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HomeMy WebLinkAbout0081 HIGH STREET Ail I 1 i I I� i i i l , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION,. 1. Map 09S Parcels ©3 2'fi�3� Application Health Division Date Issued .? .� Y- Conservation Division 9 r A_ Application Fee S Tax Collector ', Permit Fee _ Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board I� Historic-OKH Preservation/Hyannis , Project Street Address 61 1 (0 �l Village WTV F ' Owner Jm t 0 so F Address Alg5AA) C-4A/R A-JV G?`. • 0 6�j Y 0 Telephone �f ' ?.t�3 ' ��y- 903/ C Zo 3 • V9 • NO MO Permit Request ' 9717W 67- 16 ' X 3 Z '00/r w f w G 0 IWA STD 196JR4YM • 5.,'V Ll( 6CO A/EA4 14 T'U-SiJ Square feet: 1st floor:existing proposed 321 2nd floor:existing proposed "® Total new2,04 ZoningDistrict rl Flood Plain ZOIJ& C A ON y p � Groundwater Overlay `/ Project Valuation Bso� Construction Type 05GO _ Lot Size {7 Z Grandfathered: ❑Yes ❑No If yes, attach supporting documentation*5� Dwelling Type: Single Family A Two Family ❑ Multi-Family(#units) Age of Existing Structure f 13 0 !E '? Historic House: ❑Yes XNo On Old King's Highway: ❑Yes XNo Basement Type: )�,Full Did Crawl ❑Walkout ❑Other . Basement Finished Area(sq.ft.) '�" Basement Unfinished Area(sq.ft) �2.5 L4tl'NO Y Number of Baths: Full:existing new AJ A- Half:existing -®"' new -®-' Number of Bedrooms: existing 3 new -6- t -(�F-- NC-W Total Room Count(not including baths):existing .6- new 57ME First Floor Room Count q C 0 0 f,S N 01- 1A.) CJu4er, S C . 1009 E . Heat Type and Fuel: )(Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes XNo Fireplaces: Existing I New 15- Existing wood/coal stove: ❑Yes ANo �JA Detached garage:❑existing ❑new size k)(P� 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❑ �...6. Commercial ❑Yes No If yes, site plan review'# - - _`" - • __ .. Current Use SW G kS- f4AAM #6`�ICJ. Proposed Use BUILDER INFORMATION c; 5D8 ?J7 01 Name 1�1��l QPICJ"S-A&L-L o6 yI WR< Telephone Number 0 " SO% -3161• 76 17 Address �(�O �J (b A License# C- 0 2, I N "�• 90X •s-( G Home Improvement Contractor# I-L 0 9 7 U 5,<• Worker's Compensation# At9b01_7010 O2.0(3 7 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO OiN ,S'I I BIZ 1A " k L- -14000AJJ SIGNATURE /91 DATE yLt 1 ' FOR OFFICIAL USE ONLY APPLICATION# + DhE ISSUED MAP/PARCEL NO. - f a' ;ADDRESS VILLAGE ' ;_OWNER r ..+ 5 DATE OF INSPECTION: - f A FOUNDATION �7 VI/��/7 /Rlu FRAME < tea.. , i INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL - PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ®tom 4 S DATE CLOSED OUTy,., �. ?�:? ASSOCIATION PLAN NO. r r Town of Barnstable Regulatory Services Thomas F.Geiler,Director °rEp; ;►`' Building Division Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 568-862-4038 Fax: 508-790-6230 PLAN REVIEW �'osoFC ® 3� 0 3a40 33 Owner: - Map/Parcel: Project Address 15 b4A Q, P. Builder: ;I J iv w The following items were noted on reviewing: �Grf �,cl �, � D � G o S o S'C o�'► �� � %k �s ��f) 60 T` X�i��� Via-0-[e�v�ti S Ce AkLk-4 T E �IE---fIJEA Reviewed by: Date: O Q:Forms:Plnrvw u l Patrick M.Butler Direct Line: .508-790-5407 Fax: 508-771-8079 E-mail: pbutler@nutter.com MEMORANDUM January 12,2006 #106749-1 By Hand (TO: Tom Perry Building Commissioner JFROM: Patrick M. Butler RE: Property at Lake Street and High Street, Cotuit Tom, l Thank you for taking the time to meet with me recently regarding the above property. As I indicated during our meeting,we have been retained by the property owners with reference to an addition they wish to build onto their house. A concern has been raised regarding the status of a way shown on the GIS map obtained by Cape Surv, a copy of which is attached. The property owners have requested I research the status of the way to determine whether or not it creates any frontage that would raise additional requirements for set back associated with the addition being proposed for their house. I have highlighted the property in yellow. As you will see,the property consists of two assessed parcels(Map 35,Parcels 31 and 32). Our clients' property has a back title consisting of two chains of title, one beginning as a triangular parcel bounded on the northwest by Neck Road and on the east by High Street. The second chain consists of a parcel described in a deed dated November 21, 1902 and recorded in Book 258,Page 474. That property is described as a parcel bound on the north by a"proposed street"which appears to be Lake Street, on the southeast.by Old Cart Road leading from High Street to School Street(Old Neck Road). From looking at some of the surrounding properties, it is clear that properties to the south must use a portion of what is called Old Neck Road for access to what is now Highland Avenue. I enclose a copy of the chain of title together with a plan of the Lake Street and Highland Avenue which depicts the"way" as two dotted lines,which I have highlighted in pink. I also enclose a copy of a plan recorded in Book 79, Page 113 which depicts the dirt road as ending in the middle of our clients' property and being partially cut off by the fence shown on the.property at that time. A review of the current topographical map and GIS mapping indicates a fence which encompasses the entire south and west property lines of the entire property and which has cut off any rights that anyone would have to come from the south over that way to get to Lake Street. Tom Perry, Building Commissioner January 12, 2006 Page 2 encompasses the entire south and west property lines of the entire property and which has cut off any rights that anyone would have to come from the south over that way to get to Lake Street. Based upon all of the foregoing, it would appear that the "way" does not rise to the level of being deemed a "street" or other recognized roadway necessary to create frontage. Upon title vesting in both properties to the prior owners, the way, and the lot is, for zoning purposes, deemed one lot and the two assessor's parcels are deemed merged. Per our prior discussions, we have conducted additional research within the records of the Town of Barnstable. The Town of Barnstable Engineering and Surveying Department provided a mapping which depicts Lake Street and High Street as being public ways and no notation of Old Neck having any "roadways status". In addition, the Town Surveyor provided to my office a copy of an historical data entry in the surveying records of the Town which provides that Old Neck Road is not an ancient way. This is a notation written by Frank D. Schlegel and dated June 14, 1989, I enclose a copy of that historical notation. Taking into account all of the foregoing, it is our opinion that the way shown on the GIS mapping attached is neither an ancient way nor a public or private roadway rising to the level of creating frontage within the Iot or requiring front yard set back for structures within the two parcels. Rather, it appears to be a private way which, in all likelihood, has been abandoned based upon the prior plans, its current physical characteristics and the presence of the fence as shown on the plan. Accordingly, as we discussed during our meeting, we would request confirmation that any structure or addition built on the subject premises does not require any form of set back from the way, but rather require front yard set back is from Lake Street and High Street as shown on the GIS mapping. We would be most appreciative if you could countersign below indicating your agreement with this analysis. Certainly, should you have any questions, please do not hesitate to contact me. Thank you in advance. I, Thomas Perry, Building Commissioner for the Town of Barnstable, agree with the foregoing lysis: omas erry, Building mmissioner PMB:cam ' 1495741.1 �v�' �■ � + Lire �� � `�'�^a��w •��_- �'�' �_ •�'Uill!;�I/�1IIIIIIIIIII,��; /,��•.. ��� � - 1 , � ME All rim I' r RIS w•� Iva :1 May I r � 'ri',x%j�Iri��: r Town of Barnstable, , Regulatory Services + s �H CAB '$ Thomas F.Geller,Director - �'ArF ��, Building division Tom Ferry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www-town.barnstable.ma.us Office: 508-8 62-403 8 Fax: 508-790-623 0 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize C'S k L`Y^ A S"ke,, to act on my behalf, in all matters relative to work authorized by this building permit application for; Addxess of Job) Signature of 0Aer Date Print Name QFORMS:O dTNEUMMISSION °ETME ray Town-of Barnstable hP °� Regulatory Services '* BARNSP"M $ Thomas F.Geiler,Director 9 MASS' .ego•� Br&diIlb bivision Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 Fax; 508 790-6230 Permit no. Date ] _ AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, . -improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: Ado M Qf� k- OAO E-W b Estimated Cost ��V Address of Work: k t c (i �� 1 �'� cr� l Owner's Name: S I1 S 1�l Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 QBuilding not owner-occupied' ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVE1 E=WORK DO NOT HAVE ACCESS TO THE ARBIT$tATION PROGRAM OR GUARANTY FUND UND R.MGL c.142A. SIGNED UNDER PENALTIES.OF PERJURY I hereby apply for a permit as the agent of the owner: 110 Date Contractor Name Registration No. OR Date Owner's Name Q:f m :homeaindav BOARD OF BUILDING REGULATIONS i 'License: CONSTRUCTION SUPERVISOR 1 } Numbers CS 023212 R i Birthdate 04-12/1949 f Ezp res 04/12%2008 Tr.no: 20932 I Restricted 1 MICHAEL L KINGSTON_ } I 9 GREAT HILL RD -a SANDWICH, MA 0256S�'* C } E Commissioner [ f Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration:,-.:,120878 :'Expiration 13/2008 ( ,i ! }' Type Private Corporation } WEST BARNSTABLE BUILDERS INC MICHAEL KINGSTON ' 4' 1170 RT.$A/PO BOX 516 WEST BARNSTABLE,MA 02668 �� � ... _.. Administrator i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street ,< Boston,MA 02111 www.mass.gov/dia Workers" Compensation Insurance.Affidavit: Builders/Contractors/Electricfans/Plumbers Applicant Information Please Print Leeribly Name(Business/Organization/Individual): . W1FiSr-1— 90J 1AJ `Z 601 UO Address: O • .�D �. d x �� (o City/State/Zip: W• Q . �...,T b U Phone.#: 3(P z,- 7 (O Y 7 Are you an employer?Check a appropriate box: Type of project(required):. 1. I am a employer with 4. I am a general contractor and I employees(full and/or part-time).'" have hired the su'b-contractors 6. ❑New construction . 2.❑ I am a sole proprietor or partner- listed on the-attached sheet. 7. aRemodeling ship and have no employees 'These sub-contractors have 8. 0 Demolition working for me in any capacity. employees and have workers' 9 ,Building addition [No workers' comp.insurance comp. insurance.$• required.] 5. We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their '3.❑ I am a homeowner doing all work � 11.El Plumbing repairs or additions myself, [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c, 152, §1(4),and we have no employees. [No workers' . 13.❑ Other comp.insurance required.] . *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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 providt their workers'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees Below isihe policy and job site information. Insurance Company Name: Policy# Self-ins.Lic.M C. Z— 1 I I ZOD 1 Expiration Date: W Job Site Address: p /0 1 �� (P�� S 1 "City/State/Zip: CA� � � !��� .S� • Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine 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 ce under ains-and penalties of perjury that the information provided above is true and correct Simature: Date: �� 0-7 _ Phone#: 7 Official-use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: - Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two.or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee-of an individual,partnership, association or other legal entity,employing employees. However the e apartments and who resides there' or the occupant of the' owner of a dwelling house having not more than three p m, up 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 in trance 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-insuranGelicense 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 iil (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 fo any business or commercial venture (i.e. a dog license or permit to bum leaves-etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: T The Commonwealth of Massachusetts Department of Industrial Accidents Office of Eavestfgatitlns 600 Washingtcui Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 vtww.mass.gov/dia `.- Client#: 12900 2WBARNBU ��C'ORD- 'CERTIFICATE OF LIABILITY INSURANCE 07109/07°""""' / PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 973 lyanough Rd., PO Box 1990 Hyannis, MA 02601 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: National Grange Mutual Insurance West Barnstable Builders, Inc. INSURER B: Associated Employers Insurance Compa P.O. Box 516 INSURER C: Commerce Insurance Co. West Barnstable, MA 02668-1124 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO°THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. r !NSR ADD— POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/YY DATE MM/DD/YY LIMITS A GENERAL LIABILITY MSO43965 01/24/07 01/24/08 EACH OCCURRENCE $1 00Q 000 X COMMERCIAL GENERAL LIABILITY DAMAGE REM SETO RENTED occurrence) $50 OOO CLAIMS MADE FX]OCCUR MED EXP(Any one person) $5 000 X BI/PD Ded:500 PERSONAL&ADV INJURY $1 00Q 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY PRO LOC JECT El C AUTOMOBILE LIABILITY 07MMHVV651 04/16/07 04/16/08 COMBINED SINGLE LIMIT ANY AUTO - (Ea accident) $ ALL OWNED AUTOS BODILY INJURY $100,000 X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $300,000 X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $100,000 (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ - OTHER THAN AUTO ONLY: - qGG $ _ EXCESWUMBRELL.A LIABILITY - EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION AND WCC5002701012007 06/11/07 06/11/08 X WC MI sTArT oTH- EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1 OO,000 OFFICER/MEMBER EXCLUDED? NO E.L.DISEASE-EA EMPLOYEE $100,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT s500,000 OTHER r I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Insurance coverage is limited,to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE-EXPIRATR Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10_ DAYS WRITTED Attn: Building Inspector NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 200 Main Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Hyannis, MA 02601 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08)1 of 2 #S48318/M48316 LS1 © ACORD CORPORATION 1' Table asstn(eoamanrao 1 ,�srscrigtirn paaksges for flue anti Tiro-F'si BY Rsaidmatial Baiidinga$ssisH wo' . M.A?lfP4NM , Rffi'�IR'l>:T14� CIIazing GIa:3ng Ceiling Wail Floor Bass c:d Slab 'SeatinglCcoling Am'ma) u-Yzluo R-mul? ' R vale R-Ywd wILU •I a I� yam . 1' 'fie • • • R-vsitte' R--value 570I to 8300 F.tr$ting B Da la'ra. 0,40 38 I3 t9 l0 6 2darsasl 12fa Q.5? 30 39 l9 I0. 6 Alotrr�sl R .� I21e p.50 33 13 19 10 I3a 0.36 31 13 25 ILIA NdIA. oraial' tJ I3'/s 0.44 31 19 19 10 S' 11% 0.44 3B I3 23 NIA' p+IlA !S AF�IS 13% 0,52 30 19 V AFM • ,� , lIi'�a 03Z 31 • !3 23 � ATI,�► PI/A Afoimal 19°f. Q4Z 3B 19 25' NIA NIA' Nartsial 2 1B° 0.41 S 90AFM A A 1 o°fie am 30 I9 19 i� d rT AFVE DRESS OF P&Omm. �. AD . 2, SQCIARE FOOTAGE OF ALL BXI=- ORWALLS: 3, SQUARE FOOTAGE OR ALL GLAZING; 1 , Li 4, OLAZINO AREA 03 DIVMED B Y',u,2): 5, SELECT PACKAGE(Q AA see chart above); , 'NOTE.;. OTHER MORE MWOLVEINMTRODS OF M ERGY REQZRnSTTS ARE AgAMABLI A?'K. S FOR THIS MOPJLClYp , t . BLrILDIN(2 LN8PE0TDR.A2M0•YAL.' YES,,, tti0; q-iu�`t�aG3Q3e - GCS ,I�6000000ol�r. ICERTIFICATE OF COMPLIANCEi- CHAPTER 148, SECTION 26, M.G.L. Iued By Cotuit'Fire Dept jC4 High Street, Cotuit, MA 02635 - (508) 428-2210 Application is hereby made to install approved smoke detectors as required by MGL Chapter 148, Section 26E or Section 26F, and to have same sted by the Cotuit Fire Department. Applicant/Owner Signature This certifies that the property located at Cotuit, MA, has been equipped wi approved smoke detectors and was found to be in compliance with Chapter 148, ❑Section 26E ction 26F, chusetts General Law on the date tested. The above was inspected/tested on: l 20 and was found to consist of: Dwelling Unit(s), with Primary Power Detectors Batte Power Detectors Paul A. Frazier, Head of Fire Department Inspector: Y Notice: This certificate expires sixty (60) days after date of issue. This form meets the requirements for F.P.7 as revised 11/84, Commonwealth of Mass. Fire Prevention Division. Form Distribution: White - Homeowner, Yellow - Fire Dept. Inspection Date/Time: Reinspection Date/Time: Contact Person & Phone: IAY447�� TOWN OF BAKN5TAHL1✓ f I [TON r f .4'7' SEWAGE # ASSESSOR'S MAP& LLER'S NAME&PHONE NO. : TANK CAPACITY IING FACILITY: (type) d (size) ell BEDROOMS LF _ ! ER OR OWNER TDATE: COMPLIANCE DATE: ion Distance Between the: im Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Water Supply Well and Leaching Facility (If any wells exist .te or within 200 feet of leaching facility) Feet 'Wetland and Leaching Facility(If any wetlands exist in 300 feet of leachin facility) Feet edby go A , 44gJejf i I i � I i Pi4- i h2e—+ I j, COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION [TITLES OFFICIAVINSPECTION'FORM NOT FOR VOLUNTARY ASSESSMENTS 4 SUBSURFACEJSEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 81 High Street Cotuit, MA 02635 Owner's Name: Margaret Dunnicliff Owner's Address: 457 Mount Auburn Street 92 Cambridge, MA 02138 Date of Inspection: May 2, 2005 Name of Inspector: (Please Print) James M. Ford Company Name: James M. Ford Mailing Address: P.O.Box 49 Osterville,MA 02655-0049 Telephone Number: (508) 862-9400 CERTIFICATION STATEMENT 1 certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP . approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ✓ Passes Conditionally Passes Needs F,�ther Evaluation by the Local Approving Authority Fails I/ /j Inspector's Signature: Date: rMay 4, 2005 The system inspector shall subm' copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 81 Hijzh Street Cottlit, MA Owner: Marizaret Dunnicliff Date of Inspection: _ May 2, 2005 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. CSystem Passes i ✓ I have not found any infonnation which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the "Conditional Pass"section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not detennined(Y,N,ND)in the for the following statements. If"not determined",please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent.. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. , ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or. obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain- 2 • f Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 81 Hikh Street Cotuit, MA Owner: Margaret Dunnicli f{ Date of Inspection: Me 2, 2005 C. . Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to detennine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for colifonm bacteria and volatile organic compounds indicates that the well is free from ponution from that facility and the presence of anunonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered: A copy of the analysis must be attached to this form. 3. Other: 3 r , Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION .(continued) Property Address: 81 High Street Cotuit, MA Owner: Marzaret Dunnicliff Date of Inspection: May 2, 2005 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in.the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6" below invert or available volume is less than Yz day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary'to a surface water supply. ✓ Any portion of a cesspool or privy is within a Zone 1 of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes/No)The system fails, I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to detennine what will be necessary to correct the failure. E. Large System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply _ the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 f - Page 5 of 11 OFFICIAL INSPECTION FORM.-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 81 Hizh Street Cotuit, MA Owner: Margaret Dunnicliff Date of Inspection: May 2. 2005 Check if the following have been done: You must indicate"yes" or"no" as to each of the following: Yes No ✓ Pumping infonnation was provided by the owner, occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks ? ✓ _ Has the system received nonnal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection? ✓ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ Was the site inspected for signs of break out? ✓ _ Were all system components,excluding the SAS, located on site? ✓ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? ✓ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and locat.en of the Sail Absorption- Syste,L (SAS)on the Sate has been determined teased on: Yes No ✓ _ Existing infonnation. For example, a plan at the Board of Health. ' ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]. 5 r Page 6 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 81 HiQh Street Cotatit, MA Owner: Margaret Dunnicli ff Date of Inspection: May 2, 2005 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): n/a Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: I Does residence have a garbage grinder(yes or no): n/a Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use (yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of infonnation: Unavailable Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: _gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM { Septic tank,distribution box,soil absorption system Single cesspool ✓ Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records, if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: AQe unknown Were sewage odors detected when arriving at the site(yes or no): No 6 J Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 81 High Street Cotuit, MA Owner: Margaret Dunnicli ff Date of Inspection: May 2, 2005 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC _other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) (Cesspool acting as a septic tank) Depth below grade: Cover to grade Material of construction: concrete metal _fiberglass _polyethylene ✓ other(explain) Cesspool block If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 5'W x 5'T x 6'bottom to rade Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: ` -- Scum thickness: I" Distance from top of scum to top of outlet tee or baffle: -- Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: Measuring stick Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): An outlet tee was present. The cesspool had 3'of liquid on the bottom. The cover was to grade. GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other (explain): Dimensions: Scorn thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 81 High Street Cotuit, MA Owner: Margaret Dunnicliff Date of Inspection: Mav 2, 2005 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan)- Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches, etc.): DISTRIBUTION BOX: None (if present must be opened)(locate on site plan) Depth of liquid p q id level above outlet invert: Continents(note if box is level and distribution to outlets equal,any evidence of solids carryover, any evidence of leakage into or out of box,etc.): PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Continents(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 Page 9 of 1 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 81 Hi-ah Street Cotuit, MA Owner: Margaret Dunnicliff Date of Inspection: May 2, 2005 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions:: ✓ overflow cesspool,number: 1 Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): The overflow cesspool was 5'W x 5'T x T bottom to grade and was dry The scum line was approxiinately 2'up from the bottom There did not appear to be any signs of failure. The cover was to grade CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Commments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,etc.): PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,etc.): 9 Page 10 of I 1 OFFICIAL INSPECTION.FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 81 High Street Cotuit. MA ` Owner: Markaret Dunnicli ff Date of Inspection: May 2, 2005 } SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. s� t3 � as sa 1 $ y0 14 Si- 10 i Page 11 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 81 High Street Cotuit, MA Owner: Margaret Dunnicliff Date of Inspection: May 2, 2005 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 30+/- feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain: topographic and water contours maps Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable topographic and water contours maps, the maps were showing approximately 30'+/-to ground water at this site. This report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection and/or this report. 11 _ 6/ V ; Nutter Patrick M. Butler Direct Line: 508-790-5407 Fax: 508-771-8079 E-mail: pbutler@nutter.com MEMORANDUM January 12, 2006 #106749-1 By Hand TO: Tom Perry, Building Commissio r FROM: Patrick M. Butler RE: Property at Lake Street and High Street, Cotuit Tom, Thank you for taking the time to meet with me recently regarding the above property. As I indicated during our meeting, we have been retained by the property owners with reference to an addition they wish to build onto their house. A concern has been raised regarding the status of a way shown on the GIS map obtained by Cape Surv, a copy of which is attached. The property owners have requested I research the status of the way to determine whether or not it creates any frontage that would raise additional requirements for set back associated with the addition being proposed for their house. I have highlighted the property in yellow. As you will see, the property consists of two assessed parcels (Map 35, Parcels 31 and 32). Our clients' property has a back title consisting of two chains of title, one beginning as a triangular parcel bounded on the northwest by Neck Road and on the east by High Street. The second chain consists of a parcel described in a deed dated November 21, 1902 and recorded in Book 258, Page 474. That property is described as a parcel bound on the north by a "proposed street" which appears to be Lake Street, on the southeast by Old Cart Road leading from High Street to School Street (Old Neck Road). From looking at some of the surrounding properties, it is clear that properties to the south must use a portion of what is called Old Neck Road for access to what is now Highland Avenue. I enclose a copy of the chain of title together with a plan of the Lake Street and Highland Avenue which depicts the "way" as two dotted lines, which I have highlighted in pink. I also enclose a copy of a plan recorded in Book 79, Page 113 which depicts the dirt road as ending in the middle of our clients' property and being partially cut off by the fence shown on the property at that time. A review of the current topographical map and GIS mapping indicates a fence which Nutter McClennen & Fish LLP ■ Attorneys at Law 1513 lyannough Road, P.O. Box 1630 ■ Hyannis, MA 02601-1630 ■ 508-790-5400 ■ Fax: 508-771-8079 ■ www.nutter.com Tom Perry, Building Commissioner January 12, 2006 Page 2 encompasses the entire south and west property lines of the entire property and which has cut off any rights that anyone would have to come from"the south over that way to get to Lake Street. Based upon all of the foregoing, it would appear that the "way" does not rise to the level of being deemed a "street" or other recognized roadway necessary to create frontage. Upon title vesting in both properties to the prior owners, the way, and the lot is, for zoning purposes, deemed one lot and the two assessor's parcels are deemed merged. Per our prior discussions, we have conducted additional research within the records of the Town of Barnstable. The Town of Barnstable Engineering and Surveying Department provided a mapping which depicts Lake Street and High Street as being public ways and no notation of Old Neck having any "roadways status". In addition, the Town Surveyor provided to my office a copy of an historical data entry in the surveying records of the Town which provides that Old Neck Road is not an ancient way. This is a notation written by Frank D. Schlegel and dated June 14, 1989. 1 enclose a copy of that historical notation. Taking into account all of the foregoing, it is our opinion that the way shown on the GIS mapping attached is neither an ancient way nor a public or private roadway rising to the level of creating frontage within the lot or requiring front yard set back for structures within the two parcels. Rather, it appears to be a private way which, in all likelihood, has been abandoned based upon the prior plans, its current physical characteristics and the presence of the fence as shown on the plan. Accordingly, as we discussed during our meeting, we would request confirmation that any structure or addition built on the subject premises does not require any form of set back from the way, but rather require front yard set back is from Lake Street and High Street as shown on the GIS mapping. We would be most appreciative if you could countersign below indicating your agreement with this analysis. Certainly, should you have any questions, please do not hesitate to contact me. Thank you in advance. I, Thomas Perry, Building Commissioner for the Town of Barnstable, agree with the foregoing&lysis: omas Perry, Building ommissioner PMB:cam 1495741.1 iiiAl •..�Ilhllllllllluu � _ . � _ F,�• � � ., !! �s� �� KIWI 11011011111111,1111 Pme .I �► E• 1 - 1, `�� � fir �\�. ; ��, �= �. .,yam• ���-��`, � � 1 .�� . �► . � 1 �. . is � � 1 • f c�0 OOOUDOE S TR NDY z z � LEWIS � POND 1 STREET ST O s Robert D. Golden, PLS Town Surveyor OF THE T Town of Barnstable • BABMSTASLE, MAss a Engineering Division � 1639. `00�Fa Department of Public Works MAC a 367 Main Street, Hyannis,MA 02601 (508) 862-4083 I Fax: (508) 862-4711 Robert.Golden@tOwn-bamstable.mia.us F P '=SeariA by Road p NE OFF HIGHLAND AVE €, Road Index 2155 Descri lion: Print Form Road Name OLD NECK ROAD (2155) (COT) I Comment Village: Cotuik Avis Map: 020 Length: 00520 Results View Scanned Cards View Scanned Notes View Database Add Plans Edit, Delete Plans l � • b MrsTORICAL DATA /S O G� /3c?— iL��T A"AJCI t;-xT - AIoT "-Iva rt ti 1 9 ' t i t RKMARKsa i i f i e i o 11 li • -------__.. i; .R nnnn . l �!----- i --' 8 �a�=--3 a 1---�u �_`_i1-•--C�-- nn,a.n,_� 3------__-- -- - �eil� 0 0 _. I; �i i • ii j;. �i i, --..-- ------- - -- -- ------- - ' o pro.. \ a A+rar eWcam f'L 4.OV o y LA vo AV MOW OW We WIOqv- b.M rr IVAr I94&7` WArt#- YA,*AO.V*0i''A, VAX,e HY&CEY " �l r yp�inrPrina no.,r r2. ) Map 03S Parcel F' 3 IAE&A= Permit# 4c.3 House# � - Date ssued � �.. _ cpiomi oard of Health(3rd floor)(8:15'-9:30/1:00-430) /®5�lO 9 SEPTIC SYSTEM MUST BE INSTALLED IN LIANCE r WIT 19 ENVIR®NME AND BARN T® BIB I ��" , • S ' TOWN OF;BARNSTABLE Building Permit A pI* tion Project Street Address Village 04O—L 1; w a i n i Address r Owner ' ✓ , C�trG ct+�e Q S� �l� Telephone 6 /1— .y Z S— 0 Ri 1,., 6X/38 Permit Request ,, 4o k ;,:e_ 6 ! l ta,76A L ® -em .First Floor ^- square feet Second Floor_ ®v�y�c� J�� q square feet Construction Type {��-� �vYevw Estimated Project Cost $ Zoning District o 1!r ood Plain A6 �f Water Protection A& Lot Size /q200 SafY -N Grandfathered %Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure ro +— Historic House ❑Yes ',No On Old King's Highway ❑Yes )(No Basement Type: ❑Full ❑Crawl ❑Walkout �d Other Ce-/fg v- !! of;,yav Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 31 Z. Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing z New - if= - Total Room Count(not including baths): Existing_ New / First Floor Room Count Heat Type and Fuel: Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes 1�No Fireplaces: Existing New Existing wood/coal stove ❑Yes gNo Garage: ❑Detached(size) �"d�`'� Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) None ;Z� )J Shed(size) 6 Y,A ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes Wo If yes, site plan review# Current Use Proposed Usee�y Builder Information Name d mL Id A . 44ka­e4 Telephone Number Address 2e,Q License# 0 Z g Z q 8 Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN 46G1YS SIGNATURE `� �. � DATE BUILDING PERMIT DENIED FOR THE FOLLOpW�ING REASON(S) � tD�ls��� 3� r FOR OFFICIAL USE ONLY75 _ PERMIT NO. r s�^ .y' 3 DATE ISSUEDy MAP/PARCEL NO. ADDRESS• OWNER DATE OF INSPECTION.: _ FOUNDATION- FRAME s .. '_ •r- : ! t i � , INSULATION ` FIREPLACE - ., � ' -� �; `� � • � . • • :r •. ELECTRICAL: ROUGH FINAL PLUMBING: N ROUGH F ! FINAL-' GAS:- tOJGH' FINAL jFINAL BUILT�6+ DATE CLOSED OJT ' ASSOCIATION PLAN:NO. .. f i , y FINE 1 V ` The Town of Barnstable MUMSTABM 9�A �0� ' Department of Health Safety and Environmental Services TEcna't6. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner PLAN REVIEW Owner: �A t i-, -F ` Map/Parcel: 0-3 631 O 3 Z Project Address: G44 Builder: The following items were noted on reviewing:cn- 0) I y (SoinG r _ t Please call rr508 862-4038 for re-inspection. tU 4CGJ e4 Inspected by: J � o C v Date: h ! e' q:building:forms:review The Commonwealth of Massachusetts Department of Industrial Accidents g Office 01111se5ti908fis 600 Washington Street � - Boston,Mass. 02111 ems•=- - Workers' Com ensation Insurance Affidavit name: c,,4 • location: f� Q Va,V. city 1--U 0-1# I"1 625.3(. phone# I am a homeowner performing all work myself. I am a sole ro netor and have no one working in any ca acity ❑ I am an employer providing workers' compensation for my employees working on this job. company name address. city phone#: insurance co. olicv# / / , % sole proprieto general contractor, or homeowner(circle one)and have hired the contractors listed below who have , the following workers' compensation polices: company name address: city phone#i insurance crr oliev# companv name address. city-.. phone#: insurance co... oltcv# . Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to SIs500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and aline of$100.00 a day against me. I understand that a copy of"statement may be forwarded to the OMce of Investigations of the DIA for coverage verification. I do hereby certify under the p and penalties of rjury that the information provided above is true and correct Signature Date OC.�. Print name /`�w4r1Gi 1T�k s Gk Phone# �OS `Y zQ"S�4 1 official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑health Department contact person: phone#; ❑Other (raised 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law', an.employee is defined as every person in the service of another under any contract of hire, express or implied;:.oral or written. artnership, association' corporation or other,legal entity, or any two or more of An employer is defined as an individual; p the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance , construction or repair work on such dwelling house.or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation-affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents,for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. j City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event.the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be usP.d as a_efereLce nurr►ber. The affidavits maybe reftun6d to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of intlestlgatlons 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 780 CUR Append tz J TableJ=b(eondnaed) pmcriptive Packaga for One and Two-Family Residential Buildings Heated with Food Fuels MAXIMUM M1IYIMUM Olaang (3laang Ceiling _Waq Flaar, :Baaemart Slab_.. ft qug/t!ooling ' '(K) U-value= R values R value' R values Wall Pernneta Eq�P �a pie 5101 to 6500 Heating Degree Days'. - Q 12'/. 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 .10 6 Normal S 12% 0.50 38 13 19 10 6 83 AFUE T 15% 0.36 38 13 25 WA WA Normal U 150A 0.46 38 19 19 10 6 Normal V 15% 0.44 38 13 25 WA WA 15 AFUE W 13% 0.52 30 19 19 10 , 6 85 AFUE X 18% 0.32 38 13 25 WA WA Normal Y i s% 0.42 38 19 25 WA I WAWA v. Nomad Z 12% 0.42 38 13 19 10 6 90 AFUE AA 18•/. 0-50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: we� 2. 'SQUARE FOOTAGE'OF ALL EXTERIOR WALLS'- 1 SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): S. SELECT PACKAGE(Q--AA-see chart above): A NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: q-forms-1980303a 780 CMR Appendix J Footnotes to Table J5.2.1 b: ' 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 regtf. ment. For example,3 W of decorative glass maybe excluded from a building design with 300 f 2 of glazing area. 2 After January 1, 1999, glazing U-values must be'tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units: center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall. For example, an R-19 requirement could be met EITHER by R-19 cavity insulation OR. R-13 cavit•,Jnsulation 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 J5.2.1 a 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.e.,may have a U-value greater than 0.35). c) If a ceiling,wall,floor,basement wall,slab=edge,or crawl space wall component includes two or more areas with different insulation levels, the catnponent complies if the area-weighted average R-valve is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 TM?I The Town of Barnstable • m►strsrA� • . Department,of Health Safety and Environmental Services _.<.. Building Division _ _.. �_ :, , !_. . .. .._ t, i• �� ,�� .: j 367.M'. trees,Hyannis MA 0260i Office: 508-790-6227 '' y.. Ralpft Crossen Fax: 508-790-6230 Building Commission.- For office use only Permit no. Date AFFIDAVIT . .. HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization. conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requireq Type of Work, w Est:Cost �3 0 �`-Address of Work. ,• :•� Owner's Name Date of Permit Application: 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 Ownei pulling own permit Notice is hereby given that: .OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR O Date Owners Name LAKE STREET 20. 00 N85 37'10"E 150. 00' R,�`�j� II 1 �z 1 I ASS. SCREENED I Q LOT 14: 0. � 4 Ig .I #31 PORCH o ASS. 38_ - 441 N LOT iv o I b w #32 ----=----=----=-- v; o I o � SHEDS ZVI- 27. 3 =- o 141. 96 , ( CALC- ) I \ N85 39;40"E 6 & PLAN ) / o / N0539 40 E 149. 9 DEED ASS. I LOT � • 33 I . /�i , D�� NOTE. # PRE-EXISTING ASS. NONCOM.FORMING LOT / #30 RES. ZONE- "RF" This MORTGAGE INSPECTION Plan is For FLOOD ZONE.- "C" O Bank Use On REGISTRY OWNER: MUSSELL N C AAPMAN DEED REF: �3 _BUYER: - Aj�I1= 4_9I IC1,I1'F _ _ —_—_ DATE: �17L94 _ — _ PLAN REF: 79 113_ _ _ _SCALE:1" 30' FT I HEREBY CERTIFY TO COMPANY _INC.---------------THAT THE BUILDING YANKEE SURVEY SHOWN ON THIS PLAN IS LOCATED. ON THE GROUND AS f�.�ui_ �`'<= a CONSULTANTS SHOWN AND-:THAT ITS POSITION DOES ____ CONFORM A. ^ � TO THE ZONING LAW SETBACK REQUIREMENTS OF THE MERITHEW 40B (SUITE 1) TOWN OF _ RARNSTARLE-------------AND THAT I No. 32098 INDUSTRY ROAD IT DOES_ AOT _ LIE WITHIN.. THE SPECIAL FLOOD HAZARD �Fs �`C/STERE� Qa MARSTONS MILLS, MA. 02648 AREA AS SHOWN ON THE H.U.D. MAP DATED_v_w_z__ s�aAl L015 TEL: 428-0055 0 t — a e 250001 0018 D FAX: 420-5553 • _____ THIS PLAN NOT MADE FROM AN INSTRUMENT KJN PAUL A. MERITREW PL.Sr — SURVEY NOT TO BE USED FOR FENCES ETC. 15447 CERTIFICATE OF INSURANCE: NELSDAI CSR 06 10 08 98 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE Kerkorian & Na arian, Inc . DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE 39 Salisbury V . Suite 100 POLICIES BELOW. Worcester MA 01609- ---------------- 508-756-5729 COMPANY - - COMPANIES AFFORDING COVERAGE ------------------------------------------------------------- A Eastern Casualty Insurance Co. INSURED ------------------------------------------------------------- COMPANY B ------------------------------------------------------------------- David Nelson Framing COMPANY 84 Braxton Road - --- -- -- -- -E. Falmouth MA 02536 COMPANY D > COVERAGES 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 POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR DATE (MM/DD/YY) DATE(MM/DD/YY) ----- --------------------------- --------------- -------------- --------------------- ------------- GENERAL LIABILITY GENERAL AGGREGATE [ ) COMMERCIAL GEN LIABILITY PROD-COMP/OP AGG. [ ] CLAIMS MADE [ ) OCC. PERS. & ADV. INJURY [ ) OWNERS'S.& CONTRACTOR'S EACH OCCURRENCE PROTECTIVE FIRE DAMAGE [ ) (ANY ONE FIRE) [ ] MED. EXPENSE (ANY ONE PERSON) ---- --------------------------- -------------- -------- AUTOMOBILE LIABILITY ----- - - - [ ] ANY AUTO COMB. SINGLE LIMIT [ ] ALL OWNED AUTOS BODILY INJURY [ ] SCHEDULED AUTOS (PER PERSON) [ 7 HIRED AUTOS [ ] NON-OWNED AUTOS BODILY INJURY [ ] (PER ACCIDENT) [ ) PROPERTY DAMAGE - ---- ----- ---- --- --- -------- --------------- -------------- ------------------- -------------- GARAGE LIABILITY [ 7 ANY AUTO AUTO ONLY (EA ACC) OTHER / AUTO ONLY: [ ] EACH ACCIDENT [ 7 AGGREGATE --- ------------------------------- - EXCESS LIABILITY EACH OCCURRENCE [ ] UMBRELLA FORM AGGREGATE [ ] OTHER THAN UMBRELLA FORM ------------ --------------------------- --------------- -------- ------ ------------------- -------------- WORKERS COMP. AND EMP. LIAB. X ]STAT LIP, I 70T11 THE PROPRIETOR/PARTNERS/ EL EA ACCIDENT 100,000 A EXECUTIVE.OFFICERS ARE: WCV2001899 09/16/98 09/16/99 EL DISEASE-POL. LIM 500,000 [- 7 INCL. [ ] EXCL. EL DISEASE-EA EMP. 100,000 --- - --------------------------- --------------------------- --------------- -------------- ---------------------------------- OTHER -DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS---------------------------------------------------------------------- > CERTIFICATE HOLDER <____________________________________> CANCELLATION <_____________----------------_----_______-_------------ ---------------- ---- - ------------ HAN S RO 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE Ronald Hansen LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR P.O. BOX 571 LIABILITY 9F' 1 Y KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. East Falmouth MA 02536 -------- =-,�- - - - ----- -- --- -- - --- --- AUTHORIZED_REP SEN AT VE ACORD 25-S (1/95) House. rl 211LODUM 21W CERTMICATS IS X-,SUAv As A mArmk OI ..,tino"O?Q.Y Brewer&Lord LLP CONI'M NORIGM WW nIS CUTInCAT9 TWS CE"MCAIW DO"NOT AMZND-SVIND OR ALTER T=C0V=*G8 AnU=BY"118 .177 Main Street Falmouth, MA 02540 COMPANIES AFFORDING COVERAGE COMPANY 508-548.1596 LKI'm A commercial Union dr CQWFANY IrwuBUD Lrrnm Colony Insulation,Inc. Lzrm C Commercial Vnion PO Box 169 COMPANY CateuMet, MA 02534 Lrrm D AIG say State contractors E 7'. -4 �T TJa$IS T0OM11"21IAI T=rJUCIEb OF INSURANCE LIS'=BELOW UAVE BUN ISSUED 1UTIM INSURED NAMED ARMS FW I=P(JUCY FMOD MCATED.N0rWl=A?W4 ANY R20UNSAINNT,72M Oft CONDff1ON OF ANY COMUCT OR OMM VOLVMJNr Wffn PJCSPKT To wmaf rms UMTMCATIE MAY U ISSM OR MAY=TAM.TIM DOMM(S aMMW sy Tim MACM MCRMV WRMN 13 SUB KT 7,0 ALL Ta TUN& EXCLUSIONS AND CONDMONS OF RIM POLICIES.LWM SRO"MAY HAVE BEM RLWX=Sy PAID CLAIMS. TYPE OF U49URAM FWCY NUMAUR POLICY 00. TR DATS0V&;vWVY) DATECAMMONT) A CaWFALLIABIL11"Y ASR594525 6/18f98 6119199 GOAL ACGUGATS 2,000000 X CONK GVQWA.L IJASUJW PROD-COM111MAGG. 21000000 :DCLAWMAM [ZOCC. 1,000000 OWW's A Con"M nOT "Of OCCLaRmom 1,000000 7 I=DAMACZ(Om K"? m000 Mm.xxp.(Or*P 5,000 0 AVMOSILZ LIABILITY COMSL=SUWAI ANY AUTO LIMIT AM OV4=AUM gamy INMY SCII&DWO AUTOS tper WS0* nn1ZDAW= ROMY INMY =A"RMZ UABILITY MOMTy))AMAGE C Z=35 LIABILITY C8DZ93304 6115/99 "CII OCCLqM1NC1 3,000000 AGCAtEGCTE .3,000000 MOrdlit THAN UMBRELLA WORK - - D WC5820773 6118198 6/18/99 STATUTORY LIMITS WOZXU MUCUATM EACRACCWW AM -600,200 • BA1014=15 U"n= =AM-61jIty Ur.= 500,000 lAbUASE-EACM EMP. 500,000 onma 01130111`11ON OF OnWATIOMLOCATIONSTEMICLESSPROA1,AMS Installation Of insulation in buildings,homes and seamless gutters. ref:LO #1 DURHAM ROAD EAST FALMOUTH RESIDENCE: JEFFAFY GAGE 7,' SRO=ANY OF TI3Z ADOW DRKMOW POLICIES BE CA?=11"ft"Ma 7W 100VATION DATE=MKOT,TW I$SW46 COMPANY W"XMSAVOR To RONALD A. HANSEN XA116 IDDAYS WWrr=NNO1nC%(TOT=CERTMCATE MOLM NAMED ToTax LICENSED BUILDER Az WIT.BUT FAILURE TO MAIL SUCK WfftCX SUALL IMPOft NO OBLIGATION OR PO. BOX 571 LIADUATY Or An JUND UPON TITS COMPANY,rn ACWIV VK f(fW72vas. EAST FALMOUTH, MA 02536 AVr4O=EDAV&E=NTATIVT By• a a 64 RONALD A. HANSEN LICENSED BUILDER P.O. BOX 571 EAST FALMOUTH, MA 02536 E d stio_s n � i 4� i x f , ---- �tvNG'4-• 3' EXttrl� I VA:`I PADG 1PA-14-41 iN6!o �y �rw r `S I . V--�--L� �it � ti . 4ALT 0INX-Ley o� Ll - �==g1� EKT pLY�►D 1 t T -.. I p.. el lo it _.� oe o - _ -- --�� _2 100, q 10 2° DN __..- _ �G A'r --1. 7 - - ..-- o a _ 3 A� 1 DEPARTMENT OF FUBLIC SAFETY 1 1 I I' LICENSE iO1Expires: 1 !' !. I Po B07 x TE_iT" A-er-�J CA--r( c)n/ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 0 Z�Parcel 0 Permit# Health DivisionY;W4Date Issued Conservation Division Application Fee Tax Collector '� Permit Fee Is-a 5!o o Treasurer i �tY v ''� c,,.,_T51 CST SEPTIC .j d - L Planning Dept.t. INSTALLED ED IN COMPLIANCE IPJl1•9 TITLE 5 Date Definitive Plan Approved by Planning Board EWp.CNME,iTAL CODE AND Historic-OKH Preservation/Hyannis TOWN RECUL IATION3 Project Street Address 19 1 I's TPEET Village (? TUI:r Owner __WC 'T VI8W�lCu FF Address 1-45-7.Mr AyWUM S7�_ Telephone Permit Request ':IFM f aY 1 1 F N fPO Nrl° �11-?,) fdt UFMI IP4&— .zo t 6� Lc-y` boai2, L.D 6113 6 3 W rI L 3 (J6"2!tn 2 0OS4-4 Square feet: 1s1AesF.-e*is1 - d 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes No If yes, attach supporting documentation. Dwelling Type: Single Family a Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes & o On Old King's Highway: ❑Yes Q4o Basement Type: ❑Full la Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) _ Number of Baths: Full: existing new Half: existing new / Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: nGas ❑Oil ❑Electric ❑Other Central Air: ❑Yes 2lo Fireplaces: Existing New Existing wood/coal stove: ❑Yes &KO Detached garage:❑existingO❑new size Pool:❑existing ❑new size 1��?� Barn:❑existing ❑new size r ll'A/L_ Attached garage:❑existing ❑new size d IJc Shed:existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes IS"No If yes, site plan review# Current Use R QQzz�. Proposed Use BUILDER INFORMATION Cl / Name !"13f1 C tJ N'kICL,1� Telephone Number I f7 �( � l- b Address L5 ] MT, kP&U&N s►, - ,Z License# CA—M RA D� M Owe Home Improvement Contractor# AIIA- Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO IVE SIGNATURE Ho DATE e A FOR OFFICIAL USE ONLY , � r PERMIT NO. a DATE ISSUED MAP/PARCEL NO. ADDRESS - VILLAGE OWNER ` "f DATE OF INSPECTION: r FOUNDATION F FRAME INSULATION FIREPLACE �6 '• t ELECTRIC ROUGH, �'" t a FINAL ". PLUMBING: ROUGH; FINAL GAS: ROUGH U - ; e FINAL - - FINAL BUILDING DATE CLOSED OUT ' ASSOCIATION PLAN.NO. ". The Commonwealth of Massachusetts Department of Industrial Accidents - - Ofl�ee of/mrest alffs 600 Washington Street -- ` Boston,Mass 02111 Workers' Com ensation Insurance Affidavit name: location city phone# ❑ I am a homeowner performing all work myself.. ty ❑ I am an employer providing workers'compensation for,my employees working on this job. company'name......- , ;elder ver:.:*' 7Cx k::.. .:: arty . ......... . .. :. ....:' h :: :.;:. shone :3 ::»:::>::.>:;>::>'«:;:<:...... :::. c,tw Weasm® h 93i�7 5{l•R .......tR 7? r ►nsarance ca..:.. : # W . ❑ 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:..................::::.:.,::.:::.:::::.: :::::::::::::::::::::::::::.::::.::::::::::::.: :.:::::::::::::::::.::.:::::::::::::::::.::::.:::::,.:.:::::::::.:. f:::.::::::::.:::::.:::. ::::::::::.::::::::- ::name ::::.:.::::::::::.:::::::::::::::.:::: .:. ...»:»»::>>::»::>::»:::::>:ti:<;::::::»:::» >:: U '. :.: ..::......:•. : �_ : .. :: : s ; : : :....... .......... ' : ade$ Y Bn.? � E l4 i :..: r•.._ ���'�i:i�ii:L.•:�::v:Ji:i•i::::•:::..iiii:is i}.::•}}}}:•}i:iiii}iiiiii•is4:ii:::ii'::%-i:i:::-.?:ii:3iii:ii:'Oi:::^:'.::is iii:.:..,...•:::::'. :-'•::�:::is'..ii:i:.:'::4++i+:+-i:•.4i::i•.L::?•Y.isiii'4i:LY-iii:;•:b}i:•ii:?}i:::i.:hiii'J iii?}}i}:•i i:4}:L:��ii:?ii ........ Cl ....................... ....:.:.::::.:::......... :.:::::: ..................... ::�::::.�.�::::::.v: :�::::::.....:::::::::....:•:::::::::::::.::::::.�:.:::::::::::._::::::::::::::::::::::::::::::.:::::::::::::::::.�::::::::::::.�:v:::::::::: :::.ii: :}i)::'iiiiii;::ii:4��'::•:ii:•ii'?:i:i'�:i.....................................................................................................................:............................................................................................................ ..............:.::::::::. :::::::::.:v:::::::w::::::::::::::::::::•:::•::::::::::::::::._:::::.::::.v::::.v:::::::.:v::::::::::::::::::::::::::::::::.�.�::::::.�::::::.::::::n�::•.�::::::::::::.�::._::.v ::::•ii:•ii:_:-i?ii. .n}...'... ...:......:::::n....n. ......\.......:,..............:::.:{.:::.:::-:iiii::•}:...................::::v..... y............... .. ...................:...�•:-•. hvF..A.•}:.G+,.,.:..... ......::::....:v::•}......:•ii}..........•:}::::.........................................:..:. :':::::::::::.... .....i::_::::::iii:nii:�:ii::>iiiiii:..............:!!t!R........................ } 0 CQR:::::::::::::::::: :::::::::::::::::::.:: :::.:::::::::: ::::::::::::::::.v::::::v:. :fn$BranCP..,CO:;i::;::;;.;'.i:;.:.:;;:;<.i:;.:;;.i;:;;,:;;;;.is�>;i:<.>;:..;»;>;;:-::.:�:;.:;<:�;,:;<.;i:.::.:.>r>;:.;..::...::.:c;:.,>:�i::::>.t::z:;::;<;::•;;::::;:.>;i: h i:::;'>:•::: i::;?-::::-':-;: ii:.<;:-;:-i:- .is......':-:::;:->:i:-ii:•:;;•i ;;`nigij:;:}':l.�`?:k c an :.name..........._....:...............................:....:....................... .._.._......:.. .... ........ ...._.. .................................... ,..............:.::. -:wxa.�..... ............................._..........................................................,...:.i.....:......................::: '::::: ::::o::: ;<.:a::::.;;::.;ei::::r:<•i>::::;c::::a}»i:;:::�r,::-ii i'n:<;Lii}i�•: address: - p Fare to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of crimiu d penalties of a fine up to$1,500.00 and/or one yeses'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pr and penalties of perjury that the information provided above is bur and correct Signature Date — Nut name Anthony .R. Priz,zi, II phone# 508-778-2777 o4 fficial use only do not write in this area to be completed by city or town official city or town, permit/license# ❑Building Deparhnent Ucensin Board ❑ g ❑check immediate response is required ❑Selectmen's Office • ❑Health Department contact person: phone#; ❑Other &vied 9195 PJ/a MW h� (Cerfift'rate a e � t n��o �sr�� REGISTERED 1$SUED BY C�'`°.�C FABRIC Date NUMBER TOPTEGJNC. manufactured ►-�+ •, P r A'905 N.E: MAIN ST. - F191 SIMPSOIVVILLE, S.C. 29681 4 F RETp� 121 . 4 1/9/95 This is to certify that the materials described on the obverse side hereof have been , flame-retardant treated (or are inherently nonflammable). FOR UNDERCOVER TENTS `ADDRESS 80 MIDTECH DR UNIT 3 CITY W YARMOUTH s ' `-' $''STATE MA 02673 Certification is hereby made that: (Check "a" or EJ (a) .-The articles described on the obverse side of this Certificate have been treated with a flame-retardant 'chemical approved and registered by the State Fire Marshal and that the application of said ':chemical was done in conformance with the laws of the State of California and the Rules and Regulations of the State Fire Marshal. .• Dame of chemical used...................:................................................Chem. Reg. No............................. Methodof application........................................................................................................................... (b). :The articles described on the obverse side.Hereof are made from aflame=resistant fabric or material registered and approved by the State Fire Marshal for such use. The Flame Retardant Process Used :WILL NOT Be Removed By Washing TOPTEC, INC. Xz MODEL TTW73010 F.T - 20X40 Name of Production Superintendent SEHIaL# 950779 _ _ .. .' `1 � StreetOld at s� Rd (40' Wide - Public W0Y)Lakegg x 4 1 Ed e of Pavement Q g QJ I W rn ........... I ........ .. ............... rtd— LOCUS N89'37'10" R=20.00 C] i � I � � L=31.42' Lewis CB/DH 60.00' I t Pond-- Fnd it I. o o \ l Schoo z x I } 27.6' 17,280f SF ca St _ I V Fnd l i COTUIT BAY ti \ _ _ Location Mop 30 Setback ——,_— — — — _ 1 �' ---- -- - 1 X Temp. i o Road h 1 1 Storage I 37.2' 1"=2000't j Town Layout of Lake Street lu, See Plan 11-3 #7 Y� CD (dated Feb. 18, 1938) Q (No evidence on ground) I O to "Old Neck Road" IF on Ancient Way w1f p I (See Note) Shed I IV w<' :>:: `::: # 81 LI ASSESSORS REF. ro.......... 2St w/f I o # 23 1 11 y o Mop 035, Parcels 032 & 033 Dwelling 'I o ZONE: RF Dwelling w 4� I Shed i Area (min.) 87,120 SF (RPOD) N I i� Frontage (min) 150' Setbacks: o I Q ,:� tn' a :: : . IIx S: CDFront 30' j 5.5 Side 15' Septic System T Rear 15' _ —.— 26.1, as per BOH Card ♦■ � -- -- — .—15' Setback —_._ -- — -- -- —Pro/�'osed Additions r } FLOOD ZONE: , — I'''i. .... Stone Wail OPost ® Zone C �.� Community Panel No. S8 '40 #250001 0018 D z 14192' E�Meter July 2, 1992 tN»0 Z _ w/f w/f ' LMR Proper'y M °ge"1e"t OVERLAY DISTRICT: n Garage Shed � Note: 12219/79 oy� AP - Aquifer Protection District � Deb The record information and physical .h� evidence indicate that this way may Legend. be abandoned. The frontyard requirement Gj ^j has been eliminated. (see agreement with Thomas Perry, Building Commissioner, TOB Light Post dated January 12, 2006) O Water Gate (round) oy �N�F `sR © Gas Gate (round) 0Sewer Manhole �4 RICHARD 4)- Hydrant ecoNlIHEUREUX p Iron Pipe Deciduous Tree 1 r134312 14 -4 Guy � I oFESS�� -& Utility Pole Coniferous Tree I zs��/7 Sheet # Title: Prepared For: Notes/Revisions: Plan Showing Proposed Additions CapeSurvj, Scale: 1"=20' Jay S. & Stacey P. 1.) 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