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HomeMy WebLinkAbout0707 SOUTH MAIN STREET , f a �r• a,Y , a� a y Oi h e r m d ' ° � e 0 v. i oa ` c .. p y a. ° x a i n a•. o;a _ o s ` r p F S I � a V r f p fi, , a u t � v r. r Iy- C s S �:_ .. .. y,._., T p' �•- �a �M,'-^ n*3m_.._:�+ve.r�'+-.,....,v, an.,,.� ;':'.O''�'° ' '_m' $ m@-a 'iJ "�9,'. :�'n P „`y'm' `ti`: 'ice„ --Qm '•y r "§!'" ,d dr-.v4•`R•-_.,..n.p 9 - �'„ n ",,• e @ 4��o-a'4xa y F ®'a'dy T '- . • s, iaq Mfg 1' Application number. ...........^.../......... Q" 'R Fee ....... ....I. ...... ........... 16 Za39 ` TOWN M j 8NRNS-IABL F Building Inspectors Initials......... Date Issued.............`.1.� �I ................................. Map/Parcel........'. !. V TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: Y'O NUMBER STREET VILLAGE Owner's Name: DQ1V/ �G?if/� !� Phone Number Email Address: Cell Phone Number Project cost$ o(�, qO0. 012 Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: CX k6'-a'C� Date: TYPE OF WORK Q Siding El Windows (no header change)# E3 Insulation/Weatherization 0 Doors(no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles), / / n Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name Pi Cod ��X ky7e - /'y? ro vPiwtop� Home Improvement Contractors Registration(if applicable)# -16 Q 3 (attach copy) Construction Supervisor's License# (attach copy) i Email of Contractor OPM Phone number 5-yV(6 90% ALL PROPERTIES THAT H VE STRUCTURES O#R 7S YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. C APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 20 lbs. or> Yes No___,if yes, a gas permit is required. Natural Gas Yes No ,if yes, a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9.30 am or 3.30 pm-4.30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE dlY�� SignatureDate 011A16 All permit applications are subject a building official's approval prior to issuance. The Commonwealth ofYlassachusetts Department of IndustrialAccidents Office of Investigations ' 600 Washington Sheet Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information PIease Print Legibly Name(Business/Organization/Individual): co Address: ct City/State/Zip: W_ Phone#: [Are u an employer?Check the appropriate bog: Type of project(required): 1.LJ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6 ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees. These sub-contractors have g. Demolition worldn for me in an capacity. employees and have workers' g y P �'• t 9. ❑Building addition [No workers' comp.insurance comp.insurance. 10. Electrical repairs or additions required.] ' 5. ❑ We are a corporation and its ❑ P 3.❑ I 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. of repairs insurance required.]t c. 152, §1(4),and we have no ' employees..[No workers' 13. Other 100A 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. 2Contractors 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-contactors 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: �Cd Policy#or Self-ins.Lic.#: ey0 "l 2 3 Expiration Date: 0 610-319 , Job Site Address: S l"4f'VI S-7L - City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure-coverage as required under Section 25A of MCL 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•ofa STOP WORK ORDER and a fine of up to$2$0.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pa nd p nalties ofperjury that the information provided above is true and correct Y. Si tore: / Date: y �� Phone# �� `7 0 � Official use only. Do not write in this area,to be completed by city or town oywl ial City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building DepartMent 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.other Contact Person: Phone#: t , ce f 1 CAPEPCOD CAPE COD HOME IMPROVEMENT TM Home Im rowment 27 MILL POND ROAD, WEST YARMOUTH MA 02673 . (617) 710.1001, (508) 469-0102 CAPECODINC@GMAIL.COM, WWW.RoOFCAPECOD.COM,--WWW.FACEBOOK.COM/CAPECODHOME ---------------------------------------------------------------------------------------------- PROPOSAL s 08.02.2018 a . TO DAVID GAVIN LOCATION: T07 S MAIN ST, CENTERVILLE� WE HEREBY SUBMIT SPECIFICATIONS AND ESTIMATES FOR MAIN COMPOSITION SHINGLE ROOF: • REMOVAL OF ALL EXISTING ROOFING AND FLASHING MEMBRANES TO THE PLYWOOD DECK SURFACE. • REPLACEMENT OF ANY DAMAGED OR DETERIORATED PLYWOOD DECKING AT AN ADDITIONAL COST. DECKING WILL BE REPLACED IN WHOLE SHEETS ONLY IN ACCORDANCE WITH RECOMMENDATIONS BY BOTH THE NATIONAL ROOFING CONTRACTORS ASSOCIATION(NRCA)AND THE AMERICAN PLYWOOD ASSOCIATION (APA).NEW DECKING SHALL BE APA RATED FOR STRUCTURAL USE. DECK FASTENING WILL MEET OR EXCEED LOCAL BUILDING CODE REQUIREMENTS. • REPLACEMENT OF FOLLOWING FLASHING MATERIALS:STEP FLASHINGS, PIPE FLANGES,PERIMETER DRIP EDGE MATERIAL AND ALL SKYLIGHT FLASHING MATERIAL.ALL MATERIALS TO MEET OR EXCEED MANUFACTURER'S REQUIREMENTS. • ONE ROW OF ICE AND WATER PROTECTION MEMBRANE SHALL BE INSTALLED IN ALL VALLEYS AND AROUND THE CHIMNEY. • ONE ROW OF ICE AND WATER PROTECTION MEMBRANE SHALL BE INSTALLED ALONG ALL EAVES AND SHALL EXTEND PAST THE INTERIOR WALL LINE A MINIMUM OF 18 INCHES TO PROVIDE PROTECTION AGAINST DAMAGE FROM ICE DAMS. INSTALLATION OF ONE LAYER OF ROOFING UNDERLAYMENT ON DECK SURFACE NOT COVERED WITH ICE AND WATER PROTECTION MATERIAL. • INSTALLATION OF NEW RED CEDAR SHINGLES. SHINGLES WILL BE INSTALLED IN STRICT ACCORDANCE WITH 1 THE MANUFACTURER'S SPECIFICATIONS. • INSTALLATION OF A SHINGLE-OVER RIDGE VENT.VENT IN THIS AREA IS CONTINUOUS AND WILL - PROVIDE MAXIMUM INTAKE VENTILATION FOR THE FULL ATTIC VENTILATION SYSTEM. • REPLACE ANY DAMAGE FASCIA-BOARDS OR RAKE-BOARDS AT AN ADDITIONAL COST. • ALL GROUNDS TO BE CLEANED UP ON A DAILY BASIS.ALL BUSHES,SHRUBS,AND FLOWERS TO BE PROTECTED. HOMEOWNER IS ASKED TO SUPPLY ELECTRICAL POWER IF NEEDED. CAPE COD HOME IMPROVEMENT Tm GUARANTEES THAT ALL COMPONENTS INSTALLED PROPERLY PLEASE FEEL FREE TO CALL CAPE COD HOME IMPROVEMENT Tm WITH ANY QUESTIONS OR CONCERNS PLEASE INITIAL THIS PAGE CAPE COD Homer CAPE COD HOME IMPROVEMENT TM 27 MILL POND ROAD, WEST YARMOU-fH MA 02673 (617) 710-1001, (508) 469-0102 CAPECODINC@GMAIL.COM, WWW.RoOFCAPECOD.COM, WWW.FACEBOOK.COM/CAPECODHOME LABOR AND MATERIALS: $24,250.00 DUMPSTER: $650.00 TOTAL: $24,900.00 CAPE COD HOME IMPROVEMENT Tm IS PROUD TO PRESENT YOU WITH SUPERIOR 10 YEAR WORKMANSHIP AND SERVICE WARRANTY.THIS WARRANTY IS IN ADDITION TO,BUT RUNS CONCURRENTLY WITH ANY MANUFACTURERS'WARRANTIES. IT COVERS ALL SERVICE CALLS RELATED TO WARRANTY REPLACEMENT AND/OR INSTALLATION ISSUES FOR THE FIRST TEN YEARS AFTER PRODUCT INSTALLATION PAYMENTTERMS: 50%AT DEPOSIT; 50%UPON COMPLETION. JOB IS ESTIMATED TO COMMENCE APPROXIMATELY 2 TO 8 WEEKS AFTER DEPOSIT RECEIVED WORK IS SCHEDULED TO BE SUBSTANTIALLY COMPLETED IN APPROXIMATELY 1 TO 2 WEEKS. ANY WORK ABOVE AND BEYOND THE SPECIFICATIONS WILL BE PERFORMED AT 56.00$PER MAN HOUR PLUS MATERIALS OR PRICED ON REQUEST.ALL ADDITIONAL WORK,INCLUDING TRAVEL TIME AND LUMBERYARD RUNS,MOVING ALL PERSONAL OBJECTS, FURNITURE,ETC. FROM WORK AREA,WILL BE SUBJECT TO EXTRA CHARGE.IN THE EVENT OF ROT REPAIRS,ROOF REPAIRS OR ANY RELATED WORK REQUIRING IMMEDIATE ATTENTION,WE WILL PROCEED WITHOUT CUSTOMER APPROVAL. CAPE COD HOME IMPROVEMENT7M WILL PROVIDE CLEANUP ON A CONTINUING BASIS AND ALL DEBRIS WILL BE REMOVED FROM SITE(PROFESSIONAL CLEANING DOESN'T INCLUDE).ALL PRODUCTS INSTALLED BY CAPE COD HOME IMPROVEMENT tM WILL BE TO MANUFACTURER SPECIFICATIONS.ALL WORK WILL BE PERFORMED BY INSURED PROFESSIONALS. ALL MATERIAL IS GUARANTEED TO BE AS SPECIFIED,AND THE ABOVE WORK TO BE PERFORMED IN ACCORDANCE WITH THE DRAWINGS AND/OR SPECIFICATIONS SUBMITTED FOR ABOVE WORK AND COMPLETED IN A SUBSTANTIAL WORKMANLIKE MANNER. OWNER TO MOVE ALL PERSONAL OBJECTS, FURNITURE,ETC.FROM WORK AREA.ALL ITEMS AGAINST WALLS SHOULD BE CONSIDERED FOR REMOVAL DURING ANY EXTERIOR SIDING JOBS,ADDITIONS,ETC.TO GUARD AGAINST DAMAGE.IN THE CASE OF ANY ROOFING AND RIDGE VENTING,DUST AND DEBRIS SHOULD BE CAPE COD HOME IMPROVEMENT TM GUARANTEES THAT ALL COMPONENTS INSTALLED PROPERLY PLEASE FEEL FREE TO CALL CAPE COD HOME IMPROVEMENT Tm WITH ANY QUESTIONS OR CONCERNS PLEASE INITIAL THIS PAGE E COD CAP® CAPE COD HOME IMPROVEMENT Home Improvement TM 27 MILL POND ROAD, WEST YARMOUTH MA 02673 (617) 710.1001, (508) 469-0102 CAPECODINC@GMAIL.COM, WWW.RoOFCAPECOD.COM, WWW.FACEBOOK.COM/CAPECODHOME EXPECTED AND ANY ITEMS IN THE ATTIC SHOULD BE REMOVED.CAPE COD HOME IMPROVEMENT IS NOT RESPONSIBLE FOR ANY DAMAGES IF SAID ITEMS REMAIN IN PLACE. CAPE COD HOME IMPROVEMENT TM IS NOT RESPONSIBLE FOR ANY DAMAGES THAT MAY OCCUR DURING CONSTRUCTION TO LANDSCAPING OR ANY FINISH GROUND WORK, PLANTINGS,ASPHALT OR STONE DRIVEWAY, ETC.FLOWERS AND SHRUBS AGAINST HOUSE MAY NEED TO BE REPAIRED OR REPLACED BY HOMEOWNER. ANY ALTERATION OR DEVIATION FROM ABOVE SPECIFICATIONS INVOLVING EXTRA COSTS WILL BE EXECUTED ONLY UPON WRITTEN ORDERS,AND WILL BECOME AN EXTRA CHARGE OVER AND ABOVE THE ESTIMATE.ALL AGREEMENTS CONTINGENT UPON STRIKES,ACCIDENTS OR DELAYS BEYOND OUR CONTROL.OWNER TO CARRY FIRE,TORNADO AND OTHER NECESSARY INSURANCE UPON ABOVE WORK.WORKMEN'S COMPENSATION AND PUBLIC LIABILITY INSURANCE ON ABOVE WORK TO BE PLACED ON THE RESIDENCE AS A CONSEQUENCE OF THE CONTRACT.OWNER WHO SECURE THEIR OWN CONSTRUCTION-RELATED PERMITS OR DEAL WITH UNREGISTERED CONTRACTORS WILL BE EXCLUDED FROM ACCESS TO THE GUARANTY FUND. COSTS OFF COLLECTION,INCLUDING ATTORNEYS FEES WILL BE RECOVERABLE,IN THE EVENT OF NON- PAYMENT. WE LOOK FORWARD TO WORKING WITH YOU: PLEASE CALL IF YOU HAVE ANY QUESTIONS. SINCERELY CAPE COD HOME IMPROVEMENT TM THIS CONTRACT NOT.VALID UNLESS SIGNED BY ANATOLI"TONY"SIVITSIa ' ACCEPTED BY PV� SIG DATE ACCEPTED BY c ' SIGN ATE 2Z A © L CAPE COD HOME IMPROVEMENT ?4 GUARANTEES THAT ALL COMPONENTS INSTALLED PROPERLY PLEASE FEEL FREE TO CALL CAPE COD HOME IMPROVEMENT TM' WITH ANY QUESTIONS OR CONCERNS PLEASE INITIAL THIS PAGE l ® DATE(MM/DD/YYYY) A�v CERTIFICATE OF LIABILITY INSURANCE 06/15/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME CONTACT Linda Sullivan DOWLING&O'NEIL INSURANCE AGENCY PA No.HONE , (506 775-1620 FAX No: n DD RIESS: Isullivan@doins.com 973 IYANNOUGH RD INSURERS AFFORDING COVERAGE NAICY HYANNIS MA 02601 INSURER A: AMGUARD INSURANCE CO 42390 INSURED INSURER B: CAPE COD HOME IMPROVEMENT INC INSURERC: INSURER D: 27 MILL POND ROAD INSURER E: WEST YARMOUTH MA 02673 INSURER F: COVERAGES CERTIFICATE NUMBER: 281511 • REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I�TR TYPE OF INSURANCE ADD SUER POLICY NUMBER MM/DD/YLICY YYY MFF M/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑JET LOC PRODUCTS-COMP/OP AGG $ $ OTHER: AUTOMOBILE LIABILITY EaaccideDSINGLELIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Per accident $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ _ $ WORKERS COMPENSATION X STATUTE EER" AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 A OFFICERIMEMBEREXCLUDED9. WA WA WA R2WC940123 06/03/2018 06103/2019 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION F OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 O N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN AnatOli SIVItS{Q ACCORDANCE WITH THE POLICY PROVISIONS. 222 Buck Island Road 6-8 AUTHORIZED REPRESENTATIVE West Yarmouth MA 02673 L Daniel M.Crowley,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD u � C�lf�?f�2(�/7llxE'Q'GG 1t K7waf2lG�E' 1 Office of Consumer Affairs and Business Regulation 1000 Washington Street Suite.710 Boston, Massachusetts 02118 Home Improvement,Contractor Registration _ Type: Corporation t" Registration: 168043 CAPE COD HOME IMPROVEMENT,INC. Expiration: 12/06/2020 27 MILL POND RD A ; WEST YARMOUTH,MA 02673 Update Address and Return Card. SCA 1 to 20M-05/17 - - - - Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Corporation before the expiration date. If found return to: ReoistrMion• ExpiratIon Office of Consumer Affairs and Business Regulation 168043 12/06/2020 1000 Washington Street-Suite 710 CAPE COD HOME IMPROVEMENT,INC. Boston,MA 02118 ANATOLI SIVITSKI 27 MILL POND RD WEST YARMOUT NOt`ba�+a#without signature WEST MA 02673 Undersecretary F a Commonwealth of !Massachusetts Division of Professional Licensure Board of Building d ng Regulations and Standards Construct o p r Specialty CSSL-100040 _ ires : 05114/ 020 ANATOLI SIVITSKI , 27 MILL POND�AD WEST YARMOUTH MA 02673 Commissioner �= TOWN F BAR STABLE BUILDING PERMIT APPLICATIO N Map AS6, parcel OG6 Application # / Health Division I Date Issued Q IZ I� Conservation Division �� SEA sl�� Q1F^' �� Application Fee Planning Dept. Permit Fee 1 Z• Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis I 'y. Project Street Address r1oll Village -C riwzv Owner s l,..l to "� . (:5r-PAki l " Address nntl `SnOM TVnpL&A 151- l Telephone Permit Request ",D€slln�r..lELM PQ Square feet: 1 st floor: existingproposed 2nd floor: existing 5?"t proposed 14=Total new Gee k6-3Vt((V— Zoning District — d Flood Plain Groundwater Overlay Project Valuation T-e®ce;ID Construction Type r.A Lot Size ,S tl Grandfathered: ®'Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family W Two Family ❑ Multi-Family (# units) Age of Existing Structure tCt(4 Historic House: ❑Yes VINO On Old King's Highway: ❑Yes EKO Basement Type: ❑ Full ❑ Crawl ❑Walkout I/Other Czz.Ac,r=i F-L.,n qz_ Basement Finished Area (sq.ft.) v Basement Unfinished Area (sq.ft) Number of Baths: Full: existing as new fJ Half: existing ( new 40 Number of Bedrooms: (a existing O new Total Room Count (not including baths): existing new B_First Floor Room Count Heat Type and Fuel: taGas ❑ Oil ❑ Electric ❑ Other Central Air: UQ YeS ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ZNo Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ B97,i ❑ existj �w size_ / SC Attached garage: ❑ existing knew sizehed: ❑ existing ❑ new size Otie : �Y Zoning Board of Appeals Authorization ❑ Appeal # D�i7 Recorded Commercial ❑Yes Lr o If yes, site plan review # F Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name : �i\ r 5c� ,( Telephone Number G('7 `1 t 6-4— Address 2�4, � "VP4L4_,, -ZXL. ram,2-4: License`<SF'X�,, -- 1y16�• '7�s'Z�, Home Improvement Contractor# "S 14- Email &t(-kE6MC&1 ev Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Sc-::) VA _ i rV1.0.d SIGNATURE DATEi�- FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED '40AP/PARCEL NO. G ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION Cj 1 FRAME sN� o► o� �S�g �, t ' I INSULATION ''?/�S RREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r FINAL BUILDING 4 I. 1 DATE CLOSED OUT ASSOCIATION PLAN NO. . Town of B arnstabl-e . . Regulatory Services ST1pY Y Thomas F, Geller, Dirertox Building Division Tb omas P erry, CB 0, 13 nil ding C ommissj o n ar .200 Main Street, Hyannis,MA 02601 �ww.t awn.barns-table.m a.us• Ofkz: 508-862-�4038 Fax: 5 0 8 490-623 0.. ' PLA-N RE VU W Owner: Map/Parcel: )$lo Not, Project Address ?0'1 �. YnR-#) 'ST :J3u lder: �i4`� f1: F�satZ The following items mere noted on reviewing: ZO,sEt` wer� �va-s a) FLOob v SN'rS 6) lalk-rE2 2ESz'sra-,�-r CcN s-��eu can b� C3��:.cw w 13�, , 0 SIM6KE Ipmcrok Lk PG am r u�2 E:i-1 6 -d E K "TD PR6Z:D E LE71��n OF C 0 nIPL=A-rJc —= pfr � m �pE�-n 0 ry `�S� Q l�SIT' SUr2VE� • (.��FlEU,4TIy�NS AND ��ou1� Zw�E RE,6 umgF� 1WL%ND)�-norJ :TtJ PLAC- _Reviewred by: D°at.e° j tle�l� The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): �,l' Li..( 0`Q4f1C2.,fl�tG` Address: City/State/Zip: 'S ® g one#: Are on an employer?Check the appropriate box: Type of project(required): I I am a employer with 5 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling -- - -ship and have no employees— -- These sub-contractors have _ 8.,XDemolition—_ working for me in any capacity. employees and have workers' 9. kBuilding addition [No workers'comp.insurance comp.insurance$ required.] 15. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I 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.[1 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: HP4L_ 'Fe L Policy#or Self-ins.Lic.#: 14-► Expiration Date: ( ( Job Site Address: qol City/State/Zip; l y ' 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 and the pains a penalties ofperjury that the information provided above is true and correct Si mature: l Date: zps ''1.ts Phone#: Sr - Official use only. Do not write in this area,to be completed by city or town offzciaL City or Tovm.. Permitftic-nse It Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions ' ` Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for1heir employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would lice to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts, Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#f 17-727-7749 wwW.mass.gov/dia IDD A��©® CERTIFICATE OF LIABILITY INSURANCE 710/15/14 ' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Laurie Halperin Laurmark Insurance Agency PHONE FAX 781) 341-2519 1778 Washington Street E-MAIL (781) 341-0910 / No: ADDRESS: Laurie@Laurmarlcinsurance.com Stoughton, MA 02072 INSURE S AFFORDING COVERAGE NAIC# INSURER A:Western World Insurance Compan INSURED INSURERB:Hartford Underwriters Insuranc NITENSON CONSTRUCTION INC INSURERC:Citation Insurance 247 DALY DRIVE INSURERD: STOUGHTON, MA 02072 INSURER E: ' INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADOL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER M/DD/Y MM/DD/YYYY LIMITS A GENERAL LIABILITY NPP8202025 12/10/13 12/10/14 EACH OCCURRENCE $ 1,000,000 MIS X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PRE E occurrence) $ 100,000 CLAIMS-MADE F—IOCCUR ME EXP(Anyone person) $ 5,000 PER SO N4 L&ADV I NJU RY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATELIMITAPPPR - FLIESPER PRODUCTS-COMP/OPAGG $ 2,000,000 17 POLICY ,RCT LCC I I $ C AUTOMOBILE LIABILITY BBNZ11 10/15/14 10/15/15 COMBIINEDISINGLELIMIT $ ANYAUTO BODILY INJURY(Per person) $ 100,000 ALLOWAUTOS NED SCHEDAUTOS BODILY BODILY INJURY(Per accident) $ 300,000 HIREDAUTOS _ AUUTOSWNED Perrac9denDAMAGE $ 100,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE a f " AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION 6S60UB-2E11620-3-14 4/3/14 4/3/15 WC sTAru- OTH- AND EMPLOYERS'LIABILITY SlJ31LL -- ANY PROPRIETOR/PARTNER/EXECUTNE Y/N E.L.EACH ACGDENT $ 100,000 OFFICER/MEMBER EXCLUDED? N/A " (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yyes,describe under DESCRIPTIONOFOPERATIONSbelow E.L.DISEASE-POLICYLIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CARPENTRY AND REMODELING SERVICES PROPERTY LOCATION: 707 SOUTH MAIN ST CENTERVILLE, MA CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TOWN OF BARNSTABLE ACCORDANCE WITH THE POLICY PROVISIONS. REGULATORY SERVICES BLDG COMMISSIONER-THOMAS PERRY AU [ZED EPRESENTATIV 200 MAIN ST HYANNIS MA 02601 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: Massachusetts ;Department of Public Safety Board of Building Regulations and Standards Construction Supcnisor I & 2 Family ,. License: CSFA-046221 i JAY B NITENSON` - 247 DALY DR EXT STOUGHTON MA 0207: ?' i �,•`..� � 4.t� „� Expi ration Commissioner 07/11/2015 --._._....... _�__.---�_� V/'e�poann�waawecr� o�C/aGcr�oacl c�eCt� --- ^"^ - Office of Consumer Affairs&Business Regulation License or registration valid for individul use only WME IMPROVEMENT CONTRACTOR - before the expiration date. If found return to: Office of Consumer Affairs and Business Re ulation gistration 1:43895 Type: gpiration: 8/11%2016 Private Corporatio,-, 10 Park Plaza-Suite 5170 <� Boston,MA 02116 NITENSON CONSTRUCTION,fINC, 1 JAY NITENSON 247 DALY DR. EXT. STOUGHTON, MA 02072 Undersecrelaa Y Not valid without fignature L DOr-= 1 P 16Og?2? 02-25-2011 10=3V • C��T=1�3+§�1 BARNSTABLE EAKD COURT REGISTRY N ' Cl) N O N r-i -e-I y MASSACHUSETTS QUITCLAIM DEED o v Ct I, JULIA B. GAVIN, of Sudbury, Middlesex County, Massachusetts, for consideration paid and in full consideration of less than ONE HUNDRED ($100.00) DOLLARS, grant to JULIA B. GAVIN, TRUSTEE OF THE JULIA B. GAVIN TRUST, a Trust not of record, Certificate of v Trustee registered with the Barnstable Land Court Registry as Doc: /,/60,1?a g, of 558 Dutton Road, Sudbury, Massachusetts, with QUITCLAIM COVENANTS, a certain parcel of land co together with the buildings situated thereon located at 707 South Main Street, Barnstable G (Village of Centerville), Barnstable County, Commonwealth of Massachusetts 02632, described as follows: v Being shown as LOT 1 as shown.on subdivision plan 31731-B dated May 23, 1963, drawn by . 41 Nelson Bearse-Richard Law, Surveyors, and filed in the Land Registration Office at Boston, a ❑ copy of which is filed in Barnstable County Registry of Deeds in Land Registration Book 234, Page 47,with Certificate of Title No. 30187. u Said land is subject to a building line as,approximately shown on said plan by virtue of taking of 0 easement for the establishment of building lines by the Town of Barnstable dated May 2, 1928, duly recorded in Book 464,Page 410. 0 Said land is subject to and has the .benefit of a license granted' by the Commonwealth of Massachusetts Department of Public Works, License No. 1468, dated February 14, 1933, duly, recorded in Book 491,Page 425. Said premises are subject to and with the benefit of License#2614 issued by Commonwealth of Massachusetts to construct and maintain pier,ramp and float as shown on Doc. No. 528,852 Said premises are subject to all rights, reservations, easements, restrictions of record insofar as the same are now in force and applicable. RETURN TO: JAY Z.AFRAME,ESQUIRE Phillips,Silver,Talman,Aframe&Sinrich,PC 146 Main Street,Fifth Floor Worcester,MA.01608 1 BEING the same premises conveyed to JULIA B. GAVIN by deed of DENNIS J. GAVIN dated January 11, 2011, and registered with the Barnstable Land Court Registry, has Doc: 1, /40 ��,, Certificate of Title No. WITNESS my hand and seal this 1 lth day of January,2011. 4 "-GAVIVN " COMMONWEALTH OF MASSACHUSETTS Worcester, ss. On this 11th day of January, 2011, before me, the undersigned notary public, personally appeared JULIA B. GAVIN, proved to me through satisfactory evidence of identification, which was by personal knowledge, to be the person whose name is signed on the within document, and acknowledged to me that she signed it voluntarily for its stated purpose. JAY f ,Notary.Public My commission expires: 10/26/2012`, Chadsey Plumbing&Heating 10/27/14 274 Phillips Street Attleboro,MA 02703 508-962-5809 _. TO: Town Of Barnstable , ~ Regulatory Services Building Division *, 200 Main St . Hyannis Mass 02601 k The gas and water have been disconnected and capped off per plumbing code for the carriage house,from the main house located at 707 South Main St. Centerville Mass,and plumbing and gas permits have been pulled,if there areaany questions you can call Scott Chadsey at Chadsey Plumbing and Heating at 1-508-962-5809 Master License number M-15671 Journeyman License Number J-30200 'Sincere cott R. Chadsey o a Elite Electric, Inc. 203 Stow Road ifarvard,911A 01451 ECteEfectric.94A@Gmaifcom Tef-(978)340-2744 Waster Lzcense:A20589 journeyman License:E51912 October 27, 2014 To. " Town of Barnstable, MA Regulatory Services, Building Department 200 Main Street Hyannis, MA Reference:707 South Main Street,Centerville, MA To Whom it May Concern, I, Brian C. Richard, President of Elite Electric, Incorporated am writing to inform you that all power, both line and low voltage has been safely disconnected from the carriage.house at 707 South Main Street Centerville, MA as of Monday,October 27 2014. The electrical supply ran from the main house on the property to the carriage house and went no further. Please feel free to contact me at anytime with questions or concerns. Sincerely, Brian C Richard, President Elite Electric, Inc. s r �y r� D�Ao�r11::. 1 s 252:SS7 08-22-20 14• 1 D: 16 ABLE LAND COURT REGISTRY Town of Ba nS TdpU Zoning Board of Appeals Decision and Notice Special Permit 2014-037—Gavin § 240.131(D)(2)—Change, Expansion or Alteration by Special Permit For demolition and rebuilding of carriage house addition Summary: Granted with Conditions To r E` r' Petitioner: Julia B. Gavin, Trustee of the Julia B. Gavin Trust -: �.•• Y' 558 Dutton Road,Sudbury, MA F - Property Address: 707 South Main Street, Centerville Assessor's Map/Parcel: . 186/066 Zoning: Craigville Beach District—Centerville River North Bank Hearing Date: July 10,2014 Recording Information: Deed:Certificate 193691 Plan: LC Plan 31731-B (Lot 1) Background In Appeal 2014-037, Julia B. Gavin sought a Special Permit under Section 240-131.4(D) of the ordinance, which allows for expansion and alterations of existing dwellings.; The proposed ' alterations and additions did not conform to the current setback requirements of the district,and, thus required a special permit. The Applicant proposed to raze an existing carriage house and reconstruct a two-story addition to the dwelling with a first floor, three-car garage and second floor living area. The garage was proposed to be 1,088 sq.ft in area;with a finish floor elevation lower than the base flood elevation, thus making the space uninhabitable. The second floor living area would consist of 1,020 square feet, resulting in a reduction in living area.by 85 sq.ft. The footprint of, the dwelling_was proposed to-be altered but remain unchanged. A 35 sq.ft portion-of building area ..on the south.side of,the:carriage:house.will be omitted; thus increasing.the setback from 8:2 feet to : 9 79.feet; where:a side..yards7 setback of 1.5.feet is required. A 3.5.sq.ft.addition to the footprint will be included o' he'front/west=:elevation A:.12 sq:ft'second floor connector wilt:be'added aver an -existing deck to attach th_e main house the carriage_house A 171 square foot,balcony:and stairs _ _. uncover`ed ►s ro osed,at the rear of the structure ( P ) p P .. The subject property is a 23,567 sq.ft (.54 acre) lot, inclusive of upland a nd,wetland, with frontage` on South Main Street. The lot was improved with two structures: a single-family dwelling and carriage house with a combined total of 4,523 square feet of living area. The single-family dwelling is a 4bedroom;two=story wood=frame-structure constructed in 1962. The house underwent.a major renovation in 1999;which included the addition of 780 square feet of living area, replacement of a screened-iri porch and roof deck, and addition of a rear deck. The carriage house was.a 27'x 40' wood-frarne, one-siory structure with a finish floor elevation of 6.8 feet. Building permits were obtained in.2000.to convert the carriage house to living space, consisting of two bedrooms,.one bathroom and living area: The dwellings a re.located in an AE flood zone,.with abase flood elevation of 13-14' (based the FIRMS effective July 16, 2014). Procedural & Hearing Summary Special Permit.No:2014=037, filed by Julia B. Gavin, Trustee; to allow for alteration of carriage house..at 707 South,Main Street, Centerville was filed at the Town Clerk's office and office of the Zoning.Board.of Appeals on Ju he.1.7,2014. A public hearing before the Zoning Board of Appeals was duly advertised and notice sent to all abutters and interested parties in accordance with MGL ' Chapter 40A. The hearing was opened on July 9, 2014 at which time the Board found to grant the Special Permit subject to conditions. Board Members deciding this appeal were Craig'G. Larson, Brian.Florence,Alex M. Rodolakis, 'George T. Zevitas, and David A. Hirsch. Town of Barnstable Zoning Board of Appeals-Decision and Notice Special Permit No.2014-037—Gavin Attorney Paul Tardiff represented the Applicants before the Board. Gary Ellis of Northside Building Consultants'and representatives for the applicants were also present. Attorney Tardiff presented an overview of the proposal. He discussed the design of the new addition and the intent to blend it into the existing structure and neighborhood. Attorney Tardiff discussed the second-floor area limitations, stating that the garage area was below habitable grade and the garage does not constitute gross floor area, thus does not qualify as a floor. The Board confirmed that the carriage house would consist of additional living space and would not be a second dwelling unit.. The Board Chair requested public comment and no one spoke. Findings of Fact At the hearing on July 9, 2014, the Board unanimously made the following findings of fact for Appeal 2014-037, a request for a special permit filed for alteration of an existing carriage house within the required setback at 707 South Main Street, Centerville: 1. Julia B. Gavin, Trustee of the Julia B. Gavin Trust has petitioned fora Special Permit pursuant to §240-131.4(D)(2) to raze an existing carriage house and reconstruct an addition to the single-family dwelling with no increase in living area or footprint. The property is located at 707 South Main Street, Centerville, MA as shown on Assessor's Map 186 as Parcel 066. It is in the Craigville Beach Zoning District—Centerville River North Bank Neighborhood. 2. The application falls within a category specifically excepted in the ordinance for a grant of a special permit. Section 240-131.4(D)(2) allows for the change and alteration of an existing, lawfully established structure in existence as of January 19, 2011 with a special permit from the Board. 3. Site Plan Review is not required for single-family residential dwellings. 4. After an evaluation of all the evidence presented, the proposal fulfills the spirit and intent of the Zoning Ordinance and would not represent a substantial detriment to the public good or the neighborhood affected: 5. . The proposed alterations and expansions are not substantially more detrimental to the environment, community and/or historic character of the neighborhood.than the existing building or structure. 6. The redevelopment contributes to and respects the character and historic,development patterns of the area and minimizes inconsistent development and redevelopment impacts'to the historic and community character resources in this area. The proposed construction will reflect the character of the existing dwelling and has an architectural style consistent with the historic character of the area: . 7. The proposal protects and preserve_s scenic views and vistas and ways to the water..The Applicant.is proposing construction within the same approximate footprint as the existing structure, thus not creating any new obstruction to views or vistas to the water. 8 The proposal protects and improves natural resources, including but not limited to the barrier beach*and groundwater and coastal water quality and minimizes development and redevelopment impacts to the natural resources and ecosystems In this district. The redevelopment will not adversely affect natural resources or ecosystems in the district. 9. The proposal protects human life and property from the periodic hazards of flooding. The. redevelopment will remove habitable area from the floodplain. The new construction will comply with zoning and building regulations for construction within the floodplain: 10. The proposal preserves the natural flood.control characteristics and the flood control function of the floodplain. The proposed structure does not significantly alter or increase the footprint,of structures within the floodplain and thus does not have an adverse affect of the flow of flood waters within the floodplain: 2 .. r Town of Barnstable Zoning Board of Appeals—Decision and Notice d Special Permit No.2014-037—Gavin 11. The development complies with the setbacks and lot coverage requirements set forth herein, and is in character with surrounding structures, particularly structures that predate it. The proposed development does not intensify any of the existing setbacks. The redevelopment is in character with the surrounding structures. 12. The redevelopment complies with the height limitations set forth herein. The redevelopment does not increase the height of the existing structure over what is there today and complies with the other requirements of§240-131.5. The height of the structure from the average grade plane to ridge is 25 feet high from average grade (elev 6.2)to the ridge. The proposed new construction will be no higher than the existing single-family dwelling. 13. The second floor is dormered under a gambrel roof, the dormers are set back a minimum of two feet from the front and side facades. 14. The proposed garage is located below the required base flood elevation and does not constitute habitable space or gross floor area, thus it does not constitute a "floor". The proposal is in compliance with the floor area limitations of§240-131.5(B)(Footnote 3). 15. The proposal meets the requirements of the Centerville River North Bank neighborhood; the proposed redevelopment is located within the AE flood zone and all proposed construction shall be in compliance with requirements for construction within the floodplain. 16. The proposed additions and expansions do not entail an increase in gross floor area or footprint for voluntary demolition of a single-family residence. The proposal consists of voluntary demolition of an existing carriage house and its reconstruction as a new addition to the dwelling. The new construction will not increase the gross.floor area (areas capable of human occupancy) or footprint.over what exists. 17. The proposed alteration does not exceed 25% of the gross floor area of structures in existence as of July 1, 1989, or do not exceed 10% of the gross floor area of structures in existence as of November 6, 2009. The proposal does not result'in an increase in the gross floor area (areas capable of human occupancy) of the dwelling. 18 The proposal does not increase lot coverage over what is allowed under§ 240-131.6, Coverage limitations, or-by more than 10% over what was existing on November 6, 2009, wtiichever.is greater. The only proposed increase in building or lot coverage will result from the proposed rear balcony and stairs. The balcony is approximately 5'x 15' (75 sq.ft) with attached stairs. The definition for building rayerage excludes decks not exceeding 100 square feet from building coverage calculations. 19. The proposal will not increase flood hazards in the neighborhood. The proposed construction Will remove habitable floor area from the floodplain. The proposed structure does note significantly alter or increase the footprint of structures within the,floodplain,and thus does not have an adverse affect of the flaw of flood waters within the floodplain. The vote toaccept the findings was " . AYE',.Craig G. Larson, Brian Florence, Alex M: Rodolakis, George T. Zevitas, David A: Hirsch NAY: None . decision . Based on the findings of fact, a motion was duly made and seconded to grant Special Permit No. 2014-037.subject to the following conditions: 1. Special Permit No: 2014-037 is granted to Julia B. Gavin, Trustee of the Julia B. Gavin Trust for the change, alteration and addition to the dwelling at 707 South Main Street, Centerville pursuant to Section 240-131.4 of the Craigville Beach District. ..2. The alterations and expansions shall be constructed in substantial conformance with the site Plan entitled 707 South Main Street" dated December 5, 2013, last revised April 15, 2014, r 3 Town of Barnstable Zoning Board of Appeals—Decision and Notice Special Permit No.2014-037—Gavin drawn and stamped by Stephen Doyle and Associates and the floor plans and elevations entitled "Dennis Gavin Additions"dated May 7, 2014, drawn by Gary A. Ellis of Northside Dullding Consultants,Inc. 3. `The total living space of the new additional shall not exceed 1,020 square feet and there shall be . no expansion of the footprint beyond that shown in the plans referenced in Condition No. 2. 4. The rear balcony shall not exceed 100 square feet in area,'exclusive of stairs. The balcony and stairs shall remain open and uncovered. 5. The first floor garage area of the addition shall not be converted to habitable space, as required by flood zone provisions and the requirements of the Craigville Beach.District. 6. Further expansion of the footprint of the dwelling, construction of additional accessory, structures, or addition of impervious surface area is prohibited without prior approval from the Board. 7. Prior to issuance of a certificate of occupancy, a-certified as-built plan prepared by an independent party shall be submitted to the Building Commissioner to confirm that the expansions and lot and building coverage conforms to the ordinance and the conditions of this decision. 8. The decision shall be recorded at the Barnstable County Registry of the Land.Court and copies of the recorded decision shall be submitted to the Zoning Board of Appeals Office and the Building Division prior to issuance building permit. The rights authorized by this special permit must be exercised within two years, unless extended. The vote was: AYE: Craig G. Larson, Brian Florence, Alex M. Rodolakis, George,T. Zevitas, David A. Hirsch NAY: None Ordered _Special Permit.No..201.4-037 to raze.an existing carriage house and rebuild an addition to the srngle-family dwelling located within the,required setbacks at 707 South Main Street, Centerville has been granted subject to conditions. This decision must be recorded at the Barnstable County R .Registry of D g ry Deeds or Reaistry of the Land Court, ?C annrp ria o fnr,t and rr• p .# •• , . ccc and I wu v• • VG VI that recording submitted to the Zoning Board of Appeals.Office. ;The relief authorized by this decision must be exercised within two years unless extended. Appeals of this decision, if any,shall be made pursuant to MGL Chapter 40A,_Section 1.7, within twenty (20) days after the date of the frling:of"tfZis decision, a copy_of which must be flied in the office of the Barnstable Town Clerk. Craig G. Larson, Chair Date Signed • IVAnn Quirk, Clerk ofthe Town of Barnstable, Barnstab le.County, Massachusetts, hereby certify' that twenty(20)days have.elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the.decision has been filed in the office of the Town Clerk. Signed.and sealed this day of —under the pains and penalties of perjury.. Ann Quirk, Town,Clerk �TMETti Town of Barnstable ' Regulatory Services ca$ Richard V.Scali,Interim Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable ma.us Office: 508-862-4038 Fax: 508-790-6230 , Property Owner Must Complete. and Sign This Section - Xf Using A Builder T" 60�V i�k t• ,as Owner of the subject ptoperty hereby authorize —S P�'e --S&1, to act on my, behA in all matters relative to work authorized by this building permit - a (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled ot.utilized before fence is installed and all final inspects are gerformed and accepted. " Signature o er Signa e44Applicant Print Name Print N&e Date I Town of Barnstable -. Regulatory Services oFz> Tok� Richard V.Scali,Interim Director Building Division neawcr�nrF t Tom perry,Building CommissionerMASM - 200 Main Street, Hyannis,MA 02601 `�Ea lit www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6250 HOMEOWNER LICENSE EXEMPTION ; Please Print DATE: JOB.LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: cityAown state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Appi oval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S F_XX3 TION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities•of a super- or (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results'in serious problems,.particularly when the homeowner hires unlicensed persons. In this case; n our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. n.�ixrocrrrc�rr�v��rc�1,.1.i;..arPm,;FfrmmcIFXPRFS4ricc . Massachusetts Department of Environmental Protection Bureau of Resource Protection -Waterways Regulation Program W044688 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Simplified,Water-Dependent, Nonwater-Dependent,Amendment G. Municipal Zoning Certificate Joss Hill Whedon & Kai Cole Name of Applicant 707 South.Main Street Centerville River Barnstable Project street address Waterway Cityrrown Description of use or change in use: The proposed use is to provide the applicant with access to navigable waters A To be completed by municipal clerk or appropriate municipal official: "I hereby certify that the project described above and more fully detailed in the applicant's waterways license application and plans is not in violation of local zoning ordinances and bylaws." z� o Printed a of Mun!Zal fficial Date � �� gnature of Municipal i le CI /Town CH91App.doc-Rev. 10/02 Page 6 of 17 PROJEC NAME.r ADDRESS: O Jd. Ahy .S7 C7X-d PERMIT#�:3 7/83 DATE: 31l7 zlil� MR: n _L LARGE ROLLED PLANS ARE IN: BOX ..3 A SLOT DATE: q/wpfiles/archive , GEED fNEL R M d , —R w� R% �-'� l�Ur��rN T0 c o0 r /�h0 WF wov�� k— I `1 { Go�Pa_ T1; PLUM Qi l rdaSTO�A i;d0 O 5"Nt� ,,—oaZ 4 Sllvw owi�E�� KIT Co(�= ' �� F SS�s.� c-u! Nf)LL E (T AN): Jok n L.FARRt'!_L cu3Torn CARPENT2y ' P r CAPE COD HOSPITAL r 1 { T - I i °FTHE r, •'1,°� The Town of Barnstable MAS& �0� Department of Health Safety and Environmental Services 59 A Building Division 367 Main Street,Hyannis MA 02601 Cf iice: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. - Date- AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the`reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied `wilding coat:i.ning 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. ©mo o ELI4-& 4 vsE Type of Work: 11�\ /7� Estimated Cost Address of Work: 70 Owner's Name: /C GL/ (!,o le— i Date of Application: 7 10 U I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 1111milding not owner-occupied P6wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CON s RAC T S,FOP:A PI-1 IIPC'L?LF HOME 1MPRr�VEMrle['['WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. O /1/ /7 Date Owner's Name q:forms:Affidav ..... The Commonwealth of Massachusetts Department of Industrial Accidents - 600 Washington Street - - Boston.Mass. 02111 Workers'IC ensation Tuu��arance davit i name: C 0 L E location: Ci TF4 V/61[,E 2 l 3 Z. phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole netor and have no one workin in ca acitY providingworkers' comp.. ❑ employer........... ......::..:::::,::::::::::.::........::::::::::::::........:::::::::::::::::...:....::::::::::::::::::::::::.:.........:.:::::::::::::::::::::::::...........:::.:::::::::::.........::::::. :?%:'n:Yi•ii:•i}ii:iiw::•:;::ry}}':::.;{::.v:{:?.i::::::::•..v:::.ii:.ii:.:.r?::.}}:•:�:.��::•.::::: is>:i...'ii:•i:':i'•r:,.';:::ii:iii:'v:j;:';i+{::i:< `i:.:.::.::..•.;:. dt$ft'SS: s� ,� --.,vim' ....::..::::................: � llue m..`: :;?::;::;;:........ ....:.................. Tl its".nce to a � I.am a sole proprietor,general contractor, r homeowner ,cle one)and have hired the contractors listed below who have ' co ensation olice.s: the following w compensation police. f � :.:.......... � .............. one. .. '>iSKJi:�Oii :::......::..:..... .........:. ....... ......:....... ::::v::::•::::::.�::::::::.:::-:•.v:�::vv}:i-ii:?vii:;:ivi:}i:}p:iiv:v::::::iiji}:<`v?}:•i}'riii:•iTii:L::��:i}iiiyi:ij4}}i:hi•:ii ...............................n........- ... ......... .... .. ... .- .... ..:.......... ..........:�i.•:::�: .:}i:? ...:...::: .:.ii:Y::� -S4i`i::i:MiY:+� .:J i'lft.}}^Y,.•}Y?•; :.:::.:::•::?•:�ii:•::::::::::.+}i;C:SJ:}::::: ... .}'::.} ........ ...v:vi':i::4:: ::::}}:r r}:i'.i:i fi'.:i::'::4i.t:;";:y;.•}:v F.?Y.<?•:?:. ::............................. 3 T :::::i}::`::::}:: y:v:....:!ii':i:`:'� ::............... ............................................................. .........................::::::::::::............................ ...........:::.....................::.... ... ..:...:•...:.::.:•... .......... ........... .............. Irene. ..:...... :::•>::;:'� .......................................................................... ...............:................ �p��I '11`' FaLt�e io sece. cover:ge.e zy- •ea,.�.e:....y... ; to•`e+�!� `ia.^er a iw,.dtlri of a 8ne to 51,imud anwor one years'imprisonment as weir ss dvfi penalties in the form of a'�TOI'WORK ORDER and a Line of 3160.00.s day agairst me. I Wider copy of thb statement may be forwarded to the OIHce of lnvestigaflons of the DIA for coverage verification I do hereby certify airs and p of perjury that the information provided above is&w..and correct Date ��— 7_ Signatare v 5-a e- k6d - ds99 Print name /1 a l' �e— Phone# 5 X 6 — 9 9—Jf%/ oLncial we only do not write in this area to be completed by city or town official city or town• permitAicense# ❑Btdlding Department ❑Licensing Board ❑cheakffhmnediate response is n4� ❑Se alth De's rbnee ❑Health Depsrlment contact person: phone#; ❑Other. (Jemw 9/95 PJ/ia Information and Instructions Massachus etts 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 wt& inter any zontmA for the rerfor-once ofPuliiic w,rk until requirements of this have been presented to the contracting acceptable evidence of compliance with the insurance requir chapter authority. Applicants k lZ W 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 the`9aw"or if you ' being requested,not the Department of Industrial Accidents. Should you have any questions regarding 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 peraut/ Cute number which will be used as a reference number. The affidavits may be returned in- the Department by:mail or V' unless oilier ar.VM8e=L4b li Yc'oi�la.J6La+kv 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 gfflce of lnllestigadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406,409 or 375 } F THE r°� - * The Town of Barnstable BAMSTABM Maw g Regulatory Services 1639. �m AiFo l,,pra BuPd ing Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION �7 Please Print DATE: -P /—/D 6 /� JOB LOCATION: 70 S' -4'//A All number �+ street q 2 village p "HOMEOWNER":��� C��L� 6 !! 'u��/� 310— name home phone# work phone# CURRr 1N 1 MAiLTNG AiLTi,:;:J. ��O'O �'I✓���5� � ��I_ 4� - - city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provide d that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures., A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) t The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official ° Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as.Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPT.N ell? ` o Z!' 14 . O1 t2 t.y P� COiN 1 PCJ- Jv k h L- FAV ra m. _ ag-� 3 Coo LAW OFFICES OF PAUL R. TARDIF, ESQ., P.C. 'i. 490 MAIN STREET YARMOUTH PORT,MA 02675 (508)362-7799 . (508)362-7199 fax Paul R Tardif,Esq. Melissa G.MacLeod,Esq. ptardifn tardi flaw.com www.tardiflaw.com melissantardiflaw.com REFER TO FILE NO. August 25, 2014 x; Carol Puckett Barnstable Zoning Board of Appeals 200 Main Street Hyannis, MA 02601 �&E.:—Zoning Appeal.—707 South-Main Street, Centerville Julia B:`Gavin, Trustee of Julia B. Gavin Trust—Case Number 2014-037 ear Ms. Puckett: Enclosed please find a copy of the Board of Appeals Decision for a Special Permit which- was recorded for the above referenced matter on August 22, 2014 in the Land Court Division of the Barnstable County Registry of Deeds as Document 1252557. Please note that a copy of the recorded document has been forwarded to.the Building Department for its records. I thank you our assistance m this matter. - ------------------- -- 4.V ry T -1y Yours; aul R. T rdif enc cc: Julia B.Gavin Thomas Perry, Building Department�� j I V4 Est r f D0•_: 1r252r557 08-22-2014 10: 16 Town of B BarnsA�a��e TABLE LAND COURT REGISTRY � Zoning 9 Board of Appeals Decision and Notice Special Permit 2014-037—Gavin § 240-131(D)(2) —Change, Expansion or Alteration by Special Permit For demolition and rebuilding of carriage house addition. Summary: Granted with Conditions Petitioner: Julia B. Gavin, Trustee of the Julia B. Gavin Trust ;,, .;:_ 558 Dutton Road,Sudbury, MA Property Address: 707 South Main Street, Centerville Assessor's Map/Parcel: 186/066 Zoning: Craigville Beach District-Centerville River North Bank Hearing Date: July 10,2014 Recording Information: Deed: Certificate 193691 Plan: LC Plan 31731-B (Lot 1) Background In Appeal 2014-037, Julia B. Gavin sought a Special Permit under Section 240-131.4(D) of the ordinance, which allows for expansion and alterations of existing dwellings. The proposed alterationsrand additions did not conform to the current setback requirements of the district, and thus required a special permit. The Applicant proposed to raze an existing carriage house and -, reconstruct a two-story addition to the dwelling with a first floor, three-car garage and second floor living area. The garage was proposed to be 1,088 sq.ft in area, with a finish floor elevation lower than the base flood elevation, thus making the space uninhabitable. The second floor living area would consist of 1,020 square feet, resulting in a reduction in living area.by 85 sq.ft. The footprint of the dwelling was proposed.to be altered but remain unchanged. A 35 sq.ft portion of building.area -. on-the south iside.of the:carriage housewill be omitted,.thus increasing the setback from-8.2 feet to 9 79 feet, where a:side-yards.8etback.of 1.5 feet is required. A 35.sq.ft..addition to the footprint will . be rncluded`on the front7west elevation. A 12 sq ft"second floor connector will be added;overan existing deck to attach th`e main--house the carriage house_A 171 square foot balcony and s airy _ (open, uncovered) is proposed:at he`rear of the structure. . The subject property is a 23,"567 sq.ft (.54 acre) lot, inclusive of upland and wetland, with frontage on South Main Street. The lot was improved with two structures: a single-family dwelling and .,carriage house with a combined total of 4,523 square feet of living area. The single-family dwelling =-is a 4=bedroom,_fwo story wood=frameatructure constructed-in 1962. The house underwent a major renovation in 1999; which.included the addition of 780 square feet of living area, replacement of a screened-in'porch;and roof deck,.and-addition of a rear deck. The carriage house was a 27' x 40' wood=frame;:one=story structure with a finish floor elevation of 6.8 feet Building permits were obtained in_2000 to. nvert`the:carriage house to living space, consisting of two bedrooms, one bathroom and living area :. The dwellings are.located in an AE flood zone, with a base flood :elevation of 13 14' (based the FIRMS effective July 16,`2014). :' Procedural & Hearing.Summary ;Special Permit No. 2014-0.37, filed by Julia B. Gavin,.Trustee, to allow for alteration of carriage house at 707 South.Main Street; Centerville was filed at the.Town Clerk's office and office of the Zoning Board of Appeals'on June 17;2014 A public hearing before the Zoning.Board of Appeals was duly advertised and notice:sent to all abutters and interested parties:in accordance with MGL Chapter 40A. The hearing was opened on July 9, 2014 at which time.the Board found to grant the :Special Permit subject to conditions. Board Members deciding this appeal were Craig G: Larson, Brian Florence, Alex M. Rodolakis, George T. Zevitas, and David A. Hirsch. i i Town of Barnstable Zoning Board of Appeals—Decision and Notice Special Permit No.2014-037—Gavin Attorney Paul Tardiff represented the Applicants before the Board. Gary Ellis of Northside Building Consultants and representatives for the applicants were also present. Attorney Tardiff presented an overview of the proposal. He discussed the design of the new addition and the intent to blend it into the existing structure and neighborhood. Attorney Tardiff discussed the second-floor area limitations, stating that the garage area was below habitable grade and the garage does not constitute gross floor area, thus does not qualify as a floor. The Board confirmed that the carriage house would consist of additional living space and would not be a second dwelling unit. The Board Chair requested public comment and no one spoke. Findings of Fact At the hearing on July 9, 2014, the Board unanimously made the following findings of fact for Appeal 2014-037, a request for a special permit filed for alteration of an existing carriage house within the required setback at 707 South Main Street, Centerville: 1. Julia B. Gavin, Trustee of the Julia.B. Gavin Trust has petitioned for a Special Permit pursuant to §240-131.44(D)(2) to raze an existing carriage house and reconstruct an addition to the single-family dwelling with no increase in living area or footprint. The property is located at 707 South Main Street, Centerville, MA as shown on Assessor's Map-186 as Parcel 066. It is in the Craigville Beach Zoning District- Centerville.River North Bank Neighborhood. 2. The application falls within a category specifically excepted in the ordinance for a grant of a special permit. Section 240-131.4(D)(2) allows for the change and alteration of an existing -lawfully established structure in existence as of January 19, 2011 with.a special permit from the Board. 3. Site Plan Review is not required for single-family residential dwellings. 4. After an evaluation of all the evidence presented, the proposal fulfills the spirit and intent of the Zoning Ordinance and would not represent a substantial.detriment to the public good or the neighborhood affected. 5. The proposed alterations and expansions are not substantially more detrimental to the environment,'community and/or historic character of the neighborhood than the existing tuildmg or trucfure, - 6 The redevelopment contributes to and,;respects the character and histonc development patterns of the area and`minimizes inconsistent development and redei/e►opment irnnacts to the historic and community character resources in this area. The proposed construction will reflect the character of the existing dwelling and has an architectural style consistent with the historic character of the area. The proposal protects and preserves scenic views and vistas and ways to the water. The Applicant is proposing construction within the same approximate footprint as the existing structure; thus not creating any new obstruction to views or vistas to the water. 8 The proposal.protects.and.improves natural resources including but not limited to the barrier beach and groundwater and coastal water quality and minimizes development and redevelopment impacts.to the natural resources and ecosystems in this district. The redevelopment will.not adversely affect,natural resources or ecosystems in the district. 9 The proposal protects human life and property from the.periodic hazards of flooding. The redevelopment will remove habitable area from the floodplain. The new`construction will comply.with zoning and building regulations for construction within the floodplain. " 10. The proposal preserves the natural flood.control characteristics and the flood control function of the floodplain.. The proposed structure does not significantly alter or increase the footprint of structures within the floodplain and thus does not have an adverse affect of the flow of flood waters within the floodplain. 2 f Town of Barnstable Zoning Board of Appeals—Decision and Notice Special Permit No.2014-037—Gavin 11. The development complies with the setbacks and lot coverage requirements set forth herein, and is in character with surrounding structures, particularly structures that predate it. The proposed development does not intensify any of the existing setbacks. The redevelopment is in character with the surrounding structures. 12. The redevelopment complies with the height limitations set forth herein. The redevelopment does not increase the height of the existing structure over what is there today and complies with the other requirements of§240-131.5. The height of the structure from the average grade plane to ridge is 25 feet high from average grade (elev 6.2) to the ridge. The proposed new construction will be no higher than the existing single-family dwelling. 13. The second floor is dormered under a gambrel roof; the dormers are set back a minimum of two feet from the front and side facades. 14. The proposed garage is located below the required base flood elevation and does not constitute habitable space or gross floor area, thus it does not constitute a "floor". The proposal is in compliance with the floor area limitations of§240-131.5(B)(Footnote 3). 15. The proposal meets the requirements of the Centerville River North Bank neighborhood; the proposed redevelopment is located within the AE flood zone and all proposed construction shall be in compliance with requirements for construction within the floodplain. 16. The proposed additions and expansions do not entail an increase in gross floor area or footprint for voluntary demolition of a single-family residence. The proposal consists of voluntary demolition of an existing carriage house and its reconstruction as a new addition to the dwelling. The new construction will not increase the gross floor area (areas capable of i human occupancy) or footprint over what exists. 17. The proposed alteration does not exceed 25% of the gross floor area of structures in existence as of July 1, 1989, or do not exceed 10% of the gross floor area of structures in existence as of November 6, 2009. The proposal does not result in an increase in the gross floor area (areas capable of human occupancy) of the dwelling. 18: The proposal.does not increase lot coverage over what is allowed under§ 240-131.6, C overage.limitations, or by more than 10% over what was existing on November 6, 2009, g Y proposed g of coverage-will-result from the..`= - - - - _ whichever is rester. The only ro osed increase m buildm or I proposed rear balcony and stairs. -The;balcon is.a roxiEnalel o "x 1=5 75's ft" 4dith attached g. c udes deck no e n Y PP Y ( q. ) -stairs: The d8fini#ion for`h�_�ilriin� rp�iara a ay I rl + xCeeding 1 vi/ square fcci frviTi building coverage calculations. 19. The proposal will not increase flood hazards in the neighborhood. The proposed construction will remove habitable floor area.from-the-floodplain..-The.proposed structure does not sign,ificantlyalter or increase the footprint of structures within the floodplain and thus does not have an adverse affect of the flow of flood waters within the floodplain. The vote to.accept:the findings was: AYE'Craig G. Larson Brian Florence, Alex M. Rodolakis, George T. Zevitas, David A. Hirsch NAY::None Decision Based,on the findings of fact, a motion was duly made and seconded to grant Special Permit No. 2014-03.7.subject.to the following conditions: - 1. Special Permit No. 2014-037 is granted.to Julia B. Gavin, Trustee.of the Julia B. Gavin.Trust for the.change, alteration and addition to the dwelling at 707 South Main Street, Centerville pursuant to Section 240-131.4 of the Craig ville Beach District . 2. The.alterations and expansions shall be constructed in substantial conformance with the site plan entitled 707 South Main Street" dated December 5, 2013, last revised April 15, 2014, I 3 p Town of Barnstable Zoning Board of Appeals—Decision and Notice Special Permit No.2014-037—Gavin drawn and stamped by Stephen Doyle and Associates and the floor plans and elevations entitled "Dennis Gavin Additions"dated May 7, 2014, drawn by Gary A. Ellis of Northside Building Consultants, Inc. 3. -The total living space of the new additional shall not exceed 1,020 square feet and there shall be . no expansion of the footprint beyond that shown in the plans referenced in Condition No. 2. 4. The rear balcony shall not exceed 100 square feet in area, exclusive of stairs. The balcony and stairs shall remain open and uncovered. 5. The first floor garage area of the addition shall not be converted to habitable space, as required by flood zone provisions and the requirements of the Craigville Beach:District. 6. Further expansion of the footprint of the dwelling, construction of additional accessory structures, or addition of impervious surface area is prohibited without prior approval from the Board. 7. Prior to issuance of a certificate of occupancy, a certified as-built plan prepared by an independent party shall be submitted to the Building Commissioner to confirm that the expansions and lot and building coverage conforms to the ordinance and the conditions of this decision. 8. The decision shall be recorded at the Barnstable County Registry of the Land Court and copies of the recorded decision shall be submitted to the Zoning Board of Appeals Office and the Building Division prior to issuance building permit. The rights authorized by this special permit must be exercised within two years, unless extended. The vote was: AYE: Craig G.Larson, Brian Florence, Alex M. Rodolakis, George T. Zevitas, David A. Hirsch NAY: None Ordered Special Permit.No. 2014-037 to raze_a, existing carriage house and rebuild an addition-to the single-family:dwell;ing located within the required setbacks at 707 South Main Street, Centerville has, been.granted,subject,to conditions. This_decon:must be recorded at the Barnstable,County Registry of Deeds or-Registry-0f the_Land Coy±rt, as appropriate for i+ +o ho ff, a , t; �t that recording submitted to the ZoningBoard of A v v vy ai ld � "1 Appeals Office. The relief authorized by this decision must be exercised within two years unless extended. Appeals of this decision, if any, shall be made pursuant to MGL Chapter 40A, Section ..17,-within._twenty (20)-days after the date of the - f±ling of this decision; a coy of which must be filed in the office of the Barnstable Town Clerk. Araig G. Larson, Chair. - Date geed I;Ann Quirk;Clerk of the Town of Barnstable;:Barnstable County, Massachusetts, hereby certify' that twenty`(20)°days ha' Ve:elapse&since the Zoning Board of Appeals filed.this.decision and that no appeal;of he.decision has been filed in the office of the Town Clerk. Signed andsealed thisT-� day of perjury.. under the pains and penalties of. Ann Quirk, Town Clerk '4 i own of Barnstable • ASTABLE. • Assessing Division 'prE1:159. `� 367 Main Street,Hyannis MA 02601 www.town.barnstable.ma.us Office: 508-862-4022 Jeffery A.Rudziak,MAA FAX: 508-862-4722 Director of Assessing ABUTTERS LIST CERTIFICATION June 24, 2014 RE: Adjacent Abutters List For Parcel(s) : 186-066 707 South Main Street Centerville, MA. 02632 As requested, I hereby certify the names and addresses as submitted on the attached sheet(s) as required under Chapter 40A, Section 11 of the Massachusetts General Laws for the above referenced parcels as they appear on the most recent tax list with mailing addresses supplied. .Board of Assessors Town of.Barnstable I Zoning Board of Appeals (ZBA) Abutter List for Map & Parcel(s): '186066' Parties of interest are those directly opposite subject lot on any public or private street or way and abutters to abutters. Notification of all properties within 300 feet ring of the subject lot. Total Count: 16 Close Map&Parcel Ownerl Owner2 Addressl Address 2 Mailing Country Deed CityStateZip 185011 BAGLEY,THOMAS S %MATTIE,JAMES F& 10 BEAUMONT DR FOXBORO, MA SUSAN A 02035 C166127 185012001 CRAIN,RAMSAY E 5536 ISLEWORTH WINDERMERE, #D1218098 COUNTRY CLUB DR FL 34786 PATERNOSTER, SOUTH 185025 MICHAEL A JR& 48 CHATHAM HILL GLASTONBURY, 15375/049 LAURIE A CT 06073 18.5026 ANGELO,JOYCE 28 WAYSIDE INN FRAMINGHAM, 9389/165 RD MA 01701 185027 GROSSMAN, SUE-NAN TRUST 49 APPLE VALLEY SHARON,MA BARBARAITR DRIVE 02067 C138205 GOLDENBERG, %700 SOUTH MAIN 549 WEST WEST 186037 WILLIAM J& LLC FALMOUTH HWY PO BOX 399 . FALMOUTH, MA C184498 NELLIGAN,SUSAN 02574 186038 TRIPLETTE, 328INDERA MILLS WINSTON MARIANNE D CT SALEM,NC 20049/300 27101 186039001 BOUDREAU, MARK H %BARNSTABLE LAND PO BOX 224 COTUIT,MA PR TRUSTINC 02635 BA12PI762EA 186057 FLITTLETON, ROBERT JR 23 HAYWARD ROAD CENTERVILLE, C196845 MA 02632 186058 LANIGAN,CHARLES CENTERVILLE F 15 HAYWARD RD C145309 MA 02632 3 HAYWARD ROAD:. . CENTERVILLE, 186064001 CLEARY, LISA M TRS 3 HAYWARD ROAD REALTY TRUST MA 02632 C187741 SNOWDEN LEBEL 186064003 S HAYWARD RD . CENTERVILLE, LAURIE P--- : — -=-C179537 , .MA'02632-- - - 186065 ROMPALA;':RICHARD 7:4425 WATERS "SANIBEL FL M&.JEA'N M EDGE LN 11168/345._.�.;. 33957 186066 GAVIN,JULIA B TR JULIA B GAVIN 14 HERON LANE HOPEDALE, MA TRUST 01747 C193691 CC&I PROPERTY p0 BOX 1144 186082 OSTERVILLE MA MGT,INC 25256/274 -- ------ 0265S 186083.'. RUBEL;IGOR& 543 BOYLSTON NEWTON, MA ANNA STREET 02459 27506/299 This list by itself does NOT constitute a certified list of-abutters and is'provided onlyas.an aid to the.determination of abutters:If a certiBedlist of abutters is required,contact the Assessing Division to have this list certified.The owner and address data on this list is from the Town of Barnstable Assessor's database as of 6/17/2614 i h //66.203.95.236/arcims/a eoa /A`butterRe ort.as x? e—ZBA - . ttP� PPg PP P P tYP — 6/17/2014 . i Town of Barnstable Geographic Information System a . 'i8so�5t7o2 #a3o i860s7 June 1& 2014 #64 TUbue 6 186092 186050 186078 206070 #U : 186043 #685 #571 #39 186039003206 185034 #12 #600 #6451 #0 186051 206095 206050 186039002 1860 #1187 186036005 42 186063 .,#615 #16 #5 #11 Q#630 #Oj 186036002#78. 186062\ #627 186041 �18600661 35001 #�2 1860 #633 186052 206052 #10D ' 186039001 0. #664 18GD40 #22 #0 #656 186060 20G05G001 186033 #66 #118 78G038.i•`:%?•"::`:'• :':.,- *31 / 188035002 / Bq 186059 �.� 206056002 74 186036D01 ' #37 : •::..:. W#425 186053 YW #25 206059001 2 206057, 186032. #� 206059002 I / ' '., #47 20G059003 #78 '186037 ! {. <`,:- ;'_186058 i... #57 1 186071 186036004 186036003 #7.. 1 !/ /•'•. ;, ! :#.15 #69' 185070 -,. 4�i r;r�f.}fij/ /i r ,/ �i? �.� l •'°mot q� ✓� y!y , =• •• - / 186081 186056 2D6058 #41 #40 #90, `7 186074001 186CaG40pa .185057: 61 � .r•.a.:. �''> .`J SGDr22� ° '`y. ��;t>f.; �''`.'�j,' 206001 I 186 186068 F-r F>J ri$6A0i4OQ4206 186069002 -#33 186074 #55• #49 i 18608 186067 #59, r.18 DBG r f ���::.;_'•'' �2D6002 Q ry r 206003 #5N r #19' 1 S' Yi /J//^,x{ ! !✓ l,�i " #212 185008 r # 07, //; / ! '•i;,• #200 185060 #814 #780 1850109760 185058 I E# . 185 8 009 ' -! -%aSF %"'• ;. ! %i!! ! %%-S"!i,, " aY< 7r220 50 24 51505 205034 3 04 05 205006 #196818 7 #218185057 , #816 18500 185007 O tt •;iv: ;; ;...: 05203021 #210250#7 1 Q50#8 #796 2 185061 02 l 26 204 J 18 5 I! •r r-� D2 U 07 j` " #24a Q :: $ -#7+t0 '' !:'i%%;.'-::;•;" G� 205029 %% � 5 j:::, 89 18 Q #19 5 18 5 SO 0 5 13:6 -;` N O y, "% `% %i'; ':%''; 185D27 c #189 !!i .i : ;:: 205030 i 185014 ® :I #205 185026 205031 #789 185025 .9280 205032 9�229 185053 185024CND 92 • 185031 1#B 49 #�*39 # ' #0 185015 ! _!#3D6 .: #0 186D78 #819 �185032 186030 g 185023 1F 269 #259 il5gon #312 185033 #803 /. 186036 185034 #2R3 #0 185035 #293 I i #309 DISCLAIMERS.This map is for planningPurposes y 4 g t rp oses only. It is not adequate for legal Map 186 ` Parcel:066 Zoning Board of Appeals(ZBA) boundary determination or regulatory m[erpretation. Enlargements beyond a scale of 1—100'may not meet established map accuracy standards. The parcel lines on this map Abutter Li]t Type Parties of interest are those directly Opposite subject lot on Selected Parcel h� are only graphic representations of Assessor's tax parcels. They are not true property any public Or prlV3te Street Or Way end abutters t0 abutters..Notification boundaries and do not represent accurate relationships to physical features on the map such as building locations.. properties within'300 feet ring of the subject lot. otlfication of all Abutters EJ 11V F Buffer JJ� ; l t e TOWN OF BARNSTABLE - ZONING BOARD OFAPPEALS - TOWN OF BARNSTABLE s :� }, Mn NOTICE OF PUBLIC HEARINGS DER THE ZONING ZONING BOARD OF APPEALS UN is ` ORDINANCE „ NOTICE OF PUBLIC HEARINGS UNDER THE ZONING, `T JULY9 2014 l ORDINANCE hir1 l To all_persons interested in.or affected:by the actions of z f Zomng-Board of iAppeals you are hereby notrfied. pursuant i .Ta all persops`mterested_m or affected by the actions of the to Section 11 ofyChapter.40A of the;General Laws of the:,. Zoning Board.of Appeals:you are hereby notifietl pursuant-, Commonwealth of-Massachusetts and all amendments thereto :+ to $echon 11-6f Chapterf40A of the General.Laws of ae_- that a pubhc heanng on the following appeals wtll be held on I Commonwealth.of Massachusetts antl all amendments thereto, Wednesday July 9 2014 et thg Line+ndicated that"a pubhc heanng pn the following appeals.will be held on" i 7 OO:PM Appeal•No 2014-036 700 South Maui,LLC Wednesday July 9 2014 at`the lime jndtcated 700 South Marn"LLC has applied fora;variance from Section 7:00 PM Appeal No 2014 036 700 South Main LLC w 240 7(D)Lot Shape FactodRes+dent+al Districts The Applicant; 700 South„Main LLC he's applied for awanance from Section proposes to dmdeae exts{+fig developed property:pursuant to' 240J(D) Lot Shape FactorlRestdenttal Districts iThe Applicant '. Massachusetts General Law Chapter 41 Section 81(L) into two= proposes to dtvtde the ex+sLng developed prop'e'rty pursuant to lots w+fti one ewsting dwelling!on each proposed lot The two Massachusetts.General Caw Chapter 41 Secton 81(L) into two proposed lots exceed the shape factor requirements ofthe Zomng I lots wdh one existing dwelling on each proposed lot The;iwo .'_ Ordinance antl variance relief is ste requetl for both proposed lots- proposed lots exceed the shape factor[egwrements of the Zomng , The property+s located at 700 Maln Street Centerville MA as I Ordinance and Variance relief Is requested for both proposed lots shown on Assessor`s Map 186as Parcel 037 It is located in theme The,properly is.located at700 Main.Street Centerville,MA as Residence D 1 and;Resource.Protechon Oyeday Districts I shown`on Assessors Map 186 as Parcel 037,If;fs located in`the 7 01 PM`Appeaf No 2014 037 Gavrn, Residence D 1 land Resource Pr`otechon Overlay Districts Julia 6 Gavin Trustee of the Julia B Gavin Trust has peUhoned ) 7 01 PM Appeal No 2014 03T Gavin r ' r for a Special<Permtt pursuant to Secbori'2401314 Craigville:; Julia B'Gavin;Trustee of,the Juha.B Gawn Trust'has petiboried _ Beachspistnct,use regulations The;petiboner is?propo sin g;l fon,a Special!permit pursuant to Section 240-1314 Craigville �' ___ _ ______ to demolish an existing camage house..w+th hvmg:space and Beach D+stnct use regulations Tfie oehhoner, is or000sing zr reconstruct a two story flood cdmphanf:attached strpctura with a j to`demolish an;existing-camage house with hying space_ano + tnree=car garage on-inenrst�i qor and frvirig space on=thp second_-- reconstruct a::' story hood compliant attached istructuru:with a t floor.Tfie property,isaocated of+707 South"Ma n Street Centerville, -thra�car garage on thz first floor_and'liwng sparz on the second MAis shown on Assessor's Map 186 as'Parcel 066.Itis located in floor.The properly is located at 707 South.Main'Street;Centerville; ft.Oraigville Beach District(CBD)and the Centerville River North . MA as shown on Assessor's Map 106 as Parcel 066:It is located in. Bank Neighborhood: the Craigville Beach District(CBD)and the Centerville;River North These;public hearings will;be held at,the Barnstable Town. Bank Neighboihood s l `' --'" Hall„367 Main Street HyanmslMA Hearing RoomIocated on=r p g ::These ublicheann swill be held'at the Barnstable Town _ the 2nd Floor Wednesday:July 9 2014 Plans.and:apphcatwns. Hall;367 Mam;Street hlyann+s MA, f tearing f?oom located`on ma/be;rAnewed at he Zonmg;Board of Appeals Office Growth the2nd Floor:VVednesdayJuly 9,2014 Plans grid apphcatonS Management Department Town Offces 200 Main Street may::bereweWe'datthe2onin `Board`.ofAppealsOffice Growth 9 Hyannis MA , Management Department. Town Offices 200 Main Street,.' ` rs }x� u ,+ CraiO G Larson Chair Hyannis MA. � r 7 {F t"t a ' Zoning Board of Appeals. { f Craig G'.Larson Chair ,The eamstable Patriot� I yi J � •Zoning Board ofAppeats tJune 20'and June 27 2014 The Barnstable'Patrlot n _ June 20 and,June 27 2014 -1qzF/11, TOWN OF BARNSTABLE Building Department - Foundation Permit Date IIh' I /y Permit # e20JYo777/ , v Name Location 70 SoLk-rH mNT-t�j sT C�nnZKvS1.l.E 17-171 Insp. of Bldgs. - PROJECT Z .NAME ADDRESS: PERMIT# PERlSM DATE: Lp M/P: 1�fTD LARGE ROLLED PUTS 'ARE IN: SLOT �3 Data entered in MAPS program on BY q/wpfiles/forms/are,hive: � L t: Commonwealth of Massachusetts Sheet_Metal Permit 51-7l i� Map_ Parcel Date: 4AZO/ Permit# 02®/,� y — Estimated.Job Cost: $ /1 !Q-D Permit Fee: $ 3 0 Plans Submitted: YES NO APR 2015NST� �Reviewed: YES NO . - Business License# 4r Z TOWN OF BAA Applicant License# l l/7 Business Information: Property Owner/Job Location Information: Name:ae-C., /1 y1li�K, 14c Name: ,�i I e� s� ��✓i r/�v l Street: 2e / Orr-el LN Street: City/Town: o e ash Cc O Z��13 City/Town: CeAt.7-e-.-Y/ Telephone: ",T-1 6 Telephone: Photo I. qed/Copy of Photo I.D. attached: YES NO _ Auffal J-1 L-I-unr:e:stric:t:ed�license J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less Residential: 1-2 family-Z Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial Educational Fire Dept.Approval Institutional_ Other Square Footage: under 10,000 sq. ft. over 10,000 sq. ft. Number of Stories: Sheet metal work to be completed: New Work: Renovation: . .._ HVAC, -- -,.-Metal-Watershed-Roofui Kitchen°ExhaustS stem Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: L/M 0 0 Ij 2 / 0 9t_,oVaA 5 fik 2- �,e�e r PC re c PIP,r eLla r, i INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes No ❑ If you have checked YU, indicate the type of coverage by checking the appropriate box below: A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ Ili OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box ,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. f Duct inspection required prior to insulation installation: YES NO Progress Inspections Date Comments Final Inspection Date Comments Type of License: By Master Title ❑ Master-Restricted Cityrrown ❑Journeyperson Signature of Licensee Permit# ❑Journeyperson-Restricted License Number: Fee$ Check at www.mass.agy nl Email: LC U S A ti,t Fa l`a l: /derma, Inspector Signature of Permit Approval Me Commonwealth of Massadhae fs D epar&uwt of Indusdrial Acddnr& Office c f`lum igations 6#0 Washington&heet Boston,,M4 02111 wwtv.ma:mga►l X �`arkers'Ct mpensa m Insw=ce Aifidav&B=Mers/CenbmctwvTJe--Uu anwPlumbers Applicant In�rnaa an Please Print 7�ibly Dame = �1 --,� �'► S%�N L x C Add€ew 2?^r.re r zl y _. City/SU&ip: Qe y Z 7Y? Prue gr-- -5 9 y Are you an employer?Checkthe appropriate bo= T)Te of project(required): L ICJ I am a P a 1 �� 4- ❑I am a general contractor and I � 3"�' 6. ❑Neyv employees(fall an&or pmt-txme).* have hired the sub-co tr� 2.❑ I am a sale przp detour or partner Fisted on the attached sheet. 7. ❑Remodeling _ ship and hsve no employees these sub-txintracturs have g ❑Demolition emplolrees andhatm wod s' . wort-ing forme.in air capacity 9_ ❑Building addition [No-;va,: s'comp.insurance comp,ins- I 5. ❑ We are a corporation and its 1 ❑Electrical or additions d officers ha;re exercised their 1I_ Plumbic or additions 3.❑ I am a htnneotaaer doing all t�� ❑ g�� myself- -o workers' rtglrt ofeaempttonpertVlGL 12-❑Roofrepairs r c-I52,§lQ%and we have no ins�ce regauedj t � �._❑Otheremployees-[No workers camp.insnance required-] *Any appZi tbu cbeda bm#1 nmst also M out floe section below 9asrin &*wwsTrets' fimPUBU ML Hamwwaessahosubmitthisaffdxmindkatintheyaredoigx[want==&mbimou&&contaac=m3imtsnb=a new affidsF indicatin-snob. �Cautaactors that cberf thi�baoc mast attacb6d maddition3l sheet s�o�ainsthenameafthe sob-cam and rduexLetl�ocnott pose emitieshsse employees. If the sab-conUactoa hm en ayees,&q mastpw%dde they woc",comp.Ply mmibec. I am an eanp3ra er that ispmM4 nvrkers'co n vrsetra�cca,fnr tray atetpdol�ass. Below is fha pa irs and jail site ttrfarvta�n. . Insurance Policy#or Self--ins.Lic ;* � 76 2 Z ' EKpizatiouDate: Z d s Job Site Mdrass: 7-7 ML CifylStawzip: Attach a copy of the worhers'emnpensatitm polity declaration page(showing the policy amber and elpiration date). Fatluse to secure coverage as required under Section 25A ofMGL c 152 can lead to the imposition of Criminal penalties of a fine up to$1,50D OD andlos one-yearimprisanu as well as civil penalties in the form of a STOP WORK ORDEF,and a fine of up to$250.00 a stay against the viol Be a&ised that a copy of this statement may fiommrded to the Office of Irrve stigations of the DIA feu coverage vetidm I do hereby >Fdar the dpenahyes ofpredwy that the i jvtvr wYon prari&I eba�IS a its hne and correct: Date:. 0 Zo l Phone# Obeid use only. Do not write an this area,to be cvmpWed by tat}or town o,,�`idal- City or Town: FermitUcense k Issuing.Authority(tarots flue): L Board of Health 2.Building Department 3.CiWrown Clerk 4.Electrical Inspector 5.Plumbing Inspeetor 6.Other Contact Person:` Phone th 7^ ' Information and Instructions ` Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pmsuant-to this staff,an w playee is defined as"_.every person in the service of another under any contract of hire, express or implied,oral or wriiten." An employer is defined as"an individual,partnership,association,corporation or other legal eafity,or any two or more of the foregoing eagaged 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 th=iu, or the occupant of the . dweIlIIig house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurteoarit thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Iocal licensing agency shall withhold the issuance.or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work-until acceptable evidence of compliance with the insurance.. requirements of this chapter have been presented to the contracting arrfhoiity." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partn=s,are not required to carry workers' compensation insuimce. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance ce license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has.provided a space at the bottom of the affidavit for you to fIl out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in.the permWlicense number which will be used as a reference irumber.-In.addition,an applicant that must submit multiple permitdicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)_"A copy of the-affidavit that has been officially stamped or marked by the city or town maybe provided to the ' applicant as proof that a valid affidavit is on file for future permits or licenses_ A new affidavit must.be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would hie to thank you in.advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Depaiime fs address,telephone and fax number. ThD CGmm nwealth-of Massachusetts Department of Industrial Accidents Qfiice of Intvesiigatiow 600 wawnpia Strut Bash MA Q�I II Tcl,#617-'27-4900 cxt 406 or 1�-'�-MASSAFF, Fax#�617-` 27-7749 Revised 424-07 .m.�,{_gav1dia t s�xsresr.�. 16 9. ,m� Town of Barnstable, QED MI+�a Regulatory Services j Richard Scali,Director Building Division - Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.iown.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230- Property Owner Must Complete and Sign This Section If Using A Builder Pensm C6 GJ as Owner of the priY sub ro e J .P hereby authorize '46US/niv� N��( Ste.t_PM'5 R C to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) 2 > 20/5— SigtfgLte of Owner Date 6 CO�S�/� -7i3y Print 14ame If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:\WPHLESTORMS\building permit fonns\smokecarbondetectors.doc Revised 040714 THE t �F down of Barnstable Regulatory Services 9 g Richard V.Scali,Director $A i63y. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home hone# p work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER ' Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building hermit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\smokecarbondetectors.doe Revised 040714 :COMMONWEALTH OF MpSS/tHUSETTS : fi F RID-0FF � „' SHEET MEfiAL WORfitEE S WITS' sISSUfS T HE��FOLLOWINGxLIENSE ; .SCOTT A ,T1MM$ lklg 177777 iA+CUSHNET AfiH S`� TEMSIKC �� Z PO BOXd3fl1Ols AC1J5FNET MA02 43" ' � , r t ` COIVjAi ' ° �NwEALT,1 N r SOARp p SHEEN SSUESk T M L TWO KEMSsd HE FYOLuLOWI Nor AS , 1 AST �* ,�r G t ECE, � 3 , ER 'NNR4S�TR S1. 0 Ix bS. ylfi 318fl10 ACORO" DATE(MMIDDNWY) CERTIFICATE OF LIABILITY INSURANCE . 04/30/2015 7HfS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATEMOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(fes) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT J.K. Olivieri Ins. Agency PNAMNE John Mario Olivieri FAX 64 East Grove St. LAIC,No. o E :508-947-1818 (A/C,No): Middleboro, MA 02346 ADDRESS: John Mario Olivier! INSURER(S)AFFORDING COVERAGE NAIC i 1NSURERA:NGM Insurance Co. 14788 INSURED Acushnet Air Systems, Inc. INSURERB: Scott/Donna PO Box 30101 wsuRER c Acushnet, MA 02743 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW,HAVE.BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE' AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. RPOLICY EFF POLICY EXP LTR TYPE OF INSURANCE I SD POLICYNUMBER MMIDD MMIDDIYY LIMITS COMMERCIAL GENERAL LIABILITY. EACH OCCURRENCE $ CLAIM MADE OCCUR D GE TO RENTED PREMISES Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PEa F-]LOC PRODUCTS-COMP/OP AGG $ OTHER: $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) ' - $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ ' DED RETENTION $ $ WORKERS COMPENSATION X STATUTE ER H AND EMPLOYERS'LIABILITY Y/N . A ANY PROPRIETORIPARTNEWEXECUTIVE WC078242 09/66/2014 09/06/2015 E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? Y❑ N/A - (Mandatory in NH) E.L.DISEASE-E4 EMPLOYEE $ 100,00 Han describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Donna Timms is excluded from workers compensation coverage. CERTIFICATE HOLDER CANCELLATION TOWNBAI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE. Town Of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main St ACCORDANCE WITH THE POLICY PROVISIONS. _ Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and'logo are registered marks of ACORD CUSTOM INSULNTIOJSJ COMPANY, IN C. 16 Jacques Street— Rear, Worcester,Massachusetts 01603 (508) 755-2315 Or Fax(508)756.1941 On May 5, 2015 Custom Insulation installed the following at 707 Main St Centerville MA Roofline Slope — R-49 11.1 " Agribalance Open Cell Foam Cathedral Slopes —R-42.3 9.5" Agribalance Open cell Foam Exterior.Walls - R20 4.5" Agribalance Open Cell Foam Garage Ceiling — R30 6.75 " Agribalance Open Cell Foam Garage Exterior Walls — R20 3" HeatLok Closed Cell Foam Overhang — R30 4.5" Heatlok Closed Cell Foam Attic Slopes — Blazelok IB4 Ignition Barrier Dave Winslow Custom Insulation 617-839-7274 —T M e Assessors ma and lot number ./&..... ..........0 c y m MU T {�, � p .. C�i`��i �I�d�1 i THE MAX I �y Sewage Permit number .r., Q.6:..... VAM�- ... ►,��, o,► � i +rr' "TO_... �'149S1tTf�n...e h n.e +B�d9TADLE, i House number .........�..`....:-7 ...............7!../......... _ ` " 90 ') n8 e O 1639• '>TE p YpY a' ►U1_- TOWN OF BARNSTABLE 50,01ACT TO APPROVAL OF • r^,;NSTABLE CONSERVATION? BUILDING INSPECTOR �ejfjJ1SSION APPLICATION FOR PERMIT TO ....... .,. .. ...........Mf TYPE OF CONSTRUCTION .........f�� �?.. ':.. �. .................................................:............................... x ..............t,... ............................19 �.*r'�f ��r.`'.,.ti�._.�,'a�.�' �..J+�.+4.YC iy 9A7"'.:r�}I►+..<+.s..- �. ,.- 'x+5���:. 's-.ro.,guvva y - TO THE I�S EC R OF BUILDINGS: The undersigned hereby applies for(/a permit according �to� the followiinn information: x Location ........... .o-7...........:50-,..�1.��/t�,�.. ..St.. ....C 5.lead'.Kr... 7............................................... Proposed Use ........ . i 'L.�<!•� .... •< �f/��.�G. .... 1.10*11 � ...� e Zoning District ................ � .� ld�l....................Fire District s rl/� -.&R?4 y••:/•�/J,� ................ Name of Owner ..................Address �.�....���(LJ.(�.�11�<.�O�.:l./dl���;�!�;�•%���'....... Name of Builder .. �/�aG�r<�•./7�.:.. ... ® . ..... ................Address `�Q.. .2 ... GJ� � . 414?�Wo�,4/ Name of Architect Address Aw ,,Number of Rodns Ft...............03.........................,....................Foundation ................ f✓ ..................................... ' Exterior ......... .Roofing l •SFL0Y. 6-G1. y�� _ v Floors .........1-Xa�.: WO..v4l ................................. Interior �� .. . . Heating #....... ..... � ......Plumbin _. g ............ ... ......... ................ Fireplace ..................... ........................................................Approximate Cost ...../-1/421..aQo..... ........ ...................... Definitive Plan Approved by Planning Board ------------------—-----------19--------• Area ........... ... .£ �. ' Diagram of Lot and Building with Dimensions. Fee ......... r SUBJECT.TO APPROVAL OF BOARD OF HEALTH (26 s. 1 av 30r . i P� 4, X J •- �r-R � a'( �R� •yfi Y� t I hereby agree to conform to all the"Rules and Regulations of the Town of Barnstable regarding the above construction. /�Y - Name:-rG.l........................ ............. ......................... . ..... .. .. . REVECH, MELVIN Attorney 22018 Remodel No ................. Permit for .................................... Building ............................................................................... 707 South Main Street Location ................................................................ Centerville ............................................................................... Owner Attornpy...MQJV ............. ...... Type -6f Construction ....Er-ame,......................... ................................................................................ Plot ........................... Lot ................................ A March 4 , 801 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ............ 19 PERMIT REFUSED ..... 19 .............................................................. ............................................... ............................................................... ej ............................................................... pooved...................... ........................... 19 . ........................... ................................................... ................................... ....................... r � ti TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map d �O Parcel Permit# O Health Division go f (& � /��— b � Date Issued 00 Conservation Division '9LI17_�. )chi {. "L, FeeAl ^° _ -• Tax Collector Treasurer _ �� ff 9 p� 64 E 1N Planning�Dept. / E� V1R0N WITH TITLE 5 Date Definitive Plan A rb ed-b -Plannin Board s G T'� L Ri Historic-OKH Preservation/Hyannis Project Street Address �l�' SD li�} /�? /ICJ S7k_ 6� T kA/?/? � Village I!f Owner GO L4 Address -707 .S. 121 AIAJ S � Telephone r�_ �� o?��/�9 �, 3l� i� / / 3/6 —a?O 7 7" Permit Request JhZ3— �0P_ ­-S i Square feet: 1st floor: existing7A proposed _Y tP e- 2nd floor: existing proposed Total new Valuation Oe Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 3/ 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 111,6her A 0/1)-- Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing_ new a_ Total Room Count(not including baths): existing 3 new. First Floor Room Count .3 Heat Type and Fuel: ❑Gas ❑Oil LYElectric ❑Other, Central Air: ❑Yes ZN Fireplaces: Existing NMT Existing wood/coal stove: ❑Yes 2'N0 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# CurXent Use Proposed Use UJAJtF)0- BUILDER INFORMATION Name T "" Telephone Number Address 12/ Z2 License# ome Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY FPERMITNO. DATE ISSUED MAP/PARCEL NO: ' ADDRESS VILLAGE OWNER y DATE OF INSPECTIO FOUNDATION FRAME INSULATION r G FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH - FINAL GAS: ROUGH FINAL - FINAL BUILDING ' DATE CLOSED OUT, r ASSOCIATION PLAN NO. i t ; • 4 . ll } Y rr-- Engineering Dept.(3rd'floor) Map �' �P Parcel c(AP Permit# T House# Date Issued Board of Health(3rd floor)(8:15-'9:30/,1:00-4=) ff--/d t!;� VO'Ll Conservation Office 4th floor 8:30-9.30/1:00,-2:00) 1- w. . ( )( 9 Pf., oFneuId Planning Dept.(1st floor/School Admin. Bldg.) �IHE SEPTIC SYSTE Definitive Plan Approved by Planning Board `: - ._19�1�STi4LLED IN G TOWN OF BARNST WITH TITL F039.a�� �3 (•0897 B .,k. ., m��NMENTAL C �® . q '. Building Permit A--lication T®WN REC LATIMS Project Street Address so.X G 1 YX -S'Vr` kQ - ` -- (Z 2 LSQL Village 4(\/- 0C �-' Owner 3 O '1 \to U A► � (Ojil Address OU N m\rN y-S vc L U 5 A-n c S Y Telephone L?l v Permit Requests �p�2 Le- -�- Sc-r tee �.c k- ;—�x ��tL-) 't eg L , k oy 16 XZ A-Oo meo �a.nA`a0-e_ -lroUje r— i�oX 5� a,.,Q for G. She p CA--F--po&T 2 0 0 -: Apo F t I o° a' �fX �,� odd ` + h aJ,' i.n iUr Q �e�tu M �rJ �v-Ka,� L• c�rr� o�-e_,w First Floor ruare feet Second Floor '/sy�( r quare feet Construction Type wQQC� E tr-er�l �, c✓ of s Estimated Project Cost $ 020U vDU- UO Zoning District RtSlt %f al Flood Plain A14 Water Protection /UQ Lot Size 2q1 Grandfathered ❑Yes ❑No Dwelling Type: Single Family 2 Two Family ❑ Multi-Family(#units) Age of Existing Structure t U O ± Historic House ❑Yes "A No On Old King's Highway ❑Yes ANo Basement Type: M' ull ❑Crawl ErWalkout ❑Other Basement Finished Area(sq.ft.) IS y Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing I New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New / First Floor Room Count Heat Type and Fuel: E(Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing o2 New Existing wood/coal stove ❑Yes 31 0 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 5fio If yes, site plan review•# Current Use SlAes.,L AMA Of W Proposed Use Builder Information Name M j Cha d S• cS(,t 1 w-0 j Telephone Number SOS 933- 98 g3 Address 2 -Z nj JAG k tr-mP J-I.1ghQU f )W,License# C 5 U b(, : -3�- 05 �7Gt�'IG�UiI G{7 M 4 0dS3 7- Home Improvement Contractor# Worker's Compensation# A/A- NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �e Sce U -CZ v a SIGNATURE DATE /T 2 BUILDING PERMI•T DENIED FOR THE FOLLOWING REASON(S) ,a FOR OFFICIAL USE ONLY _ PERMIT NO. DATE ISSUED MAP/PARCEL NO _ ty ADDRESS' VILLAGE' - _ ' •,°„ - ..z OWNER DATE OF"INSPECTION: f _ FOUNDATION FRAME C7 , INSULATION FIREPLACEtj t ELECTRICAL: ; ROUGH �: "' .,' FINAL PLUMBING: ' RQUH G »4 FINALy: a ' FINAL'.' GAS: RQQJ-. •_ 4 FINAL BUILDING 0 f+yy •V ♦4 DATE CLOSED OUT + ` ASSOCIATION PLAN NO. � Board of Buildin a ulations one Ashburton P ace, m 1301 Boston; iV1aw.02 1'08-1 1-8 License: CONSTRUCTION SUPERVISOR-LICENSE Birthdate: 02/06/1961 : Number: CS 056737 Expires:02f05/"001~: Restricted To: 00 MICHAL L S SULLIVAN 333 Q[1AKFR MEETINGHOUSE — F.SANDWICH, .VIA 02537. Tr.no: 707 0 . . Keop top for.reaipt and chin of qe adoress:notiflcation. 12 .^L r Zl;A t ,,. k. w �''�, � t � irfl �� �V���G[MGGWCI►e[RJ` ° i � .t � c 3 , ��, ,y �4 F 4 yy '' ! a Y rry {'y^^7V 7".4� ' -Hli'i 11R[1„iFMEhT C[�fgiTR (CAS I1~GTS�CTI i. �� r� ti d z. t"5I�Ed�ic� l- { BQar�I p Btt'� S,cJ (ICt �u n II of F RA -rr� � �r-"� h i. n r � kQ11` H :p':.fai Illiui V � �,�Zi L S s '21 r of Pr N�� L f �y.R ,fir, ,�-� fi4ni•11y�4 kti"'3'V l��YTIA_.dr.Y ki i �..,'s.�'I Iz./�,r ,� xJ"X Z 741 YJX Y—'�u , NOIII"�.ZMpRQ41EI'iliNT �40�aTRA,Cft�, �' P .�` .. k��l.�����.Y--141 �,�, r ,r'k��L �L��`I I�Ilsl �_ ^ i � »r• * }tr d ]f R�'�f� � 4�4��.T(�1L SQ11- x ��J,�U�fV�� ,, r n x r 3�1 '( 11�f`_fiFR M iNFiG�itF A Ir 1lJTt h I I1A 0"':� '3 n' z y �x ? �. IFr11ElJTICS p L✓—'� ram+—=.�—�"r —{ .vim .r--.r.+—.. � :. ,.. .... �� _ PH@LBIROOK ' ENGINEERING & 107 BEACH STREET ENGINEERING t►71,tl , ` ,`o DENNIS, MA 02638 CONSTRUCTION 1.508-385.8682 s ENGINEERING DESIGN • CONSTRUCTION INSPECTIONS • SUILDING, ALTERATIONS A RENOVATIONS 12 July 1999 ! To: 'Town of Barnstable Attn: Mr. Ralph Crossen Fuilding Commissioner Hyannis, Massachusetts 02601 r - re: Residential Frame 6 Floodzone Foundations 707 South .gain Street Centerville, MA Dear .Sir: in accordance with Para 116.2 and 116.2.2.3 of the Massa•uhugetts State Building Code this let- ter shall serve as documentation for the materials and itisfactory c:oMPletion of the floodzone found- . ati nd bujLlding frame. The construction is in adh- . to F =arcs prepared by Mike Sullivan and sealed w/ cev.sions through 1.2 March 1999. The following elevations have not changed; original 1st floor xs at 11.9 ft ,and the new addition floor is at 11 .1 ft. Both are greater than the minimum required. elevation 'of 11 .0 ft (BF"E Zone A13) . In a3ditlon equalization opening ,e been installed and all mechanical equipment, 3otrical. panels have: v� :n snowed above the BY. 1st Floor. I have performed continua- ..ate inspections during the work period from 21 DEC 98 thru the ' present time. I certify that the foundation and frame. have been constructed IAW the Massachusetts State Building Code and will be suitable for their designed use. Respectfully submitted, �it1 OF \ p y F'FIILf3ROOKy r a ►.1CCHANICAL T. VARNUM PHILBROOK, P.E. K!o. 301690 ' FSS/OAS{ '•� C(D ` r i . d , ° r C,O MAScheck COMPLIANCE REPORT Massachusetts Energy Code I Permit MAScheck Software Version 2 . 01 Rel.-e-ase 2 j -Checked `by%Da.te. CITY: Sandwich STATE : Massachusetts HDD: 6137 CONSTRUCTION TYPE : 1 or 2 Family, Detached HEATING SYSTEM.TYPE : Other' (-Non-Electric Resistance) DATE : 2-24-1999 COMPLIANCE : PASSES Required UA = 394 Y Your Home = 343 Area, or Cavity ' "Cont , Glazing/Door - Perimeter' R-Value R-Value U-Value ------------------- --- ---------------------- ---- -- -------- CEILINGS y _ 184 30 _0..._ 30 . 0 WALLS : Wood Frame, 1611• O. C. 593 �11 . 0 11 . 0 WALLS : Wood Frame, 1611, O. C. 316 11 . 0 11 . 0 WALLS Wood Frame, 16" C:C. `' 376 11 . 0 12 11 . 0 WALLS : Wood Frame, 16" � , C', 568 _ 11 . 0 �3 11 . 0 WALLS : Wood Frame, 1611 O. C'. 80 - 11 . 0. 11 . 0 WALLS : Wood Frame, 16 'O. C. 240 11 . 0 11 . 0 BSMT:. Conc . 8 . 0 ' ht%6 , .0 ' bg/8 . 0 ' insul 184 11 . 0 11 .,0 GLAZING: Windows or Doors 544 0 . 360 1 FLOORS : Over Unconditioned Space 560 . 15 . 0 19 . 0 ------ -------------------------- ----------------- - COMPLIANCE STATEMENT: . The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application . The proposed building has been designed to meet the -requirements of the .Massachusetts Energy Code . The heating load for this building: and the cooling load,.if appropriate, has been determined using the ,applicable Standard Design"Conditions found in the Code . The HVAC equipment selected to heat or cool the building - shall be no greater than 125o ;of the design load as specified in Sections .780CMR ' 1310 and J4 . 4 . t 1 Builder/Designer Date • I MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permii MAScheck Software Version 2 . 01 Release 2 I Checked I CITY : Sandwich STATE : Massachusetts HDD : 6137 CONSTRUCTION TYPE : 1 or 2 Family_ Detached HEATING SYSTEM TYPE : Other (Non-Electric Resistance) DATE : 2-24-1999 COMPL I ANCE--.-.--PASSES Required UA = 394 Your Home = 343 Area or Cavity Cont . Glazir Perimeter R-Value R-Value U-Va: -------------------------------- ---- - ----------------- CEILINGS 184 -- - 30 . 0 WALLS : Wood Frame, 16 " O . C . 593 11 . 0 11 . 0 WALLS : Wood Frame, 16 " O . C . 316 11 . 0 11 . 0 WALLS: Wood Frame, 16 " O . C . 376 11 . 0 11 . 0 WALLS : Wood Frame, 16 " O . C . 568 11 . 0 11 . 0 WALLS : Wood Frame, 16 " O . C . 180 11 . 0 11 . 0 WALLS : Wood Framer 16 " O . C . 240 11 . 0 11 . 0 BSMT : Conc . 8 . 0 ' ht/6 . 0 ' bg/8 . 0 ' insul 184 11 . 0 11-1D GLAZING : Windows or Doors 544 0 . 3E FLOORS : Over Unconditioned Space 560 19 . 0 19 . 0 -------------------------------------------------------------------- COMPLIANCE STATEMENT : The proposed building design described here : consistent with the building plans, specifications, and other calcu: submitted with the permit application . The proposed building has be designed to meet the requirements of the Massachusetts Energy Code . The heating load for this building, and the cooling load if appropr: has been determined using the applicable Standard Design Conditions in the Code . The HVAC equipment selected to heat or coal the build: shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4 . 4 . Builder/Designer Date 1 L r F " �A vt- e-.e-,rr row A �vU" o ✓l f ra o o k- 11 , o -0-e j a+ o v-i' , w. V ✓�� P e(cu kd n LV t �1 !,/\.(/�_ �(J• _ `r �) l�1 V�. V l��-�„ J � I �Ir�.: Q f 11,0 1 � F r L w TabieJS:Zlb(eoaufened) . ! Prea gdive Paekatp for One and Twe-Fan*Reddeatid Budding Sated with Fad Fads MAXIMUM MINIMUM Glazing Ceilingg Wall Floor g� Slab N�B��B Areal(X) U.vWue R.vallml R value' &valuer won P E d=W' p� Rrvaluet &value ` 5"1 to 6500 Heating Degree D&W QPill, 12% M40 39 13 19 10 6 Normal R2% 0.52 30 19 19 10 6 Normd s2•A OJO 38 13 19 t0 6 U AFUE T5% 036 38 13 2S WA WA N� U5% 0.46 38 19 19 10 6 Normd v59A- 0.44 3'5 19 &a iiiA WA 25 AFUE W % 0.32 1 30 19 19 10 6 8S AFUE x 1110/1 032 38 13 23 WA WA Namud Y 1119A 0.42 38 19 2S WA WA Normal t 18% 0.42 33 13 19 10 6 90 AFUE AA IrA 0.30 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: ]021 Sow MA 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING. 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: q-forms-i980303a 780 CMR Appendix J Footnotes to Table J5.2.1b: ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space, but excluding opaque doors)to the gross wall area, expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 ft of decorative glass may be excluded from a building design with 300 if of glazing area. 2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with die National Fenestration Rating Council (NFRC) test procedure, or taken from Table JI.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. ' The ceiling R values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness-over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for 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 fu.i.nwaitinwsa—.--n 4 f{.a S.swNlotaA nArt;n"Af tho Mnf - WY YVWNVVY J�/YYV Yr WV..YuwM.wr j.Y...-.r'Wall R values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing,and interior drywall. For example,an R 19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawispaces,basements, or garages).Floors over outside air must meet the ceiling requirements. `The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements•are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to 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 J5.2.la NOTES: a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested- and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. 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.c., have a U-value S*+eater than 0.35). c)If a ceiling,wall, floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with lies if the area-weighted averse R value is greater than or equal to different insulation levels, the component comp gh g the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 ``°F a y` 3 �13199 T. VARNUM c PHILBROOK �J ISIL I o MECHANICAL v. a�'d'1 l l�Y� o. 30 9 I �Jo�ANAL� Z 1'� 1� o-t S. VLAAAA STYL�-i-r- Cs,-vA-krJdU-, Na 2IAL+' WAt�L StV rr nn ,. Q Q 2ov ldl.Q- S v 1,1. S�,Prl, f>."T• S I LA- 0 Lo(.k�N� Zx4� S�Io��oo�t. 3/�} T�� S�I�•�V - - . - _� �,-�wu.a -�'lo0 5�$�' sib-���� To l S-r S ZY 6 p.-r sit.%- 446` SILL ;FI- T� R �-ffl [91 Pj I lb lob 11•�'' a a t� <__,-_ .. ns a�- -}o p .-rr d I�'' (�►vtc,►�LfE whw 1�o-ram. pro JU-a- aAs P(u S a p o e a EMI SAD ITI rJ a ct A,t�-t� 7., � K I S7 I IJ G W k L L/ ---� e� PHILBROOK ENGINEERING & CONSTRUCTION 101 BEACH STREET Proje COLE Renovations DENNIS, MA 02638 Projec - 1-508-385-8682 Date: 25 January 1999 Design .Note Work,ups �! Sht . No. Description C4 ----------------------------------- FF #1 Provide Simpson H2. 5 hurricane clips at all. single point 1/2 rafter connections #2 Allow no horizontal joints in plywood sheathing w/in 110" Green above and below wall plates. Reduce (maintain) all panel edge boundary nailing @ 6d o/c w/ 8d ring-shank nails #3 Increase size to 12" dia. to provide dead-load anchorage #4 Provide Simpson PB44 direct _place or ABE44 bolt-down bases Deck Deck Header; 3-1/2"x 9-1/4" ParalLam beam pressure treated 1 to Service Level 2. Run continuous for 30 '+/- #6 Provide elevation step of 2-1/2" #7 Thru bolts; as stated but increase to 5/8" w/ washers on EE #8 Continuous 16ft 6"x 6" #1 or BTR PT SYP posts #9 Use Simpson PB66 direct place or ABE66 bolt-down bases #10 Space lags or anchors @ 24" o/c #11 Use Simpson- LUS28 galvanized hangers #12 Post Piers; 12" dia. sono-tuibe w/ 4 ea #4 vertical bars ex- tending from 12"x 216" square tooter pad. Adjust height out of ground to allow use of single 16 ft 6"x. 6" posts continuous to roof band box above covered porch #13 At each end only - Install 4"x 6" #2 or BTR PT SYP strut . brace @ 45 deg angle mid-height from lower level only. This will bolt to box beam & joist above w% 4% ea 1/2" carriage bolts and butt bolt to the 61,x* 6" post. w,/ 1 bolt F #14 As shown, pair- of 14" MicroLam L.V.L. split on cripple wall' 2-1 and run continuous for 30'+/-. Connect to center column w/ pair of Simpson H6 tie-down straps #15 Center Column;. 411x 8" aligned in wall. Width needed to pick-up spread of cripple wall/L.V.L. assembly above #16 End Columns; 4"x 4" or 3/2"x 4" built-up in•*exterior walls F: 1 #22 In-Wall Headers; 2/2"x 10" w/ 1/2" CDX built in °the bottom of the wall above exposed floor joists above. This carrys stepped-in walls of 2nd floor ,dormer #23 Flush Wall Beam; 5-1/41'x 11-1/4" ParalLam beam connected to joists w/ Simpsons based on width of joists 419. Run. continuous for 30 '+/- #24 Main Floor Beam; '/"x 11-1/4" ParalLam beam run-continuous over support columns. , Connect to posts w/ 3,/4"x124:' drift pins set in pre-drilled 5/8" auger holes from the- top down #25 Flush Floor Beam; /"x 11-1/4" ParalLam beam to support the 4"x 8" post load from above. ' Auger & pin to center column #26 Sun Room Header; 3-1/2"x 9-1/4" ParalLam beam to support the 4"x 4" post load 'from above. Provide double jack studs #2'/ 2nd Floor Joists; 1-3/4"x 11-1/4" ParalLam @ 210" o/c #28 Flush Floor Beam; At kneewall load points upsize joists to 3-1/2"x 11-1/4" ParalLam member #29 Addition Girt; 3/2"x 10" PT SYP or 5-1/4"x 9-1/4"PT ParalLam beam, eithet to be continous. Connect to support post w/ Simpson PC series post caps #30 Girt Posts; 6"x 6" #1 or BTR PT SYP posts #31 Flush Ceiling Beam; 5-1/4"x 11-1/4" ParalLam beam connected to joists w/ Simpsons .LUS28 flush hangers. Provide 4"x 6" I #30 Girt Posts; 6"x 6" #1 or BTR PT SYP posts #31 Floor slab equalization breaks - 4 ea 12" square clay tile or wood box liners w/ crushed gravel pack Found #12 Post Piers; 12" dia. sono-tuibe w/ 4 ea #4 vertical bars ex- ation tending from 12"x 216" square tooter pad. Adjust height out of ground to allow use of single 16 ft 61'x 6" posts continuous to root band box above covered porch beam, eithet to be continous. Connect to support post w/ Simpson PC series post caps #31 Floor slab equalization breaks - 4 ea 12" square clay tile or wood box liners w/ crushed gravel pack #32 Breakaway Panels; 1 ' 8" wide by 1 ' 81' tall - wood louvres w/ rigid insulation or pop-out panels on magnetic catches. Set invert of opening no higher than 6" above crawl cap PHILBROOK ENGINEERING & CONSTRUCTION 107 BEACH STREET Project: COLE Renovations DENNIS, MA 02638 Project No: P98-81 1-508-385-8682 , Date: 28 January 1999 Glu-Lam Beam Substitutions Sht. No. Description ----------------------------------------------------------------------- #19 Ceiling Rafter & Deck/Roof Joists; 3-1/8"x 9-5/8" GLB rated 24F-V3 SP/SP. Space members 36" o/c. No taper cuts allowed. After decking sleepers will be regiured to shape roof over rigid insulation DECK Eastern Species - Commercii3,$ or Select; 211x 6" nominal in either solid or laminated built-up. Controlled random layout installation OK; #23 Flush Wall Beam; 5-1/8"x 11" GLB rated 24F-V3 SP/SP. . Clip to joists w/ Simpsons based on width of joists #19. Run continuous for 30'+/- Y #24 Main Floor Beam; 7"x 12-3/8" GLB rated 24F-V3 SP,/SP run continuous over support columns. Connect to posts w/ drift pins set in pre-drilled 5/8" auger holes from the top down #25 F1ush ,Floor. Beam; same as 124 above; 711x 12-3/81' GLB 4" . x ' post load from above. auger & pin to center column #26 Sun Room Header Beam - same as #19 above; 3-1/8"x 9-5/8" GLB rated 24F-V3 S$/SP. Provide double jack.%ptuds #27 2nd Floor Joists; 3-1/8"x 9-5/8" GLB rated 24F-V3 SP/SP. Space members 24" o/c. No taper #28 Flush Floor team Q kneewall) ; 5-1/8"x 9-5/8" GLB. rated rated 24F-V3 SP/SP. Provide double jack studs #31 Flush Ceiling Beam; 5-1/8"x 11" GLB rated 24F-V3 SP/SP. Clip to joists w/ Simpsons LUS28 flush hangers y E? S� r "` t 3 V a r r BRAMAN & HANDY ENGINEERING, INC. eee 258 Main Street, Unit A-1, Buzzards Bay, MA 02532 - 508.759.8273 January 22, 2004 Town of Barnstable Building Department 200 Main Street Hyannis, MA 02601 RE: Joss Hill Whedon& Kai Cole SE3-4154 Propsoed Jet Ski Floats—707 Main Street, Centerville To Whom It May Concern: Enclosed please find Barnstable Conservation Commission's Order of Conditions approving the above referenced project. Please have the appropriate municipal official sign form G and return in the s.a.s.e. If you have any questions please call. Sincerely, Robert A. Braman Jr. r The Commonwealth of Massachusetts Department of•Industrial Accidents ., _ 600 Washington Street ar Boston,Mass.. 02111 !Workers' Compensation Insurance davit name: G L vUl location 1-7 6- ff t city l3�,z 0 17 6( phone# 1 [] I am a homeowner performing all work myself. am a sole proprietor and have no one working in any capacity //%%/%%%//////%%%%%% /% %%%%%//////% %% /%///%%%%%%%%%/////O/%%%%%%%%%%%%%//%%%%%%%%%/%�/%%��%%///.D//%///%%/,//..., I am an employer providing workers' compensation for my employees working on this job. com any name: r address: city phone#- insurance co. Pn11cV# ❑ 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; com anv name, address: city phone#- olicv# insurnnce cm -//.% %ME /0/0 rnmpanv name* address city- phone#• insurance co. :;<;,....:......;....•.... Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a tine up to S1.500.00 and/or one years'imprisonment as well as civil penalties the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that s copy of UdS statement may be forwarded to .O cc of Investigations of the DIA for coverage verfIIcation. I do hereby certify un r the pains an pen 'es of perjury that the information provided above is tru.-and correct �/�ignature to Print name f,r,. 0 r -e i S 14 ( � ► llG'Y1 Phone# omc al use only do not write in this area to be completed by city or town official city or town: permit/license 0 Mudding Department ❑Licensing Board ❑eheekifimtnediate response is required ❑Sdectrnen'a O1dce ❑health Department contact person• phone#-, ❑Other (mvuea 9/95 P1A) i Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers* compensation for their "law", an employee is defined as every person in the service of another under any comrac employees. As quoted from the 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 . ee of an individual, partnership, association or other legal entity, employing employees. However the owner of a trust dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of ...�.e_.,4..,P..,.,t.,.,a rip-T-Cm,c rn(in maintenance , construction or repair work on such dwelling house or on the grounds o: 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 renew of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who ha 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 beC\ 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 olicy, please call the Department at the number listed below. are required to obtain a workers' compensation P �//////// 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 permivUcense number which will be used as a reference number. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call• "<;% // M 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) 7274900 eat. 406, 409 or 375 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Paoouc�R [ ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE NORCROSS & LEIGHTON INC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR H1'TP: //WWW.Iv'LINS . COM ALTER THE COVERAGE AFFORDED 8Y THE POLICIES BELOW. 437 STATION AVE COMPANIES_AFFORDING COVERAGE — S YARMOUTH MA 02664 ; COMPANY _ __ _ __---• _.�__. A -- TTHE HARTFORD _`-- INSURED COMPANY M I CHAEL SULLIVAN _ B -- _._� —_. -•----- -- -------- — DBA AUTHENTICS COMPANY 321 QUAKER MEETINGHOUSE RD �_ ..... _— - ----- --- SANDWICH MA 02563 rCOMPANY D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.CO TYPE OF INSURANCE POUCY NUMBER i POLICY EFFECTNE POLICY EXPIRATION LIMITS ILTA I DATE(MMIDONY) DATE(MMIDDIYY) I GENERAL LIABILITY ON 'ORDER 2 O 9 9 1 0 0 0 GENERAL AGGREGATE �a4 � 4 00 , 000 X COMMERCIAL GENERAL LIABILITY PRODUCTS•COMP/OP AGGl a4 J O O O Z O 0 0 CLAIMS MADE LJ OCCUR PERSONAL!!,ADV INJURY a 2 O O 0 , 0 O O OWNER'S A CONTRACTOR'S PROT' EACH OCCURRENCE $�� OO 0 r 0 0 0 FIRE DAMAGE(Any one firo) a 300, 000 — i MED EXP(Any one Person)— a 10, 000 AUTOMOBILE LIABILITY !�COMBINED SINGLE LIMIT > ANY AUTOOWNED AUTOS ;BODILY INJURY ALL OY� / S SCHEDULED AUTOS (Per person) 1HIRED AUTOS I BODILYINJURY ^ a NON-OWNED AUTOS I(Per acmdent) J- _—_—. f I PROPERTY DAMAGE a GARAGE LIABILITY + IAUTO ONLY•EA ACCIDENT S_� ANY AUTO I k[ER THAN AUTO ONLY: I EACH ACCIDENT S`_ — —, �- _ -- _ AGGREGATE.'S EXCESS LIABILITY i EACH OCCURRENCE a ll AGGREGATE UMBRELLA FORM OTH LA ER THAN UMBRELLA FORMU. WORKERS COMPENSATION ANO TO Y LIMtT9 EMPLOYERS'LIABILITY I �EL EACH ACCIDENT— THE PROPRIEfORI INCL I r EL DISEASE-POLICY LIMIT_ PARTNERS/EXECUTNE OFFICERS ARE: EXCI EL DISEASE-EA EMPLOYEE a OT1ifR i I DESCRIPTION OF OPEIIATIONSILOCATIONSNEHICLES/SPECIAL ITEMS - ........-7... .•--�.+...-r.-�..... /�1!�1/��y i :::::x<::::�::.:?:r.::...:.::::.-:::r•. :::::;:>'i:::7•ir'..`:i:!:::>ii;<;•;%•i>.:i:i�'ac;::i'i:i�3i ::•. . ::;;:••:::;,5>r:;::o:�>tr:+'•:.:;:::...:.>::x.14:;:::;::::»>::::::::>::::>�.:�:::::s;::.:...:.�:.:?1+.!\17,SI,iri.;,;::-'.n�;<•::::r,:::::.:v..::•..•:.:::.:.:::.:•.::......:... ... .......... ..... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOnE THE TOWN OF 13ARNSTABLE EXPIRATION DATE THEREOF, THE ISSUINO COMPANY WILL ENDEAVOR TO MAR 1 O DAYS WRRTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 367 MAIN STREET BUT FAILURE TO MAIL$UpfN TICE HALL IMPOSE NO OBLIO ON OR uABILrrY HYANN I S MA 02601 OF ANY KIND UPON PANv ITS AGENV, '�_6sS S. T TIVE AUTHORIZED REPfit:8e11TAm 6Lrv� I h� son Mauna0. h C .....:.:::. ..>:.....;...::.::.....:.:: :.,..,..,:,; s1S8 ' +ri The Town of Barnstable 1"96 �g Department of Health Safety and Environmental Services Building Division 367 Main Sttt et,Hymmis MA 02601 Ralph Crossen Office; 308-790-6227 Building Commissioae Fax: 508-790-MO For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, moderni=tion. conversion. improvement, removal, demolition, or construction of an addition to any Pre-existing owner occupied building containig �a��o`building but be done by registered ore than four lling units contractorsor to with structures which are adjacent to suchg certain exceptions.along with other requirements. T e of Work: ' Est.Cost ' b YP Yn k Address of Work: S' Owner's Name` Date of Permit Application- 2 9 I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law _Job under SI.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 PPROGZAM OR G W ORK DO NOT � ACCESS TO THE ARBITRATION FUND UNDER MGL 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a.permit as the agent of the owner: l Regist mtion No. DateContractor Name OR Date Owners Name kilevra�ior? Cp1��; ` �� Massachusetts Department of Environmental Protection �oF DEP File Number: Bureau of Resource Protection - Wetlands rsrAB WPA Form 5 - Order of Conditions SE3-4154 v�A 1639. `0� Provided by DEP lF Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and Town of Barnstable Ordinances Article XXVII A. General Information Important: From: When filling out forms on Barnstable the computer, Conservation Commission use only the tab key to This issuance if for(check one): move your cursor-do ® Order of Conditions not use the return key. ❑ Amended Order of Conditions r� To: Applicant: Property Owner(if different from applicant): Joss Hill Whedon & Kai Cole Name Name 1000 Amherst Avenue Mailing Address Mailing Address Los Angeles CA 90049 City[Town State Zip Code City/Town State Zip Code 1. Project Location: 707 South Main Street Centerville Street Address City/Town 186 066 Assessors Map/Plat Number Parcel/Lot Number 2. Property recorded at the Registry of Deeds for: Barnstable County Book Page 149440 Certificate(if registered land) 3. Dates: May 21, 2003 September 23, 2003 Jai° 2004 Date Notice of Intent Filed Date Public Hearing Closed Date of Issuance 4. Final Approved Plans and Other Documents (attach additional plan references as needed): Revised Site Plan Sept. 23, 2003 Title Date Title Date Title bate 5. Final Plans and Documents Signed and Stamped by: Robert Braman, PE Name 6. Total Fee: $50.00 (from Appendix B:Wetland Fee Transmittal Form) Wpaform5.doc•rev.10/7/03 Page 1 of 7 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions SE3-4154 �p 1639. �0� Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP ffn n�o+a and Town of Barnstable Ordinances Article XXVII B. Findings Findings pursuant to the Massachusetts Wetlands Protection Act: Following the review of the above-referenced Notice of Intent and based on the information provided in this application and presented at the public hearing, this Commission finds that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that apply: ❑ Public Water Supply ® Land Containing Shellfish ® Prevention of Pollution ❑ Private Water Supply ® Fisheries ®Protection of Wildlife Habitat ❑ Groundwater Supply ® Storm Damage Prevention Flood Control Furthermore,this Commission hereby finds the project, as proposed, is: (check one of the following boxes) Approved subject to: pP 1 ® the following conditions which are necessary, in accordance with the performance standards set forth in the wetlands regulations, to protect those interests checked above. This Commission orders that all work shall be performed in accordance with the Notice of Intent referenced above, the following General Conditions, and any other special conditions attached to this Order. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, these conditions shall control. Denied because: ❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations to protect those interests checked above. Therefore, work on this project may not go forward unless and until a new Notice of Intent is submitted which provides measures which are adequate to protect these interests, and a final Order of Conditions is issued. ❑ the information submitted by the applicant is not sufficient to describe the site,the work, or the effect of the work on the interests identified in the Wetlands Protection Act. Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides sufficient information and includes measures which are adequate to protect the Act's interests, and a final Order of Conditions is issued. A description of the specific information which is lacking and why it is necessary is attached to this Order as per 310 CMR 10.05(6)(c). General Conditions (only applicable to approved projects) 1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. Wpaform5.doc•rev.10/7/03 Page 2 of 7 t„E Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: &MINSTAB WPA Form 5 - Order of Conditions sE3-4154 >Knas i639 ,0� Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP and Town of Barnstable Ordinances Article XXVII B. Findings (cont.) 4. The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: a. the work is a maintenance dredging project as provided for in the Act; or b. the time for completion has been extended to a specified date more than three years, but less than five years, from the date of issuance. If this Order is intended to be valid for more than three years, the extension date and the special circumstances warranting the extended time period are set forth as a special condition in this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this project shall be clean fill. Any fill shall contain no trash, refuse, rubbish, or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the foregoing. 7. This Order is not final until all administrative appeal periods from this Order have elapsed, or if such an appeal has been taken, until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Order has become final and then has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. In the case of the registered land, the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done. The recording information shall be submitted to this Conservation Commission on the form at the end of this Order, which form must be stamped by the Registry of Deeds, prior to the commencement of work. 9. A sign shall be displayed at the site not less then two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection" [or, "MA DEP"] "File Number SE3-4154 " 10. Where the Department of Environmental Protection is requested to issue a Superseding Order, the Conservation Commission shall be a party to all agency proceedings and hearings before DEP. 11. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of Compliance (WPA Form 8A) to the Conservation Commission. 12. The work shall conform to the plans and special conditions referenced in this order. 13. Any change to the plans identified in Condition 412 above shall require the applicant to inquire of the - Conservation Commission in writing whether the change is significant enough to require the filing of a . new Notice of Intent. 14. The Agent or members of the Conservation Commission and the Department of Environmental Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours to evaluate compliance with the conditions stated in this Order, and may require the submittal of any data deemed necessary by the Conservation Commission or Department for that evaluation. Wpaform5.doc•rev.1077/03 Page 3 of 7 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: STABM WPA Form 5 - Order of Conditions SE3-4154 �p i639 ♦0 Provided by DEP rFor,,,p�A Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and Town of Barnstable Ordinances Article XXVII B. Findings (cont.) 15. This Order of Conditions shall apply to any successor in interest or successor in control of the property subject to this Order and to any contractor or other person performing work conditioned by this Order. 16. Prior to the start of work, and if the project involves work adjacent to a Bordering Vegetated Wetland, the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging. Once in place, the wetland boundary markers shall be maintained until a Certificate of Compliance has been issued by the Conservation Commission. 17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have be en en fully stabilized with vegetation or other means. At no time shall sediments be deposited in a wetland or water body. During construction, the applicant or his/her designee shall inspect the erosion controls on a daily basis and shall remove accumulated sediments as needed. The applicant shall immediately control any erosion problems that occur at the site and shall also immediately notify the Conservation Commission, which reserves the right to require additional erosion and/or damage prevention controls it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of work line has been approved by this Order. see attached Findings as to municipal bylaw or ordinance Furthermore, the Barnstable hereby finds (check one that applies): Conservation Commission ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw specifically: Municipal Ordinance or Bylaw Citation Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides measures which are adequate to meet these standards, and a final Order of Conditions is issued. ® that the following additional conditions are necessary to comply with a municipal ordinance or bylaw, specifically: Article 27 of Town Ordinances Municipal Ordinance or Bylaw Citation The Commission orders that all work shall be performed in accordance with the said additional conditions and with the Notice of Intent referenced above. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, the conditions shall control. Wpaform5.doc•rev.1017/03 Page 4 of 7 SE3-4154 Cole Approved Plan= September 23, 2003 Revised Site Plan by Robert Braman, PE Special Conditions of Approval I. Preface Caution: Failure to comply with all Conditions of this Order of Conditions can have serious consequences. The consequence may include issuance of a stop work order,fines,requirement to remove unpermitted structures,requirement to re-landscape to original condition,inability to obtain a certificate of compliance, and more. The General Conditions of this Order begin on page 2 and continue on pages 3 and 4. The Special Conditions are contained on pages 4.1,4.2 and 4.3 if necessary.A11 conditions require your compliance. II. Prior to the start of work,the following conditions shall be satisfied: L Within one month of receipt of this Order of Conditions and prior to the commencement of any work approved herein,General Condition number 8(recording requirement)on page 3 shall be complied with. 2. It is the responsibility of the applicant,the owner and/or successor(s)and the project contractors to ensure that all conditions of this Order are complied with. The applicant shall provide copies of the Order of Conditions and approved plans(and any approved revisions thereof)to project contractors prior to the start of work. Barnstable Conservation Commission-Forms A and B shall be completed and returned to the Commission prior to the start of work 3. General Condition 9 on page 3 (sign requirement)shall be complied with. 4. The Conservation Commission shall receive written notice 1 week in advance of the start of work. 5. The Natural Resources Dept.shall be notified at least 21 working days prior to the start of work at the site, to inspect the areas for shellfish. If deemed necessary by the Shellfish Constable,shellfish shall be removed from the work area to a suitable site and/or replanted at the locus following construction. The foregoing measures for shellfish protection shall ensue at the expense of the applicant. III. The following additional conditions shall govern the project once work begins. 6. General conditions No. 12 and No. 13 (changes in plan)on page 3 shall be complied with. 7. The Conservation Commission,its employees,and its agents shall have a right of entry to inspect for compliance with the provisions of this Order of Conditions. P.4.1 8. This permit is valid for 3 years from the date of issuance, unless extended by the Commission at the request of the applicant.Caution: a future Amended Order does not change the expiration date. 9. Herbicide,pesticide and fertilizer use is discouraged on lawns within Conservation Commission jurisdiction. If fertilizer is used,only slow-release low-nitrogen fertilizer shall be applied. Over-fertilizing shall be avoided. 10. No creosote-treated or CCA-treated materials shall be used. 11. The seasonal storage of floats shall be at a suitable upland site. Floats shall not be stored on banks,marshes or dunes. The following special conditions in italics shall govern boat use at the approved pier. These conditions shall continue over time. Note: For purposes of this Order of Conditions,the term"pier" shall refer not only to the linear pile-supported structure,but also to any of its components or appendages such as the float(s),ell,tee,ramp,outhaul piling,etc. 12. Boats shall only be berthed at the float. 1 13. No boat shall be used or berthed at the approved pier such that at any time less than one foot of water resides between the bottom of the boat(or engine in drive position)and the substrate. IV. After all work is completed,the following condition shall be promptly met: 14. At the completion of work,or by the expiration of this Order,the applicant shall request in writing a Certificate of Compliance for the work herein permitted. Barnstable Conservation Commission Form C shall be completed and returned with the request for a Certificate of Compliance Where a project has been completed in accordance with plans stamped by a registered professional engineer,architect,landscape architect or land surveyor,a written statement by such a professional person certifying substantial compliance with the plans and setting forth what deviation,if any,exists with the record plans approved in the Order shall accompany the request for a Certificate of Compliance. At the time of the request for a Certificate of Compliance an updated sequence of color photographs of the undisturbed buffer zone shall be also submitted. P .4.2 I Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands BARNSTABLF = WMASPA Form 5 - Order of Conditions sE3-4154 �A19 ,0�' lf1639. Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP and Town of Barnstable Ordinances Article XXVII B. Findings (cont.) Additional conditions relating to municipal ordinance or bylaw: see attached This Order is valid for three years, unless otherwise specified as a special condition pursuant to General Conditions #4, from the date of issuance. Date This Order must be signed by a majority of the Conservation Commission. The Order must be mailed by certified mail (return receipt requested) or hand delivered to the applicant. A copy also must be mailed or hand delivered at the same time to the appropriate Department of Environmental Protection Regional Office (see Appendix A) and the property owner (if different from applicant). Signatures: On 7_ Of UTa�Qr ay� Day Month and Year before me personally appeared to me known to be the person described in and who executed the foregoing instrument and acknowledged that he/she executed the same as his/her free act and deed. Ak--a---I, Notary Public My C(Immissfon Expires - This Order is issued to the applicant as follows: ❑ by hand delivery on by certified mail, return receipt requested, on Date Date Wpaform5.doc•rev.7/22/03 Page 5 of 7 j ,►+E r Massachusetts Department of Environmental Protection DEP File Number: o� Bureau of Resource Protection - Wetlands 8 = WPA Form 5 - Order of Conditions SE3-4154 �A ,'bey Provided by DEP rEo,9.a Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and Town of Barnstable Ordinances Article XXVII C. Appeals j The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject to this Order, 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 DEP Regional Office to issue a Superseding Order of Conditions. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and a completed Appendix E: Request of Departmental Action Fee Transmittal Form, as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this Order. 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 Order which is being appealed and how the Order does not contribute to the:protection of the interests identified in the Massachusetts Wetlands Protection Act, (M.G.L. c. 131, §40) and is inconsistent with the wetlands regulations (310 CMR 10.00). To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. D. Recording Information This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions. The recording information on Page 7 of Form 5 shall be submitted to the Conservation Commission listed below. Barnstable Conservation Commission C Wpaform5.doc•rev.1017/03 Page 6 of 7 Massachusetts Department of Environmental Protection P "o, Bureau of Resource Protection - Wetlands DEP File Number: MASS. WPA Form 5 - Order of Conditions BARN gam' ` SE3-4154 �A 1639. ♦0� Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP JfD MA'S a and Town of Barnstable Ordinances Article XXVII D. Recording Information (cont.) Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission. --------------------------------------------------------------------------------------------- To: Barnstable Conservation Commission Please be advised that the Order of Conditions for the Project at: 707 South Main Street, Centerville SE3-4154 Project Location DEP File Number Has been recorded at the Registry of Deeds of: County Book Page for: Property Owner and has been noted in the chain of title of the affected property in: Book Page In accordance with the Order of Conditions issued on: Date If recorded land, the instrument number identifying this transaction is: Instrument Number If registered land, the document number identifying this transaction is: Document Number Signature of Applicant Wpaform5.doc•rev.1017/03 Page 7 of 7 4 Generated by REScheck-Web Software Compliance Certificate Project 707 South Main St Centerville MA Energy Code: 2012 IECC Location: Centerville (Barnstable), Construction Type: Single-family Project Type: Addition Orientation: Bldg. faces 270 deg. from North Climate Zone: 5 (6131 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: - Designer/Contractor: 707 South Main St Nitenson Construction Inc Centerville, Massachusetts 01632+ 247 Daly Dr. Extention ° Stoughton, Massachusetts 02072 617-549-7154 jay.nitenson@verizon.net Compliance: 6.6%Better Than Code Maximum UA: 151 Your UA: 141 The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. ' Envelope Assemblies 'e.�r%"• °' Ceiling: Cathedral 1,142 49.0 0.0 0.022 25 Floor:All-Wood Joist/Truss Over Uncond.Space 1,088 30.0 0.0 0.033 36 Wall: Wood Frame, 16in. o.c. 312 21.0 0.0 0.057 16 Orientation: Front Window:Vinyl Frame, 2 Pane w/Low-E 30 0.300 9 Orientation: Front Wall: Wood Frame, 16in.D.C. 208 21.0 0.0 0.057 11 " Orientation: Right side _ Window:Vinyl Frame,2 Pane w/Low-E 16 0.280 4 Orientation: Right side Wall: Wood Frame, 16in. D.C. 312 21.0 0.0 0.057 14 Orientation: Back Window:Vinyl Frame, 2 Pane w/Low-E 58 0.280 ' 16 Orientation: Back Wall: Wood Frame, 16in. D.C. 168 21.0 0.0 0.057 10 Orientation: Left side Project Title: 707 South Main St Centerville MA w Report date: 10/14/14 Data filename: Pagel of 9 Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2012 IECC requirements in REScheck Version 5.5.0 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. r Name-Title Signature Date Project Title: 707 South'Main St Centerville MA Report date: 10/14/14 Data filename: Page 2 of 9 J REScheck Software Version 5.5.0 Inspection Checklist Energy Code: 2012 IECC Requirements: 0.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. Section Plans Verified Field Verified # Pre-Inspection/Plan Review Value Value Complies? Comments/Assumptions & Req.ID 103.1, ;Construction drawings and P ❑Complies ; 103.2 documentation demonstrate ❑Does Not [PR1]1 ienergy code compliance for the (� ;building envelope. ❑Not Observable ; ❑Not Applicable 103.1, ;Construction drawings and ❑Complies 103.2, :documentation demonstrate ❑Does Not 403.7 energy code compliance for ` [PR3]1 lighting and mechanical systems. a ❑Not Observable ; i Systems serving multiple []Not Applicable ;dwelling units must demonstrate ;compliance with the IECC i Commercial Provisions. 302.1, Heating and cooling equipment is;, Heating: Heating: ;❑Complies ; 403.6 sized per ACCA Manual S based Btu/hr Btu/hr ;❑Does Not [PR2]2 on loads calculated per ACCA• ; Coo lin Cooling: Manual J or other methods g' ; :❑Not Observable .O Btu/hr Btu/hr ❑Not Applicable approved by the code official. Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) " Project Title: 707 South Main St Centerville MA Report date: 10/14/14 Data.filename: Page 3 of 9 2012 IECC Foundation Inspection Complies? Comments/Assumptions 303.2.1 A protective covering is installed to ;❑Complies [FO11]2 protect exposed exterior insulation :❑Does Not and extends a minimum of 6 in. below grade. '❑Not Observable ❑Not Applicable 403.8 Snow-and ice-melting system controls;❑Complies [FO12]2 installed. ;❑Does Not ❑Not Observable;• ❑Not Applicable Additional Comments/Assumptions: r 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: 707 South Main St Centerville MA Report date: 10/14/14 Data filename: Page 4 of. 9 f Section Plans Verified Field Verified # Framing/Rough-In Inspection Value Value Complies? Comments/Assumptions & Req.ID 402.1.1, ;Glazing U-factor(area-weighted ; U- U- :❑Complies :See the Envelope Assemblies 402.3.1, average). ;❑Does Not :table for values. 402.3.6, ;❑Not Observable 402.5 ;❑Not Applicable [FR2]1 r 303.1.3 ;U-factors of fenestration products w "y -. ❑Complies [FR4]1 :are determined in accordance ❑Does Not with the NFRC test procedure or w ❑Not Observable ' taken from the default table. ; ❑Not Applicable 402.4.1.1 ;Air barrier and thermal barrier ❑Complies [FR23]1 installed per manufacturer's ` ❑Does Not _ instructions. - ❑Not Observable ; ❑Not Applicable 402.4.3 :Fenestration that is not site built 10Complies [FR20]1 •is listed and labeled as meeting ❑Does Not AAMA/WDMA/CSA 101/I.S.2/A440 ❑Not Observable ; i or has infiltration rates per NFRC 400 that do not exceed code ❑Not Applicable limits. 402.4.4 IC-rated recessed lighting fixtures ❑Complies [FR16]2 sealed at housing/interior finish ❑Does Not A) and labeled to indicate:52.0 cfm leakage at 75 Pa. ❑Not Observable ❑Not Applicable 403.2.1 :Supply ducts in attics are ; R- R- ;❑Complies ; [FR12]1 :insulated to>_R-8.All other ducts : R_ R_ ;❑Does Not m unconditioned spaces.or ;❑Not Observable ,outside the building envelope are: ; insulated to>_R-6. ; ; ;❑Not Applicable 403.2.2 ;All joints and seams of air ducts, ❑Complies [FR13]1 air handlers, and filter boxes are ❑Does Not ;sealed. ❑Not Observable ; []Not Applicable ; 403.2.3 Building cavities are not used as ❑Complies ; [FR15]3 ducts or plenums. ❑Does Not []Not Observable ; 1 []Not Applicable 403.3 HVAC piping conveying fluids R- ;"R- ;❑Complies [FR17]2 above 105 QF or chilled fluids ;❑Does Not below 55 QF are insulated to>_R- 3 ; ;❑Not Observable ; ❑Not Applicable 403.3.1 Protection of insulation on HVAC ❑Complies ; [FR2411 piping. ❑Does Not []Not Observable ; []Not Applicable 403.4.2 Hot water pipes are insulated to : R- R- :❑Complies : [FR18]2 >_R-3. ;❑Does Not J :❑Not Observable ; ❑Not Applicable 403.5 Automatic or gravity dampers are ❑Complies [FR19]2 installed on all outdoor air ❑Does Not J intakes and exhausts. ❑Not Observable IE]Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) -2 1 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: 707 South Main St Centerville MA' Report date: 10/14/14 Data filename: .. Page 5 of 9 i . k 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: 707 South Main St Centerville MA Report date: 10/14/14 Data filename: Page 6 of 9 f Section Plans Verified Field Verified # Insulation Inspection Value Value Complies? Comments/Assumptions & Req.ID 303.1 All installed insulation is labeled 111complies (IN13]2 or the installed R-values El Not provided. ; ❑Not Observable ; ' ❑Not Applicable 402.1.1, ;Floor insulation R-value. R- R- :❑Complies ;See the Envelope Assemblies 402.2.E ; Wood Wood ;❑Does Not ;table for values. [IN1]1 Steel - ❑ Steel ❑Not Observable ; ❑Not Applicable ; " 303.2, Floor insulation installed per ❑Complies ; 402.2.7 manufacturer's instructions, and []Does Not [IN2]1 in substantial contact with the {underside of the subfloor. []Not Observable ; ❑Not Applicable 402.1.1, ;Wall insulation R-value.if this is a;. R- R- ;❑Complies :See the Envelope Assemblies 402.2.5, ;mass wall with at least lh of the []-Wood Wood Does Not ;table for values. 402.2.6 ;wall insulation on the wall ❑ ; (IN3]1 exterior,the exterior insulation Mass Mass ❑Not Observable (� ;requirement applies(FR10). ;❑ Steel ❑ Steel ;❑Not Applicable 303.2 ;Wall insulation is installed per ❑Complies [IN4]1 imanufacturer's instructions. ❑Does Not ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: t 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: 707 South Main St Centerville MA Report date: 10/14/14 , Data filename: Page 7 of 9 3 section Plans Verified Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.ID 402.1.1,4 ;Ceiling insulation R-value. R- . R- ;❑Complies ;See the Envelope Assemblies 02.2.1,40 Wood . ❑ Wood ❑Does Not table for values. 2.6 2,402. ❑ Steel El Steel ;❑Not Observable ; [FI1]1 ;❑Not Applicable 303.1.1.1,:Ceiling insulation installed per ❑Complies 303.2 manufacturer's instructions. ❑Does Not [FI2]1 , ':Blown insulation marked every 300 ff. ❑Not Observable []Not Applicable '402.2.3 Vented attics with air permeable ❑Complies [FI22]2 insulation include baffle adjacent ❑Does Not to soffit and eave vents that extends over insulation. [-]Not Observable []Not Applicable 402.2.4 ;Attic access hatch and door R- _ R ;❑Complies ° [FI3]1 insulation>_R-value of the. UDoes Not adjacent assembly. `:. ❑Not Observable ;❑Not Applicable 402.4.1.2 Blower door test @ 50 Pa. <=5 ; ACH 50 = ; ACH 50= ,❑Complies [FI17]1 ach in Climate Zones 1-2,and ❑Does Not <=3 ach in Climate Zones 3-8. i ❑Not Observable ' :❑Not Applicable ; 403.2.2 Duct tightness test result of<=4,; cfm/100 cfm/100 ❑Complies ; [FI4]1 cfm/100 f:2 across the system or ft2. ftz ;❑Does Not <=3 cfm/100 ft2 without air ❑Not Observable handler @ 25 Pa.For rough-in + tests,verification may need to A W ;❑Not Applicable ; occur during Framing Inspection. 403.2.2.1� ;Air handler leakage designated ❑Complies ; [FI24]1 ' 'by manufacturer at<=2%of- ❑Does Not ;design air flow. []Not Observable ❑Not Applicable 403.1.1 Programmable thermostats 10compiies [FI9]2 installed on forced air furnaces. ' '` JE]Does Not []Not Observable ❑Not Applicable 403.1.2 Heat pump thermostat installed ❑Complies [F110]2 on heat pumps. ❑Does Not V ❑Not Observable ; ❑Not Applicable 403.4.1 Circulating service hot water ❑Complies ; [FI11]2 systems have automatic or ❑Does Not accessible manual controls. - ❑Not Observable []Not Applicable' a 403.5.1 All mechanical ventilation system ❑Complies [F125]2 fans not part of tested and listed ❑Does Not HVAC equipment meet efficacy and air flow limits. []Not Observable []Not Applicable 404.1 75%of lamps in permanent ❑Complies 1 fixtures or 75%of permanent[FI6] � p r ❑Does Not , fixtures have high efficacy lamps. Does not apply to low-voltage ❑Not Observable; lighting. ❑Not Applicable 1 High Impact(Tier 1) 1 2 Medium Impact(Tier 2) 13 1 Low Impact(Tier 3) Project Title: 707 South Main St Centerville MA Report date: 10/14/14 Data filename: Page 8 of 9 . 4 section Plans Verified Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.ID 404.1.1 Fuel gas lighting systems have ❑Complies [FI23]3 no continuous pilot light. ❑Does Not ❑Not Observable ❑Not Applicable 401.3 Compliance certificate posted. ❑Complies [FI7]2 ❑Does Not ❑Not Observable ❑Not Applicable 303.3 Manufacturer manuals for ❑Complies [FI18]3 mechanical and water heating w ❑Does Not ; p systems have been provided. ❑Not Observable 10Not Applicable Additional Comments/Assumptions: ` r 1 High Impact(Tier 1) 2 Medium Impact(Tier,2) 3 Low Impact(Tier 3) Project Title: 707 South Main St Centerville MA Report date: 10/14/14 Data filename: Page 9 of 9 2012 IECC Energy r Efficiency Certificate Above-Grade Wall 21.00 Below-Grade Wall 0.00 Floor 30.00 Ceiling / Roof 49.00 Ductwork (unconditioned spaces): �=mwmft Window 0.28 „ Door -. Heating System: Cooling System: Water Heater: Name: Date-- Comments f , 1 U.s.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE FEDERAL EMERGENCY MANAGEMENT AGENCY OMB No. 1660-0008 National Flood Insurance Program Important: Read the instructions on pages 1-9. Expiration Date:July 31,2015 SECTION A-PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name Julia B.Gavin Trust 'Policy Number. " `9wo A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number. �7.0WSo'uth Main Street City Centerville State MA ZIP Code 02632 { A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) Barnstable Assessors Map 186,Parcel 66,MA Land Court Certificate 193691 -Plan 31731 B,Lot 1 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Residential ' t` A5. Latitude/Longitude:Lat.41-38-12.87 Long.70-21-11.78 Horizontal Datum: ❑ NAD 1927 ® NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 4 `A8. For a'building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 1408 sq ft a) -Square footage of attached garage 1087 sq It is b) Number-of permanentflood openings in the crawlspace b) Number of permanent flood openings in the attached garage ' or enclosure(s)within 1.0 foot above adjacent grade 0 within 1.0 foot above adjacent grade 7 c) Total net area of flood openings in A8.b 00_00 sq in c) Total net area of flood openings in A9.b 1400 sq in d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? Yes ❑ No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION Bl.NFIP Community Name&Community Number B2.County Name 'B3.State Barnstable 250001 Barnstable MA a g r B4.Map/Panel Number B5.Suffix B6.FIRM Index Date B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone 563 J July 16,2014 Effective/Revised Date Zone(s) AO,use base flood depth) July 16,2014 AE 13&14 B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in item B9. ❑ FIS Profile ®FIRM ❑ Community Determined ❑ Other/Source: B11. Indicate elevation datum used for BFE in Item 139: ❑ NGVD 1929 ® NAVD 1988 ❑ ,Other/Source: B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes ® No } Designation Date: ❑ CBRS ❑ OPA t SECTION C--BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings` ❑ Building Under Construction' 01 Finished Constructio8 'A new Elevation Certificate will be required when construction of the building is complete. �I I j C2. Elevations-Zones Al-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,ARIA,AR/AE,AR/A1 A30,AR/AH;AR AO.Complete Items;d2.a-h below according to the building diagram specified in Item A7.In Puerto Rico only,enter meters. Benchmark Utilized:GPSNET Vertical Datum: NAVD88 ( I i Indicate elevation datum used for the elevations in items a)through h)below. ❑'NGVD 1929 0 NAVD 1988 ❑Othef//Source: ' I t Datum used for building elevations must be the same as that used for the BFE. i Check the me surement Osed. l a)Top of bottom floor(including basement,crawlspace,or enclosure.floor) 3.50 ®feet [ImeteM b)Top of the next higher floor 1_0.24 ®feet ❑meters c) Bottom of the lowest horizontal structural member(V Zones only) [I feet ❑metef.j M d)Attached garage(top of slab) 6.2-0 ®feet ❑meters e)Lowest elevation of machinery or equipment servicing the building 3.50 ®feet ❑meters (Describe type of equipment and location in Comments) r f) Lowest adjacent(finished)grade next to building(LAG) 4.2 ®feet ❑meters I g)Highest adjacent(finished)grade next to building(HAG) 9.2 ®feet ❑meters h)Lowest adjacent grade at lowest elevation of deck or stairs,including structural support 4.2 feet ❑meters I SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information.I certify that the information on this Certificate represents my best efforts to interpret the data available. �.► ���� I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. ,ST�p�S���r P g P . y _ �`� LA G t ® Check here if comments are provided on back of form:. Were latitude and longitude in Section A rovided b a • y ❑ Check here if attachments: licensed land surveyor? ® Yes ❑ No ST4Et%_ s Certifiers Name Stephen Doyle license Number 37559 CD 'E cn�, t ,37-559 Title Land Surveyor Company Name Stephen Doyle&Associates o 'No. r Address 42 Canterbury Lane City East Falmouth State MA ZIP Code 02536 ►,. 0`SI3R � Signature Date 01-03-16 Telephone 508 540.2534 ���♦ ., FEMA Form 086-0-33(7/12) See reverse side for.continuation. Replaces all previous editions. 6 , ELEVATION CERTIFICATE,page 2. IMPORTANT: In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number. -_ 707 South Main Street City Centerville State MA ZIP Code 02632 Company NAIC Number. SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agenticompany,and(3)building owner. Comments This residential wood framed building has an enclosed basement(lowest floor).a separate crawl space area and an attached garage.There are three levels of first floor living space above the basement and crawl space area consisting of(1)an enclosed screened porch at elevation 10.84 feet,(2)one room of first floor living space at elevation 10.24 feet and the remaining first floor living area at elevation 1124 feet.Typical residential utilities are in the basement. Signature Date 01-03-16 SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items El-E5.If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C.For Items E1=E4,use natural grade,if available.Check the measurement used.In Puerto Rico only,enter meters. E1. Provide elevation information.for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawlspace,or enclosure)is . ❑feet ❑meters ❑above or below the HAG. . b)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or below the LAG. ' E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below"the HAG. 3 E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑meters ❑above or❑below the HAG. t E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑ Unknown.The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here.The statements in Sections A,B,and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's'Name I Address City State ZIP Code. t Signature Date Telephone Comments p ❑Check here if attachments: { SECTION G COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),and G of this Elevation Certificate.Complete the applicable'item(s)and sign below.Check the measurement used in Items G8-G10.In Puerto Rico only,enter meters. G1.❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor;engineer,orarchitect who y is authorized by law to certify elevation information'. (Indicate the source and date of the elevation data in the Comments area below.) G2.❑ A community official completed Section E for a building located in.Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3.❑ The following information(Items G4-G10)is provided for community floodplain management purposes. G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued 7 t G7. This permit has been issued for: ❑New Construction ❑Substantial Improvement G8. Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters Datum. t G9. BFE or(in Zone AO)depth of flooding at the.building site: ❑feet ❑meters Datum 610.Community's design flood elevation: ❑feet ❑meters Datum Local Official's Name Title Community Name Telephone i Signature Date Comments Check here if attachments. FEMA Form 086-0-33(7/12) Replaces all previo 11 us editions. t ELEVATION CERTIFICATE, page 3 Building Photographs See Instructions for Item A6. IMPORTANT: In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number. 707 South Main Street City Centerville State-MA ZIP Code 02632 Company NAIC Number. y If using the Elevation Certificate to obtain NFIP flood insurance;affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and 'Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, :as indicated in Section A8. If submitting more photographs than will fit on this page,use the Continuation Page. t Front View i . Photo Date 12.-05-15 , EF •�i Y p �it r ` � k n i I' t w=- r H_,�il z� G , I Rear View Photo Dater 12-05-15 FEMA Form 086-0-33:(7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page a Building Photographs; Continuation Page IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building'Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. PoIcy Numbers 707 South Main Street .., � A 'r City Centerville State MA ZIP Code 02632 Company NAIL Number ? =_ `I If submitting more photographs than will fit on the preceding page, affix,the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if.required;;'.Right Side.View" and "Left Side View." When applicable, photographs must show the foundation with:representative examples of the flood openings or vents,as indicated in Section A8. Garage Rear View Photo Date: 12-05-15 yr ROK� i 4 3 � i. y 4.r+• s4,wsv M ', �,.:� r Mrs *ram , •� x i K ` • x 1 4 FEMA Form 086-0-33(7/12)'` r. Replaces'all previous editions: ty �,• wM.W..�,w CL N .. - r.. O • cn •fir � ,gam 3 �� ���� . � c C {R r$ S� ay LOCU5 f,qy S LOCUS MAP ASSESSORS MAP: I&G PARCEL: GG REFERENCE CERT: 193G91 CB END. w 3 PLAN LEGEND REFERENCE PLAN: 31731 B NgS° FLOOD ZONE: AE 13 (BEE 13-14) FIRM PANEL: 250001 05G3 J PRELIMINARY MAP MAY 3, 2013 a : o � +v S�PTtC 5 �/� EXIST. SEPTIC TANK PUMP CHAMBER L ZONING DI:5TRICT: CBD_CRNB �P MINIMUM FRONT YARD SETBACK- 20' y !: D EXIST. DIST. BOX WITH MANHOLE TO GRADE MINIMUM SIDE YARD SETBACK- i 5' syR Cs END. MINIMUM REAR YARD SETBACK 15' GUY WIRE MAXIMUM BUILDING HEIGHT - ' G T 30 b `fir f,�,- UTILITY POLE MAXIMUM NO. OF STORIES - 2 a ExISrING`�^'~ MAXIMUM BUILDING COVER ALLOWED - 2442 5.F. " m m 5 N�DWELLING ''"J- M FENCE LINE L� MAXIMUM LOT COVER ALLOWED - 3G00 5.F. 3r o MAP IMPOG, PARCELRICHA OVERLAY DISTRICT: AP, MA ESTUARY `�,.► — N/F RO�APALA, RlCI1ARD M. �JEAN M. ' N ` Z EXISTING LOT COVER BY BUI LDINGS = 3884 S.F.I PROPOSED BUILDING COVER = 3884 S.F. q 2 S DECK LAWN EXISTING HVAC (OPEN STAIRS EXCLUDED) �r 9 tiLj + �a' dj EXISTING PRECONSTRUCTiON to EXISTING HVAC LOT COVER = 4190 S.F. iFQ j; wlp �U/tolw PROPOSED LOT COVER = 4 190 S.F. c 4 G NEW n t K POU ~ Wq�� (IMPERVIOUS CRUSHED STONE DRIVE ooNCRED AND OPEN STAIRS EXCLUDED) ANDS ; VERTICAL DATUM: NAVD88 a0 -A TITLE SEARCH HAS NC3T BEEN PERFORMED 0 20 ca.F.» `` •%:�: z ` .` LA met, FOR THIS 51TE SURVEY. SCALE: !" 20' LOT AREA TAKEN TO RECORD MHW LINE. GB D. -�.•:, lS�7ti\ O try GF -I I HEREBY CERTIFY TO THE BEST OF MY KNOWLEDGE, 5A N5TRUMENT 23,50T I 67+ S.F. \\\� ON THEPLAN Y, THE N � S�' � I E SHOWN \I e �1 GROUND. STEPHEN� yU,► \ LAWN o SSO° EXISTING ~\� o J. rn POST 2a`23, c coINIFER5 �'\\ iU -o NO3 755 �'�►► \ WF 2 \\ CB FND. 90c SS10 � SIiiVE� � 2•�3, 1 PROPERTY OWNERS OF RECORD: JULIA B. GAVIN TRUST' S\ wF-4\ o�-i 555 DUTTON ROAD SUDBURY, MA 01 77G-2525 CB FND. MAP I55, PARCEL I i CIO / WF_3 �SR RECORD SPpE2��N N/F BAGLEY, THOMA5 5. X �/ 3FC}, WF-5 �. `sod, pGe o� 51TE WETLAND CONSULTANT: 3 1X A.M. WILSON ASSOCIATES, INC. �\ / 20 RASCALLY RABBIT ROAD \ // CB END. 9,0 �`/ MAR5TON5 MILLS, MA 02G48 TELEPHONE: 505 420-9792 Lu cc FOUNDATION CERTIFICATION PLAN �o �c o��oZ o��o � PREPARED FOR �o° s& oti b #707 50UTH MAIN 5TREET 0, 2rc. ' CENTERVILLE, MA55ACHU5ETT5 C� DATE: NOVEMBER 29, 2014 `'oo'L SCALE: 1" = 20' \ � ao PLAN REVISIONS: 2 5TEPHEN DOYLE AND A55OCIATE5 42 CANTERBURY LANE EA5T FALMOUTH, MA55ACHU5ET75 0253G TELEPHONE: 508 540-2534 5JD5URVEY@AOL.COM LOCUS 4,q MPS �p��N SONG �L LOCUS MAP ASSESSORS MAP: I5G PARCEL: GG REFERENCE CERT: 193G9 1 `-� CB FND. REFERENCE PLAN: 3 173 15 LQ m PLAN LEGEND N550 3 W FLOOD ZONE: AE 13 (BFE 13-14) w w co W 8�7"lqi m;' ro FIRM PANEL: 2 5000 1 05G3 J • 00, 1 : EFF. DATE: JULY I G, 2014 o U? \ EXIST. SEPTIC TANK PUMP CHAMBER z a N m MP\Ncp � 5 �M IQ� o: ZONING DISTRICT: CBD-CRNB MINIMUM f T YARD r._., ° MINIMUM 51DENYARD S TBACK K 1 5 0 Q ® ® sH CB FND. EXIST. DIST. BOX WITH MANHOLE TO GRADE MINIMUM REAR YARD SETBACK - 1 5' R MAXIMUM BUILDING HEIGHT - 30' a ,� m GUY WIRE MAXIMUM NO. OF STORIES - 2 UTILITY POLE MAXIMUM BUILDING COVER v Q �J o N Q J Ex15rING ,�, MAXIMUM LOT COVER � � � DWELLING � FENCE LINE ALLOWED - 3000 S.F. U sr o MAP 86, PARCEL 65 OVERLAY DISTRICT: AP, MA ESTUARY N/F ROMPALA, RIGt1ARD M. #JEAN IM. LOT COVER BY BUILDINGS: " • N Z • '�• •• PRECONSTRUCTION = 3884 S.F. '' DECK LAWN - EXISTING HVAC EXISTING = 3877 S.F. Q r.:. . 9 : ., -. (OPEN STAIRS EXCLUDED) ® LOT COVER: Ln EXISTING HVAC ,:.iw •:C'.: ° '', BU��D�NG PRECONSTRUCTION = 4 190 S.F. �.\. `.,,/. . o �•8' CB FND. EXISTING = 4 152 S.F. J ve� CARRIAGE " CA (IMPERVIOUS CRUSHED STONE DRIVE O \ r�NGs � r rlousEE P�N AND OPEN STAIRS EXCLUDED) U �\\ VERTICAL DATUM: NAVD88 o zo ao A TITLE SEARCH HAS NOT BEEN PERFORMED CB FND Y"�! •' ".. '..� `•� LAWN �y4s eet FOR THIS SITE SURVEY. \ `�` _� • :.:•� •. \\\ 4 SCALE: 1" = 20' LOT AREA TAKEN TO RECORD MHW LINE. 30, m \ CB FND. I HEREBY CERTIFY TO THE BEST OF MY mOr \ �o F�T,�q\�\ W F I SUORVEYDTHE STRUCTOURES N AN ARE SHOWNT 0 LOT I \\\ ON THE PLAN AS THEY EXISTS ON THE GROIUND. cv � 23,5G7± S.P. \\\/ ►►ee®s4A \ \ ►► �ZN 01 \ST LAWN POST Oc 2�' \\\\ STEPHEN G� 2`3'F \ \ CB FND. i a J �► WF-2 DOYLE 0 / o NO. 37559 / ♦ 90 �P O�Ciy 0Ni / 2-0�� ../ �" �o - ►: l Lim F q WF-4� / G't/i s o / CB FND. A�s` PROPERTY OWNERS OF RECORD: ti / ` / PCs `S�s o 7 JULIA B. GAVIN TRUST CLEGO�O 5e P� 555 DUTTON ROAD MAAP J 85 BAGLEY,PARCEL RCELTHOM I I S. CO>\ WF 3 c�R RO' SUDBURY, MA 01 77G-2525 N/f �rjO W F-5 �� SOFA EOGE pF ti SITE WETLAND CONSULTANT: /e\ // A.M. WIL50N ASSOCIATES, INC. / CB FND. / 'O�po 20 RASCALLY RABBIT ROAD MARSTONS MI LLS, MA 02G45 TELEPHONE: 508 420-9792 CONSTRUCTION A5-51JILT PLAN o 10, 9� PREPARED FOR Q� Off'o "O �\O Cl p p p S 9 #707 SOUTH MAIN STREET \ � O G,P �.s Sho CENTERVILLE, MASSACHUSETTS ��A \ F� DATE: OCTOBER 15, 2015 SCALE: 1" = 20' F2 o \ �pO PLAN REVI5101\15: 5TEPHEN DOYLE AND ASSOCIATES �- • � '' - 42 CANTERBURY LANE EAST FALMOUTH, MA55ACHU5ETT5 0253G TELEPHONE: 508 540-2534 5JD5URVEY@AOL.COM