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Home My WebLink About0373 BAY LANE � ` ;�, � . � -� U ,� �, �. � I� ,. 4 p a 6 i, . c k R ,' � � � �� t 3 i k s i f y k Town of Barnstable _ Building d h Card ,. ., .ens�srwei� Post This Card SoThat it is;.Visible From the Street A pproved Plans Must be Retained on Job a n t is ar Must be Kept Posted Until Inspection HasBeen Madez "W 4', mm cb,,aa< Where a'Certificate of Clccu anc is Re uired such Bull' i g erllll" a p y q dm shall Not be Occupied until.a Final Inspection has been made Permit No. B-18-4032 Applicant Name: Lincoln Stubbs Approvals Date Issued: 12/11/2018 Current Use: Structure Permit Type: Building-Sheet Metal-Residential. Expiration Date: 06/11/2019 Foundation: Location: 373 BAY LANE,CENTERVILLE Map/Lot 187-002 Zoning District: RD-1 Sheathing: Owner on Record: FAVAT,PETER P Contractor Name. ,LINCOLN T STUBBS Framing: 1 Address: 23 COUNTRY ROAD Contractor.License: 122�6 2 LUNENBURG, MA 01462 _ '" N Est. Project Cost: $9,895.00 Chimney: Description: addition of ductwork to existing duct system to supply sunroom Permit Fee: $85.00 Insulation: Fee Paid: $85.00 Project Review Req: Date: .` 12/11/2018 Final: Plumbing/Gas : Rough Plumbing: s 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,theFapproved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road'and shall be maintained open for,public inspection for the entire duration of the work until the completion of the same. n Electrical W 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:( 1.Foundation or Footing w ` Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 0 N m.z,R— �+`� 9 1231 s J� Cape Save Inc. 7-D Huntington Avenue South'Yarmouth, MA 02664 s t Tel: 508-398-0398 Fax: 508-398-0399 10/12/18 . Brian Florence CBO Town of Barnstable BUILDING r Building Division s �+ 200 Main St. , ,` • . Hyannis,MA 02601 a OCT 1 8 201 TOWN OF BARN RE: Insulation Permit 18-1932 Dear Mr. Florence: } s ' This affidavit is to certify that all work completed for 373 Bay Lane,Centerville has been inspected by a third party Certified Building Performance Institute(BPI)Inspector. All work performed meets or exceeds Federal and State Requirements.'-' Sincerely, .,.. r William McCluskey, Town of Barnstable Building Post This Card So That it iSAWNSTASIZ sVisible?From the Street-ApprovedyPlans Must be Retained on Job and t 7 s rd Must be Kept Posted Until`Finallnspection Has Been Made jam 363q ♦� y r Where:a Certificate;of OccupaiicyAs Required,such Building shall Not be Occupied until asFinal In`spect�on has been made. . _ Permit No. B-18-1932 Applicant Name: William McCluskey Approvals Date Issued: 07/09/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: O1/09/2019 Foundation: Location: 373 BAY LANE,CENTERVILLE _Map/Lot: 187 002 Zoning District: RD-1 Sheathing: Owner on Record: GROSSMAN, DAVID Contractor'-Name-,,WILLIAM J MCCLUSKEY Framing: 1 Address: 23 COUNTRY ROAD ContractorLicense{ CSSL-102776 2, LUNENBURG, MA 01462 }:x a MEst Project Cost: $5,000.00 Chimney: Description: Add R-19 fiberglass, R-13 fiberglass,and R-10 rigid insulation to the :Permit Fee- $85.00 attic.Add R-19 fiberglass,and R-10 rigid insulation to the Insulation: crawlspace.Air seal the attic plane and crawlspace wrth expanding Fee Paid:: $85.00 foam. General weatherization. r Date 7/9/2018 Final: R Project Review Req: `_ p, ` - Plumbing/Gas t W� 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 a'nd theapproved construction documents for'which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and str:,ucture's 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 Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. 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" (asset forth in MGL c.142A). Fire Department Building plans are to be available on site 0 r, 2 Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT �1 Town of Barnstable *Permit# 06 gZ l Regulatory Services Fee 6monthsfro � e smxxsrnsLePR MASS.1639. $ Richard V.'Scali,Director e Building Division . JUN 0 9 2016 Tom Perry,CBO,Building Commissionl�/p' 200 Main Street,Hyannis,MA 02601 U I li BA"S�/�B L E www.town.bamstable.ma.us /`i Office: 508-862-4038 , Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY, Not Valid without Red X-Press Imprint Map/parcel Number j 87 04Z Property Address 7 aj etc C-A C G-WTC PQA t-05 Residential Value of Work$ 30W, Minimum fee of$35.00 for work under$6000.00" (Owner's Name&Address 'PE'MR- POyVA l !167", �L /660'1 � A%Je PACIFlC- PAC-1560E5 CA 902-12- Contractor's Name cQ L `ej Telephone Number .7d$ ZZl l Zd Home Improvement Contractor License#(if applicable) t Zq FIC Email: 60 LAC Y' R 0, 4.- GoM Construction Supervisor's License#(if applicable) C5 - 07 51�7'j3 ❑Workman's Compensation Insurance , Check one: R)I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance ` Insurance Company Name ' Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ` ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken,to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders.U-Value 0.51 (maximum.32)#of windows #of doors: O ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and d inspections required. Separate Electrical&Fire Permits required. 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 1 ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is r uir SIGNATURE: Q:\WPFILES\FORMS\building permit forms\E)PRESS.doc Revised 040215 I the Commorriveakh ofVassachusetts Departaretrt cof lrulmtrial Accidents Office of.lmxesti ations 600 Washington Srtreet. 4 ti Boston,M 02111 Workers' Campensatian Insurance Affidavit Bu ilderslContractors Elect cians/Plumbers Applicant Information Please Print Legibly Nye(BnsiIIess�rganiz�tionllndividnai} �� (./�G�� 3 5f%A it10(r� OQ�� Add:>:ess: t 7 , .. . CitSrlStatef I .JII-t-�= M•o' 02(.-P5r Phone ig,-_' z O 6 Z21 ' 7 2»I s 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 arrdtor part timed* have hired the sub-contractors; 6. ❑New consf:ucfion 2.[ I am a sale proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees. These sub-contractors have. 8_ ❑Demolition working for me in an capacity. employees and have wodmrs' b Y9. ❑Building addition [No workers'camp.insurance comp_insurance l rewired] 5. ❑ We are a corporation and its 10❑Electrical repairs or additions 3.❑ I am a homeoumer doing all work officers have exercised their 11.❑Plumbing-repairs or additions ' myf[No workers'camp- right of exemption per 1'i'fGL 12.El Roof repairs insurance required,]T c.152,§1(4X andwe have no �. employees.[No workers' 13.)4 Other Atj!OtIV Q camp_insurance required-] *Any apphcarrt drat checks box#1 must also fill ootthe section below showing their waskere compensation policy informzdcaL Hom mynen who submit ibis affidmit indkztmg they are doing all wat sad then]tire outside contractors amct sabmit anew affidavit indicating such- . (contractors that'back ibis boa mast attached an addid ad sheet showing the name of the sub-contracbm and state whether or not those entities have employees. Ifthesub-contm,ctarshave employees,they nrrstpradde their workers'comp.policy number. I am an�rnpl�oy`ar fJrcrtis prmRdrng iuorkers'corrrpensaliart irrsztrance for err}�enrpIaj es B'eIow is tltepoUcy and jab Sue information. , Insurance Company Name: Policy 4, or Self--ins.Lic.;9: Expip ionDate: Job Site Addr = CitylState/l rp: . Attach a copy of the wGrl-ers'compensation policy declaration page(shoving 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$1,5.00 OD and for one-year imprisonment,as we11 as civil penakies.in the form of a STOP WORK ORDER and a fine ' of up to$r250-00 a day against the-violator. Be adiised that a copy of this statement may be£arkvarded to the Office of Investigations of the DIA for insurance coverage verification.. I do hereby certi rit er the pains and penaTlies ofpedury tharthe informalionprm i&dabM'0 is 6=and correct Sit aa hire: Date: J� Phoneme `jog 7—u-1 Ze5, Official use only. Do not write in this.area,to be crrrnpl<eteel by city artown official w . City or Torun: PermitUcense,9 Issuing kuthortty(circle one): 1.Board of Health 2.Buffding Department 3.Cltyirown Clerk d.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts Geea hal Laws chapter 152 requires all employers to provide W03kms'compensation for tineir employees. PUrM.UMt`tD this ante,an.ernplayee is defined as."_-every Person i a the service of another ruder any contract of hire, express or implied,oral or Written.." An ernplayEr is defined as"an individma.I,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and inchuEng tine legal representatives of a deceased employer,or the receiver or trustee of an individual,pa taeasbip,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 oa the grounds or building appurtenantthereto shall not because of such employmentbe 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 Incense or permit to operate a business or to construct buildings is the commonwealth for any applicant who has not produced acceptable evidence of compliance with th-e insurance.coverage required-- Additionally,MGL chapter 152, §25CM states Neither tine commonwealth nor auy ofils political subdivisions shall eIlter into any contract.for the.perfopance-ofpublio woricuntil accepfable.evidence of compliance with the insuranc8.- requirements of this chapter have Been presented to the confra�a aufi ol*f ' 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 numbers) along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liabi ity-Part amships(LLP)withno employees other than the members or partners,are not required to easy workers' compensation insurance. If an LLC or LLP does have employees, apolicy is required. Be advised that this affidayit may be sued to the Department of Industrial Accidents for confirmation of fi sur noe coverage Also be sure to sign and date-he affidavit The affidavit should be rettmed to the city or town that the application for ilia permit or license is being requested,not the Department of n , ial A_'ccidehts..'Shouldyou have any questions regarding the law or ifyou are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-msured companies should enter their self-insurance license number on the appropriate line. City or Town Of f - Please be sun a that tilt affidavit is complete and pried Iegil ly. The Department has provided a space st the bottom of the affidavit for you to fill out i a tine event the Office of Investigations has to contact you regarding the applicant Please be sure to fill is the peffiitllicrose number which will be used as a reference number. In addition, an applicant that must submit multiple pitllicens e applications in any given year,nee ffi d only submit one adavit indi enn cating current policy hifbrmation(if necessary)and colder"Job Site Address"the applicant shoT,ld write"all locations is (city or town)_"A copy of the-affidavit that:has been officially stamped or marked by the city or town may b e provided to the applicant as proof that a valid affidavit is on file for furore permits or licenses A new affidavit must be tilled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (Le. a dog license or permit to burn leaves etc.)said person is NOT rcgmred 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 Dep7-t amfs address,telephone and fax number: Tht Cow wes.lth-of Masachusj--tfs Df-parimant cif Iladu�,ltziak Aocidcnts ; ice oflvestigatio-ems �Qt1_Wasbiz$Gn.St»t , Bastou4 MA 01 1 I I Tf,-L 4 617'27-4900 Qxt 406 or i-a77=IAS F., Fax 4 617-727 7M Revised 4-24-07 maQ erft�ia oFTHE ray * snaxsrnsts, • MASS. s639. Town 9� �� own o , �erEp�p Regulatory Services Richard V.Scali,Director 'Building Division Thomas Perry,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 ct property hereby authorize to act on my behalf, in all matters relative to work authorized byZ building permit application for: r (Addy ss of Job) S a o caner ate V',0A Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. , y Q:\WPFILES\FORMS\building permit formsMTRESS.doe Revised 040215 Town of Barnstable Regulatory Services oFIMME rOyti Richard V.Scali,Director Building Division t BALM STA1314 ' Tom Perry* Building Commissioner Q Mnss. 9� 1639. �� 200 Main Street, Hyannis,MA 02601 ATEo �F www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village; "HOMEOWNER": name home phone# work phone# . CURRENT MAILING ADDRESS: - city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEF gMON OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner " Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFELES\FORMS\building permit fonms\EXPRESS.doc Revised 040215 f t of Public Safety Massachusett nD Rartmen egulations and Standards Boa rd of Building -075573 License: Supervisor Construction Supe EDMUNDVLACEY`JR 137 STURBRIDGE _ OSTERVILLE M 0 Expiration: 0911912017 Commissioner Construction Supervisor Restricted to: Buildings of any use group which contain Unrestricted- gc 1 cubic meters)of enclosed less than 36,000 cubic feet( s,P,• space. Failure the Massachuse�ttts to possess a current e f i floe ocat on of this license. ; Code is cau State Building YV1Nw•MASS.GOVIDPS DPS Licensing information visit: &oadwoeM ' Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home-Improvement Cbnt�ractor Registration �--_ Registration: 129816 Type: Individual T 273166 r21, Expiration: 11/8/2017 z�' r EDMUND V. LACEY JR. EDMUND LACY JR. ' a 137 STURBRIDGE DR. . OSTERVILLE, MA 02655 - I r` w r1M. ��F Update Address and return card.Mark reason for change. Address .� Renewal Employment El Lost Card SCA 1 % 20M-05111 C�Jhe 1pomvrraarocueccl��i a��lvGa�ac�cuaeC License or registration valid for individul use only Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: IMPROVEMENT CONTRACTOR Type Office of Consumer Affairs and Business Regulation UqME gistration: :129816 10 Park Plaza-Suite 5170 lration 1l8�2{Lf7 Individual P" Boston,MA 02116 . } — f?J ? EDMUND V. LACEY J A. EDMUND LACY JR. 137 STURBRIDGE DR OSTERVILLE,MA 02655 �_� Undersecretary of valid without signature Town of Barnstable Conservation Commission Form ICI WLRNSTAB`X' 200 Main Street i659. a`® HY annis Massachusetts. 02601 Fp ru�'t Office: 508-862-4093 E-mail: conservationCccDt own.barn stab le.ma.us Fax: 508-778-2412 Pier Maintenance Form for Marine Contractors SE3--3 �9_� Original Applicant's Name:` Project Location 3(3 m2p: l Parcel: w -w!'z n piers- - As a marine contractor doing business within the Town of Barnstable, you are expected to comply with the following requirements for maintenance of docks or piers and their associated structures. Please complete and return to the Conservation office prior to work. When considering maintenance work:' ❑ Your customer's name: Verify that a Certificate of Compliance was issued forthe structure.If no Certificate exists,no maintenance may be performed. ' 1 5$v el O S )VU'J. 700 Z ❑ Review the most recently approved pier plan.To be sure,back-check with the approved plan date in the Order of Conditions and any subsequent revisions. Noti ry Conservation Division staff of any deviations between the approved plan and.the existing structure. If the above conditions are satisfied,move on to..: ❑ Notify Natural Resources Division of your intent to'perform maintenance and give them an accurate start-up date. Provide the Conservation Division with an accurate start-up date for your maintenance work. Date: 2�J� ❑ Comply with all conditions in the Order of.Conditions and Certificate of Compliance. tJ Comply with d1w appruvcd Dian. Rcn]einbcr: Where as-buu.pie].fvolp ]ills n;.e in conflict with.flw approved plan or special conditions,approved plans and conditions shall govern.. ��+�� ❑ Of special note: 'A. No creosote-treated wood allowed;CCA-treated wood only for large- diameter pilings and structural timber B. Pilings driven;jetting only for initial pilot hole C. Work mid-tides and higher to avoid grounding D. Deck plank spacing at least 3/4". Grated decking to be replaced in-kind.. E. No lead caps on pilings F. The DF.P permit number and street address(at least)shall be permanently , a d conspicuously placed on the dock so as to be visible from seaward`= Please ca us at 508-862-4093 for ass lance pcmut verification. Thank you for your.cooperation. , Your Name Contractor's Signature Plion.e Number Date Q:',('onservt\i)GPFORMSTorm M.doc Ems:t4m1 0 ,(Z. i A 1� l _36(4�p 1-43_,:;� Town of Barnstable *Permit# 1F1E � Expires 6 months from issued e ` Regulatory Services Fee XAS& Thomas F.Geiler,Director 619• Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.townbarnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number ') Property Address 313 G'P�,`/ L"b esidential Value of Work$ 2vta Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 6Tc= F✓ VA-1 3"f 3 0A-1 L,ANa Cl:vy ie�(t�f(�l,C t ►��' t�Z63Z- Contractor's Name CQ L-ACZ 1 Telephone'Number Home Improvement Contractor License#(if applicable) Ems: EEO. LASS ` TOL Q Cr W%10h L- • toM Construction Supervisor's License#(if applicable) C`3 -T 5 5^l 3 �s� E r%r"'M 0 a 1"A ❑Workman's Compensation Insurance Che ne: SEP 16 2013 Lcff I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Requ (check box) ra— RTRe-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to (32NST14f3L t� 'C-IZAr"S 1'' ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *where required: Issuance of this permit does not eicempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Prope Owner must sign Property Owner Letter of Permission. A py o the Home Improvement Contractors License&Construction Supervisors License is r quire . SIGNATTUTREs QAWPFl1M\F0RMS\building permit forms0TROS.doc Revised 060513 '1 .... .. ... ..... ... . ... .... .... e Comtnonnfeakh ofMassachusefts Department ofI7dk3&id Accidents - Office of Invesfigafiens ... . ' 600 Wla hingfon,S`treet Boston,M,4 Q2I1'.I wnnm 7nass go 1dia Workers' CompensatiouInsuranceAffidavit:Btrilders/ContractursfE ectricians/Plumbers Applicant Infarmation Please Print Lmibly Name 00rA%A,^/0 J, t.Auy T(L. Address: i3'7 5rzH(ZBt2t0&4 Oatue' City/State/Zip: l i)r OU.S-�_ Phone 4-772�'� Are you an employer?Check the appropriate bGx: Type v#, o.ect r . 4. I am a contractor.and I YISe Pa' .I �s��= 1-❑ I am a employer with l� 6. ❑New construcfiion oyees(full and/orpart-fmae}* have the sub-contractors 2: am a sole proprietor orpartner- listed on the attached sheet 7_ ❑Remodeling ship and bane no employees These sub-contractors have: g- ❑Demolition working for me in any capacity. employees and have workers' 4. El Building addition workers' comp.insurance comp.insura,�I required-] 5_❑ We are a corporation and its MCI Electrical repairs or additions 3.❑ I am a homeowner doing all wordy officers have exercised their 11.F]Plumbing repairs or additions mywIf [No workers'comp. right of exemption per MGL 12_0 Roof repairs c. , 1 4, instt3tnre r-e�re-]$ 152 § and we hmm na( ? 13.0 Other employees-[No workers' comp.insurance required-] *tiny WpUomt that checks boa#r1 mast also fill out the section below showing iheu wadreis'compensation:policy aafiOrnntio u. T Homeowners who submit this afidxvh indicsting they axe doing all wa l mad then hire outside contractors inn#submit a new affid3uh inericating such TC'ontrwrors that check this boot nwst attached m additional sheet showing the nave of the s 2mrs and stale whether ornot tbase entities h3ee employees. Ifthe sub contmaurs Lwe employees,they oast provide their workers'comp.policy number. I am an employer that is prmidYng workers'compensadan inuurance far azy emplayeco: Below is the polfcy and jolt site in}brmatiam Insurance Company Name: Policy#or Self-ins.Uc_ ExpirationDate: 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 o€1'tjiGL c. 152 can lead to the imposition ofaiminal penalties of a fine up to S1,500.0a and/or one-year itnluisanment,as well as civil penalties in the,form of a STOP WORK ORDER and a fine of up to P50-DO a.day against the violator. Be advised that a copy of this statement may be forwarded to the Office of hLvestigations of the €ar instmaace coverage tmrffic.aation. I do hereby cerhjy i tkspru rs and penalties ofperjury thatthe�injbr meian provided above rs true and correct Sitnrature Date: 1 L ! 3 Phone Olic al use only. Do not write in this area,to be completed by city or town officiaL gly or Town: PermitUcense It I sning Authority(drde one): 1.Board of Health 2.Building Department 3.Cityfrown Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuanttto 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 Iocal 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 auy applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGI;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 ofinsurarnce 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 lime. 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 oa file for future permits or licenses. A new affidavit must be filled out each year.Where a homeowner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required 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 Depazt ment of 1i dustrial Accidents Office of kvestigatiGm 600 washvvon street Bostoi4 MA 42111 Tel.A 617-727-4900 cxt 406 or 1-377-MASSAFE Revised 4-24-07 Fax#617-727-7749 - w ,mamgovfdia ^fFFF+ a• oFmE r Town of Barnstable Regulatory Services �sn M�r.Eg* Thomas F. Geiler,Director �A 0.19. r�r„A.ca Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnsta6le.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 Lp to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final Wuanrformed and accepted. Signature of Applicant Print Name Print Name Date Q:FORM&OWNERPERMISSIONPOOLS 62012 I 1 THE>b Town of Barnstable Regulatory Services 9KABS, Thomas F.Geiler,Director �] bg9 i . �0 �E 639.t• 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 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control., HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homedwner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\ContentOutlook\QRE6ZUBN\EXPMS.doc Revised 053012 INlassachusetts- Dcparhncnt of Puhlic Safct, Board of Building Regulations and Standards Cott T[> iMiori 5�7pe>�7isi3f��n"?y� *J c License. CS 75573 EDMUND V LACEY JR 137 STURBRIDGE DR OSTERVILLE, MA 02655 Expiration: 9/19/2013 ('ununissiuncr Tr#: 3945 Orffice of Consumer Affairs&a3 sines.¢Regulatlohn y r I cepse;or t•egistration yalidlfor indrvidul use only HOME IGAPj20VMENT CONTRACTOR S1 Before tlie-�zpiration date If found return to wX Re�rstr�tioll„f� gg16� �Ty '- ffice of Consumer Affairs and Business Regulation .Expiration: 11/8/2013 Individual; � YU1 Plark�Plaza=Suite 57°�`fi F } Boston,M 116 ED. NO V LAC YkJR t` EDMUND LACY JR 4 f 137 STURBRIDC-,fr DR {k I € OSTERVILLE, MA 02655 Undersecretary. Not valid without signature i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION i 1�I1V Map Parcel ; ' Application # Health Division Date Issued Conservation Division =' Application Fee Planning Dept. Permit Fee l �� SYr? w a-K/Od L IFI'CS Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis V s Project Street Address Village CLN r c;6Z Ji LLC Owner 106T6 ftNp NMI r0kVA1r Address 3-73 13A'Y L-aWE Telephone Permit Request 2c Mov a, S RF_ 0T2oGK- a lk/O t(*fSu LAT'oa✓ >'(Z0 it 47T-r i C f2 P AC-6e uN 9 i/ w_ S C r✓�zT 1�1r' er-raw a-af n t-i G of.T AA It, fZ ez- v o'er Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District 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 Ki g's Highway: ❑Yes ❑ No Basement Type: ❑ Full Crawl ❑Walkout ❑ Other ��I �_ =k Basement Finished Area (sq.ft.) Basement Unfinished Area(sgcift) ry Number of Baths: Full: existing new Half: existing 91 Sew r Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: �ill Gas ❑ Oil ❑ Electric ❑ Other Central Air: $2 Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size — Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name E 1ACeY !!A. Telephone Number 50'T 1 - 12-J Address �3'7 5T vi 9hP I Q 6-i PiZi ✓tom License # o 5-rc f?_%1 1e.[.1� dnti" p Home Improvement Contractor# V?a IF f Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE a® 1.a i4 .4 FOR OFFICIAL USE ONLY C APPLICATION# DATE ISSUED r`. MAP/PARCEL NO. k ADDRESS VILLAGE s: OWNER DATE OF INSPECTION: FOUNDATION FRAME r INSULATION FIREPLACE i ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS,'-, : �-:- ROUGH _ FINAL 'FINAL BUILDING' a° 'g A DATE CLOSED OUT i ASSOCIATION PLAN NO. l . i s The Commonwealth of Massachusetts f Department of in ial AccideiztsLL + Office of Investigations 600 Washington Street r Boston,MA 02111 j www.mass go v/dia Workers' Compensation twurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le0bly Name{Business/Organization/Individual): Address: 1 cA �'L l iae tV45,- r. Ci /State � � /Zi �' P• � '�Phone#: . �S 22i 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. I am a sole proprietor or partner- listed on the attached sheet t 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. Demolition workingfor me in an capacity., o y parity. workers' comp. insurance: 9 Building addition on [No workers comp. insurance 5. ❑ We are a corporation and its ❑ g required.] officers have exercised their 10 ❑ Electrical repairs or additions 3,❑ I am a homeowner doing all work 'right of exemption per MGL 1 l,.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] t. employees. No workers' comp. insurance required.] 13.❑ Otlrer _ *Arty applicant that checks box#I 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 their workers'comp,policy information. 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 Dater 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 der rtthe eppains andpenafties ofperjury that the information provided above is true and correct Signafore: / Date: /U Phone [6. fficial use only. Do not write in this area,to be completed by city or town offcciaL ty or Town: Permit/License# uing Authority(circle one): I. Board of Health 2. Building Departinent 3. City/Town Clerk 4, Electrical Inspector S. Plumbing Inspector Other ntact 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." f MGL chapter 152, §25C(5)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 com liance " P p with the insurance coverage required." q 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"lob 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 proofthat a valid affidavit is on file for fist ire 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 t or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would hke to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA G2111 Tel. # 617-727-4900 ext 406 or 1-977-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass..gov/dia —' Massachusetts- Department of Yubhc Jaime: Board of Buildinq, Re!lfulations and Standards Restricted to: 00 EDMUND V LACEY JR 137 STURBRIDGE DR a f OSTERVILLE,.MA 02655 Expiration: 9/19/2011 ICommissioner Tr#: 4667 / �ne iJarrvmaouea a�✓iGaaaaerru6e t �r Lrcerise or registration valid for'indiyidul use only Office of Consumer Affairs&Sus�aessiegufao before the expiration date If found return to HOME JNLPW EMENT CONTRACTt s t Office of.Consumer Affairs and{B3sfnesseRegulation Registration's 129816 10 Park Plaza Suite 5'170 Ezpiration #'291490 Boston,MA 02116 . Type.lrz�"40Pdavtdusl EDMUND V.LACEY JR EDMUND LACY JR 13T: TURBRIDGE"DR= r OSTERVILLE, MA 02656_ Undersecretary Not valid without signature TIE Tp�� + BARNSTABLE, MASS i63iq- ,0 Town of Barnstable Regulatory. Services Thomas F. Geiler,Director ".Buildin Di .- g.; v><sion Thomas Perry,CBO Building Commissioner 200•Main Street, Hyannis, MA 02601' www.town.barnstable.ma.us Office: 508-862-4038 'Fax:" 508-790-6230 v Property Owner Must * .Complete and Sign This Section - If Using A Builder '5�4-- 4 I, as Owner of the subject property hereby authorize to act on my behalf, . in all matters relative to work authorized by this building ermit application for: s gwner (Address of Job) -: . �. Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form qn the reverse side. Q:\WPFILESTORMS\building permit forms\EXPRESS.doc Revised 072110 Town of Barnstable ti Regulatory Services " IBLA a B Thomas F. Geiler, Director �Ore1,,Nr0. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 598-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print S DATE: JOB LOCATION: number street village "HOMEOWNER". name home phone# work phone# CURRENT MAILNG ADDRESS: city/town state_ zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building?permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, rules and regulations. . The undersigned"homeowner"certifies that he/she understands the Town of,Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. . HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building p&mit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such.Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit formsTXPRESS.doc Revised 072110 v 373 Bay Lane , Centerville i b1: f ,III 73 Bay Lane , Cent ille 8/2/ 10 40 't 3 Bay Lane , Centervil� , 8/2/ 10 373 Bay Lane , Centerville 8/2/ 10 z i I h r �r Po �ya��,s, t�a. o2Coo v 1ceft �' 137 Ma � °S 5 � owner onro Owner,DELNEGRO, JOAN EM & MARK R Streeti 99 ROSEMARY LN city :CENTERVILLE Land Info Acres 0.36 use Single Fam MDL-0 Topography Level utilities Public Water,Gas,Septic Construction Info Permit History Visit History Date Who 7/1 7/2007 12:00:00 AM Paul Talbot 4/25/2006 12:00:00 AM Martin Flynn 1/18/2005 12:00:00 AM Martin Flynn 12/20/1999 12:00:00 AM Paul Talbot http://issgl2/intranet/i)arcelinfo/Parce]Detai l.,i.nx?Tn_c) TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel ?_ ` Application # Health Division = 1,wd Date Issued l Conservation Division 1)K 9610 Application Fee � Planning Dept. Permit Fee ZO OD Date Definitive Plan Approved by Planning Board Historic OKH Preservation/ Hyannis C 16h3169 h Project Street Address ?J� Qty L/A igi5 ' Village C 1E N Tole, LI.LI� Owner '. 96Te2 (--ARIA 1 Address 53!6 tJoafill Ah16,., w6s-ib/J. rAA Telephone �- Permit Request 1P-1E wi-D ey, sny JJ WOc6 DecK, Square feet: 1 st floor: existing proposed 2nd.floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family" ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) f� Number of Baths: Full: existing new Half: existing new S 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 0 new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: € j+Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ o� o ° -a Commercial ❑Yes ❑ No If yes, site plan review# �„� , _ Current Use Proposed Use oa APPLICANT INFORMATION w rn (BUILDER OR HOMEOWNER) Name 1�0 tAsEl Tit. Telephone Number 'DOZ 221 MI Address )37 S14OZ 3 (L(a&e�r nR • License# C 5 ? SSA 3 Osf&R yic..Le v^Pr QZs S<- Home Improvement Contractor# ! Zc3 �t 6 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO 13AX%ys J`Jk(3 L L 'f(Z AfJ5lFWL STAT/d it/ SIGNATURE ot- � DATE " Zd`8 t .f FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE P J OWNER 1 DATE OF INSPECTION: FOUNDATION -FRAME - INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL,., -PLUMBING: ROUGH FINAL .•GAS: ROUGH FINAL FINAL BUILDING 1 . DATE CLOSED OUT, ASSOCIATION PLAN NO. " Al Vie Comrnonwealth of Massachusetts _ Department of Industrial A ccidents Office of Investigations .600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Tnsurance Affidavit: Builders/Contractors/Electricialis/Plumbers Applicant Information Please Print Le 'bl Name(Business/Organintionandividual): L . A(-E lit. 65 Address: t'��l STl.�2(ri2.i�[rG' fl2 City/State/Zip: OSI RVtt-�L, �I�Pr Q2b'S� Phone*: '`7 O7.' ZZi - ZZ1 S Are.you an employer? Check the appropriate boy: Type of project(required):• 1,❑ I am a employer with 4. 0,1 am a general contractor and I 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors . listed on the attached sheet. 7. ❑Remodeling 2 I am a'sole proprietor or partner- ship and have no employees These sub-contractors have g• E] Demolition working for me in any capacity. employees and have.workers' 9 Building addition [No workers'comp.dnsurance comp. nsurance.t 5. [] We are a corporation and its 10.[]Electrical repairs or additions required.] . Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required]t c. 152, §1(4), and we have no employees. [No workers' 11D Other comp.insurance required.] "Any applicant that checks box#1 must also.fill out the section below showing their workers'compcnsation policy information. t Homeowners who submit this affidavit indicating they are doing an work and then hire outside cant-actors must submit a new affidavitnndicating such. xContractors 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. Lie.#: Expiration Date: Job Site Address: City/StatcMp: 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 c fy er the nd penalties of perjury that the information provided above is true and correct. Si afore: Date: _ Phone# �� $ 2-'Z-� • 2-t S� Official use only. Do not write in this area, to be completed by city or town offcciaL 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#t:. r Information and InsAr'u.ctions 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, of 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." AdditionaIly,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, i.f necessary, supply sub-contractors)name(s), address(cs) and phone numbcr(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 nurnber listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Towli Officials Please be sure that the affidavit is complete and printed legibly. The D epartment 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 an applicant pp Please be sure to fill in the permitllicense number which will be used as a reference number. In addition, only submit on affidavit indicating current that must submit multiple permit/license applications in any given you, need y e g 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.Whcre a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required 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 r• The Department's address,telephone-and fax number: The Commouwf,-4th of Massachusetts Dep ent of Iadustrial Accidents,µ Office of Investigations . 600 Washington Street Boston, MA 02111 Tcl. # 617-727-490.0 ext 406 or 1-V7•-MASSA.FE Fax# 617-727-7749 Revised 11-22-06 www-.ma-s5.gov/d.ia - Massachusetts-Department of Public Safety: . Board of Building Re�-ulations and Standards Construction Supervisor License License: CS 75573 Restricted to: 00 EDMUND V LACEY.JR 137 STURBRIDGE DR OSTERVILLE, MA 02655 � - f—� Expiration: 9/19/2011 Commissioner Tr#: 4667 _..;, ✓lie T9aritinuY�sueal��aa � ;��,�' ? '*��x z T � �a Board of Building Regulations u�d St�noai�'s nY;Gene or registration valid for mdrv%dul use only .� ,r. HOME IMPROVEMENT CONTRACTOR, !' t fcfore the ezp►rahon date.;; found return tot Registration 129816 �b fd of Bu'ifdmg Regulations and Standards: 1 31u�on Place Rm 1301 kh; Expiration1/8/2009 Tr# 260135. $oston,Ma:021.68"' g-t Type Individual EDMUND V.LACEY JR ' F EDMUND LACY JR`� r X�AfLl 137 STURBRIDGE,,DR ' Not valid without signature. OSTERVILLE,MA 0295-�` Administrator i , ,pp o¢THer Town of Barnstable a Regulatory Services s�B�'� Thomas F. Geiler, Director CD ya 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, �ere L 7-6%/A 1 ; as Owner of the subject property hereby authorize L 0 LACevll to act on my behalf, in all matters relative to work authorized by"this building permit application for: (Address of Job) -1 Signature of wne D to Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form. on the reverse side. Town of Barnstable �OpTHE rgy� yw� o„ Regulatory Services " Thomas F. Geiler, Director +' BARNSTABLE, !` Q MASS. 1659. Building Division �1E0►.AA't A Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS- city/town state zip code The current exemption for"homeowners"was extended to include owner-occ6�ied'diwellings-of six.units'or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not.be considered a homeowner. Such "homeowner" shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1:1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official ` Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from.the provisions of this section(Section 109.1.I -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to-do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. l I�O.w�rj CAr��. �lC rr-I t�nJ rei xo v r S� F-42 - Alr i-Uo0 F�Lv TIME r Town of Barnstable Regulatory Seivices # Y * BARNSTABLE, 9 MASS. g Thomas F. Geiler,Director _ �A i63q. �0 rF0:%q Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 September 18, 2008 Peter Favat 535 North Ave. Weston, Ma. 02493 RE: 373 Bay Ln., Centerville Map: 187 Parcel: 002 Dear Mr. Favat: This letter shall serve as record that this office is in receipt of a copy of an enforcement order issued by the Town of Barnstable Conservation Commission. The enforcement,, order includes the building code violation previously brought to your attention in a letter sent by this office dated August 27, 2008 and, therefore; this office will delay further action until after the show cause hearing scheduled October 21, 2008. The stop work order remains in effect until such time that this office issues a building permit. By Order, ®rQe?-1$�L/aAu7o—n Local Inspector Q:zoning5. �pIME loy, Town of Barnstable Regulatory Services ' BARNSTABLE, Thomas F.Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 August 27, 2008 Peter Favat 535 North Ave. Weston, Ma. 02493 RE: 373 Bay Ln., Centerville Map: 187 Parcel: 002 Dear Mr. Favat: In accordance with 780 CMR 5118.6 you are hereby notified that a stop work order has been issued on the above property for violation of 780 CMR 5110.1 which states in part "It shall be unlawful to construct, reconstruct, alter, repair, remove...without first filing a written application with the building official and obtaining the required building permit and all other required permits therefore." You must contact this office and arrange for compliance. Failure to do so by September 10, 2007 will result in further action which may include criminal prosecution and/or fines for each day the violation persists. Please call this office at (508) 862-4034 with any questions. Thank you for your anticipated cooperation in this matter. By Order, *r L. Lauzon Local Inspector Q:zoning5 e-I"— . a a � 4 n I � r � s k l � 373 Bay Ln. Cent., 8/21/08 # .m ' ,x �u rrt C,✓nX � V �,n a r� .0� ' t, t>. " I x � N o ee v fro 1 t �`: r�✓-" { AN I1;1 � � � .`�`,".� � AYY�� ^bf'� ,f"S �� §' 3 ?31� n •,.�., ..,•.n... .»«..w.z.�,Si,�r.su.n. 's 'i r �= H "s' t a µ �p Town of Barnstable Regulatory Services * BMWSTABLE, 9 MASS. Thomas F.Geiler,Director �p .s6g9 ♦� rE1639 a Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 June 4, 2009 Peter Favat 535 North Ave. Weston, Ma. 02493 RE: 373 Bay Ln., Centerville Map: 187 Parcel: 002 Dear Mr. Favat: This letter shall serve as notice that this office has observed that a stop work order issued on August 21, 2008 by this office has been (without authorization) removed from the above referenced address. Furthermore, as you may recall, this office delayed further action on same pending an agreement with the conservation department. As you are aware, a site plan has been approved by the conservation department and still this office has not received an application for a permit for the deck. Failure to obtain a building permit by June 18, 2009 and the subsequent inspections thereafter will result in this office to pursue further action, including, but not limited to, fines for each day the violation persists. The stop work order remains in effect until such time that this office issues a building permit. By Order, eL4az on Local Inspector Qzoning5 l 4 NAME OF OFFENDER Ed ADDRESS OF OF END R TOWN OF BARNSTABLE CITY,STATE.ZIP° } 4' r �tHE YD� s MV/MB REGISTRATION NUMBEfl; , BARNSTABLE. OFFENSE .......- d C'� Y MASS. 8. � 639 r ,0p.\ .. �gy kGr��.,FD IAF �_�F4.d no') TIME AND DATE OF VIOLATION L•U N F VIOC'A ON 4P NOTICE OF a:, SIGNATURE OF ENFORCING PE SENFO DEPT BADGE NO_ W VIOLATION ,,:-- , a OF TOWNq HEREBY ACKNOWLEDGE OiPT OF CITATION X, ` a` Unable to obtain sign ur o off nd w' ORDINANCE THE NONCRIMINAL FINE FOR THIS UFFENSE{IS So � w Date mailed , OR YOU HAVE THE FOLLOWING AL ERNAT ES WITH REGARD TO DISPOSITION OF.THIS MATTER EITHER'OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL DISPOSITION WITH NO.RESULTINGCRIMINALRECORD.. REGULATION (I)You may elect to pay the above fine,either by appearing in person between 8 30 A.M.and 4 Oil P.M: Monday ,through Friday legal holidays'excepted rw before:The Barnstable Clerk;200 Main Street,Hyannis,MA 02601,or by mailing a check,honey order or postal note to Barnstable Clerk;PO Box 2430 J 4, Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE.OF THIS NOTICE:: r ' r 3., B2))If you desire to contest this matter in a noncriminal proceeding,you may 60 so by making wntten request to DISTRICT COURT DEPARTMENT FIRST ARNSTABLE DIVISION,COURT COMPOUND,MAIN STREET,BARNSTABLE,MA 02630 Attn:21 D Noncnmmal Heanngs and enclose a copy of this citation for a hearing. (3)If you fail to pay the above offense or to requasi'a hearing within 21 days;or if you fail to appear for the hearing or to pay,any fine determined at the hearing to be due,criminal complaint may be issued against you. ❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ xt t n _��Signature Massachusetts Department of Environmental Protection DEP File Number: oFtro,y Bureau of Resource Protection -Wetlands WPA Form 9 — Enforcement Order " B MASS.`��, Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 ass �0t 163q A�0 §237-1 TO §237-14 TOWN OF BARNSTABLE CODE fp MpN A. Violation Information Important: When filling out This Enforcement Order is issued by: forms the Barnstable September 16, 2008 computer, r, use only the tab Conservation Commission(Issuing Authority) Date key to move To: your cursor- do not use the Peter P. Favat return key. Name of Violator 535 North Avenue,Weston, MA 02493-1839 Address 1. Location of Violation: as above Property Owner(if different) 373 Bay Lane Street Address Centerville 02632 City/Town Zip Code map 187 parcel 2 Assessors Map/Plat Number Parcel/Lot Number 2. Extent and Type of Activity(if more space is required, please attach a separate sheet): Alteration in a resource area, flood zone, by rebuilding and extending deck (168sq.ft.)and placement of old deck under it. Alteration in a resource area by construction of anew 8.5'by 8.5'deck and removal of vegetation. (shrubs). Alteration in a resource area, flood zone, by addition of light post and alteration in a resource area, marsh, by phragmites removal. Unauthorized activity beyond the scope of an order of conditions (SE3-3497)and approved plan by adding 3 additional canoe racks to permitted boardwalk B. Findings 9 The Issuing Authorityhas determined that the activity described above i y e s in a resource area and/or buffer zone and is in violation of the Wetlands Protection Act (M.G.L. c. 131, §40)and its Regulations (310 CMR 10.00), because: ® the activity has been/is being conducted in an area subject to protection under c. 131, §40 or the buffer zone without approval from the issuing authority(i.e., a valid Order of Conditions or Negative wpaform9a.doc•rev.7114/04 Page 1 of 4 Massachusetts Department of Environmental Protection DEP File Number: oFIKE Bureau of Resource Protection -Wetlands WPA Form 9 - Enforcement Order 8ARN3`"B`��' Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 �•`` §237-1 TO §237-14 TOWN OF BARNSTABLE CODE ED MA'f C. Order (cont.) ' ❑ Complete the attached Notice of Intent(NOI). The NOI shall be filed with the Issuing Authority on or before: Date for the following: No further work shall be performed until a public hearing has been held and an Order of Conditions has been issued to regulate said work. ® The property owner shall take the following action (e.g., erosion/sedimentation controls)to prevent further violations of the Act: see attached sheet Failure to comply with this Order may constitute grounds for additional legal action. Massachusetts General Laws Chapter 131, Section 40 provides: "Whoever violates any provision of this section (a) shall be punished by a fine of not more than twenty-five thousand dollars or by imprisonment for not more than two years, or both, such fine and imprisonment; or(b)shall be subject to a civil penalty not to exceed twenty-five thousand dollars for each violation". Each day or portion thereof of continuing violation shall constitute a separate offense. D. Appeals/Signatures An Enforcement Order issued by a Conservation Commission cannot be appealed to the Department of Environmental Protection, but may be filed in Superior Court. Questions regarding this Enforcement Order should be directed to: Darcy Karle Name 508-862-4093 Phone Number M-F 8:00 am -4:30 pm Hours/Days Available Issued by: _Barnstable Conservation Commission wpaform9a.doc•rev.7/14/04 Page 3 of 4 Massachusetts Department of Environmental Protection DEP File Number: oFt►+�,� Bureau of Resource Protection - Wetlands ti WPA Form 9 — Enforcement Order 8A1� ' � Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 �pt 163q A�0 §237-1 TO § 237-14 TOWN OF BARNSTABLE CODE ED MP'f B. Findings (cont.) ❑ the activity has been/is being conducted in an area subject to protection under c. 131, §40 or the buffer zone in violation of an issuing authority approval (i.e., valid Order of Conditions or Negative Determination of Applicability) issued to: Name Dated File Number Condition number(s) ❑ The Order of Conditions expired on (date): Date ❑ The activity violates provisions of the Certificate of Compliance. ❑ The activity.is outside the areas subject to protection under MGL c.131 s.40 and the buffer zone, but has altered an area subject to MGL c.131 s.40. ❑ Other(specify): C. Order The issuing authority hereby orders the following (check all that apply): ® The property owner, his agents, permittees, and all others shall immediately cease and desist from any activity affecting the Buffer Zone and/or resource areas. ® Resource area alterations resulting from said activity shall be corrected and,the resource areas returned to their original condition. ❑ A restoration plan shall be filed with the issuing authority on or before Date for the following: The restoration shall be completed in accordance with the conditions and timetable established by the issuing authority. wpaform9a.doc•rev.7/14/04 Page 2of4 Peter P. Favat—Enforcement Order The property owner.shall attend a show cause hearing to be held at the Barnstable Town Hall, 367 Main Street,Hyannis, 2°d floor Selectmen Conference Room, October 21St at 9:00 am. The property owner shall bring the upper deck back to compliance (8' x 21').by, removing the newly extended area by November 18, 2008. Remove decking below and lumber by same date. The property owner shall remove the ground level deck(8.5ft. x 8.5ft.)by November 18, 2008. The property owner shall submit a replanting sketch plan showing the area disturbed by the construction of the ground level deck, replanted, by November 18, 2008. Shrubs shall be chosen from the approved planting list(3 to 5 gallon pot size) and cover disturbed area including one large shrub, to replace the one shown in the 2000 and 2002 photo. Planting shall be in consultation with staff. Planting shall be completed by May 16, 2009. Any shrubs that do not survive a three year growing period must be replaced. The property shall remove the 3 unpermitted canoe racks and light post by November 18, 2008. The property owner shall cease and desist cutting the phragmites back. The property owner shall set up compliance inspection with staff by November 24, 2008. A second inspection for the replanting must be set up by May 30, 2009. Massachusetts Department of Environmental Protection DEP File Number: oF,THE Bureau of Resource Protection -Wetlands WPA Form 9 — Enforcement Order ST"B' �" Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 q'Ar 6•`` §237-1 TO § 237-14 TOWN OF BARNSTABLE CODE. fD MP'� Conservation Commission signatures required on following page. D. Appeals/Signatures (cont.) In a situation regarding immediate action, an Enforcement Order may be signed by a single member or agent of the Commission and ratified by majority of the members at the next scheduled meeting of the Commission. Signatures: 1,11L' Signature of delivery person or certified mail number wpaform9a.doc•rev..7/14104 Page 4 of 4 I-------------"—NAME.OF OFFErNDPR --- — ----- --------- .__._—._� 1 TOWN OF 76886- ADDRESS OF OFF�DE(1 i . BARNSTABLE CITY,STATE,rZIP COQE. y y� �1 P I i 1rd� S. i�wLle y!d"7 4J'F. 9 93 a F pf t Ip� �" MV/MB REGISTRATION NUMBER OFFENSE "',-•.^^",. !TABS CL �� ) A AWR,• �a��. dj ]( •�! - �� .679• �0� `",r ��`1I'ir'AJ 1 �~�n�6.,9 .14 �`�w�, .. - W':i �fD MAC , p y O `r+` �s..,. �•��J�'131 y�+�;;��a•j4; +,p+ 4� > TIME AND DATE IOLATION _ >� -r r.., LQ•(�`ATION VIOLA��JJJDDD NOTICE OF �' (A.K ON 4 ,✓ N 2 61 �[' /�� y Q`��y SIGNAT�k.x KING PERSON ENF VIOLATION �� •' � •� t(NGDEPT� BADGE NO. N OF TOWN I EREBY ACKNOI 'DGE RECEIPT OF CITATION X w.'I ORDINANCE Unable to obtain sigVu(e,of ofven ¢`„ v�' " THE NONCRIMINAL FINE FOR THIS OFFENSE IS $ ~ ORLU Date mailed 4 ; YOU HAVE THE FOLLOWING ALTERNATIVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(i)OR OPTION(2)WILL OPERATE AS A FINALLLJ REGULATION DISPOSITION WITH NO RESULTING CRIMINAL RECORD. W (1)You may elect to pay the above fine,either by appearing in person between 8:30 A.M.and 4:00 P.M.,Monday through Friday,legal holidays excepted, w.I before:The Barnstable Clerk,200 Main Street,Hyannis,MA 02601,or by mailing a.check,money order or postal note to Barnstable Clerk, Q Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE. P0•..Box 2430, ; (2)If you desire to contest this matter in a noncriminal proceedin ,you may do so by making written request to DISTRICT COURT DEPARTMENT FIRST BARNSTABLE DIVISION,COURT COMPOUND,MAIN STREET,BARNSTABLE,MA 02630,Attn:21D Noncriminal Hearings and endow a copy of this citation for a hearing. (3)If you fail to pay the above offense or to request a hearing within 21 days,or If you fail to appear for the hearfng or to pay any fine determined at the hearing to be due,criminal complaint may be issued against you. PI ❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose paymeht in the amount of$ GI -----------Signature NAME OF OFFENDE•". TOWN OF ADDRESS OFOFFENDEBw BARNSTABLE CITY,STATE,ZIP CO E. �• ,. t, _- - MV/MR REGISTRATION NUMBER P� o• OFFENSE �,�w.•""' 8 • - I IIAa\S1AXI.r: M •' ypg ,/� 'IQ S9S eg. ru • iTw,pl� 'f�Ty�'t�y/� 6,r ir�rWT,•., '+w+R 4ii '+fi•+A _.01 r"v ens )"C-S,,C;v"164% LLJ TIME AND DATE pf.l(IOLATION .ypp � LO��10. OF VIOL N NOTICE OF � :Mr� (A.M. P.M. ON a�sy 2008 ,.� 1 SIGNATVREOPfNFOfl61N}G PERSON ;f ..FORCING DEP,Z, rti9 f :BADGE NO VIOLATION rt y • r�4 d. „ aiA CeM I/6n PQ o l OF TOWN I HEREBY ACKNOWL DGE RECEIPT OF CITATION X Q . Unable to obtain s gn ,r of offender. ORDINANCE THE NONCRIMINAL FINE FOR THIS OFFENSE IS $ + W, Date mail:d ,L OR YOU HAVE THE FOLLOWING ALTERNATIVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL CL ! DISPOSITION WITH NO.RESULTING CRIMINAL RECORD. w i REGULATION (1)You may elect to pay the above fine,either by appearing in person 8:30 A.M.and 4;00 P.M.,Monday through Friday,legal holidays excepted, w I 1 before:The Barnstable Clerk,200 Main Street,Hyannis,MA 0260/,or by mailing a check,money order or postal note to Barnstable Clerk,P.O.Box 2430, � Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE: ': (2 If you desire to contest this matter in a noncriminal proceeding,you may do so by making written request to DISTRICT COURT DEPARTMENT FIRST, i l BARNSTABLE DIVISION,COURT COMPOUND,MAIN STREET,BARNSTABLE,MA 02630,Attn:21D Noncriminal Hearings.and endow a copy of this. citation for a hearing. ` (3)If you fail to pay the above offense or to request a hearing within 21 days,or if you fail to appear for the hearing or to pay any fine determined at the hearing to be due,criminal complaint may be Issued against you. ❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ Signature i NAME OF OFFENDER RAR:7 - C�v TOWN OF ADDRESS OF OFFEN BARNSTABLE" CITY,STATE.ZIP CO E �pF 19E Jp� MVI MB REGISThATION NUMBER- - OFFENSE;'".. • IIAHNNIANI.r:. *1 - 9� MASS. Lli ,639. JIY'✓ `•' P ,wY'✓Lf�f�� J 71�.r�'�" {IT �JfD MP�e ] }� ) O.'. —r'iW? r�W« �?�$ —�.: LU ' TIME ANQ_OATE�OF VjOLATION r �. G,TION IDEATIONfj/� - '�'. r � rw f NOTICE OF )) �a} cA.M. P.M�N �'� 200 ��.� � SIGNATURE OFENP G PERSON' ENFORCING DE.. BADGE NO. W VIOLATION ,. W a OF TOWN 1— EREBY fACKNOWL GE RECEIPT OF CITATION X LU'I I ORDINANCE jtX Unable to obtain sin re of der. THE NONCRIMINAL FINE FOR THIS OFFENSE IS S. I Date mailed w. w OR YOU HAVE THE FOLLOWING ALTER ATIVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)OR OPTION f2)WILL OPERATE AS A FINAL 'a.'' DISPOSITION WITH NO RESULTING CRIMINAL RECORD. _- LU REGULATION (1)You may elect to pay the above fine,either by appearing in person between 8:36 A.M.and 4:00 P.M.,Monday through Friday,legal holidays excepted, Q before:The Barnstable Clerk,2DO Main Street,Hyannis,MA 02601,or by mailing a check,money order or postal note.to Barnstable Clerk P.O.Box 2430, �'. Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE. d j i If you desire to contest this matter in a noncriminal proceeding,you may do so by making written request to DISTRICT COURT DEPARTMENT FIRST i RNSTABLE DIVISION,COURT COMPOUND,MAIN STREET,BARNSTABLE,MA 02630,Attn:21D Noncriminal Hearings and enclose a copy of this citation for a hearing. (3)If you fail to pay the above offense or to request a hearing within 21 days,or if you fail to appear for the hearing or to pay any fine determined at the hearing to be due,criminal complaint may be issued against you. - i ❑ 1 HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ Signature j NAME OF OF ¢ ER �— . y �' BAR7161 . TOWN OF � ADOflESSOF� DEfj,,. BARNSTABLE CITY.,TAT ZIP COD OF cpy My/MB REGISTRATION NU MBE -1 OFFENS IIAH�«IANIJ: 9C6 1179• � 6 f. b C./'4.1��!"!'�l e3P /�futiw d°II R �i��4✓yr.�"y��0 0' ,�y i� ,�y�+.. TIME AND gAT 0 VIOLATION ~ ! w4 Ld NOTICE OF Z. a v._ LD4TION,pFtaO IQ z$I (A.M./ ON 200 .�. w l SIGNATURPOlfENFR N PERSON g7A "w.+ �' Q - :;�j.r VIOLATION :.* t• °"p ENF(p�BINGDEPT BADGE NO, OF TOWN I HEREBY ACKNOWLEDGE RECEIPT OF CITATION X ORDINANCE Unable to obtain si nap f e,n er. _ OR Date mailed �' d'� THE NONCRIMINAL FINE FOR THIS OFFENSE IS YOU HAVE THE FOLLOWING ALTERNATIVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION .(1)OR OPTION(2)WILL OPERATE AS A FINAL DISPOSITION WITH NO RESULTING CRIMINAL RECORD. REGULATION be You may elect to pay the above fine,either by appeann in person between&30 A M.and 4 00 P..M.,Monda through Friday,legal holidays excepted l!! g y � before:The Barnstable Clerk,200 Main Street,Hyannis,MA 02601,or by mailing a check,money.order or postal note to Barnstable Clerk Box 2430 Hyannis,MA 02601,WITHIN TWENTYONE(21)DAYS OF THE DATE OF.THIS NOTICE.. a B if you desire I contesISION this matter in a noncriminal proceedingg,you may do so by making written request to DISTRICT COURT DEPARTMENT FIRST BARNSTABLE DIVISION,COURT COMPOUND,MAIN STREET,BARNSTABLE,MA 02630,Attn:21D Noncriminal Hearings and enclose a copy of this citation for a hearing. (3)If you fail to pay the above offense or to request a hearing within 21 days,or if you fail to appear for the hearing or to'pay any fine determined at the hearing to be due,criminal complaint may be issued against you: f Ei ❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of.$ .i _ Signature FINE�� Town of Barnstable *Permit# 5 0 Expires 6 months 4amUssue state BMWSTABI.E. : Regulatory Services Fee KASS'i639. � Thomas F.Geller,Director A'ED1A°'p Building Division Tom Perry, Building CommissionerRESS r 200 Main Street, Hyannis,MA 02601 Xvp .W... Office: 508-862-4038 jUN •Y, 7 ZOOS Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENL4T :4Q gp,R�sT "`- Nl!ot Valid without Red X-Press Imprint Map/parcel Number t�r7 40FO 2 ,�fST 2 Property Address C ft6 Z\1 t LLiF t M A o-2 Cad Residential Value of Wory 6n Minimum fee of$25.00 for work under$6000.00 /Owner's Name&Address KA i�( T.PzlisP la_ tcA Contractor's Narne_VKC0_K]UWeZ Telephone Number U 0 598 i5T 0 t Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable)_ (e ❑Workman's Compensation Insurance Check one: 'FrI am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's #Compensation Insurance rr_- Insurance Company Name IVOc('�5k )e� 6t A &ot�l lG 'o7 7zo Z 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 ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side e`� XReplacement Windows. U-Value 0%3�t (maximum.44) AN�ees"A *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home rovement Contractors License is required. Signature Q:Forms:expmtrg Revise063004 II� 90 VASCO NUNEZ CARPENTRY 79 Mayfair Rd. Pagel of 2 SOUTH DENNIS, MA'02660 MA Lic. #069680 H.I.C. #124793 (866) 398-1511 + Toll Free (508) 398-1511 Dennis, MA PHONE DATE TO: M/M Peter Favat 781=647-1462 6/13/2005 535 North Ave. JOB NAME/LOCATION ' Weston MA 02493 Replacement .Windows & Door 373 Bay Lane Centerville, MA 02636 JOB NUMBER: JOB PHONE 146.2 . A17-875-1258 We hereby submit specifications and estimates for: 1: Remove aluminum windows from sun porch;' and.repl:ace/install. wi h' Ande:rseri vinyl clad casement. windows: All Andersen windowswill have white vinyl exterior with pre finished white interior, . wh'ite hardware, white screens, and no grilles. Andersen casement windows viewing deck will' be three units mulled together with 24" visible glass, leaving approximately 2" of space to fill.' Casement .wihdows viewing marsh will be three units equally spaced. These units have two''windows per unit with 19" of visible glass per sash. There will be 12" of space to fill. Casement windows on exterior door side of porch will be two units with two sashes per unit, each sash will have 24" "of visible glass, and there is 4" of space to fill. All units will be 48'• in 'height. 2. Remove one wooden exterior door from sun porch, and replace/install with one fiberglass 9-lite exterior door. New door will have a single bore for original lock set. 3. Frame out three walls to accept new windows. New walls will be approximately 27" in height, and door frame staying the same height and width. 4. Make exterior weather tight with same materials as existing, ( pine trim and white cedar side wall shingles) . 5. NO INTERIOR TRIM APPLIED. 6. Supply exterior trim and framing materials where needed. 7. Supply town building permit. * This proposal does not include any painting, plumbing, or electrical work. * All Andersen windows, and Fairview door described above will be- prepaid by owner. ** If this proposal is satisfactory, please sign the YELLOW copy and return with payment schedule. ** Please make a check payable to Fairview Millwork Inc. in the amount of $3,799.39 for your new windows and door described above, and please include this check with your signed proposal Al 1 ow d—S weeks for Cielivery, this ig a fAr_tnr31r nrdpr We Propose hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of: Cont'd dollars($ Cont'd ) Payment to be made as follows: Labor: 50% Down payment to start. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$1845.00 Labor: 50% Upon completion, at time of completion. . . . . . . . . . . . . . . . . . . . . . . . . .$1845.00 All material is guaranteed to be as specified.All work to be completed in a professional manner according to standard practices.Any alteration or deviation from above specifications Authorized involving extra costs will be executed only upon written orders,and will become an extra SignatureZI •charge over and above the estimate.All agreements contingent upon strikes acciderrts or delays beyond our control.Owner to carry fire,tornado,and other necessary insurance.Our Not : pr O al may be workers are fully covered by Workers Compensation insurance. withdrawn b us if ac ithin 30 days. Acceptance of Proposal—The above prices,specifications and con- ditions are satisfactory and are hereby accepted.You are authorized to do the work as specified.Payment will be made as outlined aboye. Si lure Date f Acceptance: Cam , Si lure PRODUCT 13128M USE WITH 771 ENVELOPE NEBS To Reorder.1-800-225-63t10 or www.nebs.com PRINTED IN USA. 8 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations _ 600 Washington Street, fh Floor _• ,?� Boston,Mass. 02111 Workers'Compensation Insurance Affidavit:Buildin lumbin /Electrical Contractors mum ) e `w sname: address JG city_—Sn state: zin. 6(a(S phone# sap -,--n Is!1 0 work site location(full address): B-7-2) 1?)G454_" - yi ty2 " Ci -5 ❑ I am a homeowner performing all work myself. / Project Type: ❑New Construction®Remodel I am a sole proprietor and have no one working in any capacity. ❑Building Addition .. " `">a*'i•*�' ',� �"�;'w'�y,a% %y �VN.4,. :a?�1:,%" a'�� ` ' gin.-b , r` '•?•`: K '_r54"T oaf=�. ` ❑ I am an employesc',r providing workers' compensation for my employees working on this job. name: com an address Cltl �l V Q ca - n hone M y insurance co. t(4 V(ex�.tit ` v l�to-,�cx oli K 02-0 2C5j, ❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: co name:... address city phone M insurance co. oli .# company name: address: city phone#• insurance co. oll # Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties.of a fine up to$1,500.00 and/or one years'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. - f do hereby cert under the pains an enalties of perjury that the information provided above is true and correct Signature ( -f�f" Date 24 1QS Print name V G Q 1\�UlV1 e Z-- Phone# b�q! 'mg official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (rcv'iscd Sept.2003) 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. 3 i 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. Please supply company name, 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 calf the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number'which-will be used as a reference number. The affidavits may be returned 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 Office of Investigations 600 Washington Street,7`h Floor Boston,Ma. 02111 fax#: (617)727-7749 phone #: (617)7274900 ext. 406, II - * BOARD OF BUILDI G REGULATIONS t License: CONSTRUCTION SUPERVISOR Number.CS 069680 Expires 10/03/2006 Tr.no: 2545.0 Restricted: ;1G VASCO E NUNEZ IIi :._ 4 79 MAYFAIR RD `: �j �• .MA 02M0_' S DENNIS, ,:-``'` Commissioner a - ��e�amv�nareure�of�.�Lattae�l6 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR =_ k Registration: 124793 J' Expiration: 80W005 Type: Individual Vasco E.Nunez,III • Vasco Nunez,III 79 Mayfair Rd. . � ' S.Dennis,MA 02660 Administrator i From:Donna Seviour,CIC,CISR At:TD Banknorth Insurance Group FaxID:2077750339 To:Vasco Date:06/27/05 09:25 AM Page:2 of 3 ACORD CERTIFICATE OF LIABILITY INSURANCE SOP CO S DATE6/127/0 vAsco-2 06/27/05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE TD Banknorth Ins Agcy Inc (CC) HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 14 Lots Hollow Rd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOV I. Orleans MA 02653 Phone: 508-255-3212 Fax:508-255-9864 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Norfolk & Dedham Mutual INSURER B: Vasco Nunez INSURER C: 79 Mayfair Road INSURER D: South Dennis MA 02660 INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DDIYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $1000000 A X I COMMERCIAL GENERAL LIABIL TY R0207202 09/12/04 09/12/05 PREMISES(E`,occurence) $50000 CLAIMS MADE ❑OCCUR MED EYP(Any one person) $5000 PERSONAL&ADV INJURY $1000000 GENERAL AGGREGATE $2000000 r11N'LGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OP AGG $1000000 ICY PE4 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND TWC L IMITS ER EMPLOYERS'LIABILITY CRY ANY PROPRIETOR/PARTNER/E)(ECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Favat @ 373 Bay Lane Centerville, MA CERTIFICATE HOLDER CANCELLATION BARNS-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Town Of Barnstable NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 367 Main Street 200 Main St. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR - Hyannis MA 02601 REPRESENTATIVES. • AUTHORIZED REPRESENTATIVE I Small Business ACORD 25(2001108) ©ACORD CORPORATION 1988 • ring Dept. (3rd floor) Map i 'Z Parcel Z Permit# 1 House# .3?3 Date Issued C�"'9 Board o ealtY(3rd floor)-(8:15 -9:30/1:00-4:30) 7 E �Fee ',C li"onservation Office(4th floor)(8:30-9:30/1:00-2:00) 5) ram fW ..�3•- ray zz, <,��. '.:� �e ;c�� 1 i ept. st oo coo dmi . Bl �� .) €a�STALLE t IBANCE tive pproved b PI mg oa _ 19 W ENVIRON DE AND ✓ TOWN OF_EARNSTAELE TOWN _ ' IONS Buildingg'Permit Application Project Street Address _?j 7 3 La N(- J (��. &oO 7Y Village Owner -Qf�"G✓- F AV O d- Address 3?3 AA-\ Telephone qy Permit Request 7W 6,A[a 0L_ po-Ictn First Floor square feet Second Floor square feet Construction Type Estimated Project Co�s,tt $ �,coo of Zoning District IJJ— I Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family 21"--Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ©-go On Old King's Highway ❑Yes 2-No Basement Type: ❑Full ZrIc"rawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing �� New Half: Existing New No. of Bedrooms: Existing 7—• New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: &rGas ❑Oil ❑Electric ❑Other Central Air ❑Yes 10 Fireplaces: Existing New Existing wood/coal stove ❑Yes amo' - Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) 2- one ❑Shed(size) _ ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use n ` Builder Information Name u�S�l( /� C� i �Sa Telephone Number Address 2 0 il p io,�r� C 1 v� e-- License# 00 1 q S Z Home Improvement Contractor# 0 IC/ �(Z ' Worker's Compensation#NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. � O ` ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN T ��--`ate( lip M S rk— SIGNATURE DATE fZt BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY t ' PERMIT NO. DATE ISSUED } MAP/PARCEL NO. ADDRESS c VILLAGE OWNER F _ So ,,, a o ��S DATE OF INSPECTION:� f ' FOUNDATION . f/I ✓ �12� r FRAME ,.'•• INSULATION "FIREPLACE f t ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGHS FINAL FINAL BUILDING DATE CLOSED OUTS ASSOCIATION PLAN NO; h t�• r J yl� { �11l waatV �_.' + a -� i a. �, /�zj.. �- b_ �, • '..." �i gl oo so The Connm,nivealth of Afassachu etLs Department ojLldustrial,9cculults �- 011ic.6811N W9,711o17s 600 If a.vhntgton Street • r Bovon.111ass. 02111 V1'orkers' Compensation Insurance Affidavit J .. .--- --•---- •---- - ' --._.. Please PT!e ""`""'..�..�... .,..•,._. - - .- - �PPlicant information• _. ..RIN._...-.1�2j.Y:-- - n._amc_ rr ,. Incatinn• � D �m i"-�� C l-�� n coin �G.�1vt-�.c c/r� A��- /iZ6 3®� nhnnc# 3'� 2- �?Z7 1 am, a homeowner performing all wort: myself. I.am a sole proprietor and have no one work-in_* in any capacity ._.... ...+...;-.7�..s_............__�.�—._�,..w..,.-ta+1.sir..�...n`+�.a•�.-r.:>w.......-•.w..+'!T!w+..�..�e.�..w. .�..�.+.......�.�..�..-.....--....+r,.__...._-.. ... [j I am an employer providing workers' compensation for my employees working on this job. c y cm1111anv n•tmc•• address: city: /��"�$ � �• 6Z,r!�' phnne t!t 36 2" e-LI . insurance co. policy# [I I am a sole proprietor. general contractor, or homeowner(circle otte) and have hired the contractors listed below who have the following workers compensation polices: comnanv n•tmc• address• • gin phone#: insurance ro policy# 1 ....i�:•+... `•."^._�..-.,_ .�.t..._... _ _- -�t•�.:�.�'\L iT"S!'1ww:si. ._Tr..._._,.. - .....ti....�.._ice.._ _ emmnam• n•ttnc• addrecc� rip phone#- insurance co. to Attach additional sheet if_necessary -:..r..��.+..�.:.. - ,..,,may..,._-__... '� •�.__•.....r_.��_'.._.......-..,a��,�.�>-°-._.�a;tr.:.. ....w.r�:n. Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a line up to 51.500.UU andiur une i cars' imprisonment as sell:rs civil penalties in the form of a STOP NVORK ORDER and a fine of 5100.00 a day against me. I understand that n copy of this statement may be forwarded to the Olticc of Investigations of the DIA for coverage verification. 1 do hereby certift•tin •r the pains and penalties of perjury that the information prorided above is true and correct. Sienature Date 412-QA07 Print name (l-sS �� !�Sd J" Phone# 3 6 Z — C-l7 2 7 ' nlTicial use only do not write in this area to be completed by city or town official city or tn%vn• permittlicense# rRBuilding Department C3Llcensing Board 0 check if immediate response is required OSelectmen's Office f" C311e21th Department contact person: phone#; r•9Other Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "la\%••'. an cmplgrce is defined as every person in the service of another under anv contract oThire, express or implied, oral or written. An entplt rcr is defined as an individual. partnership, association, corporation or other legal entity.lor any two or more . the foregoing CIiLaged 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 d\%,ellin_ 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 hour or oil tile urounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that even- 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 common-ti•ealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionallv. 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 Ina 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' supplyin_ company names. address and phone numbers 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 tite 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 tine number listed below. - City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in tine event the Office of Investigations has to contact you regarding the applicant. Pleas be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to tine Department by mail or FAX unless other arrangements have been made. Tine Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to uive us a call. . The Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents - rr Office of Investigations 600 «'ashington Street Boston,Ma. 02111 fax #: (617) 727-7749 phone #: (617) 7274900 ext. 406, 409 or 375 The Town of Barnstable Department of Health Safety and Environmental Services 1"9. BuiIding Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph CrossenBuiIding Comr. Fax: 508-790-6230 For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but 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: �} (nc ��o�� D�G� Est.CostiE -�� Address of Work: Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work exciuded by law Job under S1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. 9 9 DEPARI'MENT OF PU81- CC SAFETY 119599 ONE hSHBLIWION 111-ACA-'-' Rm 1'3w1- BOSTON, MA 02108-1-618 CONSTRUCTION SUPERVISOR LICENSE Number`: E x pJ,r e s Restricted To: 00 WEA RUSSELL A GIBSON JR JUL 19971 P0 BOX 118 BARNSTABLE, MA 02630 Keep top for receipt and change Of ciddress notific:Eitiot-1. 'z "t ff HOME- IMPROVEMENTCONTRACTORS -REGISTRATION Q K"f. Board ,of Building Regu- 'a.t'donsi`,and -Standards W-One 'AE§hbur,tonl-;Pl'a"66t?;,7-'�:Ro'om-l.,,,1301 Boston Massa6hLsetts o 2108.- - HOME-.:IMPROVEMENT CONTRACTOR — L ------------------- ' , ----------------- Regi-stration 104428 Ex piration,: 07/14/98 ;Type: INDIVIDUAL -T HOME IMPROVEMENT CONTRACTOR Registration 104428 ,fi RUSSELL A GIBSON.,JR..' Type - INDIVIDUAL Russel'l:' A Gibson , Jr .' ' Expiration 07/14/98 4,i ountry Clu- 6 Dr*lve,�.,�,,-.�,,,.,,�.,,,',,�,,,�,,,.,,.., ummaquid MA RUSSELL A. GIBSON,JR. I Wsell A. Gibson, Jr. /0 Country Club Drive ADMINISTRATOR Cummaquid MA 02637 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 1, (`7 Parcel O v Z Permit# s Health Division r�..r►a �Iu Date Issued, ! 2� ion - Fee .PrS o0 SEPTIC SYSTEM TAUS a BE _—Tew6effector Yd-7/f KST LLED IN COMPLIANCE 0Treasurer 1lG7Ci TITLE 5 , EN VI OI�l 404TAL CODE AND Zat ePt TO'! f J Rf_-0UL�?` 11r:� ,;,�, rove y Project Street Address Village Cep ��ret (c_ ' Owner P� �' ��u Address Telephone Permit Request ti-S 4-wr la V6 -G+41e- &-,4,1 /�'�-G't• ��-��iG fs i't ctr''�iS�G/ ' �4litG— tt�,lir/f 7� C�i.�i ire '(o�,� �� 1"��t� t_ ✓9zCe ct d1,C� ��r�f rZ �4 cC 57',` ,,.1e_ ery-eq„ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Estimated Project Cost 1 5-0-0~0' Zoning District Flood Plain Groundwater Overlay 1 Construction Type i Lot Size l•35-Ae'i:c' Grandfathered: ❑Yes ElNo If yes, attach supporting documentation. .Dwelling Type: Single Family ff' Two family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl , ❑Walkout '❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Numberof Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas 'Lloilr ❑Electric ❑Other J 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: A Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ • 9� Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use n BUILDER INFORMATION Name j1t�S5�'<< - CR �SaN Telephone.Number 562- q?Z7 Address L �c i'e__ 6-v- License# Home Improvement Contractor# 106tcl Zf ° Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE ..��J� �' / DATE 1�-/� 4y i FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED _ MAP/PARCEL,NO. - ADDRESSF z j' • VILLAGE OWNER• • T �. ,. • _ , DATE OF INSPECTION FOUNDATION ' FRAME INSULATION FIREPLACE t - ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL y ` GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED.OUT - f ASSOCIATION PLAN NO. ti The Town of Barnstable MAM ►`� Department of Health Safety and Environmental Services °ram Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 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: .��'�i !( �l i�/��J�9/ Estimated Cost O,o0 Address of Work: `�"' "' < <e Owner's Name: Pe4-,-- r lval Date of Application: J 7 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law [3Job Under$1,000 Building not owner-occupied [30wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME U"ROVEMENT 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 Contractor Name Registration No. OR Date Owner's Name gIbmis:Affidav r The Commonwealth of Massachusetts Department of Industrial Accidents ' oxce 8/1"esdostleas - ` 600 Washington Street - -. J Boston,Mass. 02111 — Workers' Com ensation Insurance davit name: 26.S, {/ °r-1- (fir'4a4 /) —, location: S 2- �(d PIN-Nt P. t / city ( cLN 0.-t Ut4 ") phone# �41- Z_.C()?- Wl a homeowner performing all work myself. . m a sole etor and have no one worlan in apacity ❑ I man employer.providing workers'compensation for my employees worldng on this job. a<,;»>:.. :::::>::BOY n me` :;; ' -; ` ? :, ''. . ° ;f..... : ' " <''2? ' y X. ? ?``':' ?{'<' } ' 't C4IDQ ..... ........................ :...... ..... ... ...... .... ........ ........ : . ........................................................................ :::::::::::.::::::._:::.:::::::::•:::::::,:.:::.,.::::::::::::: :::-... ::::::::::::::: ::::.:.:;•.::•:;•::;:;;;;;{•::•;:;:;:::;;:•;':.>:•::.;;.:.....::::..;..;:...:.......::::•...........:...:.....................::::......:........::::::..;..................................:..............;...:.......:..................{.......:.:..:..............:...............:........ 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N. shone#. :..::::. ..:.;;:::.;:.:.;:.;:.:.;:.:.;:.;:.;;::.;:.;:.;:.;:::.:- I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who � have `. :::.:the following workers'compensation po1. lices:::.:::::,:.:.:...:..:..:::.......................................:........................ �,..M r.e %��""'<�'`'} "` ys >< '` >` %tfk'<sf2t??Ei. yi.i >"%`iiiY '.Y''.i2`[ ` '} `' <'r >?2ci ?ca}''s<25<2ai i olnoanv nam F? i?:>.:i':iii'::i:':iiii.--. :`i::::'::i s;:}:iiiii:{::<::%:i::::>i:,*,�iii�iiiii:%:ii:v::i::>y:i::v i;:'t2;:. i?i::;3:;Y:iJr?'::iiT}}}}ijii:iii:><:'ii?':ii?isisC iiii`ii.?:?iiiii:>:::Jii.ii�T......"..I.; iy iiijk..:...iiiiv:}L�''t:iti>::i'�>tv::i:riti'v. •?C':v':ii:;; : :.::...:..:...;;.....::..::::.......:.:...:.:::.:.::::::::::.:::••..:::.::::::::...:.�::•.:...:......:: :v::::::::•:::.::.�...�:.:::::::::....................:.:::.v::::.::::.::::::.::::•::.;....:.......:....::.::::::::'.x.:::v:::i..w:.----4nv::::::. 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I undesstaod find a copy of this statement may be forwarded to the Ocoee of Investigations of the DIA for coverage verification. I do hereby certify the pans and pen o Perjury that the information provided above is&w.nand correct SignaturekL,11�dlgl", Date I/ Z 7 If f - Print name a J �4s clv � Phone#_3 2 - 60 Z 11111 olndal use only do not write in this area to be completed by city or town offlddd city or town: petmiNicense# QBWding De=fteat ❑dudcifimmediats response is required ❑selectmewss OIDee (Health Deparbnent contact person: phone#; ._ ❑Other *mud 9/95 PIA) 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 co=r-1 , 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 c: trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is _being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax member. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of lovesduadons 600 Washington Street Boston'Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 ��.�=` -: I✓�ie i�anraa�i a�^�,crr:iac�iu.;ell DEPARTMENT OF PUBLIC SAFETY CONSTRUffIOVSUPERVISOR LICENSE 3 Number Expires: Res'triteG Be RUSSEII A OIBSON JR BARNSTABLE, MA 02630 f r.,..rFw .,cs n? t hx a l'•�'.. i ti x 3 r wv r,r .y',,. a c: 'Fn.'N:y �# ,y -•+ ,.: F �i' S Y r,i<;; �"r5' .N at' fp - t° E r is a ,°_r ,�'+, t� ..;t ;C •� I. Y°f t ,'s•'S"' sa a Sys Fr>- +' s ¢ Y �/� 'i7 i 4j,,j d Y• °� Rom. 4'3�t 0 �� J <, x�� Q ryM �Pg � Y �,.. f .y-,�` `:: \'E �F ' ra• a ti#r � }t "k 4F .. - �`" �,�,.,#. ,{ ,t rY� w. '}i :,..�. a��b-iaa m"da}k r•.,.v as r.'� �,:} yt..:.T'�x• ..k? k`s,"'',•?R,v 'ire 17, £ h d- »zrvyi? {. I c' a.:a ��T5., k 5 a.�; r'as•S .` v`-" �i.. HOMEIMPROVEMENT—CONTRACTORS REGISTRATION 'I Y a :vu Board of Buwilding Regulations and Standards I, � Y 4 h1 P. s tr U z One Ashburton Place Room 1301 ,.Boston, Massachusetts'°02108 ya i �h�� x ° s x s I } # v$ n # t_ - '�? •'� '.sJ.,. v� � F^�. � k�� +. 1 et a -as 3 � t^r a HOME ,IMPROVEMENT CONTRACTOR , }ri + Registration 104428 d a Expirata_on 07/14/00 < s A2 r -. ;s_,.;.. A,.a"3 P , "Ta'cw F, '7..* S._'. & S y y •,�',°� I -.�, '%} " " •� p .�fir,. ,•a t .� '^,, 4 isr{e� t-' r .r c a Type -,INDIVIDUAL = HOME IMPROVEMENT CONTRACTOR. ^, .✓4 •3±ai �+ s -`-w.e ai✓ a f' '�' av To- hr... '+T 1 f;a y x as ''"'• "�6« x �.�w� 'inw t'�'�`l+ r°r,.y-- 9.-+ L H-.r (+_a.,a a 3s - r .s -i Registration 104428 a$ i✓ F:Y 4 ` :;If,E3^arrxSlY,r < p `t ,.t ,E -}' � =•t RUSSELL A iGIBS0 ,JR .,TYPe INDIVIDUAL ation 07/14/00 r t 3 aEzpir .``Russell A Gibson , jJr s� �a ��^, x � �� x' r. • � xc Eyy a �� 3 ''.� �";.« 32 MID .PINE b? : ' " z}; " / �� r I ,� � � ``� BS fi v - GRUSSELL A 6IBSON,JR �. YARMOUTHPORTj�MA 02675 I r r x h � t, az�Y,. 3 I L{P °r'X` .,`Russell A Gibson, Jr a , y41iMID PINE S a.x Xa ' j. Y z� e I C��noMiws�uroR YARMOUTNPORT MA 02675 F �•. g 4 �y ,a , 71 �tkn pt Ib of Ve, el l � _ + _ t _+_�_ �-}. , � � E [ �✓�1t,irwn tfca�k- t ' `�� t �` � T1 e � Tl _f 3 { f I fl �'i i ' R 1 R ,;i ,• . +{��'f {7�� Y1r�.h�'k�'��S�J+ tt P�'��A��fj��kr�� R; ��4 '':trt '• ; ;1. � �� b�•`��%�j��q+�'I{,�''yA S�RIt fi 113f�Et �. $ �' �x��"rts� 4��t �` J�• nt �ah f}t ceg e z m iti{t A S+.frl, On W'R wm iq I� kr i Pill 17, t r ® tuns .1 { FROM Panasonic FAX SYSTEM PHONE NO. Oct. 27 1994 05:49AM P1 BH�I�:_THD,Lr LAND COURT REGI'STR'i wry: s' -97 #1u I o p 3 Town of Barnstable Zoning Board of Appeals Decision and Notice Appeal No. 1997-115 - ..Favat J Variance-Section 3.1.1(5) Bulk Regulations Front Yard Setback Summary Granted With Conditions Petitioner: Peter Favat 'T Property Address: 373 Say Lane,Centerville, MA cs Assessor's Mapiparcel.. ........ 187/002....Area: 1.35 ac. Building: 1,156 sq.ft. Zoning:.............................I..............RD-1 Residential D-1 Zoning District Groundwater overlay....................AP Aquifer Protectipn Overlay District Background: -T The property, located at 373 Bay Lane Centerville, MA, is developed with a one story, 1,156 sq.ft. single family dwelling. The 1.35 acre parcel has only 0.35 acres of upland located adjacent to Bay Lane. The applicant is seeking a Variance to Section 3-1.1 (5)-Bulk Regulations, Front Yard setback to permit a 7 foot by 37 foot"Farmer's Porch'onto an existing structure. According to the plot plan supplied, the existing`structure has a 27.5 foot-front yard setback and the proposed new setback appears to be 21.4 _feet: According to the Assessors Record the building was built in 1968. In 1968,the locus was zoned RD-1 as it is today, In-1968, the required front yard setback was 30 feet with a qualifier that"no building need be set back,more than the average of the set-backs of the buildings on the lots next thereto on either side". Today, the RDA requires a 30 foot setback from the front property line. Procedural Summary: This,appeal was filed at the Town Clerk's Office and at the Office of the Zoning Board of Appeals on October 10, 1997, 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 November 05, 1997, at which time the Board granted the request with conditions. Hearing Summary: . . Board Members hearing the appeal were Ron Jansson, Tom DeRiemer, Gail Nightingale, Gene Burman, and Chairman Emmett Glynn, Lynne Hamlyn of Hamlyn Consulting represented the applicant. She submitted a notarized letter from Mr. Favat for standing and a memorandum of support. Ms. Hamlyn noted that she had.been before the Board seeking a non-conforming Special Permit to .expand a non-conforming structure in Appeal Number 1997-100, In that appeal, the Board had desired documentation of the legal non-conforming aspects. If that can not be done, then Ms, Hamlyn must seek Variance relief. Ms. Hamlyn stated she could. not prove the nonconforming status of the property and was now seeking a variance from the bulk regulations. As to variance conditions, Ms. Hamlyn indicated that the property is unique in that only a small portion of the.property is located in the upland and the farmer's porch can only be constructed where it is proposed due to soil conditions regarding the marsh area to the side. The porch would be constructed in the front r 'jog" of the existing footprint for the-_louse. The house is one of the oldest on Bay Lane and one of the 1 smallest home.in the area. The petitioner seeks to improve his dwelling'to be in greater conformance with the surrounding structures. Granting the relief being sought will allow the Petitioner to increase the aesthetic value of this house thus benefiting the neighborhood. Ms. Hamlyn submitted pictures of the houses in the immediate area, and a copy of the Order of Conditions from the Conservation Commission. SNU 5.6 '-`c.t,t K e-i?('AG STONE. 2 \ MARSH �^ RETAINING \ PROPOSED WALL ADDITION �. A PICKET LOT 6 y�'y 5,� , #54.2 FENCES 3 LCP 35308—B A� co 74 '�o c� i��` ROCK AL GAS / 't p. .y WALL METER 1 o �3.0 ,. 4 ALCe EX G DW IfJ SUNROOM HOUSE #6 ON POSTS AL / P / IF �j 7.2 ` BORDERING \:p. VEGETATED S N \ WETLAND . PROPOSED \ ^ ;% AL ,\. PORCH 61 5 . BENCHMARK \ X. TAG BOLT #371 FIRE HYDRANT. �c��\`, \ "9 ELEV. = 9.28' NGVD �Zc 4.2 \ 2 �Ic 3'51 . NF FIELDS POINT PROPOSED. MANUFACTURING 2 Ail I y.F j FENCE 1' OFF (J 1 ci SCh l�t� PROPERTY LINE PAVED - SWAL.E ' 97.."063 __ ■■ w■ ww ■1 tw ! ■ www■wwwww■ ■■■■ ■ ■ow■■■■■■0 ■■■mom ■ ■ ■■■■■■ ■w■w �■ ■■■■ww ■■ ■■ ■■■ ■ ■ ■ w■■w■■� ■ w■ ■w■wwww ON ■ ■ ■ ■w ww■ ■ ■w ■■ ■ ■ ww■ww w■■ w■ ■w ■ ■■ ■■■ ww■ ■ ISM■■■■■■ ■■■ ■■ ■mow w � . mom a ■ ■■www■w ■w ■ ■■■w■■ ■■■■■■ w■■ww■MEN w� ■■ ■� ■■ www ■ww � � �w� � ■■■w w ■ ■■ w■■w NONE ■■w■ ■mom■■MEMO ME ■Iwo ■■■ M ■■■■■■■■■ ■■■ . ■■■ ww ■w ■■w■ ■MOM ■ w ■ ° ..__ ��■ ■ ■■ ■■■■■ f SEPTIC SYSTEM MUST BE si Ass- ol"s office(1st Floor): "n Assessor's map d lot number v �O INSTALLED 0N ®MP`-I o t>o Conservation "' "' .1 °t�� WITH TITLE 5 Board of Health 3rd floor) ENVIRONMENTAL CO ( t 4 Sewage Permit number AV R. sr►ntE TOWN ��CUL6�TI ...�� „�a Engineering Department(3rd floor): 1e39. House number /,3 Definitive Plan Approved by Planning Board, 19 APPLICATIONS PROCESSED 6:30-9:30 A.M.and 1:00-2:00 P.M.only' .';. TOWN OF BA-RNSTABLE BUILDING - INSPECTOR APPLICATION FOR PERMIT TO ��r• n U&f-r—� p� (S7in1(,- � TYPE OF CONSTRUCTION 7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 373 Pj--"Aff t yQAlt (�r -f6 V f L L F Proposed Use esrArrfo,L Zoning District 212 Fire District Name of Owner J7t IZ y A VAT Address Name of Builder�ySS�ct _ bsoel. JR,Address IV jatitlTRy t�Lrrb p�A�,,Q Name of Architect Address Number of Rooms Foundation Exterior - Roofing /�M1P h2Gt �/? n7 �j�a le,H Floors Interior Heating Plumbing Fireplace Approximate Cost OQO• — Area 119 Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License 4FAVAT, PETER No 3 6 8 5 5 - P&miffor SCREEN PORCH Location 373 Bay Lane, Centerville ell i Owner Peter FAvat f i - • , .. Type o Construction YP. J Plot Lot c i r•i F Permit Granted July '7 , 1994 ` Date of'lnspection �l t.J 19 I t 19 Date Completed 19 i # � i �D1 f± y COMMONWEALTH OF 4W-SACHUS13T TS - JEI'AR17 Z 'T OF LN'DUSTRMA*ACCIDENTS ' ^ 600 WASHINGTON STREET fames s CanoDei. BOSTON, NMA.SSACHUSEITS 02ni �omn.-sstone: 'CORKERSMPENSMON INSURANCE:AFF!DAVIT a ' �4k7 _ - . t � . with a principal place of busrness/rrsidcaec at: 6 (GtYr.=CdZip) _rig do hereby certify,under the pains and penalties of perjury,that: 164 lam an employer providing the following workers'compensation coverage for my employees working onthis job. Insurance Company Policy Number X,I am a sole proprietor and have no one working for me (] I am a sole proprietor,general contractor or homeowner(circle one_)and have hired the contractors listed below who have the following workers'compensation insurance policies: - - Name of Contmaor Insurance Company/Poliey Number i Name of Commaoi Insurance Company/Policy Number Dame of Contncor Insurance Company/Policy Number Q l am a homeowner performing all the work myself. 1.`0TE.Pleuc be a•Yarc that while boroco%'Mers who employ persons to&caiatcaaacc,constructioa or rcpairworl;on dwcliinc of not more loan v^rec units in waicb tic borrcowaer aiso to:ices or oa t_^e Frouaes appurtenant thereto ate not ceaeraJl, eonsiderccr to be emoJovcrs t racer tSc�or);en'Coe oc saucer Ae.(CL C 152.scc- 10)),application by a bomeowoer for a!;cease or permit may eviccacc 6e JccaJ sutus of a.a erz:aloytr.uader toe' orkcrs'Compensation Act. y� .. .:ccc co�:-✓c�:r-cn10:i-c1 ::: Acridcnts'Ofn«or Ins uran� for covc: c ag �c�''c- c' �'•c ";.: .arc :a score c^vcrsc_z rccui:cc uncc.Scc�c.?5:• ,.SG: .'c 'c_cr.ic:c to t:,c it Ipoiition orm:ni�:J per.:Jc_ con=J=n-c of:Lnc ci c. tc S'5-00.00 Mc. -1.^' zL•O: ^1 O: �G to C::e�'C:.:inc C�'�GCn:::J.:.2 L^^. Le 10zrn Of:StopWOfl:OfOC:.:7c fine of S 100.00 ii ns: Se `'f�-, Signed this day of S� 19 ..:usor;r:rrri.:x i� w� /6tw►G Wr4-!� l-" .' ' 3� X 7� I � NAG K •I it i ;r { Y Map Parcel Permit# c5 House# , 3 Date Issued -�a Board of Health(3rd floor)(8:15•-'9:30/1:00- ) ' 114 7 d l Fee. " Conservation Office(4th floor)(8:30- 9:30/1:00`:2:00) - �- 06513VC'SY Planning Dept. (1st floor/School Admin. Bldg.) INSTALLE UST BE LIANCE Definitive Plan A proved by Planning Board 19 W 1 ENVIRON ' TOWN OF BARNSTABLE TOWN R IONS DE N� Building Permit Application a Project Street Address e._ Village GPI Owner Qe-�e Address i Telephone syy- _ �O Permit Request l U c `'� 5 (( 1- �r�4 e- 14 IDUV9e- A,tu'a First Floor_ square feet Second Floors square feet i Construction Type 1A,100� Estimated Project Cost $ (90 (00 Zoning District R C) ( Flood Plain Water Protection Lot Size �� Grandfathered W4es ❑No Dwelling Type: Single Family Ur-' Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes IZNo On Old King's Highway ❑Yes @ 10- Basement Type: ❑Full -awl ❑Walkout, ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) / Number of Baths: Full: Existing 2 New Half: Existing New No. of Bedrooms: Existing 7 ' . New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: a as 0,Oil ❑Electric ❑Other Central Air ❑Yes Of4o Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑A ched(size) ❑Barn(size) None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes No If yes, site plan review# - Current Use Proposed Use Builder Information Name Telephone Number 3 1, Z- 7 2-7 Address A121 . License# bum S Home Improvement Contractor# 10 c-/41 ZF Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOUEE FOLLOWING REASON(S) MOUL- �� 1. �}+ FOR OFFICIAL USE ONLY - PERMIT NO. T h: DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER �._ . 1 j DATE OF INSPECTION: FOUNDATION t _ . FRAME INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL , PLUMBING: ROUGH FINAL GAS: ,ROUGH Q FINAL FINAL BUILDING'M ...Jo :- 5 I.- DATE CLOSED OUTin t s ASSOCIATION PLAI�10. t ` 0 f ke td-c-6 a4 6-1�tL WW o Cu 2- YC(- LtA( (S The Town of Barnstable NAM �e8 Department of Health Safety and Environmental Services BuiIding Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 503-790-6227 BuiIding Commissio::: Fax: 308-790-6230 For once use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, moderni=tion. 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. �J�►I w��, ,�S��c ��'t�� Est.Cost 1 ZOO Type of Work. CAAC ? Address of Work: Owner's Name / Date of Permit Application:( I hereby certify that: Registration is not requircd for the following reason(s): Work excluded by law Job under 51.000. 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. 14r ec.,,sS e Date C ntractor Name Registration No. OR Date Owners Name parr ve '. - _ Office of/nee UffJ NS 600 Washington Street t. '` .�=- +r Boston,Mass. 02111 Workers' Co m ensation Insurance Affidavit. MGM 016i name location Z t> f city !< `� lid ce3S phone# ❑ am a homeowner performing all work myself. am a sole pro rietor and have no one working in any capacity ❑ I am an employer providing workers' compensation for my employees working on this job. company name• address: city phone#: ... insurance co. Rolicv# ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: ......... company name: address: city phone#: oluv# .. ; insurance cm cam anv name: address: ci hone#: oll&# _ Insurance CO. /// Failure to secure coverage as required under Section 25A of AiGL 152 can lead to the imposition of criminal penalties of a tine up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine 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 verification. I do hereby certify un the pains and penalties of perjury that the information provided above is true and correct Signature Date Print name /��JS CG� i1� l�1 tv��I Phone# 3 6 Z — Cl-7 Z.? oincial use only do not write in this area to be completed by city or town official city or town: permit/license# ❑BulldLng DeF—t) (]Licensing Bo ❑check if immediate response v required ❑Seleconen's e ❑health Department contact person: phone#; ❑Other (mNwed 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their is defined as every person in the service of another under any coutr employees. As quoted from the "law", an employee 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 o: 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 apartments and who resides therein or the occupant dwelling house having not more than three ant of the dwelling house of p 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 beta Se of such employment be deemed tobe an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or reney of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who h; 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 yo, are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of th affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned 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 Office of ImlestlgaUana u 600 Washington Street Boston; Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 f 4 y.w i. '' � � �..`. ��,, %� I '�,�e•�•Y 9rs Oas..w. ... 4� '1 r 'max v'�- L t � '� '+ � t�� h s:.a•'� � r c, } v / ,:•'v.{F' a,ax3fx r s v )}'•�a 'i•Y..r k r ' 7 ro i5 : r {w��'4x rr4St3" : ui _ i HOHE: IMPROVEMENTCONTRACTORS ,S- REGISTRATION p •S *� Board of'h.BuiIding Regulations--``,,,and Standards r, a fir' x i Sf t ` [ ` ; One "Ashbur;ton Place' Room 1301 `r ' t' Yv��.o� 1• 'R t , f " Boston,Y Massa.ehuse.tts,. ax `d" �k i:<K •�` , i a `✓��Y'r• .. t" , �' ` .'�.. a. s ,,.:$'°� }.� +�}. S: it Eyct, } p�fi' r�+ a i�`�I'�i'j a(F F r ,� S-, - -.• : ,. " �. °..6 rt'v�,s,r r n x�. �"�.�`. ryr, ,r J ry,v+.a �` K#' °+.."4$ r d � r`z :.*i +. t�`S `L ga s HOME'=IMPROVE MEN T4O','CONTRACTOR .� a • L � ..; 37 i -- „ ;�- a� ';s:=.a�'zT, ° I 'n4•d•`e'x :'� i•S j `33 �nrXr � x t.. — _ _ Regiiitr,ation 104428r 4 Expirat1:bn 07/24/98 : e. �� t # r x ,r t` erclOoaMrrowrceo�GE' .��1 g, fType t,INDIVTDUAL ;„ f a ��.x�J a" kii, �t ,y r-•`t+ rr r"` to, � �"'+ ,� ;u ;� �' �$1�3". 4`�' �'�:��- '�y� ¢. '�r.;:sy�`��x��y��-�'x.-„#Q �.�f� �:�{s X�,� �K� . { �.#� X'�.'§•'.^si'.,a S, ,.i sf �,}n -c iii{# i.t r Yt +�P�v .3- Ya � �-a'' •�: ',C'a'r -'� , �A+ . v;. �� Ft :, < � , _ ►�� F k.M,� , A„�=. err . �. ,NOME'INPROVENENT CONTRACTOR P '$ i ,�t y `^r. ki' ,F•,;� , � Regtbtcation=.104428 Vie,.xYF2USSELL� A GIBBON w`!;Type A INDIVIDUAL e; ':.Russell A -'Gibson ,Jra k s �� : 3 . , �� i • ., � ,f r g?-= >r §. +:ti,. !.' 1 v Vx •LCl f,, Y. 77r •e 4- C ' t•.* s.._ ...} EXplrflt1011a* 07/14/98 3l f 3 1 r w L x C0Untl" C1U •al R-y'r 1� Drsl Y e ff�?r y'lel '6 S.a,fG`'�,� 'FY'. b `�+ _.. R,f '� �Yj4 ' ,; 4k '. 1�)"x _ A -}S. 'F.�•' .. +:. -? .,t��.. 1r "a'Yi. a • ' .ab .rs i_3+,# I-.; ''W v *. ..r - r."fit E CummaquidxMA,,02637 ,,� ,RUSSELL A. 6IBSON'J .�� i R e ... sell A Gibson, Jr „�,�,z � -..xy o � t f 9 K d y - + �', I v :dr� a r c v �Ld�✓!CO� rii v w f s ADMINISTRATOR.70 Country Club Drive xr 1 y.:a 4 x ; ,.• ' v t ' rc f +p's;' g. r . aSK d Cumaaquid MA 0260 21 s , •- w:�,.. .. � •., ,.-� � _ -.:�..n..�ofdw�.YK6"<'4'3i`A•'F�i�.�4��ur .. - _ ��: 1/�dI7Y/)LO!'u�/PQLI�Z O��!i(,uJJ2(.17.uJ s - DEPARTMENT OF PUBLIC SAFETY CONSTRUCTFOVSUPERVISOR LICENSE Number Expires: Restrlctd To BB RUSSELt, GIBSON JR l +w y!Cry PO BOl! 118 BARNSTABLE, MA 02630 V Town of Barnstable Planning Department ` Staff Report Appeal No. 1997-115 Favat Variance Section 3-1.1(5) Bulk Regulations Front Yard Setback . Date: October 29, 1997 To: Zoning Board of Appeals From: Robert emig, Director. Art Traczyk.Principal Planner . Petitioner:' Peter Favat Property Address: 373 Bay Lane;Centerville, MA Assessor's Map/Parcel...:........... 187/002....Area: 1.35 ac. Building: 1,156 sf. Zoning:..................................I.........RD-1 Residential D-1 Zoning District Groundwater Overlay....................AP Aquifer Protection Overlay District Filed: October 10, 1997 Hearing: November 05, 1997 Decision Due: January 16, 1998 Background: The property;located at 373 Bay Lane Centerville, MA, is developed with a one story, 1,156 sq.ft. single family dwelling. The 1.35 acre parcel has only 0.35 acres of upland located adjacent to Bay Lane. As the Board may recall, the applicant was.before the Board,in Appeal No. 1997-100 for a Special Permit for a change in a Nonconforming Structure. During the hearing on that appeal, it was the Board's determination that a nonconforming situation did not seem valid and the applicant was instructed that the appropriate relief may be a Variance. Appeal No. 1997-100 was continued to this date so the Board can determine the appropriate relief needed and if Variance conditions exist. Zoning Relief Requested: The applicant is seeking a Variance to Section 3-1.1 (5)- Bulk Regulations, Front Yard setback to permit a 7 foot by 37 foot Farmer's Porch onto an existing structure. According to the plot plan supplied, the existing.structure has a 27.5.foot front yard setback and the proposed new setback appears to be 21.4 feet'. . According to the Assessor's Record the building was built in 1968. In 1968, the locus was zoned RD-1 as it is today. In 1968,the required front yard setback was 30 feet with a qualifier that"no building need be set back more than the average of the set-backs of the buildings on the lots next thereto on either side,"2. Today, the RD-1 requires a 30 foot setback from the front property line. Staff Review: It is important to cite that the structure is located within an A-10 Flood Zone and is prone to periodical flooding to elevation 11. The existing top of foundation is at 9.62 feet. Any substantial improvement to the structure should.be abided by Section3-5.1 -Flood Area Provisions. ire buildable onion of the lot is within 100 feet of wetlands and is subject to an Order of ' The entire p Conservation from the Conservation.Commission. The applicant should be prepared to submit to the Board and file any Conditions of the Conservation Commission issued to the site for the improvements made. Is ource: Site plan submitted. 2 Source:.19682oning Bylaw,Town of Barnstable r r Town of Barnstable-Planning Department-Staff Report Appeal No. 1997-115 - Favat Variance-Section 3-1.1(5)Bulk Regulations Front Yard Setback i Variance: In consideration for the Variance, the Petitioner must substantiate those conditions unique to this lot that justify the granting of the relief being sought. In granting of the Variance the Board must find that: unique conditions exist that affect the locus but not the zoning district in which it is located, • a literal enforcement of the provisions of the Zoning Ordinance would involve substantial hardship, _ financial or otherwise to the petitioner, :and the relief may be granted without substantial detriment to the public good and without nullifying or substantially derogating from the intent or purpose of the Zoning Ordinance. Staff Recommendations: If the Board should find to grant relief in this instance it may wish to consider some of the following conditions and staff recommendations: 1. The relief granted is for an addition of a 7 foot wide by 37 foot long open "farmers porch"to be located as per plan titled; "Site Plan of Land in Barnstable(Centerville), MA prepared for Peter Favat", prepared by Down Cape Engineering Inc: dated March 19, 1997, and last revision date of May 22, 1997 and scaled at 1"=20' . 2. The porch shall remain open to the elements and shall not be enclosed. 3. There shall be no further addition or increase in the gross square footage of the dwelling without permission from the Zoning Board of Appeals. Attachment-Assessors Card Attachment-ZBA Application Forms and Submitted Materials .2 > i THE ZONING RELIEF BEING SOUL TOWN OF BARNSTABLE • . BEEN DETERMINED Ey TTiE ZONII1Ta �W Zoning Board of -Appeals ENFORCERfENTOrI_CERTo � Application 'to -Petition for. a Variance BE APPROP?IATE RELIEF G CIRCLij, �,VCE°. MW TWE Date Received For office use only: Town. Clerk office OCT , Q 19J7 f.Aplseal. # 011 - %15 Hearl g Date,- ►1 • CS•an Decision Due" *I- 1`- qd 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: Peter Favat , Phone Petitioner Address: c/o HHF, 360 Newbury Street, Boston:, MA 02115 Property Location: 373..Bay Lane, Centerville Property Owner: Peter Favat , Phone Address of owner: 373 Bay Lane, Centerville, MA 02632 If petitioner differs from owner, state nature of interest: Agent: Hamlyn Consulting 70 Hi ary s Cartway Brewster, MA. 82631 (508).394-5803 Number of Years owned: Assessors Map/Parcel Number: AM 187, P 2 Zoning District: RD 1 . Groundwater Overlay District: Variance Requested:. 3-1 . 1 (5) Cite. Section & Title of the Zoning Ordinance Description of variance Requested: Proposed construction of a farmers porch. which will be set back from the front property line a ' minimum of 2.1 .4 feet: current setback requirement is 30 feet. Description of the Reason and/or Need 'for the Variance: The existing dwelling is presently located a .minimum of 27.5 feet from the front property line Discription of construction Activity (if applicable) : Farmers porch to be attached to the front .of an existing dwelling Existing Level: of Development of the Property - Number of Buildings: 1 Present Use(s) : Residential , Gross Floor Area: 1 , 156 sq.ft. Proposed Gross Floor•Area to be Added: 259 sq f t , .Altered: Is this. property subject to any other relief (Variance or special Permit) from the Zoning Board of Appeals? Yes [ ] No Jj; if Yes, please list .appeal .numbers or applicant's name Application to Petition for a Variance Is the property within a Historic District? Yes [ ] No k] Is the property a Designated Landmark? Yes [ ] No ] For Historic Department Use only: Not, Applicable [ ] oKH Plan Review Number Date Approved Signature: Have you applied for a building permit? Yes E] No [] Has the Building Inspector refused a permit? Yes (x] 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 prior to submitting this application to the Zoning Board of Appeals. For Building 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 Appeals may deny your request: 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 its determination. signature: �- 6� Date: 10f9/97 Petitioner or Agent's Signature Lynne Whiting Hamlyn Hamlyn Consulting Agent's Address: 70 Hilary ' s Cartway Phone:(508 )394=5803 Fax No. __ Brewster, MA 02631 s's. oil .119:5� L •, �i =� .9f•6L .891Z ' d N� �o. 4bh 9� ~ r At o to ry0' <� •� • � � ,t•'� "•`•. 4"ail Cie ,. �� •� G� ��[' r ?>,•:/ � •it ' ,' - '. 'EIR BAY . � .�= itv�.:J'�7'. �'r. r jjI ..wig••• '� •; •:-•� M �i:< _ .r � �'•.•' ';U y''•..wiy� L ,,;' -' Jam.:+'• `!•*� Mj - Y .•yyr� - •-+ 1 ... »51�r .J k'[ • ,rt�i�•!j1 � �rQ «�°>3�+•:fir-< •� ZS ' tom.. � '', 'fib „n J ..k� ,f '•R -t� R�t�� Y ,�'••'1'•' :.P.'�' 1 \ ��.'• lop' _\ m •�': d. 1 ;,�`i " �+ Sa ., °, ram..•:'' ;1 to 0- cc EM p .1� tL n f _ .�••1' tr _ 16 t IYC�/ODEA /Ar AOPFK .•.•s UD^ MS lPIICf ilt. too �t f j•1 4OAc_ Y + • 37 I + �.• : �: TT • ss•c LP I ; \ ass.... oafw•' 3.2 ••� j-1 � SiMLL 44aC Gwu+O TOT4L i • �' \ OPEN 5RK[ M.t < 17 uPUw M_��•1.1. weT o lb 6 3,4 7. j� 1•( �3 > at p f 4L 2*4� .!t w..• • � , 3�7•CTe7r� ' *7 O . S h •• 1/7rte ' s � SAO AL 16 4 JJ4C 3 7. op AT •' w A 1 c • - 2 �` y 1.22AHO • 34 1 2.62 w 1; t 0373 BAY. LANE .. 10 R'D 1 300 101.0 .. 1 /04/96 1011 JJ 43W8 k147 002. 107574 LAND%UlHCf FEATURES DESCRIPTION- ADJ1__It L NI FACTORS r' UNIT ADYD.UNIT F.AVATP PETER P MAP— , b u D.moo>,on ACHES/UNITS VALUE U.aoi . LOC/YR.SPEC CLASS'ADJ. COND. P PRICE PRICE cD FF u.r,UnAa , __ M L A N D 1 7 S 7 00 CARDS IN ACCOUNT - :15 1WAT'ERFNT .1 X .35 =.13 194 109999.9 213399.97 .3�5 747UJ -1dLDG(S)-CARD-1 1 74P600 01 op 01 16 1WETLAND, 1 X 1 =10 100 16GO.0 1000.00 1.00 -1JJJ 4PL 373 JAY LANE COST 0 so :1DL..LOT 2B7 MARKET 16i200 BATHS 1 .0 U. X � .. C. .100 3500.00, 3500.00 . 1.00 35JO d IRR 0084 0120 (INCOME f � . FIREPLACE U ?(. G=. 100 Aico.oco 310C.0U 1 .0..0 31Ju 3 USE iAPPRAISED VALUE IA 150.300 PARCEL SUMMARY LAND 75700 i BLDGS 74600 I T I 0 _IMPS - i - INO[NST 150300 - UEED REFERENCE 1rPn DATE R.r'wn.a P R I O R YEAR VALUE Htw. -- PAAtr Ina MO Y, p_ $aef rr«:. LAND 75760 C1t434: 09/91 155000 ELDGS 74600 I. C 1 1.9709. I:01/90 B 10 TOTAL 150300 C30533 00/00 BUILDING PERMIT LA N 0 LAND—A DJ INC" 14E I I SE. SP—BLDS FEATURES BLD40JS U3ITS I 75700 6600 :535E35 7/44 AD 6000 51. T-�tAnl.. _.- YBAr Hti,ll Norm DosV' �._�.._.._-� —...—.1.-.- 1,,,�,I l-�s I un�,., I 3.,_I"",: I Ad R." t-�t 1 A.. OnG. CunO. CNO LOC. a0 R G RUPI Cusl NB Atf, n1 w VAiun Sl4nns I,1'a.tlfn Htr,ms �MO Rmf O.T. •F.A.' ✓.nr wAll F. j01C+ UJO 110 110 63. 30. 59.63 68 75 19 80 100 80 93297 74600 1.J 5. 2 1.0 4.0 Dc,vna�un Rale SgnarA Fam Rc•PI Caal MKI' INDEX: 1.00 IMP.SY/DATE. / SCALE: 1 100 77 ELEMENTS CODE' CONSTRUCTION DETAIL - -AS i00 69..63 1156 80492. ELT"G ENS —uri-up i fWD 65 6.50 163 1428 *-------21------*----14----* TYLE 03 ANCH 0.0 FOP' 35 24.37 196 4777 8 FWD 8 ! DESIiN.ADJMT Q1Dc$ [GN ADJUST 16.0 -- ---- -- ----- - ! EkTER:aALLS 01W000 .,FRAit 0.0 34---21------ 1.4 EATI it- TYPE -04OIL - --------- 070 ! 6 N T"E R.F'rN I S H 00 ! ! FOP ! INT-ER:L-AY0UT_. -01 ------ -- --U C ! *----14----* INTER:JUALTY 02S.�ME AS EXTER:- 0:0 ! fL uSR-3TRUCT _00 -------- •--- - -- 0:0 I W ! BASE ! E LJ IR O - COVER 00 ----- D - --- U:0 E ,nt:,lA,nAs An..- 364 a._ 1156 28 -! ODF'TYPE .. J0 - - - --- Q.O. BUILDING DIMENSIONS ! 18 t L E L T R-I-C KL -00 . - --- -_0.0 • T BAS W37 SO4 W13 N23 E34 FWD N08 ! ! fLi1A01ATL0N 0C ----9 �«21 S03 E21 BAS S06 FOP E14 ► - - IN14 W14 S14 .. BAS E16 S16 .. ! ! " dEI�N3OItHOS6' 45Q[3 CENTERUfCLE I_ ! *-------------37-- -----*X LAND :TOTAL MARKET 4 PARCEL 75700 150300 *----13---* AREA 115222 VARIANCE +o . +30 STANDARD 25 From the Zoning Board of Appeals Minutes of September 17, 1997 Appeal Number 1997-100 Favat Board Members hearing this appeal were Richard Boy,Ron Jansson,Gene Burman,Gail Nightingale,and Chairman Emmett Glynn. Lynne Hamlyn of Hamlyn Consulting represented the applicant,Peter Favat. The Board asked Ms.Hamlyn if she had standing before the Board. She replied she is the wetland's consultant hired for the project and presented it to the Conservation Commission. Although she did not have a letter of standing with her,the Board allowed the appeal to go forward with the understanding that a letter from the applicant would be delivered to the Planning Department. Ms.Hamlyn submitted the Order of Conditions from the Conservation Commission for the proposed open farmer's porch that will not be enclosed,the space is not habitable. The Board asked the applicant for proof that the building is nonconforming,as this must be established since the applicant is seeking a special permit. If it can not be established then the applicant would need a Variance. Ms. Hamlyn could not answer,but will check. The Building Commissioner stated that in the Building Department files there is a building permif for a screen porch from June 1994. That was built in the back of the home. The front of the house is nonconforming by 3 feet and the proposal would make the front setback further nonconforming. Based on the age of the house,the.Building Commissioner felt that because the house was more than 10 years old and built with a Building Permit, it is lawful today. The Board clarified that just because the house is over ten years old does not make it non conforming, it just means the Building Commissioner can not compel the applicant to remove the structure. By definition of nonconforming, the location of the house when it was placed on the ground had to have been legal and some zoning change had to have occurred that made it nonconforming. The Board needed evidence that this is what happened with this dwelling to prove it is nonconforming. Specifically the Board needs the date the house was built. Also needed is the placement of the adjoining houses on their lots in terms of setbacks to compare to with this property. This will allow the Board to determine if the home was not setback more than the average setback of the adjoining buildings. Public Comments:No one spoke in favor or in opposition to this appeal. A motion was made, seconded and unanimously voted to continue this appeal to November 05, 1997 at 7:30 PM. This will allow the applicant time to establish the nonconformity of the structure. If nonconformity can not be proved,then the applicant will need to seek a Variance. Appeal Number 1997-100 has been continued to November 05, 1997 at 7:30 PM. srnak»r.}.•�vkr,,'Y;�}??�??k^:%�'?r?K:'�e�,�Y2Y;.::�x}}Yzz�'?x.�xr;��;�vKxYv:z.�;�;�k�wk`y.,,,.xzmmYz»'?`x?kµkzr;zuxx}:.YYukwY;ar?`w!rrr'�?kY>z.�;;k;;�!z"}»x:•:Ymk�;c:kxxzvY,}nuu:cxYYYYYv>kxx�;:µt,y 'li^Y.. `•4.{: vn'{:'»vn»»wn::.;.!!ta»v.:•n:Y:h.:»v. »`iv`Y»Y. 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[ ] [R187 002 . , ] LOC] 0373 BAY LANE CTY] 10 TDS] 300 CO KEY] 107574 ----MAILING ADDRESS------- PCA] 1011 PCS] 00 YR] 00 PARENT] 0 FAVAT, PETER P MAP] AREA143WB JV1285541 MTG1200.1 % HOUSTON HERSTEK FAVAT SP1] SP21 SP31 360 NEWBURY STREET UT11 UT21 1 . 35 SQ FT] 1156 BOSTON MA 02115 AYB] 1968 EYB] 1975 OBS] CONST] 0000 LAND 75700 IMP 74600 OTHER ----LEGAL DESCRIPTION---- TRUE MKT 150300 REA CLASSIFIED #LAND 1 75, 700 ASD LND 75700 ASD IMP 74600 ASD OTH #BLDG (S) -CARD-1 1 74, 600 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #PL 373 BAY LANE TAX EXEMPT #DL LOT 2&7 RESIDENT' L 150300 1.50300 150300 #RR 0084 0120 OPEN SPACE COMMERCIAL INDUSTRIAL EXEMPTIONS SALE] 09/91 PRICE] 155000 ORBI C124345 AFD] LAST ACTIVITY] 06/26/96 PCR] Y R187 0.02 . • P E R M I T [PMT] ACT* [R] CARD [000] KEY 107574 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR .CMP NEW/DEMO COMMENT [B36855] [07] [94] [AD] A 60001 [LK] [01] [95] [100] [NEW ] [CE PORCH ] [ ] [ ] [ l [ ] ] [ l [ l [ ] [ J [ ] [ ] [?] t I R187 002 . P P R A I S A L D A T :# KEY 107574 FAVAT, PETER P LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RD- 1 75, 700 74 , 600 1 A-COST 150, 300 B-MKT 164, 200 BY 00/ BY /00 C-INCOME PCA=1011 PCS=00 SIZE= 1156 JUST-VAL 150, 300 LEV=300 CONST-C 0 ----COMPARISON TO CONTROL AREA 43WB -- --MAY NOT BE COMPARABLE-- NEIGHBORHOOD 43WB CENTERVILLE PARCEL CONTROL AREA TREND STANDARD 151 15 LAND-TYPE 757001 LAND-MEAN +0% 1503001 345667 IMPROVED-MEAN -780-. 250 ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 100061 LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP] ADJS/SB/FEAT STR] STRUCTURE ARR]AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [000] DATA- [ ] XMT [?] •T -0} Town of Barnstable Planning Department Staff Report Appeal No. 1997-100 -Favat Special Pe uant to Section 3-1.1(5) Bulk Regulations Date: Sep bee7� �7 To: Zonin Appeals From: Robert P. Schernig, Director Art Traczyk Principal Planner Applicant: ......................................Peter Favat Property Address..........................373 Bay Lane, Centerville, MA Assessor's Map/Parcel............... 187/002....Area: 1.35 ac. Building: 1,156 sf. Zoning:...........................................RD-1 Residential D-1 Zoning District Groundwater Overlay....................AP Aquifer Protection Overlay District Filed July 30, 1997 Hearing Sept. 17, 1997 Decision Due Dec. 15, 1997 Background: The property, located at 373 Bay Lane Centerville, MA is developed with a one story, 1,156 sq.ft. single family dwelling. The 1.35 acre parcel has only 0.35 acres of upland located adjacent to Bay Lane. Zoning Relief Requested: The stamped, approved application, submitted to the Board, requests a Special Permit to Section 3-1.1 (5) - Bulk Regulations. However, in the request, the applicant states"non-conforming as to front setback- proposal is to get more non-conforming". The non-conforming section that may be applicable appears to be Section 4-4.3 Nonconforming Building or Structures Used as a Single or Two Family Residences. Or as an alternative a Variance to Section 3-1.1 (5)- Bulk Regulations- Front Yard Setback may be the appropriate relief. The legal notice was constructed as per application received and section cited by the applicant. Staff Review: It appears the applicant desires to located a 7 foot by 37 foot"Farmer's Porch" onto an existing structure. According to the plot plan supplied, the existing structure has a 27.5 foot front yard setback and the proposed new setback appears to be 21.4 feet'. According to the Assessor's Record the building was built in 1968. In 1968, the locus was zoned RD-1 as it is today. In 1968, the required front yard setback was 30 feet with a qualifier that"no building need be set back more than the average of the set-backs of the buildings on the lots next thereto on either side,"2. Today, requires the RD-1 a 30 foot setback from the front property line. To qualify for a special permit for a non-conforming structure, the applicant must substantiate the legal non- conforming aspect of the buiiding. It is important to cite that the structure and lot are located within an A-10 Flood Zone and is prone to periodical flooding to elevation 11. The existing top of foundation is at 9.62 feet. Any substantial improvement to the structure should have abided by Section 3-5.1 - Flood Area Provisions. Also of concern is the fact that the back"Su Porch" is a,completely,,enclosed room today. The area was originally an open deck that, according'to plans submitted and permitted-by the-Building Department, was to 'Source: Site plan submitted. 2 Source: 1968 Zoning Bylaw,Town of Barnstable Town of Barnstable-Planning rtment-Staff Report w Appeal No. 1997-96 -Favat 0 0 Special Permit pursuant to Section's-1.1 5 ( )Bulk Regulations be a "Screened-in Porch" (Building Permit No. 36855). The complete enclosing of the deck area has added to the gross square area of th 9 q e building. The entire buildable portion of the lot is within 100 feet of wetlands and is subject to an Order of Conservation from the Conservation Commission. The applicant should be prepared to submit to the Board and file any Conditions of Conservation issued to the site for the improvements made. Special Permit Findings: The standards for granting a Special Permit require the following findings of fact to be made by the Board (Section 5-3.3(2)): • that the application falls within a category specifically excepted in the ordinance for a grant of a Special Permit, (Special Permit pursuant to be Section 4-4.3 Nonconforming Building or Structures Used as a Single or Two Family Residences appears to be applicable.), • that a site plan has been reviewed and found approvable in accordance with Section 4-7 (The locus is a single family dwelling that is exempt from Site Plan Review.), and, • that after evaluation of all the evidence presented, the proposal fulfills the spirit and intent of the zoning ordinance and would not represent a substantial detriment to the public good or the neighborhood affected. Staff Recommendations: If the Board should find to grant relief in th s instance it may wish to consider some of the following conditions and staff recommendations: 1. The relief granted is for an addition of a 7 foot wide by 37 foot long open "farmers porch"to be located as per plan titled; "Site Plan of Land in Barnstable (Centerville), MA prepared for Peter Favat", prepared by Down Cape Engineering Inc. dated March 19, 1997, and last revision date of May 22, 1997 and scaled at 1" = 20' . 2. The porch shall remain open to the elements and shall not be enclosed. 3. There shall be no further addition or increase in the gross square footage of the dwelling without permission from the Zoning Board of Appeals. Attachment-Assessor's Card Attachment-ZBA Application Forms and Submitted Materials 2 ZONING RELIEF BEING SOUGHT Ea TOWN OF BARNSTABLE ,BED'DETERMINED BY THE ZONWG Zoning Board of AppeaW- -t FN"';?CEMENT OFFICER TO . Application for a Special P ROPRIATE RELIEF GIVEN THESE CIRCUMSTANCES. For office use only: Date Received Town Clerl ��ge Appeal # I q'1- O � 1� �, Searing Date � •qh ' _ Decision Due Lo IaIs1� a JUL 3 0 __. The undersi ed hereby applies to the Zoning Board of Appeals for a Special Permit, in the;w; for the reasons hereinafter set forth: Applicant Name: I�e-1 P r ��J c`� Phone "� Applicant Address: T �' '� a D {� P cJ b,�^� S1�e-� /yA 0 Zt I Property Location: •37'� 13G� �G.ne P..�cc-�r� �1t Property owner: i e��r Iff"'If Phone Address of. Owner: 119 'S r e r-%J i l e An-A d Z-L&3 2 If applicant duffers from owner, state nature of interaati 77o o 2-U _3 (50) 31 q- S So 3 number of Years owneds Assessors Hap/Parcel Number: Zoning District: a_V Groundwater overlay District: =� Special Permit Requested: S _ �' \ S Cite section T1tle of the Zoning Or nance e Description of Activity/Reason for Request: set A�i - M ZIT `ta Description of construction Activity (if applicable) : - .4a12 C Proposed Gross Floor Area to be Added: c// , Altered: Existing. Level. of Deve opment.of the. Property - Number of Buildings: Present Use(s) : ., Gross Floor Area: sq. ft. Application for a Special P*t Is the property located in an Historic District? Yes [] NOX If yes OKH Use Only: Plan Review Number Date Approved Is the building a designated Historic Landmark? Yes [] No Sf yes Historic Preservation Department Use Only. Date Approved Have you applied for a building permit? Yes/ ' No [] Y )�,, Has the Building Inspector refused a permit? YestX��- No [] All applications for a special -Permit require an approved site Plan. That process must be successfully ;completed prior to submitting this application to the Zoning Board of Appeals. For Building Department Use only: 1l,, Not Required - single Family 1� Site Plan Review Number Date Approved Signature: The following information must be submitted with the application at the time of filing, failure to supply this may result in a denial of your request: 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 and surrounding roadways and the location of the existing improvements on the land. Five (5) copies of a proposed site improvement plan, drawn by a certified professional and approved by the Site Plan Review committee is required. for all proposed development activities. 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 detailed requirements. The applicant may submit any additional supporting documents to assist the Board in making its determination. Signature: Date Ap icant�s or Age is Sign ure Agent's Address: Hamlyn Consul ina Phone (508)394-5803 70 Hilary's Cartway Brewster, MA 02631 Fax No. Same ISCUDDER mor •I \ •yLA& OPEn yoACE .As •L' AL ima J 40AC 3.6. . C 4LAC I ... 2$AC,$ �•.Z�-XCCE L! C�n•T 'a _4 * AL ' 0 37 � � a •: I - V AA o ® 3-d r• ` , w y� E 32AC- I '• J. p Io it tie sDa © 3'3 n�eJ f •� 2 \�•, 37AC• �► OPON 3-2 • 3-1 N • \ SPA" 44AC G7iAND TOTAL if. CWEN SPACE .Aq rc L d 17 uPLAN r4. WET D �.16 `j4 2.77A TML . y! • Its 374 DIP 1 f Alf 1 �a74C .9t y/YAA S,�,yrywa* IS-L � 1® 3 7 Ac TSTLL • 430 A.L. O .70 uILAND g 1 •� y T N �A) .� ?j 1 a WAX 1 Zq-2 c 1 '47 77 ugAND ( 47 04 � I•+0 TOTAL / J� A O c, 2e 1.22„pLwNO f 1 .SS w67 TOTAL �� 1 •4y. `r 34 i L 4 4C o 2.626G 1 1; ►� WATER GATE UTILITY POLE a) I C- GUY WIRE UNDERGROUND 072 GAS UNE. EXISTING TREE. 13.93. BORDERING A SPOT N. ELEVATION �� VEGETATED . WETLAND LiC Lei ,. - COASTAL �3• r,15AL SALT j % AL AL MARSH �iAf11?SGIC•PG. L!a AL _ AL 4.s FENCESdc. LOT 6 '�� f 3 } LCP 35308-8 ROCK AL WALL � o. ^ 4 L oi, AIL AL i,. SUNROOM _ 373 ON POSTS q %.X.7 AL , ff3 AL O. 7.X BORDERING c0 ' J ' • 4' yJ/ P WETLAND 4j 1.- �� :J' sd p � s.T Xl (\ ..r 4.2 AL -.ate+_ .1.G6Gt1.�! !' •'M. ♦ t-:, cY .1 �` ) - ♦ AL $ .. ly �� '' s 3.5;T 1g�5 T,r FIELDS POINT MANUFACTURING CORP.' L, PROPDsED _f2S\��V� �� .1 j Ay ! .. � .. .PAVE^ _ - f SWALE - - ATE .... _ _ do ♦�'' _ i t-19pPE!?Tl'MJRESS I ZONING I DISTRICT CODE SP-DlSTS.I DATE PRINTED I CLASS I PC I N6Hp PPR Ijj,F1yTIFICATION NUA -_ KEY NO. _ 0373 BAY LANE 10 RD_-1 300 loco 01/04/96 1011 JJ 43W8 R137 002- 107574 - LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS _ (l..r�o Rr/Dalo _ s .<Dmen.on v UNIT ADJ'D.UNIT UE D.,crpnon F A V A T o PETER P MAP- -1 ,• / CD. FF-0ep0,/Acres �LOCJYR.SPEC.CLASS :1D.1. CO NU ACRES/UNITS VAL . P PRICE PRICE #LAND 1 75o,700 CARDS IN ACCOUNT - L 15 1WATERFNT 1 x :3 =10 . 19+4 y �- 109999.9E 213399.97 .35 747UJ #BLDG(S)-CARD-1 1 74.600 01 OF 01' A 16 1WETlAND 1. x 11 =10 100 1000.0 1000.00 1.00 1OJJ #PL 373 3AY LANE COSI N #DL LOT 2B7 MARKET 164200 p BATHS 1 .0 U x C= .100 3500.00 3500.0.0 1.00 3500 a IRR 0084 0120 INCOME q FIREPLACE U X C=. 100 .31GO.0C 3100.00I 1 .00 31Ju 3 IUSE D APPRAISED VALUE D I A 150,300 A PARCEL SUMMARY S �. LAND 75700 A T BIDGS 74600 0-IMPS E TOTAL 150300 E E ! N CNST E n) � UEEU REFERENCE TYpe DATE Hecoraeo PRIOR YEAR VALUE. q T i dtiok PeQe Incl. MO. Yr,p Saee Pr ce LAND 75700 T Si C124345 09/91 155000 SLDGS 7460C U C119709 I:01/90 a 10 TOTAL WOO R C30533 bo/00 E BUILDING PERMIT S NumUo• e19- T" M.wunl LAND LANID-ADJ I14C014E SE SP-BLDS FEATURES SLD-ADJS UNITS I^ �' 75700 6600 o 3iE5> 7/r4 AD 5000 Consl. 7o.al Year Hull Norm, ObSv. T-- Cit+s, I ..u� R' A,11 Hale, Aqe CND. Lot. °b R.G. Rcpl C-1 New Ad,Rep. Val- iy t H ere Rms delve I Fia. Pertiwell FK. 101C+ 000 110 110 63.30 59.63 68 75 19 80 100 80 93297 74600 %J 5 2 1.0 4.0 D . Rate Syuale Feel Repl.C-1 MKT.INDEX: 1-QG IMP.BY/DATE: / SCALE: 1/00.77 ELEMENTS CODE CONSTRUCTION DETAIL r esci•lion S BAS 100 69.63 1156 80492 GR055 AREA 1 15 6 SINGLE FAMILY DWETCMG . CNST G► : t ! FWD 35 8.50 168 1423 *-------21------*----14----* STYLE 03 ANCH 0.0 T i R FOP 35 24.37 196 4777 8 FWD 8 ! DESIi.N ADJ.MT 01D SIGN AUJUS_T16-0 ! ! EXTER.aALLS 01 WOO 6 FRAME ____0.0 U I *---------*--34---21------* 14 E.ATlAC--TYPE 04oIL ---- ------------0- .0 T 6 ! NTER:fIt41SH. -00 ------------ ---6:0 T FOP ! INrER.:LAYOUT" -01 ----------------Ti:O U I ! *----14----* If TcR:'WIfACTY R ! ' FLUSR STRUCT- -00 -------------------U.O A W ! BASE ! EFLUiSR-COVER-- -00 ,------'-------- - U:0 L D T-1A-- Aoa_ 364 BJSe • 1156 28 ! DOF-TYPE---_ -00--------------------U 0 T ! 18 ELcCTRIrAl C--- -00 -------------------Q.O BUILDING DIMENSIONS • A BAS W37 SO4 W13 N23 E34 FWD N08� ! ! F0UJ5ATION-_-. -0C ____V9.9 W21 S03 E21 .. BAS S06 FOP E14 ! i - - ----- ----- I N14 W14 S14 .. BAS E16 S18 .. ! NEIGHBORH056 439e CEF ERVIILE L ! *-------------37-----------*X LAND TOTAL MARKET ! 4 PARCEL 75700 150300 *----i3---* AREA 115222 VARIANCE +0. .+30 STANDARD 25 � ,I S. 11.13S1DENCE D-1 DISTRICTS _ acter, said determination to be made by the Board of Ap- t. Use—No building shall be erected or altered and no build peals following a petition of the land owner or owners and a ing or premises shall be used for any purpose except: special perinit granted therefor, including only uses con- (a) Detached one-family dwelling. ducted in dwellings or in accessory buildings and involving (b) The taking of not more than six (6) lodgers by a family only the services of persons living on the premises and not resident in the dwelling. more than one (1) other employee, except that the occasional 2. Size of Lots—No building, except one story buildings of presence of additional employees on the premises shall not -accessory use, shall be erected on a lot less than one hundred be prohibited, and further excepting physicians, surgeons twenty-five (125) feet wide and containing not less than twenty and dentists, which professions require clerical and medical thousand (20,000) square feet, provided that one (1) one-family assistants. Such permitted accessory uses shall not entail dwelling and its accessory buildings may be erected on any lot pp any external changes in the structural form of the building. which, at'the time this by-law is adopted, is separately owned, 1 Permitted uses shall be restricted to such as are not offen- or which. is shown on a plan of lots approved.by the Board of sive by reason of the emission of odor, dust, smoke, gas, Survey and recorded in the Barnstable Registry of Deeds after noise or vibration, or otherwise obnoxious such as by reaso January 1, 1956, and before the date this by-law is adopted. of the accumulation of materials or debris. 3. Front Yards—No building shall be erected within thirty (c) The taking of not more than six (6) lodgers in any (30.) feet of a.street line, provided that no building 'need be set dwelling. back more than the average of the set-backs of the buildings 2. Size of Lots--No building, except one-story buildings of on the lots next thereto on either side, a vacant lot one hun- dred (100) feet or more in width or.a lot occupied by a building accessory use, shall be erected on a lot less than one hundred set back more than thirty (30) feet being counted as though twenty-five (125) feet frontage and containing not less than occupied by a building set back thirty (30) feet. twenty thousand (20,000) square feet, provided that one (1) 4. No building to be erected closer than ten (10). feet from one-family dwelling and its accessory buildings inay be erected sidelines or rear line. on any lot which at the time.this by-law is adopted is separate- This district added .by 1957 An 55, approved by the Atty. ly owned, or on a lot shown on a plan of lots approved by the Board of Survey and recorded in Barnstable Registry-of Deeds Gen. June 10, -2 D after January 1, 1956, and before the date this by-law is adopted. T. 1.Use N o bull DISTRICTS 3. Front Yards—No building shall be erected within fifty (50) 1. Use—No building shall be erected or altered and no build- •' feet from the center line of the road or thirty (30) feet from in.-or premises shall be used for any purpose except: the side line of the road, whichever is larger, provided that no (a). Detached one-family dwelling, except that alterations of building need be set back more than the average setbacks of single family units may be permitted, to allow use as a two- the buildings on the lots next thereto on either side, a vacant family unit by the granting of a special permit. lot one hundred twenty-five (125) feet or more in width or a (b) In addition to accessory uses permitted under paragraph lot occupied -by a building set back more than fifty (50) fe E of this by-law the following uses may be permitted; subject from the center line or thirty (30) feet from the side line beidW to the operator living upon the premises.and to the iimita- counted as though occupied by a building set back fifty (50) t.ions stated herein. A billboard, signboard or advertising sign feet. shall In no case be permitted as an accessory use, except as 4. No building to be erected closer than fifteen (15) feet from herein specified. The placing of a "For Sale" or "For Rent" side lines or rear lines. sign shall, however, be permitted as an accessory use. A sign This district added b 1957 An .58 pertaining to a home occupation, as herein specified, shall p y approved by the Atty. Gen. June 10, 1957. be permitted, provided such signs be not over three (3) square feet in area. U. INDUSTRIAL DISTRICTS (1) Offices for professional use and customary honne occu- . 1. In any Industrial District, no building, structure or premises pations such as arts,.crafts, service businesses, antique and Shall be used and no alteration, enlargement or extension of gift shops, or any use determined to be of a similar char- an existing building or.structure shall be designed, arranged, Page -16 Page- 1.7. offte(tit Floor)- v . SEPTIC SYSTEM MUST BE'. w abr:a map�d lot number — � �c:.� °" . INSTALLED IN COMP o ° TITLE Board of Health(3rd floor),f ... . — ik ENy1RONMENTAL CO Sewage Perm numb N REGULATI En neerieo Department(3td floor) ie a ar°'t� ••� - .� �o.a�. + House number s�f ��I. . 1: ' s a►r siDafinitive Plan Approved by PkMn8 Boyd �J APPUCATIONS PROCESSED 8:30-goo A.M,and 1.00-xCo P.M.only 77, � pry� 7,. .' OfWN 0F BA'RNSTABL { BUILDING* ;INSPECTOR:, � ;APP,=TlW1 FOR PERMIT To ,sc r4en ed!-r nJ OF CONSTRUCTION AIW Q 19 s:•TO THE INSPECTOR OF BUILDINGS � a The undersigned hereb appNes fora permM according to the following information: Location 3,73 Ry L.i�lfl� �FAl7FI?r/r,!F Proposed.Use +`Zoning District '1 Fire Dlstrid Name of Owner Y hVA-T Address r Name of Builder_ usStil. r�S 7.Address_ r-10 ��+JnJT/TN L[✓� K.Ie,✓E ✓yrA�,t,C {{ Name of Architect Address {44:i F'.Numberof Rooms Foundation As Q& S� d Exterior Roofing � r ns Floors Interior c Healing Plumbing Fivace Approximate Cost 000•io Area C f Diagram of Lot and Building with Dimensions Fee a a< • OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS breby.agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ...Name Construction Supervisor's License r T .. pe z FAVA PETER r 55 Pe►mR For SCREEN PORCH r ha/�• 3�•X 73 Locabon 373 Bay Lane Centerville Ownei 1 teter FAvat - Type of Construdiori s PIOt l- Lot Permit -4 Arno✓ Its D if Inspection QoyF_p Dl mpleted t . a• 7 tr ri cl J► .Y. c-.I• �cs�.:�} , .�.�-�:��`r,- yr} :. .�`J o , - ;., �'.:. Y - ,V a ::.. :.�,.�• '' I I ! .-.war .. - y C 4 t4 LOCUS _ .. .. o m�. A o i� �� LOCUS'.PLAN ate. scale: 1 =2000' Assessors Map 187 . 0 /I Z -- _ Parcel 002 O�tv Jr IV J. / I Q' L 0 � / h�0 ,�� 0. v � v�dl / a Q Q /y- J h�60l� UAd tqt- / J 2 s �f C �„__ MAR ;5 200 Ic V, m E3ARNSTAGE I�O ! !:IIATiQ ! SULLPQ NO. 29733 IP CL PLAN VIEW 1 o o i y LQ -A , c 'q \ R, E.. Scale: I"= 20' aF� The applicant acknowledges that the phragmites are not to be cut unless a separate NOI or RDA SITE PLAN is filed with and approved by.the Commission. s PETER FAVAT The applicant will file an annual report to the Commission for a three year period. The report will have photos and will address the health of plantings_ Within the 3 year reporting period all dead 373 BAY LANE plants will be replanted C ENTER V I LLE,MASS. SCALE: AS SHOWN DATE :MAR. 4 , 2009 Directions to Site from Hyannis: Take Route 28 toward Osterville. Take a left onto Old Stage Road SULLIVAN ENGINEERING INC..' and follow as it becomes Main Street.At the second stop sign take a right onto South Main Street. OSTERVI LLE,'MASS: Take a right onto Bay Lane. House is on the left#373. Z. E3 0 Z.O r .1 VN 1 DEC 1t, "1 _ It z � 'TatAtCY> m eoar:sp -ro -,4N P-SV5 PoRC-N 7 E + a i 1 � -1 Till 11 , fig 1. t� g -OVA , • . rr,t t� �Pit s`► lb --I-Lll mll ILI, II / 4 2t IA y � PASR. 4+ NY 25 SITS PLANSCUD= ! a Mr OF LAND IN LOCUS BARNSTAB.LE ( CENTERVILLE) , MA PFEPARED FOR PE TER FA VA T LOCUS MAP SCALE 1" = 200 LEGEND - ASSESSORS MAP 187 PARCEL 2 -� FIRE HYDRANT DATE: MARCH 19, 1997 -' SCALE: 1" = 20' WATER SERVICE s n GAS SERVICE c 0 ►N WATER GATE 20 0 20 40 60 Feet `� UTILITY POLE a' ELEVATION DATUM: NGVD BARN PANEL FLOOD STABLE ZONE A-10 (SEEN 1 C- GUY WIRE #U Y0001 19926 —G— UNDERGROUND X2.8 GAS LINE { EXISTING TREE 13.93' �+ 5.6 SPOT ELEVATION 51 ,\ ` BORDERING -� OWNER OF RECORD: —VEGETATED 43 PETER P. FAVAT WETLAND 56 REFERENCE: CERTIFICATE #12, a� LOT 2 LCP 35308—A SH 1 TOP ' LOT 7 LCP 35308—B -1 COASTAL � �3• !":•'(t�,� (' �. ^ti.fA _ - \ SALT . 5. Ak- MARSH STONE 2 � (7�r E{;S'E't,i.(,, 1,r-AiJ 0� , ` RETAINING PROPOSED WALL \\ \ "�► 'n1 n'�� ADDFTION -\ ? V • - PICKET ALisF5 FENCES I LOT 6 �h�� s.#3 a.2 ' rn LCP 35308-B �o I 73 i o 9� ROCK GAS �/ yy WAL l METER / ^ 0. c 3.0 / O 4.# . 7Tr f QO EXIS ING DWELLING#373 OM HOUSE � ON T.F. s 9.6 3.7 7.2 BORDERING I J • �� X VEGETATED i y 0' WETLAND \ J PROPOSED PORCH 6. i BENCHMARK % TAG BOLT #371 FIRE HYDRANT F GF OA— 0. 4.2` #2 �Ic ELEV. = 9.28' NGVD 3.5#1 2 j 9, E "7 4 off 508-362-4541 -` if ��; rn N/F �� fax 508 362-9880 FIELDS POINT ,r + ' ;a`�`�, --- L:.. MANUFACTURING COF 1� zl!w' M Y PROPOSED tl 6 tJlsl.L FENCE 1' OFF down cape engineering 1 1 r PROPERTY UNE PAVED JfV�� u:s L0 o "CAI,E0 SWALE a� CIVIL ENGINES- LAND SURVEYO 97-063 DATE TIMOTHY H. COVELL, P.L.S. 939 main st. yarmouth, ma 0267,