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1141 MAIN STREET (COTUIT)
i/ U INE A Application Number.......4—./X7.X ........................... . BARNSTABLE, Permit Fee..........?. .......................Other Fee........................ MASS TotalFee Paid.................................:............................. ...... TOWN Of BARNSTABLE Permit Approval by..M. ...............On.. BUILDING PERMIT APPLICATIONMap........................................Parcel....,........................................ Section 1 — Owners Information and Project Location Project Address.gZV f 3 �r- Village Owners Name- 14o J_ i S Owners Legal Address 1//Air, 1,0 City State. zip OS Owners Cell #. E-mail JA4� 'Q_A e,o a e_,A Yxa-i 1-cem ,Section 27-Siructural Use Single Two Family Dwelling ❑ Commercial',Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Section 3 -Type of Permit '❑ New Construction E] Move I Relocate E! Accessbry Structure E] Change of use El Demo/(entire structure) El Finish Basement El Pool EJ Fire Alarm Rebuild El Deck ❑ Kar I ❑ Sprinkler System 7 Addition ❑ Retaining wall Insulation ❑ Renovation in. Other-Specify 12 %.Ulu Section 4-Detail ARNS 74 Cost of Proposed Co' struction,3 n Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total # Of Bedrooms;1(p roposed) 1100 MPH Wind Zone Compliance Method MA Checklist ❑ W1, FCM Checklist, F] Design Last updated: 10/31/2017 Section 9— Construction Su ;ervisor Name Telephone Numbed Address (D nd Ile .I 9e City F,,? alydCdstat Zip Dd 7d o License Number Z03 k 6 l License Type U EN° iration Date 74 ill 9 i Contractors Email Qf%SDd1 LQ tee ,, �?jcc lrP,bi e.Y-' ell'# G F—Y:26 -- Y-4 a I understand my responsibilities under the rules and regulations for Licensed Co istruotion Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction ins ection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a cop of your license. �� f Ll Signature Date ` i Section 10 — Home Improvement Contractor Name Telephone Number 5'6 '6 1--6, '76 e, Address 1ko City F e..,- Stat 7#0 Zip 7cL'0 Registration Number /T/7 V7 Expiration Date d I understand my responsibilities under the rules and regulations for Home Impro iement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction insl ection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a cop of your HIC... / Signature Date �CDIG Section 11 —Home.Owners Licens.D Exemption Home Owners Name: %'�'(�e.y r�` i Telephone Number fa Cell or Work'Numb r I understand my responsibilities under the rules and regulations for Licensed Co struction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction ins,ection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature 1 Date APPLICANT SIGN ' TURF Signature Date Print Name eq/ / 'n Teleph6 ne Number 6a 7-66 7^6 7y(o E-mail permit to: ez� o � Z �� ! e ' I Last updated: 10/31/2017 i Section'5 - Work Descr pl on , J P� a,:r ,�a.l( xit O4"� L e 1, l ( 4 49 ^Ft h It E Ls d ,I Section 6 — Project Sped Vs . 4 ❑ Wiring VC it Tank Storage ❑ Smoke Detectors Plumbing as ❑ Fire Suppression ❑ Heating System: ❑ Masonry Chimney ❑ Add/relocate bedroom i Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site i Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility,,¢, ea.v ' &f'' I using a crane ❑' Yes ❑ No G0 P O Azv a � a iUPG' 0 Z 2 ° . Section 7— Flood Zon' Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage _, #of Dwelling Units(on site) Setbacks Front Yard Required Propo 3 d Rear Yard Required Propo' d i Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? . Yes ❑ No Last updated: 10/31/2017 Section 12 —Department Si n-Offs Health Department C, Zoning Board(if required) Historic District- ❑ Site Plan Review(if required) ❑ i Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire partment for approvak Section 13 — Owner's Autho i ization I, h,` , as Owner of the subject property hereby authorize Z- e..0 ' to act on my behalf, in all matters relative to work authorized by this building perm application for: (Address of job) Signature of Owner date Print Name Last updated: 10/31/2017 DocuSign Envelope 1D:8827104E-64AE-4488-BE96-9AA71520471C Town .of Barnstable Regulatory Services Richard V. ScaI4.Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis AA 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 1, Mary Christian , as Owner of the. subject property hereby authorize to act on my behalf in all matters relative to work authorized by this building permit application for: 1141 Main St. Cotuit, MA 0263S (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. omuSi9ftd br. i ►`'�28` `Owne.r Signature of Applicant Mary Christian Print Name Print Name 2/3J2018 1 5:34 PM EST Date The Commonwealth of MassUchusefts Department o f Industrint Accidents I Congress Street;Suite 100 < Boston, MA 0211.4-2017 www mass.9ov1ilia Workers'Compensation insurance Affidavit:Buitders/Contractors/Electr eians/Ptaimbers. TO BE P11.'ED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leaibiv Name(Business/Organization/Individual): Insulate2Saye.Inc. Address:410 Grove Street City/State/Zip: Fall River MA 02720 Phorie##: 508-567-6706 Are you an employer?Check the appropriate box. Type of project(required): 1.�x 1 am a employer with 20 employees(full andior part-timc).* 7, ❑:New construction 1[]T am a.sole proprietor or partnership and have no employees working for me is $, 0 Remodeling . any capacity.[No workers'comp.insurance required.] 9. 3.a 1 am a homeowner doing all work myself.[No workers'camp.insurance required.]t Demolition 10 Q Building addition 4.E]l ant a homeowner and will be hiring contractors to conduct all work on my property. t will ensure that all contractors either Have workers'compensation insurance or are sole 11. Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.C]1 am a general contractor and 1 have hired the sub-contractors listed on the attached sheet, 1.3.[:]Roof repairs These sub-contractors have employees and have workers'comp.insurance.t b.Q We are a corporation and its offrcors have exercised their right of exemption per MO1,c. 14.[]x Other Insulation 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box tt t must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavivindieating they are doing all work and then hire outside contractors must submit:a.new affidavit indicating such, ,Contractors that check this box must attached an additional sheet showing the name of the sub contractors and state whether or not those entities have employees. If the sub-contractors have employeesi they must provide their workers'camp.policy number. I am an employer that is providing workers'compensadon insurance for my employees. Below is the policy acid job site information. Insurance Company Name: Liberty Mutual Insurance Policy#or Self ins.Lic.#: XWS 56418741 Expiration Date: 12/1.0/2018 . Da& Job Site Address: e t i`I S �' City/State/2i 3� Attach a copy of the workers?compensation policy declaration page(showing the policy number and expiration date), Failure to secure coverage as required under MOL c. 1:52,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil.penaltics in the form of STOP WORK:ORDER and a fine of up'to$250.00 a day against the violator,_A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under tlae s an a ties of perjury that the information provided above is true and correct fi Si nature: Dater Phone M 508-567-6706 Official use only. Do not write in this area,to be completed by city or tarn offaciat f City or Town: Permit/License#t Issuing An (circle one): 1.Board of'Health L Building Department 3.City/Town:Clerk 4.Electrical inspector.5.Plumbing Inspector , 6.Other Contact Person: Phone#: Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 51 70 Boston, ma, usetts 02116 Nome Improvem tractor Registration Type. Corporation Registration: 180747 INSULATE 2 SAVE , INC Expiration: 12/28/2018 :.k • 410 Grove St Fallriver, MA 02720 r s� Update Address and return card. Mark reams for change. >cA 1 0, 20M-06 1 Y .&p� rvR. a iq© lnpiavrnent 0 Lost Card ..,..__d�re dL'C}MI"tfYlWil-.aG c�/l x xcs�ar<aeGl . office of Consumer Affetm&Business Regulation HOME IMPROVEMENT CONTRA CTOA Registirationvaltd for Individual use only. TYPE;Corporation before the eIration data. if frac€nd returr •to: ., Office of Consumer Affairs and.Business Regulation gXgl1ration 10 Park Plaza-Suits 5170 T 12/28/2018 Boston;MA U2116 INSULATE 2 Si p d, Roland Lan9 evidP , 410 Grove St Falirtwr,MA 0272 3 ' Undersecretary; Not.valid without sl4nature convoonweafth,of massachrusetts 410, D si of �sio l LicensureBoard of Gilding Regulations and Standards Consir '' z �r€lsa J, CS-103861 ir" 1241204 REL AlND CAE k FALL RIVER • Conrtlnussioner J r z Hui OR A.' r a y reWre an A t t ' -i'�. ' �}�- 1w RERa 71 pm Y 2 bvjRERC r . ''x �s �' r o t..• 4 trs� r4 '�7'f 1, a. _ tfii ti#A11 $�;15Ei3'Ta^<: �7E Fv�2:� 13L#L FtI3 : GOP TK3Est'_ rk�IYfAI�f #L £ tE3 f3F.#��M Srl? 4 5r_S.T �f�':1ivt 'TsfS f=RfIS SjlB TO �E XH31VE3EEftBY - - � r �� �-•� � � ��4z$a8a s � i5 ���� •}' -C T9 �Z Fill ?'Yt3� C �� <- 'f t'�-,��:�`d'"�r•.s'ri..�L �d"{ �,„ _i r t i�- FE2Se^Nl{.8 AD' M- _ 1 2.;`X�il'•"4*G"5. . i s .56418741 � s2/10/171 12l10ft a f BY$k#3Y{P8r 27etsa) l S 5'&438741 y aA t z 5:64 8741 12lavts1 1213.1Tf2 $ +- F13 •EbSr� axApYti3 �i « �Y 6�I. )� }{- -,. � it • G • ' 1 `� AC<1RFJ;M7 Ad *PAftned6" e'6a.6g/ Cspecafs2gta 9 Y f+u"'' WSW S ..h}sue , i _ ��rt '.�F Jy��yy�,y„�/���+M�F.�..p���� {��+ .'•! �.. 7 %-b V Y S r SHOUW/YYI.f�3� iF11='f_WVE i/ESOR =PWGEV - t e FtE.EX00AT}G'Db BATE• Tt{£ �• �f L T 'E �'J ACIc.,oRoAljgE �}1'7#E'P�3�1Ci'l #IS4� s i t RISE Engi Bering ' 3 ilupaat e1Ye,Santk Yarmoofti A 02"4 ENGINEERING �fifi-i68-1926 FAX S1I8=5b8-1933' . Pagi3• � PROGRAM. i:sis corrraAri:ss E3dTERER tifra to Ttex is Cj.rCk}r '£k{3tNE RI1dGRt TFiE,CifSTalA£A,FpTk.Wtl3itGAS OE.$gii8ELt8EtOtN,, - - i. C3ST0lNER r .GATE ..aims: wofi;x Ootw m0yv K:G tltlST1AN" ( Q8}4?8-1280 1 f13/2Q,1.7 ?"45$t)fi: _.._..._....................................... ..., _.. .......... ... .. ...... _,...................__., s�nsts .':riTa + alum tsra�r !141:.1v4atn-$&6dii 'PQ Box.1928 __... _,;..._..,... - SERHCE;�ttY STATE.ZtP,.- .ESLt1NO.IXTY,,,BTATE.�P CaWk,MA Q2.535 C i3tutt,M:A t72G3J JOB DESCRIPTUON, liEA(Tfi&SAfFTY: A Binw Door:Test will not be coaducted,at:your home::du to,the presetsse g ssshestos.; l AiR SfiAIJrIG P.iotiule laliirr and matenaLs to sea!_areas.sif�uur ltomtagainstastefui eatPss asr leakage fhls>Korl will.tie perforrrie8 SfO 0t7 r in conceit�s tth theuse of special tools"and.diaostic ttsfs to assure Thai}our home wt}i be left Kith a;ltealtftful les el of aircehatie and sniloor au quality irTateiiais to be users to peal�tiur hpme can incltxle caulks',foams,xeaihersirippiiignnd ether products. 1'rimary' , areas fd`st�lsng titciude atc leal.age tip 4YttC5 bssesnents attaehed garags and oihzr unheatei;areas(wiiidaws are:tot generally addresst±d� (8)worl.mg bouts A redssetran m cubic ft�t per:minute{cfin}pf afr ipfiluatson:wtii occur'-but the nrisal number pf�im;ss' STORAt;E BAitRI>R Homeowner is,fesponstbie for the rertio4aI of tltit stared items bloc pitg the u stallauon of {salt th} s weathers aeon uziik to tlte'Attie, Bemsiya must'aLur pnoi tp tht;schtxiuted work'star{ COMIv1ON ki'A1 US 1'iovlde labo`aed`maieriaisAo tnstall:,2n rsgid':boaid with:the rettutred:fire raungto(104}square tz et o3"comiiwn 14010A. . . mall arrii'. ATTIC ACCESS:Provide:labbr stall matt r3a}s to insulate:the;hack of(.t}attic hatch with 2 gjd Therm x board.Ykratherstrio file8�fat? pa rimef.. VElSi7f A flO ;Pro,idelaborand marerralsto rstall(1)intulatsd exhaust hors to eesstsng batnrapm.<fan(s). 5fit}OtS VEh"17T:ATION Provide,labor and mrakrsals to nstall,vent lauon chutes"in(9i)wafter baysto maintain:air flow; S33S t?4 COMhIn d I ALI S f'rpytde:labpr and;matenak;(o tnstafl 3: R-13 is Rd fiberglass Batt insulation 20( 5)squurie feet pf kneesvalt aFea $236�5 , 2"ngiil;bsxud witl•the required fire rating% be,,stalled over the surface: ATTIC LA7 Prrivtde laliot:arid materials to mstat!e i?"to cr of It=3&unlaced fi: " Y 1) ass baits to( E})sgtiare€Bet pt attic apace E12 ofl A =;:I-I.A I.Provide labor-anti materials to=iristall a s3"layer of JO utife ed filierglassshtitts.ta(270Jsquare l'e"et-pf tttia:zpact :$SI 40 baits to.(2UQ4 sgitarc=fixK of attie.,s $ _ ATTIC FLAT:Itiiivsde fabaz and fnateriats to iriSKall$'3:5"layer of P-:13 unfaced fiberglass paces: i 94 00 S y" RIWEngneenna S:Ditpont Ace,Sonth'.Yarmoeifj,.:�fA=02554 . �!e g��, �+ •EN� tNE£R1NG ,... vird4a�, 508568-1.9?6; FAXSW5684913 KOGRAM ittla.CO!iTRiiC7 i8 ENTtttdf0 61•TfREtl : C1;CM.ES wf.�exa�aflTr>gaasto�Tt�-�mcA4 ;; . f?! DA7£ i;5&7fT• V#3t'ORDf t�1AFLY.K CittlSTtAN t3Q8}43$=:1280. 12f 1312i117 2�Sxf?5; fl34Q2` _. . s£+mrx srnr _ _ .. . fTiiiNo aTRsi£T 1141,;vlain Street PO B6, I928 ...,.... .... ,.. wwwo Crrvi.sTir t;XW.: BERV{ -_CITY BTAT£:ZlP - COtuit,MA 42635 C�tutt, �iA 62535, ...... J6 DES $W� Y{WRRJCEhTIVE EXPi.�LREiJ: RISE EngmsxfTngTtt apph-,gif apglrcalite clfgftiie'•.incentives and you.will be bilfpd only tfrc;n`et ampunt: Cnrtesitly for eligihie measures,0 Cape:Iagh{,t'ompact offt rs 75°>o igcentne,RO!,to£XCCed. 10.bCr:CBIeQGar ve3T,Sttd aR tnLenil -,f6 th6,-A3T Senfing measures. t,llvill'ED TlM)~„$PECIALI�tCEN't711[: ; The C>}pe i Ipht Ciimpact wail}tiatue the' OOft limit wwards Lhe w f.erimtton)Vv k RIS! .will reduce:}our wst b� ail the wtatherirauon cork ourittu d:in this proposal 7hu'spectef inceptive's;avallablr:to`homepwiieis wfio sign th, wea;henraYlot'pTop6sal befom tXcember 31,201 7 and submit to RISE by January 8.2019: inib Oram tf3cen#vd; l' Customer TOW. 446.t fE AA3R £tiE ti BY TCf FURtdtS}t SERVVtC£,4-COMPLM..W ACCOfmANC£MM ABOVESPECIMAMOW fink 113E 8U9b10F -Six Hundred One.&421100.Do!lars $609 a2 tlPOld FiNAi;llrBP£CTlON A!A APPROVAL SY Rf.4E-£f.OiNEETtIH6 CUSTONI62 AS'3ft£ESTO fYclji7 A2701jNT:01lafR GULL.INT£RE5T O£J°b imu BE r:kAR6£D MOW LYON ..UNPAID afd:AdiCEAiTER-s0 OAY8.SFEREVl778£r•ORlIiPORTAtdXlf�0i8710�tOM 6UARRNrEgS.Rt3NT$� OiV,. 3aAii6,A1�iCOMTRAGTOR-A3fifRA7i0AL:.: _...:.: d............................. .,, jt c- RISE-REPR£&ENTATNt:: ^_•- ._. NOTE;T4s:coNMc,MAYSe"T,,DRAVN$YusIFtIbTEY£CU'T£DSWWN DATEOr'ACLFAT �..._ DAYS. ACC£pTANCE OF CONTRACT.,Yt!E" VE 9PECjF=T10P35:AND ...,_ 8AT13FAtTORY 7O US:nNtI,LRE HER£Br:ACCEYrVA,YOUARE AUTstibtIKEII TO.og.7ftE-M>DA7c• , AS.4P£C7 M PAYMW.lYM 9ZMAM i9`OUT AMA8>fYEi- ."` `.. - C :3 Engineering_Dept.(3rd floor) Map; Parcel .-Permit# ..�/ House# Date'Issued Board of Health(3rd floor)-(8:15 -9:30/1:00-4:30) �.y %s "� E IC SYSTEM MUS INSTALLED COMPLIANCE Conservation Office(4th floor)(8:30-9:30/1:00-200) LWITH TEE 5 Planning Dept.(1st floor/School Admin. Bldg.) ;• ; ENVIRONMENTAL Definitive Plan Approved by Planning Board 19 TOWNRECI! � C y Y BAMSTABLE. MASS. j IE1 M. ( — TOWN OF BARNSTABLE Building Permit Application 't Project Street Address Village Z! — —U� Owner��S/,L1� /�'lL�'. i�/.fi//�� Address A&^) c�J 47y r - Telephone Permit Request First Floor square feet Second Floor square feet Construction Type `I it/L1L ," ` 2>/nJ Estimated Project Cost $ er Zoning.District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type:. Single Family ul*�. Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ®'No On Old King's Highway ❑Yes ErNo 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 No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No - Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) - ❑Other(size) y Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use ��----- Builder Information Name d/n /ZZ/ �/`Z Telephone Number 41a8—9cS�7� Address /G - XZV2VWA1 ZED e17Vr License'# 4`7Q3 2 " 1 Zzi �rl/I a' �'I��' Home Improvement Contractor# /OD 7 6 '�'�- /? 9�Z�FPJ7"✓� Worker's Compensation# 00"97. NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO U SIGNATURE DATE /pj — ; BUILDING PERMIT DEI\ FOR F0LL WING REASON(S) FOR OFFICIAL USE ONLY t PERMIT NO. 2,2- � DATE ISSUED `MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION s FRAME. INSULATION FIREPLACE ELECTRICAL: ` —ROUGH FINAL we, � � 4.7 .ate" 4 { • s -, - - z. a S e j t PLUMBfNG"� .* SROUGH FINAL " GAS: R UGH FINAL, Ils[ A ; . FINALor ru'o DATE CLQS D OUT: ,;ASSOCIATION PLAN NO. v�; Town of Barnstable Regulatory Services ,•� Thomas F.Geiler,Director ► BARNSTABM • 9 �. . $ Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 9 Office: 508-862-4038 Fax: 508-790-6230 PERMIT# rf 903W FEE: $ 7,S,00 SHED REGISTRATION ], 120 square feet or less Location of shed(address) Village. 4 Property owner's name Telephone number Size of Shed Map/Parcel# Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? ( lam Conservation Commission(signature required) f0 3 v3 ' PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. „ PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 L ATI O N O F PRO Y--L"I N ES AAA. N-OY E3 .... -EE)-1 A E . STANDARD LEGEND NOTE:not all symbols will appear on a map Ma 34 GOLF COURSE FAIRWAY EDGE OF DECIDUOUS TREES EDGE OF BRUSH ORCHARD OR NURSERY # 1131 v "'J..`,....., EDGE OF CONIFEROUS TREES ` ... MARSH AREA 1 EDGE OF WATER DIRT ROAD t DRIVEWAY PARKING LOT --- I��--PAVED ROAD Ma 34 DRAINAGE DITCH 1� Map 34 — PATH/TRAIL 1 PARCEL LINE # 33 MiloMAP# �. ; —PARCEL NUMBER #186o HOUSE NUMBER 2 FOOT CONTOUR LINE # 141 io— 10 FOOT CONTOUR LINE Elevation based on NGVD29 4.9 SPOT ELEVATION STONE WALL X------X— FENCE RETAINING WALL ———F—;— RAIL ROAD TRACK - STONE JETTY vooL'1 SWIMMING POOL PORCH/DECK CT BUILDING/STRUCTURE DOCK/PIER Ma 34 Q HYDRANT e VALVE O MANHOLE o POST OFP FLAG POLE T O W N O F B A R N S T A B L E G E O G R A P H I C I N F O R M A T I O N S Y S T E M S U N I T .a SIGN ® STORM DRAIN M PRINTED SCALE:IN FEET *NOTE:This mop is an enlargement of a **NOTE:The parcel lines are only graphic representations DATA SOURCES: Planimetrics(man-made features)were interpreted from 1995 aerial photographs by The James UTILITY POLE a TOWER Ke w e 1"=100'scale map and may NOT meet of property boundaries.They are not true locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD 0 15 30 National Map Accuracy Standards at this do not represent actual relationships to physical objects Corporation. Planimetrics,topography,and vegetation were mapped to meet National Map Accuracy Standards p LIGHT POLE O ELECTRIC BOX s 1 INCH=30 FEET* enlarged scale. on the map. at a scale of 1"=100'. Parcel lines were digitized from FY2003 Town of Barnstable Assessors tax maps. 1 ' .� The Town of Barnstable • n�xrrsr� • j 17, 9 Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. 0 Date 1�41 _/B—14 7 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. e" Type of Work:�/�L!/�L �f //���' Est.Cost Address of Work: /<<f/ ��/✓�' ��/f Owner's Name�K� �/�/��'� L .P/�3T/ffi'✓ Date of Permit Application: V—Alf—_9 7 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A 'SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: ..� 1 do 7P� Date - ntra r Na Registration No. OR Date Owner's Name The Commonwealth of Massachusetts -- 0 Department of Industrial Accidents � _ 01/IcE OI/flYEStlyellODS 600 Washington Street i Boston Mass. 02111 Workers' Compensation Insurance Affidavit . : rQ _ :�.,,.... na • ZZz z , locatio 7 /0 0 WA cityG Dj f//T erZG phone", ZBr 9S/g I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. COM12anv name* address: city phone# insurance co / T i %/���� polio•# dealg&z` T - .�.. _ ri 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: companyname: address' cir phone#• insurance co policy# �....«....»».....mot:>>.�:.:.�.:_.;. om anv name- address: city: phone#; insurance co poltcv# ?Attach additional'sheet if Failure to secure coverage as required under Section 25A of NtGL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP wORI:ORDER and a fine orsloo.00 a day against me. T understand that a copy of this statement ma. be fon+arded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certifi- pains a penalties of perjury that the information provided above is true and /correct. Signature Date Print nam, „'`file � �L-J�� Phone olTicial use onh F f do not w rite in this area to be completed by city or town official cin or town: permitNicense# rlBuilding Department e O Licensing Board 0 check if immediate response is required OSelectmen's Office DFlealth Department . : contact person: Phone _ _rtOther t 4 t t . t t - OME . IMPROVEMENT CONTRACTORS RECTSTRATIOt� t :ward or suiidins Resulatiores and Standards One Ashourtorn Place - Roca 1301 - t Boston , tiassachusetts 02106 I",PROVEMEN T CONTRAACTCR t �:stratioR 100740 Expiration 06/23.l96 - PRIVATE CORPORATION t KCy_ I7°z:Yu=fj' C'YTR„CiCB t,Cp?aCagT-7Om CAP IZZI t• OME IMPROVEMENT., INC. �rira�iaa tl=3/ga Thomnas Capizzi , ST. - 1.64.5 Newta n P.d . j .9, ,r hp?! Uac.VE!:.`{i, I?'= CotuT t MA 02635 t i:'c:as C,pr.-, Sr. .r COSTUNJ {.i CT-7QN.S'uPE<YiS0FZ L10ENSC Expires: . �i�thda�e L010�:iZ�K,09jZ5I1S r7 ;t t7SIZ6lt•a� � - - . . .. .00 QS=CURITY. � Q30-5f3- �yXi�.�AP_1ZYs.tJR: ! �GiVPLS ,� " :�+� •:.z II� t .'�.....%� .1�:�.r. - '} �� :`:�•_ �.:aiy.ti�_ ter: .•:: _ - �ng�ering Dept.(3rd floor) Map, ' 6 4 Parceldp4 Permit# ��Z ' House# 1141 ate Issuedr 'l` t/ c/ Board of Health(3rd floor)-(8:15 -9:30/1:00-4:30) 11 -0.7 T Fee ,/ Conservation Office.(4th floor)(8:30- 9:30/1:00-2:00) ' I A Planning Dept. (1st floor/School Admin. Bldg.) �� ►p `" Defi • • an roved by Planning Board � 19 ' BARNSTABLE. ` - i.. ED D� TOWN OF BARNSTABLE / Building Permit Application roject Street-Address I K% Li k VillageG�t '�,t k- F Owner Ki r1 L 1-- rzls i i'�Q Address IA-tt kKMY S) Celt'j Telephone 195n% qallol " laOO Permit Request Cb0 5`i 61AkC-ki t6j ZISiX, 1 0% cy$ & � T V rf- --AL) Z iL '�$N'AACA i, - � II r First Floor square feet Second Floor square feet s Construction Type Estimated Project Cost $ C�%coo .00> Zoning,District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ . Multi-Family(#units) Age of Existing Structure 100 \JQ-% Historic House ❑Yes ry1Go On Old King's Highway ❑Yes a No Basement Type: ❑Full (,Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 6 9�yt Basement Unfinished Area(sq.ft) L2Af Number of Baths: Full: Existing�_ New Half: Existing �_ New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: �as ❑Oil ❑Electric ❑Other Central Air ❑Yes &<0 Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: fL§15etached(size) l+k to Other Detached Structures: ❑Pool(size) "t ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) " ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes J l�o If yes, site plan review# - Current Use Proposed Use c- Builder Information , r Name 1� J� > � Telephone Number L� y Address License# OCOGZA Home Improvement Contractor# co izjl-j)�- M 6ZA03 N Worker's Compensation# _ ij�c�' NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ' /01 BUILDING PERMI DE ED OR THE FOLLOWING REASON(S) 7 J V . _ FOR OFFICIAL USE ONLY PERMIT NO. r . DATE ISSUED } ' MAP/PARCEL NO. + - ADDRESS VILLAGE .OWNER f DATE OF INSPECTION: - FOUNDATION { ell FRAME 4,..{ , 4 INSULATION FIREPLACE ELECTRICAL: ROUGH _ FINAL PLUMBING: ROUGH FINAL • ` , - GAS: + ROUGH FINAL - FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Town of Barnstable • UMABIA • 9 M �0�' Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT j 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: Est.Cost Address of Work: I Y�O Z C-0—iLt hP,,s- 6 u-3 Owner's Name VA Cic�t->ri I (' Date of Permit Application: I hereby certify that. Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent he o er: Date ont for Name Registration No. OR Date Owner's Name •� The Conr»i'unl+Iettlt/t of Afassacbusclty - •rti Departnunt of Industrial.4ccitients ff at .. Street !!'asllin 4: •��+� Bastan. Mau. (12111 Workers' Compensation Insurance Affidavit F AIIItlic tot inforntatititi• - ........_. I'Icise PRINT Ieb'ily"" •"�'•-M ~ mine• lacition- city nhcmr I am a homeowner performing all work myself. C] I am a sole proprietor and have no one working in any capacity [� I am an employer providin_workers' compensation for my employees working, on this job. conm•tnv n• roe: •ttldrecc• city nhnne I!• - insor-ince co nolicv# I am sole proprietor general contractor. or homeowner(circle one) and have hired the contractors listed beiow who ha the following workers' compensation polices: r7ir-t-, nanv n•ttnc• tJ l�to�iwor•tncc ro con any name: addresr. city -- nhonc try incur•tnce co - noiic�• _ Attach additit'nal sheet if neccssarv_ ...R •i•r__._..� _ �i• :an�L. �" "���•"•.• ��.,_.v: "':'"" ye:�......w�w�.r Failure to secure coverace as required under Section 3A of hIGL in can lead to the imposition of criminal penalties of a line up to 51.500.00 andiur unc y cars' imprisonment ins well as civil penalties in the form of a STOP~FORK ORDER and it fine of 5100.00 a day against me. I understand that a Copy of this seatcntcnt may funyarded to the Otlicc of Investic2tions of the DIA for coverage verification. !do lrerebr ccrtifi r leg re ins. r pcuaI - ojperjuty that the information provided above is true td erred. Signature Date Print name UPhone>r official use univ do not write in this area to be completed by tiny or town official `+ city or tmyn• permit/license i# rRlluilding Department ❑Licensing iluard C] check if immediate response is required ❑ selectmen's Ufftcc ► �. ❑Health Department ' contact person: phone ii• r•tUthcr - IFIJUVIIIaLU111 , Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As duotcd from the "law". an etnplt rce is dcf incd as every person in the service of another under an\• contract of(iire.;:cxpress or implied. oral or written. An emplt rer is defined as an individual. partnership, association. corporation or other legal entity. or an, two or more . dic foregoing encaged in n joint enterprise. and including the legal representatives of a deceased emplover. or the rccci\-er or tnistee of an individual . partnership. association or other legal entity, employing employees. However time :m ,ner of a dwellinu, house having not more than three apartments and who resides therein. or the occupant of the -iwellim_ house of another who employs persons to do maintenance , construction or repair work on such dwelling hous tr oil time `:rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. AGL chapter 152 section 25 also states that every state or local licensing agency sliall witliliold the issuance or enenal of a license or permit to operate a business or to construct buildings in the commonvealth for sn• pplicant i -lio has not produced acceptable evidence of compliance svith the insurance coverage required. ;dditionall�. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the crformance of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha -en presented to the contracting authority. pplicants ' your situation and ease fill in the workers' compensation affidavit completely, by checking the box that applies to :pplyin`= company narnes. address and phone numbers as all affidavits may be submitted to the Department of dustrial Accidents for• confirmation of insurance coverage. Also be sure to sign and date the affidavit. The •tidavit should be returned to the cite or town that the application for time permit or license is being requested. )t time Department of Industrial Accidents. Should you have any questions regarding the "law" or if you are required obtain a Workers* compensation policy. please call the Department at the number listed below. n• or Towns =ase be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of affidavit for you to fill out in time event time Office of Investigations has to contact you regarding the applicant. Pleas sure to fill in the permit/license number which will be used.as a reference number. The affidavits may be returned to Department by mail or FAX unless other arrangements have been made. e Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. ,ase do not hesitate to give us a coil. e Department's address. telephone and fax number- The Commonwealth Of Massachusetts Department of Industrial Accidents _ r i Office of lnvestigatinns 600 Washington Street Boston,Ma. 02111 fax #: (617) 727-7749 �_ phone #: (6I7) 7274900 ext. 406, 409 or 375 Assessor's map and lot number .............................. ........... 7J Sewage Permit number .....�1 1f.. .. .... . . ...... QyOf?HEr��� TOWN OF BARNSTABLE S r i MARNSTdDLE, i M6 9• M a'-' BUILDING INSPECTOR ,EE PY APPLICATION FOR PERMIT TO ......../. �.(...(/ .�1�^.............................................................................................. TYPEOF CONSTRUCTION ............ .. ................................................................................................................... ..........G...L.... ...... ................t 9. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the followin information: Location ........ . .`, ....... ,>� .. r4 ... ..... ..... ` . .................................. f� ProposedUse ............1......G. .....Pr.QA `...........................................................................................4.......... ZoningDistrict .........................................................................Fire District ....!.... i l4 r�':........................................................ Name of Owner .. �. .Q ..........Address ... rl ..... ................................. n Nameof Builder ..f-�. ..`cti5k ! ..._..................Address ...................................:............................. ............. Nameof Architect ................. ............................Address .................................................................................... Numberof Rooms ..................................................................Foundation ........................... .. ................................ Exierior ............... A) ................................................Roofing ............. ........ .... ................................................... Floors ..................................................... Interior .................................................................................... Heating Plumbing ................: ---:::......................z........: ........ Fireplace ..................................................................................Approximate Cost ............ ....................................................... Definitive Plan Approved by Planning Board ---------------_---------------19_______. Area ......15;�3., v..............:..... S Diagram of Lot and Building with Dimensions Fee .......... i�....................: SUBJECT TO APPROVAL OF BOARD OF HEALTH l / NavS 19 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name f...... .4%��c .............................. �r Bor ton, Samuel No ...1.... 1.. Permit for ...........apa............ . ... ,�llZnvie ..................................... . ....................... 9 Location .......S. �ainSt. . ........................................................ Cotuit ............................................................................... Owner .........Samuel Borton ......................................................... Type of Construction frame.................. ........................ ................................................................................ i Plot ............................ Lot ................................ { a November 8 73 Permit Granted 19 Date of Inspection f� . �- ' Date Completed .. .. V.........19 ! PERMIT REFUSED .......... ................................................. 19 k ...s......... .......................... ............................................................................... a ............................................................................... ............................................................................... Approved ............................................................................... 4 ............................................................................... Amiderson 781-857-1000 Fax 781-857-1054 Ensulation, Into www.andersoninsul.corn 706 Brockton Ave PO Box 2003 Abington, MA 02351 Insulation Ce/'d cate WORK AREA ITEM IINSTALLED EXT.Walls 2x6 R-20.5 Icynerie Closed Cell Spray Foam Insulation MDC-3in Blockers/Rim Joist R-20.5 Icynene Closed Cell Spray Foam Insulation MDC 3in Windows and Doors Foamed Great Stuff- Minimal Expansion Foam Blockers/Rim Joist R-20.5 Icynene Closed Cell Spray Foam Insulation MDC-3in Main Ceiling R-19 6 X 15 Unfaced Fiberglass Batts Interior Partitions R-19 6 X 15 Unfaced Fiberglass Batts Crawl Ceiling R-30 10 X 16 Kraft Faced Fiberglass Batts Crawl Ceiling 17in Wire Supports EXT.Walls 2x6 R-22 Icynene Closed Cell Spray Foam Insulation MDC-3.2in < Blockers/Rim Joist R-22 Icynene Closed Cell Spray Foam Insulation MDC-3.2in `: First Floor Ceiling R-41 Icynene Closed Cell Spray Foam Insulation MDC-6in Furred Walls R-20.5 Icynene Closed Cell Spray Foam Insulation MDC-3in r Windows and Doors Foamed Great Stuff- Minimal Expansion Foam Second Floor Ceiling R-19 6 X 15 Unfaced Fiberglass Batts Between Floors R-19 6 X 15 Unfaced Fiberglass Batts Interior Partitions R-19 6 X 15 Unfaced Fiberglass Batts Interior Partitions R-13 3 1/2 X 15 Unfaced Fiberglass Batts Basement Ceiling R-30 10 X 16 Kraft faced Fiberglass Batts Basement Ceiling 17in Wire Supports Underside of Roof R-41 Icynene Closed Cell Spray Foam Insulation MDC-6in Gable End Walls R-20.5 Icynene Closed Cell Spray Foam Insulation MDC-3in Underside of Roof R-40.5 Icynene Closed Cell Spray Foam Insulation MDC-6in Gable End Walls R-21.6 Icynene Closed Cell Spray Foam Insulation MDC-3.2in Customer: Kenneth Vona Construction,Inc. Job(dumber: 199822 lob Address i 1141 Main St-Cotuit(Rushy Marsh Farm GateHouse) Date Completed: In r nature I