Loading...
HomeMy WebLinkAbout0350 SANDY NECK ROAD y i OxfordNO. 152 1/3 ORA x o o © m ,�� 1d ��' 1 a '',l —"� J� p � i r _ — � �. I I' �� i ' � � �. ��� � ��C _ �� 1� � r r 1 __ 9 ®� ��� �. -- �., ;. sGv� � f - �, �� �� -- - - �i: �:. y �; i uwu pi Darastame Building Department Services FtHe tqk� Brian Florence,CBO o* Building Commissioner ' f f &AMNGrA=. 200 Main Street,Hyannis,MA 02601 . v 039• ��� www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date.: d;r c1 7. Name: \(I cl�Z l Phone#: -77 H' a`3�— gS&a Address-: Sr yn c�►�l nC��- 1«\ Village: k/'S Name of Business: S <— C nc�Sc id1 Type of Business: Lc•sA Map/Lot i3`� Av INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,'subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the.dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is tamed on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • " Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing-the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included • No person shall bg employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and with the above restrictions for my home occupation I am registering. Applicant: Date: F / Homeoc.doc Rev.06/20/16 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which your must do.by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this forrn.at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA.02601 (Town Hall) and get the Business Certificate that is required by law. MR]Laf DATE: "a �- l Fill.in please: ay.p. 't '} : APPLICANT'S YOUR NAME/S: =4` Y BUSINESS Y E S: R HOME^^��DD t� is rrls S> _TELEPHONE # Home Telephone Number ti rw EIN':'or; Email Address: NAME'OF CORPQRATION: NAME OF NEW'BUSINESS TYPE OF BUSINESS IS.THIS-A HOME:OCCUPATION?. ES NO. ADDRESS OF BUSINESS ' 'S� S 1U2C, MAP/PARCEL NUMBER t J I (Assessing). When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is"intehded to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits.and licenses required to,legally operate your business in this town. 1. BUILDING C MISSIO R'S OF E This indivi ual h e n�nf�r a any �mt e ui eme is that pertain to this type of business.MUST COMPLY WITH HOME OCCUPATION RULES AND REGULATIONS. FAILURE TO Auth d i rlatu * ?_OPAPLY MAY RESULT IN FINES. COMMEN U 1 2. BOARD OF ALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual-has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: l_ Message Page 1 of 2 Anderson, Robin From: Kaspan, Steve Sent: Sunday, July 10, 2016 2:46 PM To: Hartsgrove, Elizabeth; McKean, Thomas Cc: Anderson, Robin; gallantt@barnstablepolice.com Subject: RE: Beach parking & Hot Dogs I took a look at this location Saturday. The attendant at the gate said the properties do take in parkers when the beach gets full. He said they did this last year as well. If the weather is good next weekend, I will be back. -Steve -----Original Message----- From: Hartsgrove, Elizabeth Sent: Wednesday, July 06, 2016 9:05 PM To: Kaspan, Steve; McKean, Thomas Cc: Anderson, Robin; gallantt@barnstablepolice.com Subject: Fwd: Beach parking & Hot Dogs Steve, can you swing by this location to verify if an illegal parking lot and hot dog cart is operating, over the weekend? Thanks L Sent from my iPhone Begin forwarded message: From: "Anderson, Robin" <Robin.Anderson(cD-town.barnstable.ma.us> Date: July 6, 2016 at 12:15:18 PM EDT To: "Hartsgrove, Elizabeth" <Elizabeth.Hartsgrove .town.barnstable.ma.us> Cc: "McKean, Thomas" <Thomas.McKean(@town.barnstable.ma.us> Subject: Beach parking & Hot Dogs HI Liz, just got a complaint about private beach parking and a hot dog truck. The caller stated that 350 Sandy Neck Rd, WB is (for a fee) accepting over flow beach parking and shuttling customers in a golf cart to the beach. In addition, they have set up a hot dog truck and are selling food items from the same location. They have a sign on the property indicating that they are parking cars. I assume the hot dog truck is informative enough to notify the willing public about its products. I was also informed that the 380 Sand Neck also solicits over flow parking and has its own sign on site as well. 7/11/2016. Message Page 2 of 2 Both properties fill up only after the beach is full and closed to additional vehicles. I am not aware of what time the hot dogs sales begin but I would guess around noon. The activity occurs only on the week-ends (so far) so I thought maybe your parking staff could check this area for evidence of overflow parking and hotdogs. If they could snap a photo of the hotdog truck that would help us address the health & zoning issues associated with that unpermitted use. Thank you for your anticipated assistance with this matter. Please advise. p�g6Le Robin C.Anderson Zoning Enforcement Officer 200 Main Street Hyannis,MA 026oi 5o8-862-4027 7/11/2016 . 1 M rTM i w ■ ��j • t - ` _'firow N . + • .fo./ .J K I i � > Town of Barnstable Regulatory Services Richard Scali, Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Hand Delivered: Mr. Adrian Vickers August 31,2016 350 Sandy Neck Road West Barnstable,MA NOTICE TO CEASE AND DESIST PREPARATION OF FOOD AND SERVING/SELLING FOOD FOR THE PUBLIC The Town of Barnstable Health.Division recently received complaints that you are allegedly preparing and serving foods at 350 Sandy Neck Road, West Barnstable Massachusetts, without a valid permit from the Town of Barnstable Board of Health. Food prepared a private home and served to the public, without a valid permit from the Board of Health violates Section 8 of the Federal Food Code and.violates 105 CMR 590.004 and 590.012 of the STATE SANITARY CODE CHAPTER X—MINIMUM SANITATION STANDARDS FOR FOOD ESTABLISHMENTS as per below: 590.004: Food—federal 1999 Food Code Chapter 3 (A) FC 3-201.11(B)Food Prepared in a Private Home. Food prepared in a private home may not be used or offered for human consumption in a food establishment except as provided in 105 CMR 590.000. 590.012: Permit to Operate—Federal 1999 Food Code Chapter 8-3 (A)Mobile Food Operations. In addition to the requirements set forth in FC 8-301.11 Prerequisite for Operation:The operator of a mobile food operation shall obtain a permit to operate from each board of health in whose jurisdiction he sells his product. (B) FC 8-302.12 Application Form,Approved. FC 8-302.12 A person desiring to operate a food establishment shall submit to the FC-regulatory authority a written application for a permit on a form provided by the board of health and approved by the department. (C) FC 8-3 Permit.Form. In addition to requirements set forth in FC 8-3 Permit to Operate: (1)There shall be one permit form issued to each food establishment. Federal Food Code: 8-302.12 Form of Submission. A person desiring to operate a food establishment shall submit to the regulatory authority a written application for a permit on a form provided by the regulatory authority You are ordered to immediately cease and desist from preparing any foods intended for public consumption at 350 Sandy Neck Road, West Barnstable,MA. , You are also ordered to cease and desist serving and/or selling any foods to the public within the Town of Barnstable. You may request a hearing if written petition requesting same is received by the Board of Heath within seven days. Q:vickers 350 Sandy Neck Road.docx.docx Any person who fails to comply with any order issued pursuant to 105 CMR 590.000 shall,upon conviction,be fined not more than$100 for the first offense and not more than$500 for a subsequent offense. Each day's failure to comply with an order shall constitute a separate offense. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, CHO. Director of Public Health Town of Barnstable i i i Q:vickers 350 Sandy Neck Road.docx.docx Message Page 1 of 1 Anderson, Robin r To: Hartsgrove, Elizabeth Cc: McKean, Thomas Subject: Beach parking & Hot Dogs HI Liz, I just got complaint about private beach parking and a hot dog truck. The caller stated that350 Sandy Neck Rd, WEB is (for a fee) accepting over flow beach parking and shuttling customers in a golf cart to the beach. In addition, they have set up a hot dog truck and are selling food items from the same location. They have a sign on the property indicating that they are parking cars. I assume the hot dog truck is informative enough to notify the willing public about its products. I was also informed that the 380 Sand Neck also solicits over flow parking and has its own sign on site as well. Both properties fill up only after the beach is full and closed to additional vehicles. I am not aware of what time the hot dogs sales begin but I would guess around noon. The activity occurs only on the week-ends (so far) so I thought maybe your parking staff could check this area for evidence of overflow parking and hotdogs. If they could snap a photo of the hotdog truck that would help us address the health & zoning issues associated with that unpermitted use. Thank you for your anticipated assistance with this matter. Please advise. I Abu Robin C.Anderson Zoning Enforcement Officer 200 Main Street Hyannis,MA 026oi 508-862-4027 7/6/2016 c3�5� Spa-��� ,t1.c� f . ����� �' o��- 1�I � _ - ��� G� �. . �� •.�f �vt, rn�h , EAST SANDWICH. MA VARIANCE REQUESTED THIS Is A� /� _/�_ syq� oPa MAY BE GRANTED IMMEDIATELY BY HEALTH AGENT OR HEALTH INSPECTOR. 32 COLOR OIr�C ' EL // E V A T§O�II S '�T / 310 CMR 15.221(7) - COMPONENT `VJ PLAN Il �l ELEVIAATIONS SPECIFIED ARE INVERT ELEVATIONS DEPTH TO FINISH GRADE. 36 in (BOTTOM OF PIPE) EXPRESSED IN DECIMAL FEET (� O MAX REQUIRED - VARIANCE TO / USE COLOR PLAN ONLY 60 in OF COVER REQUESTED. FOR INSTALLATION SEWER LINE OUT - EXISTING 34.25 ` y / �� r FULL DETAIL IS BEST SEWER LINE OUT - GARAGE 33.00 ` VIEWED IN SEPTIC TANK IN 31.75 I a NOT FULL SEPTIC TANK OUT 31.50 9ov ` TO T • \ D-BOX IN 29.33 e 6q/ '9q,VeF SCALE\ D-Box OUT 29.16 '9Ay ` LEACHING SYSTEM IN 29.00 S, o'S'kq y BOTTOM OF LEACHING 27.00 WEST BARNSTABLE. MA 10 PhLOCUS MA 'P 4 �O\O L Oo T 2 AREA = 1119 aC f EL EVA TION �0 33. 89 48.744 sf f P 33 OF CONCR9( g0� PLAN BOOK 392 PAGE 48 A SSR MAP 136 Pa 14-2 / ; 2 34 CONTOUR �^ 35PROPOSED SOIL `� m* ABSORPTION / / �Q` / �-� i/i�''• oil. •9C may'"'- SYSTEM -PROVIDE VENT PIPE ro G9 , AL -SEE DETAIL AR ON BACK ® / ®# s o. IVE / ® n , C 9a'90 1 FEET RAL , C� \33 WELL GARB \34 ® OQ �� OT O Q OWED � ., 35 `? / � pQ\JF, 6 OF Mgss9y tN OF Mgss9 °9 8 �' DAVID CyG 7/�Iv/J � \ po � DAVID o o 3 S�. \ O COUGHANOWR COUGHANOWR 37 No. 1093 No. 461 37NOTES VET lV SOIL REMOVAL AREA - REMOVE ALL FILL I c n ; AND UNSUITABLE SOILS DOWN TO THE O� '� JeNt 2-4, Z�I O pO�FTy C2 STRATUM AND REPLACE WITH CLEAN MEDIUM SAND PER TITLE 5 `e (3/� CMR 16.255(3)). �c0 38 THIS'PLAN IS INTENDED SOLELY FOR INSTALLATION OF THE SEPTIC SYSTEM GF DEPICTED T IT. FOR ANY OTHER CHANGES S THE PROPERTY INCLUDING LEGEND ���^ n� PLACEMENT OF ADDITIONS. SHEDS. FENCES OR SWIMMING POOLS. OWNER EXISTING 1000 GALLON SEPTIC TANK �� /,�n -4`F 39 /Ll� W SHOULD CONSULT WITH A MASSACHUSETTS REGISTERED LAND SURVEYOR. IS TO BE PUMPED. COLLAPSED AND u v EXISTING . SEWAGE DISPOSAL ABANDONED /N PLACE OR REMOVED. 39 1000 GAL E3 SYSTEM PLAN SCALE. 1 in = 30 ft \ _ SEPTIC TANK -TO SERVE EXISTING DWELLING ABANDON EXISTING LEACHING 1 30 60 1500 GAL JEAN K E I R SYSTEM /N PLACE. • 10 SEPTIC TANK " 0 20 30 \OWNER SHALL OVERSEE FINAL GRADINGRUSSELL • • SCHEME. DO NOT ALLOW RAINWATER PRINT ON 11 x 17 in PAPER DISTRIBUTION BOX n Ec? OF RECORD FOR PROPER SCALE TEST PIT ® 350 SANDY NECK ROAD RUNOFF TO POND OVER SYSTEM. WEST BARNSTABLE. MA NO OTHER WELLS WITHIN 750 ft OF P.O. BOX 1265 PROPERTY ADDRESS INSTALLER TO INSTALL VENT P/PE THE PROPOSED LEACHING GALLERY WEST CHATHAM. MA PEEAR CODE. 02669 IDATE. SEPTEMBER 20. 2014 -- 508 364-0894 PG.1/2 -jDe, ETE-3863 SU�IL EST LOo DESIGN C f� L C U L , , T I O® N S SEPTIC 1500 GALLON TA-.-DIMENSIONS & DETAIL NK DISTRI6UTION SOX SOIL EVALUATOR: DAVID D. COUGHANOWR. ASE 0461 DESIGN FLOW: 4 BEDROOMS X 110 GPD = 440 GPD WITNESSED BY: DONALD DESMARAIS, HEALTH DEPT. SHOREY ST-1500-H-70 '• �' SEPTIC TANK: 440 GPD X 2 DAYS = 880 GALLONS TEST PIT � NO GROUNDWATER ENCOUNTERED t � 2 MIN/INCH IN C2 SOILS INSTALL NEW 1500 GALLON SEPTIC TANK. .�� ' ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER DISTRIBUTION BOX: USE SHOREY DB-3 H-20 1 in NOT 12 ,n INCHES HORIZON TEXTURE (MUNSELL) MOTTLES T A PER T O MIN 33.70 p SOIL ABSORBTION SYSTEM: t ., -r -► 0-5 A LOAM 10 YR 4/2 NONE FIRM SCALE to 5 _ -► THE LONG TERM ACCEPTANCE RATE FOR A CLASS ONE = © FROM ' 5-27 B SILT LOAM 10 YR 4/3 NONE FIRM �� ,A� t N TANK V3 to TO SOIL WITH A PERCOLATION RATE BELOW 5 MINUTES .o. -� a K 545 27-104 Cl SILT CLAY 2.5 Y 6/3 NONE FIRM PER INCH = 0.74 GALLONS PER DAY PER SQUARE FOOT. 5 ft- O. 25.03 LOAM THE 41.5 ft x 12.83 ft x 2 ft LEACHING GALLERY ° f ' 8 in e ,n sr�oNE SASE 17.70 J104-19� C2 MEDIUM SAND 10 YR 5/6 NONE LOOSE DEPICTED BELOW CAN LEACH: - r� NO GROUNDWATER ENCOUNTERED BOTTOM AREA = (41.5 x 12.83) = 532.44 sq. ft. fi \� 21 in 2 CROSS SECTION VIEW TEST PIT 2 2 MIN/INCH IN C2 SOILS SIDEWALL AREA = [2x(41.5+12.83)] x2 = 217.32 sq. ft. ELEVATION DEPTH SOIL USDA SOIL SOIL COLOR SOIL OTHER TOTAL AREA = 749.76 sq. ft. INCHES HORIZON TEXTURE (MUNSELL) MOTTLES FLOW CAPACITY = 0.74 x 749.76 = 554.82 gal/day /Q ft-6 /n J 33.85 0_8 Ap LOAM 10 YR 4/2 NONE FIRM INSTALL A 41.5 ft x 12.83 ft x 2 ft GALLERY AS CONFIGURED 8-30 B SILT LOAM 10 YR 4/4 NONE FIRM BELOW. FLOW CAPACITY = 554.82 gal/day WHICH EXCEEDS S O I L ,A S O R P T 1 O N 30-108 Cl SILT CLAY 2.5 Y 6/3 NONE FIRM THE 440 gal/day REQUIRED. INLET CENTER OUTLET SYSTEM"CONSTRUCTION DETAIL g y COVER COVER COVER 24.85 LOAM q �. ,. .:.�. -..� USE SHOREY PRECAST 500 GALLON LEA CHING ►. YWELL 18 02 108-19J C2 MEDIUM SAND 10 YR 5/4 NONE LOOSE �3 IN DROP FLOW LINENy 1 -. DRYWELL 41.5 ft PERCOLATION RATE BU��NG to in = 14 TO UNIT DETERMINED TO BE LESS THAN 2 MINUTES PER INCH '^` D-BOX w v w BY SIEVE ANALYSIS OF 911712014 (99% SAND). 48 in -�r y, 00 co co IrL� OOUIT Ir'L��IIV ?. LIOUID GAS a`ho �,. �® � . ® j 4 MAIN LEVEL. BAFFLE N N w HOUSE BATH ' STONE N -INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE 4 tt8.5 fta tt8.5 ft4 ft8.5 ft4 ft STARTING WORK. ROOM BED 6 in STONE BASE -ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM ROOM SEPARATION BETWEEN INLET & OUTLET 41.5 ft 30 REQUIREMENTS OF MASSACHUSETTS TITLE 5 SEPTIC TEES NO LESS THAN LIQUID DEPTH 5�� GALLON DR YWEL L 0 CODE (310 CMR 15). UPPER FLOOR T -INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND CROSS SECTION VIEW DIMENSIONS & DETAIL INSTALL ONE INSPECTION I UTILITIES BEFORE EXCAVATING FOR SYSTEM. 0 RISER TO WITHIN THREE BREEZE INCHES OF FINAL GRADE I -ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION GARAGE KIT- - & INDICATE LOCATION OF LOW FLOW FIXTURES & APPLIANCES. AND PERIODIC WAY CHEN BED ON AS-BUILT PUMPING OF THE SEPTIC TANK. LIVING Roots 9E0 BA H ROOM �p 36 -SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. ROOM r.:., .,• 0ppy DO NOT PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM. in usE 102 /n TOP OF FOUNDATION RAISE COVERS TO WITHIN ALL PIPE TO BE SCH. 40 PVC VENT CROSS SECTION VIEW EL = 37.41 +- b in OF FINAL GRADE AND TO PITCH AT 1/8 in/ft MIN ____j PIPE INSTALL AN APPROVED GEOTEXT/LE -\34.00 35.00 FABRIC OVER STONE =BO 5' usE o H-20 .• ' , 314 in TO �© 24 in .�, 3/4 in TO USE H-20 MAX RATED 28 �1-I/2 in GRAVEL! EFFECTIVEc I-)/2 1. GRAVEL INSTALL �� 30.00 UNITS OBSERVED G W NONE AT 17.70 in _ �+� DEPTH .�� 34.25+- //�� pp pp ��pp INDEX WELL SDW-252 48 in 58 in 48 in �eJ00 GALLON oo °uovoo ZONE A 0o PRECAST M o4READING DATE AUGUST. 2014EXISTING SEPTM TANK 31.50 29.16 054 in ��$�0°�o8 DRYWELL °0a° READING 47.40 ALL STONE TO BE 1 DOUBLE WASHED AND 31.75 SEE DETAIL ON BACK 6 in SOQ L QBSORPTPON + ADJUSTMENT 1.5 FREE OF IRONS. DUST AND FINES IN PLACE 29.33 STONE 29.00 ADJUSTED GW BELOW 19.20 BASE SYSTEM -SEE DETAIL o) 25 ft 6 in STONE BASE 61 ft a) 4.5 ft PAGE 2 0Lo - b) 54 ft b) 16 ft 27 00 ADJUSTED SEASONALTJ w G OUNDWATER - 19.20 5rWAGE DISPOSAL SYSTEM PLAN 350 SANDY NECK ROAD WEST BARNSTABLE. MA SEPTEMBER 20, 2014ETE-3763 PG 2/2 Message Page 1 of 1 Anderson, Robin From: Miorandi, Donna Sent: Monday, September 22, 2014 4:13 PM To: Building Dept Cc: Heath DeptMaiIbox Subject: 350 Sandy Neck Road Hi All: I have building dept. file for this address. They have a permit for a 2 car garage only but now they say they have a bedroom in the garage. Past septics state three bedrooms for the main house and now they say they have 4 bedrooms.??????? Donna 02-1 0,C) jo i 9/29/2014 i TOWill, OF RARNSTABLE INS ULATVON 2Q4y APR 16 Al 8, 28 IFV]7®® 1— 31 ilA IM W TWAN 1N6I1N010 BARS Gonm IHSu-noN C ma, 1-800-696.-6611 DIlIICtiC ""own of Barnstable Regulatory Services 'RS` Building Division a0` 200 Main St Hyannis, MA 02601 „r r r Date: is-a -13 Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BP'1) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village J ea�t 12� 36-D 5m,cy AckAD 4 Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( K) (k ) ( yam ) ( ) (X) Slopes ( ) ( ) ( ) ( ) ( ) Floors ( ) ( ) ( ) ( ) ( ) Walls ,Qt✓t-- a�nS Sincerely He ry E Cas y Jr, President C• e Cod I - ulation, Inc. TOWN OF BARNSTABL-E BUILDING PERMIT APPLICATION ' J ," � � BARS TA BE LE Map Parcel Application # Health Division 7,013 AUG 15 AM q: 47 Date IssueddO Conservation Division Application Fee Planning Dept. Permit Fee DIVISIOI'I Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address Village ��';-�,� Owner *OAI �y��S /` Address -S Telephone Permit Request G✓Dd Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ,S�.3a op , z2Construction Type ftz�0)f a,. Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes PI No On Old King's Highway: ❑Yes XrNo Basement Type: ❑ Full ❑ 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: existing _new Total Room Count (not including bath;): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No 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 ❑ A Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use - - - APPLICANT INFORMATION J (BUILDER OR HOMEOWNER) Name f ��� Cod Zx4fi,, -4.00 Telephone Number 1� �'��/�f � Address �� �� f ro g, License # ./� &IN, Home Improvement Contractor# Worker's Compensation #AL&0OD_i�Jae ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ` SIGNATURE DATE // // 3 j _ • FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED Y! g r; MAP/PARCEL NO. i ' ADDRESS VILLAGE OWNER st DATE OF INSPECTION: -FOUNDATION.,- FRAME INSULATION h � FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL t 1 _ GAS: ROUGH FINAL F FINAL BUILDING • I DATE CLOSED OUT ASSOCIATION PLAN NO. Y w i '• �Ires.,:u•Irusctts - l)c11:u'hUcol of Puhlic Ltfc1� 13u;.rrd ul 13eril'tlinh Rc ul:ltjolo mid "m;1od:11-ds Qonstruption Supervisor License Ltcen '.CS 100988 ,r- W�6 HENRY CASSIDY 8 SHED ROW . ._ WES;)- 1JARMOUTH, MA 02673 ' <fi., d• ___Y ------- Expiration:-�- Expiration: 11/11/2013 l , nurri...i ucr Tro: 7620 I i _ ��`l�' C�yYl�y�[-CZ'`2•ll..�E'CGI `!- Cz >�/MY.;1 Okt`ice of Consumer Affairs and Business Regulation =� 10 Park Plaza - Suite S 170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/4)14 Tr 1i 23;3831 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE ------.....__._.._-..-...-_-.............. SO. YARMOUTH, MA 02664 ...............-...... _._.____ _...__... __ . Update Address and return curd. Marls rclrson for change. 17 Address LI Renewal lant.11oynluut I.. I Loss Card rr• r•r.n�ircri[rrc:rrll� O`C <'r.i7JJRC.7rult:r�J .—A Unirc rrr Crnrsumcr Aff,rirs a Badness RegulaIio„ before the ex Lict nse or registration Valid for individul use only TOME IMPROVEMENT CONTRACTOR P tralion date. If found return to: eyistration: 153567 Type: Office of Consumer Affairs and Business Regulutiou xpiration: 12/15/2014 Private Corporation 10 Park Plaza-Suite 5170 Boslou,MA 02116 t:rd'I:C00INSULATION,.�1NC' t113NIO' CASS10)' 18 RFA120)N CIRCLE �v. Sid Y,\Rib10t11 I1. MA 02664 ------- — • —. _ ._.- ._ .._._._.______..._...._ . 1-ludcrsr.crcUIry of Val, 1VIf110 ( ' nat re The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations kip 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 1,94Ao Address:_ ./J City/State/Zip: Phone #: -5--Z, 77,;,./Z/ C�_ Are you an employer?Check the appropriate box: general contractor and I Type of project(required): 1.❑ I am a employer with' 4. ❑ I am a g employees(full 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' [No workers' comp. insurance comp. insurance.t 9. ❑ Building addition required:] 5 We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doingall work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no 3a.❑ I am a homeowner acting as a employees. [No workers' 13•❑Other general contractor(refer to#4) comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensatiodi)olicy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. j lam an employer that is providing workers'compensation insurance for my employee& Below is the policy and job site information. Insurance Company Name: ���,��/� j Policy#or Self-ins. Lic.#: Expiration Date: lo�, �/ Job Site Address � ;koJ �Z,L Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required tinder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and enalties of perjury that the information provided above is true and correct Da /-3 Ph Z % Offlcial use only. Do not write in this area, to be completed by city or town official 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#• CAPECOD-27 MYOUNG CERTIFICATE OF LIABILITY INSURANCE DATE 78/ /YYYY) /8/202013 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). PRODUCER License#PC-514062 CONTACT Margaret Young Rogers&Gray Insurance Agency,Inc. PHONE FAx 434 Rte 134 Alc No xt: AIC No South Dennis,MA 02660 E-MAIL m oun ro ers ra ADDRESS: Y 9@ 9 9 y•com INSURERS AFFORDING COVERAGE NAIC# INSURER A:PEERLESS INSURANCE COMPANY INSURED INSURER B:COMMERCE INSURANCE COMPANY Cape Cod Insulation,Inc. INSURERC:Evanston Insurance Company 18 Reardon Circle INSURER D:ATLANTIC CHARTER INSURANCE GROUP South Yarmouth,MA 02664 INSURER E: ' INSURER F: COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCEADDLSUBR POLICY EFF POLICY EXP LIMITS LTR D POLICY NUMBER MMIDD MMIDD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CBP8263063 4/112013 4/112014 PAMAGE TO_RFN REMISES(Ea occurreE n� $ 100,000 CLAIMS-MADE F;�_­l OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PROjE - LOC $ AUTOMOBILE LIABILITY -COMBINED SINGLE LIMIT 1000000 Ea accident $ > > B ANY AUTO 13MMBCKVMK 411/2013 4/1/2014 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULEDAUT AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED ROPERTY DAMAGE $ AUTOS PER ACCIDENT) $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 C EXCESS LIAB CLAIMS-MADE XONJ453512 4/112013 4/1/2014 AGGREGATE $ 1,000,000 DED I X I RETENTION$ 10,000 $ WORKERS COMPENSATION I WC STATU- OTH- AND EMPLOYERS'LIABILITY 0 LIMITS IN ER D ANY PROPRIETOR/PARTNER/EXECUTIVE Y N/A WCA00525904 6/30/2013 6/30/2014 E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) 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 I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) _ Workers Compensation includes Officers or Proprietors. Addtional Insured status is provided under the General Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN p ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 01 d Houising Assistance Corporation Cape Cod HOME OWNER WEATHERIZATION WORK PERMIT & FUEL RELEASE: PLEASE FILL OUT AND SIGN THIS FORM IF YOU ARE i THE APPLICANT HOME OWNER. I 1;15 J'ed hereby consent to and agree that weatherization wo may be done by the Weatherization Program of Housing Assistance Corporation (herein after referregd..,as "Agency') on th_e�pro�erty a d at: The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather-stripping &caulking of windows and doors, insulation of attics, sidewalls & basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows. In consideration of the weatherization work to be done at my home I agree to the following: 1. I give permission to the "Agency' its agents and employees to travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. I have read the provisions of this ement as listed and fre give my consent. _ Home Owner. (Signature) 01, _ y`�- Date:,-- A _ 1 Agent: (signature) Date: HAG approved Weatherization Company : � e-�� -'V, All Cape Energy 4p:eCod Insulation pe Save Efficient Buildings,LLC F:ro:nt i.e.r.Ene,rgyRe.sol:utian Energy TOWN .- OF BARNSTABLE PAS& %639- BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...... TYPE OF CONSTRUCTION ...... . .................. ............................................................................. . ............19.6... ............ TO THE INSPECTOR OF BUILDINGS: The undersigynidahn eby applies for a permit according to the follo formation: Location ....... ........................................... Proposed Use .... ...... .. .....ot.1.1 ....................................................... ...................... ZoningDistrict ........................................................................Fire District ........................... ....... ........................................ .. . , ......Address Name of Owner . ... . ........... flel�...... ..... +. . �97 ....................... Name of Builder e�44�17e...Address Nameof Architect ................................................................Address ..................................................................................... Number of Rooms ..................................................................Foundation ....... Exterior .... ................ .... ...........................Roofing ............................... .... . ..�.7...............................................Interior Floors ........ce� ..... Heating ....................................................................................Plumbing ........... .... ............................................................ Fireplace .....77.........................................................................Approximat,- Cost ....................................... Difinitive Plan Approved by Planning Board ---------------—--—----------- Diagram of Lot and Building with Dimensions 2- 6-0- gy IS 15A"r, A IS C'IL'i A �e So AC Aoo 4_ I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ---.. .............. Russell, Robert No ................. Permit for ........add breezeway & garage to dwelling ............................................................. Location .......Sandi -Neck Road .............................................. ......................West...Barnstable Owner ..........Robe.rt..R..a.s sell.......................... Robert.... ......... Type of'Construction. .................fXame.............. ................................................................................ Plot ............................ Lot ................................ Permit Granted April 5........................................19 67 Date of Inspection .....................................19 Date Completed ........�&� /.........19 1�01 ...... ........ .... PERMIT REFUSED ................................................................ 19 ................................................................................ .................. ....................................................... ............................................................................... Approved ................................................ 19 ............................................................................... .............. ................................................................ THE TOWN TOWN OF BARNSTABLE i 33maiTADLB, i YFY BUILDING INSPECTOR �� a• APPLICATION FOR PERMIT TO � ��......h.. .. ...... ............5�....:. ! z..... ...,........................... S .....4vaa... //. ,/ TYPE OF CONSTRUCTION d .....�l�:R.�-z..tP.........................��. .�..�..... .1.`d�.ta.'P..��,,�••....a.. - .-7.............191�rS TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following i ormation: Location ...... ........... ................. . ................................................................ ProposedUse ...........� .............................................................................................................................. ZoningDistrict ....... ...A.................................................Fire District .............................................................................. Name of Owner ..(!.1..b..b e .....'(/?:. Address 7- ...p��..d-. �.,. Pi��.....�/�.�.sue. .... / �+ /Name of Builder .. GZ l!^..SY....�,.t..�1.v�lS;. .......Address ....,�., f...�Gz.�irC�. V./...0 ................................. Name of.Architect ..�✓..�`. e�" ... sx/C .rz': ,.......Address ....AV/. ` f:f.?-/S'............................. Number of Rooms .........5....................................................Foundation .. G. E'cL�..C'Gli:C.i L'.fF'......10............. Exterior .....CN4.Q. 'Li/ii .� S..................................Roofing ...... ..... ......................... Floors ......O..0: :...................................... ..........Interior ....5'.12 F. .7�v.Q.C. .................... ................................................ Heating L. ...%'l. .P. ....te!.8: .m... /....°..................Plumbin v �g ../..I'�...�.......I�.�t:?.�x....a�... .�. .t<.......... Fireplace ...... ...............................................Approximate Cost .... ... oa • Difinitive Plan Approved by Planning Board ---------------_---------------19-------- . Diagram of Lot and Building with Dimensions Sa. „icy. Aer x� a!_a-0 I D� to �� b I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name1/..s./ .................... Russell, Robert W. 0 No ..... Permit for ... J/Lst97t...... sin le Tamil dwellin ' ....................... Location ............. Neck Road y................................................. ............... West Barnstabl ... ...................... Owner ........... ................. r. Type of Construction ..........fXaMe...................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ...December...2 19 64 Date of Inspection ..... I�.......19 II Date Completed ......................................19 PERMIT ,REFUSED ................................................................. 19 ............................................................................... ............................................................................... .......................................................... .................... ............................................................................... Approved ................................................ 19 ............................................................................... ................ ............................................................. � 517-7' �/ Assessor's map and lot number .../..✓ ...... � -..... tNs c b x �' Q Sewage Permit number .mar. Rc... ,. .its ...C?riG...2.!�7 G�I�B� IN To ' '._v ppo: :EJ C � gat�°'I .;�' •. • ISTADLE, i House number ........................:.................................:.............. t0V1jPj FLIE � TOWN OF BARNSTABLE- �� 0"k BUILDING INSPECTOR 7.1 APPLICATION FOR PERMIT TO .. r/.�C.GJC....... '.:r.. ....... >; f .r ..........................................:......... CIO TYPE OF CONSTRUCTION ....... ,r?'J ....................................................:............................................ ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies/for a permit according to the following information: Location ....►��... flGl.`�..!Y.�'�itC....� P..C2 /.. ..(lv.............................:................................................... �.Q........... . Proposed Use ....�} .. 45.rxv.....5:..17 ..... .... Zoning District ..............9 ............................Fire District . Name of Owner .....Address Name of BuilderS..P..e... . -" Address a .. �.....f Z��.J� ....... Nameof Architect ........... ..............................................Address .................. . ...................................................... Number of R o �. ........... ..........Foundation u "A"rr�.s J , e—�` Cfi� lblc�f s V Exterior ... .%'. .. .. . ... ..... .. .. .. . .R.......��"?�t'�... 00fng ../C ��!i^ ................ ................. . .................... A Floors .....0.-X XC— '..................................................Interior ....... ................................... Heating ........... .................................................Plumbing ...........e.. ?t . .................................................... Fireplace ..:....... ...................................................Approximate Cost ........ .. .. �.......... .......... . ... Definitive Plan Approved by Planning Board -----------_______-----------19________. Area ........:,1. (..�..... ....:..... Diagram of Lot and Building with Dimensions Fee // 9� SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding t above construction. -T- ~-'- 8OSSEI,I,' BDBIIRT W. � � . v ` 22323 8oilcl Garage ' J�o -----.. Permit �v ------------ ^ ' ^. Acoaoo��� to Dwell�' �-------- .-------.� �----- . � ` Location .�35D—Saodv.�0e�k..�<�ad____ ' / West Barnstable ' � --------------------------. ~ � Owner� ....8obaxt..DJ.—JRuosell................. . ` Frame ' - Typo of Construction .......................................... < ` ...----- -----� . ------------- -- ' Plot ---------� �t ----------' ' ' . ` . ' May 27 ' 80 - Permit Granted -------------.lV ' Date of Inspection ---- —.. ---..]g . �r ' Dote Completed ----.���'�—xr�^�—lV���/ -' . °,^� . � / ` PERMIT REFUSED ' - . - ' ---------------------. 19 � -------------------------- . -------..------------------. � ^ ---------------------.----., . ' ` -------.^—.—,�.----.----.-----.. -----.��---------. l� Approved ' -------..� -----------------.. - ' ' .............................. .................................... ........... ~~~ Assessor's map,and lot number ...x/�. .... ..,k:..... 4 ?H E Sewage Permit number ..-.-.\e:,• ,, �..:.::: ...a.,c..R:!17. Z EAHHSTADLE, i House number ........ ... q YAB6 ........ 039. `0 ( TOWINC-OF ; BARNS-TABLE P U It D 11,G INSPECTOR APPLICATION+ FOR/PERMIT(-TO ....................................................... TYPE OF CONSTRUCTION ........ .:%•��? .:................................................................................................... p ................................................19..... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .... ?.�J.C ..... G✓C7 � „fV�� . ...../ rir�... ! :v............................. ..................................:................ Proposed Use ....!.?-r�,« Y.J. ......r, fay i...... 7.: ::..0 ........................................................................................... �� 1 /r�. ....�./.!"::fa"� i,! ••�o ZoningDistract . /C ..............f..-......................................................Fire District ... Name of Owner .....rcz.......°..i ......�. ......,.. r..�.�,ti. ............Address ..:..............:_............�r....................................:............... Name of Builder ;Y„/�• '�•/. �<a !>•.�7`.c:!� /s�cAddress ....:�i���fS S en .... ....... i' Nameof Architect ........... �/. ........................................Address ................../.:: .. ................................................... Number of Rooms ..r:...............�...................... ...........:..........Foundation t'��.� . :�..,,1;,.• o rr F> O Exterior .....f.:~�..::.-7 ........" T.1"� `......... ..Roofinge�/ Floorsr.-: 2r... :: :. iQ..................................................Interior ....... ...................................... Heating ............4. .✓?. ..................................................Plumbing ........... .................................... Fireplace ..:...... t.✓r? .P'....................................................Approximate Cost .. �7 ..........0........................................ Definitive Plan Approved by Planning-Board -----------_______-----------19________. Area :.,./...C............:.) ..:..... Diagram of Lot and Building with Dimensions Fee �.�� ....—'............... SUBJECT TO APPROVAL OF BOARD OF HEALTH I I hereby agree to conform to all the Rules and Regulations'of the Town of Barnstable regarding the, above construction. _— --" Name ......... ......... .................................................... ... RUSSELL, RORERT W. A=136-14 'No .2222.3... Permit for ....B..1A Ild...GAr.a.ge. .......... ..to...Dwelling.............. Location ...350 Sandy Neck Road .............. .................[^1�St... ...................... ....Robe rt...Tgr...R,Laell................ Owner N Type of Construction ......1Frame...................... i Plot .......................... Lot ................................ Permit Granted ......May...2.�.!...............:19 80 ... Date of Inspection....... ............................19 Date Completed ...............................:.......19 L PERMIT REFUSED ................................... ................ ... 19 C Y-i ... ?!. .. ...................• .• .. • • ..................... ......• ..................................... •.............................................................................. Approved ....:........................................... 19 .............. ........................................ ................. ............................................................................... y �C SYSTEM cru�°T Assessor's o fice(1st Floor): /� ,/ .1 �/ P-30TALLED IN OO�� � «� E c� tp �C7 7 ��aC Q• It. C 'fHE Assessor's map and lot number �TM•��E� �Q���•_ `o Board a Health(3rd floor):` �', �`q� EMVIRONMENTAL CO®1_, Sewage Permit number TOWN " '� •k •� w a®� �� q-w Z BAHd9TABLL Engineering Department(3rd floor): ULAMONS raaa House number 3�� �° i639• Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO '/M E Ab & TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 350 Ls�nd✓/lP�F /Q- ll��i S'To� P �- LQ� *14 Proposed Use • Zoning District OFIrL Fire District Name of Owner Address � Q W >errdici�✓ • Name of Builder GrAft it A4000-AAddress V0 Name of Architect • Address Number of Rooms Foundation Exterior IRk Roofing At Floors eVAC M" Interior Heating MM Plumbing MOW- Fireplace Approximate Cost Area Jew Diagram of Lot and Building with Dimensions Fee N k oars sANoy NEB R hea�h � e fer °u zor 2 . .�3.�o S�dy Aleck�Pd N QM w. 8anvs 6/ , A. 1. 119250 1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnst regarding a bove c st uction. Name //��c Construction Supervisor's License 6¢L5� RUSSELL, ROBERT W. :No 33096 Permit For Add To Parr-h Single Family Dw -11ina Location 350 Sandy Neck Road West Barnstable Owner Robert W. Russell Type of Construction Frame Plot Lot July 24, 1g 89 Permit Granted 4 Date of Inspection 19 Date Completed 19 -VA t F f c/ Assessor's office(1st Floor): /36 / Assessor's map and lot number /y• ODD 0. K. r �Q�o*TN E Board lth(3rd floor):C� , Sewagea Permit number ;� q` � Z DMUSTAXLL, i Engineering Department(3rd floor): ��� rues House number 3 So °0„�+639• \e� Definitive Plan Approved by Planning Board 19 c YFY d APPLICATIONS PROCESSED 8:30-'9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO �'/ '� ! 1 ✓ F :.' t ��Are z eI (' ��, TYPE OF CONSTRUCTION �J7 19 AG1 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for apermit according to the following information:: Location --�� � d se-)hn Proposed Use Zoning District Fire District Name of Owner v �� / a�a /f // Address 4 Name of Builder Address .;�. Name of Architect `3 Address Number of Rooms Foundation 9 � j 1 2 Exterior st %; k � �� �, ? ; ° /W 2 Roofing Floors Interior Heating Plumbing �' Fireplace �.�= �,���/��_- Approximate Cost Area Diagram of Lot and Building with Dimensions Fee . (Y y.� »� a f )4Ai z \� jr j,ale ' • 1--- -�-�- - _;, .�_�.... �50 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License RUSSELL, ROBERT W. A=136-014. 002 I No 33096 Permit For Add To Porch Single Family Dwelling Location 350 Sandy Neck Road West Barnstable Owner Robert W. Russell Type of Construction Frame Plot Lot Permit Granted July .24, 19 89 Date of Inspection 19 Date Completed 19 - i m /D 0 8 a P /`'�— /� ... 7 77 Assessi �s ma and lot number .... ............. �- `C SEPTIC SYSTEMS MUST BE Y Sewage; Permit number ...........l,c .. ... 1�• INSTALLED I;I COMPLIANCE >- WITH ARTICLE II STATE c NITARY CODE AND TOWN yoF.T"Eros TOWN OF BARNSARLNF . 111 BAHB9TODLB, i t4AM 6 q�,•� B1.111DING INSPECTOR �F�Yf►Y:p" . 5 APPLICATION FOR PERMIT TO / e4mlL.,r.iF..P...� ...°°�...1� !PP.f ?. TYPE OF CONSTRUCTION ..��/V. ... .f....� ��/1 ,�f......(..A.D.LI.177CZlJ. .........:... N.. .......17........,9.77 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: yy� Location 50....J�// !.N.. ..LI./u ... �.... ,...� iC% Y!..l. Gi.� f.. '✓. � ............................... ProposedUse / '.fir/<J� .�....�Q..Q ..................................................................................................................... Zoning District .....p..................................................................Fire District ..W.....e46A.RAI j'7'��� .�,..�1✓�%... Name of Owner .�r�,B ,APT- ..l . .�f� ..............Add VA06�iC.G�_.,42rlv&644 My Name of Builder(f1M1J7V1'W!o ee. e..ZM`fed!V! ....Address SMlz7rp.. Name of Arch itectC11441M. .�iy,Lle.i4...�PA!5.1_rAFAe1,'-1<(/kAddress ....................................... Number of Rooms ... ................................................Foundation G Exterior ...............................Roofing .EiQ .... i��/tV �., .............................. Floors /Q �y TQ............................................................,p Interior J .ETAPO . ................................................ Heating 1le�...AiR....�4t k..014.....................................Plumbing ./.C4J4L..,04771.................................................. .�Q.� ........................................Approximate Cost .. 0 Fireplace .. ....................... ......................................... .. ...... Definitive Plan Approved by Planning Board -----------_____—-----------19____ . Area ....... S! Diagram of Lot and Building with Dimensions Fee ...........7............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH i rj �ARA�E ADo i row /6 16- `x 20 I hereby agree to conform to all the Rules and Regulations o4theT of Barnst le re rding the above'construction. Nam .. .... :....... Russell, Robert W. - � a �.,9310 add to single - No .-�:..`........ Permirfor ..................................... _ - � ''amilywdwelling ............................. 350 Sandy Neck Road ` L'ocation........................... ...................... West Barnstable - ............ ....................................... .................... Robert W. Russell' Owner x frame' l ' Type of Construction ............................'............ _ ......................•,✓.................................~....... ........... ' H � _ y '" `� /' r � i� +�� � � .,. J ' � •�- � _ III Plot .........:.................. Lot ........ '' ......... .Jnne 17J 77 ..................Permit.Granted ........... 9 I f f Date of Inspection ....;l9 y Date•Completed .. 37. 19 .r - 4' ( •� =PERMIT-REFUSED - i+ t..................... ..............................:'...�`�9 ................ ................................ ..... •. a. ....... ?';................... "' ..:;;� ............. .....�................... ............. ................. %r ; ',�� `'� ry T !� •'' a 't { / i L IA' a - .c • mot:• �•. . .. Approved .................................. ..... 19 ........................................................................... _ _ _ �,� Assess map and lot numbe r er .........3�--.. A/ ................................. ,q�)1 �J� ol— 17` 7 7 Sewage Permit number l/�!�? -��,z. ` TOWN OF BARNSTABLE Bpi THE BAR35TLBLL i 9� D��ae� BUILDING INSPECTOR APPLICATION FOR PERMIT TO ... ! � ..... �........................................................................... TYPE OF CONSTRUCTION ................................... 7......1977 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .�:5 ... 1 ,,�1 1 G"!"/r f'1�:... 1 �., .l�,.�-';,w 1; 'o�l /L"- 1 ,.. ............................... _ `• - Proposed Use �... . . ..................................................................................................................... _ ... Zoning District ........................................................................Fire District . .WAX F 17t Name of Owner 1..,/..... ..,...62 1'X//..............Address O"O.if .5�7ie,4,0.14-A'4' W. Name of Builder �1�P/l �° F�° p�°.� ��'!G"L l !�(J,...Addressa Name of ArchitectC AROU.F....................................... Number of Rooms �> .:. ...........Foundation ............... ..................................... ........................................................ Exterior �'F'/�A .... .�/.(... ...............................Roofing .............................. Floors(; peC T r "GT� r�r................................................ ...... ................................................................. Interior ... Heating4/ T AJR ......................................Plumbing .................................................. Fireplace .. J/a e '..............................................................Approximate Cost ..7/�......................................:11 Definitive Plan Approved by Planning Board _________-__________-__-__19______. Area .....3c#V..;..5: ........ Diagram of,,Lot and Building with Dimensions Fee f7 .......... ................................ SUBJECT TO APPROVAL OF BOARD OF HEALTH I 4"K r rri,v c BREEi6 w,4 y �ARAGA�' ' i 4,"e f7-/N 9 /Y0vre /a00 r ow 20 ' I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..:............... .... �f.....�.0�..�� �, .. . _ ................. Russell, Robert W. A=136-14 19310 add to single No ............ Permit for .................................... family dwelling ..... .......................................... :i%........................... Location. ....................................................350 Sandy Neck Road............ West Barnstable ............................................................................... Owner .................................................Robert W. Russell................. Type of Construction .....................frame. ............................................................................... Plot ............................ Lot' .......... ..................... Permit Granted ...........June...1.7.........*.....1977 Date of Inspection ....................................19 Date Completed ........................................19 PERMIT REFUSED e ....... .. ......... . 19 ...... ... ..........ve.................................................... .................................................................... .......... ............................................................I................... ............................................................................... Approved .............................................. 19 ............................................................................... ................. ............................................................. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ! 3& Parcel Dom Permit# Health Division Date Issued' Conservation Division Fee t2S.o6 Tax Collector & Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis ' Project Street.Address 3 J`r6 Seta JV Village ace(.e Owner �d�3 '1�u,�S>�C.(_ Address 5 �. Telephone Permit Request 4 9 D L. + �o-W15 = O. 3 S 9_ Siz,P, Square feet: 1 st floor: existing proposed 2nd floor:existing proposed Total new Estimated Project Cost # 700 Zoning District Flood Plain Groundwater Overlay Construction Type t JO 1t. Lot Size Grandfathered: 0 Yes `�o If yes, attach supporting documentation. Dwelling Type: Single Family R," Two Family ❑ Multi-Family(#units)- Age of Existing Structure Historic House: 0 Yes ❑NT" On Old King's Highway: ❑Yes m-w Basement Type: ❑Full ❑Crawl O Walkout 0 Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: O Gas ❑Oil ❑ Electric ❑Other Central Air: 0 Yes ❑No Fireplaces: Existing New Existing wood/coal stove: O Yes ❑No Detached garage:O existing ❑new size Pool:❑existing 0 new size Barn:0 existing ❑new size Attached garage:❑existing O new size Shed:0 existing ❑new size Other: Zoning Board.of Appeals Authorization ❑ Appeal# Recorded❑ .Commercial 0 Yes If yes,site plan review# -Current Use Proposed Use i BUILDER INFORMATION Name C WIz4i &M,415, j r;Wpk . Telephone Number Address IL gJ License#_ Q,S Co 6-2o'S. Home Improvement Contractor# 1 OJ 7e-lb Worker's Compensation# CQJ c- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY ' it PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE A OWNER .. DATE OF INSPECTION; FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH n FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. - -- -- The Commonwealth of Massachusetts Wes === -= - Department of Industrial Accidents , -:�� ''. Olflce allat�sllpaU�os . •`� 600 Washington Stred Boston,Mass 02111 Workers' Compensation Insurance Affidavit tin csu : oratnha .,.�. /.. /I//������//%%7%///////M� �t � w. ... name: /;�A be� Steil location: I3 Sv LAW dl, L ,�✓ . CitVW �o�le_ . °hone ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working iin/��aav ca acity �I am an employer providing workers' compensation for my employees working on this job. eompanv name: 111E address: � Ateii7 wA< cites ba to.3s phone Insurance co. oliev# .Ua//.11�U/�/.✓/i.G,�!////i�cul�i /tea///.�G.�,lv��i/,.� ////,�/// ;.�,,,� ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have . the folloning workers'compensation polices: eomoanv name•. address. :.•......:...:. .:..:. dtv phone# insornnce co. ... . ...... olicv#.. X, i /////�i�/u�i� //ii�v/�i////a//�a�//i�///i//////riU/�%�////////l�//a/1�/ eamnanv name: ,.. .... ..;:........:::.::......::.. address. eih- ... phone#: ::..:.:::, °lieu# .. . cif #1sfs+ 8A�G/!G///l/%/%�%/%////%/l/%/%/%/ Failure to secure coverage as required under Section 25A of MGL 152 can lend to the imposition of ertminal penalties of a 0ne tip to 51.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a One of S1o0.00 a day a;aina me. I tmderstand that a copy of this statement may be forwarded to the Omce of Investigations of the DIA for coverage verification. I do hereby certify corder the paces anddppenalties peJyttry that the information provided above&tra:and correct Signan,nJ !/' — Date Print name rie Ed wa— V. RA s e k_�' phone 0 q�37_9 S 18' (contuact Mdal use only do not write in this area to be completed by city or town otlldal ty or town: pernSftAluttse K OBuilOLIce zin Board ���Board ❑check if Lnmed-te ropo se fs rrgmr:a ----- —- --- -- - - — --- ------_)Selecnen's OMce - - -- - ❑Health Department person: phone N. QOther Ilr-UM 9,95 PJAI The Town of Barnstable . 9 M �e�' Department of Health Safety and Environmental Services ��. Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-790-6227 Building Commissioner Fax: 508-790-6230 For office use only 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 uild not more than four dwe be done by registered lconttra torso with structures which are adjacent to such residence orb ling uni certain exceptions,along with other requirements. Type of Work: S�L Est. Cost i2 �vni9L�vr-�,ff� Address of Work: �SD Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under SI,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED ME IMPROVEMENT wORK DO CONTRACTORS FOR APPLICABLE GZH.O,h1 OR GUARANTY FUND UNDER MGLO 14Z�A� ACCESS TO THE ARBITRATION PR SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: D Q /1. Registration No. Date Contractor Name OR r%—nor'c Name r ✓lae Lar7vnzoruoe2��• P� •ll�;�:tac/:.udeCld 'ANC 'U'_ITOi1 ;ilPFF,V OR C'-• 0O74a` j';.,r'_00�7 /�eTOamoxo.W l(�c�✓uaa+LzuEuset7a '?stfl_c°d To: 3" HOME IMPROVEMENT CONTRACTOR x /THOMAS CAPT_ii Registration 100740 t6=S NEWTOWN RE. Type - PRIVATE CORPORATION t _OT_!_T. fiA f26 Expiration 06/23/00 CAPIZZI HOME IMPROVEMENT, INC �o � as Capizzi, Sr. ADMINISTRATOR 1045 Newton Rd. - Cotuit MA 02635 -------—• -- ✓/ze �a7Jz»Lanlueal� P/�.,llira�nc/uaeCl6 s DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Number: Expires: Restricted :To:. l0 THOMAS X -tAPIZ-ZI JR 280 PERCIVAL OR —W BARNSTABLE, MA 02668 •- �'=•;�' ✓1JC 'C09JL7J1P'7L![�Q��I P/v(/�J(4C�CLJP.C.IJ DEPARTMENT OF PUBtIC SAFETY i :ONSTRUCTTON LICENSE Number: EXDires: Restricted To: a0 J _ FREDERICK V RASCI ill Crt4--"i060 BOURNE RD PLYMOUTN. MA 09360 r r oor Map l J G Parcel - Permit# 20/3/ House# �S Q Date Issued - icy Board of Health(3rd floor)(8:15 - 9:30/1:00- Fee Conservation Office(4th floor)(8:30-9:30/1:00-2:00) d✓L � Planning Dept. (1st floor/School Admin. Bldg.) IKE►p Definitive Plan Approved by Planning Board 19 ; _ RNMBLE. ` rFO MJ.. TOWN OY BARNSTABLE Building Permit Application ' Project Street Address r Village erx h ' Owner Lzk C_)s _ Address TelephoneArm 1 Permit Reques First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size ` Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name 1,2aotpo Telephone Number Address 7/ License# Home Improvement Contractor# Worker's Compensation# A10/3/S 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 /f/1G�21r"vl SIGNATURE DATE ' B> .� E Fr REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. - DATE ISSUED MAP/PARCEL NO. _ i 4 ADDRESS VILLAGE OWNER ` f DATE OF INSPECTION:+ ' FOUNDATION FRAME INSULATION ' FIREPLACE + ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ' GAS: , , ROUGH FINAL FINAL BUILDING = ' DATE CLOSED OUT J i ASSOCIATION PLAN NO. WE rq� .` . 'Y The Town of Barnstable MILMAI" 1MAM 6 9. ,0�' 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 For office use only 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: Est. Cost Address of Work: S' Owner's Name Date of Permit Application: 3 D I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied Owner 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 t agent oft a owner: Dat Contractor'Nam Registration No. OR Date Owner's Name The Commonwealth of Massachusetts Department of Industrial Accidents Office offnrenfoofrons 600 Washington Street -- -� Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name: FAa-��, s location: / 69 2 ck Sc^ C(/( �(p city C� .,± 11q A . phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole ro rtetor and have no one working in anv capacity $� I am an employer providing workers' compensation for my employees working on this job. company name:: _ . sp address:::: .: . . .:... . . .. crty 6Fi ire#: insurance co.:,, - v/ olicv ❑ I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name: :, address:.. . _... :>::>, ::<•: #. .. - ..:.,. �. iz2> ?>i%ti,.:' 'hone `` 1i•,`'it�fGSiti'r3:'iii'? .:.......::..;:.. insurance co.: ;:>;:.;;:;:. olicv# : . :.. /, company name:. .:•:,...:_:>:::e:;:>::<:;::;;.<.;::. ;::; _. . address: �,. ..... .................................... .. . ......... insurance co:::,. :.;.;::;>:.::....... �/ Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that s copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby ce under e p u + eieahi ojperjury that the information provided above it truo and correct Signature Date �///-3/4 9 _ Print name one# official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Deportment ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (Devised 9/95 PJA) .Y 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 contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the 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 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 permit/license number which will be used as a reference number. The affidavits may be wturh d io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of InveStlgadOns 600 Washington Street - Boston; Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406,409 or 375 Application to 9 9 8 0 68 .� Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a CERTI FICATE 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: RrHouse ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign Q Existing sign ❑'Repainting existing sign 4. Structure: ❑ Fence ❑ Wald ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY DATE ADDRESS OF PROPOSED WORK �-� -S)' t1 �'� /puf ASSESSORS MAP NO. OWNER P-8.6p►2T,- kA, ,l_/)S;5 4P J ASSESSORS LOT NO. HOME ADDRESSrf�}�Xy 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). .SPA AGENT OR .CONTRACTOR f/c�A'SE/C� (70.dS77f'ut-774,t1 TEL. NO. ya ADDRESS�7� �_T r ti5 < f7� D2elf'� 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). oeF W to5.17►_bIs r1;4rA-7VIV4 e6to Jc - Cn"w-S,c> W'bl/wi7/j06uw W/71�a �s✓ /po-Prl? DOv,H.v/Z!. � ? l .�►���M�no wIvi . ow S— a/M!Y It : SAW s '1�W0 � vAe Co 1G JaMV /4?"— ,Signed owner-Copt ct -Agent Space below line for Committee use. �,`• � r �� .Received by H.D.C. - Aff -" ,Dat The Certific is hereby 44 � Date �O Time- ` Approved IMPORTA If Certificate is approved, approval is subject to the 10 day appeal period provided in the Act. r 1 ■■■■■■■■■■■■■'OEM■■■■■■■■■■■■ ■ _ ■■u■■■v®■■�■E■�it .■■■■■NRIVE ■E■N■e■■■■■■■■■ v ■■ ■■■■■■■■M■■■■■ ��i■■�■■■■■� =' No- no =d■■; , NOON■/ ■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■ ■■E■pE■N ■ !► d . ME MEN NOON■■ NONE smoo�■■E■■■■■ENE■■■N■Ep ■■E�■■■■v■■■�N■®ism■■■■■■�■®■■■� MEMOMEMEM mom ®sN,� OVE■®MENO■ONEO�N�O�NNNNinNNEO■■mom SOMME mom NNE ■■■■■■■■NN■E■NN'�� .�0�■NN■■■■ a=' -Np-mma0■■■E NONWOMEN ■■■E mom No NOME VIEW ® NOON■NNE■NNUL ■ENE■vN NOOSE ■ vN■N■■■NNE■NNE■■EN■■■■■■ ■■■E■ ION■■ ■NEE■ EE ■■■■■■■■■■■■■■■■■�W ■ ■®NOON■■ v E Town of Barnstable ' ' Old King's Highway Historic.District Committee SPEC SHEET FOUNDATION SIDING TYPE COLOR CHIMNEY TYPE COLOR ROOF MATERIAIQV ffj&NJSED XL 04g COLOR N.p�► ��j.i/Z Q 4 �p PITCH WINDOW Vyy�L �C, �.pNb StMv !4 TRIM COLOR DOORS COLOR .SHUTTERS. COLOR GUTTERS DECK GARAGE DOORS COLOR ''' r SIGNS COLORS FENCE. 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. Site plan should show all structures on the lot to scale. . SPECSHT I i i G OPP . . G �B ce G dl prop 0Se G:dra9 x22' • e UIL DIIUGS sKE TC p Scxn c1 Ne ck rho a d �5 y wesfBarn SAC 6le imcxss. 0 13 6 -1 VV& Gr cyc e Sc ale Rc-�sse/� �o , f ,• • . r r i • _ Al7delSE`? 2 2 .c�seIM12 ` Lt l�ldD v _ , c �—r- -J Cx�s W,7`lf/!/IC10;Y cas f 47,elf, r r� /2 5 ex . O. rnGP�rrsirt� _ a p . 9 - , a +r �+ r �_ y, 'i ,� ..-_..if} �1�r-.3--1._.w..L �,.w-a-1.}-f--• --: - - - • ._ i , `� +. `:� I ` i ./7W, 6 it ' � t N - - -�--+ 1. ,- _i•�.J.' p• a `_ - nr . t ex�sfi�g gar�9e rerTor���ed seji,7 pO�c Ex%stnq <-� `. I _ .127,g«16,8q steel 9-/�/,u dopy r FRONT ELEVAROw • �/�,7d2rser� Cw;,..,� Cc2seilleot wwdou✓ FZOOFR P1_AN - cei/wq nx- ' rniNg PRO v E r. ! P "r eX i IMOW 4 C0riC /%01 BORNST lot X/rill , house r'e/70tVtL9d su?71?t h t 9;I c7 r7e1'Sf' CMC, 62r��! REAr� EL Z7VAr/ON �5FCT/011/f�-A S'UNPOR�f/ R�"NOYf�17QN E�!/�A �`�t��NT _ R�/SSEL f/oU�S�` • 1zt 911 RATS M61 F, NlA . _ SCALE p < N APPROVED BY. DRAWN By _ DATE V REVISED • A � cTU/I2 2�/ _ DRAWING NUMBER . /IlER�O14AI CoA116 Ti :%1cr1aN CO- 4.�