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0017 HIGH SCHOOL ROAD
Sch�o( Rd 0 v: SCAHNE� o.nr�oinojnwealth of Massachusetts Sheet Metal PermitI DE PT. L_tr �t:d T . U Fee: st .k NG QF ' Submitted: 3 Dept Plans ReNi6wed-. ITS ; O 0 2020 usi ss License 9 _ AppHcant T cense V. � B s Bess . 'n ation: 84e operty. tad"mer r oh Location ILforma o .._.� ` tre strcetl- ._ ..._ _ C it�'t' t l � L ' '✓"is ° d 0 2. A etas Copy O -j � at � ;' Staff initial 5 r' W r s el l _ s rk's o las any:i.Qt3:�k,mercj.a k7 to,1..000 scl. sf$::;J 2-stoties.or less Residential: 1-2 f.l.inil _ I'vIulti-f&-mly,� Co?1db x' Townhouses _ {Jt2uT Commercial. Offlice_ le t a hidtistTial Educational Fire,kept" tpproval % s itatdctm_ Other Square Footage. 'undex 1 , 1,10 dad ft„ t v.r : IN,Umber of Stories: ee,metal work t--he completed.- New Work: tmovatlon: :;"AC W a .c#aiater d 1 �,�1�a� .._._._._ �ti �E�aust S; km Metal t �°xx:r l :� qua ,r alancin tdt6 to kmPro i led r s � on.o ivor dams. .___.._.......... IANA30 § fitcf ' have a rr r€2 cnsuraarr its ag:iwa€er t which rrseets therequir meats of 4 G1.Ch.11 des R<0 f you have s checked indicate the type of c€verage'by checking fhe appropriate box below: i . .€tin i s ran i y Other type o aria i �" 15t E3 I R WSURANCE WAIVER:l ern a that th&iic cn oo r M2 h ve the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application this requirement. hack, One Only Corner C Agent Qa S ignatCifa Of Ovine, or Owner's Agent. By checking this box ,i hereby certify that all of the detAls and information i have submitted(or ehthned)regarding this application are true and accurate to the best of my knowledge and that all shoat metal work and installations pe,,Iormed cancer the permit issued for this application will be l in cor oliance with atr pertinent provision of the Masszc�.-usevts a lding Code and Chapter 1 12 of the General Laws. Yu ins titan re€ `, ` etcr to insulation installation. YES NO 1frooi" c ens; a, E c,n ............ i Date Comments i f j Type of License: i K L,,,.iou,ney+lar.mon i nature cf Licensee f i -]Journey aerson Restricted License dumber: Check at f nspector Signature.of Permit Approvai � I r The Commonwealth of Massrachusetts Department afIndushialAccid'ents 1 Congress Street,Suite 100 Boston,MA 02.U4-2017 wwM .govldia Workers'Coampensatioo Insurance Affidavit:BuilderslContractorsMIectricians/Plumbers. u,p TO BE YLEIi WITH THE lPERNUI"MG AUTHaTtY'T'Y. Applicant Information P1ease Prin# bl Name usia.,.s organizad.€ngadiv-�acf'I): .-- ^"../ ;Lea; i A.te you sm employer?Check the appropriate bou Type of project(required); E, I am a.employer wa Ptoyees(full and/or part-time);* 7. D New tutu trust ion 3.[]1 am a sole proprietor or pactnesbip and have no employees Woriring for me in b. [Reumodeling any-parity,(No workers'c=pi insurance required") 9. 3 i am e horo=wnar doi;ag all work myself:jNo worrssk 'comp.isLs=te iaeail I}enlolition a 4 g a a� an wM tie' co all irk an My .i Will lil Building addition =sur-, t a rare sole 1L[3 Electric-1 repairs or additions i " ` 'caplayter, .12.nPl=abing repairs or additions a; i.ha ve hia�d ttx a s its e3 oaa 4h 11M Rcaof repairs ' c sshm employees and bvza ,a eon.' z c a a and its c shave extruised tex-d&cd .on C 14. other l 52. £'z and e hzVe:no=9ioyers_ ?+7o�mj=rs sa mpp insatgorc d l ' a. #1 also fall out the ' bestow "a policy i ' :� � � lr aril-It aili ng they a &ing alt m tic must submit a new d0davit indtca#ing such. 4e t.r' R Mustan a ilional w g t of the mb-matrodws and state whether or not those entities have e s.B-,drrstactora bm m employees, j most prova .tbaar 'U, .pobq a naba. r a der zs�ralitaan��uaro 'raoart�e as insrt rates fVP'MY ensPtcyees Belvw is tlaeprraacy and job site � iaa,�torn Inca rsrr.y.i°i ems- i Policy m self-ins.Lie.4 �� atiitm Dad: Job Site Address: Attach a cnpy of the workers.'compensation policy dmlaradou page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c.152,§25A is a criminal violation pua ishtal le by,a fine up to$1,500.00 and/or one-year'smlirisomnent,as-Well as civil penalties in the form of a S TOP WORKOR13ER and,a fine ofup to$2 50.00 a day against the violator.A.copy of this stet-,ment may be forararded to the Office of kvesfigatior s of 13IA far insurance ' coverage verification- I da kery cm jy uxd theta ` as vlauies#f pw j sry that the iLfo npr is ai^aaeandeorrea P'ho##f , Official use voaly. fro not write fro this area,to be.compl by c*or mat offlCiat. s , City or Town: PermitlC.ireuse# Is-suing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4,19ectrical1apector S.Plumbing Inspector 6,Other Contact Person: Phone�: — —" Ste= x_ E FALMIOU.s-� iYL 5 s^yr t z- 98311 zY /2422 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA 497 Thomas 3.Lacces Roac i:rr i - -- '-- - y {''' -1#y$... F"aS Y� #r'1 ! f, a,..,:r ''`.' - 4 yr. t # �.^ k « NO ' -ter; NA nasC, .J.e.!l�iC �_�z =Maii. Teter ;` , �t � a fNil-US .. a Vc-S-'l.l,i..� ram.+,V'--d &n,Z Suf m`a�'m4 Design Conditions ��si�e 4+I � C, is �� 82 `'F s, P71 = l isic'e db 72 'F 10 +iV?ar-ic ! .zve humidity 00 Qk J'ois -difference 4/ c 7 _ 974-4 BUh Central vent(n cPm) 0 r�Uh CcentrGl vent(0 cam) h (none) (none) I"'I1 midific2-oon 0 =-;r; 0 SEA-, Piping 0 '{"! Equip'Men-i load 177A8 to Use rn-anufactirees data ,+ krfl`3�`infr wSF° FR Equipr-n-_M sensible load SS0 —Sta t Method 4 tent Cooling Eq ipm- ent Load Sizing Constt;dbon quiaily ;,�. Fireplaces v ri J;_Ud!tr e 2297 -B—h ! DUct_-- 2SO Btuh Central vent(0 .c m) 0 s f le_=;'± Co]}r.c: (none)rr _ i ,�` l/j f £ Equi"'Etie'n'€�ten�load 2.:3/7 BUn (' r A:r - 'f $ ' i Quir' rent Iota.L.oad .7en+'_z-t) 12'-�.G� '7tL°YY lcapadtyatUOSHRI Cooling Equipment Summary .. Make v;-:rP..er i 7r .de COMF{}IR;I3 AL Coi -Id 2 : 187 €3 _ 10 ;e a Fty. ut i 0,`M1 T I!'� ^..,(:c Jt�LiYLfFii[� -1 21'L`LA ".'�3.L1'�! ft l_i ;'s: i ni-i=ff1'i(� it24 t 7AOO Total Iok4 basehoad � ua:f air ticw 580 di-11 High f3Ut3csE-baseboard, v,±I wr ff" t8 tlr 0.C:��� r i Tot41'.hig baseboard i c �t cciresre .8 Space Load sansible heat ratio 0.7 I Cal.^-.j atP on..``.. 0 QOyev t1V�rC,. v ;eat all r=awireinants or Manual J ft E_ I n --- 1 � C r hen 2 14 f..n is $ !t S E _w l f E E 34 f ~ A i ` v ��g/Dining j EG }w E i f 19x ; 4 r 104 cfm _- �or ODM. Pan- f��Rzad last 1 a. w l I ' h I >�ri Sed 1 1 o h g ..� Ve E n kf. j xO `� S `f 1 3 i ! Y V ti a II � . 2.5 Bed 2 8 P r Ii Ij =Ms&v Cor M., Lkitl J Y✓ ctm I\ I' Ss�;X�; I -'-- ti a 4.: 'pOpl h - 9MA I - f:9 i �I ko tommanwealth of Massachusetts. Permit 'BUILDING DEFT. JUN 0 0 2020 Date.- Permita 2020 � � A 0 OF BARIVST f C7,Mit ee=F T r A N A E ABLE { Plans tt d: Plan,,.eN ie'wed: YES N0 E sin License;'-' -Apphca 1,License Bus.iF n v Jor atFt r: Property 01w Job J,ocatlon la.15 rtuation. Street & C',ti>f�,a,x s,... -..,,'m,8„,,,-.^.1` i'°"� Cw i €.��6'w"E.''c.. ...,L+" ° L a».. 1✓ s elephw -,: Yam` L�. _ _el.ephon r Staff:Inifi . 2 M rcstriotcd .o dl ilp 3 m:;,-,or Icss wnd,coinmercial up to;lfl;C0 sq. ft.: 2 stories or'less a � _. rCodoTI n _Kt. " w � t o t o Office ReLi Industrial Educational Fire kept. Approval � __ I.stltA Other Square Footage: It over . '00 so N4mher(if Stories.* _ Sheet r,et bl work to becom pT ew Work: enovarLo :_— f l C TcW latershcd.kofin :_:_ I itehet Exhaust 4 tict li:I I:" t�l:r'T3alneln21 _ ...... Provide dotailed escziption of work to be dom.: .. '21— i t i i i rn OIL have a c�rrznt ,! irate sir its equivalent which meets the requirement of .G.'L,Ch.11 Yes 't� `. If y to .tao-oers f fs 3svrs ' S °tf� iirs theappropriate box below: ia fiabir i s rai c poli y Other type,of indemnity Bond VM UR C WAIVER::t a�a arc that the licenser: l�s not acre tho insurance coverage required by Chapter t 12 of the Massachusetts General.Laws,and that nay signature on this permit application M this requirement. Check One Only owner ,agent LD Signature of Owner or Ownefs Agent rp By checking this box0y,i'hereby certify that all of the details and information=have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and instaliatlons performed under the permit Issued for this application will be r In compliance with ali per nerd provision t:f the Massachusetts Building Code anti Chapter 112 of the General Laws. duet iras'feto tirt required pritortoInsulation installation: YES O �i Prc-o—ress lasnections. co=eats l _ l Dae T ype of License i i Ma st r- eslrided �... 3 i ltyffl own 3 -lioumeypemon Si nature of Licensee �rrra:ii 't`� E s r ! []Joumeyperson-Restricted License Number: '..r I Check at , rrlst t31 1 nspector Signature of Permit Approva€ i f 7 ¢¢ 1 The Commonwealth of 'ressaaclr!aasetfs Department ofIndustrialAwidents } 1 frongress,Stre4,Suite 100 Boston,MA 02.U4-217 � win mm ass gov/&a • Workers'Compensation Insurance.Affidavit:Builders/ContractordElectrieLtuaTiumbers. TO BE FILM VVIM TRE PERK TT1'SI*dC AUTHORrry. Applicant Information please Print L,e ibly Nmne Pwi—ssr'Or anlza lndm&al): Add s: i Cj-,-y1t-ateip^ /:-` ; 'hone#: Are you an.erngloyer2 Mock the appropriate) Type of)project(required); t. I M a.=qilbyer Wien -_ Ioycea(ti ll anclksG par tint}.' 7. ®iNew CCDn5t 11C2lO?A 2.[]i am a sole proprietor or pmtmabip and have no en:ployees working for me in 8. Remodeling any capacity.(No workers'comp.iasivanae required,) . Den7tSlitlOLt 3. sun a ham,,- mar doing all work myself.[No s'csau x.' a tcquiresi.]t 1,0 0$Building addition k F4!am,a h and wai bt-kdng cout=t=to condo In m M my PrEparty l Wl cdh-- =Nntip.MVXM=or we sok 1.I,00=trical repairs oradditions 12.[]Plumbing repairs or additions 5,0 f a=a S=m=d=ftmtor and.l'.hwe hired t zd Urm3 on f-11Wchad Abott13;�Raofrt�pairs � c s h employ=made 10E10theer e am-Lzc%,catx and its ofirc=bane of ` par MM C. b'z £41'a?-d we have no employees:[lqo =Mp,fiwivn=nVXdzdJ .hz:im box gl m=also fill oxatbe w=dm Wow sriw POUZY.1uhmatim e rates '.fais aTuhvTtin&oanng try are doing all x &contutm mud subudt anew.a$tdavit indicating suob- 1Co=tmfzm tattbeck dais box inust attached an additional 6tasb*vring the of&e and statewhether of not thosa:entities have r ff vA-coat=tors bkyt=3ployees,dwy mast lauvide their wza s' PObay der-. lazt an empLwAer that is r ` g or 'compem=dOn iftSura=fvP tray enTJgees. Bellow is policy aria',oh site l a Ins `ance Company Name: Policy I to Self-ins..Lie. .+ l G:;, Date: t Job Site Addiass: 'Qtyn - - Attach a ropy of the wvorkers compensation policy declar-e osc page($bowing the policy number and expiration date). Failure to secure coverage as required under MGL c.152,§25.A is a,=iminal violationn punishable by a fine up too$1,500.00 and'or one-year imprisom=e as'tell-as civil penalties incc the form of a STOP ORI�€'3RDER and a fine of up to$250.DO a day against the violator"A copy of this statement may be formrarded to the Offee of lnvestigatioiis afthe D1k fbr insurance c4"vzm ru verification. I ner;iy Certify sander the pains nf'pmjury that the isrf"or a adon prowde a'.above is true and correct Fho-ce0 r in�a to be completed b or town'a cart t�'rrul use araly: l?a rtn write � �' �'�t3' .:� , City or Town; 3Pert2icelnse ` g Authority(circle one): 1,Board of Health Z.Building Department 3.City/Town Clerk 4,Fdectrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: lose i t�2 36,510$ 1wa 82. : fi!t28t2022 job Ms-Ridgemmod AlU gpi 497 7homas3.Larders Rocc U-r' a.r z __ .: { +y� a� i-- .�d+ �--'x Y .:�• S _'�_�., '' 6 R _ {k`.3� c a�"' �I k C."jr+ A67. 'Summ-r Design Conditions Oi'_ - _ - O�1=;rye do 82 "r ?,ai4y rcn6= € �-„r,s ure dtfference 4�-1 ffl! fai -nsk le Cooling Equipmeewit Lead S .irig S uc.ire 'i 91178 i r _„pure 974 Styrit Ducts Central vent(0 cfrn) J ~✓h.1i p Ce .r a v-nt(0 ca rn) . (none} (none) Humidifica-bon v h ED awe r 0 E-0,t, Piping t Equiprnent load •12748 'r: Use manufacturers data Y EatelsWino muff-oliea t.00 Equipi-nerii sensible load SE-07 Stmh Met iod S Pir ` Latent Cwfing Equipm- ent Load Sizing g Construcsc-oualii.y = Fireplaces rr -ruct re 2G97 Ri17 Ducts 280 Central vent(0 cfm) 0 �.en A-ea(:'"• 77; r Equfoment latent lead 577 Bbih r.Ar r EgUV - dPe..s't 1E9t..l Load(Sen_L z^ 12484 2Len �Z. R-a ._ aIcCprcity-at 0.80,S'HIR, 9.0 Ems? # .MFLF ff Cooling Equipment Summary r - NIak CQa�r�ii .r��{ 2d.1'-^; 18ABW40 I MR 4 SEER �ieaLtG Jat��° Jt�'€3J Low r;: GOO c 3 c4v g �74EM �?"a Total Iovv baseooard 21 t; A-u:!air flow 580 of In Nigh oub4 baseboard Ci scU=,lj;. wr tc afacxor OD59 r erg -1 Total high e�aseboard 1 Sit �resssure 0-50 isaO Space thermostat Loadsensible heat rabo 0.79 Cial at' isappr JJo:d bY.A .CA.. .,tee-ali rC-li fir=ments os Marpjaf J M Eta. rvi,'� 0`;iV:,G1�E2S`Or_--.,rres.'c °•�'.:Cevr7c-j-1=., - .=tit)'= =:.-.=.,..o_�� ., - LLO # y nien i ? , rur i u � h P It b 12 e iy // 6y R :< x 4 12 ii Nb_-noamt�Corp Z-7 T; B.t �3�utart r •,x,.w I ip f l v� iJ J c Bed 1 a I F8 R. ! d�:' { 126 m 6 q 3 Bed 2 �1 r I 26 Ch - I jlII I �..1'•J4.'l 7r�11 ta. _.�.Jh: + �• ..EX l _.G+.^c"'= •'.' G ii C ra,w, 9 � Utl P e s ti 3 9 pp + k Y 1 -;n:a ti�1 =tom �: 5 +' Commonwealth ® ass, C s tts Sheet eta Per BUILDING DEPT. Map Parcel DUILEIVU DER JUN 17 2020 Bate: I �O Permit#' ,B 04 `—Z& - - JUN 3 0 2020 _i _ OE 6ARNSTABLE Estimated Job Cost: $ Permit Fee: $_ 9 _ ` .... . N OF BARNSTABLE Plans Submitted: �,NO Plans Reviewed NO —63 Business License# Applicant License Business.Information Property QkA r!Jad L.o ation.;Iuf rio I ?� me; Naze: e'*ts �+ �, ®✓Ze Street: 4 �e ..2� Street. �' fox Z +/e�,�� City,,Tovvn: C1t lTOVv31 Yeil/�l Telephone: JOB -54 7-!!Zgg Telephone; Z 7 - �?7 ' hK Photo I.D. required/Copy of Photo I.D. attached. YES.:kl_� NO ". ` 'sctr 16g 3-1(l@� --uxestricted license t� N,(�y 1 61W1 V1(1�t� 14 -k- J-2 JAM-2-restricted to dAell ngs_5 stories=or less and eor mere,al up.tc.10;0 0 sq:;ft /2� tones or less Residential; 1-2.famzly .. _ Wti-faiiailY _' fi;Condo Tow oases Other aainereial: C3ffJoe_ Retail' Industrial Educaonal Fire Dept. Approval Ibstitutional.�, Other. Square Footage: under I0,a00 sq:.fl over.10,000"sq fU', anihOr o 5toriesa . Sheet metal work*-to be cbmpleted New Work: ✓ Renovation. rVAC._ :Metal Watershed RoofingKitchen Ekhaust.System,_A/ Metal Chirpney;l Vents.: Air Balancing ' Provide detailed description:of.work to be-done IF . e _ a r INSURANCE COVERAGE: 1 have a.current lia hili insurance policy or its egwyale.14;which me.e%the requirements f M.G.L.Ch.112 Ye's If you have checked Eradicate the a of coverage checkin the.appropriate box taelctw: Y +� �Y. g . 1 A liability insurance policy Other type of indernnity [ brill 0 OWNERS INSURANCE WAIVER: !am aware that the Acensee dogs nrsf 4aave the, nsairance;9yerage regoi.red.4 y Chapter.f 0#:the Massachusetts General Laws and that m si nature can this permit:a lication y g pp" s the reg4irement 1 Chgck::®ne Qrily Owner: �g�erl4 E. _ _ Signature.of Owner,or Owner's Agent i By checking thils;boxW,I hereby cerpty1hat all!of the details and.information[:have sutariifted(or entered)rega-rding.this applicationare true:and: accurate to the`:best:of:my knowledge and that alGsheet metal work and insiallatiohs perforitied aindbt the permit:iesued for this appticaieon.:ryll[be in,co plranre with till pertlnent`proAsion of the;Massachusetts',Buiiding Code and;Chaptbr'112 of:th6 General Laws. I Duct inspection required prior tas_insti6attal� in�tal9atic rl BLS�a. f Pr i Date ClanezitS • 1 t ts Date Comments YP is Fite ©:N3aster Restnef :: ;tylT a10, Wn _ OJourneypetson: Signature of Licensee l 'arniit; .. FlJourneyperson-Restricted ©gyp License Number : end Cieck at_v�vvv.r><aess.aorr/flail j 11spopt9t 1gnature ofpennit,4pproyal. i a r i �\ The Commonwealth of Massachusetts Department of Industrial Accidents Z Congress Street;Suite 100 Boston,MA 02114-2017 www mass govli is Workers'Compensation Insurance Affidavit:Builders/ContractordElectricians/Plumbers. TO BE FRXD WITH THE PF.RhUTTING AUTHORITY. Applicant Information Please Print Letribly Name(Business/Organization4adividual): D Address: *f 2 �1$� ,4640C.RS id City/State/Zip: Phone* —9L61-q 06W Are you as employer?Check the appropriate box: Type of project(required)' La am a employer wa 16 _employ.(full and/orpert-time).' 7. ❑New construction 2.[]I am a sole proprietor or partnership and have no employees working for me in $. Remodeling any capacity.(No workers'comp.insursnce required.) 3.[]I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. El Demolition 4.FJ I am a homeowner and will be hiring contractors to conduct all work oamY ProP�Y• I w.M 10❑Building addition ensure that all contractors either have workers'compeaMEM insurance or are sole 11.❑ repairs Electrical rairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5r]I am a general contactor and I have fired the sub-couttactors listed on the attached sheet 13.❑Roof I airs These enb-coahractors have employees and have workers'comp.insmsmce 6. We are a corporation and its afficers have exercised their right of exemption per MGL c. 14.Q Other 152,§1(4),and we have no employees.(No workers'comp:a^pra^M required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy 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. tContactors 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 most provide their workers'comp.policy number. I am an employer th4t is proidding workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: G Policy#or Self-ins.Lic.#: 9.T-C.'-00 &C31 Co Er' EmpiratimDate: i Z Job Site City/Stateq4: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify under thepains an enables of perjury that the information provided above is time and correct. Si e: Date: 2- Phone#: t 3 Official use only. Do not write in this area to be completed by city or fawn a}ficiat aRa S City or Town: Permit Ucense# Istnvag Authority(circle one): 1.Board of Health; 2.Building Department 3.City/Town Clerk 4:Electrical Inspector 5.Pl mtbing Inspector 6.Other Contact Person: Phone#: i WONWETIL AITH MA �Q�3fi�flf SH ETMf+ --TAL;WORK RS ISSUES THE FOLLOWINGCEt+CSE, '! MASTER{tNRESTRICTED z: W1 MAM R�HEMPENIUS "CE CT t r EALMd IT F i I I , I I t I I . ! t ��® ��� Job: 185 Ridgewood Ave Summary pate: September 22,2018 Entire House My: Ai Gagne MECHANICAL CORP Bayside Mechanical Corp. 497 Thomas B.Landers Road,Unit 1,East Falmouth,MA 02536 Phone:508-548-4068 Fax:508-548-4406 Email:agagne@baodemech.net Web:wwwbaysidemech.net License:MasterESOM ... For: Mason,Dennis,Seashore Homes P.O.Box 462,Dennis,MA 02638 Phone:774-487-8086 Email:dennis@seashorehomescapecod.com Notes: HVAC from crawl space. Weather: Barnstable Muni Boa,MA,US Winter Design Conditions Summer Design Conditions Outside db 16 OF Outside db 82 OF Inside db 70 OF Inside db 72 OF Design TD 54 OF Design TD 10 OF Daily range L Relative humidity 50 % Moisture difference 42 grAb Keating Summary Sensible Cooling Equipment Load Sizing Structure 12178 Bluh Structure 9744 Btuh Ducts 570 Btuh Ducts 163 Btuh Central vent(0 cfm) 0 Btuh Central vent(0 cfm) 0 Btuh (none) (none) Humidification 0 Btuh Blower 0 Btuh Piping 0 Btuh Equipment load 12748 Btuh Use manufacturer's data y. Rate/swingg multipplier 1.00 Infiltration Equipmentsensible load 9907 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Tight Fireplaces 0 Structure 2297 Btuh Ducts 280 Btuh Central vent(0 cfm) 0 Btuh Heating Coolin (none) Area(W) 771 77q Equipment latent load 2577 Btuh Volume(fta) 7488 7488 Air changes/hour 0.27 0.14 Equipment Total Load(Seril 12484 Bbuh Equiv.AVF(cfm) 34 17 Req.total capacity at 0.80 SHR 1.0 ton Heating Equipment Summary Cooling Equipment Summary Make Carrier Make Carrier Trade Carrier Performance 95 Single-_ Trade COMFORT13 AC Model 59SP5A040E14-10 Cond 24ABB318ABN340 AHRI ref 4702804 - Coil CNPHP2417ALA+59SP5A040E14-10 AHRI ref 0 Efficiency 96.5AFUE Efficiency 11.5 EER,14 SEER Heating input 40000 Btuh Sensible cooling 12180 Btuh Heating ou ut 39000 Btuh Latent cooling 5220 Btuh Low output aseboard 600 Btuh/ft Total cooling 17400 Btuh Total low baseboard 21 ft Actual airflow 580 cfm High output baseboard 850 Btuh/ft. Air flow factor 0.059 cfm/Btuh Total high baseboard 15 ft Static pressure 0.50 in H2O Space thermostat Load sensible heat ratio 0.79 Calculations approved byACCAto meet all requirements of Manual J 8th Ed. 4 - wvrlghits®fig- 2020-Apr-1018:22:14 I-- °^�^ •11— Right-Suite®Universal 201919.0.18 RS000405 Page 1 oft HVACGeashore Homes,185 Ridgewood 7-18.rup Calc=MJ8 Front Door faces:N f Level I WID PD R 4 x 1.4 Kitchen 4x10 147cfm 21 cf m T 10 x 12 347 cf m Living/Dining 1 12x4 . 12x4 104 cf m 104 cf m Job*185ffdgew®®d Am skle MechanicalCorp. Soa e:1:50 Peif®�ed byPJGagneff®r Pagel Masal Denis 4RManas B.Laxhs Road,Uit 1 ROSUUrimsd 2019 P.O.BoAE2 East Palma Oh,MA 02MB 19018RS11 Dervis,MA OMB Phase:53564088 FEDc 5 B5O4405 2MDApr 1018034 Phxe:7744374M wmv.b OcWiechnd agxjv&4sid3nechret ieHomes,1E5RcbmoW7-18ap da vis@omh mdcorn N Level 2 Bath 2 Bed 1 3x3 6 x 6 125cfm4 31 cf m 611 q. 3x3 7ip 135 cf m I g ,1 � gIf 7 „ Stair 8 x 6 126 cfm' 611 ; , Bed 2 3x6 126 cf m Job it 115 FWgewood Am ftside Mechanical��. Scale:1:50 Peifoavned byAJGagneforr Paget Masai Danis 497Thomas B.Lams Rai lkit 1 RgttSUWUrivesal 2Q19 P.O.Bac 42 East Falmaff,MA C20 19.Q18RSUODO Danis,MA ON38 Phom 3.1664:0 Fac 905684CS =AR1=21:34 Phom.774437-KM www.baodmechns#agagv&ffod3neohrEt to Homes,185Rdg oW7-1anp dnis@xaInF*=escgmoodon r N C ravel Space a� w�� ram)i�i vv Craw 7 5 �? 44 k 9 14 1011 q �+ go N 611 fo All 9 F JobA 1859lgewdod Aie Scale:1:50 Perfo�r�byAGagnefor We tV hanis:�iCorp. Page Masan Daeis 497Thomm B.Lardats Rod,Lkit 1 R_c tS4 its&L hvamA 2019 P.O.Box 40"2 East FdmcLtK MA 02536 19.Q18 RSUODM Doses,MA OnB Phone:5BS454M Fac 8MS644:6 2MDApr 101a21:M Phme:774497-ECE6 v wv.bayadaneduwt egags@xoyschmechrol reFtmes,185Mcbmcod7--lAnp derves( ovehom-cq--cd=n DensGgase '®classical Service 61ot1irfe, ,?�;6999 or Sheathing .www.0gypsum.com Physical Properties r o Flhominal 4'(1219 min)t 1/8 (3 mm) 4 11219 min}t 1/8 (3 mmj ength, B'{24A0 mml 9 (2743 mm), B (2440 min) 9'(2743 m) — {30A8 min) + 1/A (6 min)__�._.___ 10 (3048 mm).t 1/4 (6_mm) n _ _. Weight nominal lbs./sq ftv(Kg/m2} ___ _ 1 -----___ Edges Square - Square Bendnig radius --6'(1829 mm) -- 8 (2438 min} Raeking strengths lbs/ft(dry)(N/m)�Uipmate not design value - __._. >654(9544} ftexuralstrength ;parai(ei lbf.(N) 4 weekdlrectidii Z80(356) -� ... IA 100(445) Compressive strength - -- --- - - minm 500 psi(3445 kPa) min'500 si 3445 kPa) Humidified deflection'° nce2,Perms(n0/Pa s•mz) _ - _._ _ _Permed >23(1300) --__...._ >17(970) R Valued,ft�•°F•hrLBTU(mz.K/W) 56(0.099J —_ 67(0118) Combustibtllty' Noncombustible _ Noncombustible - - _. Linear expansion:roth moisfure cflange m/m 9°RH,(min/min%RH►s 6.25 x 10 6.25 x 10$ Surface burning characteristics per ASTM E84 or `-- ---- CAN/ULC:S102_.fiame spread/smoke developed 0!0 Coefficient $ of thermal expansion, 85 x 10 CoinF (min/min/C) 85x10 {t53x10� _ 153x1 i0$W 'Tested in accordance with ASTM C473 $Double fasteners an ends as needed .•_. _. _ z Tested in accordance with ASTM F9(dry cup:method/ rested ; Q 'Tested in aanrdanee withASRt?C518/heat fiawmeter/ 'AsdefinW-d in accordance with ASTM E72 rested in.accordance with ASTM E134 nr CAN/UtC 51l4°Specifietl values par ASTM C1177 eAs stated tPyGypsumAssociationGA=235 ' 'Tested in accordance tvfthAS7MF22M5 i TRADEMARKS Unless otherwise:rioted,all t 6demarks.are owned by or licensed`:to.Georgia-Pacific Ge ® _. IfIC Gypsum LLC, Gypsum WARRANTIES,REMEDiES AND TERMS. SALE For current warranty information for this product,please 90 to wnrrw:gpgypsum.com and,select the product:for warranty information.Ail'sales U-SA. Georgia-Pacific Gypsum{LC, of this product by Georgia-Pacific are subject to'our Terms of`Sale available at wwwgpgypsum:com. Georgia-Pacific Gypsum If LlC UPDATES.AND CURRENT INFORMATION The information in:this document may change without Canada Georgia P cific.Canada LP notice.Visit,our website at www:gpgypsum.com for updates and currerif:infbrmation: ,i SfliE5INI'dRUATI0f3 AND ORDER.PLACEMENT CAUTItli�'.For r011160fire,$�f 'P cty;arsd arse Isaforsssatama,96 to wtrmiarv;bgesldgp.r m/sAfatyistfre West 9-8{Ig 82q-7�Ct or'ea11 t- -2�-61 9. Midwest: 3-SrFM6 g74s SIRE SAFETY CAUTION Passing a#tie tost:in a controlled laboratory,setting and/or certifying or :Southeast; 1South Central: 1-O 327 33 231$QSO labeling a product as having,a one-hour,:two-hour;.or,any otherfire resistance or proiectiograting andi therefore,as acceptable for use in,certain fire rated assemblies/systems,does not mean that NortheasC 9 �497 CANADA Canada Tolt°Free:t 387 6823 either a particular assembly/system incorporating the product,or any given piece of the.product itself,will necessarily-provide one-hourfire resistance,two hour fire resistance,or any.other'. Quebec TAT free;t-80D 36t ail specified fire resistance or protection in.an actual fire:.in the went of an actual fire;.you should r caruacat Ira�ORsnArrap immediately take.ar y and all actions necessary for your safety and the safety of others shoal U:SA.and Canada:1 4l19;,www:gpgyp,umxorn regard for<any fire rating of any product or assembly/system: ®�114 Gr�iaPadr'c Gypsum llC.:Nrrights.lest+ved;l/14:GF-i}d-tfC Item 4.537,15G: :. ) i Georglaftcfflc DensGlass@ Technical Service Hbdine 1.8002 si19®r Sheathing www.gpgypsum.com GeorgmanufacturerPaci When DensGlass Sheathing panels are used in slanted wall applications,that portion Georgia Pacific Gypsum Georgia-Pacific Canada of the wall must be temporari}y.protected from the elements.Do not allow water 133 Peachtree Street 2180 Meadowvale Boulevard,Suite 200 to.pond or settle on sheathing.Also,_exposed wall ends must.be covered to Atfanta,GA 303M Mississauga,ON L5N 5S3 prevent water from:infiltrating the cavity. Technical,Service Hotline:t 80D 225 119: Georgia-Pacific Gypsum does not warrant and is not responsible`or liable for the Description performance:of the:claddin br xt r g e e for systems applied over DensGiass Sheathing, DensGiass®Sheathing rs a gypsum panel made of a treated,water-resistant The suitability and compatibility of any system is the responsibility of the system core,surfaced with fiberglass mats and a GOLD colored primer coating.Providing manufacturer or design authority. superb protection from the elements,DensGiass Sheathing is.reIsistantto Do not.laminate masonry surfaces to DensGiass Sheathing;use furring strips or delaminatiomand deterioration due to weather exposure=even during construction `framing, delays that last as long as twelve months after installation and.are backed by a bensGlass Sheathing is not intended roof applications.For roof applications, iimit�warranty against delamination and deterioration for up to 12 months of exposure toinormal weather conditions:'DensGiass Sheathing panels are also consult our DensDecke Roof{;card brochure. mold-resistant,and have scored a 10,the highest level of performance for mold DensGiass Sheathing is not intended for interior or exterior life applications.For resistance under ASTM,D3273 test method. interior life applications,Consult our DensShiei&Tile Sacker brochure. DensGiass Sheathing exhibits a dtmensionakstability that assures resistance to warping, DensGiass Sheathing should not be used in lieu of plywood where required. rippling-buckling and sagging for a flat and even substrate"and is noncombustible Do not apply DensGiass Sheathing below grade. as defined and tested inaccordance with ASTM E136 or CAN/ULC S114.Since DensGtass.Sheathing is strong in both directions,it maybe installed either For all installations,design details such as fasteners;sealants and control joints per system specifications must be properly installed.Openings and penetrations parallel or perpendicularao.wall framing members(always follow specific assembly installation instructions). must be properly flashed and.sealed.Failure to do so will void the;warranty: Primary Uses Do not use DensGiass Sheathing as a base for nailing or mechanical fastening. Because of the superior performance of DensGiass Sheathing it is pacified for Fasteners should be flush to the face of the board;not countersunk. , exterior walls;ceilings and soffits;in a wide variety of applications.These include Technical Data exterior insulation and finish systems(E1FS);cavity brick or stone veneer applications; DensGiass Sheathing is noncombustible as described and tested'in accordance cladding"such as woad siding,vinyl siding;:composition siding;wood shingles, with ASTM El36 or GAN/ULC S114: shakes,conventional stucco systems,plywood siding panels;and interiorfin DensGiass Sheathing exceeds ASTM C1396 sheathing standards for humidified systems that require a substrate panel with superior fire and mgisture resistance.f deflection by a factor of.toxin tests over Standard for regular gypsum s..heaathing, or,E1FS applications;DensGlass Sheathing is an ideal substrate for adhesive or 5/9'(15.9 mm)DensGlass°FireguardO Sheathing is UL and`ULC.classified Type DGG. mechanical application of expanded polystyrene or extruded polystyrene insulation; and is recommended in all climate zones. DensGlassSheathing is manufactured to meet ASTM C1177. Manufacturers of water and'air resistive barriers winch include attached flexible Flame spread and smoke develop rating of 0/0 when tested in accordance with membranes,self-adhered membrane and liquid applied,have found:DensGiass AsTm E64 or CAN/ULC S102. Sheathing to be a:suitable substrate for their systems. Handling and Usa-•CAUTION DensGiass Sheathing:is an ideal product for exterior ceilings and soff its rfor both This product contains fiberglass facings which may cause skin irritation.Dust cold and warm climate zones.It resists sagging,even under exceptionally humid and fibers produced during the handling and installation of the product may conditions.Panels are applied directly to structuralframing.Surface and joints cause skin,eye and respiratory tract irritation.Avoid breathing dust and-mini- may be finished and painted;or surfaced with an exterior finish system. Mize contact with skin and eyes.Wear long sleeve shirts,long pants and eye Limitations protection.Alwaysmaintainadequate ventilation.Use a dust masker NIOSH/ DensGiass Sheathing is resistant to.normal weather conditions but it is not intended MSHA,approved respirator as appropriate.in dusty or poorly ventilated areas. for immersion, water.Cascading'roof/floor water should be directed away from Material Safety Data Sheet(MSDS)is available at www:buildgp.com/safetyirtfo the:sheathing until appropriate drainage is installed. or call 1-404-652-5119, Avoid any condition that will create moisture in the air and condensation on Product Data DensGiass Sheathing.The.use of forced air.heaters creates volumesof water Thicknesses:1/2112.7'mm);5/8,(15:9 mm)is Type X(ASTM Ci 117) vapor which,when.not.properly vented,can condense on building materials. Width:4'(1220 mm)standard,toferance up to±1/8 (3.2 min) 'The use of these heaters and any resulting damage is not the responsibility of Lengths_8'(2d38.mm),9'(2743 min}or 10'(3048 mm)standard Gebrgia•Pacific Gypsum:Consult heater manufacturer for proper use and ventilation. Edges:Square "For complete Warranty details,.visit www.gpgWsum.com. continued---- Submittal Job Name �pprmvals Contractor Date , s s> s Q , 5 ' WOOD-FRAMED WALL 5/8"(15.0 rnm)TcughRock®Fireguard'X6 or 5/8"(159.mm)DensArmor Pius6 Fireguardo.gypsum;panels applied vertically(or horizontally to each side of double row of 2 x 4"wood studs 16"(406 mm)o.c.orr separate plates t"(25 min)apaitwith l-7/9"(48 mm)6d coated nails 7"(:178'mm)-o c..Waltboard nailed to top and bottom plates 7'(178 mrn)ox.Stagger Joints each side.Horizontal bracing required at mid height.ULC W30:1 allows verticat,application only. Hourly Rating:l-lour STC:Rating:50-54 STC Fire Test Reference:UL U305,ULC W30l icUL U305,GA WP 5512 Sound Test Reference:tAOAL 17-0837,8-25-1.7 Approved for Assembly. DensArmor Plus®;Fireguard CO Products: DensArmor Plus®:Fireguard®Products, DensElemento Barrier.Sheathing king DensGlass®Fireguard®Sheathing `DensShield®Fireguard®Tite Backer ToughRock®Fireguard CO Products ToughRockO Fireguard X®Mold-GuardTM'Products ToughRock®Fireguard XO Products ToughRock®Lice-Weight Fire-Rated Products(Meets Ere-rating but not evaluated for.Sound) f x m� l.�r©s�� sQuruaANr ®o:L�Y��I{ sP�EAc zaFIFIE� ., �' (c i, COMPANY J Johns Manville,a Berkshire Hathaway company,was founded in 1858.Our ownership by Berkshire Hathaway,one of the most admired companies in the world and one of the most financially secure;allows JM to invest for the future.This enables JM to g> , continue delivering the broadest range of insulation products in the industry and offering innovative solutions that meet your needs. DESCRIPTION JM mineral wool batts are made of inorganic fibers derived from basalt,a volcanic rock. Advanced manufacturing technology ensures consistent product quality,with high-fiber density and low shot content for excellent performance.JM mineral wool batts are inorganic,noncombustible,moisture resistant, non-deteriorating,and will not mildew or support corrosion. USE JM Sound&Fire Block®batts are designed to deliver noise control in wood-stud cavities of interior walls and ceilings between floors. PERFORMANCE ADVANTAGES INSTALLATION Excellent Acoustical Performance: In standard wood framing,carefully insert batts between the wood studs or joists to Lightweight,flexible insulation batts are fill the cavities with a friction-fit to framing members.JM mineral wool batts are easily excellent sound absorbers,efficiently cut with a knife for quick installation and snug fit in nonstandard size cavities. reducing sound transmission.JM mineral wool batts improve the Sound Suspended Ceilings:When approved by the ceiling system manufacturer, lay JM Transmission Class(STC)ratings of interior mineral wool batts over the ceiling area so that the insulating material is supported by partition walls and suspended ceilings. the ceiling suspension system, not the ceiling panels themselves. The high-density, non-combustible fiber in mineral wool reduces unwanted noise PACKAGING from traveling from room to room, making JM mineral wool products are compression packed for more efficient storage homes quieter. and transport. Fire Safety:Mineral wool Sound&Fire DESIGN CONSIDERATIONS Block has a melting point in excess of 2000'F(10930C).See Applicable Standards for details. Noncombustible:See Applicable Standards for details. Durable&Inorganic:JM mineral wool d batts do not support growth of fungi, nor .xvY do they sustain vermin. Interior walls t Ceilings between floors �.. ��*'�,..�5�6 9�„���« �'� �'�. � �_ r ,,,« d 3� </sf ,..M �;a ,�f A..x � 5 ��1'• .Ps.E.( LIMITATIONS OF USE Check applicable building codes. PHYSICAL PROPERTIES PROPERIy � � TEST;NIEIHOD .2. ,.h d, R{1FING .. ` ..... Sound Transmission Class ASTM E90 See Acoustical Ratings below Surface Burning Characteristics ASTM E84 Flame Spread/Smoke Developed,0/0 Critical Radiant Flux ASTM E970 Greater than 0.12 W/cmz Noncombustible ASTM E136 Pass Water Vapor Sorption ASTM C1104 Less than 5% Odor Emission ASTM C1304 Pass Corrosiveness ASTM C665 Pass Fungi Resistance ASTM C1338 Pass ACOUSTICAL RATINGS FOR COMMON ASSEMBLIES CONPGNENTS � ,,; RATING 2x4 Wood Wall 2'x4'wood studs 16"o.c.,5/8' STC-47 gypsum drywall both sides,resilient channels,3'JM Sound&Fire Block® insulation 2x10 Wood Floor 2'xl0"wood joists 16'o.c.,23/32" STC-47 OSB subfioor,5/8'gypsum drywall, resilient channels,3'JM Sound& } Fire Block®insulation STANDARD SIZES ,,,PRODUCT,„ ��'� THICKNESS n�(mm,),. ��WIDTH€rn(mm1,,._ fj�I.ENGTH in(mm) Sound&Fire Block® 3'(76) 15Y4"(387) 1 47'(1194) r Visit our website at www.JM.com or call 800-654-3103 Building Insulation Division PO.Box 5108 Denver,CO 80217-51 OB Technical specifications as shown in this literature are intended to be used as general guidelines only.Please refer to the Safety Data Sheet and product label prior to using this product.The physical and chemical properties of mineral wool insulation listed herein represent typical,average values obtained in accordance with accepted test methods and are subject to normal manufacturing variations.They are supplied as a technical service and are subject to change without notice.Any references to numerical flame spread or smoke developed ratings are not intended to reflect hazards presented by these or any other materials under actual fire conditions. Check with the sales office nearest you for current information.All Johns Manville products are sold subject to Johns Manville's standard Terms and Johns P anWife Conditions,which includes a Limited Warranty and Limitation of Remedy.For a copy of the Johns Manville standard Terms and Conditions or for information on other Johns Manville insulation and systems,visit www2.im.com/terms-conditions or call 800-654-3103. BID-0170 6/19 ©2019 Johns Manville.All Rights Reserved. I f _ I TOWN OF BARNSTABLE 2020 F,_ 5 0 ell 41 •�� roe / OF o q Hr MgSSgC' ( r. o�, .DANIEL ':yes e afi ryl \t �? [?f0jALl� `�: o A QJALA N civIL Cn 'No.40080' ,� I`q 'No 4650? �. Fts, 'V OQ CAV f 4 FIRE DEPARTMENT SKETCH PLAN - . OF . scale'1"= 40' 17 HIGH SCHOOL ROAD HYANNIS, MA 0. 20 40 .60 80 100 FEET PREPARED FOR off'-508=362-4541 fox 508-362-9880 downcapp.com JACOB DEWEY d�WO Cape ellglNeer/Qg,•/IIC. DATE: FEBRUARY 4, 2020 ci vil engineers land' sur_ veyors j 93.5 Main' Street ( R.te 6A) YAR.MOUTWORT MA 02675 ;DCE #19-251, . _ Town of Barnstable_ _ Building Post This Card So That it is Visible From the Street-Approved Plans Must be RetainFed on Job and this Card Must be Kept sAmsrAaLL Mns�. 'Posted Until Final Irispect_on Has Been Made Permit Where a.Certificate of Occupancy Required;such Buildm shall Not be Occupied until a t Final Inspection has been made P Y q g Permit No. B-19-595 Applicant Name: 'Henry Cassidy Approvals Date Issued: 02/26/2019 Current Use: Structure Permit Type: Building- Insulation- Residential Expiration Date: 08/26/2019 Foundation: Location: -17 HIGH SCHOOL ROAD, HYANNIS Map/Lot 308-259 Zoning District: SPLIT Sheathing: Owner on Record: PLOCHARCZYK, RAYMOND TR Contractor Name:'~,HENRY E CASSIDY. Framing: . 1 Address: PO BOX 614 Contractor License. °CS=100988 2 HYANNISPORT, MA 02647 M, Est. Project Cost: $4,400.00 Chimney: Description: Insulation/Weatherization Permit Fee: $85.00 Insulation: a Fee Paid:,� 585.00 Project Review Req: Final Date. 2/26/2019 R E/ Plumbing/Gas i Rough Plumbing: ,,Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within''six months after'issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for'which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures.shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for,public inspection for the entire duration of the work until the completion of the same. -- -- .� Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this.permit. Service: Minimum of Five Call Inspections Required for All Construction Work:; ,*`5 ' 1.Foundation or Footing Rough: 2.Sheathing Inspection - 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. _ .Final:_ "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Buildingplans are to be available on site t�- p *� S Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT - /1r' i '+�. 1.•�:i t� T :ye^ry..Y"Ml..i4'�_i�a:`a. .. f* � M1i-.,,,:-ter.., xi. G.^ _ �PyofHETo��o TOWN OF BARNSTABLE i' sasTL 'r Office of the Building Inspector G >00 NAM 3 1 ` E D MAY k, Date ..,,January 9, 1987 $25.00 Fee .................................................. Permit No. 87-2 F PERMIT TO ERECT SIGN IS HEREBY r F GRANTED TO ............Harvard Real t v ....................................................................................................... D/B/A 17 High 5choal Road i, ......................................... ......ll....................................................................................................................................... LOCATION ...................Hyannis..:...Massachusetts ............ ................... ............................................................................................................................................................................................................... ANY VIOLATION OF THE SIGN LAW WILL CAUSE IMMEDIATE REVOCATION OF THIS PERMIT - -=-------- ------------------------ ' Building Inspector .> >- i- o, TOWN OF ' BARNSTABLE �� BUILDING DEPARTMENT c_�)5 60 t sa"n TOWN OFFICE BUILDING 9659. 'S reap ` IiYANN15, MASS. 02601 ' �s■►Y APPLICATION FOR SIGN PERMIT DATE Application is hereby•made for a sign permit in accordance with the description and for the purposes hereinafter set forth This application is made subject'to- all Rules and Regulations of the Town of Bornstoble .now in force or that-may hereafter be enacted affecting or regulating thereto and which are hereby agreed to by the undersigned applicant and which shall be deemed a condition-entering into the exercise of this permit. INSTRUCTIONS 1. This application must be filled out completely. 2 A drawing, in duplicate, showing the shape and dimensions of the sign, lettering on same, height, method of securing to building, or if freestanding,.method of erection. Drawing must show sizes of structural supports, and size and depth of foundation. SIGN LOCATION. Owner'. Har.vard Realty Street- Rd. 17 High School Road. Hyanni Zoning District Barnstable Fire District Barnstable OWNER OF PROPERTY Name Harvard Realty Address 17 High School Road City Hyannis St MA — Zip 02601 TelyNo.(617 ) 771=1778 Area Code SIGN CONTRACTOR Name Amidon & Company, Inc. Address 376 Route 130 — P.O. Box 681. City Sandwich St. MA Zip 02563 Tel No.(617 ) 888' 0565 Area Code Type of Construction Wood Sign Free Standing or Attached Free Standing' DESCRIPTION DIAGRAM OF LOT SHOWING LOCATION OF BUILDINGS AND EXISTING SIGNS WITH DIMENSIONS LOCATION AND SIZE OF THE NEW SIGN. "Harvard Realty Assoc " TO BE DRAWN ON THE REVERSE SIDE OF THIS APPLICATION. 28 1/2" ,x:49. 1/2" Is there any electrical wiring required for this sign? Yes No If "Yes," who ts_the electrical contractor ? FOR OFFICE USE ONLY Area Ao. DATE DATE .. -DATE' Permit Fee s• DEPT. ROUTE RECEIVED APPROVED REJECTED INITIALS PLANNING Mail permit to: &.ZONING k> ELECTRICAL INSPECTOR BUILDING INSPECTION Q ' I " I hereby certify that I am the owner or that I have the authority of the owner .to make application that the informattor given is correct and that the use and construction shall conform to all the' Rules and Regulations of:'the Town of..Born• which are imposed on the property. 888-0565 NArfi;7_y Hesek {6 :nC, Phone Signature of sin weer/authorized agent 1 1 Aeo--e,I_� ter' I 0. (-,a o #?. !a r (HR IF V- il 'T RFALTOW QED GtMITE- i i I p - - I v��(Ni+O ftl?(17Z'o"" I j C.; 1 WOODCARVERS/SIGNMAKERS j _ 376 RTE. 130 P.O. BOX 681 j 7 SANDWICH, MA. 02563 (617)688-0565 ` I i Parcel Detail Page 1 of 4 T $ 8 h Logged In As: Parcel Dex a Friday,September 7 2018 Parcel Lookup L il Parcel Info __ --- .... Parcel ID r308 259 ' Developer Lot Location 17 HIGH SCHOOL ROA Prl Frontage 116 Sec Road Sec Frontage I Village jHyannisW m Fire District!kW YANNIS « ) Town sewer exists at this addresses Road index 0705 , ua a � Interactive Map ` 3 « er Owner Info Owner lPLOCHARCZYK,mRAYM� owner l7 HIG H�SCHOOL ROAD streeu 1-BELMONT ROAD UNf�Streetz city WEST HARWICH ) state g�MA I zip>02 7676 1-13Z � �country Land Info .... ..... _... ................ ........ Acres[0 35 --, ��.,1 use OFFICE BLD MDL-94 1 Zoning .SPLIT HVB;SF F Nghbd}CI09 � Topography( �� _ Road Nam, Utilities� .,...�.,-....•...,.,..�,.,,�,. f � Location�•a,..„..M,.�,„ ,.,,�,,....... �. _...,,,�«f. Construction Info ..... Building 1 of 1 Year l`1950� Y Roof Gable/Hip"« Ext Wood Sh"ingle Built I Struct Wall Living Area 22710 a cover Asph/F GIS/Cmp�. Type ;None Style Conventional Int Plastered Bed v nt�.,�..,�.,,,� Wall :u, .< Rooms. Int Bath .<"". Model Commercial Floorarpet Rooms 13 FUII-2 Half trade vera e "eat Hot Water Total g Type Imo,, ,� ,,,°,;- Rooms Heat 2.4 Fuel Found- Storiesation ConC. "BIOCk rye,. Gross4810 p Area Permit History Issue Date Purpose Permit# Amount Insp Date Comments rip & replace 6 square 10/13/2016 SidNVind/Roof/Door 16-3000 $6,000 white cedar siding shingles 8/11/2011 Demolish 201103939 $3,000 DEMO BARN http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=25123 9/7/2018 Parcel Detail Page 2 of 4 1/11/2012 I I ) I12:00 00 AM I Visit History Date Who Purpose 2/8/2017 12:00:00 AM Anne Leonelli In Office Review 5/24/2016 12:00:00 AM Anne Leonelli In Office Review 9/4/2015 12:00:00 AM Anne Leonelli In Office Review 12/24/2014 12:00:00 AM Jeff Rudziak Cycl Insp Comp 1/13/2012 12:00:00 AM Jeff Rudziak In Office Review 7/1/2011 12:00:00 AM Jeff Rudziak In Office Review Sales History Line Sale Date Owner Book/Page Sale Price 1 7/20/2016 PLOCHARCZYK, RAYMOND TR 29809/148 $0 2 4/12/2015 CAREY, JEANNE S TR 29809/136 $0 3 2/27/2015 CAREY, JEANNE S & DENNIS M TRS 28706/50 $1 4 5/9/1975 CAREY, DENNIS M & KELLEY, JEANNE S 2180/252 $20,000 - Assessment History Save Building Total Parcel # Year Value XF Value OB Value Land Value Value 1 2018 $169,500 $37,800 $4,200 $174,000 $385,500 2 2017 $166,900 $38,500 $7,700 $197,500 $410,600 3 2016 $166,900 $38,500 $7,700 $197,500 $410,600 4. 2015 $160,500 $34,800 $6,300 $216,800 $418,400 5 2014 $160,500 $34,800 $6,400 $216,800 $418,500 6 2013 $160,500 $34,800 $6,500 $216,800 $418,600 7 2012 $157,200 $33,800 $15,700 $216,800 $423,500 8 2011 $161,200 $5,700 $15,500 $216,800 $399,200 9 2010 $161,200 $5,700 $16,000 $216,800 $399,700 10 2009 $161,200 $4,600 $12,000 $246,500 $424,300 11 2008 $189,300 • $0 $12,000 $218,000 $419,300 13 2007 $189,300 $0 $12,000 $218,000 $419,300 14 2006 $173,800 $4,100 $12,400 $218,000 $408,300 15 - 2005 $165,400 $4,100 $12,700 $182,800 $365,000 16 2004 $155,500 $4,100 $12,900 $182,800 $355,300 1.7 2003 $108,700 $4,500 $13,300 $98,600 $225,100 4 18 . 2002 $108,700 $4,500 $13,300 $98,600 $225,100 19 2001 $108,700 $4,800 $13,300 $98,600 $225,400 20 2000 $105,300 $5,000 $13,100 $78,900 $202,300 21 1999 $105,300 $5,000 $10,200 $78,900 $199,400 22 1998 $105,300 $5,000 $10,200 $78,900 $199,400 23 1997 $149,600 $0 $0 $78,900 $233,500 24 1996 $149,600 $0 $0 $78,900 $233,500 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=25123 9/7/2018 Parcel Detail Page 3 of 4 25 1995 $149,600 $0 $0 $78,900 $233,500 26 1994 $140,800 $0 $0 $75,300 $221,800 27 1993 $140,800 $0 $0 $75,300 $221,800 28 1992 $160,600 $0 $0 $83,600 $250,700 29 1991 $152,200 $0 $0 $119,500 $282,700 30 1990 $152,200 $0 $0 $119,500 $282,700 31 1989 $152,200 $0 $0 $119,500 $282,700 32 1988 $101,600 $0 $0 $91,300 $203,300 33 1987 $101,600 $0 $0 $91,300 $203,300 34 1986 $101,600 $0 $0 $91,300 $203,300 Photos FT- _ v y` I iP '. 'T. i mly U,j t r http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=25123 9/7/2018 Parcel Detail Page 4 of 4 massim r: d. v h i y� http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=25123 9/7/2018 Town of Barnstable *Permit# 0?606 Expires 6 months from issue date X-PRESS PERMIT Regulatory Services Fee -. Dd Thomas F.Geiler,Director OCT 2 7 2006 Building Division TOWN OF BARNSTABLE Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint ,lap/parcel Number L�� 0+�-7� 'roperty Address f ]Residential Value of Work /.S Minimum fee of$25.00 for work under$6000.00 )wner's Name&Address ✓ lei /<� :ontractor's Name t (`UT _t c ��_ elephone Number ) ,��a come Improvement Contractor License#(if applicable) . 00 :onstruction Supervisor's License#(if applicable)_ � � f ]Workman's Compensation Insurance Check one: , 4-1-am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance nsurance Company Name Vorkman's Comp.Policy# ,'opy of Insurance Compliance Certificate must be on file. 'ermit Request(check box) N-Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Co:trac icense is ed. ;IGNATURE: t:Forms:expmtrg levise071405 The Commonwealth of Massachusetts . Department of hidustrial Accidents office.ofInvestigations' . 600 Washington Street ' Boston,MA 02111' ' www.mass.gov/dia •'• 'ciaris/Fluma�bers • lectn . etors/E NVorkers' Compensation insurance Affidavit. Builders/Con#�•a . Please Print Le 'bl licant Information pdzatotaadividud): ,,Tame(B4=ssfpr C) Address. Phone#:' •� : . City/StatelZip.:° r lieckthe•appropriate bor. :'I`ype of project(require'd).- oa an employer?.C ire 7 4. I am a eneral contractor and I Q Z aMoyer with ❑ g _6..❑New cobsttuction employees(fall and/or part tie)* have hirad the snb-contractors 7. ❑ Remodeling rietor or partner- listed'oa the attached sheet.$ am a sole-pm These sub-contractors have a. •[] Demolition /, ship and ►aveno employees. ing for mein any'capacity, workers' comp'insurance. 9. ❑ Building addition work Woo ng foS, ten,insurance 5, [] Yee are a corporation and its 10.0 mbctdcal repairs or.additions officers have exercised their required-I right of exemption per MGL 1Y.0 PIUM b)Mg repairs or additions 3.❑ I am a homeowner doi_g.9 all.work and a have no of r airs c. 152,�1(4), w 12.�. O cp myself,•�No workers comp. employees.[No workers' insurancetegnired..],t 13',❑ Other . .. comp.msurancerequired.] L•• ... �y applicant thaf checks box#1 must also fin out the section be]ow showing thew workers'campensatioa policy information: . gomeowners whb snbmitttsis a$davit indicating they are doing an•work and then hire outside=tma.Wq must submits now nffidavitindi s h. Coatrooms that check this box must of tachcd an additional sheet shdwing the rime df the sub-conttactars=dtheir wcrkdrs;ro=PV0Uey' f am an employer that is providing,workers'compensation Insurance for my employees.'Below is the policy and job site. Information. once• nay Name: �- [nsUs Cornp Expiration Date:• Policy#or Self-ins,Lic, #: W6al �}Job Site Address: City/State/ : , • � . Attach a copy of the workers' compensa on policy declaration page(showing the policy num er and•eagiration date). Fallure to,secare coverage as requiredunder Section 25A of MGL e. 152 Bari lead to the imp SitOp���PX O p naltles and a a i'ine up to$1,po,,OQ and/or one-year b3prisoament,as well as civil.penalties m'le form of of-up to$250:00 a day against the violator. $e advised that a copy oftbis statementmay'�o forwarded to.the Office of Ines dgatidns of the DIA for insurance coverage verification. —— I doh hereby certify under lhepains and p en of pe ry that the information provided above Is true andcorrect Date: Phone#• Ofj`'ictal use only. Do not write in this area,to be completed by city,or town official City or Town: PermhUcense# Issuing Authority(circle one)3 1.Board of Health 2.Building Department 3.City/Towu Clerk 4.Electrical Inspector 5.Plumbing Inspector 6,Other .ContactPerson. Phone#: ' d I�stru�tions• ^ Information aji. • to to vide workers' compensation for their envloyees. ' General Lay chapter 152 tequires all employers contract of hire, Massach mite, an employee is defined as"...every person in the service of another under any pursuant to oral or "exprr • ;t .tion or other legal entity,or my two or more ' dxvi pal,,part�ersI':assoaation, zpora , . An employer is defined ag�: ' . and including the legal representatives of a deceased employer,or the of the foregoing.engaged=a joint enterprise, to to HoRtcver:tbe• indindnal,partnership,as or other legal entity,emp ymg�P Yees. receiver'or trustee of as not more than, apartmeata and who resides therein,or tat occapant of the owner of a dwelling house having air wo=2�•on such dwelling house house of another WILD eazploy$persons to do mainteriaace,construction or rep to er." dweTlaag notbee ause of snch eraploymentbe deemed to be an crap Y ereto shall a urtenant th ��the grounds or buiYdmg•PP . old the issuance or . Ibh • all wit . states that:"eYery.stati%or local Ticensing agency shall A. MGL chapter.152,§25 C(6)also . enewal of a license or perms to operate a business or to construct buildings in the�ommonwealth for any lr a produced acceptable eyidencetof compliance with the insurance coverage required." applicant who'has not p states"Neither a commoncwealth nor any of its*political subdivisions shall Additionally,MGL chaPteT 152,§25C(� ce,V the insurance eater into any contract for the performance Of pudic work until acceptably evidence of co i��eIDeats of his chapter have been presented to the contracting authority." Applicants � ' • • ' to m situation and,if. ensatfon of idavit'eompletely,by checking theboges that apply Yo Please fill out the workers' comp addresses)Dail phone numbe (s) along certificate(s)of necessary,amply,sub-contractor(s)name(s), 'h&no employees other than-the insurance. Limited Liability Companies(LLG)or Limited Liability Pntaenbips'(LLP) are ity Co np n es carry workers' compensation insurance. If an LLC or LLP does have members or p artaers, aired. Be advised that d�i5 off,.idavit may b e submitted to the D ep artment of Industrial employees,a.policy is req ccidents for confrrnnation of insurance coverage., 'Also be'snre to sign and date the mod$not theDepaar{meat of A or.town.that the application for the peimit'or license is being req tcd, be returned to the uestions re arding he law or if you are required'to onl .�' Industrial Accidents, Should xou have Day q g anies should rimer their compe�ationpolicy,please call the Department at number listed below, elf-insured�S COMP self-insurance license number on the appropriate line. City or Town Officials • ace at the bottom Please be sure drat the affidavit is complete and printed legibly. The Department has provided a sp applicant of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the agp Brant Please be siae'to fill in thepetmit/hoense number which wMbe used as a reference number. In addition, as Opp t submitmultiple permitllieease applications in any given year,need Only submit one affidavit indicating (Citycurre o thatnms and under"job Site Address"'die applicant should write"all Locations is_____(city or policy information(if necessary) ed or marked by the city or town may be provided to the 10*4"A copy ofthe davitthathas been af3ieiaIly stamp licaut w proof that•a valid affidavit is•en,file for;future p ermst •orn��related tQ any m�scommercial venture be filled out eath DPP year. There a home owner or citizen is obfainmg a license or p Ir a dog license or Permit to burn leaves etc.)saidpenon is NOT required to complete flits affidavit ( ' lions would bko to thank you in advance for your cooperation and should you have any questions, The Office of Inv t e us a call.. please do nothesitate td� TheI)eputt eafs address,telephone and.faxmmber. r. The Commonwealth of Massachusetts . Department of Industrial.Accidents • ..Office of hlVestigattps . a f �OQ W sliington S reet41 . Boston,MA Q2111� TeL#617-727-4900 ext 40'6 or 1-877 MASSAFE r Fax#617-727r7749 „_:__� c ��115 �raras.maRS.SOVIala f �TME, Town of Barnstable Regulatory Services ss Thomas F.Geller,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I ,as Owner of the subject property hereby authorize eb y it to act on my behalf ,o in ail matters relative to work authorized by this building permit application for: lee (Atess of Job) 'Z' Signature of Owner Date Print Name QyORM&OWNERPERNE SION a i - - ': ,lJie �O?92nZCyILUlP/.dd.L1Z ry�..l��Jctcd7.u6�s BOARD>OF BUILDING�REGULATIONS License: C.QNSTRU:CTIOWSUPERVRSOR Number CAS, 078687 . Expires 0.5/29/2008 Tr:no: 22140 i RestrFcted 30 BRUCE P MILLS 16 CROOKED POND RD `` l HYANNIS, MA 02601 '" .` Commissioner Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration:,_.,136003 Expi ration. :6/30/2008 r ' Type -Individual BRUCE P.MILLS HRUCE MILLS 16 CROOKED POND HYANNIS,MA 02601 Deputy Administrator I ; TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application Health Division ��J` Date Issued: Conservation Division Application Fee Planning Dept. 'a!?, Permit Fee Date Definitive Plan Approved by Planning Board OAR �b' Y, E �- Historic - OKH _ Preservation/ Hyannis Project Street Address / 7 I-l�y�, 51� ad Village I��Gnu L S Owner Ray 1)10c�CrC7-W K Address Telephone CS-6 8) L-j 3 70 Permit Request r(.k .re D)Cg G 3011r4re Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ 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 Number 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 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 --- -APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �1 �► �U-•� � Telephone Number (5-u �� l -o>a Address 6o aak b�, A Go, 4�/ License # C S ` /D )7d`-/ Home Improvement Contractor# 6 S— 73 Email ac,4 ( ,2- ,C�� Worker's Compensation # 06 3 S ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ,c�• ,Sf-e ✓� 4�,d- 2v "C'A C, 31 vd SIGNATURE DATE /0��20 r FOR OFFICIAL USE ONLY t APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER Y" i, ` DATE OF INSPECTION: t. FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ` FINAL BUILDING DATE CLOSED OUT s ASSOCIATION PLAN NO. 1 .25e CQMrriaT"Peafth of•Mirssachusdts Dep artrraerit afrud--usaialAccider-a 600 Washingtort jilreet Boston,MA 02M unviv:arass.•garyilur Wank-ers' Cumpensa an Insulmce Affidava-L Lmldei-slCuntrae.tarMectriciansfPIm:Lbers Applfcant Infaa-matian /' fl Please.Print Lem �r7i'71P.(�ncina� aIlI2afiaal�i �'���h.� �hIX C�h . Address: 00 CV-u g 6 i 0,"J k Gifyf tatel i Oi Cn&qg Phone O j O Are you an employer?Checkthe appropriate bow Type of project(required}_ I_RI ara a employer with. 4 ❑I am a general confiactor and 1 employees(full andfor part-time * 'have luredthe sub-contractors d- ❑New consf cticm 2.❑ I am a sole pmpfsetaf arpartner- wed oil the aftched sheet ?`_ Rem6&fig ship and have no employees. Mese sob-cotutractors have g_ ❑Demolifioa ' w,,,��i,,g for i i ^.�, employees andbatre Workers' """i'b �1�"'""J' 9. E]Budding addition INO Wolbars camp.Insurance, comp-F171BL'dII $ rewired I I ❑ We are a corpomfion and ifs 10-0 Electoral repairs os adddious officers have e�rcised their 3111 am a hnmeo�,mer doing aft v*ork 1LD Fiumbrngregairs or add%tiaas myself[No-Xarkm'cartap_ rigfit of exemption per MGL L_0 Roofrepairs an fimurce required j i c.152,§I(4h aadwe have no i employees.[Na tumkers' 13.0 Other cowp_'kmxan,m required_] #Any agp&,MtIhtCheCubOxftltit also ffiovf the seraaa.bekwshawkgflieswo&es compmrsf; apaRcginffinnstiaa_ #gAII]eailalRlivrhasubmitehis8 3[76in rTtingthayace-daiaga]lwa¢Ysadt5eah oRtsidecaatractarsnmstSUTt]IIItanew7[i�da�tindif MCT3 rC'an„=ctm:s•3izt rIiPrir This box mmt attached=21ffwnn dea s uncEngthenaua of the sub-c -mx d gwawhdher arnat r me mflseshave empIIayem 1€thesob taatsttacshice mnpIofeez,tfieyrmcstpm-i their=Eke&wmp.polio•nimnbm I am as elrtg�}�r Heat is pra�idi►t�rt�arkers'cantpertrrrh'art irrsriratzca far m}*enrpin}�es $eZa�9 is riTEspDfiry•anrd1ab r�� Frcfarmruwn. / / Iasurance:Compaaghrame- L �U�C 9, •;rA S . Pokey r or Self-ins_IIC_:ff.: � �7 7 EkpirationDate_ /U Job Re AddressCifylStafelTsp�T�lTrw`—`P Attachacopy oftheWorkers'compensafionpolic_rr decla' ration page-(sh-ouing the goli ynumber.andexpirafiondate). Fail=to secure coverage as requiredunder Section 25A of MGL m 15"Z can lead to the imposition of r urinal penalises of a fine up to$L500:00 aniVor one-year imp soumeuf,as va ll as civil peaalties.m fbe form of a STOP WORK ORDER.End.a flue. of up to$25U_00 a clay ag&st the violafur. Be adsdsed that a copy of this statement may be forwarded fa the Office of Iu`restiaati=o€the DI,AA for insurance cam rage s riffmh n. I dta here-by c&trfl�rrard�r tlzc�prurts a�td}�aa�is afg t3'tlratflae inforarta#iarFprm,*Tkd above cs barE aJ:d correct Siffiature_ �/ Bate_ phone ikC' O QX ial aw ariTy. Do prat ivrffe in dds veir,ter be wtupfeteJ by'cify rartomtr official City or'Fouu: PermitUcense:9 ' rmuing Antharify(carIe one): L Rom.-d of IieaItdi RuTd'ing Department 3.tjIrvvm C-le-rb- •.Eleefracal Inspector! S.Plumbing Inspector 6.Other Contact Person: Phone#: -- — 6- r. armatian and In.strac-ions Massachnseffs General Laws chapter M requires aU employes to provide wodces'come ns�ion for their=]PIoyees. this ,an�Ioy�is defined as"eYelYPeasonm hie seavic5 of another under any coact°fIxQe, dress or=IPH54 Aral or writ" - co oration or other IegA eufsty,or any twO or more An erz�Iayer is defined as an mdividnal,partnership,assDd on, rp of the foregoing ezlgagud m aJ° Vie,andmctn�the Iega1 represaiives ofa deceased employer,or the reccr�r or trastee of an individnaL patam-hip,associa m or otherIegal entity,employing�p1DY�- Howeverthe owner of a dwellnZghonse baviognotmore tbm tl=aparim=fs aacIwhO resides therem,or the occupant of e- dwel mg house of another who employs persons to do mai�aance,CDMI uch on Cr repair work on such dweIIing house or on the grounds or bmi1�app tT:L=t°shall notbecanse of sash maploymentbe daemedto be an employ=" MGL chapter 152,§25C(6)also siatts ihzt"everystate-or Iocal Iiceusing agency shallwifbh.old tTie rsman.ce or renewal of a$cease or permitto opmafe a business or to construct b• ffElings is f e.commo-nwealtii for any applicantIWTi°has notpradttced acceptable evidence of compli=m WU the hjsat2.nce_covEtmgerequired-" Additionally.MCr`L chapter 15Z,§25CM sb-tes-Nenex- the=m mweahhnor any ofits Political subdivisions shall mtsr into anycontract for theperfa�c,0fpobLwozkuniaamiableevidenceofcomplia;acewiiiithem�c& rtT3i ements of iiais chapter have lieen preseD ted.in the contracting al Iffiozity-" Applicants Please fill out the workers'compensation affidavit completely,by checking file b oxes�apply to your situation anti,if necessary,supply s�-co�a�aCtor(s)name(s), addresses)andphonenumber(s) alongwitlithe=r ceri£cste(s)of Li ifed Liabflity Companies(LLC)or I invited Liabfiity Parineiships(LLP)widtno r�ploye an the- other the members or pmta=s,are not req�'d to cosy wormers'comp ensafion insazance Fran LLC'or LLP does hate To is re Be advisedtiiatthis affidayit may be snbmitredto the Depar mmt of Industdal P- Y ees � a P o li cY d- Accideuts for con�ation of insrz M=coverage Also be sere to sign and dafe he affidavit affidavit f d be ret¢med to ihe city or town that the application for the permit or license is b ring regne� t eP ons $ie law or Lyon a m reqid to obtain a workers' T„rh,�r,;a1 Accide�s. SShgnldyon bane any gaesti r g dines should enter their co=psaiionpolicLpleasecalltheDepartme±atthenumberlistedbeIow- Self-insrne ev acomp s elf-m saran ce lic:==fiber on the apProgrzate 1me- Cify or Tolwa OfUcials Please be su=that the affidavit is complete and pried Irgibly_ The DeparimenLhas provided a space at the bottom of the, n affidavit for yotn fill out iathe event the Office ofIUVM aafions has to c°utaCtyouregardmgthe applicant Please be sure f to I hI the pe�itllicease M=ber which wiII be used as a refereince mmmber. In.addition,an applicant that:must sabm,L multiple perntUcense applications in.any grV`Mytzr�nerd only submit ane affidavit Mdicafmg cunt and®der"lob S`rte�STess"the applicant sh.oTtldw�"all locaf,ns za (cry or policy inforaationL(ifneC�Y) be provided to Iho town)_'A copy of-he•affidavitihathas been.officially stumped ormmkrdbythe Y ortuwnmay appTicant as proof that a valid affidavit is on ffie for fufine putts of 1•icemM Anew affidavit must be filed oist each year.'¢�here ahome ownea.ar finis obtaining aIicense orp�.itnotzelatedfD anybnsiness or cpmm.ercialy� L a dog liamse or penmrt to bmn leaves eta.)saidpeasgn is NOT regoiredt°co�Iete this affidavit The Office oflnvesbgatiansv�°uld elathankyoumadvance forgo=cooper, on and shovldyov lie my 4 6m� please do not hesiinto to give us a calL The De j artmcnfs address,telephone and fax amber: . Tie CC�=�artan of MassaGhuSeM DepartMeot ofIi dustda Aocid�' �t�of Xxt�t?l�tio� Ragboo-ns MA Eii 11 T(i-L 4 617-' -4 Qxt406 or 1477 MASWE Kevised4-24-0-1 rna l gWfil . . Massacuusetts Dep artment of P Board of Buildin ubllc Safety g Regulations and.Standards Constructioti-Supern isr,i License: CS-107704 JEREW ANDER_$bN" 80 CRANBEkRy RIb ' Marsto 4 -nsMiLsifA 0 41, Commissioner Expiration 10/13/20171 . Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991m3)of - enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS License or registration valid for individual use only it before the expiration date. If fou nd'return to-egulation -Office of consumer Affairs and Business R j - 10 Park Plaza-Suite 5170 E Boston,MA 02116 E J Not valid without Signature �pammarxcuea�Z�CU�Gcra�ac{uc�eli'a Office of consumer Affairs Business Regulation HOME IMPROVEMENT CONTRA.C.T-OR . Zype: Individual ::_Re'istration Expiration I+'- -36 08/02/2018 I; zy' ..=_ 7 Jeremy Anderson ,';. m; �= Jeremy Anderso,r�t ice; 1 �-. 80 cranberry ridge)rd_- Marstons Mills, Ma 02648 Undersecretary J rom:Leon^ard Insurance 10/13/2016 09:37 #191 P.001/001 '4�� CERTIFICATE OF LIABILITY INSURANCE °"�'MM'°°"""' 10/13/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)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 N Ac Rebecca Powers LEONARD INSURANCE AGENCY PHONE 508 428 ss21 IF lbCX No): E_Ap pgEss: Rebecca@Leonardagency.com 683 MAIN STREET SUITE B INsu 's AFFORDING COVERAGE Naclr INSURED OERVILLE MA 02655 INSURERA: TRAVELERS PROPERTY CAS CO OF AM 25674 - INSURER B: ANDERSON JEREMY DBA ANDERSON BUILDING MAINTENANCE wsuRERc: INSURER D: 80 CRANBERRY RIDGE RDINSUR E: MARSTONS MILLS MA 02648 INSURERF: COVERAGES CERTIFICATE NUMBER: 93214 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. IILTR NSR I AD TYPE OF INSURANCE R POLICY EFF POLICY EXP Vivo POLICY NUMBER MM/DD DrYYYY LIMITS COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ CLAIMS-MADE OCCUR - - PREMISES Ea NTEDoccurrence $ MEO EXP-(qry one Person PERSINJURY' N/A - ONAL 8 ADV INJURY' S ' GENL AGGREGATE LIMIT APPLIES PER I GENERAL AGGREGATE 4-3$ POLICY a PR6 ❑ i JECT LOC PRODUCTS,COMPIOPAGG $ Wvr OTHER: — AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ + Ea accident i ANY AUTO BODILY WJURY�(Per person) I g� ALL OWNED SCHEDULED I —� A11105 AUTOS NON-OWNED I I NIA - BODILY INJURY''(Peraccident) S^ HIREDAUTOS AUTOS rKUrFKTY DAMIGE Per accident UM13REUA LJAB OCCUR i - EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE I N/A AGGREGATE g DED RETENTION WORKERS COMPENSATION AND EMPLOYERS'LJABILITY � P ATUTE ERX OFROE ECTENY/N AE /MMBEREXCUDED? NIA NIA N!A 7PJUBOG35777415 10/13/2015 10/13/2016 E.L.EACH ACCIDENT $ 100.000 I(Mandatory In NH) E.L.DISEASE-EA EMPLOYE S 1 DO,000 If yes describe under - w DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Ramarks Schedule,may be attached H mars space is required) - Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the Insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at ' www.mass.govtlwdhvorke rs-compensation!nvestigabonW. Sole proprietor has not elected coverage. CERTIFICATE HOLDER CANCELLATION } SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TOWf1 Of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main St AUTHORUM REPRWENTATNE - Hyannis { ��� MA 02601 Daniel M.Cro I�i ey,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Town of Barnstable Regulatory Services Richard V. Scab,Director rua' Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 - www.town.barnstable.ma.us Office: 5 08-862-403 8 . Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I z , as Owner of the subject ro l P PertT hereby authorize CJ to act.on my behalf; in all matters relative to work authorized by this budding permit application for. i (Addre ms ss of Job) volt **Pool fences and alar are the responsibility of theiapplicant Pools � are not to be filled or utilized before fence is installed and all final ins ectLons are performed d accepted. r e o Owner ignature of Applicant P/Ant Name '' Print Name Date Q:FORMS:OWNERPER MSIONPOOIS l Town of Barnstable Regulatory Services ' pGTHE Richard V.Scali,Director Building Division s�vsrear, Paul Roma,Building Commissioner mesa � i639. 200 Main Street, Hyannis,MA 02601 E°► M www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: - number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was.extended to include owner-occupied dwellings of six units or less and to allow homeowners to Engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) ' responsibility for compliance with the State Building Code and other applicable codes, The undersigned `homeowner' assumes resp ilrty p bylaws,rules and regulations. — The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection d that he/she will conp y procedures and requirements.1 with said procedures and requirements an Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION F The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt Su • from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);)� Provided that if the homeowner i such Homeowner shall act as supervisor." -engages a.person(s)for hire to do such work,that s P 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 2J5) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this-case,our Board cannot proceed against.the unlicensed person as it would with a licensed.Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities, many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities.of a Supervisor. On the last page- this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc r 06/20/16 Bk 29809 Ps 138 07-20--2016 02 = 25p Return to: Connor&Hilliard PC 1350 Main Street Walpole MA 02081 3. The space above this line is reserved for recording information DECL&R,ATION OF TRUST ESTABLISHING THE 17 HIGH SCHOOL ROAD REALTY TRUST The 'undersigned, Raymond,,Plocharczyk, of West Harwich, Barnstable County, Massachusetts, hereby declares that he and his successors in trust hereunder will hold any and all property that may be conveyed to him;in trust,as Trustee, for the sole benefit of the beneficiaries hereunder, and upon the terms and conditions herein set forth. The term "Trustee", wherever used herein, shall include such person or persons who hereafter are serving as Trustee or Trustees hereunder, and the rights, powers, authority and privileges granted hereunder, to the Trustee may be exercised by such person subject to the provisions hereof. 1. `-The Trust hereby established may be referred to as the "17 HIGH SCHOOL ROAD REALTY TRUST" and the post office address of the Trust shall be: 1 Belmont Road,Unit 630,West Harwich,Massachusetts 02671. 2. The original beneficiari6' 'of this Trust are those persons listed on the Schedule of Beneficial Iriterests executed this day by the beneficiaries and the Trustees and filed with the.Trustees. The Trustee(s) may, without impropriety, become beneficiaries hereunder and exercise all rights of the beneficiaries with the same effect as though they were not Trustee(s). The Trustee(s) shall hold the property conveyed to them as Tru-stee(s), and receive all the,gains and profits there from for the benefit of the beneficiary or beneficia- 1 - , . Bk 29809 Pg139 #36622 ries hereunder (hereinafter the "beneficiaries', and shall make all distributions pursuant to the directions of the beneficiaries. If, at any time, a beneficial interest hereunder shall be held by a minor, a parent of such minor beneficiary shaU have full power and authority, without the necessity of obtaining the license or permission of any court or the requirement of being appointed such minor's guardian, to make all decisions and sign all documents or instruments with respect to the Trust or Trust Property on behalf of such minor beneficiary. 3. With the consent of the beneficiaries, the Trustees shall have full power and authority to deal with all property, real and"person, conveyed to or at anytime held by them- as Trustees hereunder. When, and to the extent specifically directed by the beneficiaries,the Trustees shall have full power and authority to: (a) sell, assign, mortgage, deal with, or otherwise dispose of,all or any part of the trust property; (b) open and maintain accounts of any type in banking and/or financial institutions; (c) sign checks, drafts, notes, bills of exchange, acceptances, undertakings and other instruments or orders for the payment, transfer or withdrawal of. money-for whatever purpose and to whomsoever payable, including those drawn to the individual order of'a signer; (d) as lessor or as lessee,to execute and deliver leases and subleases; (e) borrow money and to execute and deliver notes or other evidence of such borrowing; grant or acquire rights or easements and enter into agreements or arrangements with respect to the trust property; and (g) take a.0 other actions in connection with. the Trust Property which the Trustee, in his/her discretion, deems necessary or helpful. I ' By suitable written delegation (but only by such delegation), any Trustee shaU have the right to delegate to-any other Trustee his/her power and authority hereunder, and any such delegation may be subject to such limitations as may therein be stated. Any and all instruments executed pursuant to powers herein contained may create . obligations extending over any periods of time,including periods extending beyond the date of any possible termination of this Trust. i Notwithstanding any provisions contained herein, no Trustee shall be required to 4 take.any action which will, in the opinion of such Trustee, involve him in any personal 2 i Bk 29809 Pg 140 #36622 liability unless first indemnified to his satisfaction. Any person dealing with the Trustees shall be fully protected in accordance with the provisions of Paragraph G hereof Y 4. Unless sooner terminated by the beneficiaries hereof, this Trust shall terminate fifty(50)years from the date of the initial Trustee's death. Upon such termination, the Trustee shall transfer and convey the specific assets constituting the trust estate, subject to any leases, mortgages, contracts or other encumbrances on the trust estate, to the beneficiaries in proportion to their respective interests. 5. Any Trustee hereunder may resign by written instrument signed and acknowledged by such Trustee and recorded with each Registry of Deeds in which this Trust has been recorded. In the event that the original Trustee shall cease to serve as the Trustee hereof, for whatever reason, then,_in such event, Anastasia R. Plocharczyk, of 2097 Corbin Avenue, New Britain,Connecticut,shall serve as the successor Trustee hereof. In the event that there shall thereafter be a total vacancy in the office of Trustee, succeeding Trustee(s) shall be appointed or any Trustee may be removed, by an instrument or instruments in writing, signed by a majority of the beneficiaries hereof, provided in each such case that such instrument or instruments or a certificate, by any Trustee, naming the Trustee or Trustees appointed or removed, as the case may be, and, in the case of any appointment, the acceptance in writing by the Trustee or Trustees appointed shall be recorded with said Registries of Deeds. . Upon the appointment of any succeeding Trustee, the title to the trust estate shall . thereupon and without the necessity of any conveyance be vested in said succeeding Trustee(s) jointly with the remaining Trustee(s),if any. Each succeeding Trustee shall have all the rights,.power,authority and privileges as if named as an original Trustee hereunder. No Trustee shall be required to furnish a bond. This Declaration of Trust may be amended from time to time,upon authorization by the beneficiaries, by an instrument in writing signed and acknowledged by the then 3 I Bk 29809 Pg 141 #36622 Trustee(s) hereunder; provide however, that in each case, the instrument of amendment or a certificate by the Trustees setting forth the ,terms of such amendment and the,due authorization thereof by the beneficiaries, shall be recorded with the appropriate Registries of Deeds. 6. No Trustee hereunder shall be personally liable for any error of judgment nor for any loss arising out of any act or omission done in good faith, but shall be ' 1 responsible only for his own willful breach of trust. No license of court shall be requisite to the validity of any transaction entered into by the Trustee. No purchaser or lender shall be under any liability to see to the application of the purchase money or of any money or property loaned or delivered to the Trustee, or to see that the terms-and conditions of this Trust have been complied with. Every agreement, lease, deed, mortgage, or other instrument executed by the said Raymond Plocharczyk, or his successor Trustee(s), shall be conclusive evidence in favor of every person relying thereon or claiming thereunder that, at the time of the delivery of such instrument,this Trust was in full force and effect and that the execution and delivery of such instrument by the Trustee was duly directed by the beneficiaries. Notwithstanding any preceding provision hereof to the contrary, at any time that there is more than one (1) Trustee serving hereunder, any of the said Trustees, if the beneficiaries have in a particular instance authorized only one of the Trustees to act on behalf of the Trust, shall have full power and authority to act on behalf of the Trust and execute and deliver any and all instruments and/or documents in the name and on behalf of the Trust. Any person dealing with the trust property or the Trustees may always rely,without fin-ther inquiry, on a certificate signed by any person appearing from the records of any Registry of Deeds in which this Trust shall have been recorded,to be a Trustees)hereunder, as to. (i) who is/are the Trustee(s) or the beneficiaries.hereunder; (u) the authority of the Trustee(s) to act,with respect to a particular matter;or (iiui) the existence or non-existence of any fact or facts which may constitute conditions precedent to the authority of the Trustee(s) to act hereunder or which are in any other manner germane to the affairs of this Trust. s - 4 Bk 29809 P<3 142 #36622 III The Trustee or Trustees hereof shall have full power and authority, without I obtaining the prior approval or license of any person, to execute deeds on behalf of.the i Trust to one or more of the persons who are then or were formerly serving as Trustee(s) hereof for nominal consideration. 7. The personal assets of the beneficiaries of this Trust shall,in no event, be liable for or subject to the claims of or attachment or seizure by any person(s) or entity with respect to any claim (whether in contract or in tort or otherwise) against the Trust or the Trustees or any claim whatsoever arising from or with respect to any real property belonging to the Trust and all persons'dealing with the Trustees, as Trustees of this Trust, shall,by the existence of any dealings with the Trustees, be deemed, for all purposes, to have knowingly and voluntarily waived all claims or rights which they may have against the beneficiaries of the Trust and to look for satisfaction of such claims solely and exclusively to the assets of the trust ESS the execution hereof, under seal, by the Trustee herein above named, as of this day of July,2016. 17 HIGH SCHOOL STREET REALTY TRUST B a nd Plocharczyk,frtTstee COMMONWEALTH OF MASSCHUSETTS Norfolk,ss. On this 1 day of July,2016, before me, the undersigned notary public,personally appeared Raymond Plocharczyk, proved to me through satsfwtory evidence of identification,which were: o Massachusetts driver's license; ersonal knowledge;o United States Passport, to be the person whose name is signed on the preceding or attached ' document, and acknowledged to me that he signed it voluntarily for its stated purpose as Trustee aforesaid,and not individually. Notary Public -.---� My Commission Expires: 2611 BARNSTABLE REGISTRY OF DEEDS 5 Jahn F. Meade, Reglster rir Gk 29809 Ps 138- �36622 07-20-2016 02 : 25e+ Return to: Connor&Hilliard PC 1350 Main Street Walpole MA 02081 The space above this line is reserved for recording infom► -ion DECLARATION OF TRUST ESTABLISHING THE 17 HIGH SCHOOL ROAD REALTY TRUST y The undersigned, Raymond Plocharczyk, of West Harwich, Barnstable County, Massachusetts, hereby declares that he and his successors in trust hereunder will hold any and all property that may be conveyed to him,in trust, as Trustee, for the sole benefit of the beneficiaxies hereunder, and upon the terms and conditions herein set forth. The term "Trustee", wherever used herein, shall include Lsuch person or persons who hereafter are serving as Trustee or Trustees hereunder, and the rights, powers, authority and privileges granted hereunder, to the Trustee may be exercised by such person subject to the provisions hereo£ 1. The Trust hereby established may be referred to as the "17 HIGH SCHOOL ROAD REALTY TRUST" and the post office address of the Trust shall be: 1 Belmont Road,Unit 630,West Harwich,Massachusetts 02671. 2. The original beneficiaries of this Trust are those persons listed on the Schedule of Beneficial Interests executed this day by the beneficiaries and the Trustees and fled with the Trustees. The Trustee(s) may, without impropriety, become beneficiaries hereunder and.exercise all rights of the beneficiaries with the same effect as -though they were not Trustee(s). The Trustee(s) shall hold the property conveyed to them as Trustee(s), and receive all the gains and profits there from for the benefit of the beneficiary or benefida- 1 I Bk 29809 Pg139 #36622 ties hereunder (hereinafter the "beneficiaries', and shall make all distributions pursuant to i the directions of the beneficiaries. I£, at any time, a beneficial interest hereunder shall be held by a minor, a parent of such minor beneficiary shall have full power and authority, without the necessity of obtaining the license or permission of any court or the requirement of being appointed such minor's guardian, to make all decisions and sign all documents or instruments with respect to the Trust or.Trust Property on behalf of such minor beneficiary. 3. With the consent of the beneficiaries, the Trustees shall have full power and authority to deal with all property, real and person, conveyed to or at anytime held by them as Trustees hereunder. When, and to the extent specifically directed by the beneficiaries,the i Trustees shall have Rill power and authority to. (a) sell, assign,. mortgage, deal with, of r otherwise dispose of,all or any part of the trust property;(b) open and maintain accounts of r any type in banking and/or financial institutions; (c) sign checks, drafts, notes, bills of exchange, acceptances, undertakings and other instruments or orders for the payment,' transfer or withdrawal of money for. whatever purpose and to whomsoever payable, including those drawn to the individual order of a signer; (d) as lessor or as lessee,to execute and deliver leases and subleases; (e) borrow money and to execute and deliver notes or other evidence of such borrowing; (f) grant or acquire rights or easements and enter into. agreements or arrangements with respect to the trust property;and (g) take all other actions in connection with. the Trust Property which the Trustee, in his/her discretion, deems necessary or helpful. By suitable written delegation (but only by such delegation), any Trustee shall have the right to delegate to any other Trustee his/her power and authority hereunder, and any such delegation may be subject to such limitations as may therein be stated. Any and all instruments executed pursuant to powers herein contained may create obligations extending over any periods of time,including periods extending beyond the date of any possible termination of this Trust. Notwithstanding any provisions contained herein, no Trustee shall be required to take any action which will, in the opinion of such Trustee, involve him in any personal r 2 Bk 29809 Pg140 #36622 liability unless first indemnified to his satisfaction. Any person dealing with the Trustees shall be fully protected in accordance with the provisions of Paragraph 6 hereof 4. Unless sooner terminated by the beneficiaries hereof, this Trust shall . terminate fifty (50)years from the date of the initial Trustee's death. Upon such termination,the Trustee shall transfer and convey the specific assets constituting the trust estate, subject to any leases, mortgages, contracts or other encumbrances on the trust estate, to the beneficiaries in proportion to their respective interests. 5. Any Trustee hereunder may resign by written instrument signed and acknowledged by such Trustee and recorded with each Registry of Deeds in which this Trust has been recorded. In the event that the original Trustee shall cease to serve as the Trustee hereof, for whatever reason, then, in such event, Anastasia R. Plocharczyk, of 2097 Corbin Avenue, New Britain,Connecticut,shall serve as the successor Trustee hereof. In the event that there shall thereafter be a total vacancy iii the office of Trustee, succeeding Trustee(s) shall be appointed or any Trustee may be removed, by an instrument or instruments in writing, signed by a majority of the beneficiaries hereof, provided in each such case that such instrument or instruments or a certificate, by any Trustee, naming the Trustee or Trustees appointed or removed, as the case may be, and, in the case of any appointment, the acceptance in writing by the Trustee or Trustees appointed shall be recorded with said Registries of Deeds. Upon the appointment of any succeeding Trustee, the title to the trust estate shall thereupon and without the necessity of.any conveyance be vested in said succeeding Trustee(s) jointly with the remaining Trustee(s), if any. Each succeeding Trustee shall have all the rights,power,authority and privileges as if named as an original Trustee hereunder. No Trustee shall be required to furnish a bond. This Declaration of Trust may be amended from time to time,upon authorization by the beneficiaries, by an instrument in writing signed and acknowledged by the then 3 Bk 29809 Pg141 #36622 Trustce(s) hereunder; provided, however, that in each case, the instrument of amendment or a certificate by the Trustees setting forth the terms of such amendment 'and the due authorization thereof by the beneficiaries, shall be recorded with the appropriate Registries of Deeds. 6. No Trustee hereunder shall be personally liable for any error of judgment nor for any loss arising out of any act or omission done in good faith, but shall be responsible only for his own willful breach of trust. No license of court shall be requisite to the validity of any transaction entered into by the Trustee. No purchaser or lender shall be under any liability to see to the application of the purchase money or of any money or property loaned or delivered to the Trustee, or to see that the terms and conditions of this Trust have been complied with. Every agreement, lease, deed, mortgage, or other instrument executed by the said Raymond Plocharczyk, or his successor Trustee(s), shall be conclusive evidence in favor of every person relying thereon or claiming thereunder that, at the time of the delivery of such instrument,this Trust was in full force and effect and that the execution and delivery of such instrument by the Trustee was duly directed by the beneficiaries. Notwithstanding any preceding provision hereof to the contrary, at any time that there is more than one (1) Trustee serving hereunder, any of the said Trustees, if the beneficiaries have in a particular instance authorized only one of the Trustees to act on behalf of the Trust, shall have full i power and authority to act on behalf of the Trust and execute and deliver any and all instruments and/or documents in the name and on behalf of the Trust. Any person dealing with the trust property or the Trustees may always rely,without further inquiry, on a certificate signed by any person appearing from the records of any Registry of Deeds in which this Trust shall have been recorded,to be a Trustee(s)hereunder, as to: (� who is/are the Trustee(s) or the beneficiaries hereunder; (u) the authority of the C Trustee(s) to act,with respect to a particular matter;or (iii) the existence or non-existence of any fact or facts which may constitute conditions precedent to the authority of the Trustee(s) to act hereunder or which are in any other manner germane io the affairs of this Trust. 4 Bk 29809 Pg142 #36622 The Trustee or Trustees hereof shall have full .power and authority, without obtaining the prior approval or license of any person, to execute deeds on behalf of.the Trust to one or more of the persons who are then or were formerly serving as Trustee(s) hereof for nominal consideration. 7. The personal assets of the beneficiaries of this Trust shall,in no event, be liable for or subject to the claims of or attachment or seizure by any person(s) or entity with respect to any claim (whether in contract or in tort or otherwise) against the Trust or the Trustees or any claim whatsoever arising from or with respect to any real property belonging to the Trust and all persons dealing with the Trustees, as Trustees of this Trust, shall,by the existence of any dealings with the Trustees, be deemed, for all purposes, to have knowingly and voluntarily waived all claims or rights which they may have against the beneficiaries of the Trust and to look for satisfaction of such claims solely and exclusively to the assets of the trust. TNESS the execution hereof, under seal, by the Trustee herein above named, as of this day of July,2016. 17 HIGH SCHOOL STREET REALTY TRUST B 4and Plocharczyk, rustee COMMONWEALTH OF MASSCHUSETTS Norfolk, ss. On this day of July,2016, before me, the undersigned notary public,personally appeared Raymond Plocharczyk, proved to me through atisfactory evidence of identification,which were: o Massachusetts driver's license; ersonal knowledge; o United States Passport, to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he signed it voluntarily for its stated purpose as Trustee aforesaid,and not individually. . P Notary Public A�lB:.11�;#iI�tA t My Commission Expires: BARNSTABLE REGISTRY OF DEEDS 5 Jahn F. Meade, Register APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name d^c-)C,e Telephone Number yd,6 6 1 Address //6 ran 61ced (�c'�� ��_� License#L :) 6 K) ^�d Home Improvement Contractor# r✓ CEO Worker's Compensation # ALL CONSTRUCTION DEBRIS.RESULTING FROM.THIS PROJECT WILL BETAKEN TO (krl4c) 26 SIGNATURE � � —, -� � ���,� -_ DATE : TOWN OF BARNSTABLE BUILDING PERMIT APPLICATIONjy/ � `7 Map- b8' Parcel 'offer! ..,Application. Health Division Date Issued ' l Conservation Division Application .. Planning Dept: Permit Fee; Date Definitive'Plan Approved by Planning Board . Historic -:OKH: Preservation/ Hyannis Project Street Address /7 A-D Village A/Y jv.,-S Owner E-W X!I-S ry,.. C'-A-,r2 c� Address Telephone0�— Permit Request �Q e-)IV A, ! L7 n/ }- A) ' ,mac l l C c7 i nc .2'4 c7 vi Square feet: 1 s floor: exis ng q40 proposed 12nd floor: existing - proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation43,d� Construction Type Woo o t Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0 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 _q Basement Finished Areas ft. Basement Unfinished Areas ).ft ( q ) ) Number of Baths: Full: existing new Half: existing mew - s.w :5 Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑ Oil ❑ Electric ❑Other or. M Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing 'U new size—Pool: ❑ existing ❑ new size _ BarnXexisting ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes O No If yes,-site plan review#' Current Use '6 kA_ E Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 1 Its Telephone Number �� 36�e— --a--36 1 Address `a 2 H-r ��— 0 2-- 2-49 License 4 H e Improvement Cont ctor# 1 I Worker's Compensation # ALL CONSTR CTION DEBRIS RESULTI G FROM T IS PROJECT WILL BE TAKEN TO ow p SIGNATUR __'� DATE J t FOR OFFICIAL USE ONLY ,,,.APPLICATION# ' DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: t 'v FOUNDATION r FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Y _ The Commonwealth of Massachusetts Department of Industrial Accidents ' Office of Investigations ' a 600 Washington Street Boston,MA 02111 w4 ;� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual):�� Address: j� r �U(Lp �c� CK��� .�� UD 6 City/State/Zip: Phone.#: . c�?' ) t 0,b� Are you an employer? Check the appropriate box: Type of project(required): L❑ I am a employer with 4. ❑ I am a general contractor and I 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 shipand have no employees These sub-contractors have g• Demolition workingfor me in an capacity. employees and have workers' Y P tY• $ 9. Building addition [No workers'-comp.insurance comp. insurance. 10.❑ Electrical repairs or additions required.] 5. ❑ We are a corporation and its 3.❑ I am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] "Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowneirs who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an 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. Iam an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site information. Insurance Company Name: Policy#or�Self--ins. Lic.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: � � � Date: � p Phone#: y�—. �y �. U �6 Official use.only. Do not write in this area,to be completed by city or town official i "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 1 I Contact Person: Phone#: Information and Instructions- Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in.the service of another under any contract of 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,'§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for,the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials _ Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in _(city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said persona is NOT required to complete this affidavit. The Office of Investigations would like to-thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations, 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 <<,. Revised 11-22-06 www.mass.gov/dia 77, Office of Consumer Affairs&Business Regulahon HOME IMPROVEMENT CONTRACTOR _ j ; Registration.4:136001. Expiratrort _-5/30/2012 Tr# 294281 t Type Individual ' ,& +'. BRUCE P.MILLS 5 ' t k BRUCE MILLS S 16 CROOKED POND'RD HYANNIS,MA 02601 Undersecretary.;: ; tilassachusetts- Department of Public S.tfetN MOIL Board of Buildin!, Rel-ulations and Standards Construction Supervisor License License: CS 78687 Restricted to::00. .. BRUCE P. MILLS 16 CROOKED POND RD; HYANNIS, MA.02601 4, Expiration: 5/29/2012 Cunurrissiuner' Tr#: 26675 ROBERT J. : IR( ELECTRIC A Phone: (508)394-3339 P.O. BOX 1076 Cell: (508)280-0537 SOUTH YARMOUTH, MA 02664 Fax: (508)394-3341 carreiro.electric@yahoo.com ... . . Aueust 3.2011 Dennis Carey 17 High School Rd Hvannis Dear Sir/Madam: i Robert J Carreiro Mass License#E19861.of Robert.J Carreiro Electric have disconnected all electrical wiring to the existing barn located at 17 High School Rd in the city of Hvannis Massachusetts. Sincerelv. - RnhPrt T Cprm-drn f July 30,2011 TO: Dennis Carey FROM: Tom Roche RE: Barn: 17 High School Road,Hyannis,Ma. 02601 Mr. Carey: Regarding the demolition of the Barn located at 17 High School Road in Hyannis this notice is to verify that there is no plumbing installation in the barn. There are also no gas lines going to the structure. Tom Roche,Master Plumber Massachusetts License Number: 11635 Master Plumber#11635^Fully insured^Gas Piping Kitchens and Bathrooms•Water Heaters^Winterization Tom Plumbing and Heating 6 North Road TOM ROCHE West Dennis,MA 02670 508-394-9377 ., y_ r t Barnstable ° \ Hyannis Main Street Waterfront "efiicacily Kj Historic District Commission t 2007 George A.Jessop,Jr.AIA,Chair Marylou Fair,Administrative Assistant DECISION Certificate of Demolition - t Linda 1-lutchenrider, Town Clerk Town Hall 367 Main Street 79 Hyannis,MA 02601 Re: Certificate of Demolition for 17 High School Road,Accessory Barn t; :P The Hyannis Main Street Waterfront Historic District Commission, pursuant to the Code of the-down of Barnstable Chapter 112,Historic Properties,Article III,Hyannis Main Street Waterfront Historic? District,hereby grants a Certificate of Demolitions for the following property: y,. CProperty Address: 17 High School=Road Assessor's Map/Parcel: 308 259 The Hyannis Main Street Waterfront Historic District Commission considered the above referenced application on April 6,2011. A public hearing before the Commission was duly posted and notice sent to all abutters and interested parties in accordance with MGL Chapter 40C. At the hearing, after consideration of the testimony given and materials submitted by the applicant and members of the public,the Commission found the proposed demolition of the barn is appropriate and will not compromise the historic character of the Hyannis Main Street Waterfront Historic District. In making said finding,the Commission considered the condition and historic significance and contribution of the structure in question, and determined the structure was beyond repair. Based on these findings,the Commission voted to grant the certificate of demolition subject to the following condition(s): I. This certificate of appropriateness is granted to the property owner of 17 High School Road,. Dennis Carey and/or successors and assigns, for the demolition of an accessory barn located at 17 High School Rd,Hyannis. 2. A demolition permit from the Building Division is required prior to beginning any work. Present and voting in the affirmative to grant the certificate of demolition were: George Jessop, Jr.,AIA, Barbara Flinn, Joe Cotellessa,.David Colombo,William Cronin,Meaghann Kenney,Paul Arnold Opposed:None Absent: Marina Atsalis r George A`�cop, Jr`'rIA,�Chair Date Hyannis MainiStr et Waterfront Historic istrict Commission 200 Main Street,Hyannis,MA 02601 (o)508-862-4665(f)508-862-4784 �FSHEtp� Hyannis Main Street Waterfront ,,,R,sr„HIE Historic District Commission 9� ,6� ��� Growth Management �ED �A 200 Main Street Hyannis, Massachusetts 02601 Phone: 508-862-4665/Fax: 508-862-4784 CERTIFICATE FOR DEMOLITION OR REMOVAL Application is hereby made, in triplicate, for the issuance of a Permit for Demolition or Removal of a building or a structure or part thereof, under M.G.L. Chapter 40C, The Historic Districts Act, for proposed work as described below and on plans, drawings or photographs accompanying this application. TYPE OR PRINT LEGIBLY DATE a/ I -1 ADDRESS OR PROPOSED WORK :2 kJ.Zq fi-• aGfl,�o L -f� ASSESSORS MAP N0. OWNER E-�N/ 3 ASSESSORS LOT NO. oZ�� HOME ADDRESS Y D D Ex_ .6:Lzf 1 LAtEL. NO. Q S'" c-j�C `1- NAMES AND ADDRESSES OF ABUTTING OWNERS: Include names-of adjacent property owners,across any public street or way. (Attach additional sheet, if necessary). » AGENT OR CONTRACTOR TEL: ADDRESS l e C��IL�7� ��?. '`L —J� 1 i4v�! �l 15 1 7) . DESCRIPTION OF PROPOSED WORK: If building is to be removed, give new location. Snap shots showing all views . of building must accompany application. (Attach additional sheet, if necessary). t Note: If approval is granted for relocation, a separate Certificate of Appropriateness is required for new location_if within the Hyannis Main Street Waterfront Historic District. SIGN Owner-Contractor-Agent Space below line for Committee use. , Received by H.D.C., The Certificate is hereby y J Date � 2 E -Date __ 'VE' Y 1 2011 i Time' MAR B' TOWN OF BARNSTABLE y ION Approved ❑ IMPORTANT: If Certificate is approved,approval is subject to the.20 day appeal x w period provided in the Ordinance. Disapproved - ❑ i; Y, '. Town of Barnstable.Geographic Information System March 25, 2011 3#35 6 309225CN D; ,o #460 th 326015' 308077 308078 308075 #486 #474 308079 ru, O 308082 326016 #435 #26 a'A # 308081001 326017 �� #447 .� � #32 ilk 308262 308083 ..*`' 308090 #459 #31 308089 "� � 308261 -;, 308091 ° #514 #491 � t #39 308074CND 308092 - #0 #497 308084 #473 ,308088 a 5� 308081002 #274 308D93 3 �' #300 #286' 08087 308271 #11 CAP #505 . #11 308086 #29 tP� #306 308096 ' 308094 �0 308085 #521 #517 308259 Off: #310 #572308278 ,!1 �p 7� 7� 308276 #568 308269 308095 ( 5� 308277 308103 E#529 #619 326011 #547 308101 #289. � . #574 ® #336" ' 308069001 ® 308130 308100 .. #,580 308104 #541 #348 308234 <#556 308099 #299 ® #356 ., 30809 308236 . f 308105 #362 #323 308235 #309 30#561ND #557 3#307 � <; 308275 308113 #33 0 ," .. #577 e308,2156 308115 308247 326012 #585 30 394 308129 # 1 308239 8 #394 #380 308248 0 308114 �1 r' t #402 #81 308249 #357 3308285 6 308237 #0� 308218 #369 #°2238 3#92°' 308241 #379 #104 DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal - Map:308 Parcel:259 boundary determination or regulatory interpretation. Enlargements beyond a scale of Selected Parcel 1"=100'may not meet established map accuracy standards. The parcel lines on this map Owner:CAREY,DENNIS M&KELLEY, Total Assessed Value:$399200 are only graphic representations of Assessors tax parcels. They are not true property Co-Owner: Acreage:0.59 acres Abutters 'y boundaries and do not represent accurate relationships to physical features on the map such as building locations. Location:17 HIGH SCHOOL ROAD Buffer f Q. its r- T. 9��fJ-F,. 1117t6F,11 ja7Q7� 1 Le i�P� 9rf��:rt � �.9.4'J.Si,rL-tom 7G y�G� WIN r �-H.L,s.:+Lell - ri�l!(it� �-L' � alatfl{2 W s {kIF,• u , y ue:ruJwu to NtrW@fi11�8sj� ` €hluu ' ;"I l ,, 'Mr, Ia.2sE lyiuyi1171 (1 ��f ' v#s i! 1 � ' J!• aarF,!: 1 t" E �Y t JJ�'�1s_91YY+ ] d i�il�lG �� a c N t c�9Ltl,d►� Y/ `FJ Dr 1d �F qrt It � ��F s L f ��' q� ��•. rtt�l NI�W,�f/fit ij � srll f 14�Ai � F s � ...I ,. i .. yL�,t•c+ �•,�t'S,S`�v1''r��•,6.�; ♦ z'r-,!,t ,�'.� �'ti ,� S.lf +{ jlt jjis y h C�: aS J } 53 d + X � K 211, as-1 gg1g Ualt F ' �p;.�it1l� Y `-V � S kF�€�Ger h4�u Jr r• ' f gt y �tl �✓u�F r� lttlti-� l tr r t j� I r x �ttp g 1 1 i t .t rl[I�✓r i B Cf�i _ 4G�.`�41��f���• �;.y rp"t l J .yu'�} ! - 1 p s191d1t� [�h�� Ptet L � �k� 11EE 1&"r �l�lq�4 a k 9Y a t''rt lid �, gruu•Um C{ �r �srcy\b { Z� r Sls f ` �`• pta � ,El .yi'ti{ ��L7�15{ + 1`s�L ui'`s� ! -•®1 w`y`n. �- � A..i ��` ���j't,� F.�'�[s l��f->!,*�,�i�i>:5\k�4a g - L� .N-. >•� t i u�� + rytY��-'q t t j?i` ��11+�1�` "� .�F- o. ' r � 4'e u U .� k' t •t4yi: �` fit! f � t i SL 4. -•1 I 3 M+1 3 t I � F , t i. a�ae c WIT9 t�'+�tY. r".Ys�S��•>a f r a i i v x p'v ra��y gS °i { ,�. -Ly f -x t € ,✓� � 1 rE-f }t �f ik, e &A6 ,yd r tL1aEt�9.�Ljj�`4��L.ffiE9 54x?1�6t19r G��3 C l if t�'+'�11d:, ��SII���,/1fff�l�+t+�lt�a�yll�l�/$/ys�c�u 1' .aIyJ t4� ��� r�9fair Ja �'F, 1 Efi+1.r f1a� EF�Sj Ifh S� { 3uY &J1{n��tfllCSif fate p�S � £l It t ��Y - rs..ea(3]t[�,�Y 2�sr.l.i[�r34A e I ak• , + �7�� !- 'S&all Ya }c1 p11�SF r L ri{'�l 1 Pity srst��ME �1?•, � r V ~ fi \ p' s, �I,Ti..mi111F s'bF � I d j � 111 ��tt l ,l z+. taT✓ JL ♦�.�`� � �7• L-• \ r tr b �f� .r@g a sr`kaFzC�,rr 7� e iV a J L� s #S 3 �°6:t K 1Ez31� n & rysb � tiS {} 4aLr�q+ Al '�n+U a'J F P a .adi ri r a tf s-kd`w y i:' .ul2C s+ L Kt!I�'C7 si ,is us la �`td.5, `F` sty. L�f 2 < � •r # is rd ;, G1au, L3 Mu L . r _ y T c`F��� t ., f k X ,�'•" . t 'R'S"y.. K`z?��� 3 T,a �2y f: 4 1 Town of Barnstable ' Regulatory Services Thomas F.Geiler,Director' Building Division Tom Perry,Building Commissioner 200 Main_Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) l Signature of Owner Ifate Tint Name If Property Owner is applying for permit please complete:the Homeowners License Exemption Form on the�reve e de.F Q:FORMS:O WNERPERMISSION r - �pP trtt:r�� Town of Barnstable Regulatory Services BARNE.,BLF— : Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main-Street, Hyannis,MA_0260,1._. www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 HOMEOWNER LICENSE EXEMPTION Please Print JOB-LQCATION - C f"I 9 �Ch�-oO L �014� ` 7�J A7 ^zAk-S — v number street ) village �E'/(/�/ts r� G4rej . -D�— "HOMFOWNER": + � ? ! ?-7� name home p one# � y fawork phone# CURRENT,MAILING-ADDRESS: �J pis cityltkm / state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to- be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The,undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies thathe/she understands the Town of Barnstable Building Department. minimum inspection procedures and requirements and that he/she will comply with said procedures and ements. �ignatirry_of Homeowner"''' Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Constriction 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 superuism(kre Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that hdshe understands the responsibilities of a Supervisor. On the last page of this issue is a,form currently used by several towns. You may care t amend and adopt such a form/certi£cation for use in your community. Q:forms:homeexempt TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel .Application# � Health Division Date Issued Conservation(Division Application Fee �i Tax Collector Permit Fee ' b Treasurer / Planning Dept. �•17� Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 172 ate-g- SC,t�&da,( K eAn Village 2l.&,+N,4k /-;r)-4-- Owner �W e,Lt S d Address I " op fm Telephone .�C�8�-- -7 7 /-1 !�j �- l t•mod >w�2 i /)') - Permit Request L ,Square fe-et: 1 st floor:existing .D proposed 2nd floor:existing/A0 proposed Total new oZ ,I District A1AJ--_S Flood Plain IV 0 Groundwater Overlay Project Valuation�!Jb$-b Construction Type 06 0 it Lot Size A Zkc-_ Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family 0 Multi-Family(#units) Age of Existing Structure /Q�a Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes Y�No Basement Type: lull ❑Crawl Walkout ❑Other Basement Finished Area(sq.ft.) 36 Basement Unfinished Area(sq.ft) Number of Baths: Full:existing c2, new Half:existing / new Number of Bedrooms: existing_g new Total Room Count(not including baths):existing 16 new First Floor Room Count 6 Heat Type and Fuel: VGas ❑Oil ❑Electric ❑Other Central Air: ❑Yes Fireplaces: Existing c. New Existing wood/coal stove: ❑Yes o Detached garage:4xisting ❑new size Pool:❑existing ❑new size Barn: existing ❑n`ee'' size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: all Zoning Board of Appeals Authorization ElAppeal# _ Recorded❑ t'' Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use , BUILDER INFORMATION Name ekm, ' Telephone Number Address I G,eo d)t Ed �66W License# C S D 7 r 4 Y7 V-A-e AWN I C 00)A C)Z.-A 0.1 Home Improvement Contractor# 3 G 0�3 Worker's Compensation#` ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE / `� +f j FOR OFFICIAL USE ONLY 1APPLICATION# DATE ISSUED 4, at MAP/PARCEL NO. "ADDRESS' VILLAGE OWNER DATE OF INSPECTION: i FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT .` ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations d 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bl Name(Business/Organization/In-dual): a,eQ n •Address: /'o a0i City/State/Zip: �� 0` Phone.#: Are you an employer? theck the appropriate bog: -Type of project(required):. 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part;time). have hired the sub-contractors 6. ❑New construction 21 I am a•sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp. insurance comp. insurance.#' required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' .13.❑ Other 1. comp.insurance required.] , *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy 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. xContracton 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 providb their workers'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees. Below is.the'policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure•to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a 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 penalties of perju that the information provided above is true and correct. Sienature. Date: SL- Y-C) Phone#: Official use only. Do not write in this area,tb be comp cit leted by y or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions ` Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant an ern to this statute employee is defined as"...every person in the service of another under any contract of hire, P Y express or implied,oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity,or any two.or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee-of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the' dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to'operate a business or to construct buildings in the commonwealth for any . applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the mi surance requirements of this chapter have been presented*to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-conti actor(s)name(s), address(es) and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies*(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. *The affidavit should be returned to the city or town that the application for the-permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workeis' compensation policy,please can the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate-line. City or Town Officials Please be sure that the affidavit is complete*and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference iiumber. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"al'Mocations in (city-or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves-etc.)said person is NOT required io complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number:. Tie eommonwEalth of Massachusetts Department of 1nftst al Accidents Office of Investigations 600 Washingtoii Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax 4 617-727-7749 Revised 11-22-06 www.mass.gov/dia �TME'O Town-of Barnstable Regulatory Services Thomas F.Geiler,Director MASS. p 1639� �•�� Building Division lED Mpi b Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-403 8 Fax: 508-790-623 0 Permit no. Date . AFFIDAVIT HOME MROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMrr 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 adj acent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Wcrk:��.5�T �(G, Estimated Cost 0 40 ,Address of Work: 97 C.VI•&8, Owner's Name: . ` ) �t Date of Application:-? / �O-7 I hereby certify that: Registration is not required for the following reas on(s): []Work excluded by law []Job Under$1,000 []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 ARBrrRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES.OF PERJURY I hereby apply for a permit as the agent a owner: yo / 6 (50 � Date Contractor Name - Registration No. OR D� Owner's Name Q:fo=:hcmezZdav a. Town of Barnstable, Regulatory Services Haxxvsns ' t Thomas F.Geiler,Director ems. , for Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 5 06-862-403 8 Fax: 5 08-790-62 3 0 Property Oder Must Complete and Sign This Section If Using A Builder II, �'n�`�D!_cam , as Owner of the subject property hereby authorize Rem C,� A I L(,S to act on my behalf, in all matters relative to work authorized by this Building permit application for; . (Address of job) Signature of Owner ate I e � Pant Name f Q:FORMS:O WNERPBRMv1ISSION r , BQARD OF BUILDING REGULATIONS License CONSTRUCTION SUPERVISOR Number:CS, 078687 % :- Expires 05/29/2008 Tr. no: 22140 Restricted 00= BRUCE P MILLS 16 CROOKED HYANNIS, MA 02601 Commissioner ,p� ✓fie V�omunzaizuseal�o�✓�'aaecccludell6 �-\ Board of Bui{ding Regulations an:l Standards HOME IMPROVEMENT GONT.2ACTOR Registrafi0.h:'. 136003 Expiration. 5/30/2003 ,`Type ';Individual BRUCE P. MILLS BRUCE MILLS 16 CROOKED POND-O Hl'ANNIS, MA 02601 Deputy Adminisir;-.01./ I - Map Page 1 of 1 Town of Barnstable Geographic Information System New sear. Parcel Yiewer Wstom Map Abutters Map Size 0 zoom Out a 1 1 L L O O 1 O In ® •+ •y a■...._ 71 � ® � 3PG Map: 308 Parcel: 259 Location: 17 HIGH SCHOOL ROAD g3�1 Owner: CAREY,DENNIS M& Location Information 63 Map&Parcel 308259 k®�? 1308260i1 308M Location 17 HIGH SCHOOL ROAD tfour' 9473 Acreage 0.59 acres f DSO Current owner s4� - Mailing Address CAREY,DENNIS M& KELLEY,IEANNE S PO BOX $r HYANNISPORT,MA 0264: O 30=3 jAppraised Value(Fy 2007) Extra Features $0 f Out Buildings $12,000 /✓1 - ` Land $218,000 49 t Buildings $169,300 \ E Total Appraised $419,300 / Assessed Value(FY 2007) Extra Features $0 308M Out Buildings $12,000 Land $ , 00 Buildings $189189,300 / \ Total Assessed $419,300 Construction Detail t - Style Office/Apt lISt7 _ Model Commercial Ir . 308101 Grade Average 0330 Stories 2.4 Exterior Wall Wood Shingle _ _ Roof Structure Gable/Hip _ - Roof Cover Asph/F GIs/Cmp i � 3getao Interior Wail Plastered (832t - N348 Q 35 Fe . Interior Floor Carpet Neat Fuel Oil Neat Type Hot Water x AC Type None Set Scale V=-35 I Aerial Photos - Number of 00 Copyright 2005 Town of Barnstable,MA All rights reserved.Send questions or comments to GIS BarnstableMA v0.2.91 (Production] Z—/ http://www.town.bamstable.ma.us/arcims/appgeoapp/map.aspx?propertilD=308259&map... 8/14/2007 1 + � t �p. t i l lq , d ' r � c - E eggs 60 t pps DIX ►0 s l R f 94 ifF - 'Crkkk r 4 01 Fl F4 1-1 ♦� ICI r _ 61 c�c-- - __, A (=(, ` V i { i Assessor's' map and lot number ........3p8....... zYNE Py� Sewage Permit number *....... ...... SEPTIC SYSTEM M INSTALLED IN CC IN CC AXLE, House number ............#1.7.................................................... a 9& . . ..... .. W" TITLE 5 639. ENVIRONMENTAL CODE 'TOWN OF BARNSTNRLE BUILDING !`N'S?E C TO R ' APPLICATION FOR PERMIT TO ..........Add room to existing building�... ..................:..................................................... ................................... TYPE OF CONSTRUCTION .........Wood.....freme ........... ... ...................................................................................I.................... September 24 80 ................................................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 17 High School Road, Hyannis, Location ...............................:........................................................................................................................................................ Proposed Use .....Additional..office.. ... . ........................... ................ ................................... ........................................................................ Zoning District ...Business.................................................Fire District ............. ......................................... Name of Owner ...Dennis .................................. P Address. .......P. (0�'...Box...1...........I ........ .............. .. ........ Name of Builder ..Leonard.............................Bacchiochi...................Address ....qakland Road,.. .. . .. ....... ... .......................... ......................... --------------------------- ....Address ...........:of Architect ....... ...........................................................Address .................................................................................... Number of Rooms ........One....(1) Foundation Cement block............................I........... .. .... ............................................... ......I............................... Exterior ..........Shingle.......................I .._Roofing .........Asphalt.......................................................... .... .... .. .... Floors ............1�99.d.............................................................-..Interior .........Drywal.1......................................................... 1-i6ating FHW off existin ..................................................... ......Plumbing ........( perhaps. ...nite)..................... Hugh ........ Fireplace .........11g.nu.................................................................Approximate Cost .......P..15W.i.99...t................................ Definitive Plan Approved by Planning Board --------19--------- Area ..........or less:...... Diagram of Lot, and Building with Dimensions Fee . .. . ...................... ... ...... SUBJECT TO APPROVAL OF BOARD OF-HEALTH Note : According to thekZoning By-Laws of the Town of Barnstable , Section D, #2 , the proposed "Building Addition" falls within the Business Zoned District with the allowance of the 301 extension. 00 q6 sev V0 0 e4 "BUSINESS ZO.VeD 1.7 HIGH -SCHOOL 'ROA3) Presently office ofHarvard Realty, I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Na .......... IC4 ...... ............................ ......... CAREY, DENNIS No ...2.2.5.5.8.. Permit ...AD.D.I.T.ION .. .... ..... .. . .. .... Commercial...Building.................. Z) V ........................................................ Location J1-7...qiall...Sqbggl...RQ.a.d...... Hyannis ............................................................................... Owner -pennis Carey............................... .. ................ ...... Type of Construction .....Fr.aMe....................... .................................................................................. Plot ............................ Lot ................................. Permit Granted ....October ...2........ .19 80 .................... . . ... Date of Inspection .....�:19 CIA Date Completed ....... ::19 y/ x. PERMIT REFUSED ........ ........ 19 .............................. rn ....................................... .................... ...................... .......... � . ' ...........................I................ m .................... ............................... W r-u 0 Approdece...-.'.. .................................... 19 ............................................................................ ............................ .................................................. r i d - Assessor's map and lot number ....... �......?. ....�`' .� ° d el"A;'C4 � �— THE - �, Sewage Permit number ...:..!n.u: .:............:........................ �� Z 89HHSTAMLE, : Housenumber ......................................................................... 94p ML 6 3 �0 �FQ AIPY Ar• TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..........Add room to existing building .............................................. TYPE OF CONSTRUCTION .........Wood...fre.m ..................................................... e ............................................ ....... ..... .............Septemb.er. ...24. ... 1980 ....... .. .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....17 High...S. ... chool Roa. d,...Hyannis. ... ............ ..... ....... ..... ....... ............................................................................................................. Proposed use .....Addit3.ona.....offiCe...spaCe........ ............................................................................................... .... ..................... ................ .. ac .... Zoning District ..BuSi3?eSS Hyannis Fire District .............................................................................. Name of Owner ..,Dennis Carey Address ......Pt....6. Box 1, Hyannisport .......... .................................................................... Name of Builder .Leonard Ba..c. 1? OCh.i...................Address ...Oakland Road, Hys,nnis ......... ................................................................. ----------- --- --------------------------- Name of Architect .. Address ......... Number of Rooms One (A). Cement block Foundation .............................................................................. Shingle�. Asphalt Exierior ........... fing .................................................................................... Floors Wood �.. .....:................Interior .........Drywall......................................................... ............................................................. Heating .......FHW - off existing system Plumbing .......�perhaps - Hugh White) ..................... .... ..... ..................................... ................. Fireplace ........n.021®.......................................................:........Approximate Cost .......P..5.9p.00...f.................................. Definitive Plan Approved by Planning Board ________________________________19________- Area 4rj0 s '.,,or less Diagram of Lot and Building with Dimensions Fee `�0 J. ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH Note: According to the Zoning By-Laws of the Town of Barp.stable, Section D, 42, the proposed "Building Addition" fal&s within the Business Zoned District with the allowance of the 30' extension. T_ M 410 \� 000 1 � ,i 0 W i J� yG' _ I I 117 NIGH. SCHOOL ROAi) Presently office of Harvard Realty. I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ........ ...................... ...................................... � - ` | No Permit \ ............yDoe.K^+a,1 Location 11.7....Higb/school,"I'ad.......... ^ ` - | ^m. ^ Ovvne, J).e^wa ' ' Type of .........../ . . � � . ~. � | ,en"" GrantIll Oct-lber...2............19 80 � Dote of | � � . Date Complited ........I 19 PERM LjREFUSED _ � lV � . �° �. ----- , . ' ' - _==~����_- ----�---.. '—'-------'—'J^~^—^----^^~----''' ----~~—^--'---^—^^^—^^--'----- / Approved ---------------- lA -------''~----'------^—'-----'' -------~--^----^--^^^'—^^^^--^' r i — -- — --_.--..- — — -- — — Top of Ridge f I Wood trusses by National Lumber I 5/8"Type X DensGlass Fireguard Single Closure Panel Li DZU -- --—— — — — -_ - — — — — Second Floor Ceiling -- — 1/2"Gypsum Wall Board _ both sides,typical. l = — 2 x 4's @ 16"o.c.both sides, typical. I 5/8"Type X Gypsum Wall Board __- both sides,typical. 3 1/2"JM Mineral Wool Fire — Block Insulation Batts both sides,typical. - 1"JM Mineral Wool Fire Block Insulation -- driven up into space between 2 x 10's. -- --= Second Floor 2 x 10's @ 16"o.c. 2 x 101s @ 16"o.c. X. _= = First Floor Ceiling J = _ 1/2"Gypsum Wall Board both sides,typical Y'" Q W N -- Z 2 x 4's @ 16"ox.both sides, C�5 ao typical. Q —� CD - 5/8"Type X Gypsum Wall Board both sides,typical. 2 x 12 Stair Stringer protected by 60 5/8"Gypsum Wall Board each stud space 3 1/2"JM Mineral Wool Fire _= Block Insulation Batts -_  both sides,typical. t Floor Firs Fl r 2 x IN @ 16"o.c. 2 x 10's @ 16"o.c. 5/8"Type X Gypsum Wall Board Outside Grade th sides,typical. PT2x8Sill ',. 00 "Concrete Foundation Wall l REQ�h.ri; , r F,E P Crawl Space Comcre e slab �r��Op - - - - - - - - - -- O -- ._. r o 41A. STREIBERT ASSOCIATES Architects Seashore Homes,Inc. 1915 Party Wall Cross Section 15 Linden Tree Lane 17 High School Road 0 Streibert Associates-Architects Chatham, Massachusetts 02633 508-945-1459 Hyannis, MA 02601 Scale: 1/2"'= 1'-0" 22 July 2020 Top of Ridge Wood trusses by National Lumber i { 5/8"Type X DensGlass Fireguard Single Closure Panel i i i Second Floor Ceiling 1/2"Gypsum Wall Board — both sides,typical. 2 x 4's @ 16"o c.both sides, typical. 5/8"Type X Gypsum Wall Board both sides,typical. - 3 1/2"JM Mineral Wool Fire Block Insulation Batts _ = both sides,typical. I"JM Mineral Wool Fire Block Insulation -_ -driven uo into space between.2 x 10's. _= Second Floor 2 x 10's @ 16"o.c. 2 x IVs @ 16"o.c. LLJ CL m _ t_t.J N C = 1/2"Gypsum Wall Board First Floor Ceiling i� N _ — both sides,typical. CD --- 2 x 4's @ 16"o.c.both sides, O typical. _ -- 5/8"Type X Gypsum Wall Board 1;D C) -- _ both sides,typical. x 12 Stair Stringer protected by 60 5/8"Gypsum Wall Board each stud space 3 1/2"JM Mineral Wool Fire Block Insulation Batts = both sides,typical. = First Floor 2 z 10's @ 16"o.c. 2 x 10's @ 16"o.c. 5/8"Type X Gypsum Wall Board Outside Grade i. th sides,typical. . r•• PT2x8 Sill ^ 00 "Concrete Foundation WallP. Crawl Space Conic re a slab C?00�� T9�'c`� --E- 11 STREIBERT ASSOCIATES Architects Seashore Homes,Inc. 1915 Party Wall Cross Section v�f- 15 Linden Tree Lane 17 High School Road A7 0 Streibert Associates-Architects Chatham, Massachusetts 02633 508-945-1459 Hyannis, MA 02601 Scale: 1/2" = 1'-0" 22 July 2020