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HomeMy WebLinkAbout0626 SCUDDER AVENUE,C F s� r Town of Barnstable *Permit# a oC� C)I a Expires 6 onths from issue date Regulatory Services Fee , snxtvszesi e -RANT" Thomas F.Geiler,Director �6 2008 g Buildin Division •erED MP'I� TO Tom Perry,CBO, Building Commissioner F S FNS7-ASLE 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-8624038 Fax 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 2 87 1Z Q I Property Address C^U 6 V XResidential Value of Work_ QZ� Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address 05 AL-g i oN (Z0 V&FLL c LE: i Contractor's Name � G raE.?i I {�2.�� Telephone Number S68 _72 9 Home Improvement Contractor License#(if applicable) S 4 3 i ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ,. Re-roof(stripping old shingles) All construction debris will be taken to L.l ce 1 IZ !❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders:U-Value (maximum.35) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: Q:\WPFILES\FORMS\building permit fonns,\EXPRESS.doc Revise020108 Town of Barnstable �,► >u.>:. Regulatory Services XASL Thomas F.Geiler,Director Building Division Thomas]perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable-ma.us C7fFice: 50s-862-4038. Fax: 508.790-623.0 Property Owner Must Complete and Sign This Section If Using A Builder I � -R-2 L r7 ► 67 DU h'1 ;as Owner of the subject properm hereby authori;;e 038- L le- t7 i e t - to act on my behalf, in al matters relative to work authorized by this building permit application for: 6.24, (Address of job) Signature of owner Date Print Name Q:Forms:bui ldinrpe�miulexprese itevise091307 Cf• * e 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): C� per" Address: ��� �. Z City/State/Zip: Phone. #: 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 employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7...O Remodeling - ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' Y P tY 9. ❑Building addition. [No workers'comp.insurance comp. insurance.$ required.] 5. We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work 9officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12. oof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 11L 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 subcontractors 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: U 2-(p Sc-V p®C/2 Ayr-7- City/State/Zip: 4-s (N1 S 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 well as civil penalties in the form of a STOP WORK ORDER-and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insur nce coverage verification. I do hereby c rtify and i the pai and penalties of perjury that the information provided above is true and correct Sinattue: Date: — o Phone#: Gn b 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 e 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 dwell'm_house having not more than three apartments and who resides therein,or the occupant of the dwelling house.of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address(es)and phone.number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in__(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said 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 Accidents Office of Invesstigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 11-22-06 www.mass.gov/dia "v. "'-`r ,' �/ze "L�ammzovzurealC/ �✓�aaaac�u�ael�`a x BOARD OF 13UILDIN REGULATIONS — License: CONSTRUCTION SUPERVISOR Number"CS 091222 Birthdate 10L0$/.1962 Eicpres.1110708/2008 Tr,no: 91222 Restricted 00. MARK R GRENIER` 61 HOMESTEAD LANE YARMOUTH PORT, MA 02675 Commissioner t J/� ��lt1. �1� Board of Fuiiding Regulatigns and St-ndnrds lug HOME IMPROVEMENT CONTRAC70R Registeat.l0n: 154315 Fxpireion: 2/27/2009 Tr,# 254368 T �c Pritfate Corporation MARK GREBIER,iNC. MARK GRENIER 61 HOMESTEFF)LIv YARMOUtH PORT,10A 02675 Admfaistrator _ 2 _ r Town of Barnstable bA&MANX � Regulatory Services Thomas F.Geiler,Director Building Division Thomas perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 503-862-4038 Fax: 508-790-623.0 Property Owner Must Complete and Sign This Section If Using A Builder 1 as Owner of the subject properry hereby .^e n i,e—e— to act on my behalf, in all matters relative to work authorized by this building pemrit application for: 6,2 (Address of Job) Signature of Owner Date AVL. 6 / ' 4a/7—) .r Print Name Q:Eormsibuit�iingpe�snita/rxpress itevisc091307 1IJWN OF.BARNSTABLE BUILDING PERMIT APPLICATION Map 2-$1 Parcel i .Z Application# Health Division n Date Issued Conservation Division 41l(, Application Fee Tax Collector Permit Fee Treasurer CZ1 k Planning Dept. i n Date Definitive Plan Approved by Planning Board y .A ?. 71 Historic-OKH Preservation/Hyannis ' Project Street Address G Z (p SC.v POER, AVE co Village /lw4is PoRT Owner 44A0L.D PAT R I G t A- �2 fires vS AL?i,i O/J � �����i � Telephone -1 1 Z3 7 •— 5G\ O Permit Request Sjy� eW i L. !J R®©M A-O0 I T-t G i-d ® t/ J? G15`�'I�C7 Square feet: 1 st floor:existing I (APO0 proposed 40?> 2nd floor:existing proposed `� Total new 4 O 8 Zoning District R F— I Flood Plain Groundwater Overlay Project Valuation SO, oV-0 Construction Type uJ-o-C� ; f Lot Size Grandfathered: ,Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family '1 Two Family ❑ Multi-Family(#units) Age of Existing Structure iIDOIJ lam Historic House: ❑Yes No On Old King's Highway: ❑Yes ANo Basement Type: X Full XCrawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) C.CcY Basement Unfinished Area(sq.ft) — Number of Baths: Full:existing 3 new Half:existing new Number of Bedrooms: existing-- new Total Room Count(not including baths):existing I new First Floor Room Count Heat Type and Fuel: Pas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes �No Fireplaces: Existing New Existin oo coal stove: 0 Yes ❑No Detached garage:�xisting ❑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 to If yes, site plan review# Current Use e, - Proposed Use — . 5 BUILDER INFORMATION Name A-P—V, GRSIQ I Telephone Number 5or:3 7 _7 Address I Q_1 Ci Ro07E X 32 License# 0'3 1 ZZ'Z- L Aj N iS A OZQ0 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO AW 9,-0 SIGNATURE v DATE 1Z —!!2- --O—j FOR OFFICIAL USE ONLY APPLICATION# ` t� DATE ISSUED ? ok ,`MAP/PARCEL NO. ADDRESS VILLAGE 2 L. OWNER DATE OF INSPECTION: FOUNDATION FRAME " { INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL i GAS: ROUGH FINAL f I FINAL BUILDING DATE CLOSED OUT 1 ASSOCIATION.PL'AN NO. C' 1 b r 11/28/2007 17:22 FAX 6172436371 BLUM EMERGENCY Z 002 Town of Barnstable `s d,► ►>~1.>; Regulatory,Services NAM Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.towu.barnstable.ma.us ,7 Office: 508.-862-4038 3 Fax: 508.790-623 0 Property Owner Must Complete and Sign This Section If Using A Builder as,Ownei.oi the subject propern° hereby authori.,e !, /�?A 2!C ( + ezi e-t— to act on my behalf, in a1 matters relative to wort{authorized by this building pcmut application for- (Address'of job) Signature of Owner Date. Print Name x Q:Fprms;buitdingpamits�Cxprese . kevisc091307 � d . Services Inc Land In .....BARNSTABLE Belonging to .... � .��pital Mor�q ........................................................ ....... ....... .... Deed in Book ........ Page ........ Land Court Certif icja.te..No. ..39540.... in Book ...23.7....... Page ....3A.... Registry...Qj.s.trj.c.t....... A CourtLand Plan No. 10086 filed with Cert. No. 1006 February 1923 Recorded Plan ......................................................................................... Date of Plan ................r......................... in .....Barn.s.tab.l.eRegi,t'ry ..P�i.st.r..i.c.t...................... Book ............. No. ......... Filed Plan No. ....................................... MORTGAGE' INSPECTION PLAN ATTORNEY RICHARD CAIN Harold R. Groom, Jr. and Particia A. Groom Loan NO. 626 Scudder Avenue, Barnstable ( Hyannisport) WO 76. NO z -R� L o-FA (\j ----I Two g 7 Oley Wool) ti 757 7) S C U,D D E R AVENUE Adg.2.0, 1993 jN 61028, Sca te 11" THf !S; PLAN 11 .3 FOR rvi c) R —F c3 A C3 E PURPOSES C) N I L I CERTIFY THAT THIS PLAN WAS PREPARED Ai IN ACCORDANCE WITH THE COMMONWEALTH sr p �LD TECHNICAL STANDARDS FOR THE PRACTICE ji OF. LAND SURVEYING 250 CMR 6.05 AND WITH THE SPECIFICATION SHEET ATTACHED HERET M tkk OF 12 -KENNETH B. z! ANDERSON N o. 31298 1)4- �Clsltw W LX The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations • 600 Washington Street Boston,MA 02111'. wlvw.massgov/dia '. ' Workers'Compensation Insurance Affidavit: Builders/Contractors/Eleetricians/Plumbers _Applicant Information .Please Print Lelzibly Name(Business/Organization/Individual): M AZ V C.rz.G-1-J 1 V_ 1 �►�� •Address: City/State/Zip: HA Phone.#: �2_ Q g 2-cl f' Are you an employer?Check the appropriate bog: :Type of project(required):. 4. [] I am a general contractor and I 1.El I am a employer with 6. ❑New construction . employees(full and/or part-time,).* have hired the sub-contractors listed on the'attachi;d sheet. 7. ❑Remodeling 2.❑ Tama'sole proprietor or partner- These sub-contractors have ship and have no employees 8. ❑Demolition, izvorking for me in any capacity. employees and have workers' [No workers' comp.insurance comp.insurance. $. 9. Building addition 5.XWe are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their. 1 LD Plumbing repairs or additions 3.❑ I am a homeowner doing all-work . myself.[No workers'comp. right of exemption per MGL 12,E]Roof repairs insurance.required.]t. c. 152, §1(4),and we have no ] employees. [No workers' 13.0 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. t-ontractors that check this box must attached an additional sheet showing the name of the sub-contrwtors and state whether or not those entities have employees. If the sub-contractors have employees,they must providt their workers'comp.policy number. I ant 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 well as civil penalties in the form of a STOP WORK.ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy-of this statement maybe forwarded to the Office of Investigations of the CIA for insurance coverage verification. I do hereby c rtify and r the pain n penalties ofZ! jury that the information provided above is true and correct • Date; �Z ��® Si acute: — Phone# 50 Qi -J-7 r0fflq.clal use only. Do not write Min area, to be completed by.city or town off cial. or Town: ' Permit/License# Issuing Authority(circle one): J.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5,Plumbing Inspector 6. Other Contact Person: Phone#: - ✓lie P � BOARD OF BUILDIN REGULATIONS ' — License: CONSTRUCTION SUPERVISOR Number:"CS 091222 -•. Birthdate 10/08/1962 f Expires 10/08/20, Tr.no: 91222 Restricted 00 ' MARK R GRENIER 61 HOMESTEAD LANE t, YARMOUTH PORT, MA 02675 commissioner/J _ ✓fie 1°anv�nancvea��• o�✓y�,�ivaelta Board of Building Regulat's®ns and Standards HOME IMpROVEMEN f CONTRACTOR Registration: 154315 xpitatio z: 212712001) Try 254368 f Private Cnrporation MARK GREBIER,INC. MARK GRENIER 61 1 OMLSTEFF)LN YARMOU-r H PORT,NIA.02675 AdrrAn'sstrator 1 I'. VElp Town of Barnstable Regulatory Services 9 anxr ASS. Thomas F.Geiler,Director -Up t619. rEp�,y% -Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date _5-0-7 AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: G jtj R8D M Ag 1 "C t�3 Estimated Cost �J�, �17 Address of Work: SGk-) Owner's Name: 4, ZD_—Q AT G A—UZ94`1 Date of Application: '0_7 I hereby certify that: Registration is not required for the following reason(s): OWork excluded by law Fl7ob Under$1,000 OBuilding 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 IM[PROVEMMNT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: 1 Z- -D O"1 M A>_k1_ Gp2-e-N I 1 a C- tC543►(5 Date Contractor Name Registration No. OR. Date Owner's Name Q:fomns:homeaffidav Taal!JS.Z20(COCLhtnEd]I ' pmcriptivc Packages for dne and Two-Family RaidentW Balldiaga 71-ted with-Fossffpels 144AXfMIlM rMIMUM fllaxing Glazing Ceiling Wall Floor Ba=ra! : Slab HeatiaglCooling Area' U-value R-valuc' ' R-vzluel R-ynlue' WaII Pesimder Equipment Elfidmc� P,_, gr R-velue� R-valve' 5701 to 6500 Heating Degrre Days ( 12°/. 0.40 33 13 19 10 6 Narrasi R 12% M2 30 19 -. 19 10 6 Normal g I22 0.30 38 33 19 ID 6 •15-AFUE T 15% 036 31 13 25 NIA NIA. Normal u 15% 0.46 38 19 19 10 6 Norma! y 15% 0.44 31 13 23 NIA NIA 13 AFUE N 15% 0.52 30 19 19 10 6 M AFUE x IS% 032 38 13 2s_ NIA NIA Norma! y M. 0.42 38 19 25• NIA N19 Normal Z 18Y. 0.47 38 13 19 l0 6 90 AFUE A; I51. 050 30 19 19 10 6 90AFEM 1, ADDRESS OF PROPERTY; .�pZ� jGU6 AA PE 2, SQUARE FOOTAGE OF ALL EXTERIOR WALLS; 3. SQUARE FOOTAGE OF ALL GLAZING. 4, %GLAZING AREA(93 DIVIDED BY 02): 5. SELECT PACKAGE(Q--AA-sea chart above): NOTE-. OTHER MORE INVOLVED NMTHODS OF DETERMINING EiER•GY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION, BUILDING INSPECTOR APPROVAL: YES:. NO: q7f0r'W-HS0303 a ` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION '.Map a Parcel 01 ak w Permit# Health Division Date Is Ned Conservation Division Fee Tax Collector C Treasurer _ c Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis , r -Project Street Address Village Nlajutis Owner / re l 7 ��(� 6rOd l Address 8 S R&61i Telephone ( � ��/ — o�`3?— 5t )0 r Permit Request Z5 JT Square feet: 1 st floor:existing I,WV proposed - 2nd floor:existing proposed Total new Estimated Project Cost q, Trull, Zoning District lei L Flood Plain Groundwater Overlay Construction Type �J O'UJ Lot Size a q 5 a Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 0� Two Family ❑ Multi-Family(#units) . Age of Existing Structure PUb - I g110 Historic House: ❑Yes 0 No On Old King's Highway: ❑Yes ❑No Basement Type: &Full CfCrawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing �J new Half: existing ! new Number of Bedrooms: existing -7 new Total Room Count(not including baths): existing /! new First Floor Room Count Heat Type and Fuel: t Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes UNo Fireplaces: Existing �r New Existing&coal stove: 8/Yes ❑No Detached garage:Uiexisting ❑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 a�No If yes, site plan review# Current Use Proposed Use A1.4BUILDER INFORMATION Name a�� AX� ��0 Telephone Number Address t'©5v . t!�UYS,sb , /1, License# M3 n ly Get�y 144& Home Improvement Contractor# Worker's Compensation# a FS 10U0060 30 3 q ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO (ALA, 4- b, h'-SIL SIGNATURE DATE q/ :95JO f FOR.OFFICIAL USE ONLY _ c ' ' PERMIT-NO. 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 DATE CLOSED OUT ASSOCIATION PLAN NO. ' The Commonwealth of Massachusetts Department of Industrial Accidents _, =�' -- Ofl/ceol/arest/gatioos = ; 600 Washington Street _ - - Boston,Mass. 02111 -- Workers' Com ensation Insurance davit name: f -- � ll location hAA ��(:LL�t Q.0 l ci r hone# Z S' a J Y ❑ I am performing all work myself (�I am a sole 'slur and have no one wo in /////'///// ' / 1�� / //%///�. '//// /////%%/////%%O/////%02 //////// //%%0%//////%%%%/////G/%//%//''//Oi %//////% ❑ I am an emplcryer providing workers'compensation for;my employees working on this job. rAT18�Y .•':�:•}J��':�s<�?''�•Y:��t�i������r`���?r��:%�:'<���+�-: ::� :::�:�:�:::�5:�?:���:'� ��>�::���:�:�>:�:£<:;:�:�:?•}�•:o:?+:}::•}:•}:?•>;}:•>:{??;::}:•}•:{{•:::}i}:;:.{?•::::•}:?•;:•>}:?•::•}}:??•:�:•::-::�:?�}}:�:•.}:•}>i:�i:ii:{;•::�:•r:�:{}:::�::�:�:••:::x i:�:::i; ..:::::.......... 8��t kltS ....:.:....... . Hone :.;:::•i:::•:• ........................................................................... .......... ...........................................:.::...................:.........::: ....::::::.:.....................:::.; ---------------- am a sole pmprieta general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following wor>tefs'wmpensation p°Lees: ::::::,:..,:�.::..•.,•.x• „•:r..v::::.:.,.. 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'A�.}x•:•}:•}:., ..............:....k v•.., r.,.::.. ;.�:::}:{.' Fafim a to seems coverage as requited order Seeflae<25A of MGL 152 can lead to the impowtlan of atuimd penaWes of•fime�to tI'Mmoo and/or one years'fmI I err ment as well as dvn penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a Dopy of ibis statement may be forwarded to&a OlIIee of Investigations of the DIA for coverage verification. I do hereby certify trader the pains guldpwaNa of per,jur}'that the mfomadon provided above is&w and correct Sipatm Pantname l�1�� lLA l?h=# `17 - 3I D� Bomb fdtyoLrtomwin only do not write in this area to be completed by city or town ofncid : permdt4dcense# ❑Building Department❑ BoardiomnedWe respoue is required ❑Sdeehnen's Of n❑Health Departmenton: phous k, ❑Other Onnod 9195 PW 11 1 II 1 1 I I 1 1 1 - \ i1 1 . i i«. •I/ i• 1 1 _. 1 ir11• . • . . • - . • is it it .1• •lo i11 . • i-w • • �\ • •1/1 // .11 . 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Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other. requirements. Type of Work. Estimated Cost 0,6D / Address of Work: [74 Ll b�t+ 6+6 Owner's Name: Date of Application:�T�S I hereby certify that: . Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 . Building not owner-occupied 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 agent of the owner. D to Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav t T1. i�am�stanuiea o�✓�ueaa�euaelta 'i BOARD OF BUILDING REGULATIONS Licenses CONSTRUCTION SUPERVISOR t= Number.-CS O48338. '= j BIF*4te• _l 22/1954 (t ' t5 Expires:_.01=002 Tr.no:.. 13450 Restricted T6:, tG. MICHAELJ DANGELO 105 HORSESHOE LANE__ L .•..r CENTERVILLE. MA 02632 Administrator"fM Y yiIiMINttGVt /,pzpp¢pg .- ONE I OVE i CONrR CTO " 4s "Reg str tx 17 le 91 t MDIYI� At . taw npnni ism�nTOR, SAS;: 0 SESHO NT RGI f> 2632 }, �k: : TOWN,OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# ' ,5-11, 25-:1 Health Division 3 0k Date Issued Z 6 Conservation Division rS, / G/ Fee Tax Collector - 47 `ry v44,i Treasurer 4 /r c/L0---Q SEPTIC SYSTEM MUST DE INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board /-\j C6-- � ^ ENVIRONMENTAL---CODE AND " TOWN.REGULATIONS Historic-OKH Preservation/Hyannis nn 7 12004 � Project Street Address (o�lO SCuI��Y �_ l ►Da►,a' .a..,...�a.»a-� d Village // . Owner A44U b a/ /4i 4UAI& Address SS 6Li6t a Telephone Permit Request �Cf�f�Ys�/ �'� �dYCs� �i� 914 Ada Square fegt: 1st floor: existing r/G oD proposed 2nd floor: existing proposed Total new Valuation �0, Goo Zoning Districts- f�1 Flood Plain Groundwater Overlay Construction Type 4)0d, Lot Size !,��,_ �5 Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure — 6 Historic House: ❑Yes 21"N"o On Old King's Highway: ❑Yes ❑No Basement Type: dFull t rtrawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 3 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: Lf GaS ❑Oil ❑ Electric ❑Other Central Air: ❑Yes Flo Fireplaces: Existing ��� New Existing wood/coal stove: ffles ❑ No Detached garage: trexisting ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:Cl existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use // BUILDER INFORMATION Name e/D Telephone Number(ZO) ��S - 5 70 b Address t9, License# D Y 3 3 stw� Home Improvement Contractor# 1/9917Worker's Compensation#/�ps d 0990100 3 3& ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TOgi�� Dit"sW SIGNATURE DATE /A) J r ` FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED n $ MAP/PARCEL NO. ADDRESS Oki-, VILLAGE OWNER ' -DATE OF INSPECTION FOUNDATION FRAME C246-2nA ua6lticoi V 7 l l t INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL } PLUMBING: ROUGH �: _ FINAL GAS: ROUGH ± . „� FINAL FINAL BUILDING _ ism� � DATE CLOSED OUT frt ASSOCIATION PLAN NO. The Commonwealth of Massachuseas Department of Industrial Accidents •_ � -•_� : OIllcaoll�estlBatfods S-1 ME '= 600 Washington Street Boston,Mass. 02111 Workers, Cam ensation Insurance Afridavit locations � � t:iri pam wner homea performing all work myself hone# I am a sole nroorietor and have no one worki=in anv caaadtr ❑ I am as employer pivvidiag workers'sensation for an 'ob this .... ..n...w.:. ... ..::::.}':::�:v:rvx::•::::.::�:. ......v.a•::.;;:.-, .:. {•.v:::':......... .•.•Aw:.v:::.v:::::::.a. ....vA{a::::::.v;.:.:.........v..... .......tr:}}}}:n.t::v.•:y.:v.�:�.�v:.v: ...::.....{4i:::''i:i�::'":�': ..... x•.vv.t..::.v•.'•:v:}.h;}, .....ay.•..:• .... .....:::::• ....r.. :.....,.w...... ....:...::::: %•}L.•w}}...:..t+.h,v:v.:!{fi}'•:i%?}h;is...:::.:v}}:•:::.vwn{{:::'�^^.v:>::...};:::::.�:v:::��-•.::•.. 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Q50 31 13 19 10 6 93 A M T 13% 026 31 13 23 WA WA ( Norris! U ISA OA-6 31 19 19 . 10 6 Norris! V 13% 0.44 31 13 21 WA WA 1S AFUE W 13% om 30 19 19 10 6 95 AFUE LAYA If%. Q32 31 13 2S WA WA I Norma! IfY. GA2 31 t9 2s m. WA Nord 12% 042 31 13 19 to 6 90AFUE f v/. mo 30 l9 19 10 6 I 90 AFUE { r 1. ADDRESS OF PROPERTY: cSr 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): ' S. SE=PACKAGE(Q—AA-see Chan above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: g4br=4980303a 780 CMR Appendix J Footnotes to Table J52.1b: Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space, but excluding opaque doors) to the gross wall area, expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 W of decorative glass may be excluded from a building design with 300 ft of glazing area. 'After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units: center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R 30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (rf used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. •Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing,and interior drywall For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R 13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions, but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawispaces, basements, or garages).Floors over outside air must meet the ceiling requirements. `The entire opaque portion of any individual basement wall with an average depth less than 50% below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned ' basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to insmll more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1a NOTES: a) Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b) Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordan=with the NFRC test procedure or taken from the door U-value in Table J1.53b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(Le.,may have a U-value greater than 0.35). c) If a ceiling, wall, floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door,components comply if the area-weighted average U- value of all windows or doors is less than.or equal to the U-value requirement(035 for doors). ESTIMA TEO PROJECT COST WORKSI-IEET LIVING SPACE Value (high end construction) square feet X$115/sq. foot= (above average construction) square feet X$96/sq. foot= (average construction) square feet X$571sq. foot= GARAGE (UNFINISHED) square feet X$25/sq. foot= PORCH 3(o to square feet X$20/sq. foot= DECKS a eo of square feet X$15/sq. foot= OTHER square feet X$??/sq. foot= Total Estimated Project Valueh • L+srvaMUL • The Town of Barnstable NAM 9. � Regulatory Services Eo +'' Thomas F. Geller,Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization.conversion, improvement.removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors.with certain exceptions,along with other requirements. Type of Work: Estimated Cost Address of Work: b)10 CX2�� s6/ Owner's Name: d , Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded bylaw []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 agent of the owner. Date Co or Name Registration No. OR Date Owner's Name q:fo=s:Affidav ,a �r r� n.�r� ��75.'giF;k,�.k✓rte d�i+��� delld y I f�HONE IMPROV€NENt ONTRACTOR � �P-Wlttrati j"T'll 71 ` JYPe ;INDIVIDUAIg aE' EXPiratlon f r° ' w ICHA L4, AN I ' MWISjRATOR , Q5 HORSESHOERLN F°sT , �y RUE 1j. ✓fie �a�svrnq�u o�-�aaurc�u�ael� `•. BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS O48338 Birthdate,01/22/1954 i Expires:01/22/2002 Tr.no:. 13450. Restricted To:,lG- MICHAEL J DANGELO 105 HORSESHOE LANE CENTERVILLE, MA 02632 Administrator F ia- 4. Town of Barnstable Planning Department Staff Report Groom-Appeal Number 2000-37 Variance to Section 3-1.3(5) Bulk Regulations -Front Yard Setback Date: May 02, 2000 To: Zoning Board of Appeals From: Approved By: Robert . Schernig, AICP, Planning Director : Art Traczyk, Principal Planner Applicant: . Harold R.Groom,-Jr.and Patricia Groom Property Address: 626 Scudder Avenue, Hyannisport, MA_ Assessor's Map/Patcel: Map 287, Parcels 012 Area: 0.58 acre Zoning: RF-1 Residential F-1 Zoning District Groundwater Overlay: AP Aquifer Protection District Filed:March 21,2000 Hearing:. (hOJ�1D�2�pa Decision Due: June 29,2000 Background: The property is located along Scudder Avenue and is developed with a colonial style, two-story dwelling of 3,656 sq.ft. of living area. An outbuilding of an estimated 880 sq.ft. is also located on the lot and is partially used as a two car garage. The Assessors Records indicate that the dwelling was built in the 1870's. At present the dwelling is undergoing repairs and improvements. The applicants are proposing to add an open front porch measuring 8'-3"wide and 47'-8" long. Part of this porch would contain a 29'-11" high, two story "Towerl!'with and oversized octagon base projecting 10'-3" from the existing front of-the home. The dwelling presently has a front yard setback of 24 feet and a side yard setback of 11 feet. Those dimensions do not comply with the minimum setback requirements for the RF-1 Zoning District that are 30' front yard and 15' side and rear yards. The structure is most likely a legal non-conforming building in terms of its setback. The proposed construction appears to further encroach into the front and side yard setbacks. The applicant has requested a Variance from Section 3-1.3(5) Bulk Regulations to accomplish the proposed plan as being presented in the application. Staff Review: The application cites that the specific relief being sought is that of a Variance to"encroach 6 ft. into front setback". The structure is already encroaching and nonconforming with respect to setbacks. Staff would suggest that if setbacks are the only relief needed, this proposal could be accomplished through the grant of a Special Permit in accordance with Section 44.3 (2)- Nonconforming Buildings or Structures Used as Single and Two Family Residences. That section reads as follows: 4-4.3 Nonconforming Buildings or Structures Used as Single and Two Family Residences: A pre-existing nonconforming building or structure that is used as a single or two family residence may be physically altered or expanded only as follows: 1)As of Right: If the Building Commissioner finds that: Note-The tower itself is an octagon shaped enclosed above the first floor with an overall cross dimension of 12'and appears to consist of 3 levels. Its overall height is proposed to measure 36-9". Town of Barnstable-Planning Department-Staff Report Groom-Appeal Number 2000-37 Variance to Section 3-1.3(5)Bulk Regulations-Front Yard Setback a' A. The proposed physical alteration or expansion does not in any way encroach into the setbacks in effect at the time of construction, provided that-encroachments into a 10-foot rear or side yard setback and 20-foot front yard setback shall be deemed to create an intensification requiring a special permit under Section 4-4.3(2);and B. The proposed alteration or expansion conforms to the current height limitations of the Zoning Ordinance. No clear layout plan was presented that illustrates the proposed new porch and tower added on to the existing build footprint and the lot lines. This proposed layout plan would be beneficial to illustrate the extent of encroachment into the setbacks. The application states that the"Tower" addition is"2 story". Residential Zoned Districts are limited to 30' in height or 2 & 1/2 stories. Staff reads the plans as having three levels identified on the plans as"Top Floor", "Second Floor"and "Porch". The Board has utilized the following definition when the question of half story arose: it shall be considered that a half story is that space in a residential dwelling which exists above the plate line but below the ridge line in an area commonly called the attic space and for purposes of being occupiable the ceiling line shall not extend from the second floor line a height greater than eight(8)feet nor shall the floor area of the space exceed 60% of the gross floor area immediately below the"so-called" half story. The plans presented appear to comply with this definition when considered with the existing structure and its second floor. According to the Assessors records the second floor has 1,914 sq.ft. of living area. The top floor of the tower, provides only a 12' by 8'-8" at the widest locations. A very small room with limited uses except perhaps to capture a view to water. With respect to compatibility to the neighborhood, it may be of benefit to the Board if the applicant has contacted neighbors and shared with them the plans of the proposed tower, its height and location. The tower would be very close to Scudder Avenue and situated on one of the higher points along the roadway. At present there are two stately street trees along the lot. Would those trees be affected if this were granted? Suggested Conditions: If the Board should find to grant the requested Variance, or a Special Permit, they may wish to consider the following conditions: 1. The addition shall be located as per plans presented titled "Addition -"Tower"for Harry and Pat Groom - Hyannisport, MA" drawn by JH Design and consisting of 2 sheets numbered 2 and 3. 2. The porch shall always remain open to the elements-that is it shall not be enclosed by windows or walls. 3. The two stately trees located along the street in the area where the improvements are being proposed, may be selectively trimmed so branches do not interfere with the dwelling and porch, but in no instance removed or top cut. 4. There shall be no future addition of building footprint or building area on the lot without permission from the Zoning Board of Appeals. Attachments: Applications Copies: Petitioner/Applicant Assessor's Field Cards GIS Map 2 s• TOWN OF HAItNSTABI+S e ti Zoning Board. of Appear Anlicatioa to Petition for a Variance- Date Received' I ^ZUNI"Jf RELIEF BEING SOUGHT FEE-1 DEMrzmiNED BY THE ZONING For office use Onl '� y Town Clerk office. 7G.".CLri?:NT OFFICER TO GIVEN THESE �[•INS Appeal # ra n 3 7 ,,i,;uATE-REUEF HBSr].neJ Date B Decision Due The undersigned hereby applies to the Zoning Board of Appeals for a Variance. from -the Zoning ordinance, in.the•.manner and for the reasons hereinafter set forth: Petitioner Name: L.I) 4 PfkrtZr ** Groom , Phone 9( 3 7-5 G Petitioner Address: ' A PA • W�l cs lr,�� &k A. e u!ff Property Location: Ca,,(-, 1-4. LAa_e*_ Ai e-- ' I 1 a n ,n►s rfi Property Owner: PA Mt c r A- r-j r0 M , Phone `1`A I - Address of owners i i D r\ R oGL GQ I A 3 e-A l e S U-" llA (-N- o 1-14 8 Zf petitioner differs from owner, state nature of fnteresta Number of. Years owned: 1-{ Assessor•s Map/Parcel Number: 117 oil, Zoning Districts Groundwater overlay District: ' variance Requested: ?j ^ 1 Cite section t r1t2e of the Zoidng oz%Unancs- Despription of variance Requested: 1��rci,A);tl eri c koa cG( l0 -k /1fo vrhi Sel6ack Description of the Reason and/or Need for the variance: l 0 r!" o��h ti lr� ome 04 Discription of Construction Activity.'(if applicable j: W X S-0 1 - 6' 11 d PC k zzistinq Level of Development of the Property - Number of Buildings: 07 Present Use(s j: k,V i-1 Cf'(M' Gross Floor Area: 3,200 sq.ft. Proposed Gross Floor Area to be Added: Altered: Is this property subject to any other relief (variance or special Permit) from the Zoning Board of Appeals? Yes [) No (� Zf Yes., please list appeal appeal numbers or applicants name r Application to Petition for a variance Is the property within a Historic District? In the property a•Designated Landmark? Yes [] No [�! Yes [) No [/1 'For Historic Department One Only: Not Applicable oRH Plan Review Number Date Approved Signature: Have you applied fora building permit? Yes a ' No [] .Has the Building Inspector refused a permit? �[ Yes NJ No [} All applications for a variance which proposes a change in use, new construction, reconstruction, alterations or expansion, except for single or two-family dwellings, will require an approved site plan (see Section 4- 7.3 of the Zoning ordinance) . That.process should be completed submitting this application to the Zoning Board of APPe al . . prior to s For Buildings Department use only: Not Required ., ..... [) Site Plan Review Number Date Approved Signature: The followings. information must be submitted with the Petition at the time Of filing, without such information the Board of Appe requesti als may deny your Three (3) copies of the completed Application Form, each with original signatures. Five (5) copies of a certified property survey (plot plan) showing the dimensions of the land, all wetlands, water bodies,. surrounding roadways and the location of the existing improvements on the. land. All proposed development activities, except single and two-family housing development, will require five. (5) copies of a proposed site improvements plan approved by the Site Plan Review Committee. This plan must show the exact 'location of all -proposed improvements and alterations on the land and to structures. see Contents of site Plan:" Section- 4-7.5 of the Zoning ordinance, for detail requirements. The petitioner may submit any additional supporting documents to assist the Board in making 'ts d ation. Signature: f Date: Petitioner or Agen •s gnature Agent,s Address: 10 S V s•es P , ' C" 'y 1 /4. Phone: - 0 �7 3 Fax No. Property Location: SCUDDER AVE HYANNIS MAP ID: 287/012/// ' Vision ID: 21598 Other ID: Bldg#: 1 Card 1 of 1 Print Date:05/01/2000 xSWUM,nAKULD .. escrip ion Code Assessea value ROOM,PATRICIA A 801 8 ALBION RD SIDNTL 1010 218,50 218,50 ELLESLEY,MA 02181 SIDNTL 1010 11,20 11,20 Barnstable 2000,MA q Pei MR RM ccoun an e . ax Dist. 400 Land Ct# er.Prop. #SR VISION Life Estate DL 1 Notes: DL2 IS ID: To a WX WE,A ::i �i a. s?. .a•. a loss.. r. Code Assessedvalue r. o e ssesse a ue r. code Assessed Value E MORTGAGE INSURANCE CORP C131190 08/15/199 U I 10 B lulu , E CAPITAL MTG SERVICES INC C127936 09/15/199 U 192,50 L 199 1016 218,50 199 1010 218,50 KIRBY,FRANCIS A C30548 09/15/198 Q 199 1016 9,60 199 1010 9,60 i TO , oa. o , is signature ac now a ges a visit y a a o ector or Assessor m ear 7ypewescription Amount Codeescrip ion um er Amount Comm.Int. a Appraised Bldg.Value(Card) 212,000 Appraised XF(B)Value(Bldg) 6,500 o Appraised OB(L)Value(Bldg) 11,200 s Appraised Land Value(Bldg) 157,800 �. :.. .. ON, `.�MWM... Special Land Value Total Appraised Card Value 387,50 Total Appraised Parcel Value 387,50 Valuation Method: Cost/Market Valuatio e o aI AppraisedParcel Value 387,5UU ss,6„ 4 &.i. Permit ssue a e-- Descriptioni �.. mount,: p.. a e o Comp. ate omp. ommen s ate urpose su s, t n, 's...., de _�.R:., a. , Use Code Description one .ron age ept nits nit rice Pa or ac or �. o es- pecta rtcmg �. n: rice an a ue ing a ram o es: , o an ni o a an u , Property Location: SCUDDER AVE HYANNIS MAP ID: 287/01 2/// Vision ID:21598 Other ID: Bldg#: 1 Card 1 of I Print Date:05/01/2000 .> _eME h ... - ,o ro' _ e ',a A:.z, M1= ,.< :o >>.. .._:. ztement ca. Ch. Description CommerclaTua a emen SFy e ype olonial ElementDescription Model 1 Residential Heat Grade + + Frame Type aths/Plumbing Stories 2 Stories Occupancy 0Ceiling/Wall ooms/Prtns US 5 Exterior Wall 1 14 ood Shingle /o Common Wall 2 Wall Height Roof Structure 03 able/Hip 16 151 Roof Cover 03 sph/F GIs/Cmp nterior Wall 1 8 Typical ^� -~ ` �� 5 2 Element o eiprcr ion FactorFUF bTO 31 nterior Floor 1 20 ypical Complex FUS 5 2 Floor Adj Unit Location 161 Heating Fuel 03 Gas eating Type 09 Typical Number of Units 21 1 2121 C Type 01 None Number of Levels 5 /a Ownership Bedrooms 8 Bedrooms 1612 Bathrooms 4 4 Bathroomsy401, l 0 4 Full unadj.Base Kate Total Rooms 12 12 Rooms Size Adj.Factor .89088 Grade(Q)Index .53 2 Bath Type Adj.Base Rate 5.43 16 Kitchen Style Bldg.Value New 55,439 Year Built 870 48 ff.Year Built 965 rml Physcl Dep 2 uncnl Obslnc con Obslnc ;» p ecl.Cond.Code a o o e Description ercen a e pecl Cond /0 15 mg a am erall /o Cond. 3 eprec.Bldg Value 12,000 NAM N o e Units unit «rice Yr. Dp Xt YoUnd Apr. value SHED HED ' L 309 4.0 1970 100 90 FGR3Garage-Good L 441 32.0 1970 1 100 10,30 �xs, .,�,.�.w-.,. >✓',�, arc �v...... � � '�a,.�, .v - _ ., Code escription < Living Area LyrossArea kff.Area Unit Cost Unaeprec. Value irst F loor 1,74 1,7M , FOP Porch,Open,Finished 411 8 13.0 5,36 FUS Upper Story,Finished 1,91 1,914 1,91 65A 125,23 UBM Basement,Unfinished 831 16 13.01, 10,86 Gross LivlLease Area _ 11 /Y .d.4JW� d — rrrrnr • ePe ra Af%K Uji . __ � �—_ _ SjuY.. .:'y/1f�TOIA.'/�,f/trOCI(. ,• .. 11 LLLIJ _ __ — � __ �._ � _ 1JY 9MH.17 1 ♦ �Y lo sp \ 3 1� n ^i. ' 7+Yd�GaVJM/.I' . :.:>;I,S Y.TwwYT1A L L .':la mil"� •e,::a+i4.,hwnr/ - . ..i�earn.rb•" . r -Sao,�TJB�. -7-6- ' A.RD i.Tl.olyFA. .au�l I OC 1VrI1MD MY. 00 luru�o r I� 9rA.a1PAl RPrC y 1 1 Se �vm I aM,ow, _ ;4 .. 1DY :Cy TDi p.eoe. , �. a. A...,.: i FnuH Dpa _ 1 SEter�D.P+•ema/:Gva� <feraa s,lhv�. a c .4GO�T/ON—'ToWE� • •'�d '" R /1RR wwo PAT OMMM HyANNISPeA:r•AA an,1-11�oo• r,� TN de-618-n I�YAM,46 Mk -3 BARNSTABLE G E Ca ital Mort a e Services Inc I;,�nd In .......................................... Belonging to......... .. . P .. .. .. . .� .... Deed in Book. ......... Page....:. Land Court Certificate No. ..4044.... in Book ...Z37........ Page ....M.... In ...Barnal;ablq. Registry...Dj.S.trjgJt....... Recorded Plan...Land.Court Plan No.10086 filed with Cert.No. 1006 Date of Plan February 1923............. in ....Barnstable Registry..District................... Book ..5............. No. 6......... Filed Plan No. .............'. .................. .MORTGAGE INSPECTION PLAN ATTORNEY RICHARD CAIN Harold R. Groom, Jr. and Particia A. Groom. Loan Me. 626 Scudder Avenue, Barnstable 1 Hyannisport) Two GARg66 Z i3 Lor A rrv^2Y Ci woov SCUDDER AVENUE Aug.20,1993 JN 61028 Scale 1"=30. -TH IS PLAN IS FOR IVIORTGACE PURPOSES ONL- I CERTIFY THAT THIS PLAN WAS PREPARED lJ N;� To � GRAYZ - U ;2 'S• � � v f v_ U _-� �a flip• �d_. '` ".�. '� o ° _ o ACV ETZ _ o �� 1, • , r i dam Fri o' SCALE:1u-20(' MAP 287 PARCEL 012 w f s *NOTE Plan�eMq and **NOTE The poW 1m are o� r apasado w DATA SOUKS& 1'lae'mtetna(mm►•mode woes hopmW flan 1995 mW phdopropM br The lames veydafron was b med Nal W of pmpaty bowxb&They are not hue bxatn ad W.Sod[a m TopoOnphy oW vgddm wee ban IM wW photographs by Go Mop Am mEy d o smlo of h nd rapm w odw wdonddF b physiad obit fapomNoa &nanehiq�popmphw oed wpdit wee mapped to meet National Map Aaumq Shmdards anthe map. da soda of 1'=1W. Pare)lineswen igbw from Y011OTon of kmsbblekseswstax mops. lgis)dllbamldgn1m287pl2.dgn Apr.27,2000 10:12:27 N''1J CLERK BAR r' STABLE. MASS. 70 MAY 2q P1 2: 4.4 FILE COPY ONLY! NOT RECORDED AT Town of Barnstable REGISTRY OF DEEDS Zoning Board of Appeals Notice -Withdrawn Without Prejudice ; Groom -Appeal Number 2000-37 Variance to Section 3-1.3(5) Bulk Regulations-Front Yard Setback Summary: Withdrawn Without Prejudice Applicant: Harold R. Groom,Jr. and Patricia Groom Property Address: 626 Scudder Avenue, Hyannisport, MA Assessor's Map/Parcel: Map 287,Parcels 012 Area: 0.58 acre Zoning: RF-1 Residential F-1 Zoning District Groundwater Overlay: AP Aquifer Protection District Background: The property is located along Scudder Avenue and is developed with a colonial style, two-story dwelling of 3,656 sq.ft. of living area. The Assessors Records indicate that the dwelling was built in the 1870's. At present the dwelling is undergoing repairs and improvements. The applicants are proposing to add an open front porch measuring 8'-3"wide and 47'-8" long. Part of this porch would contain a 29'A I" high, three level"Tower"with and oversized octagon base projecting 10'-3"from the existing front of the home. The applicant has requested a Variance from Section 3-1.3(5) Bulk Regulations-Minimum Front Yard to accomplish the proposed plan as being presented in the application. Procedural Summary: This appeal was filed at the Town Clerk's Office and at the Office of the Zoning Board of Appeals on March 21, 2000. A public hearing before the Zoning Board of Appeals was duly advertised and notices sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened on May 10, 2000 at which time the applicant requested and the Board granted a Withdrawn Without Prejudice. Hearing Summary: Board Members hearing this appeal were Gail Nightingale, Gene Burman, Richard Boy, Dan Creedon, and Chairman Ron Jansson. Michael D'Angelo, the builder, represented the applicants, Harold & Patricia . Groom, who were present. Mr. D'Angelo reviewed the plans. The applicant is proposing to construct a porch addition and a"tower' structure to the existing house which already encroaches into the setback. The house is located on the lot such that it can not be placed anywhere else on the lot. Mr. D'Angelo indicated there are three septic systems in the back/side yard which precludes any addition being located there. The Board requested engineering plans so the current setback and the setback of the proposed located can be accurately determined. The Board also asked about the height of the tower and questioned if it might need zoning relief. i` Public Comment: No one spoke in favor or in opposition to this appeal. e' Town of Barnstable-Zoning Board of Appeals-Notice-Withdrawn Without Prejudice Groom-Appeal Number 2000-37 Variance to Section 3-1.3(5)Bulk Regulations-Front Yard Setback Since the Board wanted a certified plot plan and questioned the tower's height, the applicant requested his application be withdrawn without prejudice. Motion: Based on the applicant's request, a motion was duly made and seconded to allow Appeal Number 2000- 37 to be Withdrawn Without Prejudice. The vote on the findings was as follows: AYE:. Gene Burman, Gail Nightingale, Richard Boy, Dan Creedon, and Chairman Ron Jansson NAY: None Order: Appeal Number 2000-37 has been Withdrawn Without Prejudice. Appeals of this decision, if any, shall be made pursuant to MGL Chapter 40A, Section 17, within twenty (20)days after the date of the filing of this decision in the office of the Town Clerk. S a} Ron . Jans on, Chairman Date Signed I Linda Hutchenrider, Clerk of the Town of Bamstable, Barnstable County, Massachusetts, hereby certify that twenty (20) days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision has been fi ed in the office of the Town Clerk. Signed and sealed this day of under the pains and penalties of perjury. Linda Hutchenrider, Town Clerk 2 F. RefNo mappar ownerl owner2 addr city state zip 37 287 009 CAREY, DENNIS M & JEANNE S P O BOX 1 HYANNISPORT MA 02647 287 010 WARREN, LAURIE A 41 OVERLEA RD HYANNISPORT. MA 02647 , 287 011 DEBLANK, LAURA K 317 W MONTEBELLO AVE PHOENIX AZ 85013 287 012 GROOM, HAROLD R JR & GROOM, PATRICIA A 88 ALBION RD WELLESLEY MA 02181 287 013 CARBERRY, JOHN V & MARY A 56 WOODCLIFF RD WELLESLEY MA 02181 287 014 001 MCPHEETERS, CONSTANCE B 700 SOUTH PRICE RD ST LOUIS MO 63124 287 014 002 FOSTER, ANN MARIE P 0 BOX 564 HYANNISPORT MA 02647 287 035 001 EDWARDS, CHARLES P LICIA S EDWARDS BOX 368 HYANNISPORT MA 02647 287 035 002 EDWARDS, CHARLES R ET ALS - %BISHOP, ELIZABETH EDWARDS 10 BUENA VISTA PARK CAMBRIDGE MA 02140 287 036 CANCIAN, ROSEMARY S ET ALS BOX 574 HYANNISPORT MA 02647 287 037 BICKEL, HARRY C SR 1516 LEXINGTON RD CHATTANOOGA TN, 37405 287 043 WOODWELL, JOHN K JR& MARTHA WOODWELL, RICHARD H & LINDA 36 WYNCOTE RD HO HO KUS NJ 07423 287 044 GRAVES, JAMES W & MEREDITH PO BOX 847 HYANNISPORT MA 02647 287 045 ONEIL, WILLIAM W & NANCY B 100 STUART AVENUE LEOMINSTER MA 01453 287 046 SPENCE, WILMA 14 AMBER RD HINGHAM MA 02043 287 047 GARGAN, JOSEPH F BETTY GARGAN BOX 394 HYANNISPORT MA 02647 287 048 GALLAGHER, EDWARD M GALLAGHER, SUSAN P 621 SCUDDER AVE HYANNISPORT MA 02647 287 049 ANDERSON, DORIS T TR PETER C ANDERSON 229. E LAKE SHORE DR CHICAGO IL 60611 287 050 BLAIR, BARBARA %WEED, B MELLON BANK. ONE MELLON BANK CENTER RM 3845 PITTSBURGH PA 15258 287 051 STEWART, NANCY P PARSHALL, C WARD 4 BREEZY POINT LITTLE SILVER NJ 07739 287 052 PETERS, RONALD E & LORI S 14 WACHUSETT AVE HYANNISPORT MA 02647 287 150, BACON, CARTER S JR TR %MANNHEIN LLC 7 MARTIN BUSSMANN . 712 5 TH AVE 32ND FLOOR NEW YORK NY 10019 287 151 ODONNELL, THOMAS F JR & ODONNELL, CAROLYN R 49 CLIFF RD WELLESLEY MA 02181 287 152 VITELLO, MARY J 20 WINCHESTER RD ARLINGTON MA 02174 287 155 CAREY, DENNIS M 658 SCUDDER AVE HYANNISPORT MA 02647 287 157 WOLFINGTON, VINCENT A 4530 WISCONSIN AVE 5TH FLOOR WASHINGTON DC 20016 287 159 WOLFINGTON, VINCENT A 4530 WISCONSIN AVE 5TH FLOOR WASHINGTON DC 20016 Count= 68 3 '- Prof of ublica Town of Barnstable Zoning Board of Appeals Notice of Public Hearing Under The Zoning Ordinaries for May 10, 2000 To all persons interested in,or affected by the Board of Appeals under Sec. 11 of Chapter 40A of the General Laws of the Commonwealth of Massachusetts, and all amendments thereto you are hereby notified that: 7:45 PM Chretien Appeal Number 2000.36 JosephJ.&Martha Chretien have petitioned to the Zoning Board of Appeals for a Special Permit for a Family Apartment pursuant to Section 3-1.1(3) (D) of the Zoning Ordi- nance.The pr6pertyis shown onAssessor s Map 047. Parcel 020 and is commonly ad- dressed as 1605 Race Lane,Mansions Mills, MA in an RF Residential F Zoning District. 8:00 PM Groom Appeal Number 2000-37 Harold R. Groom, Jr. and Patricia Groom have applied to the Zoning Board of Appeals for a Variance to Section 3.1.3(5)Bulk Regu- lations. The applicant is proposing to con- struct an 8'x 50'front porch with a 10'x,12' addition of two(2)stories. The porch will encroach six(6)feet into the front setback. The property is shown on Assessor's Map .287.Parcel012 and is commonly,addressed as 626 ScudderAvenue.Hyannisport,MAin an RF-1 Residential F-1 Zoning District. 8:15 PM Popcom Realty Trust Appeal Number 2000.38 --- Popcorn PAelty Trust, Elizabeth Grazul, Trust".has petitioned to the Zoning Board of Appeals for a Special Permit pursuant to Section 4-4.5(2) Expansion of a Noncon- forming Use. . The applicant proposes to constructatwo-storyaddition(2,240squam feet) to the existing office building. The property is shown on Assessor's Map 024, Parcel 034 and is commonly addressed as 4527 Falmouth Road/Route 28.Cotuit,MA : . in an RF Residential F Zoning District. 8:16 PM Popcorn Realty Trust Appeal Number 2000.39 Popcorn Realty Trust. Elizabeth Grazul, Trustee,has petitioned to the Zoning Board of Appeals for a Modification to Special Permit 1982-73,Condition q1 which states. 'There shall be no more than five employees on the premises at any one time.' The property is shown on Assessor's Map 024. Parcel 034 and is commonly addressed as 4527 Falmouth Road/Route 28,Cotuit.MA in an RF Residential F Zoning District. These Public.Hearings will be held in the Hearing Room; Second Floor, Town Haft, 367 Main Street, Hyannis, Massachusetts on Wednesday.May 10.2000. All plans and applications may be reviewed at the Zoning Board of Appeals Office. Town of Bam- stable, Planning Department. 230 South Street.Hyannis, MA- r Ron Jansson,Chairman Zoning Lard of Appeals Barnstable Patnot April 20,2000&April 27,2000 BARNSTABLE G E" Capital Morta�e Services Inc. _ _ LandIn ...................................................... Belonging to ......... Deed in Book ................ Page ........ Land Court Certificate" No. .. Q54$.... in Book ...Z37....... Page ....M.... In ..B.P.C.RMUJe. Registry ...RJ.stdct....... Recorded Plan Land Court Plan No. 10086 filed with Cert:No.1006 Date of Plan February 1923 in BarnstableRegist'ry ..District.•••••••••••••„•••• gook ..5............. No. 6......... Filed Plan No. ................................ .. MORTGAGE INSPECTION PLAN ATTORNEY RICHARD CAIN Harold R. Groom, Jr. and Particia A. Groom Loan No. 626 Scudder Avenue, Barnstable ( Hyannisport) Two' o c'72 ,v s`r' - GARgbE i f LO-F A - Ill;> rn y srvRy WOOL) ti �T 1 �17527) jl I SCUDDE R AVENUE Aug.20, 1993 , JN 61028, Scale 1"= 30, —F IS PLAN I !E; F(DR MORTCAGE" PURPICUSES ONL I "? I CERTIFY THAT THIS PLAN WAS PREPARED j .:;';';^;'; Y�, � ��'•• :; sy IN ACCORDANCE WITH THE COMMONWEALTH OF MAS$ACHUSF.TTS PE30CE�;.URAI. AND=77- TECHNICAL STANDARDS FOR rT HE PRACTICE �? w OF. LAND SURVEYING 250 CMR 6.05 AND WITH THE SPECIFICATION SHEET ATTACHED HERET ;fr.:,. ;,b:,..�:r..... ...... t N s 9 c f KENNETN ANOERSON $ No. 31298 0 GL LN G E Services Inc _ Land In . BARNSTABLE Belonging to ,,Capital Mogt.qe.. Deed in Book .......•........ Page ........ ... ...... ... Land Court Certificate No. .. ��4$.... in Book ...Z37........Page ....M.... In ..5.0-01AXd�Je. Registry ...Q1.S.t1 1Gt....... Recorded Plan „Land. Court Plan No. 10086 filed with Cert.No. 1006 Date of Plan February 1923 in ....BarnstableRegistry ..District.................................... Book ..5............. No. 6......... Filed Plan No. .............-.............. MORTGAGE INSPECTION PLAN ATTORNEY . RICHARD CAIN Harold R. Groom, Jr. and Particia A. Groom Loan No. 626 Scudder Avenue, Barnstable (Hyannisport) Tivo . o cq2 N , M Gs1Rg6E Z lf/ � LoT A __ =- (\; '­ s� srv�y ti I SCUDDER AVENUE Aug.20, 1993 JN 61028 IScale 1"= 30, . THIS PLAN I �3 FOR IViORTGAGE PURPOSES ONL_ I y ,, ' -.F. P i'::•.>. "? I CERTIFY THAT THIS PLAN WAS PREPARED 's I 1 N ACCORDANCE WITH THE : COMMONWEALTH 1 ` *�a OF MASS,ACHUSETTS PR0CE2URAL_AI_. dD_ _--._= i ECH.N.ICAL STANDARDS FOB TIiE:PRACTICE- OF.LAND SURVEYING 250 CMR 6.05 AND WITH ie M €> THE SPECIFICATION SHEET ATTACHED HERET _ OF M i' L N .0 f,S. 9 11 y G KENNETIi y Iifl t ' M s4Ik ANDERSON W­ No. 31298 �o ;.,:.. ass/�fC Elk_S_ 6--r GL LI®ra � ( II i e� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map. o�57Parcel `�� Permit# �664 1 0 Health Division r & Date sued a'2" 0 / ® Fee Conservation Division4 0 oZ- &a� Tax Collector Treasurer p� Planning Dept. Checked in By Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis Project Street Address GAG• SGu �. Village Owner Address 6 oZCo Telephone Permit Request OZ�� 'X0 e ' ,. •-dc. �2.2�� 9/�?o2/m2.av Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Valuation 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 Cl Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) i Number of Baths: Full: existing new Half: existing n6,w �Y Number of Bedrooms: existing new < r� w U�, �.r• Total Room Count(not including baths): existing new First Floor Room)Count Heat Type and Fuel: ❑Gas 0 Oil ❑ Electric ❑Other - rr; Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes O No Detached garage: 0 existing 0 new size Pool:❑existing ❑new size Barn:0 existing ❑new size Attached garage: 0 existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded 0 Commercial ❑Yes ❑ No If yes, site plan review# Current Use - - Proposed Use BUILDER INFORMATION �-7 Name �P�`' Telephone Number / /`" " /Q Address__( License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE "r7 S FOR OFFICIAL USE ONLY n" PERMIT NO. x DATE-ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER ' DATE OF INSPECTION: FOUNDATION FRAME INSULATION R� FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. AUG, 15, 2005 1.1 : 22AM FIRST CARDINAL 5182131901 N0, 259 P. 1 FIRST CARDINAL CORPORATION 10 British American Blvd Latham NY 12110 FAX TRANSMISSION FAX: 518/213-1902 TELEPHONE: 518/213-1900 or 800/948-4850 To: Pat Groom Fax: 617-778-6798 From: ]essica Clendaniel Customer service, ext. 1954 Date: 8/15/2005 insured: Party Cape Cod J Re: Massachusetts Retail Merchants Workers'Compensation Group, Inc. As requested by the above insured, proof of Workers'Cow coverage. First Cardinal Corp. is the administrator for the above noted Trust We handle 9AII the workers'compensation coverage. *Please contact the insured with any guestionsregarding any other required rgquired certificates. Number of pages including cover. 2 I, AUG. 15. 2005 11 : 22AM FIRST CARDINAL 51.82131901 N0, 259 P. 2 TEWCERTIFICATE OF LIABILITY INSURANCE °A 8/i 05 Producer THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE First Ordinal Corp. CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT 10 British American Blvd. AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY Latham,NY 12110-0141 THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIL# Insured INSURER A: MA Retail Merchants WC Group Inc. Party Cape Cod,Inc. INSURER 8: 660 Mac Arthur Blvd. Pooasset„MA 02559 INSURER C; INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISIED BELOW HAVE BEEN ISSUED TO THE IN8LIRCIOMAMEDABOVEROWTHE POILICYPERIC6 I DICATED,NOTWITHSTANDING ANY REQUIREMENT T1ERNI OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT YO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCEAFFORDED BY THE POLICIES DESCRIBEOHEREIN IS SUEUECTTO ALL THE TERMS,EXCLUSIONSANO CONDITIONS OF SUCH FOUCIES. AGGREGATE LIMIT$SHOWN Y AVE BEEN REDUCED BY PAID CLAIMS. FQUCY EFFECTIVE RATE POLICY D�IRATION INN LTA W—.0" TYPE OF rNBVRANCB POLICY M NM MMA70 DATE M LIMITS GENBRALLIABILITY EAC14 OOCURRENCE COMMEROAL 4WAL LIABILITY FIRE DAMAGE(AnY one fre) $ CLAIMS MACE O OCCUR MED EXP(Any o1fe Parton) $ PERSONAL SADVINJURY $ GENERAL AGGRECATE $ GM4L AGGREGATE LIMT APPLIES PER, PRODUCre-COMMOPAGG $ PRO- POLICY JECT 7L AUTOMOBILE LIABILITY COMBIN12DSINGLELIMIT $ ANY AUTO (Eaaaidenq ALL OV4490 AUTOS BOOILY IN,MRY $ SCHEDVLW AUTOS (P'e'Peran) HIREDAUTOS BODILY INJURY $ NONZWNSD AUTOS (Par amrdenq PROPERTY DAMAOE $ (Per aoetden0 . GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGO $ EXCESSS LIABILITY EACH OGWRRENCE s OOGUR CLAIMSMADE AGGREGATE $ g I DEDUGTIBIA $ REnrt'ION 8 $ WOWARS COMPENSATION AND WG STATU• OTF4 EMPLOYERS LH181LITY TORY LIMITS ER ANY PROPMUEWPARrNER/EXEC(MVE I-I.LAU"PQCIDENT $ 100,000 OFMCEWMEMBER EXCLUDEDI Wdw4ftau cw NO 014000500406106 1101106 1A71w L. 4 -EA EMPLOYEE $ T00,000 GAL PROVISIONS0elaw EL DISEA—ff--POLICY UMIT 500,000 REFERENCE: E90 IPTION OF OPERATIONBr WCAYIOW VEMCLM E C—LV3 NS AODEb BY ENOO SEMENT I IWEVAC PROVISIONS WodrelV cornpensaWn ccverage is provided by cc aract to ail employees of Peril;Cape Cod,Me. Covere0o does not apply to any errpbyeos not approved and aselBnsd by Party Cape Cod Inc.eltectNe 011012005 CERTIFICATE HOLDER ADDITIONAL INSURIM:INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE D93CRI OCO POLICIES BE CANCELLED BE FORE Pat Groom THE EXPIRAVONDATE THEREOF,THE ISSUING INSURERWNLL ENDEAVORTO 68 Albion Road MAIL 35 DAYS WRITTEN NOTICE M THE CERTIFICATE HOLDER NAMED Wellesley,MA 02401 TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. �AIITHORFZ7 D REPRESENTATIVE r,. C THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA r - 08/15/2005 11:41 5085646904 PARTY CAPE COD PAGE 02 -_ J JCILC%14uCPJ IMPORTANT (JAL PCPrJ�c fCPCPcPCJ�CPLP car 11 DOCUMENT �A',ION ISSUED BY d Date of Shipment i :u H 03:0310� f :.�►tial �q t t t EVANSVILLE. INDI ANA 4 7 Tent Identification 7 25 MANUFACTURERS OF THE FINISHED • •- TENT PRODUCTS DESCRIBED HEREIN �_.-..._ _J :S to certify that the materials described have been flame-retardant treated ':r .vc: :rtherently noninflammable} and were supplied to: 5a'00 PARTY CAPE COD 660 MACARTHUR BLVD POCASSET MA 025592230 '...,ikon is hereby made that- �:►r s described on this Certificate have been treated with a flame-retardant approved +c;.rti and that the application of said chemical was done in conformance with California --rai Code, All fabric has been tested and passes NFPA 701-99. CPAI 84. ULC 109. .::lrnn • 1 •IptTt c;r-rhlt�rl .....�_� «..._...____ . I I Flange Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric Signed: — SPECIAL.EVENTS DIVISION•ANCHOR iNDUS;;IES!,N, i.?�c,,gJ QZc4'r?�LIt?,�C Tt�P[17C f 3CIL C1'►Gl 4 r IE�lC(r.PLPcP1�c�LPClr3f[f[J:5-513rar,IdfOJ�[PtPelPJ7,J`?1 -,i Please take this certificate of Flame Resistance to your local building department to attain a permit for the tent installation. Massachusetts State code requires a permit for all tent installations. Please be advised that a Dig Safe inspection is also required for all tent installations. In preparation for the Inspection Dig Safe requires all sites to stake the tent area with white markings. Party Cape Cod will tali you the week of your function to advise you of your inspection date. a la, Town of Barnstable ° Regulatory Services BARNStAft ' ' Thomas F.Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790=6230 Property Owner Must Complete and Sign This Section If Using A Builder I, ,as Owner of the subject property hereby authorize � � �;.�.- _ to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name Q:FORM&O WNERPERMIS SION r ..-AEG-s•° 9 '4Y O.GI �, � � � ^ 1 S� -cR41 'V. W /DY" .FAaEgp G&.ILINO \�' \ •s, c 4cnx Y Vol — i•+NRIGAOOi:4",r*O FF.-C�SA�YFGT'GU _ A - ._—__—_— .. 9Y6_.-_, � :/Ir- _.- '�` wsN � GA�1.Nsrve coarveAL _ W�.P?�'1•� .. .. e � 1-0 � o _tD_1ZAF'*�A3ENaJpJaLS .Pint,= ( _lo FR7E'z v. 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(�!a 8.`:VV_iLalwz:-Sl otu-i - _ - ...2x4 P.•(.'SLEEpF_K$:'(APEREn____ / - . 2+B.Blsx ta.5� 3o tusula — •d:..__.._._...._u-t'k4lnijs,WALL -R. ToN f U.I SEINE U4v vEN. _ .` /i '7 X I t81 vERSa-�?'M �ui coNE/Ac>-nt.,d - _ ��o_'•sNt�=rRcrk - .. ' _...._ - >',: .o:(Q { y i i 1 � IIi W2i40 I +/2'er.elrwGn -'P.G eo '.an e �� _._. 2�'rzS,.et w/srw£ ... Rcl°once ext�fw5 cua rtzucl )'Sf q NG(.Apq,e .10':n wml Hal•o0,t ,-w&p ... .. oN 51% .. SIN/Fivxl�Y fiCC),,A Arn j - $Rl10E DEVtfN DESIGNS ...�-�-,,:a'• •.o... • CHATHAM, HA. e:11,2S 107 a�sao • � . � »4•zoy•9�so �_� ���R ��E I 111 I�iN�5 PPVR.-(,(/x.; � 2NoF 2•ea r A complete Ti-Xpert framing plan requires the Trus Joist Framer's Pocket Guide See True Joist Framer's Pocket Guide for Product Trademark Information TJ•Xert® 6 U p U ***NOTE*** MISSING DIMENSIONS WERE SCALED FROM JOIST AND BEAM LIST DRAWING PLEASE VERIFY: ! NOT ENOUGH INFORMATION TO CALCULATE Plot ID Length Product Plies Qty EXISSTING 2ND FLOOR LOAD OR EXISTING Al 20' 11 7/8" TJI 230 joist 1 12 ROOF LOAD ON 14" LVL. BEAM AS ARCHITECT A2 18, 11 7/8" TJI 230 joist 1 1 r A3 16' 11 7/8" TJI 230 joist 1 2 HAS DRAWN M1 20' 1 3/4" x 14" 1.9E Microllam LVL 3 3 PLEASE VERIFY: I ACCESSORIES LIST la a lie^ Plot ID Length Product Plies Qty Bkl 1' 9 11/16" 11 7/8" TJI 230 Blocking Panels 1 3 Bkl* 10 5/8" 11 7/8" TJI 230 Blocking Panels 1 1 Bk2 1' 1 11/16" 11 7/8" TJI 230 Blocking Panels 1 25 Rla 1 ;r 2 Bk*, Randomllength blocking " TJI 230 Blocking Panels 1 1 panel cuts Bk, Blocking Panels Bk2 LEVEL NOTES File Name: GRENIER - SUNROOM.JOB 4 Level Name: ROOF ' Plotted: 12/13/2007 14:42 Design Status: FIRST FLOOR...Not Designed Al A2 A3 m ROOF..........12/13/2007 14:34 9' NOTE: Level design times indicated above provide _ FILE COPY - assurance for proper level stacking. 4 MUST BE SIGNED AND RETURNED Design Methodology: ASD PRIOR TO PRODUCTION Roof Area Loading Is: 35psf Live Load-(115% LDF) and 20 psf Dead Load APPROVED: Maximum Joist Deflection: L/360 Flat Roof - Live Load DATE' L/240 Sloped Roof - Live Load L/240 Flat Roof -Total Load L/180 Sloped Roof - Total Load NOTE ANY REVISIONS ON THIS PRINTNormal O.C. Spacing 16"* - *Unless noted otherwise ti 1 Layout Scale: 1/4" = 1' Ri r Bk2 SYMBOL LEGEND 'k Rl x Note from Operator t. O Point Load ( CREATED BY _ Line Load —� Mid-Cape Home Centers Area Load la lia^ a a 3ia^—� PO BOX 1418 465 ROUTE 134 O Detail Callout Label I SOUTH DENNIS, MA 02660 (See Framer's Pocket Guide) 5083986071 X4987 FAX: 5083984559 SYSTEM WARNINGS TRUS JOIST { Jos COMMENTS 3 Skew cut joist ends at all skewed support locations. MARK GRENIER FOR THE TJ-XPERT WARRANTY SUNROOM 626 SCUDDER AVE SEE FRAMER'S POCKET GUIDE HYANNISPORT, MA TJ-Xpert 6.42(#693)C6.42 D6.42 S6.42 P6.42 i r t i 'ti , IjEnUU 1�.21052\v 1N1 REN. 2452 w . r - �[j-�J +'/.// 1:: '\VIWn4\v5?O V.t f lb"11W41NSUL50•tKAuSIY+'S (3)I•(-J�I'r4•.LV�S uNo.EK \ . • - _ i COX pVf 14We nt4Av "FlL?R tRlX4E°i 18"U.C. . • . 13 B c c - - I RGOF _=.,�!.._ t_. .'.._ '..,i-r-.. - - �^,�•.••.% - - .-r --- .. 1•u.fa 2t4 sl-ECPECSa 'AWSS�to RC tnrEC.90 nuM t o• ` WILD�.1-4tn1'E¢S 'Pli o4 fY�x.r.t,t R144t I / �H,I • 54w41£S-i..ucE cnCN�45 SIDE Plfr l:'f0 KIy Ht F�iJFnJ •fE cEnnil l:75 nu)•{0.u55 u4�(. . F1Nnl AZA*l OISS OES14N y(MnuF./REPeJwU (liE - .CC4nM1 OF (JUVSs� •1 ^ _ ' Ei tssr<I�upnn mien -- _. . \Y o 13n sM Nx , lsr, rs B"x8",n�'Coifc•1<Wc'-ccou I�L3z"` I .I �'t LitulaORY...RLG. wli'TNK.COLIC.Ff4.48^µIN•pEILnY ` I ®'I WaK-Pouci+. -" __ Tlf CIt! �\•fn:�v/Ehltt'S In 4 nV.:l4 FRE@VIpFD ..'�911•cIU -__ . 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