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0035 PETER BLOSSOM LANE
r ,,�. _ . ������9� _ - - __ �. _ �A:. ... .. . V --__._.-...Y. � ._.__...._ _".�..�.____"� I �� � �. � ��� (/' �� �. '; e O � � � o �,,��� �� _ . .. � � �.� .� �- o � �- � . - 5-oF wd e,,r— o (e-dt+,-- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION d' Map G 8 8 Parcel__ad 009 rmit# 9-9 3 ,,---Health Division Q6—'VG -9/4rJC3 3 �� to Issued 3 Conservation Division t �s ! I f 03 pplication Fee GtkJ44 Tax Collector .� � Permit Fee s Treasurer �/ D �, 770 SYSTEV 52, MUST EE �,pS AILED IN COMANOWN� • .Planning Dept. . YWTy TITLE Da t e i 'tive Plan Approved b PlanningBoard F �ONru�ENTi4L CODE'A1N�G� His KH No ex{e2�n e, TOM REGULONONS a � n S Preservation/Hyannis :; P� �e 1, S g,5 Q �t 6A�e �� Project Street Address � Jr' a: - Village �,�f A /-_44 :> c tee i Owner U t ''L I N A `T �ekq oko Address ISA �e M Telephone ' 3-2 zf 3 II Permit.Reque �� ti IA-E? U,oc`e l W S& v-cc_7 �Gc o s4-0V& ; smy< 012 y Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Toth(new Joning District Flood Plain Groundwater Overlay project Valuatio .- o o y Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family O' Two Family ❑ Multi-Family(#*units) Age of Existing Structure 7 y A-S Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: Dull 0 Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) - — Basement Unfinished Area(sq.ft) 75^s'y Fe"I' - Number of Baths: Full: existing new Half:existing l� new Number of Bedrooms: existing new Total Room Count(not including baths): existing new 2 First Floor Room Count Heat Type and Fuel: MIG"'as ❑Oil ❑Electric ❑Other Central Air: ❑Yes 34o Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No 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 ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATIONNd_ L) l 0- _T "9©01 atcv Telephone Number\, 6o3 3 7 5 — o Y/ 3 Address 5 pe_�P16== BLD:&o M LAA(License# LU e_S 7 A ML IA4/>- Home Improvement Contractor# µ Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO V,J SIGNATURE r FOR OFFICIAL USE.ONLY e l w PERMIT NO. C DATE ISSUED MAP/PARCEL NO. ADDRESS, VILLAGE OWNER,S _ r DATE OF-INSPECTION: 'Y FOUNDATION t '.S FRAME' '? INSULATION 4 FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH-'. r? FINAL FINAL BUILDING ' DATE CLOSED OUT ASSOCIATION PLAN NO. s T I RESIDENTIAL. BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions' $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE wORKSHEET NEw LIVING SPACE 7c square feet x$96/sq.foot= x.0031= l G plus from below(if applicable) ALTERATIONSIRENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: x.0031= square feet x$96/sq.foot= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= Fireplace/Chimney _—x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moviug $150.00 (plus above if applicable) Permit Fee u s' projcost The Commonwealth of Massachusetts '-- Department of Industrial Accidents =_ = OlBce o11flY8Sf 9J119HS _ 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit filp name. V L1ti JtiA � a D acn_p k location. / city A k a- jA shone# g 0� . 0� f.3 ❑ I am a homeowner performing all work myself. 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I do hereby certify under the p and penalties of perjury t at the information provided above is truce and correct r Signature , ` ate — Phone# Print name ' - official use only do not write in Us area to be completed by city or town official city or town: perandtliicense# ❑BnIlding Department ❑Licensing Board ❑Selectmen's Office ❑checklf Immediate response is required ❑Health Department contact person: phone#; _ ❑Other ocyiud 9/95 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 employee is defined as every person in the service of another under any cgntract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an.individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 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 along with a certificate of insurance as all affidavits maybe 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 retained 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 e number which will be used as a reference number. The affidavits maybe retarh to be sure to fill in the pernutJhcens 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 Invesugadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 New England D6sign Architectural Services PO Box 311 West Barnstable,MA 02668 508-362-9724,ext.28 Telephone 508.362-9734 Fox 508-395-7492 Cell steve.nedesign@direcwoy.com Steve Kortis �pFtHE ro�y� } Town of Barnstable Regulatory Services �BSrABM MASS. � Thomas F.Geiler,Director rFp .l A Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of.Work: /�-�S �r J3q 5 e UL@;--+ .Estimated Cost Address of Work: 3 PL° `T +� u SS uk, Z a- 0L19 j 6Ak A-,36;k wl-.9 Owner's Name: t h I.)-4 Date of Application: b I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied _�er pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date 2nt7rorName Registration No. R ate U twn-er'-i" e Q:forms:homeaffidav Town of Barnstable CF THE 1py� y� p� Regulatory Services STAB Thomas F.Geiler,Director stnss. 0 9. .0� Building Division rED �� Tom Perry,Building Commissioner 200 Main Street�Hyannis,MA 02601 Office: 508-8624038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB L.00Anom PeAe [® 55&t" L A t'-e- GUe-14 number street village o8-37r 'HMMOWNER": V L+1 9 1 A —T- �'_o a t o c,C name V home phone# work phone# CURRENT MAILING ADDRESS: �� �- t G D 4 6 1 +^'' 6 A It ks (A1IX,Z � 4,4 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structuies. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under'the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with.the State Building Code and other applicable codes,bylaws,rules-and regulations. The undersigned"homeowner"certifies that he/she understands.the Town.of Barnstable Building Department... minimum inspection procedures and require nts and that he/she will comply with said procedures and re ements. Signatak of tome weer Approval of Building Official Note: Tluee-family dwellings containing 35,000 cubic feet or larger.will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This ladk of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a fora certification for use in your community. AFFIDAVIT OF VIRGINIA THEODOURO Virginia Theodouro, being duly sworn, deposes and says : I am the owner of the property located at 35 Peter Blossom Lane, West Barnstable, Massachusetts . It is my present intention that the basement of the house, which I am in the process of 'finishing, will be used solely as an adjunct to the living space in my house, and will not be used as separate living quarters . If I sell the house, I agree that I will remove the counters that have been constructed in the basement . If I later determine to f / create separate living quarters in the basement, I will not do so without first obtaining the proper permits and zoning relief, if any, required by the Town of Barnstable. ' -rno it i is Theodouro COMMONWEALTH OF MASSACHUSETTS Barnstable, ss . September 24, 2003 Then personally appeared the above-named Virginia Theoudouro and acknowledged the foregoing document as her free act and deed, before me War b ission expires : NOISIAi0 _ 6S :6 A TOWN OF BARNSTABLE { CERTIFICATE OF OCCUPANCY } ' PARCEL ID O S 007 009 GEOBASE ID 43536 ADDRESS 39,. PETER BLOSSOM LANE PHONE._ , : ZIP - LOT 10 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT. WB PERMIT 27792 DESCRIPTION SINGLE FAMILY DWELLING '(PMT.#17957) ! PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: _ Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: BOND $_00 Oki iCONSTRUCTION COSTS $,00 I 756 CERTIFICATE OF OCCUPANCY * ; * 1ARN3fABLE, • t . . 1 ,l BUILDING D.IVISIONC BY J� J DATE ISSUED 12/16/1997 EXPIRATION DATE '` 0 . =.- ©O 7 a O 7AOWN OF BARNSTABLE . BUILDING PERMIT. ° PARCEL ID 000 000 065 GEOB SE ID ADDRESS 35 PETER BLOSSOM LANE� PHONE (508)775-22 WEST BARNSTABLE, MA f - 1, ZIP . 02668- LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT PERMIT 17957 DESCRIPTION SINGLE FAMILY DWELLING (SEW.PMT.096-464) PERMIT TYPE BUILD TITLE NEW RESIDENTIAL BLDG PMT CONTRACTORS: BALODIMAS, SPIROS A. . Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: . $372.00 BOND ttlE CONSTRUCTION COSTS $120,000.00 � Qi► 101 SINGLE FAM HOME DETACHED 1 PRIVATE P Q ` + BARNSTABIM s' MASS. OWNER THEODOROU, VIRGINIA 03A� ADDRESS. 76 ELSWORTH HYANNIS, MA BUIL G I BY DATE ISSUED 09/18/1996 EXPIRATION DATE 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 OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS% PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. i MINIMUM OF FOUR CALL INSPECTIONS REQUIRED 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- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY VISIBLE- POST THIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS /2-`o S•97.��3� 2 2 �sNk U 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMEN 2 OT VJA� SITE P N EVIEW APPROVAL &Qea.,17.G'�e� //l /n�7 1I D y /1 WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORD IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY wARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE ORWRITTEgNOT! CA- TION. NOTED ABOVE. TION. , �j a1 ;L, M t I. t 4 '1 V all • L TOWN OF BARNSTABLE BUILDING PERMIT PARCEL ID 000 000 065 GEOBASE ID ADDRESS 35 PETER BLOSSOM LANE PHONE . (508)775-2247 WEST BARNSTABLE, MA ZIP 02668— LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT .PERMIT 17957 DESCRIPTION SINGLE FAMILY DWELLING (SEW.PMT_#96-464) PERMIT, TYPE BUILD TITLE NEW RESIDENTIAL BLDG PMT CONTRACTORS: BALODIMAS, SPIROS A. . Department of Health, Safety ARCHITECTS and Environmental Services ( TOTAL FEES: $372.00 CIE ' BOND $_00 CONSTRUCTION COSTS $120,000.00- 101 SINGLE FAM HOME DETACHED 1 PRIVATE P:,4-?E:. _ c + ■A�NSTABLE, MASS. OWNER THEODOROU, V I RG I N I A 1639' ADDRESS 76 ELSWORTH HYANN I S, MA BUILD/ ' G I BY l�l DATE ISSUED 09/18/1996 EXPIRATION DATE —�_ a TOWN OF BARNSTABLE BUILDING PERMIT PARCEL ID 000 000 065 GEOBASE ID ADDRESS a 35 PETER BLOSSOM LANE PHONE .(506)775-2247 W19ST BARNSTABLE, MA -ZIP 02668— LOT _ BLOCK LOT SIZE DBA — DEVELOPMENT DISTRICT PERMIT 17957 DESCRIPTION SINGLE FAMILY DWELLING (SEW.PMT.#96-464) PERMIT TYPE BUILD TITLE NEW RESIDENTIAL BLDG PMT- CONTRACTORS: BALODIMAS, SPIROS A. Department of Health, Safety ARCHITECTS': ' and Environmental Services TOTAL FEES: $372.00 . � OkIm BOND $.00 -" j CONSTRUCTION COSTS $120,000.00' QA 101 SINGLE FAM HOME DETACHED 1 PRIVATE P .. ABLE, MASS'1639. OWNER THEODOROU, VIRGINIAEDA , ADDRESS 76 ELSWORTH BUILD,YNG IV HYANNISy MA BY . I DATE ISSUED 09/18/1996 EXPIRATION DATE 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 OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. I MINIMUM OF FOUR CALL INSPECTIONS REQUIRED 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 ELECTRICAL PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE gNICAL INSTALLATIONS. I 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLEPOST THIS CARD SO IT IS I BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS I 1 1 1 i 2 2 2 I I I I I 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT I I 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL I .WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. I I I I i -- ,: _ y . � �. s . . ,, s . -- — : - _ �� � � - � 044 IF �All �� �F�i Z � 'I iz ai 074 ow iO4 Qi o W4.M ti ' o.. .^j, O.Pr,; ` 3� ' r�rO� �o ry ri 1!�1f + jfZay X c+ o �� O Ql, �s� - 7 � rY � ill Y�`• iF��, � 4'� I �" �,' tO�j�d � rll S wy� �. >r7-,` •{' �L,'F 4 �1 A� W `y �"'�� ►� 1�� �1' JM�C ] 1f o' C f v , ��� U y WA 'C'1ay �,f � u- e y 0-0 f d' fN. 6.0 � 5087752799 SHEPLEY WOOD PROD 75.3 PEi1 DEC 02 '97 14:16 Shepley RX wood pfoduct-0 216 Thornton Drive,Hyanms,Massachusetts 02601 •505-771-7969 FACSIMILE TRANSMISSION DATE: TO: FROM: NOTE: ftT634f a, A0-m c )ai-e-' FAX NUMBER 14508) 775-2799 SHOULD ANYTHING BE UNCLEAR PLEASE NOTIFY US IMMEDIATELY AT: 1 (508)771-7969 TOLL FREE 1 (800) 227-7969 TOTAL COPIES (INCLUDES COVER SHEET) v m N m u w G S M N g O I CD G Q n n( w J I w ifl N V VI N Ln N N O S U1 000 000 - n 6S' Parcel 0 7 ermit# Conservation Office(4th floor)(8:30-9:30/:1:00-2:00) c5h0olf, ate Issued Board of Health(3rd floor)(8:15 -9:30/.1:00-4:45) 7-0 �y ��� ��)-be�� „3 70� • D-v - Engineering Dept. (3rd floor) House# �� n,E r Planning Dept.(1st floor/School AdminMIdg.) SEPTIC SYS E I've,o ck.,.- �o.., � TI�LLE®IN CE D eIan Approve Planning Board c�,�' 19 _ �� peg iF;R0NMENTAL AND TOWN OF BARNSTABLoE�^t� T�� : Building Permit Application Address Village �! c Owner Address Telephone Permit Request First Floor XF4 square feet Second Floor (?e V square feet ! Im J- Estimated Project Costt $ %2-0 006 /C Zoning District F Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No. of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name L3 _Telephone Number —v73a 3 Addre s ,� �Q� `/� License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DE RIS RESULTING F OM THIS PROJECT WILL BE TAKEN TO -z�, , - n SIGNATURE I DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) z 1 FOR OFFICIAL USE ONLY r PE MIT NO. � y - DATE ISSUED - MAP/PARCEL NO. Jr r ' 1 IDRESS VILLAGE O NER DATE OF INSPECTION: ' FOUNDATION FRAME' INSULATION - l FIREPLACE ELECTRICAL: ROUGH . FINAL ' PLUMBING: • 9-0 GH FINAL GAS: ; . FINAL ' FINAL BUILDING r � ` r -s y,T'•Sc71 C� r , DATE CLOSED OUT �_ ` • ; ►01 . ' ASSOCIATION PLAN=NO. • 1 1 �- } I �i V . i "`=• TheCdn7l11UnH't'allln of?I tassaclnusctls •• •� - ` Department of Industrial Accidents i OfllceafIal Tsffriffaas 111, ; a 600 11 asbia.1.7nn Strcct 02111 Wori:crs' Compensation insurance A1lftlavit ngme- �s o?3a3 :XL am omeowner performing all work myself - I 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. .ty. "hone� snrnnee co noiin•d r,. .. �„_. _......,�,; .,.�,.......,qr .. I am a sole proprietor general contractor, or homeowner(dreie one)and have hired the contractors listed below whr owing wo •er-s' co,I^/1mpensati poll es. MM re • phone fh mop- gU m 1nv,nA e• ✓k r — o insurance co. :attaeh additions!'shei!lCtieeessa � w� t ..d�•a-.r�� ����'�`` Lr ds.. �v ....-:.����..� Failure to guano coverage �required under Sation 3A of D1GL 152 can lead to the imposition of Brim- peaailies of aline up to S1300.U0 R. one reap'secimpimpure coveronmc well uias ;civil penalties is the form I a STOP WORK ORDER and a flue ofS100.00 a day sptimt me: I understand t' copy of this stateme may be forwarded to the OlTece of Int a stigatioas of DIA for eoreraae veeititaition. an C I do herehr c fj•under the pains and penalties ojpct7urr that the infornmtion pm-ided above is true and cotrrra: • rue Sicnature Phone# Print name i ofricial'use onir do not write in this area to be completed by city or town oMCW leertnit/Ileettse t1 ntluilding Department citg or town- �Uexnsin�Board is required ride ctmen's Omce a cheek if immediate response1311cNith Department phone ft• nothex��. contact person: -� 4 21 t DEPARTMENT' OF .P LIC SAFETY 2110 -ONE ASHBURTON PLACE, RM 1301 PAID BOSTON,:,o�8 02108-1618 �.; FS 1596 CONSTRUCTION SUPERVISOR LICENSE ray_ =3 Number: Expires: -_' —= Q`p Restricted To: 00 -=--� = 0 a- SPIROS A BALODIHAS F Detach bottom, fold sign on 35 CARLA RD � �"�-'w$ -a=` back, and laminate license card. HYANNIS, MA 02601 - `' = Keep top for receipt and change - ae of address notification. DEPARTMENT Of PUBLIC SAFETY Restricted To: 00 42110 CONSTRUCTION SUPERVISOR LICENSE 00 - None 9w, lumber: Expires: 1G - 1 & 2 Family Homes Restricted To: 00 Failure to possess a current edition of the Massachusetts State Buiilding Code .V1 vrciv SPIROS A BALODIMAS . is cause for revocation of this license. 35 CARLA RD HYANNIS, MA 02601 Application to Old Kings Highway Regional Historic District Committee, in the Town of Barnstable for a QJ O 4 �19 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: a 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). March J2,' 1996 TYPE OR PRINT LEGIBLY DATE - ADDRESS OF PROPOSED WORK. 35 Peter Blossom Lane ASSESSORS MAP NO. R088 007.009 OWNER Highview Realty Trust C h r ' ASSESSORS LOT NO. 10 HOME ADDRESS 1600 Falmouth Road. Centervil l p, MA 0262 TEL. N0. 508-778-4700 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). SEE ATTACHED PLAN SHOWING ADJACENT PROPERTY OWNERS. AGENT OR CONTRACTOR Home Improvement of Cape Cod, Inc. TEL. NO. 508-771-2323 ADDRESS 182 Barnstable Road, Hyannis, MA 02601 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). !7 SEE ATTACHED BUILDING PLANS AND SPECIFICATIONS Signed ��`� Owner-Contractor-Agent Space below line for Committee use. SO 1 rb S �D U i M gC �ReceiG��dy�HrD,E. _ 't 7 Da �T. a Certificate ereby Date pem Trine 2 gy TOE n;nT'�; Approved ❑ IMPORTANT: If Certificate is ap ved, approval is subject to the 10 day appeal e 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. `ar,.max 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 featuaes'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. ENVIROTECH LABORATORIES, INC. MA Cert. No.: M-MA 063 gy .ti 449 Rte. 130 • Sandwich, MA 02563 (508) 888-6460 • 1-800-339-6460 FAX(508) 888-6446 CLIENT: Aqua-Jet LOCATION: Lot 10 ADDRESS: 135 Rte. 130 Petr Blossom Ln. Mashpee, MA W. Barnstable, MA SAMPLE DATE: 4-17-96 COLLECTED BY: Mike/Aqua-Jet Wells DATE RECEIVED: 4-17-96 TIME: 9:OOAM LAB I.D. #: E4-208/E3-353 JOB TYPE: New well SAMPLE I.D. #: E4-208/E3-353 WELL SPECS. : 140, RESULTS OF ANALYSIS: Parameters Units Recommended Limit Result Coliform bacteria/100ml (MF Method) 0 0 { pH pH units 6.0-8.5 7.18 9,4 Conductance umhos/cm 500 89 Sodium mg/L 28.0 9.3 �f Nitrate-N mg/L 10.0 0.50 Iron mg/L 0.3 0,.21 Manganese mg/L 0.05 0.021 Volatile Organics See enclosed report. t EPA 54 ug/L None detected k. Yes No WATER IS SUITABLE FOR DRINKING PURPARAMETERS TESTED. XXX �,:UTC4,' Date , 4 Ronald J. Sa ri Laboratory Director LT = Less Than LAPUCK LABORATORIES, INC. ENVIRONMENTAL TESTING WASTE WATER DISCHARGE 50 Hunt Street TESTING Watertown, MA 02172 FOOD ANALYSIS (617) 923-0300 CHEMICAL ANALYSIS Fax (617) 923-0301 FORENSIC TESTING REPORT LAB NO. 54778-B April 09, 1996 Mr. Ron Saari ENVIROTECH LABORATORIES, INC. Sample Received: 03/29/96 449 Route 130 Client I.D.: Aqua Jet Sandwich, MA 02563 Sample I.D.: Lot#10-Blossom Test Results: Volatile Organics- ppb(ug/L) Method#524 Benzene N.D. 1,2-Dichloropropane N.D. Bromobenzene N.D. 1,3-Dichloropropane N.D. Bromochloromethane N.D. 2,2-Dichloropropane N.D. Bromodichloromethane N.D. l,l-Dichloropropene N.D. Bromoform N.D. Cis-1,3-Dichloropropene N.D. Bromomethane N.D. Trans-1,3-Dichloropropene N.D. N-Butyl Benzene N.D. Ethylbenzene N.D. Sec-Butyl Benzene N.D. Hexachlorobutadiene N.D. Tert-Butyl Benzene N.D. Isopropylbenzene N.D. Carbon.Tetrachloride N.D. P-Isopropyltoluene N.D. Chlorobenzene N.D. Methyl Chloride N.D. Chloroethane N.D. Naphthalene N.D. Chloroform N.D. N-Propylbenzene N.D. Chloromethane N.D. Styrene N.D. 2-Chlorotoluene N.D. 1,1,1,2-Tetrachloroethane N.D. 4-Chlorotoluene N.D. 1,1,2,2-Tetrachloroethane N.D. 1,2-Dibromo-3-Chi oropropane N.D. Tetrachloroethene N.D. Dibromomethane N.D. Toluene N.D. 1,2-Dichlorobenzene N.D. 1,2,3-Trichlorobenzene N.D. 1,3-Dichlorobenzene N.D. 1,2,4-Trichlorobenzene N.D. 1,4-Dichlorobenzene N.D. 1,1,1-Trichloroethane N.D. Dibromochloromethane N.D. 1,1,2-Trichloroethane N.D. 1,2-Dibromoethane (EDB) N.D. Trichlorofluoromethane N.D. Dichlorodifluoromethane N.D. Trichloroethane N.D. 1,1-Dichloroethane N.D. 1,2,3-Tr ichIoropropane N.D. 1,2-Dichloroethane(EDC) N.D. 1,2,4-Trimethylbenzene N.D. 1,1-Dichloroethelene N.D. 1,3,5-Trimethylbenzene N.D. Cis-1,2-Dichloroethylene N.D. Vinyl Chloride N.D. Trans-1 2-Dichloroethylene N.D. Total X lene N.D. N.D. =Not Detected Analysis Date : 04/08/96 Method Detection Limit =0.5 ug/L Recoveries of Surrogate- 1,2-Dichlorobenzene-d4 80 P-Bromofluorobenzene; 100 D.E.P. -MA 061 Testing" & Consulting Services ),;,Ijn:es Fontenarosa, Lab Manager For over 30 fears . . . This report is rendered upon the condition that it is not to be reproduced wholly or in part for advertising or other purposes over our signature or in connection with our name without special permission in writing. "Total liability is limited to the invoiced amount. The results listed refer only to tested samples and/or applicable parameters. y c000 PLAN APPROVAL I, LAURIE P. SNOWDEN, Trustee of HIGHVIEW REALTY TRUST, under Declaration of Trust dated June 12, 1991 and recorded in Barnstable County Registry of Deeds in Book 7579, Page 193, Document No. 627572, hereby approve the S#e and Sewage Plan as: drawn by Down Cape Engineering, Inc. , 939 Main Street, Yarmouth, MA and dated February 26, 1996; and the Building Plans as drawn by Devlin Custom Designs, 56 Kerry Drive, Marstons Mills, MA and dated March 7, 1996 for the construction of a single family home on LOT' 10, ' 35 Peter Blossom Lane, West Barnstable, Massachusetts as shown on Land Court '° Plan 40599-B (sheet 3) . IN WITNESS WHEREOF, I; -LAURIE P. SNOWDEN, as Trustee, hereby acknowledge execution hereof this March" 12, . 1996. HIGHVIEW REALTY TRUST i� urie P. owden, Trustee COMMONWEALTH OF MASSACHUSETTS i Barnstable, ss. March 12 , 1996 Then personally appeared the above named Laurie P. Snowden, Trustee, and acknowledged the foregoing instrument to be her free act and deed, before me, Notary Public ' My commission expires: ..1Aw�,r.Fy 2•S, 2002 /14211 P w (� TOWN OF BARNSTABLE BAR—W 4093 r Ordinance or Regulation �'SSIA r --713) )�3 WARNING NOTICE Name of Offender/Manager ! r ih 1 o_ T�e_oJo f OlA Address of Offender MV/MB Reg.# Village/State/Zip Business Name am/pm, on 20_ Business Address L oP k S ' a re of Enforcing Officer Village/State/Zip W. ?30.cv\A0 b1f. ; as' O-to�8 Location of Offense 35 Peke- 910Ssom 1--ake- sto UI '' II LL --tt Enforcing Dept/Division Offense (�UOf'f�� loca�l (h 2rm%"� Facts ICt L'0►�� LILC MCohS [rLAC,+ o j fi�n►r� o of �r.�rr e a( r remove or del"oliS4 �li, r S�uC+4f< „ 6ta.n;k 'tie uincd This will s rve only as a warning. At this time no legal action has be taken. Pe It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. P TOWN OF BARNSTABLE BAR-J. 40=43 Ordinance or Regulation 55LA E__ WARNING NOTICE { �1-31 ) Name of Offender/Manager Vi rain i ae00o f OUl v Address of Offender MV/MB Reg.# Village/State/Zip Business Name am/pm, on 20_ Business Address Lit. c7p �-- S ' aide of Enforcing Officer Village/State/Zip �,J, .�YrST0. � Mass , =0Z 8 Blossom i 1 Location of Offense 35 Pe-kec� bosom �Ahe Enforcing Dept/Division Offense (,t�p('�C� r1 W iOk� Q NOerm nn l Facts !280 elne J)D, I _+ s1��,it be. wt{`law-(L I 4n 0_c K5krc&C_+, rP_coas`{� _( ruc+ ** %okt 'Fit,r1' A )�fr ,. reQai r, remove or dPMo�isA a Iu;)Ji Ks nr S�uC+W,( to. 6� 1 4K4 tic �jui.ed This will s rve only as a warning. At this time no legal action has been taken- pert; It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. T - - .. _�-,..t...._ . .•r..-•-.r...,�...-y-^r v-,-r---:-••<..-,.v -.v....--... .--...rr'x•�w�vr -."-.; .. -., .. � .. .. 6 P TOWN OF BARNS TABLE BpR_14 6093 Ordinance or Regulation -•�'C'S� �� WARNING NOTICE 7)-31 > Name of Offender/Manager V lr4 n k Q , b e-0jo rOU. Address of Offender MV/MB Reg.# Village/State/Zip Business Name am/pm, on 20_ Business Address J L r \\ ++ SITn re ;of Enforcing Officer Village/State/Ziprh5"tq� 1eQS , Location of Offense 35 N4e-r ,Q os-5om �Ahe Su' �c�� nck Enforcing lDept/Division Offense Oorkl eke, w'ii AAou� Q ioe.rryv1%_� Facts r790 L'#74C PD; 1 . _T+ shell be u41aw-Z ` n con+ r"C+ , recons4ruJ 1 A 4er , re-oa; r, remove or jes"o1jsA a lu, )JI'oo or S4rac Off A6 :nolie, +At rgtrinj This will serve only as a warning. At this time no legal action has been taken. Pcp,+ It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. TOWN OF BARNSTABLE BAR_W Ordinance or Regulation WARNING NOTICE Name of Off ender/Manager +'"Ile -C a ill,a ", Address of Offender MV/MB Reg.# Village/State/Zip Business Name am/pm, on 20_ Business Address S gnature �of Enforcing Officer Village/State/Zip r Location of Offense jw Enforcing "Dept/Division Offense y i Facts ���✓vy �a<:� L,,� �, a G ��� N = ;� _� - f _ ., . This will serve only as a warning. At this time "no legal action has been taken. , It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. The Town of Barnstable o� BAR E.MAS& p• Department of Health Safety and Environmental Services MASS O i639.1, Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-790-6227 ell" Ralph Crossen Fax: 508-790-6230 Z� Building Commissioner Inspection Correct' otice Type of Inspection Aj Location 61 pe-I-C4 6-STIOYI-4 Permit Number Owner Builder (VIA One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: -� W Ll %� VN i . ���,,.y ►^.� 1 l &two r-N l 1 ,� �� S eat Sru ST�� �-S TS -I-op Poke 0 kw t4 L`-b -`" 'l•.d A-X `f Please call: 508-790-6227 for re-inspection. d Inspected by Date V . �f r�'^T�.P'.►' ..-._ � Y-v.—...-,^Y�r.'.T"i+.. -.-.�y�-:-..�..+�.r`rr.*+..,..`r(+nr'Y.r".1�:r-.-.��+^�„{j•�Y vsw�.ro,.�� ,jr. t�l+. �^J'�`+ o"R'�T'�2'..� ati--+ 'i���`f.+�-..,.'',. .err". "�tirr..n.{Y-✓-"�..r BIKE 11, The Town of Barnstable ' BARNSTABLE. Department of Health Safety and EnvirO mental Services t619 �Eo Building Division 367 Main Street, Hyannis,MA 02601 Office: 508-790-6227 j Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction"Notice Type of Inspection 1j C P f _ Locatioi E, �. Permit Number Owner Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: G� pe-rvt ��� �� r L ► 1 r n I Please call: 508-790-6227 for re-inspection. Inspected by Date - (1--- ' 1 pF1NE A The Town of Barnstable BARNSM LE. • 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 L Inspection Correction Notice TI pe of Inspection �--- Location`,�g Permit Number Owner Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: rll.., p • fC J �.�--/.,t f(' � i11 i4 r l, � �(' ��1!'C r' .�� .�.�,�0�'7a •`55 Jn �► ( A o arr o-t w i Please call: 508-790-6227 /fore-inspection. Inspected by -, Date `7 r r To- Date Date /Z " �C�Time � WHILE YOU W RE OUT M. of Phone Area Code Number Extension PH E LEASE CALL CALLED TO SEE YOU 4 WILL CALL AGAIN WANTS TO SEE YOU URGENT nRE_TURNED YOUR CALL Message 3S cd • la, Operator AMPAD 23-021-200.SETS EFFICIENCY® 23-421-400SETS CARBONLESS 40 I F ADJACENT PROPERTY OWNF�ftS Lot 9, Peter Blossom Lane William & Adrienne- Spellacy 59 Moulton Road., `Duxbury, MA 02332 !� \l••, !�,-''`' a=. ley`, fo+• e. � t,n"^aet,N�,.► :1 �, _ Lot 11, Cedar Street Kristen Nugnes Street H annis-, MA 02601 ram . ., as"•a e�)e• r 56 Norris .� ..o i L Lot 12, Peter Blossom Lane Agostino & Jane .Ruggiero 45A Brentwood Street, Malden, MA 02148 . . ` 04 Lot 16, Peter Blossom Lane �t Highview Realty Trust e D 1600 Falmouth Road, Centerville, MA 02632 Lot 59, Cedar Street Patrick & Lois Ann Demko 765 Cedar St. , W. Barnstable, MA 02668 ,_` ►i*as e�o�se... (y�� e!\ ,ea.{••• Lots 57 & 58, Josiah's Path Michael J. Princi & Donald W. Nickulas P.O. 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