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0171 MAIN STREET (HYANNIS)
� '�� l�'�a c ram] S�re I i �I �I j, i. •,,.Y::��'s_.:..A�..w,....-.......,.ro.r..:s..s.nra..:.� ..s:�;....y -.,,y.��:z-,i;.'s"..2�u"�°,:t:s�ic��Yr;.-•$'b «�,:i.x�A...:3n,.�g,y...,,%`..,..,w5�""#..ci..5._,,.v aii�2a y,i ^.�„�.q�r:'.vssi..'�4<,�d�'vGam•. -7c,:. a�„ Assessor's office (1st floor): Assessor's map and lot number h:.i} ...:.� ...K ,..<f�jYi�u_"4� Q�OF ENE TOE` Board of Health (3rd floor): --— Sewage Permit number .. .... .....3,1 L BaaasTsntE, ! Engineering Department (3rd floor): -S77 FPS MA39 / • 00,e�.i639, House number ................ .................. ... .. ...................... 'ED YAY d� Definitive Plan Approved by Planning Board ____ _________ _________19________ . -" APPLICATIONS PROCESSED .8:30-9:30 A.M. and 1:00-2i00 P,M. only TOWN OF BARNSTABLE .�R BUILDING INSPECTOR APPLICATION FOR PERMIT TO .................. -,�'J�".. �� .f1 ,t ......�� � � U �...................... TYPEOF CONSTRUCTION ................................................................................:.................................................... :... C 0-.. .............19-P TO THE INSPECTOR OF BUILDINGS: , The undersigned hereby Q'applies for ar permit according to the following information: Location .......................1e�......79........../.f!( ... ........d�!kf/Gl �'4! � ...........u��� .�,.......................... ProposedUse ..... e d ,-1) ................................................................... Zoning District ..............................Fire .District .............. Name of Owner .... ........................Address 9n �•<�'r•1� ..!�t:'.:...... �../.. . . !... � /��............... .. s _.� Name of Builder : .... / Cr ............ //! 'a.............Address ......�.?..�.4+ yf. Nameof Architect ..................................................................Address .................................................................................... Nurrrberof Rooms ...................................................................Foundation .............................................................................. ExleJor ................ :.............................................. ...Roofing Floors ......................................................................................Interior ......... Heating ..................................................................................Plumbing .............................c .. ................................. Fireplace ..................................................................................Approximate Cost ... .. ..,. � !'; Area ,o'�/ ...1.:............ � Diagram of Lot and Building with Dimensions Fee i I j I t1l.LY J OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. \ Name ...... ......... .... _ �.J. ..... ....... �; � .. Construction Supervisor's License....0 ..A... 0..��..... CAREY, JAMES A=308-113 A No ..a 2.72Q...,Permit for Add..N.e.w...R.00.f... ....(Qringos Location ....5.7.7.... ...................... Hyannis .............................................................................. Owner ..James....C.ar......ey. .................................. .. ....... . .. .... Type of Construction .....FRame ..................................... ............................................................................... Plot ......................... Lot ................................ Permit Granted ....March 20 , 19 89 ....................... Date of Inspection .......... ..........19 Date Completed ......................................19 PERMIT COMPLETES TOWN OF BARNSTABLE SIGN PERMIT PARCEL ID 327 232 GEOBASE ID 24334 ADDRESS 171 MAIN STREET (HYANNIS PHONE HYANNIS ZIP LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 36282 DESCRIPTION THE ARC OF CAPE COD, INC_ (18"X 32" ) PERMIT_ TYPE BSIGN TITLE SIGN PERMIT C014TRACTORs: Department of Health, Safet, ARCHITECTS: and Environmental Services TOTAL. FEES: $10.00 pxTM BOND �, $.00 CONSTRUCTION COSTS $.00 �7 753 MISC. NOT CODED ELSEWHERE * BARNSTAB14 •' MAS& B LDI DIV O�B .G !' � DATE ISSUED 02/04/1999 EXPIRATION DATE TOWN OF BARNSTABLE SIGN PERMIT PARCEL ID 327 232 GEOBASE ID 24334: ADDRESS 171 MAIN STREET (HYANNIS PHONE HYANNIS ZIP -- I LOT BLOCK—`-X LOT SIZE DBA DEVELOPMENT DISTRIC% 11Y j PERMIT 33703 DESCRIPTION. MANUAL ORTHOPEDICS, P_C_ (15 SQ. _?`T'_ ) I PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS Department of Health, Safety, ARCHITECTS: and Environmental Services BOND NDZ" FEES.-- -- .,.. r ..-_. a_ $2 .00 INE CONSTRUCTION COSTS $.Oa , . i 753 MISC. NOT CODED ELSEOHERE : BARNsi'ABLE, # MASS. BUILDING= LVISIO BY --- DATE ISSUED 09/30J1998 EXPIRATION DATE __ —� a - k�c4& Z Tow, Regi �oftHe royti Thom Publi * BARNSTABLE, Mass. 1639. ATE p 3�s 200 Main Office: 5087862-4644 November 1, 2004 CAPE COD CHICKEN - 1671 FALMOUTH RD. CENTERVILLE, MA 02632 ATTENTION: JERRY DEAN Your food service/retail permit(s) will be i ESTABLISHMENTS FOOD SERVICE RETAIL FROZEN DESSERT MOBILE FOOD BED & BREAKFAST The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): - Address: City/State/Zip: ` �Yl ..� Phone#: -5 O "6 1�3 S--ram (iS1 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I ployees(full and/or part-time).*. have hired the sub-contractors 6. ❑New construction 2.ETllm a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' Y P tY• t 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 I I.❑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 Homeowners 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. I am 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.#: ' 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 pe aloes of perjury that the information provided above is true and correct Si afore: tz Date: 10/-,-y1 Phone#: 50 C6- 3-_�>, — G Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 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-contractor(s)name(s),address(es)and phone number(s)along with their certificates)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 permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense 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 person 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 Accident Office of Investigations 600 Washington.Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www,mass.gov/dia Commonwealth of Massachusetts 3 Division of Prof essionalLicensure �`- Board of Building Regulations and Standards Construction 1 & 2 Family lj G CSFA-046861 Ekpir es: 10/09/2019 ROBERT C S60TTW� . 41 APPALOOS W MARSTONS M ILIA A, 48 Commissioner ulatWn LmLr r=F business CT ' 01f�oe�'Co ' T ^(dRACTt3fi tr . `S OME iIAPROV.€Mlrftlividtl� R istP _ Ex iration �09,,2312020 ROBERT SCOIL TRUCTING SSI('0 4N& t ROBERT C.SCd 41 APPALOSA Undersecre MARSTOBNS MILLS,MA 02648 r,-= = Town of Barnstable Building BARMMAHL6,1I`l Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept �,•,v mn s. Posted Until Final Inspection Has Been Made. `!39, /.0 ' .+ Permit Where a Certificate of Occupancy:is Required,such Building shall Not be Occupied until a Final Inspection has been made. - Permit No. B-17-3580 Applicant Name: RAPHAEL F SCOTTI Ap provals Date Issued: 11/01/2017 Current Use: Structure Permit Type: Building-Sid ing/Windows/Roof/Doors Expiration Date: 05/01/2018 Foundation: Location: 17.1 MAIN STREET(HYANNIS), HYANNIS Map/Lot: 327-232 Zoning District: MS Sheathing: Owner on Record: MYCOCK,ARNOLD W TR Contractor Name: RAPHAEL F SCOTTI Framing: 1 i Address: P 0 BOX 371 Contractor License: CS-069312 2 COTUIT, MA 02635 Est. Project Cost: $ 15,000.00 Chimney: Description: replace windows as needed and exterior trim as needed Permit Fee: $ 160.00 Insulation: Project Review Req: Fee Paid: $ 160.00 Date: 11/1/2017 Final: Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Final 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. 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: Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. 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 Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT P� Application number ' Max F �� �o . o � ee .............#I ................................. .................... L AM _ OCT Q 8 2019 Building Inspectors Initials.... TO[4/Al OF�ARAJSTAIBLE Date Issued.:..,.® 1 ` �3 Map/Parcel....................... .............. .........:........... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: NUMBER STREET VILLAGE Owner's Name: _ Phone Number Email Address: Cell Phone Number Project cost$ O 6 Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a 'lding p rmit ' !cordance wi 780 CMR Owner Signature: 1 /�-tj/T/ ate: k © .� TYPE OF WORK D Siding Ind'Windows(no header change)# ❑ Insulation/Weatherization ❑ Doors(no header change)# Commercial Doors require an inspector's review ❑ Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name ✓J Home Improvement Contractors Registration(if applicable)# ck --1S (attach copy) Construction Supervisor's License# C. _ %-I C c6 C 1 (attach copy)- Email of Contractor d`�SLO fit' 1 Q-C D r`C`67n In e 1 Phone number J O tK—3��`� %61 ct ' ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY-IS IN • u�rTi+n1�r%#rv* IP'T VPUI RAN1C1TP%nTA/A/LJ1C7*/10/P Annn/11/AI nCCt1nC A nCOAAITPAAt DC/CCIICn APPLICATION NUMBER................................................... ...... *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent . X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 20 lbs. or> Yes No ,if yes,a gas permit is required. Natural Gas Yes No ,if yes,a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date ` C) All permit applications are subject to a building official's approval prior to issuance. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION CmNr L s rjT— Map r� Parcel Application :3s(C�`�`', Health Division Date Issued 1 Jig Conservation Division Application I Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH. _ Preservation/ Hyannis Project Street Address. �'-1 \ A 1 Village Owner Address 'Telephone Permit Request e. t•. S V\ ep, E x1.AJ i 6 e e. Square feet: 1 st floor: existing proposed 2nd floor: existing 'proposed Total new Zoning District I tA Flood Plain Groundwater Overlay Project Valuation 000 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: 0 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) a Name d Telephone Number Svc 566 '907r' Address N 0 tiT� \' /JP-S-r C`, \ `�- License# �- S o 6 CA �N C_1 h 0 Home Improvement Contractor# Email �(Af�Sc®tT c G- F�j 1p'1Ai L 1Q_0 1"1 Worker's Compensation # S6 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOQ- L SIGNATURE DATE G / FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL - PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING II DATE CLOSED OUT ',� ASSOCIATION PLAN NO. M d hr1 Kl �• p • r ter . a ', ,• E:l ❑ ICI n r r+ H Ul ra Pk _ ., LIA PM CP sop yl pp�� Gl tbh! r :au 6 ■: X^as ... I ■� ■ :r WO I k'11,411 low, • r � c •6 ; Er_ . e-•ere■• -■� ■�au r In� -'� ■la■.. Its■I:r Ifs ■ .�■■ ■� r■1' / t[ 1■ tr to al • II•\A..■• .■1. �JL t■. ■ a 1 t ■tr ■1■■IJi!■■ar 1■■. 1■1 � _ Y Ila•■r■ /I:w tr r•.I ■■It■ t1 1■t■M.1 � •tom ■■ ' •■■■ -tr a1111•r ■■ ■ ■■■■+ � r- :Ir r■■altar u l■ 1 .:■■■ ■ .. r l■I utpr. ■■■�.• _ uu■a u1 L■.. 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Mil Ia ■ ■.. .■■- la - ■na"+ -+ a Ia 1 la tl1■r at■■� :■tl[ar I[. !■a1I r!t1 a 11' - ;Ir■� ._■■■ a■ A 1 .r It1■� rL a1'■ .• al■■V ■ .11 1■■ ■l■ta'"a�as■■I■r Yri'■•.. _■ •a la 1■ Y�.a oFTHE ram, 9� MAS& Town of Barnstable prED �A Building Department Services Brian Florence,CBO 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 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: pl- t ( c ills (Address of Job) AA Signature of OwneV Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q W)W LESTORMS\building permit forms\EXPRESS.doc 08/16/17 ti Massachusetts Department of Public Safety Board:bf Building Regulations and Standards License: CS-069312 -Construction Supervisor RAPHAEL F SCOTTI r` a 33 N WESTGATE RDr HARWICH MA 02646 ! 1.0 �..�n CA, Ex j Commissioner 06/02/2018 yy B t= q LAST WILL AND TESTAMENT KNOW ALL MEN BY THESE PRESENTS,that I,EDWIN S.MYCOCK,of 103 Long Pond Circle, Barnstable (Centerville), Barnstable County, Massachusetts, being of full age and sound mind,declare this to be my Last Will'and Testament,hereby revoking all other testamentary instruments heretofore made by me. After payment of my just debts and funeral expenses,I give,devise and bequeath as follows: FIRST: To my sister,EVELYN BLACKLEDGE of Somerset,Massachusetts,the sum of Ten Thousand($10,000.00)Dollars,provided she is living at the time of my decease. SECOND: To my sister, PHYLLIS DWELLY of Somerset, Massachusetts, my 18th Century Hepplewhite mahogany Sewing Table,provided she is living at the time of my decease. THM: To my stepson,CHARLES J.MacEACHERON of Hyannis,Massachusetts, the sum of Five Thousand($5,000.00)Dollars,provided he is living at the time of my decease. FOURTH: To SHARON W. STITES, of Naples, Florida, the sum of Twenty-five Thousand ($25,000) Dollars, my Elmer Stennes Grandmother's clock and my 19th Century oil painting"A Brief Pause",provided she is living at the time of my decease. JU FIFTH: I direct my executors,hereinafter named,to pay all specific bequests,and all . inheritance, estate, succession and legacy taxes payable under my estate from the residue of my estate and not to use the hereinafter named trust property unless it is necessary. The executors'sole, discretion shall be the determining factor as to what funds shall be used for this purpose. SIXTH: To my Trustee or Trustees hereinafter named: the premises known as 171 Main Street,Hyannis,Massachusetts; 163 Main Street,Hyannis,Massachusetts; 16 School Street, Hyannis Massachusetts; and the balance due on the promissory note to me from Mycock, Kilroy Gieen and McLaughlin dated January 1, 1981,but never the less in Trust upon the following terms and conditions: a) The Trustees shall manage said Trust and turn over the net income to niy Brother, ARNOLD W. MYCOCK,of Crocker Neck Road,Cotuit,Massachusetts,as often as quarterly. PAGE ONE OF THREE -------..._------ - ..__.......... , — b) Upon the decease of my said brother,ARNOLD W.MYCOCK,this.Trust shall y� C� terminate and the corpus of said'Trust, together with any accumulations thereto shall be paid as �•!' follows: 1) All the rest,residue and remainder of my said Trust to my two sons,FREDERICK C. MYCOCK and RONALD J. MYCOCK in equal shares per stirpes. Title to said Trust's real estate shall immediately vest in my said two sons without further action upon the termination of said Trust. 2), In the event any or all of the premises described in said Trust have been sold,then the net proceeds from said sale shall go into the Trust and become a part thereof. SEVENTH: All the rest, residue and remainder of my Estate, whether real, personal or mixed and wherever situated and to which I may be entitled at the time of m decease y y as to my two sons,FREDERICK C.MYCOCK and RONALD J.MYCOCK,,in equal shares per stirpes. EIGHTH: I constitute and appoint my said brother ARNOLD W.MYCOCK to be both Executor and Trustee of this will. In the event he predeceases me or is unwilling or unable to serve then I appoint my two sons,FREDERICK C.MYCOCK and RONALD J.MYCOCK to be both Executors and Trustees. In the event either predeceases me or is unwilling or unable to serve,then the remaining one shall be the sole Executor and Trustee of this will. I request and direct that any executor or trustee be exempt from giving any surety or sureties on their official bond or bonds as such trustees or executors. NINTH: In addition to all powers conferred by law or by other provisions of this Will, my Executors and Trustees shall have the following powers without order or license of court: to retain for any period any property I may own at my death and to invest or reinvest in any property, even if any or all of the property retained or acquired is of a character or amount which would not ordinarily be considered suitable for fiduciary investment, and for reasonable periods to hold cash uninvested;to sell,exchange,lease and make contracts concerning real or personal property for such consideration and upon such terms as to credit or otherwise as my Executors or Tnistees deem advisable, which leases and contracts may extend beyond the term of the settlement of my estate; to give options; to execute and deliver any appropriate instruments; to discharge mortgages of record; to settle by compromise or arbitration or otherwise any claim or matter in dispute, and to concede or abandon any claim my Executors or Trustees do not consider worth pursuing;,and,to the extent.permitted by law applicable to my estate, to distribute any property payable to a minor beneficiary to the minor or any other person deemed suitable by the Executors or Trustees,and the receipt of any such distributee shall be sufficient evidence of the satisfaction of my Executors' or Trustees'obligations. PAGE TWO OF THREE IN TESTAMONY WHEREOF,I hereunto set my hand in the presence of two witnesses and + declare this to be my Last Will and Testament this /) d y of June,1996. EDWIN S.MYCOCK On the /./ day of June,'1996, EDWIN S. MYCOCK, signed the foregoing instrument consisting of THREE pages, in our presence declaring it to be his Last Will and Testament,and as witnesses^thereof,we both do now at his request,in his presence and in the presence of each other, hereto subscribe our names. of COMMONWE TH OF MASSACHUSETTS COUNTY OF BARNSTABLE June // ,1996 Before me the undersigned authority on this day personally appeared EDWIN S.MYCOCK, t ( DI LPn.['CAI.OM I f) and �fj/1 R�(� r �J N c.li,e known to me to be the Testator and witnesses,respectively,whose names are signed to the attached instrument and all of these persons being by me duly sworn,EDWIN S.MYCOCK,the Testator, declared to me and to the witnesses in my presence that the instrument is his Last Will and that he willingly signed it and that he executed it'as his free and voluntary act of the purposes therein expressed,and each of the witnesses stated to me in the presence of the Testator that he signed the Will as witness and that to the best of his knowledge the Testator was eighteen years of age or older, of sound mind and under no contraint or influence. Wi tneTestator 71r �,Iozl W' ness Subscribed and sworn to b.efor me by the Testator and the said witnesses this day of June,1996. Notary Public / My commission expires. 61 /J� PAGE THREE OF THREE 9II iIII�II�III�I ,X Con,inonwea Rh,ofMassachusetis * Registry of rrtaI Records and Statistics StateFile# 2016 018684 f CERTII'ICATE OF I�EK s� 4 : i -Regiser•ed# 270 ' Form R-301 08012015 �%�„�' - Place ofDeath " 81 CROCKER NECK ROAD,BARNSTABLE, MA Date ofDeath -APRIL 22;2016 Age 92 YRS Say MALE CurrentNdrne MYCOCK , ARNOLD W SurnameatBnihor-Adoption MYCOCK SSAr 030-16-8720 AKA _ F Date ofBh-thFEBRUARY 05,1924 . Birthplace SOMERSET,IVIASSACHUSETTS Residence 81 CROCKER NECK ROAD,BARNSTABLE, MASSACHUSETTS 02635 u Race Education o WHTTE SOMECOLLEGE CREDIT,BUT NO DEGREE MaritaJStatzrs Occupation/Snchisny . NEVER MARRIED TITLE EXAIVIINERILEGAL Last Spouse-Last,First,Middle(S:oiram e a t Birth ol-Adopt on) Decedent:U.S.Peter•an(Most Recent) WWII Mother/Parent Name=Last,Fast Middle(SurnameatBinhorAdoption) Birthplace MYCOCK,EVELYN (WORDELL) MASSACHUSETTS Father/ParentName-Last,First Middle(SurnanreatBirth orAdoption) Birthplace MYCOCK,ABRAHAM (MYCOCK MASSACHUSETTS Pai-11.Cause ofDeath-Sequentially list immediate coz ise then antecedent causes then undei-�vingcouse Iiternnlbemeeno—t—ddenrh a.Immediate Came(Final condifion resulting in dea th) FAILURE TO THRIVE 1 NIO S- b.Due to or as a consequence of.. z PROGRESSIVE DEMENTIA 3.YRS. C.Due to or as a consegnenee Of. - L r d.Due to or as a consequence of < Par7,llOthersignifrernueondilioriseontribittingto death butnotiesultinginunderlyingcouse Mann erofDeath: U CHRONIC KIDNEY DISEASE\ NATURAL CEREBRAL VASCULAR DISEASE Time ofDea the 10:15 AM Resultoflnjwy: NO Certifer• MICHAEL BARNETT, MD Lic# 40820 Addr. 348GIFFORD STREET,FALMOUTH, MASSACHUSETTS 02540 Funeral Licensee'Designee WILLIAM B.CHAPMAN,JR Lic# 50359 o Facilityl4ddr- JOHN-LAWREN,CE FUNERAL HOME,BARNSTABLE, MASSACHUSETTS t- lnimediateDisposition BURIAL o Date oflmmediateDisposition APRIL'29,2016 `_' Placel4d&-ess J� ° MOS.SWOODCE ETERY, 280 PUTNAM.AVENUE, BARNSTABLE, MASSACHUSETTS 02601 FD te ofRecord APRIL 28r 2016 teofAmendmentt — CLERK, ,CITY OF BARNSTABLE I.the undersigned,hereby certify that 1 � t I 1-- g y } at I am the Town Clerk for the Town of Barnstable Ih��.t,w:�ucra,1,,rave custody of the records of births,marriages and deaths,required by law to be kept in my office and I do hereby certify that the above is s true copy from said records. WITNESS:My hand and the SEAL OF THE TOWN OF BARNSTABLE A TRUE COPY ATTEST:at Barnstable,Massachusetts Ann'M.Quirk,Town Clerk,Barnstable (If the Seal is not raised,this document has been illegally copied—do not accept it.) TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# 7. Health Division Date Issued 113 Conservation9 Fee �oZU 00 Tax Collect Treasurer Planning Dept. ; Date Definitive Plan Approved by,Planning Board Historic-OKH Preservation/Hyannis " Project Street Address L) "Village I S .Owner 'Q I�J YC064, MWV_44" Address 3 7 Telephone M • ' Permit Request D A 00at- 0e,- h f%D ( Sc6 W t `X1•7 Square feet: 1 st floor: a isting proposed 2nd floor: existing proposed Total new Estimated Project Cos 12' Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size t ^ Grandfathered: .❑,Yes. ❑No If yes, attach supporting documentation. ` Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes 0 No �On Old King's Highway: ❑Yes ❑No •Basement Type: CI 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 t Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No " Detached garage:❑existing ❑new size ' Pool:O existing ❑new size `Barn:❑existing ❑new size ,, `t - 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 ' r BUILDER INFORMATION Name Telephone Number 7 6 71 Address 2 V_c License# C 5 00' 6 q C014-fe' 111 k , qO . (lam 3 Home Improvement Contractor# d Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO .SIGNATURE AVDATE �7i — FOR OFFICIAL USE ONLY PERMIT NO. t DATE ISSUED ; '..� ;;t �• . _ ;— MAP/PARCEL NO. ADDRESS t a �. VILLAGE' r f ' OWNER' DATE OF INSPECTION: - : ,' , • * t _ Y t } F FOUNDATION I' FRAME INSULATION ; y : �' - { �� _ — >.� � .�. r.� � •- ' ' s , FIREPLACE ELECTRICAL: ROUGH FINAL t :r PLUMBING: ROUGH FINAL GAS: ROUGH . 44' FINAL L+; «., 2 1 1 ' t t 't Y _ - .. •2� 1 -"'t' . f tY Aa FINAL BUILDING DATE CLOSED OUT. ASSOCIATION PLAN NO. f ; Building Division 367 Main Street,Hyannis MA 02601 ffice: 508-862-403 8 , Ralph Crosses ax: 508-790-6230 BuiIding'Coramissior.e: Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal, demolition, or construction of an addition to any pme-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: on u G Estimated CoJI st y �� Address of Work: Owner's Name: , Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law aJob Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME ZIPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 14ZA. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. 6 Date Contractor Name Registration No. ch / Date Owner's Nanie 4 q:fomu:Affidav I _= a 600 Washington Street ,.. Boston,Mass. 02111 Workers' Com ensation Insurance Afridavit 10 0/07 MM name: — ... i 6 L 4 ��k, location 911 citV ❑ I am a homeowner etformin all work hone p myseiE am a sole aroarietor and have no one tivorkin in amr acitn ❑ I am an emplo�•er providing tivorkers' compensation for tav empltrnees tiwrking on this job. camnnnv name: addre3s: city: "hone#: insv nce cn. oiiev# rho✓%/��//�!u�u!'i///.c�.�/ e J I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the folloning workers' compcnsatio is comnanv name: address: Cftv- eye one Ltisarnce ca. ..... iii�# .... ... �'. �"»',k,.,...: �r�. ;w d..s.. comnanv name! hone#: ; .., x: rUnrBn[C[o. h:.. . r:• :rib... ::„ cM w.,:•, m;02,:.;'.ri. a$ure to secure coversice as required under section %�� IRA of MGL 152 can lend to the lmpositloa of atatinai peaattlea o[a Doe nP to SI300.00 aadfor ne pears'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a tins of SI00.00 a day asaimt am I understand that a py of this statement may be forwarded to the OMce of Investigations of the DIA for coverage vetiSeadou. do hereby certify under the purrs and penalties of perjury that the information provided abovie is traw and coIred �� Date t name pb= oincial use only do not write in this area to be completed by city ortown oiDeiai city or town: ptlllceme C3Building Deparoaent ❑check if ln�tediate response is required (]Lleenriag Board ❑selectmen s Ounce contact person phone If; Health Department ❑Other trrmm Y,95 P/A1 Massachusetts Genera!Laws chapter 152 section 25 requires all employers to provide workers' compensation 11br•she- empiovees.. As quoted from the "law", an employee is defined as every person in the service of another a nder a`av'cc 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 the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the:ec.,•e: _ 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, ortbe occupant of the dwelling house o: another.who employs persons to do e , construction or repair work an such dwelling house or on the grouruis c_ building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or reneur= of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who hzs not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither.the commonwealth nor any of its political subdivisions shall eater into any cammact for the performance of public work=zl acceptable evidence of compliance with the insurance requirements ofthis chapter have been presented to the comae:. .= authority. ------------------ Applicants • Please fill in the workers' compensation affidavit completely, by checking the box%bat applies to your simation and supplying company ramps, address and phone numbers along with a cite of insmaace as all affidavits may be submitted to the Department of Industrial Accidents for canfirmadon 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 licc=c is :being requested, not the Department of Industrial Accidents. Should yrnr have any questions regarding the "law"or if you ;are required to obtain a workers' compensation policy,please call the Dqm==at the number listed below. City or Towns Please be sure that the affidavit is complete and printed Iegibly. Ike 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 applicatL Please be sure to fill in the pennitllicense number which will be used as a reference member. The affidavits may be retaned io the Department by mail or FAX unless other auraagemeats have been made. The Office of investigations would like:to thank you in advance for you cooperation and should you have any questions. ®lease do not hesitate to give us a call. The Deparaneat's address, telephone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents 0MCC Ot ImrestlMBE 600 Washington street . Boston;Ma. 02111 ••• fax#: (617) 727--7749 • phone #: (617) 727-4900 exL 406, 409 or 375 .,e.-?cl a 1'rl -M �S i(� rn o s -s, t � � —s 'e ,�{� •' . ht�-�"ss-�.:O�S —1�""-s?�.A,+� .�7„•. i r � b:��5t�,Li. ,f�� ;� �_ 'f��i.—� x-1 w'�A��mf;e-►k'rr� r+ $ r�+i's O` ®� .o �^' ' jii 1`C�-q-, ^„yY:.£,= Z 6i-r rn s� z,V+a� 1'*1 S <, •.'a, rn � o , {,F 4" x..,dddi,',,Z O 1,P l7 Y 1 era ui r a l pp } O OR, a t 0 Hyannis �dlsin Street Waterfront i $ Historic District Commission 230 south Stint Hymn*Massachusetts 02601 TEL: S08.862-665 / FAX: S08-79"288 Application to Hyannis Maim'Street Waterfront Historic District Commission In the Town,of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under M.G. L Chapter.40C, She Wistoric Districts Ad fhr proposed work'as described below and on plans, drawings or photographs accompanying.this application for PLEASE CHECK ALL CATEGORIES THAT APPLY- I. Exterior Building Construction. ❑ New Building ❑ A 'tion ® Alteration Indicate type of building:❑ House ® Garage Commercial ❑ Other 2. Exterior Painting:❑ 3.Signs or Billboards:® New sign ❑ Existing sign ❑ existin sign 4.Structure:p Fence ® ❑WaH Flagpole OthEr t,DCGh A/y S. Parking Lot ❑ New Building ❑ Addition C?Altaadon (Please see the guideHnes for explanation and requirements) TYPE OR PRINT LEGIBLY DATE -111_` ` Q ADDRESS OF PROPOSED WORM ��� �iASSESSORS MAP NO. °2 -4 La uY4x.�,rnGt IMowNER w ,u. !r�„u sr ASSEssORS LOT N®. 3 2 HOME ADDRESS �'t�' TEL.NO.Q?6—2 2 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS.Include name of adjacent property owners across any public street or way.(Attach additional shoat if necessary). AGENT OR CONTRACTOR M.NO. ADDRESS `- OTTcv�', �qkt i l f DET'AILM DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done, inciliding debiied data on such architx�val Semmes aa: foundation,fey,Wig,rooft&ref pmb,sash and'doors, window and door ftmes,trial,gutter- leaders,rooting and paint color,including materials to be ued,if speclfleadow do not aaooarpany plans. In the can of signs, give locations of ousting signs and proposed lotions of new signs. (Attach additional diet,if }. G o c�i�eta icy R'ec, c — r`-ear bid , 1?rw�4-o 61 Plfrecsure Quw6t,, Siped owner Contractor Agent RECEIVE® trace ow i for Commissiee use. ReWVW by HMSVVHDC MAY 2 11999 TOWN OF BARNSTABLE 10 ,fie By HISTORIC PRESERVATION DIV. The Certificate is hereby: Approved a Disapproved ❑ Date 1 N20RTAW If this Certificate is approvod,approval is subject to the 20 day appeal period provided in the Ordinance. r 14 ;. PLEASE SUBMIT THE FOLLOWING INFORMATION AND/OR MATERIALS WITH YOUR APPLICATION TO THE HYANNIS MAIN STREET WATERFRONT HISTORIC DISTRICT COMMISSION. THREE(3)OF EACH.IN THREE(3)SETS APPLICATION: All Need=$not 6e completed SPEC SHEET: Complete appucabk informad= &OT FLAN: Shaw fires on the lot and any proposed ad cbangcs carmwclot Dian for new homes MIT DIGS: All Elevati®se and phase include Undinko Dim for ADDITIONALLY THE FOLLOWING MAY BE SUBNOTTED: Of area(s)alected;Street view for addidons/chauges. AMP E : Of materlaWcolon(i.e.color chart) m FOLLOWIIITG E MIDST A&SUBMITTED 1 TgyICATION FIL GMADE PAYAKS T TOMIN Q TSTABLE CERTIFICATE OF APPROPRIATENESS 9g@.�0' j q S, 00 CERTIFICATE OF EXEMPTION _ lecog a5:6 C7 CERTIFICATE FOR DEMOLITION OR RE140VAL $&CA - pU *******a***********************s***********art***s*►******#********�**•*s*#**r**«***** IF YOU HAVE ANY QUESTIONS REGARDING APPLICATIONS,PLEASE CALL THE HISTORIC PRESERVATION DIVISION AT 862466S BETWEN 8 A AND!a NOON.M-F. HYANNJS MAIN STREET WATERFRONT HISTORIC DISTRICT COMI MSION •"' SPECMCATION SHEET'*' ADDRESS OF PROPOSED WORK r ` t fttuuSf. IS FOUNDATION SIDING TYPE COLOR CHRANEY TYPE COLOR ROOF MATERIAL COLOR PITCH WOW COLOR TRIM COLOR DOORS COLOR SHUTTERS GUTTERS DECK GARAGE DOORS COLOR NOTES: Fill out completely, including nmsuremwts and materialsloolors to be used. Three o_othpe�es of this form are required for submitW of an lication,along with three vapies not be"Cectiiio ,but should structures a�the tot licable.The Plot plan need t. a , 171 Main St., Hyannis Filing abutters Map 327 Parcel 232 Applicant Arnold Mycock, Trustee P.O. Box 371 Cotuit, Ma. 02635 233 Applicant 234 John E. Kilroy P.O. Box 601 Barnstable, Ma. 02630 231 Woods Hole Steamship Authority Woods Hole, Ma. 02543 174 Richard D. Arenstrup, Trustee Park Square Trust 11 P.O. Box 2248 Hyannis, Ma. 02601 173 _Nancy L. Johnson, Trustee P.O. Box 342 Hyannis, Ma. 02601 150 Helen C. Redanz 201 Main St. Hyannis, Ma. 02601 149 Paul Neary 1 Henry F. Loring Rd. Centerville, Ma. 02632 GY 19 G.4 _ utI Y e+N b vU aA 0 aZ Np �Ls{ O wZm C RI D WW m fp IN ` op to I R f A . N1110 via 1IA A p !r 0`OY OGt N p H A y 1p � �� •�o P..� RB' � e tirr � �+ RO R� Rm to oil too°°,3S 1 l• � PI .N ' �m 7 � r 4 � 0 Z i�3Yis �, •• i 56 N� �0 r ® a It 40 • RN of 1 N N J 10 _ N 4A R'-i N N R� µ 0 g St11171 Y"b �N p m m it O Property Location: 171 MAIN SIP IIY MAP7D: 327/ 232/// Other ID: Bldg M 1 Card 1. of 1 Print hate:05/19/19" — iTi�UZ'7'lUl1zETi4IL FCe»aent Zd —Description ommercur a[a menu Ririe»i —�)escriptton j lsiz•167'Type cc g godel 4 ommercial eat& CC--33 rade B rame Type 2 WOOD FRAME _ r aths/Plumbing 2 AVERAGE �Storie2 Stories us /1 (Occupancy 0 CeilingfWall s ER,&WALLS ooms/Prins 2 I (AVERAGE 38 Exterior Wall 1 14 Wood Shingle /o Common Wall 2 (Wail Height ! I LIS 14 �70f f Structure 3 �abte/IIip Cover 3 sph/F Gis/Cmp --- - ;. 1 6erior Wall 1 3 lastered a»tent o e escnption ae.o.r — S 11 i 2 -- 4 3 us 4 17.nterior Fluor 1 9 IPine/Soft Wood omG Ad FUS 2 loor Adj I 15 7 Unit Location ! 2 AS jlieating Fuel 2 tl I ! �leating Type 5 �H.ot Water umber of Unirs AC. I ype I(e masher of Levels i 24 1 fi 80 3 astral %Ownership �edrooms 2 j Bedrooms athrooms 5 ! g 1/2 Bathrms 1 lt3 i r Full+3/2 >...s- _: { na`dj Base Kate otal Rooms 4 Rooms Size Adj.Factor .84496 r IOrade(Q)Index l36 ba th Tvpe dj.Base Rate 0.90 tr_chen Style i ldg.Value New ,130 ear Built 945 1 ff.Year Built 980 rml Physcl Dep 7 uncnl Obslnc H-con Obslne 5 pecl.Cond.Code I rcenta a I Cond% ver %Cond. 58 0101 SingleFam 40 prec.Bldg Value 292,400 Cbde -Description 178 Units Unit Price Yr. Dp Mt o Apr...Value Liarage-Good -- — —� escription LivingArea GrossArea rea rut st eprec. a ue irs oor— -�;UT,----4,W 4,07 . — Zd'1;18 Porch,Open,Finished 11 1 14.6 36 FUS tipper Story,Finished 3,7 3,791. 3,79 60.94 231,11 PTO_ p 23, 1 3.1 73 UBNf Raiment,Unfinished 1,9 39 12.1 23,93 ross tv se rea _ g Pa v NO NIC r Y L/ TS S, , I �•��� STANDARD LEGEND - note:not all symbols will appear on a map " 1 GOLF COURSE FAIRWAY A0 DECIDUOUS TREES _... 13 I EDGE OF BRUSH .........._z ^ +" ORCHARD OR NURSERY CONIFEROUS TREES MARSH AREA ...�..-..._..._.._.._..._.._..._..._...__. �!/ 36 . J.. s. EDGE OF WATER / \ t DIRT ROAD DRIVEWAYS \ A ',1 PARKING LOT \.•/ '1 PAVED ROAD 35 . 8PATH/TRAIL DITCHES 6 - - PROPERTY LINES , , , MAP 327�_ � _ _ I o _ ;., O� ..._ ' ,i MAPH s 21�PAR(ELNUMBER �'t. !2-3-2 °O�HOUSf NUMBER --- ---"�ii - P FOOT CONTOUR LINE O # 163 ' ,' O FOOT CON NE ,, ( SPOT ELEVATION 1 ''I -_"'_ STONEWALL O 'i.� ..I ^-- — ' ',, AILRET ROAD WAIL 3 ❑ 4 I y i n. RAIL ROAD TRACKS �" I - , �' STONE IETry / \ ;_._. MAP 327 SWIMMING POOL , , 'i!, PORCH DECK I \1 BUIIOINGs/STRUQURfs r o 1\ �� µ}{A• DOCK/PIER/1EI1Y ,,5• r \ 1` ',1- _ 0 ASSESSOR'S MAP BOUNDARY - ------------ VALVE ® ME - [ 1 POST OR FLAGPO FIAGPoLE SIGN m SORM GRAINS TOWER C. LIGHT O ELfOROIl M 7 i it SITE MAP .f �I , I nw � �•,,,,,_ i / ' 0 B GE SYSTEMS UNIT 6 ' i SCALE: i OGRAPHI(INFORMATION in feet --------- -..l I -; 20 4- 0 INCH 0 . 1 - 0 FEET' 4 J i t ` -- _ ���'''ttt •..� �� S FO.Ea»'.dPn off uni, NOIf:THE PARCEL LINES ARE ONLY GRAPHIC REPRESfNIAF10Ns OF �'4 PROPERTY BOUNDARIES,THEY ARE NOT TRUE LOCATIONS-11111 VEGETATION AND TOPOGRAPHY DATA INTERPRITID FROM 19B9 AERIAL PHOTOS. 4 = _ - 1 , 1' MEBI(DOA INIERPRUEO FROM 1995 PHMRIDGRA➢HYPNO B00.PUNT b0D'.BOTH MAPPED AT I' IDD'. � '' 'DATA MAPPED All- PAINTED AT DIFFERENT GGIE MAY DECREASE. , O - r'gt Q J cov - - ' I 4.1 TS fi _ _ ' Y� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division Date Issued Conservation Division Application Fee LPr Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation/Hyannis Project Street Address Village Owner ddress �a�v t-AA Telephone _ S O aS Z3"00 d26 Permit Request O Square feet: 1 st floor: existing proposed 0 2nd floor: existing proposed Total neyy'0 v © SR p Zoning District S Flood Plain VJ 0 Groundwater Overlay Ln Project Valuation �"� -0 d Construction Type 12 ,Q_u%r r Y w Lot Size ° LA Grandfathered: ❑Yes ❑ No If yes, attach su gporting docurrLP&tation. Dwelling Type: Single Family ❑ Two Family ❑ Multit amily (# units) A e of Existin Structure Lt S Historic House: ; es ❑ No On Old Kin 's i hwa :,-'*U Ye &No 9 9 g 9 Y� ,sr, Basement Type: YFull Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new 0 Half: existing new Number of Bedrooms: existing O new Total Room Count (noZG ding baths): existing new O First Floor Room Count Heat Type and Fu I: s ❑ Oil ❑ Electric ❑ Other Central Air: Zes ❑ No Fireplaces: Existing New C) 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 peals Authorization ❑ Appeal # Recorded ❑ Commercial Yes ❑ No If yes, site plan review# Current Use Qf�.,��-�2. Jlss Proposed Use _ .,�,,_0 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Nance Telephone Number 45bd 1.6451 ;Z?A64:9syZ Address 57 r b4) 6&tW!L,/ License #(:5 _6 P6452 E3 F&W9kA_ 44#4 a zJ.3 l Home Improvement Contractor# 15"Z4 Email: C6Ak S_T, ,�e� Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE - DATE /DL2,f Z,6I 3 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED � ; MAP/PARCEL NO. r 7 ADDRESS VILLAGE P _ OWNER DATE OF INSPECTION: ! `.E _._ FOUNDATION FRAME INSULATION FIREPLACE t ELECTRICAL: ROUGH FINAL •9 PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING t t DATE CLOSED OUT ASSOCIATION PLAN NO. r` ' f the Cammonwealth of Massachuseas Departirnent of Industrial Accidents Office of luvestigations +600 Washnigion Street Boston,MA 02111 wwwv.massgov/dia Yorkers' Compensation Insurance Affidavit:BtuIders/Cantractursf]EIectrician?lumbers Applicant Information Please Print Legibly Name Far 2 S - 40 S AA�t P A.dslress:,5-7 t4a.4x( Hzei �2fw - City/Sta&Zip: 1 2(Z"%ie2 AN• OZ63( Phone#: ffg�276 US-( 611 ag, 36+i 91512— Are you an employer?Check the appropriate box; Type of protect(required):1.El4.I am a employer with ❑ I ant a general contractor and I 6. ❑New axtstiuction. loyees(full and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet y- ❑Remodeling ship and have no employees These mb-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Budding addition [No workers' comp.insurance comp.insurance., required] 5. ❑ We are a corporation and its 10_❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions rnysel€ [No workers'comp- right of exemption per MGL 12.❑ of insurance required.]1 c.152,§1(4),and we have no employees.[No workers' 13. Other7�k, t comp.insurance required.]; 'Airy appbcsat that checks boa#1 nmst.also fill opt the section below shoring their workers'compensation policy infiarmadon. 1 Homeowners who submit this affidavit in&catiang they are doing an wort.4 then hire outside contractors ntnst submit a new affidavit indicating such. (Contractors that check this boa must attached sir additional sheet showing the name of the sob-contractors and state whether"not those entities bane employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. lam an employer that is providing n orkers'compensation irrsurance for my employees. Below is the polio and job sits information. Insurance Company Name: Policy#or Self-ins.Lic.#: 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 imptrisonment,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 liere4r c render thepains and penalties of perjury that the information provided aboire is true and correct Si tore: 6Date: f I I Phone#: f( Sb? Ff4 465t &I l Ofj7cial use only. Do not write in this area,to be completed by city or town officiaL City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk &Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 Class Board achusetts-De Of Buildin Aartment of License:C Re�riaoicns and sranaa�ety S-08 ds S,ET R SI�p `K I E BifTp RE N wSTER CIA=0' - issioner EXAiratio_ OS/16/?015 Town of Barnstable Regulatory. Services F RIANRTA AT,i f .. .MARS. Thomas F. Geiler, Director . ►+� Building DMsion Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us' . Office: 509-862-4-038 Fax: 508-790-6230 Property Omer Must Complete and Sign This Section If Using A Builder _ Yc0C- I14 CL as Owner of the subiect property hereby authorize . ?e—JIrk G S. V�I to act on my behalf, in all matters relative.to Work authorized by-this b ddia permit application for. (Addmss of job) Signature of Owne Date Print Name /YJ YcCC1� If Property Owner IS applying for permit please complete the Homeowners License Exemption Farm on the reverse side. Q:FORt�ts:owrt�Ex�sia�t �t ToWn of Barnstable Regulatory Services {a RlR%t�PART.R Thomas F. Geller,Director KAM .�� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstablexm us Office: 508-862-4038 Fax: 5508-790-6230 goMl�owN�x LICEINSL�MPTIDi�r 'Please Print DATE: JDB LOCATION: m=bcr strtt2 village "HOMEOWNER": . name home phone# work phone# CURRENT MAILING ADDRESS: _ city/town slate zip code The current exemption for"homeowners"was extended to include owner-occupied dwelliazs 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 6uperVlsor. DEF'INMON OF HOMEOWNER Persons)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 "homeowners"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) . r. The undersigned"homeowner"assumes responsibility for compliance with the State Budding Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner:'certifies that he/she understands the Town of Barnstable Building Department minirrfjrn inspection procedures and r D ui„>,T,ents and that he/she will comply with said procedures and retdrirements. Signat uc of Homeowner Approval of Building Official Note; Thre�,f unily dwe.Ilmgs confab 35,000 cubic feet or larger will be mquire .to comply with the. State Building Code Section 127.0 Construction ContrDL HOMI OWNEWS EXEMYTIDN The Code states that "Any homeowner performing work for which a bru7ding 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 pamon(s)for his to do such work,that.such Homeowner shag act as supervisor," Many homeowners who use this exemption am unaware that they arc assumring the rrspoasibilities of a supervisor(see Appendix Q Rules&Regulations for Licensing Construction Superniimr;Section 2.15) This lack of awareness often result in serious problems,particularly when the homeowner hire unlicensed persons: In this case,nur Board cannot proceed against the unliccnstd ponon as it would with a&caned Supervisor. The homeowner acting as Supcavisw is ultimately rrsponsibla To ensure that the homeowner is fishy awarr of his/her rzsp=bilitiee,many communities require,as part of the permit appFicatioa, that the homeowner certify that hnIshe understands the responsibilities of a Supervisor, On the last page of this issue is a form crar catly used by several towns. You may cant aroend and adopt such a form/oc ti5cation for use in year commtmity. Q:1WPFfT ESIFORMSIhome rmptDDC i r gym; TOWN OF BARNSTABLE BUILDING PERMIT:APPLICATION Map 7 _ Parcel Application #dh Health Division Date Issued 1-3 Conservation Division L Application Fe V �✓ Planning Dept. Permit Fee V71 Date Definitive Plan Approved by Planning Board =' Historic - OKH _ Preservation / Hyannis Project Street Address _ l rn Village 01044iV -� Owner_ WA44, s U 1 Address.—P— f6d Telephone 507- '567— 4 5(aD Per it Request �eaw . ilk c U U'571- Square feet: 1 st floor: existing proposed _2nd floor: existingproposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio V.j017D —Construction Type Lot Size Grandfathered: ❑Yes ❑ No !if yes'attacf }supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) _ Age of Existing Structure 45 11ol YRg Historic House: A'Yes ❑ No On Old King's Highway: ❑Yes Flo Basement Type: U1 Full ❑ Crawl ❑Walkout LJ 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: as ❑ Oil ❑ Electric ❑ Other Central Air: kKes ❑ 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 ves, site plan review # Current Use _ y _-- -- Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name. ��\ _ Number r _ -- Telephoneu be Address '®' �` �✓ — License #_ A-rN Home Improvement Contractor# _ Worker's Compensation # i ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO_ A'Y15�V� SIIGNATUR DATA \ Z' 4 FOR OFFICIAL USE ONLY APPLICATION# _DATE ISSUED:a.. jt: . MAP/PARCEL NO: ADDRESS VILLAGE r r OWNER - 7 DATE OF INSPECTION: 'r= `FOUNDATION FRAME t -_INSULATION- FIREPLACE 4 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL N GAS:-,,?-:, ROUGH-,, FINAL F .FINAL BUILDINGAtl <_=- q . DATE CLOSED OUT ASSOCIATION PLAN NO. T ' I The Commonwealth of Massachusetts 127 Department of Industrial Accid,& Office of Investigations 600 Washington Street Boston,MA 021.1.1 www.mass govIdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electriciam/Plumbers Applicant Information Please Print Le�bly Name (Business/Orgamti� onflndividuaI); I Address: �4 a , go SCI t:) �5 �o r' A City/State/Zip: Phone#: Are you an employer?Check the appropriat5�t 1 [] I am a to m with Type of project(required): . erg y 4. a general contractor and I . employees(fuIl and/or part-time).* have hired the sub-contractors 6• ❑New construction 2.[] I am a sole proprietor or partner- listed on the attached sheet; 7. ❑Remodeling ship and have no employees These sub-contractors have S. ❑Demolition working for me in any capacity employees and have workers' No workers'comp,insurance comp.iasvrence,t 9. .0 Building addition required-] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3•❑-I am a homeowner doing all work officers have exercised then 11. Plumbin myself [No workers' comp. right of exemption per MGL g repairs or additions insu ance required.]t c. 152, §1(4),and we have no 12.0 Roof repairs employees. [No workers' 13.0 Other ��j comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information, t Homeuwmors who submit this affidavit indicating they art doing all work and thm hire outside contractors must submit a new affidavit indicating such Coatractars that check this box mast attechcd an additional sheet showing the namc of the sub-contractors and s�tz whether or not those entities have employees If fire sub-contractors have employees,they must pravidc their workaa'comp,policy number, I am 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.# 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 tip to$1,500.00 and/or one-year imprisonment, as wr, 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 ibis statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby MU der p d penalties of perjury that the information provided above is true and correct Sim tune: Date: Phone# Officz d use only. Do not write in this area, to be completed by city or town qfficiaL City or Town: PernikUcense# Issuing Authority,(circle one): 1.Board of Health 2. Building Department 3. Cify/T uwn Clerk 4.Electrical I Ins ector 6. Other Inspector 5.Plumbic g P Contact Person: Phone#: I i '`,C ® CERTIFICATE OF LIABILITY INSURANCE °ATE'M6/2011 „) �..,..�� o9ros/2o11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: German)Insurance Agency PHONE FAX 908 Main Street 508 428-9194 A/c No: 508 428-3068 E-MAIL ADDRESS: OsterVllle, MA 02655 PRODUSTUCER EIR ID INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: SAFETY INS CO Peter D Field PO BOX 16 INSURERB: COtuit,MA 02635 INSURER C: INSURER D: AIM Mutual Ins.Co. INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1 EXP �TR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM/DD�Y MM/DDY/YYYY LIMITS A GENERAL LIABILITY CP00001803 9/21/2010 9/21/2012 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE ( RENTED PREMISESS Ea occurrence) $ CLAIMS-MADE ElOCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ F—IPOLICYF—] PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ $ UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ D WORKERS COMPENSATION AWC 7023784012010 5/16/2011 5/16/2012 1 WC sTATu- I I OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION PETER D. FIELD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD ivlassacnuseits - vepartment of runuc �Nateq Board of Building Regulations and Standards Construction Supervisor License License: CS 15044 PETER E KELLY 50 RUSTIC LANE " HYANNISPORT, MA 02647 Expiration: 8/15/2013 commissioner Tr#: 1601 �TME Town of Barnstable Regulatory Services MAMAS. Thomas F. Geiler,Director 63� `t� Brulding Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www-town-barnstable.ma.us Office: 509-862-403 8 Fax: 508-790-6230 b Property Owner Must Complete and Sign This Section If Using; A Builder ",Vfi/ J- CGS , ro as Ownet of the subject f J P PAY Hereby authorizePtowoz�k G to act on my behalf; in aII matters rela authorized by building pP-,rr,1t (Address of Job #Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. Sigriatate of et Signature of Applicant Print Name cj 1�I Print Name lo� to QT0RI&:0WNERPERJvMSI0NP00LS i I Town of Barnstable Regulatory Services TOWN � RSTA� ' Thomas F.Geiler,Director LE . Building Division ?_ OCT ! 5 P 3 28 t639.A, �+ Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us D I V .S;10N, Office: 508-862-4038 Fax: 508-790-6230 Permit# Application for Sign Permit Applicant: M,lTy- Map&Parcel# 3 2: � Doing Business As: F7-d- hJ L.RAI OJT Ple,0.f Telephone No. 97 Sign Location ' Street/Road: /7/ AI A/w2 ;S T', h -Jf'1 AZA. S Zoning District: Old Kings Highway? Yes Ti)Hyannis Historic District? No Property Owner -D Name: M yCyU� 4,g wJDLp W—, TiC Telephone: Al? 27 2 Address:!ji/ OR VCR", A4 Le 1CIV Village: (1,0 Sign Contractor Name: 9 ND mac-/ball Telephone: .122 7 3 93/ Mailing Address: f2 Description Please draw a diagram of lot showing location of buildings and existing signs with dimensions,location and size of the new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? Ye Its) (Note:If yes,a wiring permit is required) Width of building face fDD ft.a 10= OD z.10= .Oy Sq.Ft of proposed sign_ I hereby certify that I am the owner or that I have the authority of the owner to make this application,that the information is correct and that the use and construction shall conform to the provisions of§240-59 through§240-89 of the Town of Barnstable Zoning Ordinance. o/_ Signature of Owner/Authorize Agent: 't/I�����1 Date: O i Permit Fee: ,J� Q Sign Permit was approved: Disapproved: Signature of Building Official: Date: In order to process application without delays all sections must be completed. Rev.9/12/06 �Y A�9�✓'�_� �'s.N �S '. " r-�tii�� # `es1..i•A•�'���°r'',.,f� ,y.Ys•' �� a�}<C .. •�i Seer ' •�>, f�",`?. �ti �J'a�l. .�. e�Pa�t•• � ,�'+� e ti ��:t �.�'� t. a �, !� •f h���t�' h, vY ! �71 i ,9 i� I . Z v rt` �yc r,`Y�' �/ ai A.. / /��[ �''. � a 6�' s,F vi'L;� 'g�� �7t t'.` 'Y°�' s• �F ,�' - c� r���';Bar •i � � /' <.fY';9-. •.�-4n „r A�-.Sr..Y' A r, Gi.�! ♦ � t 1• :r1' e.r:t t ��• �// .�� - P .Y. �" TTTT + P`4 1. �'�C r t y s i• � sr,$ ,,,,,,�ypp ,�PL ' ?s( M. yN.t3,� rrva•• , r .r;., ' .+R", .} ,w MAIN STREET � ', _ „�—_ ••e- a •ice. �.3�'�I'�`r� _ �""�,�1 � 6j0171 c THE ARC OF CAPE COD Jw DATE: Wednesday, September 23, 2009 CLIENT. Law Offices CONTACT, Matt Cote ` n 78-804-8999 SIG Itl'S _ Tj- - • . • • •• THE ABOVE DESIGN IS THE PROPERTY OF CAPE AND ISLANDS SIGNS AND MAY NOT BE DUPLICATED OR • USED WITHOUT EXPRESS WRITTEN CONSENT_ CHARGE FOR DESIGNS USED WITHOUT PERM/SSION. $500.00 DIME Sign TOWN OF BARNSTABLE Permit * E ARNSrABLE, • MASS. � s6prF1 39. A� Permit Number: Application Ref: 200905511 20070393 Issue Date: 11/10/09 Applicant: MYCOCK, ARNOLD W TR Proposed Use: MIXED USE OFFICE & RES Permit Type: SIGN PERMIT Permit Fee $ 50.00 Location 171 MAIN STREET (HYANNIS) Map Parcel 327232 Town HYANNIS Zoning District M$ Contractor PROPERTY OWNER Remarks 5 SQ SNIPE ON EXIST LADDER SIGN FLETCHER, TILTON & WHIPPLE, PC Owner: MYCOCK, ARNOLD W TR Address: P O BOX 371 COTUIT, MA 02635 Issued By: p .. POST.THIS CARD SO THAT IS VISIBLE FROM THE STREET Main Street Waterfront Hyannis M Historic District Commission ="'UNT"gLA ' 200 Main Street ems. s614- &.�� Hyannis,Massachusetts 02601 4 TEL: 508-862-4665/FAX: 508-862-4725 , Application to .0 Hyannis Main Street Waterfront Historic District Commission in the Town of Barnstable for a —------- s!~~`_�>_._-------------------CERTIFICATE OF-APPROPRIATENESS.. ,..�ti,. . }. Ap.plica�ion is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness 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 for: PLEASE.CHECK ALL CATEGORIES THAT APPLY: 1. Exterior Building Construction: ❑ New Building ❑ Addition ❑ Alteration Indicate type of building: ❑ House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑' 3. Signs or Billboards: t?rNew sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other 5. Parking Lot: ❑ New Building ❑ Addition ❑ Alteration (Please see the guidelines for explanation and requirements) TYPE OR PRINT LEGIBLY DATE 9 Z 3 ASSESSOR'S MAP NO. :37�—ASSESSOR'S PARCEL NO. Z 3 Z C 07IE APPLICANT IF 7' d !/!/ 1-48-1 TEL.NO. q7 9- a0y 9 APPLICANT MAILING ADDRESS_/'Z/ A!IA/al/ Z5r, 7 A— ADDRESS OF PROPOSED WORK PROPERTY OWNER 19/Z JZeL!g M`JP-JP TEL.NO. A-/Z ?7 BZ OWNER MAILING ADDRESS Al 0= )mw_ _a0 ryl7 FULL NAMES AND MAILING ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. This information is best obtained at the Town Assessor's Office. (Attach additional sheet if necessary). 3 Z7Z����iH/L4 VS'TE ! �S5- rlp v✓061,9s A-i474 t, / 0 2 5-V3 GHi L �oLL OGIJ AGENT OR CONTRACTOR C19079- ISLfq NbS.S/bL.NO. ADDRESS /03 EA/le Pr�/J� 40 AJ�9�/✓/✓�S f DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done, including detailed data on such architectural features as: foundation, chimney, siding, roofing,roof pitch, sash and doors,window and door frames,trim, gutters - leaders,roofing and paint color,including materials to be used,if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet,if necessary). PrR O-V='LU Signed Owner ontractor Agent (CIRCLE ONE) SPACE BELOW LINE FOR COMMISSION USE Qewed(6y HMSINHD �;§1 EI►UI I `te� i�i R This Certificate is herebyM�QY Mul T e i Date .. T` P� laJ-i\ 1iS Signed IMPORTANT:If this.Certificate is approved,approval is subject to the 20-day appeal period provided in the Ordinance. CONDITIONS OF APPROVAL: Barnstable Hyannis Main Street Waterfront oFtHe r Historic District Commission All-AmedcaChy ti 200 Main Street Hyannis, Massachusetts 02601 + BARNSTABLE. • 9 MASS.. g Phone: 508-862-4665 / Fax: 508-862-4784 m A 1639. ` www.town.barnstable.ma.us TEo Nay° 2007 George A. Jessop,Jr. AIA,Chair Marylou Fair, Commission Assistant SPECIFICATION SHEET FOR SIGNAGE • Prior to filing your application for a Certificate of Appropriateness, please contact Robin, the Town's Zoning Enforcement Officer, at 608-862-4027 to discuss the amount of signage allowed for your building, as well as any other Town Sign Code regulations which may affect the sign(s)you propose to install. • Even if you are applying for the same amount of signage as previously existed on your building, the laws may have changed since that sign was installed. • Once you have applied to the Hyannis Main Street Waterfront Historic District Commission for a Certificate of Appropriateness for signage, you may apply to the Building Department for a temporary sign permit. The Building Department can provide all information regarding the temporary sign permitting process. • Please fill out all information requested below. • If you are applying for Certificate of Appropriateness for more than one sign, please fill out ONE SPECIFICATION SHEET FOR EACH SIGN. BE SURE THAT YOU HAVE INCLUDED WITH YOUR APPLICATION: • a scale drawing of the proposed sign • color chips for all colors on your sign • a photo or scale drawing of the building on which the proposed sign location, as well as any light fixtures proposed to light the sign, are indicated • a scale cross-section of the sign, with dimensions, showing edge detail • specifications for any light fixtures proposed to light the sign • a scale drawing of the sign bracket, indicating dimensions, color, and material Size of sign /� rS— S,:f Ftj Material(s) of sign '' L y flU_0 071 Material of Lettering (if different)) Vl 1� The Sign will be (circle one): carved wood / anted woo Ptvinyl letteri g other (explain) Location in which the sign sill ha ng !!1� !! Ll9bDEi� S,/G9!l /9T 1-71 M/91A.1 v if j ! SEP 2 3 2009 � Will there be exterior light fixtures to light the sign? /V U If so, what type of fixture? O Where will the fixture(s) be located?- Town of Barnstable Geographic Information System September 23, 2009 327165002 327169 .-a 32719 5 227rJ156002 #75 # 327181 #94 #27 327180 327.19`4� 327170 #19 327193 #162 327,179 #11 7+ '4 327200 327171 t6t ,r+y #83 327162 � f #26 _ 4 327178 `{gyp 327266 "327201 327;174 #0 327,165001 #126 #0 j #97 #200 �#164 �_, 327176 � �,( 327163 327175 #146 ,b . #2232 0 - #206 #156 0 �;, 327237 327202 x Q #0 #115 4 327172 #174 3 #182 327265 ""' - 327204 ,- 327203 #0 #84 O #.104 327161 327205 #220 = PA R 74 YAK�dS) 7229 #135 #135 32�210 " ,�,g� t� .,,,,,..-�""'�-'�""� 13172�32 . � �#105 MAt1 17 327230 327209 27158 242 _ 327231 #149 #91 #155 327211 �.. 9,16 327208 +fi 211 13m 327228 327233 t #20 3272420�02 " #16— #21 327212 •.23, ' yNa . 32724 3271 -F 30 #20191 #17 p 3207#2 2123 32 72 1 4 327 215 2 #23 # #20 327150 327227 " #0 9 ` 327234 #29 7 327148 p #22 327218 vn, 9 #23 ?' [n #32 2724 CND 327,131 327147 247 - #24 327245 #31 327235 327246CN D #2 e#38 %A fN27219 #21 327225CN D O #40 327224 #53 342001 32Z124% 327146327225CN D #27 327,132 327243 #37 E37236 #61 O #43 #27 #30 #30 327123 . V""327251 #35 327257 #52 327220 327,133 327145 #63 #66 7 e #44� 327138 #49 ' _ 327,134 #76 327144001 327252 �#56 #57 #60 DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:327 Parcel:232 boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:MYCOCK,ARNOLD W TR Total Assessed Value:$654400 Selected Parcel 1"=100'may not meet established map accuracy standards. The parcel lines on this map are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner: Acreage:0.45 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location:171 MAIN STREET(HYANNIS) such as building locations. Buffer ff fp s .t klrr gam.. I,.r O •"'..4:r._.� •,tlr/�"� � ° - �5� rya " � a ON r - - 171 o rya' MAIN STREET , x ao a FLETCHER,TILTON &WHIPPLE,P.C. - s £- C O U N S E L O R S A T L A W s a- - � . ` THE ARC OF CAPE COD 0 d .�-✓/TLC 1S lax .� GC' {� Np �DATE: Wednesday, September 23, 2009 CLIENT: Law Offices CONTACT: Matt Cote PHONE: 978-804-8999 FILENAME: Fletcherl APPROVED BY 103 ENTERPRISE RD, HYANNIS, MA 02601 e' (9p M MD m Gm 0 508-8 1 5-343°1 r'' C'�" G3 CL •• •• Assessor's offioe (1st floor): .,.,. C�'f N E t0 Assessor's map and lot number .......3` .rL. .. ..-r .. Q t Board of Health (3rd floor): '• Sewage Permit number . Engineering Department (3rd floor): oo rb 9 i House number ...?.1?...........................1.77n Vic......................... _ ,,�oMP*11- r APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ......CQXast- uct an addition -P" ... r.r... TYPE OF CONSTRUCTION ..............W.<?.nc ..f'.ra.?n..Professional Office ......................................................... : ..................f. .........t1_a.rgh...5..............1917.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: • Location 171 Plain St. ... ...Hyanni.s.a...MA........................................................................................................... ...................................... Proposed Use .....P.rofessional Office ........................................................ ............................................................................................... Zoning District ...Professional/Residential .Fire,;District .....Iiyannis. ... .... ........................................................ Name of Owner Mycock—Kilroy ———— Attys ....Address .171 Plain St . , IHyannis-y-.NA ................................................. - ... Name of Builder John B. Lebel Canstr.......Co. Address 4. Oak St..........Ce. .nterville, PIA . .. . ................................................ Name of Architect Keenan & Kenny Cataurnet , MA „ Address ......... ......................................................................... N r.,oi- l toms ... ..new Concret e . ................................................Foundation .............................................................................. r ,.Exterior .......!jcq .j...-?.b;L ,1.gje.............................................Roofin Asphalt g .................................................................................... Floors .......... q...?.'.T?P ........................... Interior .......?heel-rock ................................. . . ................................................................... 'r-� rater rieating '.:'.'..... ...............................................................Plumbing ..........T10...new...................:................................................. Fireplace ........'..:...». Approximate Cost $50 oao Definitive Plan Approved by Planning Board ________________________________19________ , Area 2 st.or�.'.,....378...sq. ft . _Diagram of 'Lot and Building with Dimensions Fee ...... ..................... SUBJECT TO APPROVAL OF BOARD OF HEALTH go t , FKIsr1laCr- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Paul T. Lebel Name ... ...... .......... Construction Supervisor's License .6 ............o025..... .................. MYCOCK-KILROY �/ ATTYS. A=33 7- No .._ Permit for .BUILD ADDI^lION Professional Office .................................... y Location ......1.71. Main Street Hyannis Owner .....Mycock-Kilroy, Attys. ............................................... Type of Construction ..Frame ........................................................................... Plot ............................ Lot ................................ Permit Granted March 6...........19 87 Date of Inspection ....................................19 Date Completed ......................................19 Al- 0/5 ►111 A 4's PERMIT COMPLETED 1/1/.',L/ 327/a2SC, a3.2, 23 3 ;..� Assessor's offioe_(1st floor):' - = A Assessor's map-,and lot number 3� - ` "� o�TNeTo ``''S • Board of Health!(3rd floor): II**AAWU Sewage Permit number 4.h.... . .1 . .42:..��r!%?'......... { ' oB \E ngineering Department (3rdfloor):E ba0� House number ..:1 Zf....... ....... 7�. ... o r a. x 019 C YI1 APPLICATIONS PROCESSED 8:30'-9:30 A.M. and 1:00-2:00 P.M. only, i j TOWN OF BARNSTA•BLE SUILOIHG IHSPECTO'R APPLICATION 'FOR PERMIT TO .:....QQ.�iat•rg.........................n addition ...................... ................................................... TYPE OF, CONSTRUCTION ...............W.0.Q.d...ft!aMe: . . '4fes,s onal Office 3 ,• ....................................... •...............M .r-o-h---5. TO THE INSPECTOR OF BUILDINGS: d The undersigned hereby applies for a permit according to the following information: 1 1 Main St Hvannis MA ' ...............�..... Location ......:......7........................�.a.....�.._.............�...........,.......�.......,...,:.......:.....:..................... :.:.....:...........:..... Proposed Use ::...Professional Office Zoning District ...Professional/Residential : Fire District Hyannis -Name of Owner 14iycock—Kilroy ---- Att ys. :Address 171 :I'�Iain St.........Hyannis, MA Name of Builder John B. Lebel Constr. Co. Address .4 Oak St . ; Centerville, MA ............................................................... Name of 'Architect Keenan :& Kenny Address Cat.aumet, .MA . Number of Rooms ......4...new Concrete ..................................................:..Foundation :............................................................................. Exlei:ior .......Q.0.d...S.k11r.l.gje.............`...'............................Roofing .......ASS?halt ' ..................................................... Floors ..........C-arp.et.......................... ......Interior .......Sheetrock ' ...........................................................-....... nearing ......Hot...wa.t er ` ' ......`....Plumbing ..NO...new............................................................. :.......................... ..:.. Fireplace ......No...new...............:.............................................Approximate Cost ..........$5........................................................ Definitive Plan Approved by Planning Board ________________________________19________ . Area 2 S •Or'y,-- 3.78 Sq. ft . Diagram of 'Lot and Building with Dimensions. a Fee ...... .1.00....0.0..............:...... SUBJECT TO APPROVAL OF BOARD OF HEALTH . n 30 . " 8// OCCUP NCY PERMITS REQUIRED FOR, NEW DWELLINGS I herebl agree to conform to all the Rules and Regulations of the Town, of Barnstable regarding the above co struction. y Paul T. Lie el Name .. �. ........` . ` Construction Supervisor's License..... ................. t MYCOCK-KILROY/ATTYS . ;� w t . 30485 BUILD ADDITIOTar No ...... . Permit for ................................ Professional Office ....... ... . ........ ................................... t_ Location ....f 1.71 ,Main Street tj '... Hyannis...................................... Owner Mycock—Kilroy�...AttXs TypeF,Construction ..... rame......................... _ a ...... if ......... .... .` .................. + .............. Plot ...... 1of' '............................ e i Perm ranted ......March...6 ........19 87 r ^ IL. Date Inspection .... ............. 19 Date pmpleted ..............................» ...,19 e t - ...�_v�'t, � s w� . �. �: 55 F�, _ a' � ,4. i. a. ,a „S k " • •. a t .. ' �~ . •. w ei Sir 1a '1A,e) - ; = _ a • . ' ` ; • ' TOWN OF BARNSTABLE BUILDING PERMIT.APPLICATION Map � '� Parcel Permit Health Division Date Issued 3 o Conservation Division Fees Tax Collector - Treasurer Planning De Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis 1 Project Street Address Village �s s Owner /G M &'Otis ml Address Telephone Permit Request L-n�aa ��'• �s9-3c All RZY-L& Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation (JUG Zoning District Flood Plain Groundwater Overlay 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 w Half: existing new Number of Bedrooms: existing new J Total Room Count(not including baths): existing- new First Floor Room Count v 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 r BUILDER INFORMATION Name 31*V- AQaWC9y Telephone Number L53.5 466 9,32-4!( Address V6AO C�ce_c License# Q 16 late 7-, 4W J? Home Improvement Contractor# Worker's Compensation# 5/11V 52 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE �d .�' FOR OFFICIAL USE ONLY E PERMIT NO. DATE ISSUED a„ MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION FOUNDATION c FRAME } INSULATION FIREPLACE A P 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 Ofl�ce of/o�estigadOHS 600 Washington Street - >� yi Boston,Mass 02111 Workers' Compensation Insurance davit Aw- CPA nary:e: locatic�_ city � P�yZD7/lDt �,� phone# � [ am homeowner performing all work myself: [ I am a sole proprietor and have no one working in ally ca achy ME VA ME Z- am an empiover providing workers' compensation for my employees worlang on this fob comninv name ....:: one city oiicv# t in s u rn n ce cc I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below wnc have the follm«ing workers`compensation polices: company nam e- .......... ..,.::.. ..:..........:.. address: X. ,..::::. .. :::.:......<..:.>;:;•:;::;:::max::;:.::. ,:i�::>.«:;::::::;;;:.:;::. .: . tit,.- _.. oiiicv insurance cry. ..... . ///////////////////// - //////////// ..rr::•.:is•ii:::••:::v::r::••.::•.�.. ca any name: address: .. ..::.:.. one ... : :::.. ... .. city- :..:.:..::::...::.:..::. ..:,.:... :,..:.. insurance co. FaUure to secure coverage as required under section 25A of MGL Is2 can lead to the paposmon of criminal penaltin of a ilne up to S1,S00.00 anolo one vean'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a One of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verincation. I do herenv cerri y der th pains and penalties of perjury that the in forntation provided above is truce and correct Data: ` sie_nature phone# �80— 3-3026 Print name , c otnciai use only do not write in this area to be compieted by city or town ofIIuial peemitNcense# ❑Building Department city or town ❑Licensing Board . ❑Selectmen's O}Hce 7 check if Immediate rnQ..e is required QHesith Department Other contact pet-son: phone#; ❑ Information and Instructions , Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their Mersa person in the service of another under any cow' employees. As quoted from the,law",an employee�s defined as every 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 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 c building appurtenant thereto shall not because of such employment be deemed to be an employer. ter 152 section 25 also states that every state or local Iicensing agency shall withhold the issuance or rene� MGL chap of a Incense or permit to operate a business or to construct buildings in the commonwealth for any applicant who h: neither the not produced acceptable evidence of compliance with the insurance corn eractg foreperdforman °IIf public commonwealth nor any of its political subdivisions shall enter into any have been resented to the contracting acceptable evidence of compliance with theme of this chapter p authority. / . Applicants 'f ` affidavit completely,by checking the box that applies to your situation and Please fill in the workers' compensation home numbers along with a certificate of insurance as all affidavits may be 4 "y supplying company names,address P of insurance coverage. Also be sure to sign and - `''' submitted to the Department of Industrial Accide�s - application for the ermii or license is to the ar town that the app P date the affidavit. The affidavit should be returned �5' Accidents. Should you have any questions regarding the"lain"or i yc being requested,not the Deparment of Industrial at the number listed below. are required to obtain a workers' compensation policy P the Department F FAr City or Towns and printed legibly. The Department has provided a space at the bottom of i Please be sure that the affidavit is complete to fill out in the event the Office of has to contact you regarding the applicant. Please affidavit for you be sure to fill in the pejiit/licease number which will be.used as. a reference number. The affidavits may be returned t^ the Department by mail or FAX unless other mft have been made. The office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. a The Department's address,telephone and fax munber: - The Commonwealth Of Massachusetts Department of Industrial Accidents 0Mce of ImtestloadOns 600 Washington Street _ Boston;Ma. 02111 . fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 oftME A The Town of Barnstable • BARNSCABLE, ' 9� " ; ��� Regulatory Services prEO 59. A Thomas F. Geiler, Director Building Division Ralph Crossen, Building Commissioner 367 Main Street,Hyannis MA.02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW "SUPPL`EIVIENTTO PERMIT.APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one-but-not more:t. _four>dwelling units or to structures which are adjacent to such residence or_buildingbe-done.by registered contractors,with certain exceptions,along with other requirements. Type G�of Work: �y7�F Estimated CostAl Oda _. p%Address_ofWork x_r j/_,:- / cJ = ?{,_S Owner's Name: IcO/e- 1 l C07&,'`- Date of Application: I hereby certify that: Registration is not required for the following reason(s): PWbrk 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 ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the a t of the owner: Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav _.... ..._._ . - ........._._ roe 6iF4j vvrt-ITf- A 4 A Tl'%T c rT' v r r ,,r 1Y.11 , 11 IN kj 1 1V1.rL 1 1MANN' T'AL `. % i 1 w/ WMT9 l ar ry � t x� j AR A TNT CTvur,- ' 'm ArAN"w 'rAL 0 m RT0�� PEDI `S N �.� �I • I, u c � w wrnTf� ` ar I _ _ _ _ � � � ya v� �:�.!� .. ,L. ! . tin.- y` '`,.� ` f '�'�,� ry`—� s/jI i�s�r M..� i �t CI F '.. � i ill .— — � � � s 4r' i� ._ �ti :{ _ � - - The Town of Barnstable • Department of Health, Safe and Environmental Services " p Building Division & 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Application for Sign Permit Applicant: ,`(���t�i I �u I/ ' Assessors No. J,Ai 7 ' 3 Z Doing Business As: t4u u tj u! 00-1k'lLeot"r es, P.C, Telephone No. -771- 7l Q 7 Sign Location 1jqWI1I Street/Road: (7/ l`Iui� � l S M41, p 2_6 a 1 Zoning District: Old Kings Highway? Yes To Hyannis Historic District? Ye /No Property O er / Name: t vt ulc� l��/Cyck Telephone: Address: kt 6-or4rr 'V' �cf% Village: Sign Contractor 404 AName: arl t , /Y Telephone: 7g0 ` 3lSo Address: '73 p�easulrt Village: Cebttervill) 14u- Description Please draw a diagram of lot showing location of buildings and existing signs with dimensions, location and size of the new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? Yes6 (Note:If-yes, a wiring permit is required) I hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of arnstable g Ordinance Signature of Owner/Authorized Agent d4 u ,"t -M lD Date: /'?It- Size: �s Permit Fee: a'�J O .Sign Permit was approved: Disapproved: Signature of Building Official Date: Signl.doc oft ' $ Hyannis Main Street Waterfront :) Historic District Commission NAM 230 South Street Hyannis,Massachusetts 02601 508-790-6270--FAX:508-790-62887 Application to Hyannis Main Street Waterfront Historic District Commission in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under M. G. L. Chapter 40C, The Historic Districts Act for proposed work as described below and on plans, drawings or photographs accompanying this application for. PLEASE CHECK ALL CATEGORIES THAT APPLY: 1. Exterior Building Construction: ❑ New Building ❑ Addition ❑ Alteration Indicate type of building: ❑ House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3.Signs or Billboards: Ed New sign ❑ Existing sign ❑ Repainting existing sign 4.Structure:❑ Fence ❑ Wall ❑ Flagpole ❑ Other 5. Parking Lot ❑ New Building ❑ Addition ❑ Alteration (Please see the guidelines for explanation and requirements) TYPE OR PRINT LEGIBLY DATE ADDRESS OF PROPOSED WORK I I 0,A-I^J ASSESSORS MAP NOJZZ OWNER fiileAL,0 + ASSESSORS LOT NO. z3 Z HOME ADDRESS - tocL c. TEL.NO. tg-' 7- FULL NAMES AND ADDRESSES OF ABUTTING OWNERS.Include name of adjacent property owners across any public street or way.(Attach additional sheet if necessary). eP dTTflCl�P��':IeP� AGENT OR CONTRACTOR (oQ,t=iRa-Ni-..J a4Ae!/ TEL.NO. �1 Ro "31 SU ADDRESS q 3 2 tt:!�AS pau f RECEIVED AU6 2 1 1999 TOWN OF BARNSTABLE HISTORIC PRESERVATION DIV. DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done, including detailed data on such architectural features as: foundation, chimney, siding, roofing, roof pitch, sash and doors,window and door frames, trim, gutters - leaders,roofing and paint color, including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet,if necessary). Signed 7 Owner-Contractor-Agent Space below line for Commission use. Received by HMSWHDC Date Time By The Certificate is hereby: e Approved [3� JrA (1� Disapproved ❑ Date IMPORTANT: If this Certificate is approved,approval is subject to the 20 day appeal period provided in the Ordinance. 10V'.. . /t e c, 144v�rlttt- «t S �jlYa'uals (o '� waer Z� &, C,04 lzt pt"l1w; klayve rasa /7'!r4-(7 y �ic�cuPl/'eusl`rv` ?x4c 5'6vate Trvr7-/// f�K zZ y� /1,ra u4(,I r) . G 2G G/ /?3 det 4(cr ;TC1414 5'a / s, l7Z- Mee, d Z&3 z l SG Ile- ea /�CXaa AIY4UVIs- /Y9 �av tlee A, /Ileac l b/ury ?/4oPIuy y CGL1`G'rlrr�lP� /�`lc� 02Co3Z � 4 k1r6,o' Y f�ar�s��le, lea, OZC�.3o SPECIFICATION SHEET FOR SIGNAGE BE SURE THAT YOU HAVE INCLUDED WITH YOUR APPLICATION: • a full-scale drawing of the proposed sign • color chips for all colors on your sign • a full-scale drawing (or photo) of the building which shows where the sign will hang Please fill out all information requested below. If you are applying for a Certificate of Appropriateness for more than one sign, please fill out ONE SPECIFICATION SHEET FOR EACH SIGN Size of Sign 1 X I Shape of Sign � e- Material of Sign Material of Lettering GOLD L j_A-F Ld 3 K Type of Sign (carved wood,painted wood,vinyl,etc.) M GA-A1� C'A;1?{IF40 Additional Detail (molding around the edge,cut-outs, etc.) No L-C>I A) ( . OAS Location In W'I*h the Sign Will Hangg `/ Fi6w� lac�:a� !7� My - � , � �` " l�Qcr Will the Sign Be Lit? S � If So,How? �eala Qlirec p4 y1jAf _ ��AI�,T S.R-,vL-,-,rL-,rr MANNAL ORTHOPEvv"'hICS---- c�oc-tom 23X . GOLD i .e:'. g�.•. �l� +i'I M°"iss._ .dam- • I�OM �,MerW^'V,ygN� A 1 I � i r.F;7 I Engineering Dept.(3rd floor) Map a-7 Parcel ff& 1=JS Permit# oHo n e# a ( 7 ( Pus Date Issued 7 oR 3 - 9 Bo i el►Or floor)(8:15 -9:30/1:00-4*26) ( ( Lt ris Fee Q�— or)(8:30-9:30/1:00-2:00) of Admin. Bldg.) De ' ng Board 19BARNSTABLL TOWN OF BARNSTABLE '`''" '�� Building Permit A lication / Project Street A dress J Village Owner �C✓�a �-°'�� �Cddre ntKk Telephone Permit Requ st I Or First Floor / square feet Second Floor squire eet Construction Type AA Estimated Project ost $ V Zoning District Flood Plain Glib Water Protection ItiD Lot Size Grandfathered RY/es ❑No Dwelling Type: Single Family ❑ Two FamilyA_❑ Multi-Family(#units) Age of Existing Structuxe Historic Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ull ❑Crawl ❑WaIkoff' ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Al Total Room Count(not including baths): Existing New First Floor Room Count 7 Heat Type and Fuel: Uotas ❑Oil ❑Electric ❑Other 1 Central Air I(Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) Vt ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals A thorization El Appeal# Recorded❑ Commercial ❑Yes YNo If es,site an review# Current Use G Proposed Use 4e, 17 Builder Information /� Name (� ale, ttc- Telephone Number CJyO �� 71j Address 2 License#6AI Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON7HE LOT. AL�CONSTU ,11PN DEBRIS SULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 1 �Z BUILDING PERMIT DENIED FOR THE FOL WING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED s MAP/PARCEL NO. ADDRESS VILLAGE p' OWNER • _ Y DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. �rne'bo� The Town of Barnstable Department De of Health, Safe and Environmental Services • snaxsrast.E. • P �' MAM . Building Division 1 �639. �� iOrF M9.'�A 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Tax Collector 4 :3 6 Treasurer (7 Application for Sign Permit Applicant CJ A-r Assessors No.Map 32 7 /'G�«1.Z32_ Doing Business As: ' fie A�rc o ¢ 6�-e- .`tea. Telephone No. 5_ QT Sign Location �y / Street/Road: / / (°r,,' ee Zoning District: D Old Kings Highway? YesA@ Hyannis Historic District? ONO Property Owner / Name: L. a�cu�w s, /����ocK����///// e" �. ' s& Telephone: 'Y 2 Fl-2 7, Address: Box 3� , 0Z63LC Village: /&eyHirS Sign Contractor Name: Telephone: 7�o 67 Address: Village: Description Please draw a diagram of lot showing location of buildings and existing signs with dimensions, location and size of the new sign. This should be drawn on the reverse side of this application. Is the sign to be electrified? Yes/(9 (Note.If yes, a w haz permit is required) I hereby certify that I am the owner or that I have the authority of the owner to make this application, that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinance. Signature of Owner/Authorized Agent: Date: l�/l�� Size: /S X 3 Z Permit Fee: b/O. °d Sign Permit was approved: Disapproved: Signature of Building Offi 6al:1417�1;-&" U 4� Date: -ZDate: `L gn g c Signl.doc rev.8/31/98 r _ The Commonwealth of Massachusetts Z•�:.- -_ < = _ , . Department of Industrial Accidents _ Office ofialrestigatioos a ... . 600 Washington Street = , Boston,Mass. 02111 Workers Co m ensation Insurance Affidavit name: location: 1-7 city hone# /' R7 ❑ am a homeownck performing all Yc rk myself. I am a sole ro rietor and have no one workin in any ca acity //% //%/%��%i%i%%//////%/%%%%O/%%%%/%/%%%%%��/%//%%/%%/��%/�%%%%�%�%%%%%%%%%%//%%///„ ❑ I am an emplover providing workers' compensation for my employees working on this job. company name:. address: city phone#: insurance co. olicv#- / F m a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who the following workers' compensation olices: com anv name: address. f ci . o�—�o f� phone* / d (12 i r olkv# lde insurance c / 777777 ,& 'cam anv name: address: ci phone#c insurance co. ,Rolf # / / j Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby cert' r the p d penalties of erjury thgt the information provided above is tru.and co recit Signature Date _21,7 Print name (� •� Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Bullding Department ❑Licensing Board ❑checkif immediate response is required ❑Selectmen'a Office ❑Health Department contact person: phone#; —❑other (revised 9/95 P1A) ,d Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed.to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns affidavit is complete and rioted legibly. The Department has provided a space at the bottom of the da the affi P Please be sure that �P Please ' the event the Office of Investigations has to contact you regarding the applicant. P for you to fill out m ___ _ affidavit y be sure to fill in the peimit/license number which will be used as a reference number. The affidavits may be retmiied to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents 0MC0 of Invesugadons 600 Washington Street Boston;Ma. 02111J fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 COMMERCIAL ADDITION/ALTERATION ❑ Letter of Approval from Site Plan Revi (if necessary) ❑ If located in OKH or Hyannis Historic District- Certificate of Appropriateness required . ❑ Plo lan ❑ Map & Parcel number VX Sign-Offs from: ❑ Health v Tax Collector. Treasurer / ❑ Street address of project ✓ ❑ Correct square footage ❑ Estimated Cost 1_ � ❑ Owner's name& address ❑ Contractor's name, address & telephone number ❑ Contractor's signature ❑ Full sized plans, stamped plans (1 full size and 1 reduced) ❑ Workman's Comp. form ✓ ❑ Construction Super's License ❑ Check expiration date on license(00 next to restrictions) ❑ nFe I q-forms-PERMITS 1 Rev 6/2/98 CT' e �arumazcuea��i a�✓G DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Nueirer Expires: Ristr:.uteA To @0 - d GUY.Nv"'Col ETT'I !' 15 LOWPOND"CIR CENTERVILLE, NA 62631 .. r(`.,.,\-\ �✓ti a 70cm�xada o���amad�iweQa -. NOME IMPROVEMENT.,CONTRACTOR g ;Regist`ration1026831 Ar Expiration !y"07/02100 . x OLETTI DEVELOPMENT TRUST Guy M Goletti ' notiuN►s�w►1uR "Centreville MA 42632 �� - ----- _ •CAA- 1es � .�.. __400� WY VOP C--(. rf a f V / _ -- - 2 44YA-r�pY ` AWAY7�Q6s A =- A s Ira • _ i • �Tg7ea�l r s: f' 7A8'F �. ,