The URL can be used to link to this page

Home My WebLink About0264 CAP'N LIJAH'S ROAD �/ JJ +� • - TOWN`OF BARNSTABLE BUILDING PERMIT-APPLICATION Map_ Parcel / *. 4 Permit# ' Health Division 76--1/J �✓s �//7�99 Date Issued ` Conservation Division "��Z� Fee Tax Collector �.� :. � �� t �a .)'�R _ Treasurer` SEPTIC SYSTEM MUST.EE r INSTALLED IN COMPLIANCE Planning Dept. WfTI 1Tit S Date Definitive Plan Approved by Planning Board , ENVIRONMENTAL CODE AND TOWN REGULA NS Historic OKH Preservation/Hyannis Project Street ddress C -FYI " M1 l Village e Owner 2C)Le JA lC +'dy " Ad&ess � a � ► US Telephone e �-� F/G— �Permit Request �r�l r�-r"Gi J �/014-d - LAN ,14 , Square feet: 1st floor:a 'sting proposed 2nd floor:existinga proposed /�75 Total new /h 7� Estimated Project Co /9a Gb® Zoning District Flood Plain Groundwater Overlay ' Construction Type rh�p Lot Size Grandfathered: ❑Yes ElNo If yes, attach supporting documentation. Dwelling Type: Single Family V Two Family ❑ Multi-Family(#units) " Age of Existing Structure `7-4 .t en r Historic House: 0 Yes 0 No On Old King's Highway: ❑Yes ❑No. Basement Type: LFull ❑Crawl ❑Walkout ❑Other } Basement Finished Area(sq.ft.) 0 Basement Unfinished Area(sq.ft) 4190 Number of Baths: Full:existing new Half:existing new 9 Number of Bedrooms: existing new �. � Total Room Count(not including baths):existing � —new First Floor Room Count Heat Type and Fuel: A(Gas ❑Oil ❑ Electric ❑Other M Central Air: LXYes ❑No Fireplaces: Existing New (°J Existing wood/coal stove: ❑Yes XINO Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:Q14existing ❑new size Shed:❑existing'❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ i Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use — BUILDER INFORMATION Name "A / - Telephone Number Address CY4� eed L4 License# 0 44S #7 f Ya b A40tJ Home Improvement Contractor# 165 7�7 Worker's Compensation# U vs q5 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO a SIGNATURE` DATE a FOR OFFICIAL USE ONLY " PERMIT NO. DATE ISSUED t MAP/PARCEL NO:' � .' i . .; ;~� - :R • • v. • - £'- � 7 a ADDRESS VILLAGE-_. " OWNER DATE OF INSPECTION. _ ` - ± FOUNDATION FRAME Cl t i INSULATION FIREPLACE Y t' ! . j � -_ -• r ,' - '' ;; .= -r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH ;r s FINAL P } � GAS: ROUGH, d FINAL FINAL BUILDING t41 i - • c In DATE CLOSED OUT ASSOCIATION PLAN NO. `s n a 9ZUvLI.l�4� L��'G�4t1G All WINS HOME IMPROVeMSNT CONTRA arc# of 8til dJ°n C 021 HOME IMPROVEMEN'C otqTRACTN .. Type 08A mac: Troy A. W 11 w '8 _Station itive MA + BOARD OF SU1LDWG RECULATIGNS LiceriO CONST.RL'C110N SUPERVISOR: N��»tier G :04Y8 ? _�� '�B�rtNdate 071OvI1�Ci72 , k Exrrs0710.5i2(i01 Tr.;no 30 rte�ri o: 00 vv TRC)?ANB WALLS .87 CRAERRY LN SYAP440U-TH, 10A .O W �dtnin'sstatv'` U tmt3=A4Dskj ' ' TahbJSZ•tb(eommad) . hma'gMve Pwk4m for Qae and Twv'Family Ruidmdd BatldlSO Heated with Fowl Faeb MAXIMUM MQIT1 um GlIzingCdftWaU Floor 8uement Slab 11a zin, t�6 Ae ) U„v� &Wwu R Adam &vaia2 W211 PIS �I�mt Fffiaeact' pm", "I. I I I I I I RvaboO Rvdme mi to 690 HestmO DeOree Dade' Q112-A . GAO 31 13 19 10 6 Now R o s2 30 19 19 10 6 Nomw 3 850 31 13 19 10 6 UAFUE T 0.36 31 13 25 WA WA Now U 0.46 39 19 19 l0 6 Nw Vfps 1" ds 1+' '.S IgiA WA O AME W 0.52 30 19 19 10 6 1s AFLIE x A 32 31 13 2S WA WA Now Y llri'fi OA2 31 19 25 WA WA Normal Z 12% 0.42 31 13 19 10 6 90 AFEM AA 139E OJO 30 19 19 10 6 90 Ann r 1. ADDRESS OF PROPERTY: -z 6 q Go L ► PJ �j �Pry 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: Z 6 Z 3. SQUARE FOOTAGE OF ALL GLAZING. l 4. %GLAZING AREA(#3 DIVIDED BY#2): S. SELECT PACKAGE(Q—AA•see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q4=4980303a 780 CMR Appendix J Footnotes to Table J51.lb: ' Glazing area is the ratio of the area of the glazing assemblies (:_ iding sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,b :xciuding opaque doors)to the gross wall area,expressed as a percentage.Up to 1%of the total glazing area ma`- excluded from the U-value requirement. For example,3 ft of decorative glass may be excluded from a building design with 300 ft of glazing area. =After January 1, 1999,glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness.over the exterior walls without compression, R-30 insulation may be substituted for R-3 8 insulation and R 38 insulation may be substituted for R-49 insulation. Ceiling R values represent the sum of cavity insulation plus insulating sheathing(if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding,structural sheathing,and interior drywall.For example,an R-19 requirement could be met EITHER by R 19 cavity insulation OR R-13 cavity insulation plus R-b insulating sheathing. Wall requirements apply to wood-fame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-flame construction. The floor requirements apply to floors over unconditioned spaces(such as unconditioned c rawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. `The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements,are for unheated slabs.Add an additional R-2 for heated slabs. • If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5Z.la NOTES: ,. le levels. Insulation R values are minimum acceptable levels. a)Glazing areas and U-values are maximum acceptab R value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 035. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table JI.53b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 035). c)If a ceiling,wail,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R value is greater than or equal to the Rvalue requirement component for that onent. Glazing or door components comply if the area-weighted average U- p value of all windows or doors is less than or equal to the U-value requirement(035 for doors). 43 Department of Tn&utrial Accidents =• OIITCZOJ/yf/OSllg8dOo3 600 Washington Street —- Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit location � 7 t✓yet vt �� city J YA y 44/1 Vk AA4L phone# 3O 15 sq 44 W 5*-- ❑ I am a homeowner pe mling ail work mMIE ❑ I am a sole and have no one worldng in anv am as wanner.' do ,for my employees worldng on this job. ... ... ..... .. ,.v r r ...... .............rx.».... ...w,......vvv::.. »•rv:::}r:r:iS,{•}4i}:•:w:w:..:fiv:v:•.::.-.v::,.4:'+T4:T:::_.::vT::.?:�:: ........ ............ .......... .. ..:..v. .. :•:vv::w:.v-......::. :...:v:•:::S}xGxw::::::{:..•'{;.;i.;n,-:{ti v:....,.w:::+.•,..:.{.;:•??vv::::v.4i .................................. ...... r. ...... ..v n..v n....rvxr. ..}i. .x.yr .r4..n::..:.:..... {ifi`.$}}}}•i$$k}w::•}:}:?•iT:i?:?:. ........:.. r:... ... r.. .f... , .. ................................... ....... ... }.. r. ... :. ......... 'k} .4 .. ...:.:...,..;r.:t:'Yr:•}x4}}•}}:'•::•• {.,vn?{.•n:•}yd}:$v$$$i`::i:{<::>;'. IX{G} :Q••,}, .::: � A...'•r'•'::�v{, }1SY�::.�j:}i:tv.:.y:•:t;:$:'}rkY. sn 'naIIt ..............................I................... r.::.vv.4..n..... ...:•.... L4. r...vr.r.3. x:... x.•::v+• ....., ...... ....... ........... v. ........,.:... ,'}}}'vv..... }. .r::::::{••♦.•$::4`;k:;:`. tiv'•:G}"r;r.. ....::v:::......:w:•:•......:.::r•: ::::i..4 ti8` `. .4}.x"$:•:n:::..........{ ,., ,�..(C,{y{.Yr$x•b. n4.........,......n,..,..:...? .:•:::•::::::::.:.:::.,:::::.:}:.:.....c .;x..:r• 3.• r'�;..... y, ..k..,u,..;.. rrv,.:•♦•: G :4};4•:4:}r•.... .+••��:.}: �'"r"•' 5...., ...x:::.�.: .wcc♦.}: .,rcx:; 2 .. {.:.t''}�;kJx,Yf.RRp`h•+{k' ,;;vy;, t-:•:G:; Z£:tiy:}� , '$$::i ............ .. n. .. , C. .... ..........., `•r}r.?S}..:,X• .7.c ,.°<`uttG:G$$;,h: �i,'w;}:?fi?Yti#:,>.;:.:$3riii::::' geld ......;..... ;:., .................k ................::. ............... ..::::::.....v»,vr.» •, •:-:'}}}y:T:v •:-•.• x::tt•:{x::'••.k}/r}?r {• }:j4:H:�<$:r}'S.,.•'•:^:�:"::'{h{:kk:$?"?:♦:}i .♦ice: t-0` ::x::-:::n: .....•v.•.,-:xrn .. ..Av:r}}•::{{ fi. r.;.{}G}. .n��}�p� ,'f♦%x.G?•`,r'$,•�•,{.::} .,W.,.v.0.; 4:+4 ::........�:.:..::::vnv:: ....:..... ... ... .x•:G'•:id v: w.W•r♦}.S•.}::....:.v•?`::•-0�i♦ �. ..':ri:•:{.;:.:{::•.n. r.t....!•. ...........:v..........{.......... ... .k r. •.:}G.........,};4:k•.. .... .........n.. ........ .....v::..., .. ::r..:.-.:.:•. •Lk:;• .......... .........r..:.n...v.... .r.K...{#:- v.......4....5 .... ..........:........... .. .... .... ..n..v::::+::vY.......:. v:•.•�::::::r... li 'r'':.i :{?•:.. tn{ ♦Y $ 0 h diw• tl 4Y l ••v4.....v .. .. v v?•.v•v .. .xr.•.v .:r:�...::•:.-.{...r ..w}.. iv,r .. ................r........ .. .. .. .. .. ............. ............ ..,. . .. ... .......... ....... .......... of ficv ❑ I am a sole proprietor,general co�ractor,or homeowner(csrck ono)and have hired the c iacwrs lisped below who have - the Mowingon.. .....,. ...........:.. r................... ..:.............. ,...,.::.�:iry4$$;.:•r... ...r.. -.... ......:.::::... .... ♦'•. n.::{:r.:•:}.4:4:i'x,{{.T:•}?:kY{�?ri:{}{{{:,1,.;.6:{:...kTl:k;.:>]ir;$:k;:Y_:;:$:?:_;;.:::. a.:............. ...:-.:.vv:m:•}:Svr4"v:::»:::::vv:•.v{.v:v::r:Y4:.v•:v:.»:••.»vv.{:$v4,y}.S:f,•:{::vx}:??;?:{?::?G:.:::::::..:::::r�..-...:•,}'}:!:d::...................•name:::�<';:�:.>'.>•.;:?......:.............. �.. . . ._ ..............:...............N.M. ...::...::-:::.,..............:..-::: -:..,.. ,.rw.s SN?FcG+:4#•.i%�;.$�Yli�SCd«}},y,...v ,•t,2Q?♦�}•k�xi�P.i•?�2?Y4�ERR.G;td$:k$;;::k�i3i::•::i' ........ ............::::::• ........ .:. .rr ..,..r.. rv:.;}}:r!:-. r. : {••:{4:$•r,'$;::kcc•:{•}T:•..;....}.:.1.•.r 4r.;', {... .,•.,...r....:..,:'•.{a,{.x: ........:-:.??-:{R�,r.:....... `AR�...r..}$°....,.:.,•:::...:...... ,:•:•}x-}};?.:.r,.♦•}:•}Y•.:}}::•::-::::..;.; ..r t,•d:'.•'::-4..,}:4:,, •. „s,..} ,,.•.{•::T}+}......l .»4•.C.:. . . ..R.}:+.. ...�`:...; {{•... .l..r.•.dfi}:i.{. .4:,4::}.:}},cr::.;..}{ t.. "..k�`?d•♦',a:�?T., ,x}{>x:i:�":�: .: ...........:::4•..........n."}r.......r ...vv..........}:.... .........G ..{. ...i'•i:'G:...v...... .. •}•• •:}rv}:•}:.,{Sn::{t{{•}:•}}:. -.......... ..................{,...•:...,.. ....::. .....,.. ..4 ,•.,•:::•rrv:.;•::::l•.. v. ...>F4•yc r a;F r t S,stk{., �4,k ,G •:•'�. .:}}::•T.•k3..:::.::,.:•:... ,,,, ,.•.k♦�'�•;;::GY.•".SF,C; Nx;., ..r:.....'•k. ,}:•:4•.••:}:i>.•:.':kY::,•,.}„rye•. d••::••:x•.;.. F �,v.`:•�%'''yk:.:}..k+c.d•-�• .Y..$ r�'� •••x �:Yo:+r o:•Y•{;!; r�}.{...a,. „ashht. •{ ,.�. :::C,',K. .2 ::;:•,.♦->%%' .............................. }x:5•r.:....�:•:a..d� :.,;,.,,,..:::::.::::.:,:•♦:•:.y}:4:•}.' .. .} 'S,.:...f•.,v.fssaM.+t�'?Lck.,..)l; ...}::... .:::.:-.c:,.;.. ,{ �{r "' ,r:,.??;•'.'»k•''.c G.., .,.»T+<1•,tt4$�`{^-`.'.k::.,..r>vi�.w ... .. ... ........ ♦::w.-v v}}C•+:'^�+.•;'f,.;:}}:'.•lW,:}y:♦'v,!Cti}::}k.,.. j a .... 5�: ]tiLntk:•}7:rh.•r}r+.4:}nv,}T.,�.:.} ..}4........................ .. }::•. ti'x}}.G:$GT:':r; { i::x:y;$;}+:4.i"'::Y-•:'t •sv:{,.,.,.• � � r .'. .,d.:Y..;;1,{;•.•��..'{„ .'��,''. }%ti:i::4v}:. :as::${r:;.;r$,4:.}}:d•,'.�4:�3. f•4� '�2, ..:•.�'0..•.•:-•-••{•.:rr:,: '}r:•}••}.:•k>.':4�•:k..1;,}:•r;;;;`•.. '•a;. 0.,4.•. +stG ..:,.............. .. :..,.x.. ,. , r. .,•r A •. .;M$4., .. Y#,,,\. .'�+u.Gx•::}:.,, .f;, . 11�1O1E' r.'. i .�LYi k 1 :$.: r •.a r r. r �.:.::.:.r.. v c :r. :•::::4}.,•:::t! .. 9:r.,..r., G:•.'G:{ ` '.:a,.i ?::Ct}4 >�C,•?G` {•.dr ># 3:%3; ::,..:::::::?•:�::•x•:;.;:?•;}:•}}:•}:t.:..Y{{, .F{.}'�. r. }..:,'fi.:.:c•:t?k;, ' ,{•Yry:.:;'•4<:}•; a••. •.}..G{;:e+ ,e.. ,p{4,y: �,-'+°'fi�WY ...::::::::......:•:::}:::r.,•:,:4}}.'Y .h : ,u.. ,. ...... r.. l L' l F � F SP•},{ :S`A� ;\;.{:::::: ::::....::•:::::.,...... :::}. }y" ::... •','r:{v�,{4a}::•:,::•r.. .:} •x:3�::ucY»$G:;.'�2':dl:'' • '''! °{r.-'�-�'xti,.f♦. :l}'T�` -,.va' ..,{. J{. v,�A,�`, 'iii`•�•4v.#;:,••.'�,•,•: G},.. ""C ^-` dh:"\::•.�ii:i:::, .v::m•}::::::ti•}::•Sr}.v ryj;.}}}:•},^•,km, 'S.ar .. .. ...;.::..;., .. - ..r .. 'M '� ... :,•:r :....... :,v::•::,.... �...•�`•'�Ck'2�:K:ax:•:?r,.u?QZktll.. .cr?!k�rTsM.. ...:.....:..::r xi+ ..i:.}.. :. .x•X•4x>.}:..:..$;;•}.•*!;::::$::.Y'#:S.:iiY,i>1.;:';•.:,»;�-0h•'i`}.r•:•..�::::�:.,.'+ar':.•� '. ••`ig{.`, •err: .3�6:.��M1''?�.T y,;,. :::::.�::.:>::::::::•?::.}}y:•$TTT:G}:•... ..:'�S:••: :... .•.•. .},...,,.:.• ».r... '{fi,•..,,»:••:. {}}.{:x♦•::.�.+:Trs.}a�. ... kw.,.�.,..d„•x,.,.'��,.txn!�C2�fo24x}x;:kdo-:k� ............:.v:::::..• ..♦...».:x R{}5.... k.................:. .:.v:. ................ �/ ... .:::T:•:}Gx4?${}v.;r•::}:::..:...;:v: .,,:y;n;:{v;"' ♦•K .. ..... .... ........................ .................r..........r:v::::.ti??•}::::...,. ...............r.................:v..4 :..v.. vv•"xi i?:i•'F-}:.•x:r}r+:?S::•:4:vk^:::;Y' r-0'u`F kr�.:�`4}.. .Si!•}k'-�C:}}}i{:.:i;:. ::... .•.........v.::::...........w:: :...::•:.{..v............{..,..n......�..........;......... v:x:}:::::.................. JJ.fi.::r:r:•^:::F.;......r.. .r.�.. :.:`} :i:$,:;}}...{\"^:,k??�{v... �j •,},{{:•};:}•:k}{kkd:i;k}}}:{:{;:;}•'::�$:�i:ij;::'rr i:'ri:::�J: add ........................:...:..:......:::::n:�.•?ri:}i::iiTi:::.�::?•}•:iiTN:}.;.}:•}ism:•$N:SY?�i:}j::'G}:}'i}4$:r,'{i}:�;L:i}v,:3:;}:}:•'r'�:•i: .... ...........:..............::::::...:...................:w::::..................•:.v:.^..•..............v:w::... v:v »::v::::..w:::v .:v:.:.:.. {•:-4}Y+v•ti:}•,-4Tkt.}�.}:::{:vrvv:nv....:.:}•:..... ........ .. .......r ............. ...............v.......n.n.;.;..:w::::n........- ..{}+/.�...r.x....{:{v»•�.•:{v.4i.G.v}:::v.:.:G`w}•:{4i:}x4{{{.}tiri?{G:{d::4�•y}:G}:•:' •.....:::::..:.....::•:::•::.......r.......r.,.•tr,...:•..............,.:{.::}::>.,•:r<•:.:......,•::.v::r::::::::•...,....... ...:. ...:...... �}....,.:xi.4. +•t:a-09}� ....... ........... .................::•:..}.:.f................... . ..... .......r.. ............. ...... ....,;k:•.G:.,•::•:.};::{;:.� ,...,...: ,,.::.:.....,, ...Yv'k,rcas +r.•.wr.•:. ,}4,a;.• r}.'��i%c}G,:lk-..-:::......... ..:::::::......::::.�::,•.......::::. ......... . rw. :: r:....,.::r..::..••.,,r.. ........r,.{n.... ,. ..x............:. ..,,. r...r:•:::•..:::G}:.,{. G�+ ,.;.., r....: :.W:.r: S. -:::•:•'^....v..3:•:d::?•::::•.r.r r ...rr.::::•.::::•.,4......, - v/. .li•. ..... .........:..:•:::::::::...........4...uG..y{.... !:24kRa' r...,.:..... ....4xtdtY.d ...:....... rr:,,..:..:...;...:.: .h.......:•:: .. .....,.,...............}......ram'...: .. rr .....:::..:kv:. ... ..... .. •'fr..}:::•:::::�:•�::,•::•:. t1tlIIE.�t•.:::�::......r.•::::::.:....,.,...,.,:.:,?.;.::„t+••::;<::??:•,,,:... .. :.�:r.}::{:•;?::�,:•F ...r •+o-F�:Y:3'33'�a.�xA{}::..1:?°i....k'+G{})r, ,...,v.�:rr............ .Sq ............... .. .. ....::.v v:•.: .......... 0.%b%SOSKS .......................... ..... ...�.::::.... ......;...,.. .., :,i.:•:•. ......:C.}....:........}u?Y!R..;q:-k.r..•},.«.:x.....:K::;'!},.rY,rr. ;;u{{•} � i�dxti',Vi:•}}::: ... ............:::..:. ...�......, :xvw:::x:: .:t•.v•:nv}xv{•}:::}:::..v}..rlAr. r. v.Q:•}x:, •v.. ..�r:•:^ rv4v.{ ........ ............:•:::,::::••:v d. .. 4.4.\}:9!......t ..:.4....rF.............. f'.......4-r.+j,C{.•v-.�`•vr:.. {i{;:h;;{}•;•. v..•: ....k., w...v: .........::..........n.........v..: M.ttl:.. f..... ....rv. ..\..}.. ..........;;.x::::::.r........, .......,.,... .s :...ynv}:{{•,{4{�{:�:7C••:?{.xtikk}i$$::"i n>.}1:vk•. ::•::v............• ...::.v:..•..•, ..y.r{,�r. .;.:;w.»...{.}'k,.:.� •rry•:v,r.}}:•iw•'r:iiF.•'r/. •. .r}K♦{t4:4'::•:{•:::•.G'1.. .r :f.•. ''{`J �C`•vA,v,•. ..'{<>.:^?i'.F'::� ::•x:::::::::::.v{{r•:t:::•x•...Lv tr�(,v4�.G... i .{kS}..}S }.R .';•:•iy}:•;:?•x?:<$::?:?:+{"L{,^m:k4.... ,•..:. ,d,.+c£',v4.r�.'kRkk::ti:Y: .'tiler }:+•• :r: ..W tGT}k-.r. },:;{k{!:r;:.,.•::: :...........::.::.,•:+•r4•::.>.$x::YS. 'f.arSiF.?!. .f ..{, r.. �„r..., r r+.•:;:. K.�`.k*..{>rx{T;..... .. '';":•........................................•.:` ..y .. gapms to seems eovastie a regdesd®der Section 25A of MGL L4 cm bend to the imposidm of admiod penalties of a doe up to S1400.00 and/or one years'lmprisommon vvellas drH peneldes in the form of a STOP WORK ORDER and a doe of 5100.00 a day apaindme. Imdesstmd that a copy of this statanentmay be forwarded to the OIDce of IavesdgxdG=of the DU for covtsaV valdtut m I do hereby andPCxa&igs ofperjwy that the inyonnation provided aboveis&w. S' Date Print ofilcial use only . de notwdle in tbb awn to be completed bl city or town onidid city or town: P ti ent Dye;g� ❑checkif lmmediate response is reqWred ❑Selectmen's Office _ ❑HeW&Depariment contact person: phone* [30ther__. Gerald 9ro3 PJA) 1 1 11 1 1 1 1 I No 114 q MI 1 1 �f1 - 1 • • • 1 �• �i1I • • • 1 • • • • •111/111 .12 •II • / ;-11111 • • •WI111�• I:1 •II 1 11 • 1 • 1�i 11 / :/ 1 •1.1• 1 % / / % • 1 1 �• 1 II • / • •1 1 • •M • •1 • •Or.08WINOwil ai111 • 1 "• • 11 • • II • 1 • 11 ! :11 ' �'• 1 • 11 :f 11 - 1 1 • 1 • 1 1 11 - 'Y• • 6'"all Y•I• • •G L: �• �i/111 • •1 11 �1 I - • 1 1 • •I • 11 a 1 It •M t •11 • • / a Ir GI I1.1 • 1 ' :1111t • �:� • ' :•1 11 • "1./ • 1 1 1 ' 1 • 1 II ' 1 • 11 • / .1/ 1/ - • •11�111 1 \ 1 • :�Y 1 11 i•1 �1/1 • I/ ►- 11• 11 • 1 I ' 111 ' 1• • 1 • 1 • 1 �1 •II • 1 • 11 ill :/1 1 •II t 1 Mt •II •I • • 1:19011 1 / ' I 11 ! 1 • 1 • Niel Ills - 'I •IIt• • 1 / 1 ' • t 1 I:.il •111 11 �1 • 1 I 1 • t�••: • 1 1 �111• • 11 till • 111777M.9 • t .11 :•1111 • :•1 1 • 11VI11 •11 • Y.1 ;, 11 .1 1 1 :+1 1 1 I I 1 1 1 1 I 1 ■ 1 / I 1 1 1 11 1 1 1 :I 1W.611 11,1 ILI111(. I I 1 1 J. 1 I I 1 11 11 1 1 .✓. I 1 11 1 1 1 1 1 1 1I ills :•1 ffl= 1 11 1 1 11 1 / 1 II 1 1 1 1 1 �1 1 1 It •11 I 1 -111r-1 11 •11111 •II ' �% 1 1 •I .11 • If. 1• 11 W, t/l Y •11 - 1 :111 -1 I11 • 1 •I11• M • /l •:1 • 111 1 • oil 1 "\ •. 1\I• • Y. 1 1 :11 •1 Y•I1111 1 V" ' 111 11 - 1 ILI I I :+1/:e•1\. • 1 •11 •1• 1N 1 •�.••/ I :ill �• • 11 Y•111\ ••• 1 • 1 �; 11 1/ 11 ' / 1•�� •••11111 til .1\ •11 i1 I 1 •IIIU - 1' 1 ' / .•11 ' 11 t •1 /I .1 .1• • • • 11 '1111 .It to .11• • • 11 ' •I111• .11 1 •111 1 •I :� .11 1 t 1 •11 11 111 •�1 •II ' 11 Y:.1 tll w.l •1 11 1 .11 ( 11 M. . 1. 11 1 111111 �• 1 11 1 • 111 .•./1 •) 1 111 11 M • a/1•. •) V•1111 /11 .It •11 •) 1 11 .11 V• :/ 'J I 1 1 1 JI 1 • 1 1 •1 1 1 1\ 1 ( 1 • 1 1 t "-11 11 �• \ 11 MI 'y •I 1• •' 1 11 .1 11 T .11 • M;1• •II16 tuOki1 4 I w111111 •I .•I 1 =111 ' �• 1 :� IY• 1 I 11 1 :+1 .1 111 .•11 / 1 III •• VI \ :./112 11 • • \ 1 .11 1 1 � • •il n�Y• ull� 11 • • �• 111 �• • \ 1 I: 11 ' \1/.�� V•I111•.+1 .It Ts11 t • 1 1 W. I 1/ 1 w• .1 111 �11 .1 11 - 111111 l .1 1�/ t • ' 1 1 I �; 111 11 •1 1-1.1 1• 1 1 V•I111• �' •11 1 t 1111�• �.'1 1 1 1 H• tll �11 1 1 • / :• / .1 1/ 1 • 1 •I11 • 1 11 1 •-1 \ • 111 \ 11 11 11 - 1 w11 11 l 11 • 1 - t 'Y•1stall 1 1• Y•IIIY. \ 1 �.•r•1 rll/ ' 11 .Ir r V:111 1 1 • `'I 11 11 • �1.1111 r..1 111111 1 ti 1 1 I • 1 - IV. to ;. 'il�/ �1 •• 111111 t �{ 1 11 / I►- 11 1 Molt�• 11 1 • tll ti11 t ' 11 •I 111 • 11-1 •11 ! :.r11 :+11/. 1 •�.•1 11 1 i , •1 • 1 ..r t �Y.1■ •11 • 1 11191 1:46fifliAll wft-,kisjl oil or1 .11 •1 • •• 1:/ .1• •II .11 • 1 • 1 • 1 1 .11 • 1 �. • •1 1 :•S • • 1 • 1 :�Y 1 Y.1 'J ✓• I 1 1 • 111 w/l Ire1 --Zi: Iti I 1 •11 ills Y•• 11 111 /�1 1 •11 1 1 I I log1 1 1,' I I I 11 I I I 1 I I I 111 1 1' ' ll 11 ' I .� WE The Town of Barnstable sAMIvsresc.E. 9 1659. Department of Health Safety and Environmental Services En ' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: /`I rTf�/111 ��V!/h�2 Estimated Cost 1170,0VO Address of Work: Owner's Name: Date of Application: / Q I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby ply or a permit as the agent of the owner: Q Date rontraltor Name Registration No. OR Date Owner's Name q:fbrms:Affidav I . > 'iEl TOR ®� • SMOKE DMP -- - ,. g.U1LDING DEPT"`; ,' I I II 6: ARNSTABLE I `� i..l T II L , u i LJ Li �.! M 7 i i i 1 r r . r. y d �T F .. n _ ' !faw�LG`..__.'` �'"6'.v'� � # I,�''_�r�•s'� G�1�' 4te`k�..l&• ',"�!�" - �I r -{.- 11 .�. �, '.. . _ .: .I _ - 1.1• , .. a ..• 6SCl'� l.hf,� - .. .� Um bae. 4. I ow tLT Ao Iasi T I F-I a - DONALD'I MEYER rom 7.Ilo'99 . _ ottriT�tn j ,. •��N �� 'Professt, ro�tng Designer, ; f� So na .Y�tgro M:PaA:O1G6 46 „ .. - _ J...1 __ ....._..... { ]p ..I i L � ) i Ito 1 _ '14 i ...,.:: ! - 14 ' �. {U 7 - '"'•- 1 �,� ' '�' �! � {, l 7.2 -77 + .t + + - I ! A. 77 { y i ACJbf )a ER NALL r : 3 : N4y - - - — F. N .Ni x N c rI_ qt AK r � I n ' f .)— IF' OTwo � 1j o -apF� 00 -f— T`1 i - { - - " , I r.,. b .. a, `Arjr'6a . ,.. X Za FM q. :. ..;: ':'.. ::: • . '. . -'..: �Qyao ,L ¢?Ilhi.�'o PEA - .. Dlip 11, a1 BtdCdtn .. O •,r: ,.. .. ,. ...:. . ':' ,. � :... ' 4�:.�'. �: .::. '- ' m1too M/(oQ2664 . .. .. _ . Vn±� ZTW A / .. .. - 1 6 ` I c i I I • - 6M& 254x 0 g Ctx�•!i N o -ow x G : o �O Mom: l S' LTtt miallaifdI Designer :f s � f _ . m 1 1 r Tt:�Mv U6vN'.E�6JWl1 O p 7'JA%/3t 'WJG(.�3 s r1 oF'F�� • 'Tt71,>t: DaNAt'D i.MEYER i B Idrn J 4' sro�ill Pro�es �nmeoud�.Mn mke+ k ..i.: •... ..,. .. _ .. .: _...-. .•...... ..i <. .. ..i.... ., .. .�t ... .,...... ��.�� .gym .. . 14 >. 4ppptSt'.�rcu•t 2x4 ':dtitt: rc.� 'er 45lnGl lylls Pv u J� ( .. EW;:Cain elcgc.��trf � —�roPH.L _.�yr Lc> {�.. M.rdti : i2. �' A.i♦,ir11P6.ila+G _. 12; �� \ .. �:..Zg.a,_Qa2�. .. • w ��w ni. 1G ._ Q r�i2 QRp�tltvh...:. yP�1 sa. .3�. e• L g-1,;r: E rr \ p Pa.a � •r :: w `. itE;s tueap. e h G:o>< w. R•,taj, r�:5r?L.,.. :. ..: .. .:... .�.' - ...•:�, '. .moo-; y. �' �' :7 &'-'- tV2 Al 4..41ail. hLL 1.f [77 ,.. ,�. � ..Quyp 'irk: . ''• �. .; $t� --?��r� - -- s' ir J%Alr ._alEw 100 ? h m :: ?DEL...T73:t.>K : �:.� ;:.`=M `�k.� ;:_1-�6u�� .t`��.� �� w+.� Mr•: s. c) � I 7 Z I . , t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION • r Map `g3 Parcel 1 3 r, Permit# r' BLE Health Division y D3 �3 ®�j Date Issued-4 -E — 6 3 2 o i x .; 10 QI Conservation Division Z ��3 �'1'ii _ Application Fee Tax Collector I , Permit Fee Treasurer Planning Dept. SEPTIC SYSTEM MUST DE INSTALLED IN COMPLIAN^`" Date Definitive Plan Approved by Planning Board WITH TITLE 5 ENVIMNITENTAL CODE ANL Historic-OKH Preservation/Hyannis T0%%'ii r,z-C lufL A TI01.'Z` r Project Street Address Z� jli�V�S Village Crz- t L� Owner� d V}v�..� ��ya- Address Telephone ,O jf JZy 4t?3�1 y Permit Request / 41V b 2 q A` 6) �fX� v L L rK t k/ A4 e/N G � �s �✓15 e,*,l) v Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuations Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use Z `{,x AUK I BUILDER INFORMATION Namet5O47r/ -%4f % A-I (s,CAC_ Bfk, Telephone Number OaO 7 Address _7 22 1_2"f2 4 C_ License# �� 7�1 0(-4 2 IDS eu 2�> rI Pi aI d2 Home Improvement Contractor# Worker's Compensation# 21 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR - DATE �y�O3 FOR OFFICIAL USE ONLY PERMIT NO. DATE"ISSUED MAP/PARCEL NO. - ADDRESS ' VILLAGE � OWNER', DATE'OF INSPECTION: - FOUNDATION e- 0 FRAME INSULATION 1 FIREPLACE ELECTRICAL: ROUGH FINAL,% G Y PLUMBING: ROUGH' FINAL e � GAS: ROUGH FINAL 1 14 FINAL BUILDING DATE CLOSED OUT-, ASSOCIATION PLAN NO. °FINE 1of, Town of Barnstable Regulatory Services + BARNSMBLE, = Thomas F.Geiler,Director y MA$S. 16319..�a`` Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must.Complete and Sign This Section If Using A Builder Tq 0 ?✓►- ►ti , as Qvmer of the subject property hereb authorize c. p Ito ll s s ��vd�s to act on my behalf, y in all matters relative to work authorized bythis building permit application for(address of job) I —►4 � 5 Signature of Owner. ate .—TA VA 6 0 Print Name I i tee-�iomrnnonurea/,CI o�✓�aaeaclu�ae� ' �, 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: o�..�.rat�Regist on hi Board of Building Regulations and Standards 105485 One Ashburton Place Rm 1301 I w Expiration 7%17/2004 + ; Boston,Ma.02108 {Type Supplement Card SOUTH SHORE GUANO'. PNAkD BENOIT 7 Progress Ave Chelmsford,MA 01824 - Administrator Not valid without signature n., A. G / i ABOARD OF BUILDING REGULATIONS; ' License-� CONSTRUCT,IONkSUPERUISOR- �J Number CS�r. 0561Z4` Birthda16/1945 i r Expires"03/1672005 Tr no 95U4 - 13 aff ` - � � `Restt•ictetl` 00 ' �' RICHARD E BENOIT _ Ni 54 GUSHING HILL RDy. A171 NORWELL, MA 0206:1 ___• r Administrator ;' e r`V"• r: ACORDw CERTIFICATE OF LIABILITY INSURANCE 04/OS/2002 PRODuCEa (603)432-3666 FAX (603)432-6076 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Lakeside Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR One Wall Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Windham, NH 03087 INSURERS AFFORDING COVERAGE INSURED South Shore Gunite Pool & Spa, Inc INSURERA:. --Valley Forge Guarino's Swimming Pool Service, Inc. INSURER6: Transcontinental 7 Progress Avenue wsuRERC. CNA Insurance Companies Chelmsford, MA 01824-3606 wsuRERo: American Intl. Group 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. MSR POLICY EFFECTIVE POLICY EXPIRATION _. LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DWM DATE(MMMONYI LIMITS GENERAL LIABILITY - 104 34 30 3 3 1 EACH OCCURRENCE S 1,000,O X COMMERCIAL GENERAL LIABILITY S/1/0 2 5/1/�3 FIRE DAMAGE eMy one Gre) s 100,01 CLAIMS MADE aX OCCUR MEO EXP("aft persw) $ S,0(: A PERSONAL a AM#AMY s 1,000,O G GENERAL AGGREGATE S 2,000,0(1 GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG S 2,000,0(! POLICY ,�T LOC. . AUTOMOBILE LIABILITY 72299S1 COM81NFO SINGLE ANYAUTO 5/1/02 5/1/03 _ ((1-s LIMIT .S 1,000,Oc` ALL OWNED AUTOS B X SCHEDULED AUTOS BODILaY�j RY s X HIRED AUTOS BODILY INAIRY X NON-owHED Atnos (PeraomderQS PROPERTY DAMAGE S (PersoadenO GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO- OTHER THANEAA.CC S AUTO ONLY: AGG S EXCESS LIABILITY 1082102948 5/1/02 5%1/03 EACHoccL ElrcE $ 1,000,00 O�"R ❑aAaas MADE 5/1/02 S 1,000,00 C s DEDUCTIBLE S RETENTION S S WORKERS COMPENSATION AM WC9386412 = EMPLOYERS LIABILITY - 5/1/02 5/1/03 ToRY LIMITS ER 0 E.L.EACH ACCIDENT S 1,000.01 E.L.DISEASE-EA EMPLOYE S 1,000,0( OTHER E.L.DISEASE-POLICY LIMIT s 1,000,0I. . DESCRIPTION OF OPERATIONS&OCAT10N5NE"cLESAD(CLLtWONS ADDED BY ENOORSEMENTISPECIAL PROVISIONS 'Covering Installation of Swimming Pools and related operations of- tbe insured during the policy period. aoaTONAI INSURED:INSURER LETTER: CANCELLATION CERTIFICATE HOLD�R SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEO BEFORE THE TOWN OF BARNSTABI,E EXPIRATION DATE THEREOF,THE ISSUING{OMPANY WILL ENDEAVOR TO MAIL OFFICE OF BUILDING INSP. 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT SITE ADDRESS: BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIA8IUTY ' MR. JAMES RIORDANr OF ANY KIND UPON THE COIAPAAY.ITS AGENTS OR REPRESENTATIVES. 264 CAPT. LIJAHS' ROAD AUTNORIZEOREPRESENTATIVE CENTERVILLE, KA. Edwin Duvall/PROPA WORD 25•S(7/97) CACORO CORPORATION t I ,, - � ,:t` r� 7� •:,: � '..... -may, � � t •,',+"� _ 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continnied) SKETCH`OF SEWAGE DISPOSAL SYSTEM: Include ties to adeast two permanent references,landmarks or benchmarks. Locate all wells within 100 Feet. f, W02X, 3 t DEPTH TO GROUNDWATER ' Depth to groundwater: 2I Feet �� T Method of Determination or Ap ro (ion: ff t' r s. _7_ i The Commonwealth of Massachusetts (Department of Industrial Accidents Office of/nsesii9alioos 600 Washington Street Boston,Mass. 02111 Workers' Compensation.Insurance Affidavit a _ name Sa v 1 Ct S/� v✓ E 1 0 I location 7�/L��`�s �A! Dhone# C [ lk��wj�S f—yZa") ✓�r4 �J/�2� �OU city Q I am a homeowner performing all work myself. [] I am a sole proprietor and have no one working in any capacity [� I am an employer providing workers' compensation for my employees working on this job �a. T' 1 t 1" z 'rr�'.., ` -x e r Cy iggy�� 7� 'c 'ig .�a' �4 ,a '^iRsn'�:N �" r ,s�'i`.y.. 'a'zfi't •n-y P t�3 r•.ty 2A ,.�5 r { s j x t 2H r } "'.:.�� `'.J..cr' t'r' 5 d ,y � ` �,�• y r :�ts('a'`.�ruyx.i h.r ' sompahv name r At at a s !ti a°aa4c } .1evq ,u t d+;( r r �': a �c,.i �,�`ri' }e --air S� A �'. t. d "''`- .z r� ,.r .x +. .-... a',,-s.•..� r k-r -5frt•-y; IR 4�M^'itx3� ",.C.�',-Jti „S.fa'�VSn�L�.r fi, �,�„aa S{Yc��`' ii Jf-" Y9`C � Y"•Sr1��.,axx�" r;F r 17'/,.?`{�t�n. _ �'��f �A .A��` `� �"5 addresrs /.,r:57 it ... }'*�4 -..sr iy� rr S 1}r ft`'+ 3i�.. d i ,z a.•• ' q s t g .�.}i 'ic y ) r ds '+' v rt r,�' t V FAN 41 a. r^' r t r w. ti• Y, eY. I`n.? "� M � " � w i nhe# 3ry a r r•c. Y x i t�r r `�r' brut 7F rtk .d:.�r Y ��'f�'�"�7.�� J,wV`�k. 5t`�-�:y�^ ) .? �, •�. � .A Rj a=aµ x Fr'� s y r j J •a � D �t7�g �"��??'"§..�•r.�h'�'3�>n,+.�� }`fie' �Y ?��,f.is�F+'`s':a t�3t 4� .�'=Y�' fi k - ..it'S� C F.: )1 � , 4� �k rt L ._�'�'_✓.,e._. �?Y��M� 4' �ilisuranc. co•�� _. �,.........,, r.__y .:, ,.,,,.. olio #.;:z �. � _.,_ 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 M a7 'F':'i' r•�1 r:.x. k 1 y„ 7 { ,. .�k "R �Y.' r r" qq 9io t jL fi (T �Y'd'ai rii. i 3 0-t-' Y aTh v rSiti�T� 1 r},; COMP �? .y.s ivp4_•�a j k �: e Ptfitt.i3x' 0S}1. k a, u- w .g?.,r�, # ,.�`'`X: it w•,. ` 1 h•P•Ik ��y� �( T ci ...f 1 & a.F eFyt r5 r i'9 ri 1't d J> x c ,) RE NZ ray -.i_ 1, F, .)tV?"L'1Lgl�`e '�vyi�wp.i. m•s.y...�.g 'Cjr�"`^ liOtle. �a•1 t 4. i"i?"rKr• PM�?a1M Y at 'i?'.7 Cl At Tk ar „x x 4P 6 r ..r d + >.+`p v:' ' a .h a->'y'i-txj �'C .ia'4F� ". ,�. .�C.y"�, k_ hr .� s :�, 'br, t4 r •�i� it r ,rt'3`i'�° `Xx' ii+3svt�r.:, n r� 'tL{p i ii�". .,aaH ..'�+ ('m t:+.a.x x •^ 4 + F .*Y}. y t ��ut n '} I �) r ..:+.S *t .Lr ,c O11,Cs.r�,+z§a,7_ ,�, R:i^t'Yltt.�_..57+„Tt� , n._ 1w� .. . ,:.. _.. . >y ,, d )y ^'x p.'s'"'<r #'s•i^`rT'y tr'a w ''�+x'(`„rs 'fE',t"+" s,,�a-c 4SC£ ._ y ft.a'• ya.,, .Tf ?�i'1-Fds'tt:.:� "'CJ•'' :^v'� k iu.. H' .,,"i .?� +vet y ^' t aYP�. i.zh�ii- Mr.at i S+". uF. Y'''�x'+,;3 S .v. i +dt [.:fti:: r ��7 �,.,..y^'3 ',� �'y _� �, ,N�,vc- l.F : 5 t i *�-5 r 11 1- � •.�.J,�}� 'fir> Rkl- `SY .». Aa"F.I.Y t i 9i ti ,3t~' V� ora t"J rr y �� 5 PCOIii Sn name r y S _r t Ate ' }s s 3 +5 z.}r 4 n l 4p 8s t y�yyl":k.Y.rw,.._�l'-a. sV *fie-") ..N13;�� itvi-�Ri�_.... 7k+ .req h s z �' aprs :-Y . µ��xr .x-u n .s :x1X,'�a�'x_., c Ex• r t r �Yt a faa r r s r ( r i r s x �*n,Tr�^.a`�tz'3`�f.�, '�`t E' „auk - ,�. r-"..s, � .A x �( �.'. `�. tY''.4 i'+.t's`n y.� `a" .. `a,� - G � q5 xTVY' ;1. t �E li�S'.4 c++.\'S t.rv1•+�,i�3 t 3J' p 1 �` ,. .. � ac�br. ss r�riy t£0Oi° 3 S r, A h Y n v1 Fd a F .r-*+.-3r ?%. �� :.�x• xc W # it `} 'kart T z xAis *r.. q 3 ,i'1�'yZ xY,. _i' Jr4rk !1zS9t ? x s.Y x CI Y" p r >` tS �r J to r t a c n Fr s air fir � yt,i _, r��,�.�yy`�,�- 4 .,,,).k' +i,.a- �f rr,,.�',! i• :`r.� .."x , f�, "�.., a5.�"_,.5 .. ,. e ..T... O11C.,# ... . . ;.,.::,.. ..: 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. I do hereby certify u r the pa' and p es of perjury that the information provided above is true and correct. Signature e Date nt name G, ✓�Z t Phone# Fofficially do not write in this area to be completed by city or town official permit/license# F—Building Department ❑Licensing Board []cecmmediate response is required []Selectmen's Office ❑Health Department contact person: phone#; nOther (revised 9/95 PTA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased,employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you'have any questions regarding the"law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns 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 Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406 �0*1HE, � Town of Barnstable Regulatory Services B'MBLr, ' Thomas F.Geiler,Director asAss. 03; � Building 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 constriction 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 ov? ✓K .d 4 oa ( Estimated Cost Z � 00G Address of W ork: Owner's Name: vQ-m +c S IC o i7 ON,.r.J Date of Application: I hereby certify that: Registration is not required for the followingrreason(s): ❑Work excluded by law []Job Under$1,000 OBuilding not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MROVEMENT 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: 4 i o3 So��s' �',�,l �1s S 4s Date/ Contractor Name Registration No. OR Date Owner's Name — Y I LOT Z6 Qc //5.97 zs♦ f , GOT 3Z f 39 N. : L ora Izf N ��.. 4 71 Tj LOT 245 C14. . j E'E Scale In 401 i Certified Plot Plan ! i { Being lot # 27 as shown on ; a subdivision plan entitled I, hereby certify that "Crosby Hill East" in Cente the existing foundation f ville , by Charled N. Savery location is correct as Inc. , , Hyannis;, lvlass,. , dated s . shown.-and_does--conform Augi,-- 21, 1973 and recorded with the bkt-ftding setback Barnstable Registry of deeds OF aBarementseof the, Town in book 277 page 9 of $• Dee. 3, -1975 4 Tbomss A. JACK90N { NO.8937. y .w Builder: 9�o�sTEa�° Charles F. . Stanley suRot� Signed - Centerville, Mass. y �.•,..'�"""`^'1tis F-.�...r..r—..��._...`.-•r••....-r'w.r�'.� `. V �-•...r..+�r�.� •!.-r.. ...fir. +.�v .v/' '^-.IL.4 r -"-•4.--r ter._ti. 1 J^f r Assesso1�5 map':and lot number ................. ......../ .. .f.� .. ......... 00c./� SEPTIC SYSTEM MUST BE / T� } 7G INSTALLED IN C01`01PLIANCE - Sewage Permit number ....................:��.................................. WITH :ARTICLE 11 STATE SANITARY CODE AND OWN QyoFT�ETo�o TORN O F BAR ` ARLE Z BARNSTABLE, � 9Or• BUI-LDING INSPECTOR '°lE'p MPY '. APPLICATION FOR PERMIT TO ....:. .........lee. .. !4"�:....... ... .................................... TYPEOF CONSTRUCTION ........... .................cc . .. 't ..........`.......................................................... 1� c .G;..:.... ....................19.7. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora permit according to the following information: Location `�/.<1 ... .. ......`C.k..o.�...4--t.., ...a.�.:f�:/ ...... ..d..`............ .......................... ProposedUse ...... .J.I. ` -... .................. ............................... ......... . ..................................................................... Zoning District .... .....................Fire District ... Name of Owner 4 ... ....JLU`.'�"-�..... .........................Address "c...�rt!t . ...................... X, �ib�-C.rC/l�� Nameof Builder ......................................................................Address .................................................................................... Nameof Architect ............�Y..D.A �................................... .................................................................................... Number of Rooms Foundation ....... ............................................................... ............................................. . Exterior .....UMKrt.. ................................Roofing ......... ............................................. e Floors �_ �t (/�� L� �t/Gr��C�l ��'- ..� '.�!...: ....................... .......... .:........................Intenor ........:.... .............................................. 1 Heating . .G�c, ..:......<<! C 1tr Gt�Cy "`)Plumbing ............................................. ...... .. ... ....... ........� . Fireplace ............ ....................................................................Approximate Cost .......:......:./..n. .`................... . .......... Definitive Plan Approved by Planning Board ---------------_---------------19________. Area .�`:.-�v.. ................. . 7j� Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH F I 3 f ILI { I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. A !...:....... .7..................................... Stanley, C. F. 18216 one story, No ................. Permit for .................................... .0 single family dwelling 2 Capt. Lijah's Road VoLca-e* *.* ...... ........ ...... Centerville ............................................................................... c . Owner ..........C. F S.tan.1.ey........................... frame Type of Construction .......................................... ................................................................................ #27 Plot ............................ Lot ................................ Permit Granted ..........March...3...............19 76 .... ...... Date of Inspection ..... . ....../2.A.0�9 Date Completed 19 .............. PERMIT REFUSED ................................................................ 19 ......................................................... ..................... ................................................................................ ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... 4t Assessor's map and lot number Sewage Permit number ............................:............................. °`T"ET TOWN , OF BARNSTABLE Z BASHSTABLE, i ,sue "6 9 BUILDING INSPECTOR 'E�AIPY a' APPLICATION FOR PERMIT TO ......... ..............................:;a.. ..........::!.::'............................................ r TYPE OF CONSTRUCTION /! ...................................................................................................................................... ...... ... '................................19.7. . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: (0f ,^ � , 0 - Location fit , -') .................... ... ............ ....................... ..................................................... ....... ....... :: ........................... ' Proposed Use 'r I! ' .. ` T F Zoning District Fire District ...::..�.. ...............!.........., ;............................................................. Name of Owner ...........7 ...:.=.::t.. ( ...................................Address ! (.t• .; Y ' ,r;,......... . Via......................... Name of Builder ........Address .................... ............................................................ ............ ..................................................... ,� ' (' Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ... .....Foundation + .. t ............................................................. .............................................................................. Exterior �`. . ........Roofing r; .......................................... .............................. .................. ................................................................. Floors ! w Interior �! .. .............:..... ........:................................... .....:........ ................................. ............ . Heating .... ........... . :........_..................._.....:: .... ..'.. ..'_ Plumbing .:......... : ........................ ........................... ......................Approximate Cost ................................. Fireplace ............................................................ ................................... � 1 1 •. Definitive Plan Approved by Planning Board --------------------------------19________. Area ........... Diagram of Lot and Building with Dimensio-is Fee '7- ............................................. SUBJECT TO APPROVALOF BOARD OF HEALTH 1n 1 � 1� !r J f I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ` `..!...:!.... ......f......f��..................................... Stanley,C. F. ~ No .....l82.l.6. pe,mh'fov ....one_atory�_. � l f ��. � ....... ...... . ^~ fC Lijah's Road Centerville -----' C]vvnor C. F. S��"^= �� ........................................./.......*. ^ - � . ' ~' ' ` oarcu 76 Permit � ... � � �� Date of Inspection ......I......./..................19 o uo/a Completed PERMIT REFUSED .... .� ~ ............... ---- ... -------- _--- ............... ........................................ - —.-�...�p..�.*�—.-^=~�.w�.�- --.----- � ^ ^ _.--..-----.—.—.--.V.---.—.—.—.,— ^ � Approved ---------------, lQ � -------------'~^^'----------' -------`----------------~'— oFTHE)°wti The Town of Barnstable '• 9AR E. MASS.ASS. O : Department of Health Safety and Environmental Services 9 1639. �0 prEOMP'�a, Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection n , Location E� �; r� l.__ti ,� { �'t Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: CA t Please call: 508-862-4038 for re-inspection Inspected by Date -2 �. ALL SURFACE wArw-WALL ` PER J7ATS MAMI aV-e °�'`��) O�i1�/N AK�o Y f.1f�M R70L ' a t /N N - R Bo O I lF 3 �.Y BA c3Fii M ! lrTFRApNED 8Y PYaOL Aff"r7JI � n /f SiLC/rlc'G. I 727P OF AV VV BE,41W i 'pox -9-'- a/V MA-I.R IvA VF �., i�: 1 Mal: YE,P,'WALL si rYtO- 3 PL•4STER E1V7/,PE -V. jr (\/1�7784NS/T/O/V Row yr 12• 1_L NATURAL I 3 B4xe/2••o .BOTH+ NKYS I T 88-.RES. lt//D/Y/Nu' fSOAAC `f� K' � GROUNO -54rh7 / L I /8�*=",w.y_ � Q toroca=,acT- - - "'C BARS #3 aws Tea F 4-�}//DES'ANGLL \ ° CUT OF.t AS .VrED CLjY. S{O- '/ l RELJEf koz 45 - -MA/N D1P,UJV J L'ONNEQ D/RECT 7D PUMP /k ICUT aFF A�TEJPN.4TE RESio&TIAL MA MERVAL • w1rrr etdr4M 71-9 Q� Afe 6'/*N 7yo � � 6 L7QOR ,PFivF. s-3 dtiPS � - - ._ �/Z•QG COTS/ Kays T1p a STANDARD WALL SZr7l IV #7aaRSZro.C. '�B'' �— ' CONSTRUCTION NOTFS I • • ,• 'NE RAL REINFORC/ .STEi�L •CO/f=lJCTlON -WA U tWNFORM TU CITr DEFT • RE/NFORC//vG STFF1 S .4LL CONY?? f i&F-BLD 6 esA47r IdOE ? STAN0.4mas,. TO 4S.7,k DES/G NAT/ON-3' A/3 t A-�oS .• :°`: / • • of r!/n/G Boi4RD 7�t77_PE.�is!/TFD_ON AMS LAPS SIUL L BE A Al/N1iMUM ar 7s!/WW �- o.,•• /B' ( � (ZEST.7A"AO" X_M,072,� AT B,QARD. O/ �Ems' OR/B'K/ffERE SPL/CF,S' ''�' '• ou/T 6i/E4Z7h 0-Vr7 AT�Y.4L:_R5W411AS9 RLP GUN/TE CD/115'TF'r L.CTIO/V . . . a.°o •' •�.,.: :�: Q2fltfFRCDtLZYr�Ptaat3 • 6lIN/TE 5.4�4LL FE.tfi?Gf//.S/E AlLt2�D .4.YD . OW UPA.PT CE.iIT/YT 7a F,e�l!/.P A .fFKf' TN/S D.SJ6/V Q?NFORAe 7D We-4L CaLtF iN/D • PARTS' S W O A-4� ••'. .:• i.dA.`-� UR7N A RFASO/VA�LY LEVEL JJTF /s ULT. !rl,�fP STiPEilC3TiS/ EOrucJZf.R LIME r ;AND 4,v VVFD 4 MrZoA L 5;POUNO W/7.WiN ZAWr 3AT0 Psi 3S 0AY5 Copra ONLY : 6 /NOGL+WP OF TbP OF AND BEAN, ANY ZXr--PTJOK9 � 4Y.4TER-CF.N1�it/T .F,471 .S► .&Z /YOT EX2EW AUTOMAT/C SURFACE SKIMMER .�• IN//tL PMUJ.PF SlIPPLEA!ZIrTR.4RY CiE73tJL;'AQJA/ 3%s &ALS i�VA7MR AL`Y -ZAC ' 4c CwCA 'yT .r BAP5' EH' fE/1�CE ♦ C�/iPF GUN/7F 6YA L/G/1T mi4ro.,P C 1 O Offi✓iVEP, -MIALL PiPOY/L�fzNC'.S� /rV Q AMI-1.4ACE 7. T{/.tFE T/.IFS A 13+1Y AT�p.SEJ�iV A4k5 _ UNDER MAMMA L/G.VT i4! LDGafL C/T)'o1f Tbif�iV o,PLYHA/ NOTE 6�''7 5':?!Err SELF CL VW6 F L.QTIN/A 6. _� ATl�_T10T lLIN DRAIVJ� . .a ,o' °. -. • QEC?,Q/CAL SrS/i4LL CD/YR1,PM TO STATE' - PLATE eAi✓I1 LOCAL .P60U/�PEiIEN.Z3 C. 1 Fi�i4A/E i s •a o g,�s 6•oG. -o $GYM WAr! '� O • TAT/C ' � • -,:.. � SWI/NMIJ✓� POOL . FLL� OFF 94LYE COt1�cTT/ON ..- Awffrx `L�9- CV�t'T._�I ZV�HC 1ZD _•:s i r T//BF�/FRFp•D> :• r ' 'IVi!T,NY l.;T -:•: 1 tialw.E:. \` ~ SCALE: /✓OA/E APPiiOVED BY %I� DIWWN BY rkl /Bx/8xr4 c. 4 a CIVIL, LICENSED PROFESSIONAL ENQINECR �E DATE � D .- ^ . :• ...... .. 41;� ..y•.�. ii. 5 _ ,,. A • ,. TIMOTHY WALKER — CONSULTING ENGINEER o -� 19 WOODSIDE AVE., • WESTPORT CT 06880 MAIN OUT[FT t atoll jovY,v S.ifO?E Gv.NiTl`'/°!'bc tnoh[No. oWAwiNo niurwe� 7 PR06REs5 fwE. LT A# GlIEL MSFORD, -yb o •�TR✓�PC"i BAB•OB -11 x 17 Et 3/ 7 Q > 0\AE IL Ta 111� S)T �L PQOL L t CT TN n in, T3 2£ Y\ �V�T1k SELF U. TC 4[NG Gi 4- I K, T(A TR8 kT IAI\\b SPATL TVFVnvf_n 4s+ T3 LU T 3�' TL1 CC l CAL{T- WS K5' alb Y ZU2 L TLC T l L WL Ct F,00 L ti "Tuz_ \Ata cu\ U. a c Z -F L-s wntfqfl�) utL r '( .CK - � oT. 2 jr 1, 77 ., 1 It AY I SOT 28 6P, . r ZS Scale 1" 401 Certified Plot Flan j Being -lot # 27 as ahown on �. a subdivision plan entitled ; I, hereby certify"t�iat "Crosby Hill East" in Center V the existing foundation Y Y ville, b Charled N. Saver location is correct as Inc.', ' Hyannis,,144ass. , dated shown•and::does oonforar i .dug•.-'.21, 1973 and recorded with the 'btAldinP' setback ; Barnstable Registry of deeds 'A OF requirements of. the. Town in. book, 277 page 98. of Barnstable. Dom�s A. JAN No.0937 w ' Signed - `