 z Type: Supplement Card LUX RENOVATIONS, LLC. Expiration: 1/2972017 EDWARD ALLEN o 60 SHAWMUT RD CANTON, MA 02021 e •O - Update Address and return card.Mark reason for change. 3cA I Co 20M•Os/11 Address Renewal Employment Lost Card ex,�omvnwauoe a�C3�aesac�uueLla ffice of Consumer Affairs&Business Regulation License or registration valid for individul use only - ME IMPROVq CONTRACTOR before the expiration date. If found return to: egistratio ,=. Type: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Exp1rati — ;(OV Supplement Card Boston,MA 02116 LUX RENOVATION OWENS CORNING DISHING SYSTEMS EDWARD ALLEN 60 SHAWMUT RD. '-- —IT — "j CANTON,MA 02021 Undersecretary Not valid without signature I l ® DATE(MM/DD/YYl'Y) A COOR o CERTIFICATE OF LIABILITY INSURANCE 9/23/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTA PRODUCER NAME:CT Jane Logan Andrew G. Gordon, Inc. PHONE (781)659-2262 FAX (781)659-4725 ac No 306 Washington Street ADDA'RESS:jane@agordon.com INSURERS AFFORDING COVERAGE NAIC# j Norwell MA 02061 INSURER A:Liberty Mutual Agency INSURED INSURER B:Commerce Ins. Co. 34754 Lux Renovations, LLC, DBA: Owens Corning of New INSURERC:Peerless Insurance Co. 24198 60 Shawmut Road INSURER D:Star Insurance Company 18023 INSURER E: Canton MA 02021 INSURER F: COVERAGES CERTIFICATE NUMBER:Kaster JL 9/16/16 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR S BR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDD (MMIPDNYYYI X COMMERCIAL GENERAL LIABILITY - EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTE A CLAIMS-MADE FX OCCUR PREMISES Ea occurrence $ 100,000 I CBP8512851 9/5/2016 9/5/2017 MED EXP(Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- LOC PRODUCTS-COMPlOPAGG $ 2,000,000 X POLICY❑JECT $ OTHER: INED AUTOMOBILE LIABILITY EO acG dentSINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED SCHEDULED AUTOS FF_�]X AUTOS LP7677 4/4/2016 4/4/2017 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS era dent X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 C EXCESS LIAR X CLAIMS-MADE AGGREGATE $ 1,000,000 DED I X I RETENTION$ 10.000 CUB511953 9/5/2016 9/5/2017 $ WORKERS COMPENSATION X STATUT ER H AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE I E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? Y N 1 A D (Mandatory in NH) XWS57350449 5/24/2016 5/24/2017 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY.LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Cert Holder is added as an Additional Insured to General Liability Coverage per Blanket AI form 22-133 and Umbrella as coverage is "follow form" where required by written contract. WC excludes Dan Bawabe 6 Paul Deguglielmo, both LLC Members CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Insured's Copy THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Jane Logan/LOGAN ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025/7mamt Fullam, Marisa& Kevin 259 Percival Dr �� CONTRACT Customer Na West Barnstable,MA 02668 Customer Signature__ ge SKETCH Contract Date 631-317-5177631-220-6810 Sales Representative Signature ATTACHMENT Customer Pho. - Contract Price 2 1 2 3• 4 5 0 7 e 0 10 11 12 13 14 15 IS 17 18 10 20 21 22 23 24 25 28 27 28 28 30 31 32 33 34 35 38 37 38 39 40 41 42 43 44 45 48 47 48 9 50 51 52 53 54 55 58 57 58 59 80 1 _Q I 4— 3 _=Tr G 7 _ - -- - - -- -- - _ - -- -- --- - - -- - -- �•- - -- - - —-- - LeA 1a0./.1_.�_ _ S — —— -- — _ — — — —— la-a - — - -- 15 �—— 19 _ ......... - - - - - ---- -- ---- _ ----- - - - �--1•- -- 22 — --— -- -- —� I —�--I I -- --- — — __ It _ 23 26, 2728 f__.30 32LIL-L-1 ... 33 34 _ - - --__ -1- - I- - -- - - - - - - - -----�- - -�-I --� ---�- -- - -- -- -----i_i-- - --j----- 35 NOTES: -Each box equals one foot unless otherwise noted.This sketch is a good faith representation of the work to be done,it is understood that all dimensions derived from this sketch are approximate,and that all locations of outlets,light fixtures,plugs,jacks and/or switches are subject to change If necessary. _y • ,r. li•!.F.RIl�.�. I . I t GNIM __ A4pNN.T�'OOr 4nKLr• • ^ r � ..1 i 7��+ } x {Y! +�11�A i MM Oom ML:4 L.tR ff "T Vc. 9'41'"-r-VR 4- O ^u. Y.c,G.un - r f. •. Yvc h:�a-ce �1 1� I I � j:: ►APT CI-Cv.►r�r,oN :. P r�is f 'fir ("151 v t I r< txTCFIor- QZVis.�'Ioµ6 s R�•� 11, s II •I u L 5y o� 17tAtt4 IT. SILL- ff.do'. `- e i�^sl.:. p�.1 ,oF. INf•l/N�N! •"b L'U cq}4i�r_r.I'9"i"- rh 1 E p alrir I.o�wi-LClly_`��gir 1 Ll .� y �: 17 l��t 1flASS 14LD 94U."4LIOX t-"I`rz+ -ago-?— �.1. t IWL If'>tlo' � •' 1 '_1 elop 1 ..1. - 4 •D.N. N - Ql �� —if-OIra. 111 "..•'. ' 3 aN.MULL 2-2�y24 _j•�II'It�r@� 1 � �+�: IN uxt.eN g-14-2 ' 4 c 'siYZi •.8'0 (�: •.'�'t'i. 5 V. .f6 .c •I YIZ O' 114x106 Ati — E: P�4TH 1�}'-,�x►o=o wv,vl, 14! • r 1 34t o , ourr.F, SNje' -3ELoNn rz.-.e� ' ITRi1:1J QfD 6 IfyMv® 0 T I L`weR+r"w�j (F1N4 � 1�dx 23♦ j N"f'4. vnn� U{JAY .. 4Iz44r1:. 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PwRev c004 I-- --..— — -- ILI - - - - -- - - 0. 1�q Lv�oKv 9 41-0 1 _wre: �oJNr7.41"foN'P4LN .E}S'-Px 24'-c '�`,••if• e o—eE A L—Lf mr oP net Four cAinc rJ .�tV P,b1.Cd a�1ai F1e'KE. E�-T Eormm YE 7o T :r oUNvnnO N W"4 •...or.o•n ,,,•. 'Mo 'y�OoLxK 5�'i�Ps�.+s,co 4�F rV6mOH YHe 9v� . LAu. ON TH6 M"P-z ec,e a YeiE vn.so nwr rT wl- •,. f3G 0-*p-1°7 IN•111E EXMfilaF- rl "r FAR WAI, . 4 ,4 i oF� ram, Town of Barnstable *Per> w QFxpires 6 months from issue date Regulatory Services Fee t BARNSTABLE, = Thomas F.Geiler,Director MASS. 1639. .�� Building Division PTFD MAt A 01- Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 62601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number ` I ` n 3 Property Address o,Scj ['Residential Value of Work Lk Lt S 0 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Addres' '(, ._xX Contractor's Name ©�.�,.i �1.1�c L�j`'� Telephone NumberGo$ S0 1t e{ (o 4 t) Home Improvement Contractor License#(if applicable) 121251�ts"j 3orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ®��� PERMIT am the Homeowner (]I have Worker's Compensation Insurance a®rR Instuance Company Name L•�3c�t�� ,�,,,)�y.t�, FEB 19 2009 Workman's Comp.Policy# O W 024S TO OF BARNSTABLE Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) S/Re-roof(stripping old shingles) All construction debris will be taken to `{AQ p, e-roof(not stripping. Going over existing layers of roof) Q_C o G i5 , ,c,. �. 3 ❑ Re-side Qom- vxv,� Co,� . �t2p,tscQ `J�i�.NG-� �Opl ❑ Replacement Windows/doors/sliders.U-Value (maximum.44) o� *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: l_ _0 Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revise020108 .Y The Commonwealth of Massachusetts Department of Industrial Accidents Ofce of Investigations 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensadon Insurance Affldavit: Builders/Contractors/Electricians/Plumbers %PpUcant Informadon 1' Please Print Legibly Name(Business/Organization/individual): 0t_1 V:;—: Q Address:q �Q...wc, VA4,-�c City/State/Zip:90. `toX�� Q Phone#: 5606 5001 i-bq- Q Arepu an employer?Check the appropriate box: Type of project(required): 1.LJ I am a employer with 3 4. I am a general contractor and I employees(fill 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 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 an a corporation and its 10.❑Electrical repairs or additions officers have exercised their 3.❑ I am a homeowner doing all work 11. P Iing repairs or additions myself o workers'co right of exemption per MGL S's [No mp• 12. epairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box MI must also fill out the section below showing their workers'compauation policy information. t Homeowners who submit this affidavit indicating they am doing all work and then hire outside contractors must submit a new affidavit indicating such. tContrsctors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontrsctora have employees,they must provide their workers'corm.policy number. I am an employer that is providing workers'comrpensadon Insurance for my employees Below Is Hite policy and fob site information. Insurance Company Name:U e e;Q,-m AviV A-\— Policy#or Self-ins. Lic. #: (��2`� 1 3��({ ©y O� Expiration Date: 12 - 2� • 13E) Job Site Address:�Sc\ Q--Y2C ,y4�. ��_,.�� City/State/Zip:'I -,.-"A ,yc 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 tine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct signature: Date: 2 �q ` 2mc�,C Phone #.- 6026 �509 L1�040 Offle at use only. Do not write in this area,to be comp by city or town gfJlclaL City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: OLIVER KELLY ROOFING 9 PEREGRINE LANE SOUTH YARMOUTH PH/FAX 508 775 4498 MA. REGN 128957 MA 02664 LIC# 99167 INSURED February 3, 2009 Proposal submitted to Kim Fredrickson of 259 Percival Drive West Barnstable. We propose to supply all materials and labor necessary to remove and replace the existing roof at the address above All debris to be removed to town transfer. 8"Aluminum drip edge to be installed on all eaves. Ice and water damage protection membrane to be installed on first three feet of eaves Remainder of deck to be covered with#15 felt paper. 30 year limited warranty Architect style shingle to be installed(Color to be specified) Bathroom vent pipe boots to be replaced with new. Ridge vent to be installed on entire length of ridge with hand nailed caps. Protect all walls, windows, decks,plants and shrubs etc. during roof strip. Repair Chimney flashing as necessary. Obtaining of town permit. At a total cost of$4450 - - Payment Schedule; 50% with signed contract, balance upon completion. Respectfully submitted, Oliver Kelly Proposal ac epted by, Date) / l /2009 COPIE OF LIABILLITY AND WORKERS COMP INSURANCE ARE AVAILABLE UPON REQUEST AND CAN BE MAILED TO YOU BY OUR CARRIER. R � JL,�CX A WED 14:26 FAX 0"08 77.8 12118 DOWLING & ONEIL INS bovool 1/14/2009 9:59 PAGE 002,1002 LMG Liberty Mutual Group P.O.Box 9090 V0 ultu Dover,NH 0382-1-9M Mm. Telcphone(8W)653-7EW Fax(603)-145-5330 .:_nu ry 14,2009 :TX1,!OF FAUMUM HALL SQUARE AUKOL-M MA 02540-- .-MrKh OLIVER IM-11Y 9 PEREGRINE I-aNH SOUTHYARMOML MA. 02664 Number: WC2-31S-3388&4-028. Effective: 12/28/2008 Explraci=: .12/28/2W9 tr�,,,c nowir�afforded under Workers CorromsRtion Law of Che fo g tztt(s): MA SOle propri=. r/`3artQC[03vr-ra=Flcccian: 'J"ne-vorkers'cornperisaition Nun,By Accident: $100,OCKI EVC-ib Axident pel- cydoes not ptovide $ 100,OW 1-3-ta person caws age rely TI];t-iry by Dixmv; $500,000 Pvl!cy Limlis OUVISTI K-ELLY This dxe, the z—bme-referenced policyhol&r Is insured by Liberty Mutual Fire Insurance Co -:t:i,Ws.policy listed above. *.:,,,r.su=ce afforded by the listed policy is subject to 0 the terms,eKclu5ion;and conditions,ind is not :---red bv my raquimnant,tear-or condition of cry o::othef dccurnents with ie"ct to which this ficate may be issued. �'f teis issued 2s an-uttec of f ico�-, information only and conf_rs no right upon you,the certificate 111!s certificate is noz an insurance policy and does not�rnen.d,extend,of slier the coverage cancelled date, utuQ1 d t 1;'S policy is c. d before the stated expiratic-n, e,Liberty M- -,611 en eaves 0 notify you of C-ulceflation- AUTHORIZED PEPRF.8F-NTATrVE- LMERTY MUTUAL WNURANCE GROUP .,rtificnc is cxwc:cd to/LZEMMMUALINTSURANCE GR0UP3xmqA=s=hhzu=za2x is affankdby:Lou cow. Insured: Pxodnfer of Recor& SANDPIPER LINSU)ItAINCR AGF-NCY INC Mrm Y,=Y :'>HREGILTNE I-ANTE 12 ENTERPRISE ROAD MA 026"TARMOU`rf-� HYANTNTS, MA 02601 V Board of Building Regulations and Standards = One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 128957 Type:. Individual Expiration: 6/14/2009 Tr# 131109 Oliver Kelly Oliver Kelly 9 Peregrine lane S. Yarmouth, MA 02664 Update Address and return card.Mark reason for change. DPS-CA1 0 50M-05108-PC8490 Address Renewal ❑ Employment Lost Card ✓lze �oa�rnlrr✓�tttse a�✓`laarac�uaeCt Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 128957 Board of Building Regulations and Standards One Ashburton Place Rm 1301 Expiration: 6/14/2009 Tr# 131109 Boston,Ma.02108 Type: Individual Oliver Kelly Oliver Kelly 9 Peregrine lane South Yarmouth,MA 02664 Administrator Not valid without signature sxachusctt - Dcparirttcnt of t ul°fir Safety*z 3 Bo:tr-tf of Building Re�gulutions and-Standar& :• ����tra; i�;- �:��,�r�-is�r Se�ciaity�i •e�i�� . License. CS SL 99167 Restricted to: RF,V13 ; OLIVER KELLY 9 PEREGRINE LANE SOUTH YARMOUTHt MA 02664 '? 5.� Expiration;-.9128/2011" i nnmis.i nu•r T 4 99167.` _ a,Jw CF"E tpr, • R„�LF. • The Town of Barnstable . i639� `0� ABED 59 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 259 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, Kathleen Maloney Office Assistant bondrele oFTMe� - °� The Town of Barnstable RAMSTMIA "6 �0� Department of Health Safety and Environmental Services 'OrEcu►o�°` Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-79.0-6230 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. Sinc rely, Kathy Maloney Office Assistant TOWN OF BARNSTABLE � CERTIFICATE OF OCCUPANCY II . r 1 PARCEL ID 111 063 GEOBASE ID 36885 ADDRESS 259 PERCIVAL DRIVE PHONE W. Barnstable ZIP - ..LOT 17 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT WB PERRMIT TYPE BC009 DESCRIPTION CERTIIF+'ICATE OFDOCCUPANCYPMT.#11704) CONTRACTOR,: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: BOND $.00 CONSTRUCTION COSTS $.00 �T Qi► 756 CERTIFICATE OF OCCUPANCY , BARN3TABLE, ; MAS& OWNER HORSEFOOT, HOLDINGS C b fp ADDRESS 24 SCHOOL' ST PO BOX 186. BUILD//'-G DIVISIO W DENNIS MA BY DATE ISSUED 05/22'/1996 EXPIRATION DATE .. .., ....,.tf. .. __ _ _.._��.-.,.._ ;�, .__.ice J ....,'..Sj�b.f_�:L.' •..�_. ....•rR' _'L aaY ''-v.,.:?'.LL.ii.i:F+.�1...�` ti IowN JE BARNSr. ABLE BUTLDING PERMIT PARCEL ID 1.11 063 C EOBASE ID ' . 36885 ADDRE'S ?.: 3 PERt'lVAL DR1:V'i; PHONE W. Barnstable Z;IP - WT 17 BLOCK LOT SIDE - IPA DEVE")PMENT DISTRI�.;T 4+t}3.. L''.r_RM'l 1 1 P ;(� I L� '1 J_ 13. ILL I P1'T UN N}W ltiC �';�I DE��XA L,WWeVT pai=tlirient of Health, ► r , i itr Y r i, C0NTRAC a113: ,ox , EEVERi+.'.TT W_ JR_ and Environmental Serv.,< ARCHITEeC'T'S TOT.:11. FEELS: :l>187 .83 ��ME BOND $.00 ,'J's''S $1,101000 .00 C • LO i �.i:t!(�J,4t; i?AM HOME DETACHED i PRIVATE P "`.w .—ffAByF i MASS. OWNER 1,ADDRESS 1 S 1 , MIS 'ENNIS Mil , BUIL D SIbN DA''t, EXIPTPiATION DATE B 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.STREET OF. 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. MINIMUM OF FOUR CALL INSPECTIONS REQUIREi) 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 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 ME�Ii- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. in 6-wi �J �1 BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 _ZS 4 i J2G. -a.� 3 Z`-9G %-9a 2 EINIL,) 2 2 Y 3 1 ING INSPECTION APPROVALS ENGINEERING DEPARTMENT f � 2 , BOARD SOFVEA -� OTHER: c-laSITE PLA,REVIEW APPROVAL WORK 5t;;.: _ l:;.' i.)r.'�. !RT: �! ~ '' '':�?r'nlLt.. E•F ,�,'t Ni-:'!. AND VOID IF CON• 1NSPBCTiONS INDICATE- ON THIS THEW' "—c • S P A f L FH7 j • 17)14 H. e:{ * NOT WITHIN SIX CARD CAN BE ARRANGED FOR ;:'( HIG Trsi;^- AJ: . :i �a C:�.: !:;-;?�t(T !S I^::?".!ED AS TEL.EFHONEo RWRIT'EA1N0'T;FICA- N fit��: i 11r?C^'7. TICK. 503-790-6227 i a To _kjzladAiig� oete ? Time WHILE YOU WERE OUT - A, w 11 of i Phone Area Code Number Extension TELEPHONED PLEASE CALL CALLED TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU URGENT RETURNED YOUR CALL Meese e 0 Al Operator AMPAD 23-021•200 SETS �j EFFICIENCY® 23-421 •400SETS CARBONIESS I `oF,HE AThe Town of Barnstable BARASS.LE. MASS. � Department of Health Safety and Environmental Services Y �. �! 059. �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 "' �..� � IQn c -v-eaQ. Permit Number Owner c- Builder �2e'- - One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: 9 iA Please call: 508-790-6227 for reeinspecction. Inspected by Datej 6 Assessor's Office(1st floor) Map _� Lot (,Permit# /l rJ0 ,✓ Conservation Office(4th floor) / I l6 S 91 + Date Issued Board of Health(3rd floor)(8:30-9:30/1:00-2:00) �,�- 03'-)- Fee ,_ Engineering Dept. (3rd floor) House#1 e" Planning Dept. oor/School Admin. Bldg.) Definitiv lan_Ap ro ed by Planning Board I O 19t�,e,�® R"RNSrAR [ MAS&I' _ .4- 49 S C� >3' l `s yl• 'v TOWN OF_BARNSTABLE �' q Building Permit A plication �a4 Proje Street Addres �� V E J, Village cTSA Owner �25ocsrc i;btt f�GS dr- C•C, Address' �C) o� l8l0 lZ b�-=>uN Telephone �� Permit Request ✓x 104 Total 1 Story Area(include 1 s ry_garages& ecks) square feet / D Total 2 Story Area(total of 1st&2nd stories) 1 -I S 1 square feet Estimated Project Cost $ Zoning District Flood Plain � Water Protection M 'Lot Size_ 35 E l 4�1 sr= Grandfathered ? y�s Zoning Board of Appeals Authorization Recorded Current Use \[,ACy�t4-f— ,c4AT4,[) Proposed Use Construction Type W ,U n - QZJg77 A C-_ Commercial Residential Dwelling Type: Single Family V Two Family Multi-Family Age of Existing Structure N -0t Basement Type: Finished I Historic House Unfinished Old King's Highway Al?f CpQe7t\ I o`t T Number of Baths Z,�j No.of Bedrooms Total Room Count(not including baths) `7 First Floor Heat Type and Fuel rAik) Central Air No Fireplaces Garage: Detached Other Detached Structures: Pool I Attached Barn None Sheds Other ( Builder Information Name Eyee-ear tj , a 'y `1 Telephone Number Address PO ,'i�>6.X t 9�, .Z`-t' 3 o-i+c)o L-- !91-• License# V"1 C- rr hd N rs , 1/" /1, 02a _Home Improvement Contractor# - Worker's Compensation# pOt;--C- 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 n. I SIGNATURE 1AJ GtJ h DATE I t-►4- a_ BUILDING PERMIT DENIED FOR THE FOLL ING REASON(S) ,. / FOR OFFICIAL USE ONLY PERMIT NO. A DATE ISSUED MAP/PARCEL NO. ADDRESS ILLAGE OWNER DATE OF INSPECTION: ' FOUNDATION i Z' FRAME INSULATION FIREPLACE ,ELECTRICAL: ROUGH FINAL PLUMBING:, ROUGH ' FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 84, LOT 17 1 35,181 ± S.F. hh' (0.81 ± AC.) CONC. 53.6f FOUND. TF.=96.0 y�o 00, +I ri rn r- o� R=190. 91 A=26. 00 30 p0' pER CIVAL DRIVE JOB # 94-039-17 CERTIFIED PLOT PLAN PREPARED FOR LOCATION : ASES MAP 111 PAR 63 LOT17 PERCIVAL DR. W.BARNSTABLE SCALE : 1" = 60' REEF REALTY REFERENCE : LOT 17 PLAN BOOK 413 PACE 99 1 HEREBY CERTIFY THAT THE STRUCTURE OF SHOWN ON THIS PLAN IS LOCATED ON THE JOHN cyG GROUND AS SHOWN HEREON. DWAREST,JR. No.ass DEMAREST - McLELLAN ENGINEERING 24 SCHOOL STREET F 0. BOX 463 DECEMBER 21, 1995 WEST DENNIS, MA 02670 (508) 398-7710 DATE 40FE-OSONAL LANDS YOR 'r 19,2 64, LOT 17 a 35,181 + S.F. (0.81 ± AC.) CONC. 53.61t FOUND. T..F:96.0 syy m 00, of ko +1 b3 m co o) R=190. 91 A=26. 00 30. 00' PERC IV AL DRIVE JOB #94-039-17 CERTIFIED PLOT PLAN PREPA RED FOR LOCATION : ASES MAP 111 PAR 63 LOT17 PERCIVAL DR W.BARNSTABLE SCALE : 1 = 60' REEF REALTY REFERENCE : LOT 17 PLAN BOOK 413 PAGE 99 OF 1 HEREBY CERTIFY TM T THE STRUCTURE tN'O MASS SHOWN ON THIS PLAN IS LOCATED ON THE �� L HN gcti GROUND AS SHOWN HEREON. G i � DEMAREST,JR: � �Vo.36859 coDM �� � � DEMAREST - McLELLAN ENGINEERING 24 SCHOOL STREET P. 0. BOX 463 DECEMBER 21, 1995 WEST DENNIS, MA 02670 (508) 398-7710 ', DATE 40FEOSONAL LAND S YOR �'•�� .Th a Commonwealth of Massachusetts Department of Industrial Accidents Offlceo//oyesUgadoos �►� -.- 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit �I�DIICant information• �':�'�'TeaS" �t�N'i' eisib V:uara: ;wi r +�rY�C„d name- location: city 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. company name: address city K��6ST �°`) �j phone# insurance co. 4 t,� lic # 60 — 24 —7cS l C G I am a sole proprietor, general contractor,dr homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: c m any name: address: city phone#• policy insurance co company name: address: city phone#• insurance 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 S1,500.00 and/or one years'impriso ent 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 scat ent may be forwarded to the Office of Investigations of the DIA for coverage verification. /do hereby c i u filer the pai and pens ies ojperjury th�Iheformation provided above is true and correct Signature ate Print name Phone# 4" V official use only do not write in this area to be completed by city or town official city or town: - permit/license# ::rlBuilding Department icensing BoardO check if immediate response is required electmen's Office ealth Department contact person: phone#-, ther (rc,,sed 7/95 PIA) 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 enipluyer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregolmi engaued in ajoint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual , partdership, 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. �R, � Ya�!atS^k'x�% aC:r'1ti:F1F` _P_ _ -:F+ �'`• 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 be sure to fill in the permitAicense 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. :g 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 ' COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY g ' 'F•''+:ap`ccc.�acrii®Af OF ONE ASHBORTON PLACE [ "l.rct;•; ,, i BOSTON,MA 02108 �'�••►I/ C'CS J'• —F:i:C[n� MASSACHUSETTS so foricroccllon '. L I C E K S E CAUTION EXPIRATION DATE C O A S T R . S LL!'E R V I S 0 R 3 111' 1 FOR PROTECTION AGAINST R�SfiR�GTiON$996 EFFECTIVE DATE UC-NO. THEFT,PUT RIGHT THUMB g nb/30/19?3 .�032809 ., PRINT IN APPROPRIATE 1 NONE g BOX ON LICENSE. 6"' 5 F'J E f2 F_T T a fi 0Y J R BLASTING OPERATORS W DENNIS MA, 02670 MUSTINCLUDEPHOTO. . '. PHOTO(BLASTING OPAONLY) FEE: j� 100.00 NOT VALID UNTIL S'IGNED BY LICENSEE AND OFFICIALLY AIL HEIGHT, FED•OR-slcNAttraE of THE COMMISSIONER .. . 4� A/ -�•:i:}:i�(� (�;t;. ;�l fe�G;yP THIS DOCUMENT MUST BE « SIGN NAME W FULL ABOVE SIGNATURE LINE i� 11..:.•u .11'•'i�2•' .. :%�..;q•i r,ql C�.:_!pf TUBE OF LICENSEE . �::• i••.,+'i jl�rl\..::i.. 411M� C\y CARRIEOONTNE PERSONOF L` �1;`•al.• 'i.iui. 4 THE MOLDER WHEN EN- OAOEDNTNSOCQIDATIDIL .. �y, 1 � -4 _ .._.. t - Application to BpPN'QEN Y`'tEOP tN5 BPE E� Old King's Highway Regional Historic District Committee in the Town of Barnstable for a A C p n CERTIFICATE OF APPROPRIATENESS Application is hereby made, iri triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: Z New Building ❑ Addition ❑ Alteration Indicate type of building: W House X] Garage ❑ Commercial ❑ Other 2. Exterior Painting: 9 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 ADDRESS OF PROPOSED WORK LoT EKCiVA�L.. INZIVE ASSESSORS MAP NO. 11 1 co 3 OWNER l�o'(ZSEFUCTT- L CGS GF CAPE:- Con ASSESSORS LOT NO. (� HOME ADDRESS�u' �'K l � W `�N�tS; M- ° TEL. NO. FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). ��� s� �h►-r�-w xl`I �-�'e1AntA�1 _ 2.'t.t �G f'`C.t��. �t .� .� ��.IM� �Z-CaCo� `�r l n�o+�tY s` (-�� -� �a►�o�t� a,.- P�,k L83 1A • ��avWs-t1�Psc-E 1A o2G,U 1S N Sf124Ar" 4. Sr" 1,-3 LA 0-WS.e- 2-150 P62C-t0 Occ— �44 t� �rz��-t�BLe AGENT OR CONTRACTOR -�' god I��� �� L=20 TEL. NO. 3c1- ADDRESS�� $ ���� �'�£NN\�� �ll"� CSZ(01c) 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). N CyOt� it S2�` X 2L. ` r'a u1 _4 `�E rU �tv� ��--� t�4�— 5T`f,L_& +. E tJ c 3E L. v►�'CZ a E c.�4 Er,) C,PaQ� €, ` ' � — — - c DK KA',, J i-�2�LwtCE. � ODD ' �. o Signed iv_,4 Owner-Contract r-Agent Space below line for Committee use. ReceivedR bynH.D.C. Cl I� l�J � r �9 S �at.e_ .D_- The rvficate is�e eby Date �Tiffp T 7 innr Via L IJJJ 1--By 9 FRNSTABLE ' _ 0, �JiGw%1%1AY Approved ❑—" 'IMPORTANT: If Certificate isZroved, approval is subject to the 10 day appeal period provided in the Act. Disapproved ❑ 1 �,. -P 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. 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 per 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 requiri�ng�a�Certificate of iAppr}11 riateness. 8. Under heading of "Detailed Description of Proposed Work" give,de`tailed data,on9su8k9chitectural 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 Historic District may be obtained at the Town Hall. t i I i fI I i 8 �' ti .,r 3 4� t I Town of Barnstable Old King's Highway Historic District Comm ss o4 SPEC.>SHEET AP ��J D FOUNDATION 2c�f': �C�tA2Ct-a�PF3aa.P�C SZ�S�6 SIDING TYPE vJ-(,t rrE. LC:S COLORCHIMNEY z- C--- CHIMNEY TYPE J2xc-r-_ COLOR ROOF MATERIAL_�SQct►4c�� �t�►�y.C�S COLOR � E'�`rH-E21��(�(� k h PITCH (Z— WINDOW VL-a7 - U SIZE L2-'� TRIM COLOR W 14 rr-G c •#2Z�'s� DOORS (QN� �J s lcEe-l_ COLOR'TeC-_L-i-A SHUTTERS y ►� �— 20 5 S y r C Eck C— C--�o w r.� GUTTERS (V\,L rvlk_ ' CW T(��:lf�n n nr DECK �(L�SS�( G-{� ��c�i GARAGE DOORS L:� t:'---(--_��' COLOR 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. fr Application to • �""y+i�",S EP w,�" � 9 9 6 022 Old King's Highway Regional Historic District CoMIT1ittee 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: ❑ New Building ❑ Addition ❑ Alteration Indicate type of.building: ❑ 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 ) I I ADDRESS OF PROPOSED WORK QL5C '-` -C-L'Ve_( t) r 4 tom. W.h. ASSESSORS MAP NC. 3 OWNER _ 0e*,Ye. Q+ t`le\d'!3S at` C96M (:ZOA ASSESSORS LOT NO. 1� HOME ADDRESS ��' �ox (mil (1 --�erY'1►S. t1.VN-- TEL. NO. -�1`r" �b�,10) 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 1.4 A r.6(� :. -Do r a-tL._) F..a-�w�sx.v► - Z'7 I � tr c►vw� �r V.P. IZ�. r v�s bl�. Wl W y Z 4(o (.*%3 U g�arrls ►J1t, yl��, a2�F(�K- AGENT OR CONTRACTORLM t - Q •: w• � h.� y TEL. NO. 3ocl b ADDRESS PO , 3-�06- 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 c Y- C'i `T r Gi K4 ✓•'po L— Co l o Er— CS%CL f%_Ta_ 4-0 rvL 6 c-t�,►rLa.� aQPI tcc�T`ar� aT�(_40Y,*-A arl I01IV 1;5- �J1 y� Signed Owner-Co tractor-Agent Space below.line=for C-ommittee use. Received�by H.D!C.� �1 Datej--,/[Tih,�,nC33te is hereby DateJAN 1 11I9� . Time JV4%OF BARNSiABLE . _e Q,2 . BV Approved ❑ IMPORTA If Certificate is approved, approval is subject to the 10 day appeal period provided in the Act. Disapproved ❑ 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. 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 Historic District may be obtained at the Town Hall. I , r Town of Barnstable =' ,1 Old King's Highway Historic District Coc ants,.*." SPEC,'-SHEET FOUNDATION �1 SIDING TYPE COLOR � Wydc� CSw'��'►, CHIMNEY TYPE COLOR ROOF MATERIAL U ((- S',.��c� COLOR __1:>txaA 4 c PITCH WINDOW SIZE TRIM COLOR -�e- DOORS 1a� c,�.c� 5E-�c� COLOR SHUTTERS GUTTERSh�tc� DECK GARAGE DOORS COLOR r-%�Lz 0 NOTES: Fill out completely, including measurements and materials/colors to be used. Three copies of this form are required for submittal of an application, ZO 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. b Application to 1996 0 2 _ aPE� �S�NpM 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: ❑ New Building ❑ Addition ❑ Alteration Indicate type of.building: ❑ House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting:z 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 ) I t ADDRESS OF PROPOSED WORK a59 '-e.rclV0...( �`} r+yc. . �.h. ASSESSORS MAP NO. L3 OWNER ��' � ` VUA!:XS at` Q;�g. � ASSESSORS LOT NO. 1 HOME ADDRESS ��' �x (�Z -=�h''1►S: �-kVN-C2-Cv-4a TEL. NO. -,-:�54- -5,6`10 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). rr k A rro� • �� ro1�7 F�•�-�vv�sx.vt - Z-11 `trc►vo` �+' v e (�. r h S b�-� hA y Z 4(v -�'koti i �'p•e.�u� �Qkdav�2.� — ...�ok. �,0563 , W .�c-rt,s�t, �fq a2LQ(n�C MA AGENT OR CONTRACTOR�'�t' ��•' � �T� TEL. NO. 3"cl b ADDRESS PO , -p--bx ilL UL . b►1k-S FR' 0Z. 0 0 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). n c o�t r�T GL cti c� f'oo Gc> o�r- c�c�v.�-2_ �-O vYL O r-t,�)i r'LckJ a(�P(1at-�ar� a.��o� en Iof Ist '4S t J , Signed Owner-Contractor- nt Space below line for Committee use. ,Received�by-H-D'C t' Date The ert-Mr to is her Dat Ti dN 1 1'1996 1 r r By;'O roc R Poll,'tARLE i Approved ❑ IMPORTANT: If Ce fificat"e :I�Zpproved, approval is subject to the 10 day appeal period provided in the Act. Disapproved 7 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. 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 Historic District may be obtained at the Town Hall. I i r� -__z_1 r G A r Town of Barnstable ,l Old King's Highway Historic District Comm a5;;[ SPEC. -SHEET i FOUNDATION �-+•r vJ�v� �•l�w.wLS SIDING TYPE COLOR � Wyp� CHIMNEY TYPE COLOR ROOF MATERIAL U hc.(�- S�.�„�c� 5 COLOR tea4c(� PITCH WINDOW SIZE TRIM COLOR DOORS lam-c�.c,E_ S-E-cc,1 COLOR SHUTTERS Gray J,rc ��y l3� GUTTERS whxK. DECK GARAGE DOORS COLOR�r� woc� 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, 20 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: 63 TEST HOLE LOGS NOTES: v} ! 1. VERTICAL DATUM:ASSUMED FROM QUAD (NGVD CURRENT ZONING: RF ENGINEER: DOYLE ENGINEERING 2. MUNICAPAL WATER IS NOT AVAILABLE. / BUILDING SETBACKS: WITNESS: N. LEITNER 3. SCHEDULE 40 - 4" PVC PIPE TO BE USED THROUGHOUT SEPTIC SYSTEM. F: 301 S: 15, R: 15' DATE: -17-87 4. ALL PRECAST UNITS TO CONFORM WITH AASHTD H-10 do H-20 PERCOLATION RATE: < 2 MIN/IN LOADING SPECIFICATIONS. FLOOD ZONE: C 5. PIPE PITCH = 114* PER FOOT,(UNLESS NOTED OTHERWISE). TH-1 92D TH-2 101D 6. FIRST 2' OF PIPE OUT OF D-BOX TO BE LAID LEVEL. ,o \ TOP,& ELEV TOP & ELEV 7. THE SEPTIC SYSTEM HAS NOT BEEN DESIGNED TO ACCOMODATE THE LOCUS 24' SUBSOIL 1e SUBSOIL s USE OF A GARBAGE DISPOSAL. HARD INS 8. ALL CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE LOCATION MAP SAND & SAND STATE OF MASS. ENVIRONMENTAL CODE (TITLE FIVE) AND LOCAL 1 f o, ,,' ``, 84- BOULDERS 85.0 48" 97A HEALTH REGULATIONS. LOT f7 9. CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRIOR 35,181 SF SAND (0.81 AC.) 108 _ _ _ `` MEDIUM AEND�M TO CONSTRUCTION. _ . 120' 82.0 I 10. PROPOSED SEPTIC SYSTEM AND WELL LOCATION ARE IN ACCORDANCE FIN n w 93.0 WITH MASTER PLAN ON FILE WITH BARNSTABLE HEALTH DEPT. . `, '110 (SMEARING) LOCATION OF SEPTIC SYSTEM HAS BEEN REVISED SLIGHTLY FROM f o4 - - _ _�y� - , , ` ` ,,` , `` 144" 80 0 MASTER PLAN BUT STILL MEETS ALL SETBACK REQUIREMENTS. 102- _ _ � 11. D-BOX TO BE WATER TESTED TO ENSURE LEVELNESS AND EQUAL FLOW. � NO GROUNDWATER ENCOUNTERED 100 - _ ` ,, `., '.?�,� `, j 12. DESIGN ENGINEER TO INSPECT AND CERTIFY SOIL CONDITIONS AT \ ., ., TIME OF CONSTRUCTION. SEPTIC SYSTEM DESIGN 96 ` 94 - , ' - _ , • , ` . TH-2 ', , / FLOW`ESTIMATE: BEDROOMS AT 110 GAL/DAY/BEDROOM = 550 GAL/DAY 92 - ` 90, SEPTIC TANK: CAL/DAY * 1.5 DAYS = 825 GAL 1s 'goo 104 f os USE 1500 GALLON SEPTIC TANK DTca PROPMD 86 , LEAC�ING AREA: 2r 24' CAR. foz USE TWO LEACH PITS (6' x 49 WITH 2' OF STONE ss 1s 84 �� `` ++ t 't AG r10' EFFECTIVE DIAMETER x 4' DEEP) y + f oo PROPOSED DWELLING p 82,\ `` �`` `` ` a +` SIDE AREA 10 x 4 x PI = 126 SF (2.5) = 314 GAL/DAY ` + ,'BOTTOM AREA: 5 x 5 x PI = 78 SF (1.0) = 78 CAL/DAY $vb 80` ` �.o �. 98 �4 - TOTAL CAPACITY = 392 CAL/DAY ` ` TH-f ` \ .` x 2 PITS = 786 GAL/DAY 96 94 SEPTIC SYSTEM SECTION 2" PEASTONE 92 d�ti �90 COVERS WITHIN 12 OF 3/4" 1 1/2" �5 `88 97.0 OF FINISHED GRADE WASHED STONE 78 TOP OF POUNDATioN 86 82`84 � 74 _ _ - _ ` ` `80 EXISTING WELL eL'• 78 74, 0 0 74 �7s 93.8 1500 GAL ELEV. D-BOX 93.32 o LP #1: 85.0 ELEV. LP 2: 81.0 `74 PROPOSED WELL SEPTIC TANK 93.49 ELEV• LP 1 89.0 # 76 (203' TO LEACH PIT) 94.0 _ ELEV. LP 2: 85.0 !2' • 2, • ELEV. 7s. 4 q • . e R=fso ELEV. TEE SIZES: -~ 76 A-�26. 00 INLET: 6" UP, 10" DOWN ELEV. .-- 10' .c OUTLET: 6" UP, 19" DOWN TWO LEACH PITS (6' x 4') WITH BMMAMI RW AT 76. 8 7e UTILITY CLUSTER 2' OF STONE (10' EFF. DIAM. x 4' DEEP) (H-20, CATCH BASIN BREAKOUT CALC.: (85.5 - 80) / 60 x 150 = 14' ELEV.-- 75J �'L��, 10; 79. 0 SITE AND SEWAGE PLAN KEY: RITI� EXISTING CONTOUR: LOCATION.• PROPOSED CONTOUR: .............................. +J a►__ LOT 17 PERCIVAL DRIVE EXISTING SPOT ELEVATION: 25.5 4 `°xsf �4. * PROPOSED SPOT ELEVATION: 2s _. f; '� .% WEST BARNST ABLE, MA TEST HOLE:- a ;' s> PREPARED FOR- UTILITY POLE: FENCE LINE: DM f REEF REALTY HYDRANT: -� RETAINING WALL: DEMAREST-J(CLELLAN ENGINEERING �f' - SCALE: 1" = 40' DATE: 3-8-95 Y �� � ,• 24 SCHOOL STREET P.O. BOX 463 WEST DENNIS, MASSACHUSETTS 02670 REFERENCE: PLAN BOOK 413 PAGE 99 REV: 11-6-95 03.E DM # 94- _17 THOMAS McLELLAN, P.Ell JOHN Z. htMAREST =., P.L.S.