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0165 LEWIS POND ROAD
���3'PZ u�a ��� �, i '� r �i I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION& Ma �o Parcel O S� - " I p • Application Health Division 1rQ Date Issued � � r eti lS/ Conservation Division �� ®o� Application Fee Planning Dept. \,�� .�`' Permit Fee S 6 Date Definitive Plan Approved by Planning Board � ® Historic - OKH _ Preservation/ Hyannis Project Street Address �"'a;� �°euo Ro`a rn Village 04-u °I' Owner YefPtj ut4o 81 eaa:fier, Address 31 (0,#`J4 S4 • CAm 6ei'dit n,4 6213 Telephone Y�0 'f 6Y 3Y42 C n Permit Request Roil rt4nc A m �L .4/IX s® ��" �� IdWeft leyf/ 1/1/4tL / /t a Gs�r ��1t?C4 460 na,71e41 Qdd 3 C0Ntd+4,te_ JIQGIS.S 6slrne, w'R !7 �,�®u'tariojv I� a.d 'p� w Do®AR3 Ref/d,,j411 3 ✓i Square feet: 1 st floor: existing a0O proposed 2nd floor: existing ® proposed Total new Zoning District k � Flood Plain Groundwater Overlay --�-Project Valuation 331 ova Construction Type'+ O Q D rn4 m-0 Lot Size ® •7 0 AGv-e- Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation: Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes l]I No On Old King's Highway: ❑Yes ❑ No Basement Type: O'full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) ® Basement Unfinished Area (sq.ft) �2- Number of Baths: Full: existing new 6 Half: existing new Number of Bedrooms: existing _new o Total Room Count (not including baths): existing 7 new ® First Floor Room Count Heat Type and Fuel: ❑l Gras U Oil ❑ Electric ❑ Other Central Air: ❑Yes Ao Fireplaces: Existing New Existing wood/coal stove: ❑Yes IdNo 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 U(No If yes, site plan review# Current Use T t S i Pt/J '941 5itJ51 1'a01i �7 Proposed Use S4 H?- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) , y y y yY c71 e4 Name rn e S h G Co h��ck._ Telephone Number �� y�® �y (48J/df�vr� cTew Address 2 U M-e, 2► r q0 U?-140r License # S a 7 4 24 j to y 4 P -,t uJ_V cJ 14 iZ0 Home Improvement Contractor# B o d -7 v@ Email J P►K CA-r i z2�ho me• t"oay Worker's Compensation # � a W L S�r217D ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ouJrU 4 64AA/✓74e 4 Qifor, /i t 01 Selo SIGNATURE cl DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. r ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME i INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH A FINAL e, N . FINAL BUILDING 7�11 ► f'��`� '-�� DATE CLOSED OUT ASSOCIATION PLAN NO. f : on J.J. r r t : . .......... ,.. f I .f..� {...i :`� � is � • t � I r III i , I j a r , rR i { l 77T-I..il J., J i -i. rf � Il �. i , i r _ I i Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-076261 Construction Supervisor JAMES MCCORMACK 73 FEARING HILL ROAb,'�_ ,, M WEST WAREHAM MA 02576� =� l� Expi ration: Commissioner 11/13/2017 , G?%�c:`ir�a��riwrvrruc'rill�c �!.f(,i.l�rr�uJcl License or registration valid for individual use only t " Office of Consumer Affairs&Business Regul tion before the expiration date. If found return to: � + ME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation + _ 10 Park Plaza-Suite 5170 �= ,tr Registration;,,.10.0740. Type: Boston,MA 02116 `' Expiration. 6f23�2018 Supplement Can CAPIZZI HOME IMPROVEMENT,-INC. JAMES'MCCORMACK 1645 Newton Rd, No valid without signature Cotuit,MA 02635 Undersecretary r 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/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): CAPIZZI HOME IMPROVEMENT INC. Address: 1645 NEWTOWN ROAD City/State/Zip: COTUIT , MA 02635 Phone #: 508-428-9518 Are you an employer? Check the appropriate box: Type of project(required): 1. ✓ I am a employer with 40+ 4. I am a general contractor and 1 employees(full and/or part-time).* have hired the sub-contractors 6. Ne construction 2. I am a sole proprietor or partner- listed on the attached sheet. 7. odeling, ship and have no employees These sub-contractors have - 8. 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 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. Other t 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 notthose 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: AMGUARD INSURANCE COMPANY Policy#or Self-ins.Lic.#: R2WC527200 Expiration Date: 12/25/2017 I�r IWO c Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and.expiration date). Failure to secure coverage as required under Section 25A of.MGL c. 152 can lead_to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties,in,the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy.of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify and he pains and o perjury that the information provided above is true and correct. Si ature: Date: Phone#: 508-428-9518 Official use only. Do not write in this area, to be completed by city or town official City or Town: Perm.it/License# Issuing Authority(circle one): L.Board of Health 2. Building Department 3.:City/Town Clerk 4. Electrical.Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: - i Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." 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-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 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 burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. r The Department's address,telephone and fax number: The 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 Fax# 617-727-7749 Revised 4-24-07 www.mass.gov/dia ��1 ® FDATE CERTIFICATE OF LIABILITY INSURANCE DaTE(MMroom^rY) 12/30/2016 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). CONPRODUCER NAMEACT Rogers and Gray Processing ROGERS&GRAY INSURANCE AGENCY INC PHCNN Ext): (508)398-7980 FAX No): E-MAIL ADDRESS: mail@rogersgray.Com 434 ROUTE 134 INSURE S AFFORDING COVERAGE NAICO SOUTH DENNIS MA 02660 INSURERA: AMGUARD INSURANCE CO 42390 INSURED INSURERS: CAPIZZI HOME IMPROVEMENT INC. INSURERC: INSURER D: 1645 NEWTOWN ROAD INSURERE: ' COTUIT MA 02635 INSURER F: COVERAGES CERTIFICATE NUMBER: 114654 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD VYVD POLICYNUMBER MMIDD MMIDD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $' MED EXP(Anyone person) $ WA PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- LOC PRODUCTS-COMPIOPAGG $ POLICY OTHER: AUTOMOBILE LIABILITY Ea accideDtSINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ H_ $ WORKERS COMPENSATION X I STATUTE ER AND EMPLOYERS'LIABILITY YIN - ANYPROPRIETORIPARTNERIEXECUTIVEA] NIA NIA R2WC775326 E.L.EACH ACCIDENT $ 1,000,000 A OFFICERIMEMBERECCLUDED? NI (Mandatory In NH) E.L.DISEASE-EaEMPLOYEE $ 1,000,000 If yes,describe under E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be 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/iwd/workers-compensafionliinvestigabons/. 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. 200 Main Street AUTHORIZED REPRESENTATIVE . Cti Hyannis MA 02601 Daniel M.Cro y,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 i Page 8 of 8 Capizzi Home Improvement Inc. Specifications and Estimates STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I/WE, Jeffrey Heiman OWN THE PROPERTY LOCATED AT 165 Lewis Pond Rd.' IN Cotuit, MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR,THE MASSACHUSETTS.STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING ODE. SIGNATURE OF OWNER: G, — OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit, MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: _ E O 2X6 PT p z 33m ,LEDGER = v f 3 HOU5E N 3 G n v V ' (EXISTING) to 1/2 NEW 2X4s @ 16"OG ") . "R-131N5. _ .. Z IL - REMOVE EXI5TING 2X4 WALL. - O _ RAISE GONG.FND ~ J. .. _ .. WALL APPROX.16" Q Q _ EX.GONG FIND WALL Y z AND FTG5.(®APPROX. tUtl I.— TO BELOW GRADE) Q 0 _ TO REMAIN. Z Mtn Y. FOUNDATION�NALL DETAIL scale 318"=V-0" L. to a EXISTING EXTERIOR WALL TO BE REPLACED USING 2X4s Q 16"OG - = u) WITH R-13 INSULATION r— � o I L------- ----------- — —� I :• I � 2868——, - I Date: i-1—EXISTING CHIMNEY ` I - - 11-1-16 Revisions: L——_— _I \ \ / � BUILDER TO CONFIRM ALL 12-8-16 CONDITIONS AND DIMEN5ION5 ON SITE Final:7 2020FX— O — _ N UN AT O — Note:These sans are for sole F D I N PLAN scaler 1/4 1 0 p o e purpose and /� use of Gapizzl Home Improvement and are not j • to be distdbuted or used for construction other J ' than b Ga Izzl Home Im rovement. > m c, o N 3 4) � mq . .. /LEDGER = HOUSE .N.o.9 . - .. G (EXI5TING) w n NEW 2X4s Q 16"OG 1/2" KR-131N5. Z lL REMOVE W.EXISTING2X4ALL O - - - RA15E GONG FND ~ J } YVALL APPROX.1 6" � Q Q Q EX:GONG FND YyALL. Z AND FTGS.(@ APPROX. - W O 4'-0"BELOW GRADE) q <4 - ' -� - TO REMAIN. st.. C, � -j I I. FOUNDATION NALL DETAIL scale 3/8"=V-0" 'V) � A EXISTING EXTERIOR WALL 0 I M TO BE REPLACED USING 7X4s Q ib"OC I I W N WITH R-13 INSULATION I l6 I - JLn '3 - Lv I I---- --- . ----------- I , U-----------�------r-----':aee--� .,. ' I _ Date: I- --I---EXISTING CHIMNEY L——_—J " \ \ ! / BUILDER TO CONFIRM ALL Revisions: CONDITIONS 12-8-16 + 2620FX — Note:These AND DIMENSIONS ON 51TE Finali •' FOUNDATION PLAN scale: 1/4=1-0 plans are for the sole purpose and - use of Gapizzl Home Improvement and are not to be distributed or used for construction other than b Ga Irsl Home Im rovelnent. Ae4TOWN OF BARNSTABLE BUILDING PERMIT.APPLICATION .e IV Al ;;1�^ f Map 6� ® Parcel G �`� Application.#u�`��-I b—33-I 3 Health Division Date Issued f Conservation Division Application e Planning Dept. Permit Fee ' r C 4C; -it Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis (7 Project Street Address zew<.i ?CNI) Rip Village C c 7ue t Owner ,e ��v�y �- ' l ad�P� E/"7 Address 3 y ��ff��E C/a�,t� 'i/Wie %4 Telephone (T� - 14— 3 010 ® Z130 Permit Request fT�'a�'c) !�/�� �diJt � T/�E AP 1.�It twin .4J �e�Ti¢�1�2c Tan/ 17,6-M0 VX 0,te 0 eCk Q"a ee//Q ee A lee /QAl W;4 / 3 d°,.ec L,4 A1,P>ivJ f/;(y s eG i i7 ' ,u euJ �i2.�rne. E'avr�nfs /J V1*;i !e_ d`&,;y off/ 44et wiz Square feet: 1 st floor: existing 2-000 proposed 2nd floor: existing 0 proposed 0 Total new O Zoning District Flood Plain Groundwater Overlay Project Valuation ao Construction Type Lot Size © ° Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family S/ Two Family ❑ Multi-Family(# units) Age of Existing Structure 9 sy Historic House: ❑Yes C+(No On Old King's Highway: ❑Yes (No Basement Type: Full ❑ Crawl ❑Walkout _ ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: Isexisting d new — Total Room Count (not including baths): existing new O Firs V &ount EPA; Heat Type and Fuel: ❑ Gas 2(Oil ❑ Electric ❑ Other NQV a u � / Central Air: ❑Yes No Fireplaces: Existing New Existin w d� t v ❑Y ►'O N O� p g e T g o� /o�� o e es o Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size 0W%.%8AJgq ,P new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Au thorization ❑ Appeal # Recorded ❑ Commercial ❑Yes o If yes, site plan review# Current Use T e s i a�e�l��i►l S"iN�/E amid Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name :%4 m.e,P 11C C©AM c le- Telephone Number 4©p (Af`22_1p Avrn6 2rn Toile c��' G -5 074ZO Address O/ il.aa� �rl9�fi/ li License # --�-----�--• Coy ( 144 016.3) - Home Improvement Contractor# 10®- V Email T-eyoi T e, C4 P1'27i 1- v1 e- Cv11 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �outul �E ✓1M a 1,C b4)V) Fi 11 SIGNATURE �� v�l �G � DATE Q I FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER - DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 5.16' SEW/S pOND R L-146.64' �•AD 0 LP LP O O o EX. 0 EX. SHED TANK PORCH iv EX o EX. DWELLING 2504• N o RAMP 37.21' 4 31 18' 30' TO BECK PROPOSED REMOVED DECK RELACEMENT SEPTIC SYSTEM PLOTTED FROM INFORMATION PROVIDED /j LEWIS POND BY OWNER. BUILDER TO CONFIRM CER TIFIED PL® T PLAID MBLU 20-55 1 CERTIFY THAT THE IMPROVEMENTS SHOWN of M 165 LEMS POND ROAD HAVE BEEN LOCATED BY A FIELD SURVEY. 2��,P ASS9oyG COTUIT, DRAWN: RBS o DATE: 11-4-2016 ROBB SCALE. 1"=40' JOB #: S275 Co SYKES DWG. CPP r No. 35418 EASTBOUND f *LAND SURVEYING, INC. sio s P.O. BOX 442 ROBB SYKES, .LS. DATE r FORESTDALE, MA 02644 508-477-4511 5.1 s' tEwls '00�V0 46 64, ROAp 0 LP LP 0 D o EX. °DD EX. SHED TANK PORCH N EX. d- o EX. DWELLING 2S.04. No o RAMP ,� 37.21' 11 + 30 TO BE PROPOSED REMOVED DECK RELACEMENT SEPTIC SYSTEM PLOTTED FROM INFORMATION PROVIDED /% LEWIS POND BY OWNER. BUILDER TO CONFIRM CER TIFIED PL 0 T PLAN MBLU 20-55 I CERTIFY THAT THE IMPROVEMENTS SHOWN OF Al165 LEWIS POND ROAD HAVE BEEN LOCATED BY A FIELD SURVEY. ���P�t� ASsq�yG COTUIT, MA DATE: 11-4-2016 DRAWN: RBS ROBE SCALE: 1"=40' JOB #: S275 c SYKES ; DWG. CPP No. 35418 EASTBOUND *LAND SURVEYING, INC. P.O. BOX 442 ° n FORESTDALE> MA 02644 ROBB SYKES, LS. DATE 508-477-4511 . _ i1fV�fldlWfOlI6MfWI',,. _ .••w-. - .DP�Q!f�Of liE[�jl.YlP�.�ll�- I'Cotagress Swee4 Suite 100 Bost^KI 02.114-2017 www lltliS goyla i Workers'Compensatim Lu mmuee Affidavit"BuildadContrutoraffliectr1clandPlEnbers. ' TOU HIM NITS THE YI�{t1UMNGAUrHOW ', Atmllcant3nformaiiaat Please Pft_ Name •CAPUM HOME IMPROVEMENT INC Address•1 W NEWTOWN ROAD City/We/Zip:COTUIT,MA O2635 Plmne#:5084284-51$ Areyon an�wye rc ore approp aboa; Type ofpwjed(raflftvo:. 1.®I am a ompioyerwa 40 mepioyees(tbtt aud/artime)° 7. ❑New coon . ioImnasoloprupdeworpmtmbfpandbmnDmqloYmwmidgg form in 8. rl Remodeling mw cqacdy [No wadoras'comp fob ra phv l 9. ®Demolition 30IemaWm ditallwotm wZ(,ldowda&oomp.htsmwengwwdlt 4.oIamahomeovjerandw.Mbehfdogcooactmtoc luctattworkonmypWwW iwIU' 10QBWlftaddhion ensmre thatell a [errors eida have wotlaecs' n hamsorate sod 11.®B1eCftw emirs 6r ad&dm propsldswlthnoemployew. 12.[]Phmft9r4P8hBvraddft1ow S,QIemageIImWoonftdorandIhava:hWtbe Ifsmdon'doa addmek 13 s • Th�e�2�aveampiaye�aadhayswodc�'�np.hrsm��.= 6.Owemac*oza mimdhsoffi�shma **ri&ofum4doaperM(3Lc. 14. O@lef 15�,:QI{4�amiv�I►avenaemploye�►:LNowad�"c�mp.3ascusnces .l • , °Anya 0kwttlrat box#1 most alto fill oat the s bdbw*owivzfiL*woW admPoEwbonnadm tamwwnmvbDabnftftaffldzvkk&cftggwymdftaUwmtenddmbimoumMoconummnmotodbmkanmaMdatmdmmgsaA =C.ontracto dmtcbedk dsboxmr9a#whWen abed fowingdonmeafirewb•ca msandstam wbda ornottbasee hm -!Lkyaes Iftlmha+reempl. SYaa1 $'ao�p Policy>i I am ara empwer that lspvvhftg wmtml mrwmWon insunancefar n Below 19 Ae poft mdjob a* irtfarrmr. , Insttm m Camp m y Name:AmGUARD INSURANCE COMPANY Poliay#or Self-ins.Lie.A.R2WC627200 Bi0fiatim Daft 12125/2016 Job site Address• Cy/►.bWzip= � --.�---- Attach a copy of the workers'compensation pt►liicy declaration page(showing the policy number and expM"date). Failure to sectuee ommme as required under M(H,a 157,§25A is a cxlmit al eiolatift pumshable by a ffae Up to$1,500.00 and/or one-pew iWsonr4 as wall as clv5 penalties in to from of a STOP'9 O ORDER and a imM of Up tD$250.00 a day aphist the vlolaW.A WU offt may be farwarded to*a Offfm of bmsWom of*o DIA fnr maul = covmv verwiioa MIN*' psFmRfrJ' etoro�aprovedahmLstraessrdCe k Ojkw art(j. Do xaivr&e arm to be comid d by Cw ormm didd City or Town: PermdULieense# IssafngA oaity(circle one): 1.Board of Ham,2.Miling ftar Wifft A.City TOWIL Clerk 4.Electrical inspector 5.lPlamb1n9h per 6.Other wj' Contact P"erso>it: Phvae#: DATE(MMIDDIYYYY) Aco CERTIFICATE OF LIABILITY INSURANCE 1 2 15 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 poilcy(tes)must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,Certa n-pollcies may require an endorsement A statement on this certificate does not confer rights to the certificate holder lieu of such endorseme s PRODUCER NAME: FAX ROGERS&GRAY INSURANCE AGENCY,INC. PHONE A/ No -MAIL 434 Route 134 ADD INSURE S AFFORDING COVERAGE # South Dennis MA 02660 I NSURER A: AmGUARD Insurance Com an 2390 INSURED S: CAPIZZI HOME IMPROVEMENT INC SURERC: 1645 NEWTOWN ROAD SURERD: SURERE:COTUIT MA 02635 SURERF: 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 SUED OR MAY PERTAIN, THE INSURANCE CERTIFICATE MAY BE IS 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. POLICY EFF POLICY EXP LIMITS INNS TYPE OF INSURANCE POLICY-NUMBER MMID EACH OCCURRENCE $ GENERAL LIABILITY PRE IV e $ COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR MEDFJCP one $ PERSONAL&ADV INJURY $ GENERALAGGREGATE $ PRODUCTS-COMP/OPAGG $ GEML AGGREGATE LIMIT APPLIES PER: $ POLICY PRO- LOC AUTOMOBILE LIABILITY accident)BODILY INJURY(Per person)'`$ ANY AUTO �DII Y INJURY(Per acddenU $ ALL OWNED AUTOS AUTOESDULED NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS $ EACH OCCURRENCE $ UMBRELLA UAB OCCUR AGGREGATE $ EXCESS UAB CLAIMS-MADE $ nPROPRIETMORIPAIRTNER/EXECUTIVE RETENTION S WC STATU- OTH- COMPENSATION R2WC655250 12/25/2015 12/25/2016 AOYERS'LIABILITY YIN E.L.EACH ACCIDENT $ 1,000,000 t IETORIPARTNER/EXECUTIVE NIA EMSER EXCLUDED? E.L DISEASE-EA EMPLOYE $ 1000000 in NH)be ImderE.L DISEASE-POLICY LIMIT $ 1,0001000 ION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more epee Is required) CERTIFICATE HOLDER CANCELLATION Town Of Barnstable THE ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 Aun+oR¢ED . X;, ©1988-2010 ACORD CORPORATION'. All rights reserved. ACORD 26(2010105) The ACORD name and logo are registered marks of ACORD - n�1[P�[aii iirniune�r�C�r�n_<CrrJJr7c�lr:ic/t1 -,Office of Consumer Affairs&Business Regulation License or registration valid for individual use only u ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: a Office of Consumer Affairs and Business Regulation 'Registration: 100740 Type: 10 Park Plaza-Suite 5170x y� Expiration 6/23l2018 Supplement Card Boston,MA 02116 CAPIZZI HOME IMPROVEMENT,•INC. } JAMES MCCORMACK 1645 Newton Rd. Cotuit,MA 02635 Undersecretary No valid without signature Massachusetts Department of Public Safety Board of Building Regulations and Standard's. <' License: CS-076261 ' I :Construction Supervisor JAMES MCCORMACK 73 FEARING HILL ROAD, , WEST WAREHAM MA 02676 Expiration: Commissioner 11/13/2017 Off Page 8 of 8 Capizzi Home improvement Inc. Specifications and Estimates STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT UWE, Jeffrey Helman OWN THE PROPERTY LOCATED AT 165 Lewis Pond Rd. IN Cotuit, MASSACHUSETTS. . - r I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY.AGENT TO APPLY, FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR,THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING ODE _ SIGNATURE OF OWNER OWNER'S ADDRESS: 0 WNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: " LESSEE'S TELEPHONE: + APLLICANT'S SIGNATURE: . APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit, MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: , RESPONSIBLE OFFICER TELEPHONE: Bowers Edwin To: permit@capizzihome.com Subject: Permit/Application:TB-16-3011 at 165 LEWIS POND ROAD, COTUIT for Building - Addition/Alteration - Residential Dear James, We are unable to approve your application for a building permit for modifications to existing deck. This property after viewing the site on 10/17/16 requires the deck be brought to current code as there are unsafe conditions at present. Please reapply for a code compliant deck or rear egress. Edwin Bowers Town of Barnstable Building Inspector 508-862-4025 1 i� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 020 6 Y :.#Map Parcel Appcaon I Health"Division Date Issued. Conservation Division Application''Fee Planning Dept. Permit Fee 9 �' Date Definitive Plan Approved by Planning Board t cx Historic - OKH Preservation/Hyannis Project Street Address _I 65� �, 1�i-f P000 TV VillageU 0 °� Owner��� � � �1�� � t���Y �1�INAll Address C:o4fC,4 �'I/e� Telephone f6k - I Y, O-Z13y Permit Request D��I!�l'� M©v�L1�1 ° " � ivi' ! 4& . WA I I CAP Q t-" 14 to if tiv°r A)etv IPA l In S Jr?07 &T BA c-14 het 1(�� e o�c li Square feet: 1 st floor: existing OCT proposed 2nd floor: existing G` proposed 0' Total new cV Zoning District Flood Plain Groundwater Overlay Project Valuation 191600, G'0 Construction Type Lot Size 0 a Cee. Grandfathered: ❑Yes ❑ No If yes, attach supporting d;ocum�r-station. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure J . Historic House: ❑Yes ❑I On Old King's Highway.0 Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) �4::. Basement Unfinished Area (sq.ft)-- SO Number of Baths: Full: existing new d Half: existing new 0 Number of Bedrooms: 3 existing 0 new Total Room Count (not including baths): existing new First Floor Room Count N ,t Heat Type and Fuel: ❑ Gas ❑vil . ❑ Electric ❑ Other Central Air: ❑Yes L4 Fireplaces: Existing Q New Existing wood/coal stove: ❑Yes LYNo Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new/ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes a4o If yes, site plan review# i Current Use � Si�i�A,"�;A 1AilJ %'Ct !�Al Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) NameJA �a ``L CUKVnAC �4- Telephone Number ��� �� Wyy f 19P42 d ertz r-M i'eue avt Address License # L° M44 4- g f c 9 d� 7 �U)II R� to- 7 it, 3/'� Home Improvement Contractor# M it t; - v l.6M Email i CA helve , a".44 Worker's Compensation ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 1rM,PLe,iI! FOR OFFICIAL USE ONLY I ' APPLICATION # DATE ISSUED !. MAP/ PARCEL NO. ADDRESS VILLAGE OWNER =�. DATE OF INSPECTION: FOUNDATION t �> FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT t ASSOCIATION PLAN NO. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION A t Map 020 Parcel.---'-0-�y _ Application # . ,`fir�• � f Health Division - '" r_ ;Date Issued Conservation Division F k # `°ter Application Fee Planning Dept. �" Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH ' _ PreseCvation/ Hyannis - Project Street Address to a -Village C[-'U t 4" - y Y r Owner "�I N 0 lTi V u 1MAA1 Address_ C 0 - �'. V _ Telephone -6k _ GY- 3 '/�!�' AM81�I , k1A 0-Z13�j Permit Request De.Lk�,-RgMopetiu ' 'D'-0<ml SONS 14AR-0W,4e66 oNeX/JTln4. , 159.It WA .( I cA hteMr-Nr A)euI TAi1 n SV vyetn aT BAC-14 .Ae6Vi4) oI,,- ' 3 � C� Nr 18A C rG 0 e a t2 J! e /Z .� ✓2. Square feet: 1 st floor: existing a(po proposed o 2nd floor: existing G proposed 0 Total new ;1P Zoning District Flood Plain Groundwater Overlay ' Project Valuation 12,6no. 60 Construction Type WOOF rRAW 6 ' Lot Size ` �7 a C d Grandfathered: ❑Yes ❑ No If yes, attach supporting documentatiori. Dwelling Type: Single'Farnily Two Family ❑ Multi-Family(# units) � '° - Age of Existing Struoture" � %G Historic House: ❑Yes ❑�4� On Old'ing's Hsi �hway: ❑Yes ❑:No Basement Type: ❑\ull ❑'Crawf, ❑Walkout ❑ Other w �},~ Basement Finished Area (sq.ft.} _ >- "— Baemerit Unfinished A r`ea (sgft) - •-- -- u Number of Batas: Full: existing 3 new ,d ( Half:p'existing O 'new d Number of Bedrooms: existing 0 new Total Room Count (not including baths) e isting 7 new. y\` First Floor Room Count Heat Type and Fuel: ❑ Gas 0 it ' ❑ Electric ❑ Other kpN 3 CentralF _r 01 Fireplaces: Existing 0 New Existing wood/coal stove: ❑Yes ®'No Detached45u,uy���.,.,� ., ize�Pool: ❑ existing 0 new sid1�e ', Barn: ❑ existing ❑ new/ _ Attached P �n size _ hedx ❑ e` istxin 0 ❑ new size = Other: IM Zoning Board of Appeals Authorization ❑ Appeal # ``"i'r�% �� ,� Recorded L Commercial ❑Yes WC If yes, site plan-review# Current Use ,X eSi4fAd AI e,AJ4A-6' A Proposed Use eS1d-fAJ7_A1-. APPLICANT INFORMATION (BUILDER OR 119MEOWNER) NameA t71 Z'.SCl'" A C / s Telephone Number �a� �� y yy S�6 y��z�_!.. 6,4( ZZi ,Idt'q '�� p lee LiRm6 #- l� Address License # 014241 Ne011-0U41 96 rW IY4 16 3r Home Improvement Contractor#4 l 007 y0 Email lon 0, 'CA pi t i nme.• «11 Worker's Compensation # ��,(1VC. f �✓r d '' : ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO' SIGNATURE G DATE /0/0,f/aa/� FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Page 8 of 8 Capizzi Home Improvement Inc. Specifications and Estimates STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I/WE, Jeffrey Helman OWN THE PROPERTY LOCATED AT 165 Lewis Pond Rd. IN Cotuit, MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR,THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING ODE. - . SIGNATURE OF OWNER: OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit, MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: II Massachusetts Department of Public Safety I Board of Building Regulations and Standards License: CS-076261 Construction Supervisor JAMES MCCORMACK 73 FEARING HILL ROAD WEST WAREHAM MA 02576 Ezpi ration: Commissioner 11/13/2017 t. i I - ��/�r•�``[ar�iiirnircr.'r�/� / _t�lir.i.iin•�n'r•/%t --Off- of Consumer Affairs&Business Regulation License or registration valid for individual use only .> `tt;�—,� �'c��iOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 11� r'_ ',� Office of Consumer Affairs and Business Regulation: ��`�! ieRegistration: 100740 Type: 10 Park Plaza-Suite 5170 ,�,°" Expiration: ,6%23/2018 Supplement Card I Boston,MA 02116 CAPIZZI HOME IMPROVEMENT, INC. _ i JAMES MCCORMACK 1645 Newton Rd. Cotuit, MA 02635 -. Undersecretary - No valid withoutsi nature g - J . .. iJw.VVI/Nlav Qr►Nfi6ll VJ:tuNWMVIF['f1iGiW. - Department oflndtrstt'>'ad,Aecidents 1 Congress Sft4 Suite 100 Boston,K4 02114 2017 www.mamgov/dia Workers'Compensation Insurance Affidavits Bafldere/Contradors/ElectridanaiPlumbers. . TO BE FHM WfMT>3EPKBff rMGAUTHOWY, Atrniica�Infarmatlon Please Print Lesibly Name(Business/orgsa mU0n&&vldusl):CAPIZZI HOME IMPROVEMENT INC Address:160 NEWTOWN ROAD City/Sfffte/Zip:COTUIT,MA 02635 Phone#:508 428-8518 Are you an emplogeft checltthe appropriate boz: Type of project(regvhvd). i. I am a employer with- employeas(hilt andtorpact-time).47. ❑New construction 2.❑lam a sole pmprleturorpartnership andhaveno employees working forme in S. b4emodeliug any capacity.[No wo6 mrs'camp.ins ounce required] '� '3.Q I am a homeex+ner doing all work myself.(�To waders'oomp.insurance requinedj t 9. ❑Demolition 4.rl1 am abomeowner and will be biting contractors to coufta all work on my property-I win 10[)Building addition ensure that all contractors either have worlmrs'compensation insurance or ace sole 11.0 ElecWCsl repairs or additions Proprietors withno employees. 12.QPlumbitugrepairs oradditions 50lam a general contractorandl have hired the sub-contractors listed on the atteehed sheet. Those soh-eoahacbors have smplayees andhave wo&ers°cup.insuraac�t 13. frepairs 6.Q We area Aporation and its oil omshave avaclsed dietrdit ofmxemptionper MGL a 14.ff0theilJi®/�' 152,§1(41 and we have no employees.[No wodwa?comp.insurance required] *Any applicsuttihat checlm box#1 must also fill outthe section below showing their workers'compensation policy information. t Homeowners who submit this affidavitindiceting they arm doing all work and tip biro outsiders must subtaka uewaffcdavitindicaft sack tContracbrs tlhstcheckthis box must attached an atktid-al sheet showing the Dam ofthe sub-confractors and state whether oraotthoceeaffties have '~ employees. modoag'conqLpolu7 mmmbeL I am an employer that lsprovi ft workm compensation dnsuA=wjhrnr ernployeaL Below ts thepodicy arrd,fob sft informaeo Insurance Company Name:AmGUARD INSURANCE COMPANY policy#or Self-ins.Lic.A R2WC527200 Fgpivation Date:12125/2016 Job Site Address: k?t is i j hap F l City/Stata/7Ip: CO•'.'ru°J t; //4 Attach a copy of the workers'.compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as m1ulred under MOL c.152,§25A is a criminal violation punishable by a fine up to$000.00 and/or one year imprisonment,as well as dW penalties in the form of a STOP WORK ORDER and a fine of up to$250.60 a day against the r.A copy ofWs statement may be forwarded to the Office of Investigations ofthe DIA for insurance 1 ca vetage on. I do hereby- , -th de andpena0v of erjury dW the'n mwmdonpmvkW above is tree and correct S' .V x7 /t phone#:508-428-951 Offlclal use only. Do not.u*e In Ads area,to be completed by city or town o Tidal City or Town: Permwucense# IssuingAuthority(circle one): 1.Board:of Hoalth Z BuildingDepartment 3.City/To"Clerk 4.Electrical Inspector 5.Plumbingluspector 6.Other Contact Person: Phone#: ^. . AC40R CERTIFICATE OF LIABILITY INSURANCE112/29/2015 DATE(MMIDD/YYYYI 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: ROGERS &GRAY INSURANCE AGENCY, INC. PHONE FAX A/C No Ext: A/C No): 434 Route 134 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# South Dennis MA 02660 INSURERA: AmGUARD Insurance Company 2390 INSURED INSURER B: CAPIZZI HOME IMPROVEMENT INC INSURERC: 1645 NEWTOWN ROAD INSURERD: INSURER E: COTUIT MA 02635 INSURERF: 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident e ANY AUTO BODILY INJURY(Perlperson) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident)AUTOS AUTOS $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE 7L $ AUTOS Pera ccidt 4� 4r $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ A WORKERS COMPENSATION WC STATU- I OTH- AND EMPLOYERS'LIABILITY Y/N R2WC655250 12/25/2015 12/25/2016 TORY LIMITS ANY OFFICER/MEMBER/EXCLUDED?ECUTIVE� N/APARTNERIEX ""'.,\ E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION Town Of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 200 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Hyannis, MA 02601 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD r a � f p s Pei, Ife, Ait r. b ao i t c 8 - X ° 4 r L o jo t1.50TH, B 4A1 `�" _ 'fit �,Ald v , p Page 1 of 1 Rell eI d etki;t Ov Refit, dpjjv— &,Vy w �d 6 R•WDK 8..- BAS. 29. 0 A5' 18 13 BM T1 '# BAS' 1 1.2�. 24 FUS SAS 1• B_ MT 2.0 BMj " _ 18_ I 2 . FOP, 36. ; ;7� http://townofbamstable.us/sketchesl6/878_910.jpg 10/13/2016 a NU .i POW,- S C 1 i .. L + + f f f/W -eel i 3 FT , t • 7 {q( 1 y r--^--fir •: �� { �—.. � �, t .�..�., �.Y,.,�,- + �.�. r .._ ,_.._ 3,_ t z � t }_ .{.._..- 39 I i T .1.,..:.. /_+ AN 6 i .. C i ` . , �� • - -_r_avn�mc<rzi�. cu�F*c..'-i •_sA 7 ..,_ #. .+ ..-. - 4 , { , x /ED + t t $ -- ' .+� � .t .. ..., -.q..... #. rN.w4•�I,��`T�I.w_:.�. 1._. } _ �- "" ,x 4 j,.. . .- F .,.p._.. L ✓ F Page 1 of 1 �e114c4 d&kj;tS °N Rekv yetk. awe wo 1 _ . _ 31` � 6 WDKT 01, ` . BAS; ;29 1 ': 1 AS 18BMT1 OAS 1 12' 24 FUS �36 BAS n 9MT 1 OAS 0 BMT 18 t ;" OP 18 36 r/1a i7f po got lt i i f f http://townofbamstable.us/sketches16/878_91Ojpg 10/13/2016 i Town of Barnstable Regulatory Services �1Ne tp Thomas F.Geiler,Director Building Division sMaxsznsLe. Tom Perry,Building Commissioner Mesa � i639 �� 200 Main Street,Hyannis,MA 02601 prFO MA'S A Office: 508-862-4038 Fax: 508-790-6230 January 10, 2014 Elaine Giniewicz 165 Lewis Pond Road Cotuit, MA. 02635 RE: 165 Lewis Pond Rd., Cotuit Map: 020 Parcel: 055 Dear Property Owner: This letter is to notify you that an inspection was conducted at the above referenced address for permit application number 201202543 and the following deficiencies were found: 1) Guardrails for the exterior decks not installed in compliance with 780 CMR 2) Guardrails/handrail not installed on a flight of stairs. 3) Joist hangers not installed with the proper fasteners. You must correct the above deficiencies and contact this office for a re-inspection. Thank you for immediate attention in this matter. Please call (508) 862-4034 with any questions. Respectfully, L Lauzon ocal Inspector ,(508) 862-4034 jeffrey.lauzon@town.bamstable.ma.us TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Appcaion # ' Health Division 6Z °k ,p to ued ( � �-.. , c _ Conservation DivisionL Application Fe Planning Dept. - _ Permit Fee, DIV11 , Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street ress f _ Village Owner °'t \� Address. 11t �' Telephone :� 01 q Permit Request Square feet: 1 st floor: existing proposed end floor: existing _proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Typ Lot Size Q 6 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure _ Historic House: ❑Yes• ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: � Full ❑ Crawl Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) —_1 q,i2q �A� 4 Number of Baths: Full: existing new Half: existing _ new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas il ❑ Electric ❑ Other O 4 Central Air: 0 Yes No Fireplaces: Existing j l(New Existing wood/coal stove: Yes ❑ No Detached garage: ❑ xisting ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes 1,0 If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION -- - �_=(BUILDER OR HOMEOWNER) Name E1 c,1 e' LC)1"eCO i Telephone Number Address a o a` �.-' License# Home improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS FROM THII PROJECT WILL BE TAKEN TO SIGNATU DATE FOR OFFICIAL USE ONLY } APPLICATION# DATE ISSUED MAP/PARCEL NO... ` ADDRESS ` VILLAGE � OWNER DATE OF INSPECTION: { —FOUNDATION FRAME t 1 'i INSULATION! r , FIREPLACE ' g ELECTRICAL: ROUGH ;`FINAL S PLUMBING: ROUGH FINAL GAS:, ROUGH FINAL s _ -FINAL BUILDING` . `t lo:f i "� DATE CLOSED OUT ASSOCIATION PLAN NO.' t �„ E r TO'F Tr of E apstable -gegulatory Ser71ces ; � • .�c-� Thoma.F. Geier,Diractor Building Division ' Momas Perry,-CB 0,B uff ding Corn,,,i.«;oner 26D Mafia Strut, Hyalmis,MA D2601' www.EoWn.barnstab le-=-us 'Officoc 508-8524038 Fax .508-79D-623D' PLAN �''-c� . . G �• w �cam' nag m��l ��® �.�OC • Owner: �� P • Pro'cct Address 11O� �5 Uot?A Builder 'i -� The faIIowiag items were noted on revie-mng: 3 o s 5 %Ll u � REYiEwed by: f�� � 4 The Commonwealth:of Massachusetts Department of fndustrial Accidents Office of InvesVgations -600 W ashinegn s freet L ' f' Boston,MA 02111 www.mass.gav/dia Workers' Compensation Insurance Affidavit: Rudders/Contractors/Electriciayis/Piumbers A-Pplicant lnformnfion Please Print Le 'bf" Name(sue ss/o=�anizati�,� ;�;�„ai � / Address : 1 C:�i 5 Q@�(�G� MA- City/ t/Zip: i na 3 �. Phone.# - U�' y -� Ai�you an employer? Check the appropriate box: a of ro'ect re unre 4. I am a general corgiactor and I T`9P P 1 ( q d) 1.❑ I am a employer with - � � b. New crmetrnrt;pn employees(fall and/or part-tone).*. have Lured the gab:-contractors 2.0 I am a•sole proprietor or partner- listed on the-attached sheet. 7. Remodeling . ship and have no employees These sub-contra 'm have 8. 0 Demolition working for me in:any capacity, employees and have workers' [No workers' comp.insurance cnmp..msuranae.t k 9. [j Bznldmg addition required J 5 [] We are a corparatim and its 10.❑Electrical repairs or additions 3. I am a homeowner i2 work officers have exercised their ❑ epairs or additions . damp Ii. Plumb' r • . niysel£ [No workers' comp. right 6f exemption per MGL . hNarance required]t c. 152, §1(4), and we have no 12.❑Roof repairs employees. [No workers' 13.0 Other .comp•hwarance required,] *Auy applicant that checks box#1=st also fill out the section below showing thee•workers'compensation policy infra matim t l3nmeowaers who suhmit this aiidwnt indicating they are doing all work and then hire outside contract=must submit a new affidavit indicating such. $Contractors d3at check this box must attached an additional sheet showing the name of thc sub-contractors and state whather arnot those entities have employees. If fhe sub-contact us h6t e #oyees,they mustprovick their works'comp.policynumber. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. hma ance Campany Name: Policy#or Self ins.Lic.M. Expiration Date: - lob Site Address: Cz ,/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure,to,sv= coverage as required under Section 25A of MOIL c. 152 can lead to the imposition of cdminal penalties of:a fine tip to$1,500.00 and/or one-year m4fsomnent, as well as.civil penalties in the form of a STOP WORK DRDER and a fine of up to $250M 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 inmrance coverage verification I do hereby certify u e s- d�e4 es ofperjury that the information provided above is true and correc4 S - •e' Date: � 1 (�� _ Phone �.p �t Q , official use only. Do not write in this area, to be completed by ezty or town official City or Town.: PermitUcense# •Issuing Antharity(circle one): ; .1.Board of Health 2.Building Department 3.CityPTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: THE 1'b�1� Town of Barnstable Regulatory Services '* tvsrABLE, t Thomas F.Geiler,Director 1639.'°hen nett'' 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: L_e w 15 Roo-A. number �? street village "HO)v1EOWNER": �Q�e, �lelt?lTvy Qg _0�0 Jos gy)g 0339 name home phone# work phone# C�T MAILING ADDR ESS:REss: 70 b 9�l�D�;- r city/town state - - zip code The current exemption for'h meowners"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'liome in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Oflcial 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 r I`ae L 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:homeexempt . . . . ,. �Ila s Town of Barnstable Regulatory Services * �axsrnsr.E, names �, Thomas F.Geiler,Director o " Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder ` as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. - 4 Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS LEWIS POND - N87 49'40"E 4 1 01 1 Y �p 'b •LOT 24A LOT E Ewl. _ L , DES. ZONE.- 'RF" This MORTGAGE INSPECTION Plan is For FLOOD ZONE- "C Bank e Only -- REGISTRY OWNER JAN_E_-F'_ffANV&L------------------- DEED REF: �j�J1------------DUPER: �L9IN �1�INl 'K'1��---------------- DATE: —414194---------------- PLAN REF: _16__?Z$ -------------- -----= SCALE:1"= FT.40' FT. HEREBY CERTIFY TO 6 B MQ _-- YANKEE SURVEY eDRPORATIDN -- �H of THAT THE BUILDING ,HOWN ON THIS PLAN IS LOCATED ON THE GROUND AS pgat �, CONSULTANTS ;HOWN AND THAT ITS POSITION DOES CONFORM a A *_4 40B (SUITE 1) '0 THE ZONING LAW SETBACK REQUIREMENTS OF THE MEAITHJEW H 'OWN OF ___HARMIL-I&E _ __AND THAT 9 Ho• Q INDUSTRY ROAD T DOES-_N_G�.T_- LIE WITHIN THE SPECIAL.FLOOD HAZARD ���. AE �o MARSTONS MII1S, MA'. 02648 sr sty TEL 428-0055 AREA AS SHOWN ON THE H:U.D. MAP DATED_7/_2f�z� '�a�t ��Qs ;o t - ,250001- 0021 D"--- - . FAX 420-5553 _- PAUL. A. MERITHi PLS — SURVEY N TOTOMBE USED FOR FENCESMETC: 14530 KJH l/- A,vv i�� l�n D Its lad €' p 7,-11in D4')tie -3vo �tll 11-9 .940 (A �x ajlv�t44okeA "'� CID Assessor's office(1 st�Flco1: � _ ©�S- ' 'RR SUS Y"E r �♦ Assessors map and lot number C SYSTEM o Board tol`Health(3rd floor): �" �� "FALLED IN COMP Sewage Permit number ,9,-fh !�✓ ( TITLE 5 i 11ABd9fADLL Engineering Department(3rd floor): 4fCN61�E(dTAL C®® 9.House number TOWN RE�GULATi®N Definitive Plan Approved by Planning Board 19 DNA a APPLICATIONS RROCBSSM8190E 030 A.M.and 1:00-2:00 P.M.only Barnstable Con ervMo : _s >' n O rj B A R N S T A ` " �, " „� ' I" q-L - ING INSPECTOR Signed APPLICATION FOR PERMIT TO �/�S/T � l � � bh/ ' I TYPE OF CONSTRUCTION 19 � i TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following infor ion: Location l co S e-w i s PD ICJ 8 M . Proposed Use Ries r FA m Zoning District Fire District � y / Name of Owner Cwa,�S A4 ftb Address 14 w j yb 6 Name of Builder 7 f Address Name of Architect Address Number of Rooms—';), RaD+u� 4" �,fir�6�MtkTr Foundation (,dIVLTi� Exterior Roofing 45P/) uL75&04064�m Floors W�� �L Interior Y' S T � /✓�r� l Heating LTi2d. / �HTff C�UT��tiL Plumbing Fireplace � � Approximate Cost LTD Area 400 Diagram of Lot and Building with Dimensions Fee c.J y - OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. awlName Construction Supervisor's License 1. MANDELL, CHARLES , No 3 3-4-5 3 Permita,For Add To Dwe 1 1 i nq, } Single Family D 1 i ng kocation 165 Lewis Pond Road C o tu•i t _- Owner Charles; Mandell - Type of,Construction (-Frame Plot x'Lot Permit Granted January 12 , 19 90 y Date of Inspection 19 Date Completed 19 ' ® Wil CIO � t-- rn :3 40 s C5 C r 04 • -_ Q _ .. t � .sn; tr ,�c •ti r n • ' - -, , 'iia- ~J .�.. •• , •�.+:.•r°'''trr s -,...`..'T... .:.r�1.'1E'�' , V `. .yiJ-..w..:"'�1...... �• Assessor's office(1st Fbork�� Assessor's map and>ot number E o o� Board of-Health(3rd floor): t r �� `� Sewage Permit number A Z BAH.d9TODLL i Engineering Qepartment(3rd floor): , �o rasa House number t ° i639 ®� Definitive Plan Approved'by Planning Board . 19 ,F0 MAI b` APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00'P`M.only 1 TOWNOF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ®/GJ�l2 LI I ^ � '� `� - 0, 7 " + TYPE OF CONSTRUCTION L DA -'2LegCT/07? 19 i TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following infor aiIion: �i S Et )-S Polib P D , u , Location , , , Proposed Use t S I n F7P r Zoning District Fire District _ ,�7 Name of Owner ��f�j(� S {q/�>� �L.•� Address /4 1 �V 1)6fi t 0� �(�1/�'�X11. v r FY Name of Builder Address Name of Architect Address ,cam r .� Number'of Rooms PDOkAs �� ��5�� �� Foundatiop>._ Exterior WOO ) R of.- Vle Floors WA0D /l�-17 �7J�-� Interior PA65T&77— ebIl1_2L r Heating �' � d2 1 �- !r'I PI um bHTtf A7T/OA.) Fireplace & Approximate Cost __D J�a • _,Area Diagram of Lot and Building with Dimensions Fee Pei PL S _PT/ 4 n OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS , - - r I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name - /�,i '1//l . Construction Supervisor's License MANDELL, CHARLES A=020-055 N0 3 3�4'�S 3 Permit For Add To DwP 1 1 i nq Single Family DwPllinq Location 165 Lewis Pond Road _ r sf Cotuit Owner Charles Mandell Type of Construction Frame , r ' Plot Lot Permit Granted January 12 , 19 90 Date of Inspection 19 Date Completed 19 PERMIT COMPLETED 1111AL TOWN OF BARNSTABLE BUILDING DEPARTMENT _ nI , HOMEOWNER LICENSE EXEMPTION Please print. + . DATE!" , /_LOCATION .I • um er treet ' " �d� �,•� . a es ection o t "HOMEOWNER" L own ame �a —/0� 3 ome p one or p one PRESENT MAILING ADDRESS I� 1sZe; 1ty Own : The ;lk.% a e i p Code ,, cu'rrent exemption. for ."homeowners" was extended to i.nclud11` ' dwelli"n.'gs.. of six: units .or Tess an o al low such e. owner-occupied. ivi - for hire, who.does not possess a license; provided homeowners.. to engage, an..i n_rac1 s supervisor. (State Building Code Section that the owner ;DEFINITION OF HOMEOWNER: Perso•n(s) who owns a parcel of land on which he/she 'side, on which there is, or is intended attached or. detached structures ,acce resides or intends to re- to be, a one to six family dwelling, ;A person who constructs more than oneshome't�nsactwoSeednd/or farm structures. ;considered a homeowner. Such "homeowner" shall submit two-year pershall not be `on a. form. acceptable to the Building Official, that he s ;for all such work performed under the bui'idin erm' the Building Official , / he shall be responsible . :The undersigned "homeowner" ass g.p 1 ec ion . Building Code and other a assumes responsibility for compliance with the State pplicable codes, by-laws, rules and regulations. :The undersigned "homeowner" ce Barnstable Building Department.'lfi rtifies that inimum inspection procedures and requireme +and that he/she will comply with said he/she understands the Town onts f Procedures and requirements: HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic, .to .comply with State Building Code Section ` ' feet '`or-larger, will be required 127.0, Construction Control _ , r VY •.. • •• HOME OWNER'S EXEMPTION The Code state that J . Permit "Any Home Owner Y� is required shall be performing work for which a building (Section 109.1 .1 exempt from the provlsions ,of this section - Home Owner engages Licensing of Construction Supervisors) ; shall gages a persons) for hire to do such work, thatrosuahtlHom©to If wnea act as supervisor . 11 Many Home Owners who use this exemp`t,lon are the respons l b i l It l es of a supervisor se unaware that they are assuming. fot` Licensing Construction Supervisors, ( e Appendix o, are and- Re --,! Often results In serious Section 2.15 gulatlons problems - ).• This= lack of awareness Unlicensed persons. particularly when the Home Owner hires . • Unilcensed In this case our Board cannolt, proceed against the Person as t would with licensed Supervisor.. The Home Owner actin , ;::: yasisu ervisor is ultimately responsible. To ensure that the Home., Owner Is fully aware of t communities requ�lre,� as part of the permit a ills/her responsibilities, many certify that he/she understands the responsibplitlesiof ,a last•page of this Issue Is a form current ) that the. Florae Owner care to amend and adopt such a form/certification Supervisor , ' On the . Y used by several towns. You may for use In yOUr community. APPROVED e�rOTE CHA GES TOW F BARNSTABLE Building Inspection Deparbnent S1AE EL6U�T119�'1 C OAPLC S MI}NDEI - as1DENG67 it A4J O RJ�, Corti !T, A46, t ... .. Irk .._ .- , .. . . ... i I n+swt,Pt��'► (� ��e�6LFts ,n�,S u�Ario°>7 ssRXorP?)�J6 i}HAUL- /` VJ)HDS"LL 5N1NbLE5 /2" 2*8 R4M-Rs � CoarlINuouS VEUT�D DWp cj56 i ZX'1 3 U 05 2ND FipDFZ- PR/1ME / g�AGt P-9PCZ A( Pcywo(9 D ZX`I57uDS lb� �.G. 3�q Pt,Y,,uoop /T A I ztwALl U. A6Ul�LL1uMl3— �i is"� ay 47'00T11.56 vi Tj,) K ai y-6 . -6 I I _� =,.D I I t.n j3195C 1���;v'f" i r • Q b \ -TS =c�r ` aaAoTT EI L_I N� I 1` k n u y-6 ' 4-4 9)UST/N6 two o�ri CIT 3,-6,1 �gl_Tol' i 9� Yyl�=/�6' Eal. h'i�"FABLE Town of Ba* rnstable , Op THE Tp� - WP` "o Regulatory Se _h � rvlces :�-.-----�--- Thomas F.Geiler,Diiector �xivsT►sr•,E, : ' 9� KAI Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 1?ER11'IIT# ( FEE: SHED REGISTRATION 120 square feet or less Location of shed(address) Village Property owner's name • 1 Telephone number oil 05 5- Size of Shed — Map/Parcel# Signature b L Date Hyannis Main Street Waterfront Historic District? ' Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required), (� PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF TB E AB OVF, . CONT IISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE, PLEASE SEE THE APPROPRIATE COM31'IISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN LEWIS POND 91. 4Q 85" i N87 49'40""E 7. c o ,1�y �bb fr 363_:__ __ _--- ----- ------ LOT 24A DECK I LO-T aZAI ivl �3 E RES. ZONE.- "RF" This MORTGAGE INSPECTION Plan is For FLOOD ZONE- "C' Bank Use Only ---- - ----- REGISTRY OWNER: J,4�VE-�'- IYlANp 'LL---.---------------_ )EED REF: _?���.T1211-----_------BUYER: _ELAINEX__INM_F1CZ--------------------_----- DATE: _44,194 ---------------- PLAN REF: _16?_QS---------_---_SCALE: I"= 40" FT. HEREBY CERTIFY TO _�Q O� __ _____ CORPORATION _ ___THAT THE -BUILDING ��ZN OF ,� YANKE E SURVEY IHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS �o�'� pq�t CONSULTANTS: SHOWN AND THAT ITS POSITION DOES --__ CONFORM o a • 40B (SUITE 1) '0 THE ZONING LAW SETBACK REQUIREMENTS OF THE MERITH)EW y 'OWN OF _--RAEAVf LI)ELF,___ ----------AND THAT 9 Na. 3P098 e INDUSTRY ROAD T DOES AL _ LIE WITHIN THE SPECIAL.FLOOD HAZARD c,F �F �o MARSTONS MILLS. MA,' 02648 AREA AS SHOWN ON THE H.U.D. MAP DATED_ __ ss C�sTE� o� TEL: 428-0055 t - 050001 00.21 D �� `%c �anas FAX: 420-5553, THIS PLAN NOT MADE FROM AN INSTRUMENT 14530 K✓N SURVEY NOT TO BE USED FOR FENCES ETC. Assessor's map and lot number ..........��............:.::.... .. ® ' 'FCC SYSTM 1�r�t1�7J3# 'qf3liB�E+ �NSTA E' 6 t� �hi'fi 0.lf. E • { WITH STATE Sewage. Permit number .......... - y $ANITAPY CODE AND TOWN y0F TH E l� '> TOWN OF, BARNS I ME i MARNSTODLS, 0 M6 9 fz t: BUILDING INSPECTOR a�p Mai a' a- F APPLICATION FOR4ERMIT TO . RIPKKC 6.L .... © ...... i ►l ........ ................... TYPEOF CONSTRUCTION +.....,........................................... ............... ............................. . ................. .........1.9............ 19.�7.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following informations t Location L etw�S ?QQ ��' �"L .................................. ....................... ................... ..............�. ..... : . ProposedUse ....ONE........6i4&*t ............ *1..! '............................................................................................ ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner .. E� ......... i ,,. .......Address ............................... Name of Builder ..�N� .a�E't�``���' ......Address �Q k►�»U�Q. �� ��•177, .......... ... .............. ............. .............. ...... ..✓.......... . . .......... Nameof Architect ..................................................................Address ............................................................................... A,/ K Number of Rooms ...........................•!•...................................Foundation ................ ................................ Exierior 1406......sm�v . ........................................Roofng ............P5 MR .............................................. 'M IG. Floors r..... f�.....9t. .:,,.... �1 //!j`........Interior ..........QQE. tU ..................... Heating ............. ..................................................:...Plumbing .... 1 ................................................................... Fireplace .............�f1 �:..........................................................Approximate Cost ......... 0.................................. Definitive Plan Approved by Planning Board _________________________ QOC)..... ........ -------19--------. Area .. Diagram of Lot and Building with Dimensions Fee ......7.. .......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH Soy -7� 3 ���zoc>�t B�.okool'1 4 � d I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Q Name !y V............................... f r a 7240 No ............... Permit for ...................Remodel................. � . C • 1 e7 ......................0 • ........................ Location ... t........ ............................................................................... Owner ....WBY,ng..Boylan.................................. Type of-Construction ..,Frame Wood Shingkes F ............................................................................... f A � Plot ........2065 Lot ..........:..................... ' ,July 29 74 Permit-Granted ........................................19 Date"of'lnspection ,,1.. ... . ......... .. 19�°''`� Date Completed 1<. . . .. Gam''? '.. S PERMIT REFUSED ................................................................ 19 - ................................................................................ 1..:....................................................... .... ........ t r /.".+ Approved ................................................. 19 ............... .: :_s .................... .......................................................... , • i Assessor's :map and lot number .� s........ ..... ............. t-j ' -0/ —Sewage a Permit number .......���, rtJ. °f7"E TOWN OF BARNSTABLE Z BAUST"LE;0 "6 q.ae� RMIDING - INSPECTOR 0 MPY >o a v► O APPLICATION FOR�PERMIT TO !Iwt ? ai .1,,..........`�!." rr?-f 1►. ....... Ll? !ca n7lf^................... ....... .cf TYPE OF CONSTRUCTION •..••.••..•••.••• a q #4 4........A. ..............19. N TO THE INSPECTOR OF BUILDINGS: - -+ The undersigned hereby applies for a permit according to the following information: Location .......... ,,C W 1 `5..........Qrs....... ...................? ,. a? 9 ►�� ,s . >...................................... Proposed Use ... W .r'~, ttt` ....�t..f.. .......... ........... Zoning District ...................Fire District.........:. Name of Owner ' .Address .��'5AFA� :...... " *.s................................ Name of Builder .. �..:.................. ...................Address ..... ... .. .....i. .,.........:!�.. .......:�....... Nameof Architect .............................................................:....Address ...............................,.,...................................................... c�/f � r Number of Rooms Foundation AS Exierior .: .....: � ale ........................................Roofing ...................:.........LT.............................................. Floors f�li # ... ......... Interior �. .i: � .. � `...................................... Heating ....AN .... ...... ....... g Fireplace Approximate Cost p .................................................................... ......... ',. ...... ....................................... Definitive Plan Approved by Planning Board ________________________________19--------• Area ....I `?� .. I........ Diagram of Lot and Building with Dimensions Fee ..............I.......a................................ SUBJECT TO APPROVAL OF BOARD OF HEALTH f k ` RAC -,aim it G t t "I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above r�- ._ a construction. Namea0A ' ...... ............................... Wayne Boylan 17240 Remod � No ................. Permit for .................................... Location LeT^Ti.S..N.,-Ad.,,,,,...Cotuit......... ............................................................................... Owner .......g ne.,Boylan................................ Type of Construction ..........Frame Wood Shingles ................................................................................ 2055 Plot ......................... .. Lot ................................ - July 29 74 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ............................................................ 19 ............................................................................... ................................................................................ ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... The Town of Barnstable dF low* Permit# 6 J Massachusetts. �erABIA % Date NAM SOLID FUEL STOVE PERMIT 059. This constitutes an official stove permit after inspection and approval by the building inspector. Owner C'5 01�j Ct t �1 Y l C--1 n i11 tc C 2relephone no. Address of Property l �_S L,"{'l l; i S o �a Hage Location`and Stove Type 1C,2 il ail Date: Building Inspector The solid fuel burning stove at the above locatio passed: - inspection. 2 X 10 LEDGER MOUNTED TO HOUSE - Z r WITH 2 LEDGER LOGK5 @ lb"OG v x- 2X10J015T5@1b"OGWITH HANGERS AT BOTH ENDS (2)2 X 10 PERIMETER BOX J015T5 a o (3)2 X 10 CARRYING BEAM MI05PAN v_ OF 14'-0" PROJECTION WITH HURRICANE TIES TO DECK J015T5 12" VIA 50NOTUBES WITH bXb POSTS USING ' 1" STANDOFF BA5E.WITH 10" ti J-BOLT ANCHOR INTO CONCRETE v F (2)2 X 10 HEADER AND JOISTS AROUND z CHIMNEY MIN. 2",MAX b"OFF OF CHIMNEY " s s — EXISTING s o. . 5, (2)2 X 10 HEADER UNDER CANTILEVER OF _ HOME @ DECK ATTACHMENT , U J LLI i y ,y - - r 4'3"� 4,-3�,� 4' . . r . r BU DING DEPT- 4 _ J-4 - AAB L • RNST WNOF B 30' - Date: • I 11-1-16 BUILDER TO CONFIRM ALL Revisions: • _ DECK PLAN scale: 1/4=1-0 CONDITIONS . AND DIMENSIONS ON SITE Final: Note: These plans are for the sole purpose and use of Gapizzi Home Improvement and are not to be distributed or used for construction other • than bu Ga izzi Home Im rovement. J E � N -o cV E ' N O E n .Q o z v _ ►- RAIL MIN. 36" ABOVE DECK 5URFAGE _ 2x4 PT TOP RAIL _ .. 2X10 PT LEDGER WITH 1 1/2" X 1 1/2" .PT 4X4 PT P05T VINYL FLA5HING BALU5TER5 @ o LEDGER LOCKED _ 41 OG GALV J015T HANGER @ EACH 2X4 PT w J015T' 2/2X10 BOX J015T5 r m P05T THROUGH BOLTED 2 X 10 PT J015T @ 16" 1/2" X 4" LAG BOLT STAGGERED EACH BAY 6' 'Un HURRICANE GL I° P @EACH JOI5 T � 2-2 X S PT,BEAM A GALV P05T TO BM CONNECTOR : > X 6 PT P05T ` GALV P05T BA5E ' E j 12" 50NOTUBE @,48" BELOW D 1 GRADE - 1/2" X 10" J-BOLT Date: BUILDER TO CONFIRM ALL Revisions: GONDITION5 AND DIMEN51ON5 ON.51TE Final: DE G K D E TA I-L scale 1 /2" 1 t'O" Note: These plans are for p the sole purpose and use of Gapizzi Home Improvement and are not to be distributed or used for construction other 20 than by Ga izzi Home Improvement. N E 3 Q .Q 2 X 10 LEDGER MOUNTED TO HOUSE WITH 2 LEDGER LOCKS @ lb" OG 2 X 10 JOISTS.@ 16"Or,WITH N HANGERS AT BOTH ENDS (2)2 X 10 PERIMETER BOX JOISTS o � v (3)2 X 10 CARRYING BEAM MI05PAN v OF 14'-0" PROJECTION WITH HURRICANE TIES TO DECK J015T5 12" VIA 50NOTUBES WITH bXb PO5T5 USING 1"STANDOFF BASE WITH.10" y J-BOLT ANCHOR INTO CONCRETE ; (2)2 X 10 HEADER AND JOI5T5 AROUND 7— CHIMNEY MIN. 2", MAX b"OFF OF CHIMNEY E X 1 5 T ) N- G � 5, (2)2 X 10 HEADER UNDER CANTILEVER OF ~ HOME @ DECK ATTACHMENT ti F J ' m N Q 4'-3" 4'-3" 30 _ . T-b,, 30 6! ry a Date: NOV 1 ( Z��U 1 1-1-16 BUILDER TO CONFIRM ALL Revisions: AB►-� TOWN OF BARNST DECK PLAN scale: 1/4=1-0 GONDITION5 AND DIMEN510N5 ON 51TE Final: Note: These plans are for the sole purpose and use of Gapizzi Home Improvement and are not to be distributed or used for construction other • than by Ga izzi Home Im rovement. Ln N o 0 0 V E 3 6 .N RAIL MIN. 56" ABOVE DECK SURFACE v 2X4 PT TOP RAIL - 2X10 PT LEDGER WITH 1 1/2" X 1 1/2" PT 4X4 PT P05T, o h. VINYL FLASHING BALUSTERS @ A LEDGER LOCKED : a -4" OC GALY JO15T HANGER @ EACH 2X4 PT w J015T I 2/2X10 BOX JOISTS m P05T THROUGH 'r BOLTED 2 X 10 PT,JO15T @ 16" O.G. ' 1/2" X 4" LAO BOLT STAGGERED EACH BAY , ��� HURRICANE CLIP @ EACH JOIST- GA�NE E 2-2 X 6 PT BEAM n - GALY P05T TO BM CONNECTOR • GALY P05T BASE E 12" 50NOTUBE.@ 4b BELOW D _ GRADE 1/2" X 10" J=BOLT Date: BUILDER TO CONFIRM ALL Revisions: CONDITIONS - AND DIMEN51ON50N 51TE Final: PECKOETAIL scale 1 /2" = 1 -011 Note: These plans are for the sole purpose and use of Capizzi Home Improvement and are not to be distributed or used for construction other 20 than by Ca izzi Home Improvement. P 01.�D SEWAGE SYSTEM PROFILE & DETAILS AILS lei M�12 TOP FOUNDATION 42,1 pF F.F. 4.�.1 FINISH CIl�IE 1» F1NI;;4i CFi3E - h13�1i lR =IaE FINISH CI�Ap€ 16 All ��OVER TANK— i OVER "D" OX- 40..0 OVER LEACH PIT— 39.4 CLIEANBACKF,LL 0 I } I ` USE SOME RISERS T 7" I I. 3"PEASTONE� { { I ...�''`.., ....� �..._ . ` ,� $� III .����" •.._ r 10 2 ___.... _.__ . ..... .w.µ. .. _.A, WITHIN 12" OF FINISH GRADE �{ .. _ ...._ _ .... ...__._. .,,__. �' 2 _. f 1 14"Tk L ! I LOT 23 f 24 38 3 - _. . 38 25 I .. 30 800 f s . ft. 3 " f37.75 - » t fy " .f Wf I ..,XC.Y i,/ .».-,�......,# { t �"b d� R' k f F d~D ft LIOUI L►iSTR19l�itON - " " —. _ 26 11 37.92 NOX 36.E 12 ,w ..►°")s,) �.�(' d;: { 12 _. _ p I I --'`� :,---_..�•- 15C�t?Ga�LLf3N' �LF`T30 i'ANM; w - in - '�`'`r—�ET LEVEL- -"''"�._ .... } I 30 {{ r ,.I�.I..7 OF PIT I... m... _ .,., _.� Tim 31• RED. __. SEE NOTE ) cr C E� � 5.0��'`-� LOT 22 81 LOT 24 _ ; _ 3s USE 2--6X PITS WITH 12" 40 of STONE ALL ` .01 36 10 1 EX�S��pG I ' 258, op• o � �Z•�8 AROUND ip p,QO� �.O F,� 41 r` DESIGN CRITERIA SOILS LOGS CRITERIA i NUMBER OF BEDRO0, S _ -� BEDROOM - }�}T' 1 PIT 39.11 PERSONS PER .QED 0 _____ �� aj BAIL., :.FLOW PER PERSON TOP LEACHING REQUIRED t LEACHING PROVIDED ,€�. , SUBSOIL �h ES Es CALOULAT{DNS 30"� . 0 W�:.LI A, 39.41 BOTTOM = 0.785 D K .� am. 100 r ' -�lK4_._ 42.91 SIDE = 3.14 D H w M . � __ .M 75 z 4�41 —"1 �a � • � ' Q GALLONS PER DAY == 2 --= 854.E GRADED --- 3 1' � 40 o� MEDIUM - 1.81 GENERAL NOTES 0 SAND 1. ALL ELEVATIONS SHOWN ARE MEAN SEA LEVEL. 38►a 27;0 NO WATER 2. ALL PIPES IN THE SYSTEM TO ICE PERCOLATION DATE � 2 MIN./INCH C���• `a . CAST IRON OR SCHEDULE; 4-0 P.V.C.. � . . OBSERVATIONS By: .E.D.� _ _ REMOVE ALL UNSUITABLE MATERIAL 9 _ ` BENEATH THE INVERT ELEVATION 3, DATE TESTED: 10 9C} PO*.b FOR A RADIUS OFN/A, ND BACK ILL W/ CLEAN COARSE GRANULAR MATERIAL. ROAD 4. ALL CAPE SURVEY CONSULTANT MUST ICE NOTIFIED WI-IE.N THE SYSTEM la INSTALLED PRIOR TO • BACKFILLING FOR INSPECTION.` APPLICANT: CI� LES MANDEL 5. UNLESS OTHERWISE NOTED ALL. PROPOSED ADDITION LOCATION SYSTEM .,COMPONENTS SHALL BE INSTALLED IN ACCORDANCE NTH PROPOSED SEWAGE SYSTEM LOCATION MASSACHUSETTS TITLE V SANITARY - SEWER CODE AND LOCAL RULES WHICH MAY BE APPLICABLE. LO T R LEFS POND R""OAD 6. THIS LOT IS NOT IN THE FLOOD PLAIN, 7.` A GARBAGE GRINDER WILL, NOT BE INSTALLED ON THE SYSTEM. I.. ARN TA LnE, (COTUIT) MASS. PLAN VIEW OF p �o" 8. A 4' DEEP HAND EXCAVATED TEST DOLE " , a� tiP��" Mq� SHALL BE DUG BENEATH `THE 0770M SCALE: AS NOTE }SATE: 1 11 90 }DWG. NO.: SCALE: 1" 30' �. �� ���' ��y L 'oel G . ELEVATION OF THE LEACHING PIT TO LEGEND o U �H�rsrOpHFR VERIFY UNDERLYING SOIL CONDITION, ERAS°N BY: J.A.B. CHECKED BY: C.C. JOLT NO.: of . � 14 COSTA EXIST. SPOT ELEV. = 39.11 E�1SrE No. 31 • l�lT EXIST.' CONTOUR = -- 38 �ss�o�rANT a� s��'`��4 ��tiQcr �� ALL CAPE ASSESSORS MAP # 20 SECTION #PARCEL #SLOT ROUTE 28 -- SUITE 301 SUMMERFIELD PARK — MASHPEE, MASS.