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0522 BAY LANE
i i i �� I NO. 152 1/3 BGR t Q av ki W s tid1� � Y Town of Barnstable *permit (� O 2094 Reguhitory p�vir� Pao 6.�a...s-�rnr Kul Richard V.Scali,Interim Director T �� 14RNSTABLE RirtiWing UAVIS o;o Tom perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town barastabin.ma.us uitice: SUS-S6Z-4U3$ Fax: 50$-740-6230 EXPRESS PERbUT APPLICATION - RESIDIENTYAL ONLY rj Nor Valid wMouer,Red X.Pra s nVrint Map/parcel Number. 7 (p�J Property Address C to l&Z. RRasidential Value of Work$16 ® — Minimum fee of$35.00 for work under S6000.00 Ufta is Name&Address Contractor's Name A I t.•3 i 3 Telephone Numb G Homts Improvement Contractor License:#(if applicable) Email; COnstruction Supervisor's License#(ii'applieable) ❑Workman's Compensation Insurana: Check one: ❑ I am a sole proprietor I am tha homeowner I have Worker's Compens ition Insurance Insurance Company Name E! t? X Workman's Comp.Policy# w U_�� 'to s 6 g6 1 d r 3 A Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be t„keu to ©Re-roof(hurricane nailed; (not stripping, Going over existing layers of roop �] R"ide ❑ Replacement Windows/doins/slidem.U-Value {maximum.35)#of windows #of doors: Smoka/Carbon MonO ddc detectors 4 floor plans marked with red S and iuspuutiuus required. Separate Electrical&Fite Permits required. . * h m n-Rulmd; Thum"Qf*k pm dt den not tamps oomplioeoe with ad=town dopm lmont ra6vicuou,Lc,.IIaLu.n„Cwuw taamk eL, '`'`'Note: Property Owner must sign Property Owner Letter of Permission. A copy of tb..home Im }orcmwit COlitl aLLul a Lit.euaa$Cunaii ucLiuu Superyburs License is required. � SIGNATURE: 2 QAWP2'Y M\FOR&Muilding pe mittwmbkWMS.doc Revised 061313 ww: u ,. ... gym.,._. ,,.., �,.� �,:, e G� 4' �. x. 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K+ t; FvQ'I VA i N ?. �a ,�,;naya ,ur:�., aar>„�� „w., k •,,rc .° c,w 4s "'�. . az `ate '. A ;a n � �,kai5snms..� 1 Start Main S stem'f lenu p=UU ndows.` ,. -� yes�, C?�u.��� - • SMOKE DETECTORS REVIEWED 3 a d n iaLt BUILDING DEFT. DATE f IRE CEF4RTP�ENT DATE BOTH SIGNATURES ARE REQUIRED FOR PERMITTING -7! T Aof lixi (ZA �� io -" tii^•:':+'S^"'4r+x"^. .. ..Te_..erxmS y'.ty,_'.�^^' ., fa+ - ,___- 3�7 _ C_ SC)SkV-1 ��I��- ...fir.-a!�:'�...:�—'l5_`:=F+T.n.�e.m.� '+ .i�x± "w+•�*�`�^^w+,.�.'r',..... :x .. - tz SMOKE DETECTORS REVIEWED f f *tA6DING DEPT. DATE FIRE DEPARTMENT DATE BOTH SIGNATURES ARE REQUIRED FOR PERMITTING Till _ -- II i 5 $$ - - 5 j sk v-1 67 ..... ------- y � t r !g � 8 9 a � 4 Fold Than Detach Along All Perforations �.. �OMMONINEALTH��OF�M�1,S�ACHU.S�TT� _ , • • -Ifial • LEGTR`iIaC I ANS �SSUES��THE FOLL'OWING�LIC�N�E;��AS 11 t EFtED MASTE z ILECTR R>~ �5fi R , +- ' r )BARNS ABLE r�A '0263o 1525 3 13243 A . 3`1122' .. i p Town ff Ba rjast ble Regulatory Se xvx+ces Thomas Ir-Geiler,Director Bunding Division . Tone perry,BuildiAg Commissioner 200 Main Street HYanuis,MA 02601 www towu.ba=tabl&ma.¢s Office: 508-862-4038 'Paz. 508-790-6230 Property Owner Mast Complete and Sign This Section • If Using A��der . Yy J , as Owner of the subject property to arr nn Iny Lobalf in all matted read":to wQtk authotized by this buildingpej=t (Addxcss of Job) **Pool fences and alanns are the responsibility of the applicant. Po o1s are not to be filled or utilized before fence is installed and all final, inspections are Ferfb=ed.and accepted. h� 4t=eof Ownrx ' Signature of Applicant I'iiat Name Print Name Date W0RW;0WNBXFERMMI;TrWWYir•c Rmm-s � 1 e Ciamttr yritreaM of-Hassacbusettv Deparbnent aff`idusfthd Accidents - OiTwe c,flix s ions 600 Washington&reet Boston,M,4 0211I wog masmgovIdiu: Workers' Campensatiuu Insurance Affidavit:B>filders/ContracinrsMectricians/Plumbers Applicant Information r Please Print Legibly t1 Name k�esldxgauiza imgndividnal)_L�I,,O U� /�=� _ 2 i Address: ���,66 �Z Xl! Gty/Stat&Zip: 6 Phone 4 Are you an employer"Check the apimpriate.boa: Type ofproject r nire I_A I am a employer with. (p ❑ I am a�� �" 4. contractor and I New o fruc#on employees{full andlor part-time).* have hired.the sub-contractors 2_❑ I am a sole proprietor or partner- listed on the attached sheet;. 'T_ Remodeling ship and bane no employees These sub-contractors have g_ 0 Demolition w or me n an c c employees anal have workers' °1i'ng f i y � i�`[No workers'conlp.insurance comp.iasuranml 9- El Building addition reed] 5. ❑ We area corporaticn and its 10..0 Electoral repasts or additions 3_❑ I am a homeowner doing all wort officers hn-e exercised their 11_.❑Plumbing repairs or additions myself[No wcrkers'oamp- right of exemption per MGL 12-0 Roof repairs insurance required_]1 c_152;§1{4),and we have no employees_[No workers' 13-[ Other comp_insurance required. ''AiiY Rppliumr that checks boa-1 mst also fill out the section bgww showing ihrs wadcea'compensation pvlicp inffirmati H..omeowners urho submit this affidavit indicating they are doing alluodt and tbea bue outside contrwtars mast submit a new amaiwit in+r�.sash_ kAnt—Mrs that A—V this ba x mast attached an additional sheet showing the name of the mb-wnftm tors and state whether ornot those.efities have - - employees if the mb-conisactm bare employees,they mrst provide&dr warkml comp.policy number lam an employer thatispnr vidixg workers'comporr=dan insurance for my emp£vyeas Bdow is thepa&y and job site inf btmattavr. �'' Insurance Company Name: 7 4, x✓,S Policy cr Self-ins-Li-#: C,56 1 a5-6 3 Q 1 .13,4 hxpirationDate: Job Site Address: Cifyr'Statelztp` Cam, L)z Attach a copy of the-isarkers'compt4fsation polies declaration page(shavdng the policy number and expimtion date). Failure to secure•coverage as requiredunder Seetiora25A of I~i1IGL c:. 152 can lead to the imposition ofaimiaai penalties of a . fine up to$1,500.00 indlor one yearin4msonmeut,as well as civil penalties in.the form of a STOP WORN ORDEP aad a fine ofup to$250.00.a day against the violator_ Be advised that a cDpy of this scat==t maybe fnrwarded to the Office of Investigations of the DIA liar insar nct coverage trerification_ I do hereby cet* tha pains and pens f ruy that the informat&npravidedabove is bun and correct Signature: ]date Phone#: — iWkial use only. Der not write in this area,to be carnpleted by city or town o i'eiat City or Town: Permitucense# Fssning Authority{circle one}: 1.Board of$ealth. 3.Building Department I City Irown Clerk 4.Electrical Rupector S.Plumbkg Inspector 6.Other TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel *�i' Permit# a ! _ Health Division con (,�� Date Issued D S� Conservation Division e , 2 9IeS .Tf� �fl��� AL Application Fee Tax Collector Re,V �© 9Y y4, � � ¢ Permit Fee Treasurer Planning Dept. EXISTING EpTIC 8 E�? Date Definitive Plan Approved by Planning Board LIMITED TO OF®E®RO®�$ Historic-OKH Preservation/Hyannis Project Street Address d, X Village _CCNtERVd1t Owner �. �' HcS- Po+nr.t(, to flu Address &, k L ,6 F( d Q( HA Telephone 609- 1�— 2. `-' Permit Request 5Cfe_-e,t,J p-scy)M U' 1$ l3N F—JC tS+InG 190rck\ D� f t 4 Square feet: 1 st floor: existing proposed �3 2nd floor: existing 3 io proposed Toll ne N) Zoning District Flood Plain Groundwater Overlay Project Valuation oG h `� Construction Type W Ua D gmoe Lot Size I L (o AC, Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family U1.00, Two Family ❑ Multi-Family(#units) Age of Existing Structure l' Historic House: ❑Yes &Tlo On Old King's Highway: ❑Yes 1 dxo_� Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other A114 Basement Finished Area(sq.ft.) N// Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 11114 new Half: existing new Number of Bedrooms: existing */71 new Total Room Count(not including baths): existing /j/ new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing _ New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals``Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 1 -No If yes, site plan review# Current"Use ' -� + iuf 1 Proposed Use r)1 1 BUILDER INFORMATION Name 1 I�1 L..SGIJ o MC Telephone Number 502 "- 2 9- 115 l Address ( � MA1>J 17 License# C s- On- nS- r V I I MA, aZ(OS-s Home Improvement Contractor# 1 16a I Ce Worker's Compensation# A VW_HA I boo .-oacc ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO IN nsAr\&,2, kAQ )J� �I SIGNATURE DATE /-1 t°�J L-- Z�/j ?160� I FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED l MAP j PARCEL'NO. ADDRESS VILLAGE - r , ` OWNER DATE OF INSPECTION: FOUNDATION. FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH :3 FINAL PLUMBING: ROUGH M m FINAL GAS: ROUGH FINAL e� FINAL BUILDING O DATE CLOSED OUT ASSOCIATION PLAN NO. 0 w �� fr The Town ®f Barnstable SARNSTABLE. ' Department of Health Safety and Environmental Services pTECMAy° wilding Division 367 Main Street,Hyannis,MA 02601 )ffice: 508-862-4038 'ax: 508-790-6230 t PLAN REVIEW Owner: e.-V' Map/Parcel: NS 7 Project Address: . Ln Builder: The following items were noted on reviewing: Q o 1 Reviewed by: Date: i DATE(MM/DD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 08/11/2004 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MARTIN GARRIGAN ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 537 SHRADER STREET HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW SPRINGDALE,PA 15144 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: American Interstate Insurance Co. 31895 T.A.NELSON CONSTRUCTION CO.,INC. P O BOX 749 INSURER B: Silver Oak Casualty Incorporated 26869 OSTERVILLE,MA 02655 INSURER C: INSURER D: 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. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSR1 TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PREMISES Ea occurrence CLAIMS MADE OCCUR MED EXP(Any oneperson) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO- JECT 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 $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND X WC STATU- OTH- EMPLOYERS'LIABILITY fFORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 A OFFICER/MEMBER EXCLUDED? YES AVWCMA1302502004 08/11/2004 08/11/2005 1000 OO E.L.DISEASE-EA EMPLOYE $ If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION PATRICK&SUSAN BUTLER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREFORE,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 522 BAY LANE IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. CENTERVILLE,MA 02632 AUTHORIZED REPRESENTATIVE (508)428-4971 ACORD 25(2001/08) ENTERED BY RFISH ©ACORD CORPORATION 1988 1- - The Commonwealth of Massachusetts - i Department of Industrial Accidents Office of Investigations 600 Washington Street, 7'h Floor - Boston,Mass. 02111 l Workers'Compensation Insurance Affidavit:Buildin lumbin lectrical Contractors name: y address: city state: zip: phone# work site location(full address): ❑ I am a homeowner performing all work myself. Project Type: ❑New Construction❑Remodel !ii��������loyees ❑' I am a sole pro netor and have no one�w��orreking in any capacity ❑Building Addition a'. ° .w.,,.�.!'�. d.S.,o i....orkers' compensation for my employees working on this job. company name, address: ' city: Shone#: insurance co. Rolicl# to mi�l '❑ I am a sole proprietor,�neral contracto ,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name: A, Coy-)S�((jc 1m; address: Z M 1 fJ Sr• IL city (0 J 5 phone#: insurance co. c==1l* s lic # C M PZ,130, . . company name address: r city: phone#• insurance co. ollix# 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 S1,500.00 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 maybe forwarded to a of Investigations of the DIA for coverage verification. V I do hereby,certify un he and penaltie of per'u that the information provided above is true apd corr Signature- DateIle name Phone# -/�7 official use only do not write in this area to be completed by city or town official city or town: permitllicense# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (rcv.d Scpt.20011 - -. . r Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law",an employee is defined as every person in the service of another under any contract of hire,express or implied,oral or written. An employer is defined as an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. 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 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 to e Department b mail or FAX unless other arrangements have been made. the p y g 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)727-4900 ext.406 r € ' pp tiGiEaLG�G o�✓GG elt6 -�e i�arrvrr�a�r tub BOARD OF BUILDING REGULATIONS, License: CONSTRUCTION SUPERVISOR Number: CS. 009889 - - Expires 05/2=006 Tr. no: 26199 Restricted 00 THOMAS A NELSON; PO BOX 749 OSTERVILLE, MA 02655, Commissioner f ✓�ie{oanvmovuuea� a�✓uaaaac�waetta Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration;. 110216 One Ashburton Place Rm 1301 Expirationc:;;10/9/2006 Boston,Ma.02108 Type'.Private Corporation T A NELSON CONSTRUCTION CO -M3MAS NELSON' `, f 1112 MAIN ST#12 OSTERVILLE,MA 02655 Administrator Not valid without signature Town of Barnstable Regulatory Services t 13, Thomas F:GeUer,Director I°q, 163y. ���� Building Division TomPerry, Building Commissioner 200 Main Street, li annis,MA 02601 WWW.town barnstable;ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property' hereby authorize tSGuJcx�S �y�h�ru �: to act on mybehalf, in all=tiers relative to work authorized bythis building permit application for, '�2Z �A1+ LA,N C� �r .►I�, l`1 62fo Address ofjob) 4sof Owner • Date Print oFs Toy Town of Barnstable Regulatory Services BeWMABLA Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permit no, Date AFFIDAVIT . HOME JM:pROVEMENT 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 adj acent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: re�� RANI f,6 c l- , Estimated Cost J�-16 b 6 Address of Work: 5d`a _�^`� ���� ,�'C (1�}'C�l,I��C IFAA O.Hner's Name fA�G tGIC, -t SUS�tJ �u —� Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under 31,000 []Building not owner-occupied []owner pulling own permit Notice is hereby given that: WITH UNREGI OWNERS PULLING THEIR OWN PERMIT OR DEALING STERED T WORK DO NOT HAVE - CONTRACTORS FOR APPLICABLE HOME IMP N PROGRAM OR GUARANTY FUND UNDER MGL c.142A. ACCESS TO THE ARBITRATIO SIGNED UND TIES OF PERJURY I hereby apply for a permit as the agent of Contra Date, a Registration No. OR Date Owner's Name Q:fonTo.homeaffidav - i Cc�� S z z �� �� �,��m � i v i L----- vs P Qom-, S22 �q Ln , � to TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION C� Permit# Health Division f;� — � Date Issued r Conservation Divi n �,�.�� ��/off OD- 00' Application Fee Tax Collector doh oJ;" ff Permit Fee 31 q, X3 Treasurer tS / ' Dp1-� SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Planning Dept. U WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE Alit TOWN, R777 Historic-OKH Preservation/Hyannis Project Street Address -/3,—,jl C/ A/-?/1/ f- ►► Village G6/Vir2 U/ 1IL Owner A—/;f/Gl- ,T- 5U.S/9N 31Jt�F-Z-1 Address 6-2 Z 6,01 y 414PU , (,C 6k 0)�f E Telephone c-®9— -7 7 ` r�/�Z Permit Request 4QP Al 1=.qrh a Iy .�azJrn 7� �Xi b9tjrJ 4 �'�f 44e rcldCAk Square feet: 1 st floor: existing proposed '-__ �P.2nd floor: existing FOY proposed Total newS�i= Zoning District P D r I Flood Plain ,f 13 Groundwater Overlay Project Valuation //�26o D©0® Construction Type 000.D F•C�M C. Lot Size ' b 4 AL Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family , Two Family ❑ Multi-Family(#units) Age of Existing Structure 10 /y Historic House: ❑Yes �No On Old King's Highway: Cl Yes )<No Basement Type: Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) y 5 S F Basement Unfinished Area(sq.ft) 7-30 S r Number of Baths: Full: existing 22 new 0 Half: existing new 0 Number of Bedrooms: existing .3 new 0 Total Room Count(not including baths): existing - new First Floor Room Count Heat Type and Fuel: ❑Gas Oil ❑ Electric ❑Other Central Air: _AYes ❑ No Fireplaces: Existing New I qA& Existing wood/coal stove: ❑Yes VNo Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:)(existing ❑new size 2LIX2,q Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ N Commercial ❑Yes `_NNo If yes,site plan review# Fr f CD Current Use Le_,C)l uffi R, Proposed Use i R BUILDnE.R INFORMATION Name �.c I, y� t�r7� ✓( Y:'�1 l%(l Grp Telephone Number ��g � `�Z� ' � Address 11J License# Home Improvement Contractor# ,111),2_ h lo� 02 5 Worker's Compensation# d�M), 972Q© ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ='l 5 FOR OFFICIAL USE ONLY PERMIT NO. ;-- DATE ISSUED _ ,`"• MAP/PARCEL NO. ADDRS#� : VILLAGE 5 OWNERr _ I A E II SPECTI+ON. • `,. c r1 � ram' !^... (f! ' FOUNDATION" FRAME � '� i -2 INSULATION 6 (3 ,2 -/2-U C" FIREPLACE ELECTRICAL .ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGHii FINAL FINAL BUILDING -AKA i"_ DATE CLOSED OUT ASSOCIATION PLAN t � ". `pFTHE tfp The Town of Barnstable BARNSTABLE. ' Department of Health Safety and Environmental Services 7 MASS. 0q �A '.979• �0 fEOMA�N. Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: P;ts' 'R o-r z r w- Map/Parcel: IF 7 zo 4 P Project Address: 44H'f Builder: M,C G-So Jul The following items were noted on reviewing: V� J � �l L.�6� /9.1�. �/6 Z/�v /`�•�S ,�.�P/2 Gib U/✓�/®/`J/d2 / Y )4Db 56#-F/T al? i,4-Vr /6-,,y T 3 l9LL co/3'I.LS' � 1���l.IJ`l( .7-H Cigi2 , �U 64 COV4r r-P kJ/ Tf/ ts'C• cY PSv,n ' bloa-m a WL4L SvP('�Y ��/ui✓��/' ��1CGrLc ��T� �D2 �T��.L J��m Reviewed by: Date: q:building:forms:review RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE '5-0 Z-, square feet x$96/sq.foot= x.0031= / �a plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x .0031= plus from below(if applicable) G ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x .0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= S (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if,applicable) Permit Fee ° projcost t By: Yankee Survey; 1, 508 420 5553; Dec-18-99 5:50PM; Page 1 /1 60T Z� .J.J C % v LOT 4 1, lb r • :;= yr . .b• ^1 .lSy G0' a LOT 5� Rrs. ZONE „Rn—l" This MOR'FGAGE INS k PECTION Ban �T rorJae C1nly FLvvn mAw,- „B" THE DISTANCLS AND MEASUREWNTS ON T S PLAN ':zll0tlLD DE YERIFIED BY AN lwvl'Kl1MM:N'I' Sl1KVRY. ---------- REGISTRY OWNER: PATRICK &,5'11..5AN EtllT'(��_ V--__-_----__ L�_DIED REF: _L ,el-U- .E1�.? • bUYER: -(>Sb:- N 1NCE ----------------.-----------.......... I)ATE: ..12110/;i -------------- PLAN REF: _L.-C•__ -l1>O-A 40---FT. 1 HEREBY CERTIFY TOL<At'�' G'UU meCFNT,S_SgIEldl, -a&v� lNa XAN�LE SURVEY'THAT THE BUILDING . SHOWN UN '1'lIIS PLAN IS LOCATED ON THE, GROUND A5 PAfJI CGNSULTANTS SHOWN AND 'I'HA'I' ITS 1'0) ;ITION DOE',) CONFORM 40A (SUITE 1) TO THE ZONING I,AW SETBACK REQUIREMENTS OF THE mom 'TOWN 01'. DARNSTADLIs' _______AND THAT INDUSTRY ROAD IT DOES—.NOT LIE WITHIN THE SPECIAL FLUOU 11AZARL) MAz2sTONs MILLS, Ma. oasae AREA AS SHOWN ON THE HAJ.D. MAN DATED ii�/.5?.� TEL: 428-0055 ._.CgMMiinit. —Pali,el 2,50001 0018 n FAX: 420-555S THIS MAN NOT MADE FROM AN INS' NT SURVEY 2B15J DAF I'AlJT.. A.MERITHEW-!'I5------ NOT TO 8K. USED FOR FENCES H►.lIT.T)TNG PERMIT~ lrlc. Permit Number MECcheck Compliance Report Checked By/Date Massachusetts Energy Code ; MECcheck Software Version 3.4 Release I Data filename: Butler.mck TITLE: Butler Residence a H CITY: Barnstable STATE: Massachusetts r {• 4 + HDD:6137 CONSTRUCTION TYPE:1 or 2 Family,Detached HEATING SYSTEM TYPE: Other(Non-Electric.Resistance) ; DATE OF,PLANS: August 16,2002+ PROJECT INFORMATION: - Renovations to residence - 4' a 552 Bay Lane F - Centerville,MA' - s COMPANY INFORMATION: Douglas Sanford Assoc.,Inc: 22 Clay Hill Dr. Plymouth,MA 02360- , a ; ,r :COMPLIANCE:Passes> Maximum UA=278 jYour Homc.=255'; E R x [8.30/&Better.Than-Code { Gross Glazing Area or Cavity. Cont. or Door 'Perimeter R-Value R-Value U-Factor UA Ceiling l: Flat.Ceiling or Scissor Truss - 313 38.0 a 0.0 9 Ceiling 2:Cathedral Ceiling{no attic)'.. 221 30.0 0.0 .„ 8 Wall 1: Wood Frame, 16"o.c, a 1102 19.0 0.0 55 a ' Window I:.Wood Frame:Double Pane with Low-E 189 r, 0.300 '-< 57 Basement W411 L.Wood Frame,7.5'ht16.5'bg17.5'.insul 900 %13:0 0.6 51 Flood:All=Wood Joist/Truss:Over Unconditioned Space 598 :`'30.0 '0:0 f Y Floor 2: Slab-On-Grade:Unheated,0.0'insul. '53 0.0 55 - COMPLIANCE STATEMENT: The proposed building design descri bed here is consistent with the Y. building plans,specifications,and other calculations submitted with the permit application. The proposed < building has been designed to meet the Massachusetts Energy Code requirements in MECcheck Version 3.4 s , r ; t r Release I and to comply with the mandatory requirements listed in the MECcheck.Inspection Checklist:. The heating load for this building,and the coaling load if appropriate,has been determined using the applicable Standard Design Conditions found in the Code. The FIVAC equipment selected to heat or cool' the-building shall be no.greater than 125%of the design load as specified in Sections 780CMR 1310.and J4.4. 4 Buiider/Desi L-7 "' s Date Ll 6 d �-� y e Tue Aug 13 15:35:52 2002 + Renee Lopez Page: 1 DATE(MPNDD,rYYYY) ACORD T,, CERTIFICATE OF LIABILITY INSURANCE 08/13/2002 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION LOUIS MORENO,JR. t ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 105 OAKR_IDGE STREET HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR AL I tK'I HI:LUVtKACit A"(JKUtU by I tit:t'ULIGItS btLUW LUDLOW,MA 01056 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: American Interstate Insurance Co. 31895 T.A.NELSON CONSTRUCTION CO.,INC. INSURER B: Silver Oak Casually Incorporated 26869 INSURER C: P O BOX 749 INSURER D: OSTERVILLE,MA 02655 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. INSR DD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSR TYPE OF INSURANCE POLICY NUMBER DATE MMiDD DATE MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE _ $ COMMERCIAL GENERAL LIABILITY - - DAMAGE TO RENTED PREMISES Ea occurrences $ CLAIMS MADE aOCCUR MED EXP Any one person,, $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEPJ'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP(OP AGG $ - POLICYF—1 JECTPRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-014NED AUTOS (Per accident) - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY - - AUTO ONLY-EA.ACC IDEM $ ANY AUTO - - OTHER THAN EA ACC $ i AUTO ONLY: - .AGG $ EXCESSIUMBRELLA LIABILITY - EACH OCCURRENCE - $ OCCUR FI CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND X WC STATU- OTH- EMPLOYERS'LIABILITY ORY LIMITS I I ER ANY PROPRIETORIPARTNERIEXEGUTIVE "E.L.EACH ACCIDENT $ 100,000 A OFFICERIMEMBER EXCLUDED? ❑YES AVWCMA1122972002 08111J2002 08/11/2003 E.L.DISEASE-E4 EMPLOYE 100,000 If yes,describe under .$ SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT g OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION PATRICK&SUSAN BUTLER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREFORE,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 522 BAY LANE IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. CENTERVILLE,MA 02632 AUTHORIZED REPRESENTATIVE (508)428-4971 c ACORD 25(2001108) ©ACORD CORPORATION 1988 P The Commonwealth of Massachusetts Department of Industrial Accidents ,� _=•• _ OI/rce of/n�esdllat/aas 600 Washington Street Boston,Mass. 02111 Workers' C sation Insurance Affidavit name: location: city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole r rietor and have no one working in ca achy I am an em to er providing workers' compensation for my employees working on this job. :...................:.:::.................. :::.:..... .. ...............,.:.::........... .......:. :.:::�^:.,.. ,:::::::..::. .::,p..:::.... .::::.:..n.::.:.::::::::::.:......:.:.:............,. m any nam CO p +'<:::<•ii'ii:l.:J}i::::::::::::•:::SCi::isi:i:.i:}i:'::`i.•ii:i::.t..iii:::ii'r}i:•i:•ii:•i?:::::::.�:::::v::•i:ii::4ii: iii: !:i' ........... .g..................... .. 'i:'T}:::i:::�i:ir:i.:ii:::4iiii:;;;};4}ij•:;�i�iii:4iY.+i i'::v::: Syr, ..... .... ............. ............ a ......Y..... ...........+!�'r .:............... ..�::i::i::ii'.: ...:...:. .. .... :::....:..:�•::.�:::•:k:;.�.v.:'iv�iii;::!k;:ii::J ...:: ..... ::v.: InsuranNO ce MR ... ii iii.,,.:y ❑ I am a sole proprietor general contractr or homeowner(circle one)and have hired the contractors listed below who have thefollowin workers'compensation polices: mP .:::::.::.:::;'::::.;:.:;.;;:.;:.: g...................................::...:.:::.::.::::::::::::...............::..:::::':::::::::...:..........::.:.:::.:.::::::::::::::.:.:...............................,.:::.:::::::::::::.:::::::::::...::.:............::::.:::::::. com an.<name. ......: ............................................. .,: �{ .......... � [; ii%i.................... i !i. is�::o;::•:::�:if::i::a:::::isS:::�5::fi::?:i;;;;::;: s�S::::�i:�:�::::<:o:�>:�::�:;�>::�::.»;:�::�:<.::.::.:.. ............... ....................................:::::::.�::•::::::•:.�:._::•:::._:::::::::.:::::: ::::. :.::: �i''.::}'C.:::.::.i:.::.i:.::;y.i:::!r+,:::.ii::Ln:!�.i�i::.i::.:::.::::•:::::::::::::::.�:::.�::::Y.:^::iCi:•iii:!•:?:::: iii:::::{::;:;:::::i:?:::i:::ii':::::"�`::i'i::''::!!:::::'::i:::::::::::::i::::ii::::•.i;i: Y �tiraitce `•' ttddress. Iitia nsnraWe Fafime to sewn coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a line up to$1,500.00 and/or one years'imprisonment as weII a,dvfi 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 atatement may be for9►arded to the ce of Investigations of the DIA for coverage verification I do hereby certify under the p ' penalties of perjury that the information provided abov�tw.��eorr�e�d _ Signature Date ``// Priest l Clr—n S -A Phone# b q2 ' 7 S- f official use only do not write in this area to be completed by city or town offidal city or town: petmittlicense# []Building Department ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office OHealth Department contact person: phone#; ❑Other_ _ Oevised 9/95 PW Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire,express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the I.legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain'a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permitllicease number which will be used as a reference number. The affidavits may be rearmed 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 Ottice of loaestlgatlons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 Board of Building eqqulations One Ashburton Place, Ism 1301 Boston, Ma;f02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Number: CS 009889 Expires:05/28/2004 _. , Restricted To: 00 - r THOMAS A NELSON ' ? PO BOX 749 L � ' OSTERVILLE, MA 02655 Tr.no: 28626 Keep top for receipt and change of address notification. BOARD OF BUILDING REGULATIONS i I tense; CONSTRUCTION SUPERVISOR 'h 009889 G; .`Numb �> � ]� 04 Tr.no: 28626 � THOMAS A NEI, I PO BOX OSTERVILLE, Administrator +' r Nov-21-02 15:41 T A NELSON CONSTRUCTION C 508 428 4971 R_02 Rz Board of Building Regulations and Standards r - ,_,; One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration; 110216 Type: Private Corporation Expiration: 10/9/2004 T A NELSON CONSTRUCTION CO 1NC THOMAS NELSON PO BOX 749/1112 MAIN ST #12 --- - ----- _.__ _ OSTERVILLE, MA 02655 --- --- --- Update Address and return card. Mark reason for change. Addrecq I Renewal. Employment Lost Card Board of Building Reguladum dnd Stuedards License or rugistration valid for individul use only HOME IMPROVEMENT CONTRACTOR befure the expiration date, If found return to: WC5� Reglatralion: ttQ216 Board of Building Regulations and Standards One Ashburton Place Rm 1301 Expiration: 1019/2004 Boston,Ma,02108 Type: Private Corporation T A NELSON CONSTRUCTION CO IV6MAS NEL50N PO BOX 749/1112 MAIN ST#12 OSTERVILLE,MA 02655 pdminiMratnr Nvt valid without Ognmm-p DA 02-069 LlMassachusetts Department of Environmental Protection oF"'E' ti Bureau of Resource Protection - Wetlands °* WPA Form 2 — Determination of Applicability * > HASM Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 4>,,,0s9. EO MA't and Town of Barnstable Ordinances, Article XXvll A. General Information Important: When filling out From: forms on the Barnstable computer, use Conservation Commission only the tab key to move To: Applicant Property Owner(if different from applicant): your cursor- do not use the Patrick&Susan Butler return key. Name Name 522 Bay Lane /ea Mailing Address Mailing Address Centerville MA 02632 Citylrown State Zip Code City/Town State Zip Code 1. Title and Date (or Revised Date if applicable) of Final Plans and Other Documents: Site Plan October 3, 2002 Title Date Title Date Title Date 2. Date Request Filed: October 4, 2002 B. Determination Pursuant to the authority of M.G.L. c. 131, §40, the Conservation Commission considered your Request for Determination of Applicability, with its supporting documentation, and made the following Determination. Project Description (if applicable): Construction of a cantilevered bay and a foundation under existing deck for a new stairwell. A foot- ting is to be hand dug and poured, concrete block is to be 8 inches above grade.The fill excavated from the footings is to be placed back in the foundation and a concrete pad is to be poured on top. A work limit line is to be maintained to project completion. All disturbed areas to be reve etated. Project Location: 522 Bay Lane Centerville Street Address City/Town 187 068 Assessors Map/Plat Number Parcel/Lot Number wpaform2.doc•rev.10/29/02 Page 1 of 5 1 r DA 02-069 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 — Determination of Applicability # BMWSTnBie Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 9�A,, r►`e� § E�per and Town of Barnstable Ordinances, Article XXvll B. Determination (cont.) ❑ 6. The following area and/or work, if any, is subject to a municipal ordinance or bylaw but not subject to the Massachusetts Wetlands Protection Act: ❑ 7. If a'Notice of Intent is filed for the work in the Riverfront Area described on referenced plan(s) and document(s), which includes all or part of the work described in the Request, the applicant must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c. for more information about the scope of alternatives requirements): ❑ Alternatives limited to the lot on which the project is located. ❑ Alternatives limited to the lot on which the project is located, the subdivided lots, and any adjacent lots formerly or presently owned by the same owner. ❑ Alternatives limited to the original parcel on which the project is located, the subdivided parcels, any adjacent parcels, and any other land which can reasonably be obtained within the municipality. ❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate region of the state. Negative Determination Note: No further action under the Wetlands Protection Act is required by the applicant. However, if the Department is requested to issue a Superseding Determination of Applicability, work may not proceed on this project unless the Department fails to act on such request within 35 days of the date the request is post-marked for certified mail or hand delivered to the Department.Work may then proceed at the owner's risk only upon notice to the Department and to the Conservation Commission. Requirements for requests for Superseding Determinations are listed at the end of this document. ❑ 1. The area described in the Request is not an area subject to protection under the Act or the Buffer Zone. ❑ 2. The work described in the Request is within an area subject to protection under the Act, but will not remove,fill, dredge, or alter that area. Therefore, said work does not require the filing of a Notice of Intent. ® 3. The work described in the Request is within the Buffer Zone, as defined in the regulations, but will not alter an Area subject to protection under the Act. Therefore, said work does not require the filing of a Notice of Intent, subject to the following conditions (if any). See attached. ❑ 4. The work described in the Request is not within an Area subject to protection under the Act (including the Buffer Zone). Therefore, said work does not require the filing of a Notice of Intent, unless and until said work alters an Area subject to protection under the Act. wpaform2.doc•rev.10/29/02 Page 3 of 5 t 1 � DA02-069 Butler Special Conditions of Approval 1. Staked strawbales backed by trenched-in siltation fencing shall be set along the approved work limit line. Effective sediment controls shall remain until the site is stabilized with vegetation. 2. The work limit shown on the approved plan shall be strictly observed. 3. There shall be no disturbance of the site,including cutting of vegetation,beyond the work limit. This restriction shall continue over time. 4. All areas disturbed during construction shall be revegetated immediately following completion of work at the site. No areas shall be left unvegetated for more than 30 days. Mulching shall not serve as a substitute for the requirement to revegetate disturbed areas at the conclusion of work. i i DA 02-069 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands °* WPA Form 2 — Determination of Applicability AK Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 'OT 639. and Town of Barnstable Ordinances, Article XXvll B. Determination (cont.) ❑ 5. The area described in the Request is subject to protection under the Act. Since the work described therein meets the requirements for the following exemption, as specified in the Act and the regulations, no Notice of Intent is required: Exempt Activity(site applicable statuatory/regulatory provisions) ❑ 6. The area and/or work described in the Request is not subject to review and approval by: Name of Municipality Pursuant to a municipal wetlands ordinance or bylaw. Name Ordinance or Bylaw Citation C. Authorization This Determination is issued to the applicant and delivered as follows: '® by hand delivery on ❑ by certified mail, return receipt requested on OCT 3 1 2002 Date cf Date i This Determination is valid for three years from the date of issuance (except Determinations for Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. This Determination must be signed by a majority of the Conservation Commission. A copy must be sent to the appropriate DEP Regional Office (see Appendix A) and the property owner (if different from the applicant). ❑❑Signatu'res: On this tday of C ` 200k,before me personally appeared _ 04LT� j,I)AAIN l� ;,to ma.k;ne+m to,-be+he person described in and who executed the,f6 egoing nstrjment and acknowledged that he/she executed.tl e,samb as his/her free acy%&(Va Notary Public J3gC o7D0� My commission expires wpaform2.doc•rev.10/22/02 Page 4 of 5 4 DA 02-069 Massachusetts Department of Environmental Protection °F"'E'0frti Bureau of Resource Protection - Wetlands °* WPA Form 2 — Determination of Applicability * MAS& Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 b 9 am and Town of Barnstable Ordinances, Article XXvll D. Appeals The applicant, owner,any person aggrieved by this Determination, any owner of land abutting the land upon which the proposed work is to be done, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate Department of Environmental Protection Regional Office (see Appendix A)to issue a Superseding Determination of Applicability. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and Fee Transmittal Form (see Appendix E: Request for Departmental Action Fee Transmittal Form) as provided in 310 CMR 10.03(7) within ten business days from the date of issuance of this Determination.A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant if he/she is not the appellant.The request shall state clearly and concisely the objections to the Determination which is being appealed. To the extent that the Determination is based on a municipal ordinance or bylaw and not on the Massachusetts Wetlands Protection Act or regulations,the Department of Environmental Protection has no appellate jurisdiction. 9 wpaform2.doc•rev.10/29/02 Page 5 of 5 °ptHE Toyer Town of Barnstable Regulatory Services r r '* BAMSTAsLE. ' Thomas F.Geiler,Director 9`bA,�' a � g Buildin Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations, renovation,repair,modernization,conversion, improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. TypeofWork: Estimated Cost /Za�a Address of Work: 1 J �r✓�, /1✓ � 47�[ l�l/l/�� ��� (�Owner's Name: Date of Application: V l g1 !O Z I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law l:]J Under$1,000 uilding 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 PE _ Vhere apply for a permit as the agent of the owner:�/ z �1�'�n n l.� e/scan C�s `��ur�n► 4s /nC, Date Contractor ame Registration No. OR Date Owner's Name O:forms:homeaffidav RDOEOFd6Tw0 gDOPRw4® A•.covww•re Ao:�s rewE DDUGLAS S i1D ANFO exsT«a4ngABE. ASSOCIATESINC. SEESEGTmx pG�XYMLL DNN: TW�OGv�0.pEWOFK BA36 ® 0. 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E%[R«OOEIX / a W c ERwG L6 Hnrc«.Q Bo.vT. ° , _ /�OZ O N!W_ �ALRNSTAWLftSUILDING DEPT. m av REMOYEHE Q6TH0 WHOM iwp�ca'Tii w"�a°O°R wld �I.H9TW.lxM W WSOOTHO roYXTLN iXE IX6'fN0 H OHMO LE W WLS nIOOELMO.000fOHniEO1xEROEWVC w«L TlE NVOxxER M 2 9NOWEREH0.LBE RBO BYLi WRH PM MO RLLOEp4NO i ..... :..:. ..........: ... .........••..: 2 H9T«l OU«.R_MM WDXW. J 6X6TH0 w, OLQR• eu-NTEWOP/BHEf9 LM«O R¢xorE Exerwo eYLFw caax El6 - -.8X Ns EX6YHOOECN Nlfn«T.ET,.,."ME, �t'�d1�ixEW BULT-H4.t>A ' • 4mi PE.•MN nl mdE�eWu fiiee _LnR]E Owx,TRY LO WTf b y •YATCX{iNlm16 MY�Td d 6T1Y] Y.1+T61B�¢OY TOP G Race EXBTHo 000Re sTev mL d6sox� H�F�oralHoroMnrd nwlCelrlitrB xasHo.r RBrovEOOR oe�EMelrXu ...........:.......'! ......... _.._ __-- yyFX6lROOM Nm YLGW 0.00FR63T ..-I I• En - •• =IExeTHO Bn fgCLX •xI ••. R%iUPBMORu6N E�E'• • -- nNR449wNIg9MWRUCr XEM r"� . - �7•pX0 1" iH�EiCPBlx06� • N10 TOOIXi D� SYOPMF —. I Pn pNwN e GMn dEx6r. NE9 ON�TG J fill9T fiEnY WIDORIWB. 4 b IX6TM�� BnsE0.NEON�WLURI9 TOBEf i S 8REGRY Y1PDnTgI W¢L. O NEW YONEY 669KRG1 _ ��EX6 .Pnrd iEMOM1£E%6THO PoGYETOOOR diAYM OX9 i¢ O Ela NGEOR]Ixo n5 dOWx, OM 65� iRY OPBIHOy3 nTd WIBXESro O CNEQED End Hnid Q6TXgP IVJ l .. EBI�IFlpO E2QHnTM EX EX WTE NI418f 420II gE¢OLEOOOf6 nD«LLNHORr O T £ - O�/�Q I 1�•� OOXU3 H BTnLL 11 N6w W611T� YP L na°Er'P°�r"•.mE OHNwr Rw �SOOR PLANS O ( I SHEET NE Nw000a.GweaEXAl ,Be BL�G Vol pT a r t t By: Yankee Survey; 1 508 420 5553; Dec-18-99 5:50PM; Page 1 /1 I,OT 3 / •QU. / nj LOT 4 a 3•,.�:-_ CHAR .SWAMI' 1 :.0 Yf '� Sim��l✓ � ^� rs7 00, 1 U� LOT 5Plun .�` a1J• RrS. ZONE- "Rn-1" This M()R'1' INSPECTION GAGE; INSPECON Batik 'irip°pnly FLOOD 70Nr- "D„ THE DISTANCPY AND Ml:ASUHKMKNTS UN T fi C110TILD VE 31TUMED BY AN INYTNUMP:N•r ti(JKVRY. _ • . - �.','. ---------- REGISTRY OWNER: __--------_- DLEU REF: BUYER: _&:' _l MJVCE . ________________.-----------.-...._.-- DATE: -------------- PLAN I HEREBY CERTIFY TO LAf'8' G'UU tlV�_ C_F,NT.S ,Sg[�NC.511�Yg' �NOf XANKEL SURVEY __ ______ ______'THAT THE BUILDING CONSULTANTS SHOWN ON THIS PLAN IS LOCATED ON THE, GROUND A5 SHOWN AND THAT ITS POSITION 1>OI✓� CONFORM .. 40B (SUITP 1) TO THE ZONING I.AW SETBACK REQUIREMENTS OF THE YERIT1i INDUSTRY ROAD TO W N 0 P DARNS'TABLfT ___ _AND TH A'►' Ma�009 IT DOES_A0r LIE WITHIN THE SPECIAL FLOOD IIAIARD MARSTONS MILLS, MA. 02648 AREA AS SHOWN ON THE H.U.D. MAP DATED TEL: 428-0055 C�mm�.tllit -PclLlr_.l 2150001 0018 n FAX: 420-5553 - TRN PI•AN NOT MADE FROM AN INS' NT SURVEY 2615� DAF PAlll•—A. MERImF1F:w. 115 NOT 7'0 tih, 113 FOR FENCES HUII,DTNG PERMIT'` Ellf. i Town of Barnstable rmlt# 63 Expires 6 montlrs from issued e Regulatory Services Fee Thomas F.Geiler,Director Building Division J) Tom Perry,CBO, Building Commissioner °7��3/°9 200 Main Street Hyannis,MA 02601 www.town.bamstable.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 Q(!J QQ - Property Address residential Value of Work J 0 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address �/l hone Number Contractor's Name r�rd �G"�`-'I !�` , NFL t / I�G Telephone Home Improvement Contractor License#(if applicable) / J 0 1�d 9 Construction Supervisor's License#(if applicable) �O���I av. P R E S SPERM 91Morkman's Compensation Insurance J U L Q zo 0 g Check one: ❑ I am a sole proprietor ` ❑ I am the Homeowner TOWN OF BARNSTABLE ®Khave Worker's Compensation Insurance 4 Insurance Company Name �`� �' ` Workman's Comp.Policy# 111 /0( o ! 09 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) 2-'Re-roof(stripping.old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) Re-side ❑ Replacement Windows/doors/sliders: U-Value (maximum.44) ' *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. py of the Home Improvement Contractors License is required. SIGNATURE: Q:Forms:expmtrg Revise061306 ,A Board o ui in e ulalons an tan ar s g g One Ashburton.Place - Room 13.01 Boston, Massachusetts 02108 Home Improvemeht Contractor Registration mm Reqistration: 110609 Type: Private Corporation Expiration: 11/3/2010 Tr# 276582 irv � # ___ --- -- -- -...-- - -- -- -- - E J JAXTIMER, BUILDER, INC. j t ERNEST JAXTIMER 48 ROSARY LN _. - m HYANNIS, MA 02601 q} _.�riz. 1�r dw,a 16:"1 Update Address and return card. Mark reason for change. Address Renewal Employment i i Lost Card DPS-CA1 Co 50M-05/06-PC8490 C�anvrnozcuP,ca� ay a46czcluCdeCt6 , Board"of BuildmgRegulati ns and-Standards- License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date.. If found return to: Board of Building Regulations and Standards Registration: 110609 One Ashburton Place Rm 1301 Ex +katcon 11/3/2010 Tr# 276582 --� Boston,Ma.02108 Type Private Corporation E J JAXTIMER 6U1tDER r u ERNEST JAXTI ER ' 48 ROSARY LN Q\ a� --y --- - $tvalid ._— ..._...__.HYANNIS, MA 02601r wit out signature Administrator. J. Board of Building Regulat►ons-and Standards f �. Construction Supervisor License ' 51 r; ', r �' 1'%2010 Tr#; 13629Nil a 'ERNI=ST J JAXT IIGF�xA 48 ROSARY LANE -I HYANNfS MA 02601 5 Commissioner y The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information f� ,/_ Please Print Legibly Name(Business/Organization/Individual): 'ff.J. v Q Y-�1 ��' 6a l `/"6 r, l/?(—a Address: City/State/Zip: QJL"'S /77/9 02&0 1 Phone k (6-02) �7 1 sq • f l Are an employer? eck the appropriate box: Type of project(required): 1. 1 am a employer with 210 4. I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g- Demolition workingfor me in an capacity. employees and have workers' Y P h'- 9. ❑Building addition [No workers'comp.insurance comp.insurance.t required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and.we have no employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit_indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractor: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: /�6 62t fq Pad 7WROV I AI G CQ , Policy#or Self-ins.Lic.#: ��I 0l J 1 y I Expiration Date: oI Ut 0 Job Site Address: City/State/Zip: �V f y / 0 3 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify the nd penalties of perjury that the information provided abov is true and correct Signature: Date: r Phone#: Official use only. Do not write.in this area,to be completed by city or town offlciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: MAR, 13. 2009 10:24AM HART INSURANCE NO, 635 P. 2 ACOR rm CERTIFICATE OF LIABILITY INSURANCE p03/13l200099 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HART INSURANCE AGENCY, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES, NOT AMEND, EXTEND OR 243 MAIN STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO BOX 700 BUZZARDS BAY, MA 02532-0700 INSURERS AFFORDING COVERAGE NAIC# INSURED Ej Ja4mer Builder,Inc INSURER A, ARSELLA PROTECTION INS CO 41360 48 Rosary Lane INSURER e: ARSELLA PROTECTION INS CO 41360 Hyannis,MA 02601 INSURER C: AR$ELLA PROTECTION INS CO 41360 INSURER Dr. ARBELLA PROTECTION INS CO 41360 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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. EXOLUSIONS AND CONDITIONS OF SUCH POL-ICAES.-AGGREGATE-LIMITS-SHOWN MAY.HAVE.BEEN..REDUCED:BY PAID CLAIMS. INSR D POLICY EFFECTIVE POLICY EXPIRATION - LIMITS POLICY NUMBER A "NEPAL LIABILITY 8500042039 01/01/09 01/01/10 EACH OCCURRENCE s 1 000 OOQ AGF TO RENT COMMIrROIAL GENERAL LIABILITY e5amI ES Ea• nm 3 300 000 CLAIMS MADE OCCUR MED EXP(Any ono rseN S cJ 000 DERSONALS'AO�YINJGI�Y S 1'000`OIDO GENERAL AGGREC+ATE S 2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS•COMP/bP AGO $ 2 p0U 000 POLICY PRO• LOC B AVYOMOME LIABILTY 87083400003 01/0.1/09 01101/10 COMBINED SINGLE umrr S 1,000,000 (Es a�Itlent) ANY AUTO X ALL OWNED AUTOS BODILY INJURY S (Per pelaon) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY $ .(Per atcoenO NON.OWNED AUTOS PROPERTY DAMAGE $ (Per aaWenl) CAitAWl1ABR(TY AUTO ONLY•EA ACCIDENT 5 ANY AUTO OTHER THAN EA ACC S AUTO ONLY, AGO S C EXCUSIUMBRELLA LILITY 4600042040 01/01/09 01/01/10 �AcH OCCURRENCE s 2 000 000 AB 0XvA CLAIMS MADE AGGREGATE S S DEDUCTIBLE RETENTION S WC STATU- 07H. D WORKERS COMPENSATION AND 9111010109 09/01/09 01/01/10 EMPLOTERS'LIABILITY E.L.EACH ACCIDENT li 500,000 AN IF PCRROPRmTB MTmDW Uv E L D18EASl:•SA EMPLOYEE S 500.000 Ifyas,de ePT08 order E L DISEASE-POLICY LIMIT S S00 000 SPECUeL PROVISIONS pglrnv OTHER DESCRIPTION 0 OPERATIONS I LOCATIONS I VEHICLES I EXCuISIONS ADDED BY ENDORSMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SNOULn ANY OF THfl ABOVE DESCRa3ED POLI6E3 BE CANCELLED BEFORE THE EKPIRA'r10N DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS W RMN Town Of Barnstable NOTICE TO THE CERTIFICATE HOLM NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 367 Main Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON TqE INSURER,ITS AGENTS OR Hyannis, MA 02601 RFPRESENTAVVS AUTHORIZED REPRESENT ACORD 25(2001/08) 9)ACORD CORPORATION 1988 f . P Town'of Barnstable Regulatory Services 9 ' $ Thomas F.Geller,Director ; `� BuildLing Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 ffice:- 508=862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using..A. Binder I —, as Ownet of the subject property hexeby authorize &. 4,0a, /AlCto act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of job) tore of UwrDate Print Name Q:FOMa:owr+-EF2ExMIssioN li 28&72. S,F I , 35�� { r i b RICHARD . . A, o . BAXTER V c'! - No: GO/STV? cE,eTi.,=/Eo 7- • � i / c'E2TJ,c'Y THAT Th/� oO'VZ),:17/�nl .0 aC.4T/O.C/ C' N 7 :S.S/vWitJ f iE,E'EO�C/C'Ois-1pL YS l�//r// SCA Z-.Ic ANO SETBA C/G •�?EqU/.2Eit-IE.(/TS OF T,�,i� 7-oytit/a�- O.c'a`!t! .2E�'E.2Eit/CE- I �3/6��! T".�r.'.�..� Ait/O /S J�✓��a�.... L.�>T � �,�,v. .. ,��^v�r°=: I ,CacA�'E'r� Lsiiry/.t/ TyE .�LoaaPG4/�i! �U�� G7,W/S/ON ,.,`=f:�- ,• ; V r i Tf//S //✓,ST.�'U�.6it%T SU,21/E'Y� Th�� � 4STE.e'li/,C.L�a �J.4SS. 0•�•�SETS Syvl,�/.y ShIDU.Ga 11p7- g2-- USED 7v OE'TEP_..iif/�f/E .L!>T�./N6s .4F'l�.L./C,Qi✓T" -. . 1 " I• TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING rua tg t639. � HYANNIS, MASS. 02601 �o r�r►• MEMO TO: Town Clerk FROM: Building Department DATE: o� ��9 / y An Occupancy Permit has been issued for the building authorized by BuildingPernMt #/!. .. ................ .......................... ..........................................._................. issuedto Y,/.�t/ ��._. .JLY�1 ... .✓. . .............. ............................................................»». Please -release the performance bond. 4 o THE TOWN OF BARNSTABLE Permit No. .... x� .c,... BUILDING DEPARTMENT seu9r I Cash ............. .. ■6� TOWN OFFICE BUILDING '°'Pniur HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to SILVIA & SILVIA ASSOCIATES . Address 1 nt- #G, S99 Rnv T,nnn_ r..arntPrxri 1 1 a USE GROUP FIRE GRADING OCCUPANCY LOAD ' THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. F-a-b •-. r:y 19.........°.7..... .. <.� %:'• '/ .0 ! Building Inspector 1 _ - s k 9 Assessor's map and lot number .. .. ..:.. `�.� Quo FTHET o�y SeVDage Permit number ..�-.?�........... ............:�:............... Id Sl Z. SEPTJC Sl'STEN,r1 MUST S t BARISTADLE, i House number ............................................0 NC *MR !�r�, pp YY� 1639* TOWN OF .-BAR�Nv T�A�B�LE-:)SAND ` TOWN REGt. LATIQi� i BUILDING INSPECTOR APPLICATION FOR- PERMIT TO ....... /� TYPE OF CONSTRUCTION ........10c, � ��....2 ................................19.f! TO THE`INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: LocationF�.(......... /....... .G'... ............ 1� ...................................................................................... Proposed Use �,l. /ll. ./�.......r. xv IZ ........ �r /d! .................................................................. Zoning District .OAR.. .............................................Fire District .. . . 'e..................... . ..................................... Name of Owner ....°. ��.�..�.j/�lll. ... �G.7Address .. r W. Nameof Builder .................................... ............................Address ...............................,.................................................... .Name of Architect ..................................................................Address .................................................................................... Number of Rooms ............46 ...................................... .........Foundation Cle 0........ psiCot Exterior ....4".4........................:.................................Roofing ..., .� j(0/�....................................................... � C /� .Interior Floors .�l.T.. . ................................................................... ..,..�1��1��............................................................. H=�ing /e7WC1.O U� w r .......4 r Plumbing G�. �......- �0�-..... . .:...... ......... ' , I Fireplace ��—t...............................................................Approximate Cost .../. .. '.v.v.................................... ..:............. Definitive Plan Approved by Planning Board _/� __ -�_____________19__�' Area ..2�.. 4a.�.................. Diagram of Lot and Building with Dimensions Fee /0 IF SUBJECT TO APPROVAL OF BOARD OF HEALTH — ?;Pot-5 1 r' 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..................................................................... ' 2S<TLVJ- OCIATES A~& SILVIA ASS +. No ..M22 ` Permit for ...One•,Story............. .........Single Famil DWellln . " Location ....Lot.. +9.....5. 2.. ay..LaAe............... s ...................C e t p,.rx lllp.. ................................ VI) Owner ....... ilvia..&.. � S S........... .. .. .....?�......... .4... .4... Type of Construction Fxatop............................... - .....................................:................................... -, Plot..'...... ................ Lot ...... , " f Permit Granted ...... Sep tember...9.,......19 85 Date of Inspection�U..' ........... .19 G ~ r � - ti Date..CompI t ld�1. !� ...................19 ~' r - , PERMIT REFUSED ! rf ...........................................................,.... 19 / E - • ............................................................................... ............................................................................... # j Approved ................................................. 19 {�� ....:................... .................................................. F Assessor's map and lot number Om TOWN OF BARNSTABLE BUILDING INSPECTOR TYPE OF CONSTRUCTION Z�h TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information- Proposed Use /................ 'I, Nameof Builder ..................................................................'~d~'~s ..............................^......^......^.................................... / | Nome of Architect ..................................................................Address -----------------------_____ � Number of Rooms ---. '-----------------Foun6ohon .................................................... Emerior ..... -------------.------.RooGng — ............................................. Floors ..................... —,-------------..|nterior ' __ ./ �___________.. Heating ^~- .. "t..................................................... —.Munn6ing .................. _.............................................. � | AO __ ' / � Fireplace '.— . ~-----------------------..ApproximoteCos —~�t/ .. .................................... Definitive Plan Approved by Planning Board lV Area ...7 �------- � Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH � � � � �z \'o\ � . . � . ` | hereby agree to conform to all the Rules and*Regulations of the Town of Rornuhzb|e regarding the above construction. ` . ^//' . � Noma —.—.--.---.----------------... � U ' � SILVIA & SILVIA ASSOCIATE A=186-44 No .2'$399 Permit for ....One Story Single Family Dwelling ............................................................................... Location Lot 4, 52.2... ... Bay Lane. ............................. . ...... . ...... Centerville ............................................................................... Owner Silvia & Silvia Associates .................................................................. Type of Construction Frame ................................................................................ Plot ............................ Lot ................................ Permit Granted ......Sept....A..................19 85 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ................................................................ 19 . ....../....--�.--' s��...................... ................................................................................ ............................................................................... ............................................................................... Approved ................................................ 19 � r ............................................................................... i i 00 Inn, ASSESSORS MAP 187 PCL 68COURT PLAN 41594 A SHEET 1 4: ` ! CERTIFICATE 114082 @0 �_', J�P� FR OWNNER APPLICANT: PATRICK & S SAN BUTLER RD. 522 BAY LANE, CENTERVILLE, MA 02632 LAND COURT FAN ` , NT ^� i V ,t,R !S p..___.:.".;�E E_;= co'����v .ION LEGEND: , I••I �/ o 41594 SC DER m LOCUS \ `1 n + 19.4 EXISTING SPOT ELEVATION w F�f BAY BVW �1�G`�`ROJ +�®1 EXISTING CATCH BASIN 7.7 [� EXISTING DRAINAGE MANHOLE BVW #2 9 '�! EXISTING POST LIGHT / 34 6.0 7.1 �- BVW #7 to BVW FLAG BY HAMLYN CONSULTING B O A Q LOCUS MAP W EXISTING CONTOUR 6.9 � SCALE 1" = 3000' 7- � BVW #4 '+' C WETLAND DELINEATION BY 5.1 HAMLYN CONSULTING, INC. BVW #5 + 5.9 ICr w ~ \ \ 9/6/02 FIELD LOCATION 5.9 3 �,{ A BVW6 PROPOSED SILT FENCE \BVW i8 BVW #7 6.5 �! rr WORK LIMIT LINE / ,1� 14 \ \. \ 6.0 7 7.2+cv % a, , rp Q�il 6_8 _ EXIST[ ROC / v W �p 8 TO AI i NCO 76 \ \ 7 9 �1 // PROPOSED SILT 111 10 10.3 EXISTING ��"�j NO, WORK LIMIT LINE"AT 10.1 /�8 � __ 12.3 \� \ \ '8�€X1SS1N-'-E-BGE OF .�.�� (1ST FLR. LEVEL) \16.6 TOPO PROX. \ LAWN AREA 10;1 \ THIS AR ;\ \ 10.9 \ Ito \ \ \\` 9 1 1 EXISTING 8.25' PROPOSED i 10.5 / 1 D_ECK � .. 11.4 PROPOSED U, 10. / STAIRWAY ADDILI� CANTILEVERED 1j J / WITH FROSTWALL 1ST FLOOR ADDITION -EIIUAf33 F± (NO 70USD}TION) '15.�OCK RET. ° �- � IEXISTfNG WOODFRAME � •8 WALL i 'HOUSE 52 Z _ _ ,� /� AREA O.H. 8.5 a �\ " �/ \ \� \ IP RA RAINAGE SWAL'E, +2\ / 1 .0 18,3 1 .3 8.3 � d .3 LOT 4 \1 3.9 17.7 LOCUS ?cam y1 +i 20,9 PAVED 0.64 AC.t ~ \ �• BRICK / 4 �., DRIVE WALK LAWN Q. AREA f/ OCT Z 2 002 72 \ N 16.8 \ C W ° j 17.9 19.4 �� 20. � 19.1 �9 19.4 ASPHALT SIDEWALK ^� " GRANITE CURB I �8.00' S z I 18.9 48ENCH MARK - V J - CENTER OF CATCH Q BASIN."EL. = 18,1 ASPHALT SIDEWALK O w NOTE: THE LOCATION OF EXISTING UNDERGROUND UTILITIES SHOWN ON THIS PLAN IS !0 BA. Y LA /( ASSMD G.I.S.) J SITE CURB 19.2 v � APPROXIMATE. PRIOR TO ANY EXCAVATION ON THIS SITE, THE EXCAVATING l -�-/�1 NE � S 1 TE PLAN _ - 3 � Lo CONTRACTOR SHALL MAKE THE REQUIRED 72 HOUR NOTIFICATION TO -DIG SAFE 40', WIDE PUBLIC WAY. : SCALE: t"=20' O `i (1-888-344-7233) AND ANY OTHER UTILITIES WHICH MAY HAVE CABLE, PIPI=•OR , EQUIPMENT IN THE CONSTRUCTION AREA FOR VERIFICATION OF LOCATIONS. 20 0 �Q 40 60 Feet �-�■ '� o 02-253 i 1 - ,. 4�- � igftt Dou av SanfaA . _ \ Aescciaes.M.2L02 - EXISTING RJOFREWOW. O ACCCkO"ATENEW STAIRAND ACCESS ABOVE EXISTING GARAGE. SEES ECTION �SSOC.IR ES INC., a . - 22 CL AY H ILL DRIVE FLYMOUTH.MA 23G0 _ RICNE8 FAX EXISTING LA CUPO REWORK,BASE ED ry . FORNEW ROOFS n . NEW SHEDOFMERAATCH TRIM ON MAN - • " HOUSE.TYPICAL ® - NEW PNDERSEN WINDOW.TYPICAL BEOOFID FLOOR .• - , IX ISTNG G ARAGE ' al i NEW SDNGON ENTIRE REAR WALL OF GARAGE ' RRSr FLOOR E%STNG RERAN NG WALL C3G 11SAS M. Lu NEW ADDITIJN FOR • EX STING WINDOW RE100 AND 1 NEW ST AIR HEW LARGER WINDOW NSTALL®. REAR ELEVATION PATCH SIDING - - EXISTING PATIO DOOR REMOVED ANDNEW FRENCH DOORNST/G1®. �" ca PATCH S DING EXISTING RETAIN NG WALL W uj w cc ZJ NEW SHED D ORMER ON EXISTING GARAGE _ �. j Q W IN W caIN EW t� f - saMnrd area HOUSH TY R DOFMEMATCH TRM ON MAN•HOUSE T'P _ NEW SH UTTERSERS TO MATCH EXISTING. "FViSiOP}S FJ �` TYPICAL s. .. ,. STEP RASH NEW RDOF AT IXISTNG WILL ® ® ® C ® ,NEWRDOFONTI%SOE FGAR4GE__ MATGN NEW GLlSSDOORMATCH MANUFACTURER--. OF TRIPLE UN IF IXSTNG FAMLYFYWA , . � BEOOFmFLOOa { T REMAIN G:AND BALING ' TO REMAIN wsA DRAWN DYa CHECrED DI<S . : SCPLE 110'bi'O' DATE AUGUST 18.2= NEW CEDARSH NGLES 8 TRMON TITLE ADDRION TOMATCH EX STNGHOtSE - a„sAaExr ELEVATIONS . - NEN'ACtXT17R _ ... A LEFT SIDE ELEVATION r SHEET A3- ' a, r! 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