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0033 OYSTER PLACE ROAD
.�' OYSTER PL NC � � 4 e - � G, 9 vl 1 'I I / I Y ,l { 6 t f_ t +, r ," vffiP � 'r ay,a, c ria, t F�He r ' �� Printed On 3/3/2020 o C:omplaint�Call Report f aar swa+. a* wwauszara 33 OYSTER PLACERQAD COTUITr` ` .n , +."aL^w,Pe.gar II " tiw;m maruWN. ' Ca3e#✓�a C'2��6 .�,..�,. *+ - - ; r ' t as «ass x r� �, mR`ay ar*A, „( ai•; " Case#: C-20-96 Address: 33 OYSTER PLACE ROAD, Date: 2/22/2020 COTUIT Owner Info: Property Info: MACKINNON, MATTHEW J TR MBL: j3 OYSTER-PLACE.ROAD 035-101 COTUIT�MA 02635 Owner Notified?: Complaint Details: Type of Complaint Classification of Complaint Method of Complaint Interior-Exterior Maintenance, Building Medium Priority Mail Code, Complaint Summary: Citizens concerned about work without permits. Action History: Action Taken Date Description Fee Inspector Close Case 3/3/2020 all work in compliant had $0.00 carter] a valid building permit b- 19-4104 Inspector Assigned to Complaint: carterj Filed by: andersor Comments: Comment Date Commenter Comment 3/2/2020 andersor Staff found that property has been issued permits for the work shown in the attached photos. Subsequent inspections will confirm that'no un-permitted work has occurred. ..rM,r �� * ro•�* '`x -� *. ,( r -� sa ."..�wrnwx<r+'L>r�.ry cer.-. � .'�,�b9.r,�<aA'»`u a,a r -a.'va fir +r+,a c�., �" ,a,sh~ ,";;w "�``" a. i MAR 0 3 2020 TOWN OF BARNSTABLE *VGHK nM ........ . :..... .. . . .... . March 1, 2020 �P tN_OF Mqs�.,. Mr. Peter Pometti 3• ,ham Architectural Innovations orR�c �' `"� 'CEDE HOLM PO Box 2056 0 $TRUC�URAI Cotuit, MA 02635 Ho. ,39962 RE: 33 Oyster Place Rd.—Cotuit, MA— Living Room Ceiling Framing Dear Mr. Pometti, On February 18, 2020, i visited the referenced property location to perform a final framing inspection of the ceiling framing in the living room. I found the framing to be in conformance with the approved design drawings as well as my recommendations regarding the connection of the ceiling joists to the existing rafters. Should you have any questions regarding these findings, please do not hesitate to contact me. Sincerely, Eric J. Cederholm, PE Transition Engineering, Inc. PO Box 576 Cotuit, MA 1(508)404-0358 ejcpe@verizon.net o Page 1 of 1 Town of Barnstable Buildin a 9 " , Post�This"Card So That rt rsVisible''�Fromthe Street ApprovedPlans Must be Retained on Job and�this Card Must�be Kept Posted Until.Final fnspection:Has Been Made t Permit Where a Certificateof Occupancy is Regeuired;,such Bulldmg shall Not:be Occupied Until.a-Final Inspection has been made Permit No. B-19-4104 Applicant Name: SCHULZE BUILDING CO LLC Approvals Date Issued: 01/28/2020 Current Use:. Structure Permit Type: Building-Addition/Alteration- Residential Expiration Date: 07/28/2020 Foundation: Location: 33 OYSTER PLACE ROAD,COTUIT Map/Lot: 035-101 Zoning District: RF Sheathing: Owner on Record: BASS, MICHAELATR � Contractor:Name SCHULZE BUILDING CO. LLC Framing: 1� ZO Address: 33 OYSTER PLACE ROAD - ContractorLicense _112049 2 COTUIT, MA 02635 I Est .Project Cost: $20,000.00 Chimney: Description: Raise living room ceiling from 8' height to 10'height;Add(3) I Permit Fee: $ 152.00 Insulation:. windows with transom Window per the provided,planFee Paid:; $ 152.00 E, r Project Review Req: DESIGN REQUIRES STRUCTURAL RIDGEOR`DESIGN ' Date:J1/28/2020 Final: PROFESSIONAL APPROVALTO BE PROVIDED AT TIME©F ° p FRAME INSPECTION. Plumbing/Gas Rough Plumbing:_ �. Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after'-4issuance. All work authorized by this permit shall conform to the approved application ah the approved construction documenU for which-this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permitshall be displayed in a location clearly.visible from access street or road"and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. f i ¢ Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officialsare provided on this l3ermit. Minimum of Five Call Inspections Required for All Construction Work: ' Service: 1.Foundation or Footing . ' 2.Sheathing Inspection _ _ Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Application Number.................................................... Section 5—Detail Cost of Proposed Construction 20 ° Square Footage of Project Age of Structure 5E4t- Dig Safe Number # Of Bedrooms Existing Z Total#Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design i Section 6—Project Specifics i : ,Wiring ❑ Oil Tank Storage ,, El Smoke Detectors - - � 0 Plumbing ❑ Gas' .❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ` w ❑ Add/relocate bedroom Water Supply Public ❑ Private, . Sewage Disposal ❑ Municipal On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: i� .d P/+,rvrte� I am using a crane ❑ Yes No Section 7—Flood Zone 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 Proposed Rear Yard. Required Proposed Y Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/15/2018 10 Application Number............................................................. BARNSTABLE, 15� -0 6 MASS. Permit Fee.......................................Other Fee:....................... 639. Ep MA'S TotalFee Paid..*.......... ............................................. ...... TOWN OF BARNSTABLE Permit Approval by..... on.... BUILDING PERMIT 05 Map........................................Parcel........:.................................... APPLICATION Section 1 — Owner's information and Project Location Project Address- village G 4e< Owners Name SCANNED . 622,tla,40 1bt� JAc-k1VjQ5W JAN 3 0 2020 V z Owners Legal Address I141V City State Xo� zip 026-36 Owners Cell# 617 V29 E-mail 10,0m-ej, C<)WI Section 2 —Use of Structure Use Group_ F-1 Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Single/Two Family Dwelling Section 3 — Type of Permit ❑ New Construction ❑ Move/Relocate [] Accessory Structure E] Change of use E] Demo/(entire structure) El Finish Basement El Family/Amnesty ❑ Fire Alarm Rebuild El Deck Apartment El Sprinkler System ❑ Addition ❑ Retaining wall Solar Renovation ❑ Pool El Insulation BUILDING DEPT, Other—Specify, n 10 2M Section 4 - Work Description TOWN /Y .111 14910,01� e--.1 I,A.*ff -An e/-,i Last updated: 11/15/2018 SCANNED Barnstable Bld .Dept. Approved by: hermit#. 710 �s2 v r--- --------- - - -, 0 - W)) fYDnNG I I --- h SECOND FLOOR PLAN r-- ----------i OA a 1 I I U I I I I Ling RODm Deck o • I Starege 1 I roscD 1 _ 1 I - � umeoau alm+G i . Q I 1 I i 1 N Bedroom wU•}e wlc i "' I I Roof Deck M.eedloom I ` Dim�rlg Area �,. rmm w.x.rt,a/ cl = >.ze• Kdohen "ndry . I r£� O eror. 3 i0 I BeN - 9I q)Beth SUIT RDOnI I � u m I • I �� 2 (i/.l OhSONG a I w • Z Ire zaa• � AiST.iKK.°arty"_-\ f�A)fxFiIING --" (tl-)fS5nIK -- ' Q � d W _UM_rottxu—DRmw .- _. ir. ] ^ > [�^�_J�' FIRST FLOOR -PLAN k' Q O V � LL W v w craw rmce WINDOW 5CHEDULE Y m a a 611 UNIT TYPE ROUGH OPENING MANUFACTURE NOTES i O 0 A WJI12B42/WfR2Bi5 OHW/FIXEp TRANSOM <'-101/9'WX6'O 1I/1 G'H ANpERSEN-WOODPJGHT 101 1— (FACTORY MUUM) B PROPOS® g W CROSS SECTON 1/T�I'�X WTE:11139/a)1B - SP11E:A$NOTED Druwr1as Al - 2 F� N 2 P� • ag� F11 L] a _ A A A —_— 3. —. —e EXgIING m � 1•hl 16'O 1_ I OIL/_ LEFT SIDE ELEVATION . � v9oeryseG REAR ELEVATION tl a rn P a W � - -..._ LU IHEH --- ---- — - --- --- - - -- - -- - ---- - - - �- — - - O CL n a O9f1YeG ah;11125/3919 9x¢m+G FRONT ELEVATION RIGHT SIDE ELEVATION SG EA9 NO ED Al - I Town of Barnstable o `'✓i1'� dr Building Department Services Brian Florence,CBO ,� y Building'Commissioner 200 Main Street,Hyannis;MA M601 ; www.town.batnstable.ma.us Office: 508-8624038 F= 50&790.6230 t' -Property Owner Must Complete.and Sign This Section �f Using .Builder 3 v fi I, E�a�`�ti►�?is:► J ut 1C,. +►v, ,as Owner of the subject propetty �.t hereby authorize to act on my behalf > in all matters relative to work authorized by this building permit application for • i , (Address of Job) t F "Pool fences and alarms are the'responsibility of the applicant Pools are not to be filled or utilized before fence is installed acid all final inspections are perfogmed and accepted.. . f Sigaa a of er Sigaa of ppli •L'`'`z'��-1+y�w � . �Nam•�`.•v--a / !�� v Print Name Print Name • f 1 1.z3 Z,c Date Q•.Fox1 MOVIrlEtPEUMMOM ooLS Rat.08/16/17 , q Bk 32409 Pw 301 052902 1 i0--25"2019 a'1 1.1 2 53a 33 OYSTER,PLACE_REALTY TRUSTc J m RESIGNATION AND APPOINTMENT AND ACCEPTANCE-OF-NEW TRUSTEE a c ' G7 N CL Reference is made to a Declaration of Trust of 33 OYSTER PLACE REALTY TRUST dated October Lo r- m 10,2019,filed with the Plymouth County Registry of Deeds in Book 51775 Page 105 and the U- 0 Barnstable County Registry of Deeds in Book,_Paget ' a z BE IT KNOW THAT 1,Konrad Gesner,Trustee of said 33 Oyster Place Realty Trust acting pursuant to every general and special power given in the..abovereferenced,Declaration of Trust including but not limited to article 6 and 14,do hereby nominate and appoint Matthew J. MacKinnon of Carroll County,New Hampshire gas my sole SUCCESSOR-TRUST_EE,,re g g effective upon his acceptance and upon the filing of this Instrument with the Plymouth County Registry of Deeds and Barnstable County Registry of Deeds. said Konrad Gesner,Trustee as aforesaid certify as follows: 1. The Declaration of Trust of 33 OYSTER PLACE REALTY TRUST has not been altered or amended,except as referenced above,and that the above Appointment has the unanimous assent of the holders of the of the Beneficial interests. 2. The no funds are due me for reimbursement of expenses or compensation. EXECUTED AS A SEALED INSTRUMEN;OiGeswner if ACCEPTANCE BY SUCCESSOR TRUSTEE 1,Matthew J.MacKinnon of Carroll County,New Hampshire,hereby accept the appointment as SUCCESSOR TRUSTEE of 33 OYSTER PLACE REALTY TRUST,effective upon the filing of this instrument all as aforesai Sfi EXECUTED AS A SEALED INSTRUMEN th i I of Oct ber,2019 a Maiiti&MacKinnon I 8k 32388 -PV 3�22 1252 10-18--2019 all 12 n 22P HASSACHUSETTS.STATE EXCISE TAX BARNSTABLE COUNTY REGISTRY OF HEEDS Dates 10-18-2019 8 12s22va Mfg 764 - DocV 51282 Fees S4r104:0o Cons'. $1r200r0O0a00 BARNSTABLE COUNTY EXCISE TAX DatN TABLE COUNTY REGISTRY OF DEEDS Ctlrs 70-18-2019 & 12s22nm OUITCLATM DEED fee'. $3,b72.00 cons* $IP200,000,00 Michael A.Bass,Trustee of The 33 Oyster Place Road Nominee'Trust u/.d/t dated June 16,2016,a chapter 184,section 35 Certificate of which is recorded with the Barnstable County m Registry of Deeds at Book 29761,Page 297(the"Grantor")in consideration-ofOne-Million Two 1= Hundred Thousand and 00/100 Dollars($1,200,000.00), t'o gr -KonradGesner;-as-Trustee-of� W z the 33 Oyster Place Realty Tr is u/d/t dated October 10,2019,and recorded with the Plymouth ® �' CC Co y Registry of a ds a Book 51775,Page 105,and fiuther recorded with the Barnstable z CC, County Registry of Deeds simultaneously herewith,(the"Grantee")with an address at 33 Oyster — o Place Road,Cotuit,MA,02653, a .� o 7 with Quitclaim Covenants, �— the land in Barnstable(Cotuit),Barnstable County,Massachusetts,together with the buildings thereon,bounded and described as`follows; PARCEL 1 Cn Cn EASTERLY by Oyster Place Rd.,as shown on plan hereinafter mentioned;Fifty - W Two and 00/100(52.00)feet;. SOUTHERLY by Oyster.Plaee Rd.Town Landing,as shown on said plan,Twenty and 10/100(20.10)feet; . EASTERLY by Oyster Place Rd,Town Landing,as shown on said plan,Two a Hundred Thirty-Two and 001100(232.00)feet,more or less; O Rom, SOUTHERLY by the mean low waterline of Cotuit Harbor,as shown on said plan, Seventy-Two and 00/100(72.00)feet,more or less; WESTERLY by Parcel"A"as shown on said plan,Two Hundred Thirty and 00/100 (230.00)feet,more*or less;and ` NORTHWESTERLY by Parcel"A"as shown on said plan,One Hundred Six and 20/100 (106.20)feet. . . The above-described land is shown as Parcel"B"on a plan of land entitled"Plan of Land in Cotuit-Barnstable-Mass.for Frederic P.Claussen"dated May3, 1976 and recorded with Barnstable County Registry of Deeds in Plan Book 303,Page 96. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plunbers Applicant Information / J Please Print Lezibly. Name(Business/OrganizaSion/individual): Address: City/State/Zip: 02giesions �� S .,Phone-#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. 0 I am a general contractor and I , 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.�I am a sole proprietor ofpartner- listed on the attached sheet. 7. ,,Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in a aY capacity.,acitY• employees and have workers' # 9. El Building addition [No workers'comp.insurance _ comp•insurance. required.] 5. ❑ We are a corporation and its r 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[N o workers'comp. rat of exemption per MGL y p 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] 'Any applicant that checks box#I 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. - xContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. _Y I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy'and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date:: / Job Site Address: SS r Fza6F - -City/State/Zip- (011J g 6 Z 534, 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 under the pays and nalties of perjury that the information provided above is true and correct: Si -- -:� Date:� 12 G Phone#: ��� ti Official use only. Do not write in this area,to be completed by city or town ojfuial City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other r Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person id 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 insuirance 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 contacting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense 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. The Department's address,telephone and fax number: The Commanwealth of Massachusetts Department of Industrial Accidents (lffce of Investigations 600 Washington Street Boston,MA 021.11 - Tel.#617-727-4900 ext 406 or 1-877-MASSAM Revised 4-2407 Fax#617-727-7749 viww:mass.govfdia Parcels FY2019 123.456 Address Street Numbers Town Boundary Approx.Building 035-090#910 Buildings INN Decks/Patios '�• - e �• --� -- 035-084 NN #882 Above Ground Swimming Pools '' '` "-'� _�' �� In Ground Swimming Pools --- - Paved Walkways i 1 ; -- Unpaved Walkways ""`���•,,•((( 1t/ Paths ® StairwaysPZZZLtj - Paved Roads G^'Zrj Unpaved Roads 035-085 t.- Paved Driveways .' Unpaved Driveways +- Painted Lines Paved Parking Lots - Unpaved Parking Lots 4.91 Bridges 0351089 Railroad *� #37 —�— Fences 035-301 -�— Guardrails #33 Retaining Walls A4 Jgn 1 oac> Stone Walls S Other Walls / Cary y G Hedges (•e.. � sfr (EL 14) �0 Sports Areas r•1+t sn� Golf Areas Docks/Piers y t Boardwalks to 035-092 • : V Jetties #916 Streams — — - Drainage Ditches ♦.,r Marsh Areas ,J Water Bodies Spot Elevations(NAVD88) O Topo io It Contours(NAVD88) -Wbo761PAfbffsCT!nrr��N tVp8e� !— ee re x Catebbasins n Monuments �j Lamp Posts rk Manholes O Satellite Dish i 035-093 ON Fuel Tanks #932 ` r Q utility Poles ON ,... ,..,. Water Tanks Signs Flagpoles Town of Barnstable Data SOurCC Human-made features, Disclaimer This map is for planning purposes only. It is 1 inch=30 feet N �•. hydrography,topography,and vegetation were Parcel lines on this map are only graphic not adequate for legal boundary determination Feet Conservation Division interpreted from 2014&2008 aerial photos representations of Assessor's tax parcels.They or regulatory interpretation.This map does no http://w .tow -barnstable.ma.us and may have been updated from more current are not true property boundaries and do not represent an on-the-ground survey. O 5 10 20 30 40 WZ&E '200 Main Street,Hyannis,MA 026ot sources. Parcel lines were digitized from^^ represent accurate relationships to physical Enlargements beyond a scale of C=1oo'may oF• Town of Barnstable Conservation Commission 8�AS ADMINISTRATIVE REVIEW FORM ,19. ADM19- Fee $25.00 ❑ Fee Paid Address/location of proposed project: Street: 33 QyS/e✓ 41117 4E Village: Map:035Parcel: 10 0 Owner/Applicant: 100 a Y / 'n Mailing address: C7 ,ham Co `1 I T H vZ 5 Phone/cell: G 17-92cl '5V 2 5 Email:_ psn� �a» LO'r PJt�o�O.r�.e»t��o y�, Fax: �/��4 Contractor/Agent: 4 ,,, SG��1 t Z_P, Address: G�; / 574 W M) 11 dr Art io*S MJ14 Phone/cell: �V� 73�, ' 'A 7I Email: 5� ,G G C o� . Atu T Associated File# Project description: Attach additional sheet if necessary,along with photos and a site plan if available(include distance from resource) ac i : i�a�l y U•��ows A 11 a �►v�c �,.r. �, �.�►Q �.ny�r s 1. Will the proposed woZtke place within any of the following resource areas? (If"yes,"please check the following resource areas). ❑ Town coastal bank; ❑ State coastal bank; ❑ 100-year flood plain (land subject to coastal storm flowage); ❑ Salt marsh; 0 Beach; ❑Dune; ❑ Vegetated wetland; ❑ Lake; ❑ Pond; ❑ Stream; ❑ Intermittent stream; ❑ Estuary; ❑Ocean; ❑Land under said waters. 2. Will the proposed work take place within 50-feet of any of the above resource areas? 3. Is excavation by machinery required? _ 4. Is foundation work proposed? 5. Is removal of vegetation proposed? AJo FUriderstory ❑ Groundcover ❑shrubs 6. Is regrading proposed, either the addition or removal.of soil? _ 7. Is tree removal proposed? _ If so, why? ❑ Water view ❑Aesthetics ❑ Safety issue Are trees: ❑ living ❑dead ❑ dying(please supply photos) 8. Is planting proposed? Vd If so,please supply a plan which includes species. 9. -Is removal of poison ivy proposed,or other invasive species removal/control proposed? �4 If"Yes,"please explain on additional sheet. 10. Is the use of herbicides proposed? dit /a Applicant signature: _ Date: I Z 6 Reviewed by: i�f "t.. /�,cz Date: 2,4 1g Q\regulations\admin policies procedures\adminreviewform 7/1/2017 Application Number........................................... Section 9= Construction Supervisor Name Telephone Number �5c:>? ` 73 7 '11?"4 j Address IFW CityA A State Zip OZ G ye License Number C 5-ON53 License Type e_' 5 Expiration Date 1012�9 12O Contractors Email 54x,e-4 J2e coot(a-)Corncas 6 s M -. Cell # Cjoe - )73 7 - y9'71 f I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. f Signature Date Z � //9 K Section 10;—.Home Improvement Contractor. t / . Name e�1114,!i 'k �cf1 is/Z-P Telephone Number $-�� - - 0 '3 l Address City .� Z State_� Zip OZ Gyp Registration Number UZ0,41 ! Z � Expiration Date P 1 Z � I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date 12�� Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date 1Z / Print Name `1��n� L ����lL-� Telephone Number S 09` 237 -W 7/ E-mail permit to: S 6G G GO L, Last updated: 11/15/2018 Section 12 —Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ ' Conservation ❑ L .. ' m �, For commercial work,please take your plans directly to the fire department for approval Section 13 - Owner's Authorization I, Z e s h le r 6kZd4 gA , as Owner of the subject property hereby authorize Z(_;,1 A W ls L�t z,G to act on my behalf, in all , matters relative to work authorized by this building permit application ,/�f�or: or J Q (Address of job) / 12- Z 1 Signature of Owner date Les L� e, l�(ae, tk.nA5 Print Name . 4 _ x � l 1 • t i r { Last updated: 11/15/2018 " . Town of Barnstable Building + enR3 81 aBLK Post ThisCard So That it is Visible From the Street-Approved,Plans,Must be Retained on Job and this Card Must be Kept . ,� Posted Until Final Inspection Has Been Made. I Permit LVWhere a,Gertificate of Occupancy is'Required,such Building shall Not be Occupied untila Final Inspection,has been made. Permit No. B-19-897 Applicant Name: LAGADINOS BUILDING & DESIGN INC Approvals Date Issued: 03/26/2019 Current Use: Structure Permit Type: Building- Deck Expiration Date: 09/26/2019 Foundation: Location: 33 OYSTER PLACE ROAD,COTUIT Map/Lot:W035-101 Zoning District: RF Sheathing: Owner on Record: BASS, MICHAEL A TR Contractor Name:' LAGADINOS BUILDING & DESIGN Framing: 1 INC Address: 33 OYSTER PLACE ROAD 2 COTUIT, MA 02635 _.-Contractor License: 104804 Chimney: Description: remove and replace existing decks including framing.same size as Est.Project Cost: $ 10,000.00 existing first and second floor decks. Cable Railings. Permit.:Fete: $ 110.00 Insulation: Project Review Req: ' Fee Paid: $ 110.00 Final: Date:=` 3/26/2019 Plumbing/Gas Rough Plumbing: Final Plumbing: Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall'be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. - """ Electrical Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building.and Fire.Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work '`Y Rough: 1.Foundation or Footing - -- - n 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: S.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.final inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT S,v TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION TOWN OF BARNSTABif ��- - 1 �qj Map 3J� Parcel l�!' Application # Health Division 2 0 PH 4: 2(� to Issued 24C., � Conservation Division Application Fee Planning Dept. ,rt if .F ...,., Permit Fee Date Definitive ,Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 3 0YSM A tt� _ 12d Village t 1 Owner I Address b�3 Telephone AN " Cl/� — 9p/D (o,—Lo I , 11�V�— ��dS Permit Request ✓( K I (vel(yLf XOMItt.e 5Qlru , Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain / Groundwater Overlay Project Valuation/ Construction Type Lot Size S Z Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family p Two Family ❑ Multi-Family (# units) Age of Existing Structure yD Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use CT,r"e_ Proposed Use leK) �2 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 9-1& Z Z3V rft) Telephone Number 7 Address l-,?, / I&ll G,e% License # G S 0 rZ d/ZI T ryll (UG S Home Improvement Contractor# lioqmy Email �19" LC�6,4 �_ (el eyb I iyal— Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO (�U SIGNATURE DATE (FOR OFFICIAL USE ONLY APPLICATION# -DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Building D"rhowt&gym. . BARD Fbrewle,Coo Office- 5M862-4036 Property Owner U Vaine t` !. Wa l_Av/,f1 �f�'V It 1:;31"gL s car L:aPAIU ,Building=d - herby au&xmiw IW qs mmy Waif . in 2H matte rdztive to a►ork audiorized by this'buildmgP {lac v— (Addaess bf job) *" PoaI fences and alarms are the responsibi`hty of tie are not to be filled or ut ized'before feace is aIl' inspections are performed and acceDta - w- ems Signature a Owia sigaaium of Nick Lagadinos L a,,rrA . Print N=C Pnr NIsaie.: -rd IT! Date � Q,"RMs.0wn►rUEMIssI0N?W S. AF�o &17 Ac R CERTIFICATE OF LIABILITY INSURANCE UATE,MM/D°"""' `� 01/23/2019 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 have ADDITIONAL INSURED provisions or 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 Jenn Harney Leonard Insurance Agency,Inc PHONE (508)428-6921 FAX (508)420-5406 - - A/C No Et: A/C,N o: 683 Main Street E-MAIL ) 9enc.enn leonarda com ADDRESS: y - Suite B - INSURER(S)AFFORDING COVERAGE NAIC# Osterville MA 02655 INSURERA: NGM Insurance Company 14788 INSURED - INSURER B: Charter Oak Fire Ins.Co. 25615 Lagadinos Building&Design,Inc. INSURER C: Continental Indemnity Company AUC002 INSURER D 13 Thankful Lane INSURER E COtuit MA 02635 INSURER F COVERAGES CERTIFICATE NUMBER: 19-20 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 CONTRACTOR 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 AIJUL 5UI3R1 POLICY EFF POLICY EXP - -LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MMIDD/YYYY - LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGERENTED 500,000- CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) _ $ 10,000 A MSB87460. 01/01/2019 01/01/2020 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATELIMITAPPLIESPER: - 2,000,000 GENERALA AG JECT GREGATE GG EGATE $ POLICY❑ PRI LOC PRODUCTS-COMP/OPAGG -$ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $ - Ea accident , ANYAUTO - - BODILY INJURY(Per person) $ 250,000 g OWNED: X AUTOS SCHEDULED AUTOS ONLY BA-4253MO74-18-SEL 06/20/2018 . 06/20/2019: .BODILY INJURY(Per accident) :$ 500,000 X /�HIRED - NON-OWNED - - PROPERTY DAMAGE ONLY - AUTOS ONLY Per accident $ 250,000 Uninsured motorist BI $ 100,000 UMBRELLA LIAB OCCUR I„.������. C .. .. ... EACHOCCURRENCE .. $.' EXCESSLIAB- CLAIMS-MADE - -AGGREGATE DED.. RETENTION$ ... ..' .. ..` $ .. WORKERS COMPENSATION •- PER OTH- - AND EMPLOYERS'LIABILITY YIN STATUTE ER C ANY PROPRIETOR/PARTNER/EXECUTIVE 500,000 OFFICER/MEMBEREX:CLUDED? - Li N/A 46-880906-01-06 01/02/2019 /02/2020 E.L.EACH ACCIDENT .$., (Mandatory in NH) - -E.L.DISEASE-EA EMPLOYEE -$-500,000 - If yes,describe under -• -r - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF.OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required). 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 Hyannis MA,02601 n A �16 t j ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/63) The ACORD name and logo are registered marks of ACORD �� �vnino2un.¢l�a�..l��.'3(c iudcd/�• Office of Consumer Affairs&Business Regulation t Registration valid for individual use only HOME IMPROVEMENT CONTRACTOR 9 before the expiration date. If found return TYPE:Corporation e Renisfration._ Expiration Office of Consumer Affairs and Business Regulation :.104804 ' ' 07/14/2020 1000 Washington Street-Suite 710 LAGADINOS BUILDING&:DESIGN,INC oston,MA 02118 NICHOLAS A.LAGADINOS � � 13 THANKFUL LANE Not lid Ithout signature COTUIT,MA 02635 Undersecretary l Commonwealth of Massachusetts Division.of Professional Licensure Board of Building Regulations and Standards Constructiop Supervisor CS-012653 Expires 07/16/2019 . w q NICHOLAS p.:LAGADINOS 13 THANKFUL LANE COTUIT MA 02fi35 Commissioner CIL i a R i The Commonwealth of Massachusetts Department of IndustrialAccidents I Congress Street, Suite 100 Boston, MA 02114-2017 .•''V www mass.gov/dia lVorkers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH T$E PERMITTING AUTHORITY. ' Applicant Information Please Print Le-ibIX Name(Business/Organization/Individual): G i19lJl4IQS f3t)( r,tomLk<I�fd wz Address: City/State/Zip: /'D�?/i% Wl 4ZGS_ Phone#: SXV ryZzi—VIV Are you an employer?Check the appropriate box: Type of project(required): 1.R I am a employer with employees(full and/or part-time).* 7, .0 New construction ?.Q 1 am a sole proprietor or partnership and have no employees working for me in S. Q Remodeling any capacity.[No workers'comp,insurance required.] 3. I am a homeowner doing all work myself.[No workers'comp-insurance required.]t 9. C Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. 1 will10 EJ Building addition ensure that all contractors either have workers'compensation insurance or are sole I L E]Electrical repairs or additions proprietors with no employees, 12.Q Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.0 Roof repairs These sub-contractors have employees and have workers'comp.insurance.t r' 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.'[&Other D P CIL _ 152,§1(4),and we have no employees,[No workers'comp.insurance required.} *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers compensation.insurance for my employees Below is the policy and job site information. Insurance Company Name:_ ty (O Policy#or Self-ins.Lie. Expiration Date: `Lz 14,0 Job Site Address: 3 l cA�.p/aGf MW City/State/Zip: /[ ,7`_ G 3,S— Attach a copy of the workers compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL e. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance " coverage verification. I do hereb hfy der th pains and p alties of perjury that the information provided above is true and correct Signatu Date: ,z0 v Phone M Official use only. Do not write in this area,to be completed by city or town official City or Town: PermittLicense# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: � . Town of Barnstable Building a nxtvrrrae Post This Card'So That it is:�V►sible From,the Street Approved.;Plans,Musi; ;Re tamecl on Job and;this Card Must be Kept . s6,f s Posted"Until Final Inspection Has Been;Made. erea Crtiicteof Occuancy sReqired su�c " inectinhas beenmadeWh d p Permit ut .-.......er..i«a,Tw,...w.......e..<-..,,_.w..m ..- u.w+a s.wsa. +u sx r..«c.o.Y.. .-..... ......+a. :,..i... .... �«,..".§.".ww-...ek... <......,L.r..i........xm>>....,....,.,.:.�-,x.w....m. Permit NO. B-19-931 Applicant Name: NICHOLAS A LAGADINOS Approvals Date Issued: 03/28/2019 Current.Use: Structure Permit Type: Building-Deck Expiration Date: 09/28/2019 Foundation: Location: 33 OYSTER PLACE ROAD,COTUIT Map/Lot: 035-101 Zoning District: RF Sheathing: Owner on Record: BASS, MICHAEL A TR Contractor.Name:'- LAGADINOS BUILDING & DESIGNe Framing: 1 Address: 33 OYSTER PLACE ROAD I,NC 2 ".Contractor License' 104804 COTUIT, MA 02635 ' Chimney: Description: replace 88sq ft. existing deck on shed to match house. Est. Project Cost: $5,000.00 r t Insulation: Permit Fee: $ 110.00 Project Review Req: Fee Paid. $ 110.00 Final: Date: 3/28/2019 Plumbing/Gas - y � Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized,by this permit is commenced within six months after' ssuance. Rough Gas: All work authorized by this permit shall conform,to the approved application and the" pproved construction documents for which this permit has been granted. " g Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. ` Electrical The Certificate of Occupancy will not be issued until all applicable signatures'by the Building and Fire Officials are provided on this permit, Service: Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ~O Application Number.................�.j. f......... q * snaxsrna�, MAS& Permit Fee.......................................Other Fee;;...................... 1639• ''� Ep M1�A Total Fee Paid............ ..�..0 .`.. `�' ............. ...... v;. TOWN OF BARNSTABLE Permit Approval by..... ....................On... J?. 11.9..... BUILDING PERNUT 1 Map........6....... .........Parcel............ �...I................. APPLICATION E»�Azc. s moo` Section 1 —Owner's Information and Project Location Project Address 0J57270— 81*e,4::- Village /2 7ZI j Owners Name__ Owners Legal Address City 4 am 1 State ;trial _ Zip Owners Cell# 7W` �lz) . 1l0/D E-mail v✓ lr ffCi • G t�l Section 2 —Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet YA, ❑ Commercial Structure under 35,00r,-pbic feet � Single/Two Family DwellingZM w tv Section 3 — Type of Permit a z ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Chang of use �FF m ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild �, Deck Apartment © sprinkler-System ❑ Addition ❑ Retaining`wall ❑ . Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify Section 4 - Work Description s Last undated 11/15201 S ApplicationNumber.................................................... Section 5—Detail Cost of Proposed Construction G/V Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7—Flood Zone 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 Proposed Rear Yard Required Proposed Side Yard Required Proposed 4 Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No - Last updated: 11/15/2018 Application Number.................... ..................... Section 9-Construction Supervisor Name Telephone Number Kz1— W 7 Address LW City 62hJ1 j State W_Zip 4Z6� License Number G 5 —,!5l2- License Type Expiration Date Contractors Email I a�y� r'ajrra CI. 4(4 Cell# �0±-7�7-02 I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts§tate Building Cod . I understand the construction inspection procedures,specific inspections and documentation require y 780 CMR an a Town of Barnstable.Attach a copy of your license. Signature Date Section 10—Home Improvement Contractor ! Name &1'I rj/_ Telephone Number S_V— Y2y —�0 7 0 Address ), tAm City State ,MA— Zip OLG � 3_ Registration Number Expiration Date �(/Z(� I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,.specific inspections and documentation re by 780 CMR and Town of Barnstable.Attach a copy of your H.I.C... Signature Date 3 Zz Section 11 -Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date zz Print Name�ly(eL G Telephone Number 232 dc&2 E-mail permit to: � Last updated. 11/152018 Section 12—Department Sign-Offs Health Department ❑ Zoning Board(if required) Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation 1 For commercial work,please take your plans directly to the fire department for approval Section 13— Owner's Authorization L , 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: (Address of job) Signature of Owner gn ,date Print Name Last updated. 11/15/2018 } ✓/L(i/ UP/)2/720/LU'G'C/.GC/6�✓�lLr)CG LLC�B�G`r3- Office of Consumer Affairs&Business Regulation Registration valid for individual use only HOME IMPROVEMENT CONTRACTOR g Y,P'E:,C Coraoration before the expiration date. If found return to: T Reois, t Expiration Office of Consumer Affairs and Business Regulation 104804 07/14/2020 1000 Washington Street-Suite 710 1 �� —•"+ oston,MA 02118 LAGADINOS BUILDING,&DESIGN,INC + ._ NICHOLAS A.LAGADINOS 13.THANKFUL LANE:; _ ' C Not, lid Ithout signature COTUIT,MA 02635 Undersecretary f 9 Commonwealth of Massachusetts ' Division.of Professional Licensure Board of Building Regulations and Standards Construction Supervisor CS-012653 Eupires: 07/16/2019 NICHOLASA:LAGA®INOS 13 THANKFUGLANE COTUIT MA OZ635ry� Commissioner i 3 \ The Commonwealth of Massachusetts Department oflndustrialAccidents 1 Congress Street,Suite 100 Boston, MA 02114 2017 �.•�° www mass.gov/dia l orkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. A—ulicant Information Please-Print Lecrib� Name(Business/Organization/Individual): Gf 19ljis'IUS 2llll(�tka LS14l� 1L'_ Address: City/State/Zip: Phone#: S y Are you an employer?Check the appropriate box: Type of project(required): 1.N I am a employer with J employees(full and/or part-time).* 7. .F New construction 2.Q I am a sole proprietor or partnership and have no employees working for me in $. Remodeling any capacity.[No workers'comp.insurance required.] 3.Q I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. D Demolition 4.❑I am a homeowner and will be hiring contactor;to conduct all work on my property. I will 10 EJ Building addition ensure that all contractors either have workers'compensation insurance or are sole I l.[3 Electrical repairs or additions proprietors with no employees, 12.❑Plumbing repairs or additions 5.Q I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insurance.= 6.E]We are a corporation and its officers have exercised their right of exemption per MGL 14.EjOther c. l>eC k — 152 1(4),and we have no employees.§ o wor!`ers comp.insurance required.] R`I P Q ] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must 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: /'e"7-1"6Ny794 T 14D,0 A cnn 1/0 Policy#or Self-ins.Lie.#:_ yG — &0 rtz-e a6, Expiration Date: ` Z. Job Site Address:_- 6UV7�:✓ City/State/Zip: l07VI 4 rP*-Zfz6 Attach a copy of the worke•s'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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..A copy of this statement may be forwarded to the Office of lhvestigations of the DIA for insurance coverage verification. I do hereb fy der th pains and p alties of perjury that the information provided above is true and correct Si natu Date: LZ U Phone#: (official use only. Do not write in this area,to be completed by city or town offieiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person:. Phone#: Ac CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) 01/23/2019 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 have ADDITIONAL INSURED provisions or 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 - CONTANAME:CT Jenn Harney - - Leonard Insurance Agency,Inc PHONE (508)428-6921 FAX (508)420.5406 .(A/C No Ext: AIC,No 683 Main Street - - - E-MAIL jenn@leonardagency.com - - - ADDRESS: - - Suite B INSURER(S)AFFORDING COVERAGE NAIC# Osterville MA 02655 INSURERA: NGM Insurance Company 14788 INSURED - INSURER B: Charter Oak Fire Ins.Co. - - 25615 Lagadines Building&Design;Inc. INSURER C: Continental Indemnity Company AUC002 INSURERD: - 13 Thankful Lane INSURER E: Cotuit MA 02635 INSURER F: - - COVERAGES CERTIFICATE NUMBER- 19-20 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 MAYBE 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 AUUL bUISK POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICYNUMBER MM/DD/YYYY MM/DDIYYYY LIMITS - X COMMERCIAL GENERAL LIABILITY - EACHOCCURRENCE $ 1,000,000, DAM CLAIMS-MADE F OCCUR GE TO RENT D .500,000 - - PREMISES Ea occurrence -$ .. .. M ED EXP(Any one person) $ 10,000. A MSB87460 01/01/2019 01/01/2020 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: .- .. GENERAL AGGREGATE $ 2,000,000 POLICY Eo LOC - PRODUCTS-COMP/OPAGG :$.2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ - Ea accident ANYAUTO BODILY INJURY(Per person) $ 250,000 B OWNED ASCHEDULED AUTOS ONLY UT O S BA-4253M074=18-SEL 06/20I2018 06/20/2019 BODILY INJURY(Per accident) :$ 600,000 /� HIRED NON-OWNED PROPERTY DAMAGE - - AUTOS QNLY X AUTOS ONLY : .: .: Per accident $ 250,000 Uninsured motorist BI $ 100,000 UMBRELLA LIAB HOCCUR .. EACH OCCURRENCE $ 4EXCESS LIAB CLAIMS-MADE AGGREGATE $' ED RETENTION$ WORKERS COMPENSATION - - - PER OTH- - - AND EMPLOYERS'LIABILITY STATUTE .. .ER ANY PROPRIETOR/PARTNER/EXECUTIVE /N - - E 500,000 C OFFICER/MEMBER EXCLUDED? � ❑ NIA 46-886906-01-06 �01/02/20.19� 01/02/2020 .L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-'EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT: $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 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 - Hyannis MA 02601 ©1988-2016 ACORD CORPORATION. All rights:reserved. ACORD 25(2016163) The ACORD name and logo are registered marks of ACORD Town of Barnstable $ Building Department Services s,uwsrc Brian.Florence,CBU ate" Building Commissioner 200 Main Street,Hyannis,MA 02601, www.towabarnstable.ma ns Office: S08862-4038 Fax: 508-790-6230. , Property Owner Must : Complete and Sl�,en This Section If Using A Builder IT �_. �Av►S as Owner c f the subject hereby authorize Iagdunos Building and Design IN is act on Inybel>al in all nutters relative to work authorized by tf is building peanut application for::- (Address of Job) `*Pool fences and alarms.are the responsibility of the'apphcant Pools_ are not to,be filled or utilized befoxc fence,is installed and all final inspections are performed:and accepted; Signamre csf Cvrner Signature of Applicant �. J. } 'bAJ Print Name Print Name - Date ry Q:FORMS OWNERPERMISSIONPOOiS w , YI THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I A , t'- m / �C(�� LI DATA N `v U` I ^ �6 \;•• i �k �1\J tk 0 IN p(ls" �jpN 6.9 3 10P 33 D , EZ III 08 � 5 DECK s r . \\AWN N \ N lam■ 5 � �\ 3 LAWN 4 0 • /-2 Scale: / � t�pPL _ GO Of 0 10 20 30 40 50 FEET DCE ##16-318 B ld Town of Barnstable U1 In .i.. '" ;3 :,`a�.: r `,' i,. :. .a�,'�:•.s7'r"��'.i '".. °,H a ry �',.,,;e .''..w .`s. r; .,mh "<;; g PoKAM st This Card So,That it�sVlsible�From�tY,h�e��Stneet �Anffroved`;P.,.lans�=Must:be:Retatned�on3JobYand this Card�Must be�Ke t AElLE,':ibsp..+►� WPo�d�UntlF��. I .aa... Permit Permit NO. B-18-1468 Applicant Name: PETER M POMETTI Approvals Date Issued: 06/05/2018 Current Use: Structure Permit Type: 'Building-Addition/Alteration-Residential Expiration Date: 12/05/2018 Foundation: Location: 33 OYSTER PLACE ROAD,COTUIT Map/Lot 035 101 Zoning District: RF Sheathing: Owner on Record: BASS, MICHAEL A TR �, Contractor Name' PETER M POMETTI Framing: 1 Address: 33 OYSTER PLACE ROAD `, � fr Cor -tor.�L cense� CS 050457 2 COTUIT, MA 02635 �" '� R Est Protect Cost: $ 106,000.00 Chimney: Description: repair frozen pipe water damage to utility rm kitchen&1st floor Ferrn�t Fee: $590.60 bath. remove& reinstall rubber roof on 2nd floor�deck remodel ' Insulation: existing 2nd fl bath i Fee Paid: $590.60 6/5/2018 Final: Project Review.Req: r y , Plumbing/Gas � E Rough Plumbing: - Buildin Official r g Final Plumbing: This permit shall be deemed abandoned and invalid unless the work a#,hued by this permit is commenced within six months afterissuance. Rough Gas: A All work authorized by this permit shall conform to the approved appncation�andthe approved construction documents,for which this permit has been granted. ' Final Gas: All construction,alterations and changes of use of any building and structure'' shall be in compliance with the local zoning by Iaws and codes. Pam ; ;F This permit shall be displayed in a location clearly visible from access street or°roadaand shall be maintained open for ub plic inspection for the entire duration of the work until the completion of the same. N Electrical Vy The Certificate of Occupancy will not be issued until all applicable signatures by the Builld ng and Fire Officials are provided on£this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 14 Rough: 1.Foundation or Footing ,v 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&_Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) - 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT c. -..�: Application Number.... . .. . .. . . * Permit Fee....:... '•.. ...........09ier Fee........................ ED Mf¢ Total Fee Paid .............................. . LE Pena Approval by...ut.............on........................... TOWN OF BARNSTAB , BUILDING PERMIT ............................................ M................................ APPLICATION Section 1—Owner's Information and Project]Location 17, Project Address 37 d o� Village T MAY 111018 Owners Name 71 33 olJ�% �'o�t-�� iy .,✓ � i- 04 'OWN OF RAF?�ISTAt3LE Owners Legal Address �� �� �UCT. State City 60 d Zap C�Z �� ' /n� 177 ®/O _ E-mail rn�l C,c9 Owners Cell# . Section 2—Use of Structure Use Group - ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Single/Two Family Dwelling Section 3 Type of Permit y ❑ New Construction ❑ move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/AmnestY ❑ Fire Alarm Rebuild ❑ Deck Apartment ElSprinkler System ❑ Addition (] Retaining wall ❑` Solar Renovation ❑ Pool ❑ Insulation Other—Specify /-�E�oi Z(Ac;" cr✓5 ©� �c�.2 �.tal�FliE�� u//�?L�'L� GCS Section 4 -Work Description 0,fir,04&Tv (/TG r�J1< `0 ey,, �t/-Z:/?&-Z1 Tact nndzftd:2/9/2018 e L License or reti stration valid fdr individual use only Office of Consumer.Affairs&`Business Reguladg, HOiV1E`IMP..ROVEMEIVT COf�- ACTOR before the expiration date. If found return to: Re6is4ration °:109606 Type: Office of Consumer Affairs and Business Regulation 1 9.5 " � 10 Park Plaza-Suite 5170 Expiration`ir&4A2018 Private Corporawn i Boston,MA 02116 ? ���;_/ A I ENTERPRISE&IN_( s- a=_ PETER POMETTI1 140 LITTLE RIVER RD:.;.-__-. `'', COTUIT,MA 02635 - Undersecretary; Not valid without signature Unrestricted- Construction Su isor less t ,000 'Idings of any Use group than 35 Cubic feet 991 grou ( cubic t h')of contain space. meters)of enclosed Failure to possess State Buildinga current edition of the Code is cause for rev Massachusetts For informationcation of tense. Call(617 about this license this license. - )727-320o or visit wwtv.mass.gov/dpl Commonwealth of Massachusetts � ( Division of Professional Licensure �f Board of Building Regulations and Standards ConstrjgE&iori Sd Ile rvisor f. CS-050457 a i i�ires: 04/1912020 f ,1, l . J, PETER M POMETTI PO BOX 2056 COTUIT MA 02635 - ���I.S'SJ30z1 Commissioner Section 12—Department Sign-Offi Health Department ❑ Zoming Board Cif ❑ Historic District ❑ SAe Plan Review t"if Fire Department ❑ Conservation ❑ For comnmerdal work,please take your plms 'm d ew depm*nentfor*Pml L . Section_13--Owaees Authorization Michael A. Bass, Trustee as Owner of ffie-mAeat p1O 'hereby 1' �- to act on my behalf in all authorize matters relative to work authorized by this building permit application for. _ (AAAftm of job) date s• xichael A. Bass, Trustee of The 33"oyster Place Road Nominee Trust Print Name Lgaundabd:21MIB DECLARATION OF TRUST ESTABLISHING THE 33 OYSTER PLACE ROAD NOMINEE TRUST MICHAEL A. BASS of Westwood, Massachusetts (hereinafter the "Trustee") , hereby declares that Ten Dollars ($10.00) is held in trust hereunder and any and all additional property and interest in property, real and personal, that may be acquired hereunder (the "Trust Estate") shall be held in trust, for the sole benefit of the individuals or entities listed in the Schedule of Beneficiaries in the proportions stated in said Schedule, which Schedule has this day been executed by the adult Beneficiaries having a present interest and filed with the Trustee with receipt acknowledged by at least one Trustee (hereafter, as it may be amended, "Schedule of Beneficiaries") . SECTION ONE Name and Purpose t This Trust shall be known as THE 33 OYSTER PLACE ROAD NOMINEE TRUST and is intended to be a nominee trust, so-called, for federal and state income tax purposes and to hold the record legal title to the Trust Estate and such functions as are necessarily incidental thereto. SECTION TWO Trustees 2. 1 In the event there are two Trustees, any one Trustee may execute any and all instruments and certificates necessary to carry out the provisions of the Trust. In the event there are more than two Trustees, any two Trustees may execute such instruments and certificates necessary to carry out the provisions of the Trust. 2.2 No Trustee shall be required to furnish bond. No Trustee hereunder shall be liable for any action taken at the direction of the Beneficiaries, -nor any error of judgment nor for any loss arising out of any act or omission in the execution of the Trust so long as acting in good faith, but shall be responsible only for his or her own willful breach of trust. No Trustee shall be liable for any act or omission of any other Trustee. No license of court shall be requisite to the validity of any transaction entered into by the Trustee. No purchaser, transferee, pledgee, mortgagee or other lender shall be under any liability to see to the application of the purchase money or of any money or property loaned or delivered to any Trustee or to see that the terms and conditions of this Trust have been complied with. Every agreement, lease, deed, mortgage, note or other instrument or document executed or action taken by the person or persons purporting to be Trustee (s) , as required by Paragraph 2 . 1, and executed in accordance with Section 10 of the Trust shall be conclusive evidence in favor of every person relying thereon or claiming thereunder that at the time of the delivery thereof or of the taking of such action this Trust was in full force and effect, that the execution and delivery thereof or taking of such action was duly authorized, empowered and directed by the Beneficiaries (as specified in Section 3.2) , and that such instrument or document or action is valid, binding, effective and legally enforceable. SECTION THREE Beneficiaries 3. 1 The term "Beneficiaries" shall mean the persons and entities listed as Beneficiaries in the Schedule .of Beneficiaries and in such revised Schedules of Beneficiaries, from time to time hereafter executed and delivered as provided above and the respective interests of the Beneficiaries shall be as therein stated. 3.2 Except as specifically provided otherwise herein, decisions made and actions taken hereunder (including without limitation, amendment and termination of this Trust; appointment and removal of Trustees; directions and notices to Trustees' and execution of documents) shall in each and "every instance be made or taken, as the case may be, solely by a unanimous vote of the Beneficiaries having a present interest. 3. 3 Any Trustee may without impropriety become a Beneficiary hereunder and exercise all rights of a Beneficiary with the same effect as though he or she or it were not a Trustee. The parties hereunder recognize that if a sole Trustee and a sole Beneficiary are one and the same person, legal and equitable title hereunder shall merge as a matter of law. 3.4 If any Beneficiary is unable to exercise a right under this Section because of incapacity or disability, including minority, then his or her legal guardian, conservator or attorney-in-fact under a durable power of attorney may exercise such rights on such Beneficiary' s behalf as such Beneficiary' s 2 i authorized representative. The foregoing authorized representative shall also be qualified to receive any notice required to be delivered to such Beneficiary under this Trust. SECTION FOUR Powers of Trustees 4 . 1 The Trustee shall hold the principal of this Trust and receive the income therefrom for the benefit of the Beneficiaries, and shall pay over the principal and income pursuant to the direction of the Beneficiaries as specified in Section 3.2 and without such direction shall pdy the income to the Beneficiaries in proportion to their respective interests. 4 .2 Except as hereinafter provided in case of the termination of this Trust, the Trustee shall have no power to deal in or with the Trust Estate except as directed by the Beneficiaries as specified in Section 3.2. When, as, if and to the extent specifically directed by the Beneficiaries as specified in Section 3.2, the Trustee shall have the following powers: 4 .2. 1 to buy, sell, convey, assign, mortgage or otherwise dispose of all or any part of the Trust Estate and as landlord or tenant execute and deliver leases and subleases; 4 .2.2 to execute and deliver notes for borrowing for the Beneficiaries; 4 .2. 3 to grant easements or acquire rights or easements and enter into agreements and arrangements with respect to the Trust Estate; 4 .2. 4 to endorse and deposit checks in an account for the benefit of the Beneficiaries; 4 .2. 5 the Trustee may open, maintain and, at will, close out any checking and savings accounts and safe deposit boxes in any bank, banks, trust companies, federal savings and loan associations, and other banking, lending or other financial institutions; and the Trustee may deposit funds and other assets of the Trust in such institutions and such safe deposit boxes, and may disburse such funds on checks signed by the Trustee or by any person or persons authorized in writing by the Trustee so to do, and may withdraw such funds and other assets on 3 instruments of withdrawal signed by the Trustee or by any person or persons authorized in writing by the Trustee so to do. Each such institution shall honor all checks and other instruments signed by such person or persons authorized by the Trustee so to sign, and permit such person or persons to have access to such safe deposit boxes; and such institutions may rely fully on the Trustee' s signed authorization to so do, as so filed by the Trustee with said institutions. Any and all instruments executed pursuant to such direction. may create obligations extending over any periods of time, including periods extending beyond the date of any possible termination of the Trust. A direction to the Trustees by the Beneficiaries as specified in Section 3.2 may be by a Durable Power of Attorney. 4.3 Notwithstanding any provisions contained herein, no Trustee shall be required to take any action which will, in the opinion of such Trustee, involve the Trustee in any personal liability unless first satisfactorily indemnified. 4. 4 All persons extending credit to, contracting with or having any claim against the Trustees shall look only to the funds and property of this Trust for payment of any contract, or claim, or for the payment of any debt, damage, judgment, or decree, or for any money that may otherwise become due or payable to them from the Trustee, so that neither the Trustee nor the Beneficiaries shall be personally liable therefor. If any Trustee shall at any time for any reason (other than for willful breach of trust) be held to be under any personal liability as such Trustee, then such Trustee shall be held harmless and indemnified by the Beneficiaries, jointly and severally, against all loss, costs, damage, or expense by reason of such liability. SECTION FIVE Termination 5. 1 This Trust may be terminated at any time by notice in writing delivered to the Trustee from the Beneficiaries as specified in Section 3.2. 5.2 Notwithstanding any other provision to the contrary, and consistent with the intention of the undersigned that this Trust not violate the Rule Against Perpetuities, this Trust shall terminate in any event ninety (90) years from the date hereof, if not earlier terminated by action of the Beneficiary. The Trust 4 shall also be terminated by an adjudication in bankruptcy by or against any of the Beneficiaries. 5. 3 In the case of any termination of the Trust, the Trustee shall transfer and convey the specific assets constituting the Trust Estate, subject to any leases, mortgages, contracts or other encumbrances on the Trust Estate, to the Beneficiaries as tenants in common in proportion to their respective interests hereunder, provided, however, the Trustee may retain such portion thereof as in their opinion is necessary to discharge any excise or liability determined or contingent, of the Trust. SECTION SIX Amendments This Declaration of Trust may be amended from time to time by an instrument in writing signed by the Beneficiaries as specified in Section 3.2 and delivered to the Trustee. - SECTION SEVEN Successor Trustees 7. 1 Unless otherwise provided for herein, in the event that at any time there is more than one Trustee serving, then upon the failure of a Trustee to serve, by reason of death, incapacity, resignation or removal, then the remaining Trustee (s) shall remain and serve without the need to fill the vacancy. 7.2 Unless otherwise provided for herein, the last remaining Trustee serving hereunder shall have the continuing right to appoint one or more successor or successive Trustee (s) . 7.3 In the event of the failure of all Trustees, no successor having been nominated herein and no successor having been appointed in the manner provided for herein, then the Beneficiaries, as specified in Section 3.2, shall have the right to appoint one or more successor or successive Trustee(s) . 7. 4 The Beneficiaries, as specified in Section 3.2, shall have the continuing right to remove any then serving Trustee (s) and appoint one or more successor or successive Trustee (s) . 7. 5 Any Trustee may decline to serve as Trustee or resign as Trustee from the Trust hereby created, or disclaim or release any power, in whole or in part and at any time, by giving notice in writing, delivered in hand or by certified mail to the Beneficiaries. 5 7.6 Any appointment, removal or acceptance of a Trustee shall be in writing. 7.7 A certificate signed by any Trustee identifying the Trustee or Trustees appointed or removed as provided herein and, , in the case of an appointment, the acceptance in writing by the Trustee or Trustees appointed, shall be conclusive on all parties and the legal title to the Trust Estate shall, without the necessity of any conveyance, be vested in said succeeding or additional Trustee or Trustees, with all the rights, powers, authority and privileges as if named as an original Trustee hereunder. 7.8 In the event of the failure of all Trustees named herein, either through the death or resignation of a sole Trustee without prior appointment of a successor Trustee or for any other cause, a person purporting to be a successor Trustee hereunder may execute an affidavit in accordance with Section 10. 3, stating he or she has been appointed by the Beneficiaries, as specified in Section 3.2, as successor Trustee. SECTION EIGHT Assignments No assignment or transfer of any beneficial interest may be made without the written consent of the Trustee and of all the Beneficiaries as specified in Section 3.2. The Trustee shall not be affected by any assignment or transfer of any beneficial interest made without such consent, nor shall the Trustee be affected by any assignment or transfer of any beneficial interest to which the Trustee has consented until the Trustee has received actual notice that such assignment or transfer has, in fact, been made, nor shall the Trustee be required to recognize any equity to which any beneficial interest may be subject. SECTION NINE Governing Law This Declaration of Trust shall be construed in accordance with the laws of the Commonwealth of Massachusetts. i SECTION TEN Registry of Deeds 10. 1 The term "Registry of Deeds", or "Registry", shall mean the Registry of Deeds or Registry District of the Land Court for 6 the district in the state in which any real estate included in the Trust Estate is located. 10.2 Any documents pertaining to this Trust, including but not limited to, this Declaration of Trust, any Amendment to the Trust, any Resignation of Trustee, Appointment of Trustee, Acceptance of Trustee, Declination of Trustee, . Removal of Trustee, Revocation of Trust or Termination of Trust shall be recorded in the ,Registry of Deeds if this declaration of Trust has been so recorded or if recording of such document is required under local law of the district in the state in which any real estate included in the Trust Estate is located. 10.3 Notwithstanding the foregoing, an affidavit executed by the Trustee, by the person or persons appearing from the records of the Registry of Deeds to be Trustee (s) , or by a person purporting to be the Trustee, and containing a certificate by an attorney at law stating that such attorney has knowledge of the affairs of the Trust and that the facts stated therein are relevant to the title to any real estate included in the Trust Estate and will be of benefit and assistance in clarifying the chain of title may be filed for record and be recorded in the registry of deeds where the land or any part thereof lies pursuant to M.G.L. c. 183 Section 5B. 10. 4 Persons dealing with the Trust or Trust Estate may always rely without further inquiry upon any such affidavit executed in accordance with this section as to the matters stated therein. 10. 5 Recording of any instrument hereunder shall not be a condition precedent to the validity of any transaction of the Trust. SECTION ELEVEN Other Provisions All references to the Trustee or Trustees apply to substitute, successor or additional Trustees where the context so permits; words used in the singular shall include the plural, and the plural shall include the singular, and words used in the masculine gender shall include the feminine, and the feminine shall include the masculine where the context so permits. 7 -tom Executed as a sealed instrument this day of , 2016. I L A. BASS COMMONWEALTH OF MASSACHUSETTS County of Soz%�I if- 01 - On this day of -_TUC1e- 2016, before me, the undersigned notary public, personally appeared MICHAEL A. BASS, proved to me through satisfactory evidence of identification, which was personal knowledge or , to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he signed it voluntarily for its stated purpose. RACHEL L. KALIN Notary Publi Notary Public Print Name•`S�YLSL l <<(1 commonwealth of Monachusens My commission Expires November b, 2020 ' 8 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): Address: 7O City/State/Zip: (f b7'2/!i-/w DXe 3S Phone#: t^Of Are you an.employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I * have hired the sub-contractors 6. ❑New construction employees(full and/or part-time). - 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. XRemodeling ship and have no employees These sub-contractors have g; ❑Demolition working for me in any capacity. employees and have workers' - [No workers' comp.insurance, comp.insurance$ 9. ❑Building addition 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 I L❑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 13.❑Other employees. [No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees.- Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#:ACC:600-6 Expiration Date: 711'e/G� Job Site Address: �J ©r . `` City/State/Zip: 4:: Ia 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 certi der the pa' s nd penalties of perjury that the information provided above is true and correct. Si ature: Gt�� Date: ,Phone Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or .renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to 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. The Department's address,telephone and fax number: The Commonwealth.of Massachusetts Department of Industrial.Accidents Office of investigations 600 Washington Street' Boston,MA 0211.1 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 4-24-07 vvww.mass.gav/dia A6ODATE(MMIDD/YYYY) L@ CERTIFICATE OF LIABILITY INSURANCEF44 / 4/27/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(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 NAME:CONTACT Heidi Wellman HONE Risk Strategies Company A/C No Eat: (781)986-4400 FAXA/C NO:(781)963-9420 15 Pacella Park Drive ADDRESS:hwellman@risk-strategies.com Suite 240 INSURERS AFFORDING COVERAGE NAIC# Randolph MA 02368 INSURERA:AIM Mutual Insurance Company INSURED INSURERS: A I Enterprises Inc INSURERC: P. 0 BOX 2056 INSURERD: INSURER E: Cotuit MA 02635 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1842762797 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. ILTR TYPE OF INSURANCE ADDL SUBR POLICPOLICY NUMBER MIDDY EFF POLICMMIDDfY P LIMITS LTR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAGE TO RENTED CLAIMS-MADE OCCUR PRREM SES Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑JECOT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS r accident UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION R PER O' AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? FNJ N/A A (Mandatory in NH) WCC-500-51017622-2017A 7/18/2017 7/18/2018 E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Division ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE RSC Ins. Brokerage/C -1u. ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(zol4ol) Application Number.................................................... Section 5—Detail Cost of Proposed Construction Ze.�p; 00 0 Square Footage of Project Age of Structure J? Y&7?X S Dig Safe Number #Of Bedrooms Existing :P, Total#Of Bedrooms(proposed) a 110 MPH Wind Zone Compliance Method (1 MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics Wiring ❑ OR Tank Storage Smoke Detectors Plumbing Gas [] Fire Suppression Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water,Supply Public ❑ Private Sewage Disposal ❑ Municipal On Site Historic District [] Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: GN00La i I am using a crane ❑ Yes K No j Section 7 Flood Zone Flood Zone Designation VOE J Within or adjacent to a wetland, coastal bank? YesA No ❑ Section 8—Zoning Information Zoning District Proposed Use .+cr�✓4ff Lot Area Sq.Ft. AA tle . Total Frontage 04? Percentage of Lot Coverage 7�� #of Dwelling Units (on site) l Setbacks Front Yard Required ti /_7• 71 /� G ' %4P•54` Rear Yard Required 4�pMd 40w4gmr Side Yard Required /S M posed Has this property had relief from the Zoning Board in the past? ❑ Yes No Last undated_2/9/2018 Application Number........................................... Section 9—.Construction Supervisor Name ` =/�- A/. 7: Telephone Number" �a� - Address Zoj�;p City 07V/T State 1 11f Zip ©.2 p-3,-5 License Number_G�—DSb't�v�7 License Type Expiration Date A c:> Contractors Emailf,Ie/ Cell'# G 6 I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation 80 CMR and the T of Barnstable.Attach a copy of your license. Signature Date �1 6dG 'Section-10—Home Improvement Contractor 1 � Telephone Number Address/�:10f3rlx 2, ? City 60ZZ117' -State �,4- Zip 014--35_ Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required b 0 CMR an&be Town of Barnstable.Attach a copy of your H.LC... Signature Date 3/11 Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I.understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by-780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date Print Name �� J��17�l - Tel ephone Number E-mail permit to: ,het Section 12-Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation lease take our plans directly to the fire department for approval. For commercial work,p Y Section 13— Owner's Authorization I as Owner of the-subject property hereby ' to act on my behalf, in all authorize matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name - i utt{ Last undated;2/9/2018 p: Assessor's map: and lot nu r ................ .m � SEPTIC Y [• �, TIC SYSTEM MUST S C) w-.= ��� INSTALLED IN COMPLIANCE Sew6ge ,Permjt�number ...........................................:.............. WITH ARTICLE II STATE N - Y �r' SANITARY CO ND TOW �o�THET TOWN O F� BARN IAIB L SAWsTADLEJi ` ti 1639. - R U ��L.D.I�N:G INSPECTOR �O YPY a• e, I4 L ' :a cv A PLICATIONfFOR PERMIT TO. ... .......I. . . ../..L.���. �.. Iry .. ....... TYPE OF CONSTRUCTION ..................... �..see'.?.� . ..,.............................:..........:........................... ..... ......... .............19.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby �applies for a.permit according to the following information: Location .................U...k ....? =..r......�.I01.e:4........ 5 ..°'....................,...:� S!..1..�.�..� .......................................... ProposedUse .......... .f.!!1'1.. .................................................................................................. ............................... ilk - P� Zoning District ....................��....' ...............:........................Fire District ...........��[l../... .!... ............................................ ................. � 1fQ.....Yna. 7...... 1 ........�Name of Owner rt- ap ' �..�� Address ......... Nameof Builder ............................ '......Address..........:....................... ..............:..................................................................... Nameof Architect ........... ..........................................;...........Address .................................................................................... Numberof Rooms ..................................................................Foundation .......... ...... — P.(� .... Roofing Exterior ................::...... ............ ......i..�.�........ g .............. Ala. ..,r FloorsC�!ar ...........................................Interior ................. /Ih . 1............................................... Heating71.... ..q.1.....................Plumbing ..............0 ................................................. Fireplace �'� ......�..........................................Approximate Cost ...........,.P V...........00..................................... Definitive Plan Ap roved by Planning Board ------------------------____----19________. Area -- �.. .............. Diagram of Lot and Building!with Dimensions Fee ,�/.... . ................ SUBJECT TO APPROVAL OF BOARD OF HEALTH A-jce- . y I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .....1.. /'�°. ,J ........... Claussent Frederic P. No add to building permit for .................................. ....v�...and remodel to dvM11i�g .. .......... ............. ... - . . .Location Y0 IRT Place Road......................................... 7� .........................Cotoit...................... .................... Owner ..............Frederic P. Claussen ........................................... ti Type of Construction ..........fr.40P,.... ................. ............................................................................. 'Plot ....... Lot ................................ ,Permit Granted .......September. 14j,.1976 ........................... bate of Inspection ,-6vate Completed ... ��ti 9 PERMIT REFUSED ............................................................. 19 4; ............................................................................... ............................................................. ......................................s................ . i ! } R). 1 '. ................. ........................................................ .................. -;Approved .................................. .......... 19 ............................................................................. ................ ........................................................ ` I 109 S DOeu — --1 j.TS. VIC t �5 Gk �p -ON o c "TilE TOWN OF BARNSTABLE s a OFFICE OF B�nMABS. a BOARD. OF HEALTH pp i639 397 MAIN STREET ���iAY S.• HYANNIS; MASS. 02601 To : Building Inspector From: Health Department Subject: Test hole and Percolation Test A examination of the soil at (Lot) (Zddress ) ( .Village). was made on and found to be (date) suitable for sub-surface 'sewacet at site of test holed Building Permit will not be approEred or sev�age permit issued until Health. Departrlent receives tWO copies of p 1 a n, showing building, sewage systems ,and all ot_per details listed in Board of Health instructions -to sewage- ap'olicants: This a-o-oroval does not constitute a final decision concerning the installation of a sewage system. 11 5-tate and local Ilealth 'rec�uiati.ans ���1 y to final r. approval. (rigr.a—ure') 6/20/75 - rG. . 1T6✓•f1.Si':r- T� -tip ✓ <���.a_-' ` i %/Oh' FM f ,;��► { TA all L 't (.zo' ALtD/T/ON Z.ao 'XW1G' FI /tlrG•✓' �ol,:t/_-7;,7%/.l•r/ �,[J•�/Gf�� T�:�'e'%r7.-:k' Telephone: 508/563-6049 COLONY INSULATION, INC. 28 Jonathan Bourne Drive,Pocasset, MA 02559 CLOSED-CELL FOAM INSULATION SPEC SHEET CONTRACTOR: Y(Zltk ie Ir1 JOB SITE ADDRESS: _ -- 0. 1 -� �/ l_ 6_F DATE: r AREA THICKNESS R-VALUE` Ceiling v 12 Cathedral Ceiling Garage Ceiling Basement Ceiling _ Slopes W\ \ Exterior W all - Garage Hse. W all W alkout W all Cathedral W all B lockers Overhang Stair/Risers All R-values and thickness measurements are deemed to be accur< y the following installers: LZ TECHNICAL DATA FOR MATERIA T S TS A:'T'T^ CT-TED TO THIS FORM rntha /''e ThermalGuard CC2 TECHNICAL DATA SHEET appropriate PPE as required by OSHA, intended for use by nonprofessional'. ThermalGuard CC2 demonstrates NIOSH,and state/local safety applicators,or those who do not excellent adhesign to various substrates regulatory agencies. purchase or utilize tthisespumes in the When installed according to normal course of their business. The manufacturer specifications. It is the applicator's responsibility to potential user must perform any comply with all job site safety pertinent tests in order to determine the ThermalGuard CC2 resin(B)does not requirements set forth by OSHA, product's performance and suitability in require agitation. Do not pre-heat or NIOSH,and state/local safety the intended application,since final determination of fitness of recirculate resin(B)as doing so will. regulatory agencies. result in the"boiling off'of the 245fa for any particular use the h the product blowing agent which will result in poor LINIIATATIONS responsibility of the buyer. yield and poor foam.performance. ThermalGuard CC2 should not be left. All guarantees and warranties as to the ThermalGuard CC2 should be installed exposed to.sunlight,as UV light will products supplied by Amthane shall at a maximum thickness of 4 inches per rapidly degrade foam. Do not use near have only those guarantees and pass with a minimum of 30 minutes high heat or open flame. warranties expressed by manufacturer. The buyer's sole remedy between passes. It is the applicator's responsibility to test lift thickness for a ThermalGuard CC2 must be covered as to the material claims will be against particular application prior to with an approved 15-minute thermal the manufacturer of the product. The commencing installation to ensure that barrier when used as insulation for aforementioned data on this product is to the product can be installed safely at the. residential or commercial buildings. to an used as a guide and is subject desired thickness. Installation must comply with all change without notice. The information herein is believed to be reliable,but applicable building codes. unknown risks may be present. SAFETY&ENVIRONMENT . Do not install ThermalGuard CC2 at a ThermalGuard CC2 is installed by thickness exceeding 3 inches per pass NO WARRANTIES,EXPRESSED OR independent SPF contractors. It is and do not apply subsequent passes IMPLIED,INCLUDING PATENT recommended that building owners within 30 minutes of the previous pass. WARRANTIES OR WARRANTIES verify that the SPF insulation contractor. In rare cases doing so may cause OF MERCHANTABILITY OR maintains proper credentials,insurance, charring and combustion. FITNESS FOR USE,ARE MADE BYARNTHANE INC WITH RESPECT and licenses'and is properly trained to safely install SPF insulation products.' It is the applicator's responsibility to TO PRODUCTS OR INFORMATION test lift thickness for a particular SET FORTH HEREIN. ThermalGuard CC2 achieves a Class I application prior to commencing Fire retardaard rating and meets or installation to ensure that the product Nothing contained herein shall an be installed safely at the desired constitute a permit or recommendation exceeds minimum building code c requirements for fire safety. thickness. to practice any invention covered by a patent without a license form the owner ThennalGuard CC has low odor during Please contact your technical sales' of the patent. Accordingly,buyer application and produces no toxic representative for recommended assumes all risks whatsoever as to the vapors after application. equipment configurations and for use of these materials,and buyer's r exclusive remedy as to any breach of recommendations for your particula application. warranty,negligence,or other claim Always read and follow all Material app shall be limited to the purchase price of Safety Data Sheets provided with all DISPOSAL&CLEAN to adhere to any shipments.Additional copies are recommended pro UP the materials. Failure ocedures shall relieve available upon request from Arnthane Inc.or your technical sales Cured/reacted product may be disposed Amthane Inc.,and the manufacturer of representative. of without restriction.Excess liquid'A' all liability with respect to the materials and'B'material should be mixed and their use thereof: Basic PPE safety equipment is required together and allowed to cure,then for personal protection including,but disposed of in the normal manner. not limited to:long-sleeve chemically Product containers that are"drip free" resistant overalls,rubber,nitrile,or may be disposed of according to local, latex gloves,splash shield or safety state and federal laws glasses with splash guards,rubber or leather boots w/covers,full-face air- WARRANTY&DISCLAIMER A purifying respiratory(APR)with ® Arnthan e appropriate cartridges or full-face The data presented herein is subject to supplied-air-respirator(SAR),and other change without notice and is not Amthane in¢ * , 1002 W Main Street Richmond,MO 64085 P 816.776.3015 F 816.776.3215 Y www.arnthane.com Arnthane ThermalGuard CC2 , TECHNICAL DATA SHEET 4 I PHYSICAL CHARACTERISTICS i PRODUCT NAME Value Test Method Property "ASTM D-1622 ; ����� Density(nominal): 7/i ch ASTM C-518 R-value: 7/inch Compressive Strength: 35 PSI ASTM D1621-94 ThermatGuard CC2 Tensile Strength: 70 PSI ASTM D1623-78 PRODUCT DESCRIPTION j Dimensional Stability: <4%0 ASTM D 2126 . Closed Cell Content: 96o/a ASTM D 2856 ASTM E283 ThermalGuard CC2 is a fast set,closed- Air Permeability: 002 Llsm2(@ 75 Pa @ 1") ASTM E96 celled,245fa-1 blown spray polyurethane Vapor Permeability: 8 Perms @ 2" ASTM G21 foam(SPF)insulation designed for use Fungus Growth: None in residential',&commercial structures, Service Temperature: 250°F(120°C)* exterior foundation or perimeter I 'Service tempeeramres will vary depending on application. Contact yourArnthane Technical RepresentaNvefor i insulation,bellow grade applications, recommendations and limitations.Always test ThermalGuard CC2 for suitabilityforyourparticular application to i exterior tarilvpipe insulation and etc. a safe manner. ; ThermalGual d CC2 is applied as a LIQUID PROPERTIES Value Test Method liquid and expands 25x in seconds Property . to fill200-250 CPS ASTM D-2196 and seal building cavities of any shape Viscosity(A) 1100-1300 CPS ASTM D-2196 and size. It.exhibits superior thermal Viscosity(B) 10:25 lbs/gal al ASTM D-1475 insulation,air-barrier,and sound Weight Per Gallon(A) g attenuation properties compared to Weight Per Gallon(B) 9.4 Ibs/gal ASTM D-1475 ; conventional insulation materials. ; REACTMTY PROFILE Once fully cured ThermalGuard CC2 Property Value ! remains rigid maintaining significant Cream Time:, 12 12-seconds @ 25°C(77 j 16 seconds @ 25°C(77°F): j structural strength and thermal Rise Time: secon i insulation pioperties in adverse conditions across a wide variety of, COMBUSTION PROPERTIES Value est Method m applications; P e ASTM E-84 < Flame Spread Index: 25 5450 ASTM E-84 MANUFACTURER Smoke Development: . L i . ThermalGuard CC2 is manufactured PACKAGING&STORAGE exclusive) b Drum Weight(A) 551 lbs YY i Drum Weight(B) 500 lbs Arnthane Inc. Total Set Weight 1051 lbs 1002 West Main Street Storage Temperature Range(STR) 60-80 OF i Richmond,MO 64085 i Shelf Life at STR 6 months i P.816176.3015 F.816 776.3215 *Do not allow material to freeze. Do not pre-heat or recirculate(B)material as it will cause jro/hing rn�d loss of i blowing agent. Storage at temperatures above or below STR may shorten shelf life and cause degradation or loss of ch as pump www.al'nthane.com blowing agent. Cold material will develop higher viscosity which can cause during processing su f cavitation and poor mixture of(A)and(B)components. For best processing performance during application(A) CORROSION and(B)drum temperatures should be between 60 F—80 F i ThermalG i and CC2 is chemically& PROCESSING PARAMETERS 900-1400 PSI* i physically compatible with all common Processing Pressure Range: ;) building materials including electrical Processing Temperature Range: 115 105 °F* wiring,wood,metal,concrete,plastic Substrate Temperature Range: 35-105°F i 35-105°F (PVC),copper,vinyl,and glass. I Ambient Temperature: <19% i Substrate Moisture Content: INSTALL';ATION ,Yield: 3800-5000 Board Feet Per Set* j Maximum Lift Thickness: 4 inches** I, ThermalGuard CC2 must be spray type&condition,ambient applied uSlrig approved equipment.Use *Processingporameters&yields can vary widely depending on substrate temperature, temperature,elevation,humidity,equipment and other factors. During installation the applicator must observe the 1:1 ratio PropOrtlOriing system that can quality and characterlstics of the foam and adjust equipment temperature&pres,,,su?e settings as needed to accommodate these variables in order to ensure optimum yield,proper adhesion,proper cell structure,and achieve the specified temperature and performance of the foam. pressure requirements. j,_ , I •-ALWAYS test Thermalduard CC2 at desired thickness in a safe manner prior to insulating structure to ensure I 1 that it can be safely installed at the desired lift thickness without risk ojchaming or combustion. It is the exclusive responsibility of the applicator to achieve proper I�thickness for safe application. Safe Ili thickness may vary from application to application. 1. . .. \�I� O N ��60 4- � /C,B /k�9 CB , � 20..124 5p `1 . .,9, __HSE 330' 12.3� w h7 Fq C' 0 PARCEL B PARCEL A �_ y> CONC. RgT. WALL M.H. lY. COX- i- RET WALL )M.H. W. NOTE: PRE-EVSTING, NONCONFORMING 72+ COTUIT HARBOR RES. ZOXE..• 'RF" This MORTGAGE INSPECTION Plan is For FLOOD ZONE' "C" Bank Use Only TOWN: _ — — — - REGISTRY OWNER: colYSTaNTI1VE ALExAN2E TRUSTEE OF COJ AN RE.4LTY TRUST DEED REF: a32�279_ — — —BUYER: PAUL CAIIN DATE: 12/16/,9_6 _ _ _ — — P1,AN RFF: 303 /' 30140 _ _SC ALE:1"= 40_ F'T. I HEREBY CERTIFY TO CITIZE;tiS _A70RTGAGE CORPORATION P�1 OF 41 YANKEE SURVEY _____ _________ ___________THAT THE BUILDING SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS moo`' PAUL yam CONSULTANTS SHOWN AND THAT ITS POSITION DOES ___— CONFORM A.MER THEW H 40B (SUITE 1) TO THE ZONING LAW SETBACK REQUIREMENTS OF THE o No. oQ INDUSTRY ROAD. TOWN OF __RARNSTaBLE_____________AND THAT MARSTONS MILLS. MA. 02646 IT DOES_ NOT _ LIE WITHIN THE SPECIAL FLOOD HAZARD �*!,. 9FCl;Ts 1�%;c+` AREA AS SHOWN ON THE H.U.D. MAP DATED_102��0�— \a.4; ,,��_:° TEL: 428-0055 Cc jjri uriiLv—Pa�r f � 250001 0018 F.AX: 420-5 53 _ THIS PLAN NOT MADE FROM AN INSTRUMENT ?01131 DC'B PAUL A. MET HI W. PLS SURVEY. NOT TO BE USED FOR FENCES. ETC. Assessor's map and lot number a y...s....................................:..... Sewage Permit number .................................................. ....... QyoFTNETo�o TOWN OF BARNSTABLE Z 33ARNSTA13LL i "b 9 BUILDING INSPECTOR '0�•Q MAy p,. r _ A PPLICATION FOR PERMIT TO ..........`:..... �=-.r-.r'!r~!.... .�.......................�'.� ( ................... TYPE OF CONSTRUCTION 4T ............................... .............19. .. ,.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: • Location r�...► I'' � .........�C'� C �„/ cl 0 ProposedUse ..........................................,....................................`............................................................................................. Zoning District ....Fire District ...................1..... '�'� .................................. ..1. ..... ....................................... Name of Owner} 'P t-t>~ "...................../T U S >< Address .. l.. !.... �t .. C A /U. 1� Nameof Builder ..........................:.........................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms � `f,0 cl r� �.,� of c,/^P -�.................................................................Foundation ...........,.`..�...... fj ................... .........�........... Exterior ..................................^ .................,.... .'.?............Roofing .......... ........... .........;............................................... Q Floors ............... .../-�.1^r1d.�................................................Interior ................. .... .e.. .............................................. , j Heatingr�'.... .. ...t .... ... .............Plumbing .............. ................................................. 7 Fireplace ................Il.e� ......................................................Approximate Cost ........... .................................... Definitive Plan Approved by Planning Board ________________________________19________. Area ..... r- P... ........:..... Diagram of Lot and Building with Dimensions r/ ,/A >,S Fee ......... ..:............................... SUBJECT TO APPROVAL OF BOARD OF HEALTH - ply ti hereby agree to conform to all the Rules and Regulations of the'Town of Barnstable regarding the above construction. Name ... ... .......... ........... Claussen, Frederic P. A=35-,�W, 18658 ? ad(ft�-. building No ................. Permit for ............... ......... and remodel to dwellxf . ........................................................ .................. Location .3 40yster Place R6ad ,3........................................................ Cotuit ................................................... ........................... Owner Frederic P. Claussen ..............................:.................................. Type of Construction ...........frame.................... .................................................. ............................. Plot ............................ Lot ................................ September 14 76 Permit Granted .........................................19 Date of Inspectl ....................................19 Date Completed ... ..................................19 PERMIT EFUSED ....................................... ........................ 19 ....................................... .................... .................. ..........................I.A...... .. .. ........ . ...... .. .......................... ........... ............................. . .. .............. .. .... .... .... ............... Approved ................................................. 19 ............................................................................... ............................................................................... Engineering Dept. (3rd floor) Map i!5Y�5_ Parcel �//),/q�d�ermit# _4A House#• „ �CGC _ Date Issued Board of Health•(3rd floor)(8:15 -9:30/1:00-4:30) cT& 47 Fee a3c�, 7 a c/wnG rOOans Conservation Office(4th floor)(8:30-9:30/ 1:00,2:00) 111 J Planning Dept. (1st floor/School Admin. Bldg.) TMe rq Definitive Plan Approved by Planning Board 19 RE MASS. TOWN OF BARN5TABLE 'F°"�r'� Buildin PV it Application Project Street Address Village Owner Address Telephone . -Permit Request irst Floor square feet Second Floor square feet Construction Type Estimated Project Cost �d Zoning District ,�—r Flood Plain Water Protection Lot Size� .355 y Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes XNo On Old King's Highway ❑Yes ❑No Basement Type: ❑Full A C awl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing 2 New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not includingA baths): Existing New First Floor Room Count 3 Heat Type and Fuel: ❑Gas Oil ❑Electric ❑Other Central Air ❑Yes IXNo Fireplaces: Existing New Existing wood/coal stove ❑Yes kNo Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) None [ thed(size) S�f 2 ❑`' Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑N If y s, s' a plan�,view# Current Use ��/� / �/ .,, roposed Use Builder Information Name ` Telephone Number .�09`M5_-45`523 f' Address License# �Q Home Improvement Contractor# 6-1 L__Z_ Worker's Compensation# Q�� NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL COTYSTRUCTION DEBRIS RESULTIN=FRO THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 2 I —2ZZIF BUILDING PERMIT DENIED F R E FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP!PARCEL NO. ADDRESS +' x" VILLAGE-f OWNER DATE OF INSPECTION: FOUNDATION FRAME ��� F INSULATION FIREPLACE rol ELECTRICAL: ROUGH FINAL. ` PLUMBING: ROUGH FINAL" Y, GAS: ROUGH FINAL FINAL BUILDING - 1 .tom} f�' i Y •� i r"try ' F� i.�` . 4. r DATE CLOSED,OUT • ASSOCIATION PLAN NO. 4• . T 4 THE r� The Town of Barnstable ,�srrs,.,►xs~ 9019. �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 Commissior For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL,c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other re uirements. Type of Work: Est. Cost / lv�I Address of Work• . /IA/541/z - V --L Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under 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 a ply r a the e t of the owner: Date ont ctor Name Registration No. OR The Commonwealth of Alussachusctts _._ Dc partment of ludustrial.4ccidcnts l Officeaf/nvestigat/ons 600 N'ashiit,ton Street_ Boston, A1aY:c. 02111 Workers' Compensation Insurance Affidavit It an inf t ion: API P I name: location: city phone# :........:.I am a omeowner performing all work myself. I am a sole proprietor and have no one working in capacity ..-.......x.w• —+r T 'a +?r.rr-s'wsS...:T•,.-s+.Q+r-•179'? ,.+'!`7+r .P!.....•+e1�*'1f^.'�pPr++...�+sl.�+q*w�w•.... t•1.+,..•.s ,. .�r�.,y...•'+...�-+':�•..a!,.,�.�v.......e...,:. �... -....r.+..:�:.r.vr._.w.:r.n....u�:..N.,�.r...r_..vwv .,_ . rY?' :�u.'✓.iiC...4ri..:..:.,ir...r.A�vr:.. .,.:,._. .G.�.��.' - __uai..�}a rL.,:.�r.........._r._—....__ I am an emplover pr vi 'n!z worke rope s tion for piovees w rkin on this job. op con many name: l address: i city: hone#•insurance co. Polio # t I am a sole proprietor, general contractor, or homeowner(circle otte) and have hired the contractors listed below who have the following workers' compensation polices: i compiny nime• i address: city: phone#: r insurance co pnlicv# —..____....,. ..___.�.._......__ ..�.i......ry....�:�.:.1,.....es�. ":aw�I..�n:...+.1v.t.:...• — _ i'''~ �,. Y:..1.Y..ar company nvnc• address- city: phone#: insur•nce co policy# Attach additional sheet if necessary, :r`:rr.3��:� ��arnaris.. u! •ems r.:.azx.sa'ur�:1:._�i.,sr.. ..:".a. Failure to secure coverage as required under Section 25A of N1GL 152 can lead to the imposition of criminal penalties of a tine up to S1.500A0 andiur unc years'imprisonment:rs��ell:ts civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. I understand that a cop} of this statement may be forwarded to the Office of Imcstigations of the DIA for coverage verification. 1 rlo herehv certi t' rider /te a't an p talti• of rjun•that the information provided above is tru/eat correct. Si_nature Date Print name Phone# rofriciii use only do not write in this area to be complc d by city or town official ity or town: permit/license# r-1Building Department Licensing Board C3 check if immediate response is required ❑Selectmen's Office Dllealth Department contact person: phone#; MOther PIT imisad3T�l'1:\1 Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all emplovers to provide workers' compensation for their employees. As quoted from the "law", an e►►►pluree is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An e►►►plorer is defined as an individual, partnership, associatIoil. corporation or other legal entity, orsanv two or more of' the farcgoina engaged in a joint enterprise, and including the legal�represetitativcs of a`deccascd 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, Douse of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also'states that ev'ery state or local licensing a(yenc,%, shallwithhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who lias,not produced acceptable evidence of compliance with the insurance coverage required. Additionaliv;neither the cominonwealth nor any of its political'subdivisions shall enter into+any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying, company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirtnation 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 Dave any questions regarding the "law" or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations ltas to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not Itesitate•to give.us a call. + ; t\ , y.r.y,t.}.w....,.,: .;..._.r......v..r.. .•�'.'M.'SM'r Y.f..::'v1-.+w.tv.w.�'�1...s-..:.....+fT,t1l.?nl'�"?!R�:a-v:+. .ANTI^".RO.,w.�ew�.�.T�rT�aM'__•,w.:"+1A\•+11�!1..I^�LNl'11_T"'.T.-'vTt'�."1•lWiwwsa..��wty Tile Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents office Of investigations 600 NN'ashington Street Boston,Ma. 02111 _ fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 r N 0i e�ammeoxurealdE o�✓uanamdu�ae!!a`+ HOME IMPROVEMENT CONTRACTOR Registration 120594 ' Type, - INDIVIDUAL J� Expiration - 02/05/98 MICHAEL J. BUCKLEY 23 RED TOP RD � EYSTER MA 02631 ADMINISTRATOR ...:..:.,._.�..........:�a a.._. Commonwealth of MA I, Divs.of Registration a. a x M/CHAR J.BUMLEY 237NED TOPNOAD a BHEWSTF MA_O?631 Liceaxd Real Fa w Salmi [ ] [R035 101 . ] LOC] 0033 OYSTER PLACE ROAD CTY] 01 TDS] 200 CT KEY] 21372 ----MAILING ADDRESS------- PCA] 1011 PCS] 00 YR] 00 PARENT] 0 CAIN, PAUL E MAP] AREA] 07WA JV] 273242 MTG] 0000 772 LAKEWOOD CT SP1] SP21 SP31 UT11 UT21 .47 SQ FT] 1120 HIGHLAND VILLAG TX 75067 AYB11979 EYB11979 OBS] CONST] 0000 LAND 309900 IMP 65400 OTHER 900 ----LEGAL DESCRIPTION---- TRUE MKT 376200 REA CLASSIFIED #LAND 1 309, 900 ASD LND 309900 ASD IMP 65400 ASD OTH 900 #BLDG (S) -CARD-1 1 58, 600 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #OTHER FEATURE 1 900 TAX EXEMPT #BLDG (S) -CARD-2 1 6, 800 RESIDENT'L 376200 376200 376200 #PL 33 OYSTER PLACE R OPEN SPACE #DL LOT PAR B&A2 COMMERCIAL #RR 1198 0080 INDUSTRIAL #UP FY98 EXEMPTIONS SALE] 12/96 PRICE] 350000 ORB] 10532220 AFD] I LAST ACTIVITY] 01/15/97 PCR] Y f 1HE 6, Application Number...................L/........................ NM ..... .......... 0J tjyrPermit Fee...........0,5.... 0.....Other Fee......... .............. 16 9. RFD MA'S A ld2(1 0NIGI/n8 Total Fee Paid.......................................... .................. ...... TOWN OF BARNSTABLE Permit Approval by..a..b................ BUILDING PERMIT Map..... .......e6.... to ...................Parcel......... ................................. APPLICATION Section I -Owner's Information and Project Location Project Address :3 elz- p1lize- 6"9e-1%pA Village Q-1-1t t-z- Owners Name I-Ai4 9-A- L11-S Owners Legal Address— 3 3 oys-,—eit- P14,::..,-- w-tr City �-r-Q t 7- State AA ' Zip Owners Cell# C)V D E-mail F— Section 2- Structural Use Single/Two Family Dwelling F] Commercial Structure over 35,000 cubic feet E] Commercial Structure under 35,000 cubic feet Section 3 -Type of Permit FJ New Construction ❑ Move Relocate ❑ Accessory Structure F] Change of use ❑ Demo/(entire structure) El Finish Basement El Family/Amnesty El Fire Alarm Rebuild El Deck Apartment El Sprinkler System ❑ Addition Solar El Renovation. ❑ Pool. El Insulation Other-Specify )&P'l 00e r-l"ILI;V1 hXJ. See "�G�/ � Section 4 - Work Description T.nzt imAntnrl- 19./)R/?Ol 7 Application Number..................................................... .Y ,- - _ _- , - - --- - -- ---_— ----- Section -- 5-Detail _ -- - Cost of Proposed ConstructiJ� 0?� Square Footage of Project i Age of Structure Dig Safe Number Total#Of Bedrooms (proposed) # Of Bedrooms Existing � �P P 1-1-0-MPH_-Wind-Zone-Compliance Method MA Checklist ❑ WFCM Checklist_❑ Design I_ Section 6- Project Specifics • ❑ Wiring ❑ Oil Tank Storage F E] Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney Y ❑ Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8— Zoning Information - Lot Area S . Ft. Use q Zoning District Proposed , Total Frontage Percentage o f Lot Coverage #of Dwelling Units (on site) � Setbacks Front Yard Required Proposed Rear Yard Required Proposed I Side Yard Required .,Proposed- Has this property had relief from the Zoning Board in the past? © Yes ❑ No .� Town of Barnstable Building Post This Card So That it is Visible From tfie Street Approved Plans{Must be Retained on Job and this Card Must be Kept . .n PostedUntil Final Inspection Has B eery Made. ' W p bs Whe e aCertficate of Occupancy is Required,such Bwldmg shallNot be Occupied until a Final Inspection has been made 1 ermm it � . .. . _.= .... s m ill Permit No. B-18-229 Applicant Name: MULTISTATE RESTORATION CAPE COD DIVISION, INC. Approvals Date Issued: 01/26/2018 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 07/26/2018 foundation: Residential Map/Lot: 035-101 Zoning District: . RF Sheathing: Location: 33 OYSTER PLACE ROAD,COTUIT3. ^ Contractor Narne: MULTISTATE RESTORATION CAPE Framing: 1 Owner on Record: BASS,MICHAEL A TR COD DIVISION, INC. Address: 33 OYSTER PLACE ROAD Contractor'License: 140427 Chimney: COTUIT, MA 02635 Est`. Protect Cost: $5,500.00 Description: Remove flooring in Kitchen and Living Room,remove>sheetrock 4' Permit Fee: $85.00 Insulation: up from floor in same location due to water damage „ Fee Paid' $85.00 Final: VE Project Review Req: � Dater 1/26/2018 fi Plumbing/Gas Rough Plumbing: F Final Plumbing: Building Official This permit shall be deemed abandoned and invalid unless the work authorized:by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and theapproved construction documents;for which this permit has been granted. All construction;alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open forpublic inspection for the entire duration of the work until the completion of the same. Electrical R` ,x „ Service: The Certificate of occupancy will not be issued until all applicable signatures by the Building*`rcl fire Officials�are provided'on this permit. Minimum of Five Call Inspections Required for All Construction Work: ' ` �r Rough: 1.Foundation or Footing K T,m..; „, . , ° 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT The Conunonwealth of Massachusetts Deparf rent of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass.govldia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/PIlmibers Applicant Information Please Print Legibly Name(Business/Org nizafian/)ndividuel): 1L'I 4 t 1 S T7k1~e C CZ)A "7 lot" f k, 9, ./ Address: �Ntc.aL.e7TA'c W City/Stawap: ✓ S t'�e C PA - N-16 q° Phone#: / 3'-16 SZ � Are you an employer?Check the appropriate bow YType of project(re, gmred): 1 JU-1 am a employer with 4. I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sob-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have S. g Demolition working for me in any capacity. employees and have workers' inar�a�+ce.# 9• ❑Building addition [No workers co comp.insurance mp• required.] 5. [] We are a corporation and its 10.0 Electrical repass or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repass or additions myself.[No workers' comp. right of exemption per MGL 12.0 Roof repairs in urar+ce rued]t c. 152,§1(4),and we have no employees.[No workers' 13.[]Other *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. �Contrectors that check this box must attached an additional sheet showing the name of the sub-contractors and state Wbctber or not those eutises bave 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 sife information. � Insurance,Company Name: Policy#or Self-ins.Liu#: DL IN C- V 0.Lf V Expiration Date: job Site Address: 3-3 P tP S T eiL City/Stawzip: 8-0-rut�— f-fJ 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 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby un the pain s and penalties of perjury that the information provided above is true and correct Si Date: _ a `I Phone#: -7`9/ -�k-G OffwW use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector. 6.Other Contact Person: Phone 0: " . MULTI-STATE RESTORATION, INC. FIRE* FLOOD*WIND * SMOKE*HURRICANE*VANDALISM ?Iis Fed ID#050515889 CONTRACTORS REGISTRATION#140427 , AUTHORIZATION TO PERFORM SERVICES AND DIRECTION OF PAYMENT l.. 1%fLA �ti ,herein referred to as "Customer",authorizes, r MULTI-STATE RESTORATION,INC.,herein referred to as "MULTI-STATE",to perform any and all necessary clea �'ng and construction services on Customers'property at: 31 Gv-1 s►—�r �(c il%P c,� r i - 0a� s J Telephone: L)J L� and with respect to items that need to be cleaned at a remote location,to remove and clean such items as necessary. Customer authorizes L Insurance Company,herein referred to as "Insurance Company",to directly and solely pay MULTI-STATE. If for any reason the check should come to be or be made payable to the Customer, Customer then agrees to pay MULTI-STATE immediately upon receipt of the check from the insurance company. In order to expedite payment to MULTI-STATE, Customer hereby appoints MULTI-STATE as attorney-in-fact, authorizing MULTI- STATE,to endorse Customers' name, and to deposit Insurance Company checks or drafts for MULTI-STATE services.,Customer agrees to pay Customers'deductible in the amount of$ that applies to this claim. If the loss is not covered by insurance,Customer a egf es to pay the total amount to MULTI-STATE uponreceipt of.the invoice.. `" k Signature of Owner It is my understanding that the services to be.performed by MULTI-STATE will be limited to those,which are authorized by my Insurance Company. Insurance Company Name Policy Number Customer agrees that MULTI-STATE is working for the Customer and not the Insurance Company or agent/adjuster. Additional remarks: I have read this document and como tely understand and agree to same. 1,� ►�- 6 Signature Date Printed Name P.O. BOX 2210•MASHPEE, MA 02649 .866-921-9111 •FAX 774-238-4422 fi • ..� ��ie �4'����zcueal�i a�C�/�aeaac,/u�eGla k i Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Slolement Card Reaistratiorr. Enii,ration 14Q42 .10/14/201:9 MULTISTATE RES�tM MN=CAPE COD DIVISION,INC. �RICHARD LAURIA'<-:, 21 PEQUOT RD. MASPHEE,MA 02649 Undersecretary - i i r Massachusetts Department of Public Safety Board of Building Regulations and Standards;:: License: CSFA-051784 Construction Supervisor 1 & 2 Family RICHARD D LAURIA 1 LEAH DR ROCKLAND MA 02370 I i Expiration: %Commissioner_ l)41011219 Registration valid for individual use only before the expiration date. If found return to: Office of'Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 i Boston,MA 021116 I i Not validJwithout signature Construction Supervisor 1 &2 Family Restricted to: Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing information visit: WWW.MASS:GOV/DPS:'Y# r r ACCO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 01/23/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT-BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or 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: STARKWEATHER &SHEPLEY INSURANCE CORP OF MA PHONE FAX PO Box 549 A/c No Ext: A/C No): E-MAIL Providence, RI 02901 ADDRESS: INSURERS AFFORDING COVERAGE _ NAIC1t INSURER A: Am GUARD Insurance Company 42390 INSURED - - INSURERB: MULTI STATE RESTORATION CAPE COD DIVISION INC - INSURERC: PO BOX 2210 - INSURERD: Mashpee, MA 02649 INSURERE: INSURER F: - - COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT.TO'ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR LTR TYPE OF INSURANCE I POLICY NUMBER MMIDD� POP LIMITS COMMERCIAL GENERAL LIABILITY - - EACH OCCURRENCE $ 0 DAMAGE TO RENTED , CLAIMS-MADE OCCUR PREMISES Ea.occurrence $ 0 MED EXP(Any one person) $ 0 .PERSONAL&ADV INJURY $ 0 GEN'L AGGREGATE LIMIT APPLIES PER: - - GENERALAGGREGATE $ Q POLICY❑PRO-JECT F—]LOC - - PRODUCTS-COMP/OP AGG $ 0 OTHER: $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $ Ea accident - ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS ONLY AUTOS - ( ) HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY - Per accident) $ ' UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE - $ DED RETENTION WORKERS COMPENSATION SPER OTH- AND EMPLOYERS'LIABILITY Y/N - TATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 A OFFICER/MEMBER EXCLUDED? " ❑N NIA R2WC866040 07/,16/20.17 07/16/2018 (Mandatory in NH) yes,d If yes,describe under E.L.DISEASE- -EA EMPLOYEE $ 500,000 - , DESCRIPTION OF OPERATIONS below E.L'DISEASE:-POLICY-LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE: 33 Oyster Place Way, Cotuit, MA CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main St. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE ' .01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) `.►/ 1/23/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE 'DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,-EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the p6licy(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 Beth Deschene. NAME: Cross Insurance, Inc.- RI PHONE (401)431-9200 FAX No):(401).931-9201 376 Newport Avenue E-MAIL bdeschene@crossa enc ADDRESS: g y.com P. O. BOX 4830. INSURER'S)AFFORDING COVERAGE NAIC# East Providence RI 02916 INSURER A:Evanston Insurance INSURED INSURERS: MULTI-STATE RESTORATION CAPE COD DIV, INC. wSURERC: 68 NICOLETTA'S WAY INSURER D INSURER E: MASHPEE MA 02649 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1812237153 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 L7R TYPE OF INSURANCE I S WV POLICY NUMBER MM/DD/YYYY MM/DDIYYYY - .LIMITS X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE' $ A CLAIMS-MADE I—XI OCCUR - DAMAGE TO RENTED` 100,000 PREMISES Ea occurrence $ 3EP1831 - - 1/2/2018 1/2/2019 :MED EXP(Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: - GENERAL AGGREGATE $ 2,000,000 X POLICY❑PRO ❑LOC 1,000,000 PROJECT PRODUCTS-COMP70P AGG $ OTHER: - $ AUTOMOBILE'LIABILITY - COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED - BODILY INJURY Per accident AUTOS AUTOS ( ) $ HIRED AUTOS NON-OWNED - - TY AUTOS PROPER Per accident DAMAGE, $ UMBRELLA LIAB OCCUR - - EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE DED RETENTION$ - - $ _ WORKERS COMPENSATION PER OTH- - AND EMPLOYERS'LIABILITY YIN. _ - STATUTE ER - ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑N/A @ - (Mandatory in NH) - E.L.DISEASE-.EA EMPLOYE $ If yes,describe under - DESCRIPTION OF OPERATIONS below I E.L.DISEASE.-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD-101.,Additional Remarks Schedule,may be attached if more space.is required) Job Site: # 33 Oyster Place Way Cotuit Ma 02635 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town Of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL,BE DELIVERED IN 200 Main St ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE Beth Deschene/BDX ...�G'c��i 1�P�oCA ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 om4nn (,m F���� [T'i--�i L="TYuj Lf c b d S �? 0�,57 Application Number.......... Section 9- Construction Supervisor Name fZ l Cf l/•1 t) I.Pf u fZ;,4 Telephone Number {�/ Z Z-.SZ 7-7 Address I LE ( 17 i'L City State Zip d aQ 7 a License Number 6 5/-7 8 f License Type Expiration Date F Contractors Email � ' 2�d}- off/ 75/i1��Cell-# ' I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required b4y 78 MR and the Town of Barnstable.Attach a copy of your.license. Signature Date Section 10 —Home Improvement Contractor Name �� � � L-4�e�L<A Telephone Number 7Ql a6 5," SZ Address 1 LEA O — City� o c l'v� State d Zip ��3 -76 Registration Number 14W-:2 Expiration Date /0 k di9" I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 78 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Z Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date -u/t� Print Name (2[cH/�a-� L Telephone Number E-mail permit to: Z 4 u2.( "q o Last updated: 12/28/2017 Section 12 —Department Sign-Offs ' Health Department ❑ Zoning Board(if required) El Historic District' Site Plan Review(if required) ❑ Fire Department ❑ Conservation For commercial work,please take your plans directly to the fire department for approvak Section 13 — Owner's Authorization I, t , 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: (Address of job) Signature of Owner date Print Name £ T.ast undated- 12/29/2017 Assessor's p and lot number ..�J..............1�- .1.......:.�..d oFTNEro� Sewage Permit l J f ,5 �1 C� ��/L BAHH�98TADLE. i House number- .... SS: .............. .. ....... ................:.......... ..- - 9 s • Opo�i63q: ♦� 'Fa MAI TOWN OF BARN�STABLE P , BUILDING ` }I..NSPECTOR APPLICATION FOR PERMIT TO .. I.�4- ......t a 6k (,) AQ��.YTv+�I.....41/�.5,�...�.��.:........... TYPE OF CONSTRUCTION ......=...��``.-.� ................................. ........................1/9.........19Z] a• . . x.� .- fFr.:..A. li:r.:w.�s.wc..°AkrweiM�I ..w�� .�A....:t{�.n _ it 7� . ... .. . f • •.1 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..0 ts ............................................................1 :L L.1..........0.4. ........................... .. .............. .................. ProposedUse ..tl .VAt.(Y.. f'. :.................................................. ....................................................................... Zoning District .......... ............................Fire District ........ ............ Name of Owner ...(./.!....... ..................Address 6G-£(Z \ t S 1 E/\/z7IV� � �G�� cS � �-1`�c� Nita S. r�� Name of Builder .. . .... ...........�.. ...............Address ....... SS" .... .... ....................... .... ... . ... Name of Architect ............... .... .................Address ............................... Number of Rooms .I Foundation .G��. 1 �� /ties ......... ................................................... .............'....-..........v.................. Exierior ....7...-111.....n ...P4Y I/4(!0 d7TO.T/"Aaafing ...... '. �L, '✓... Q �ou/J'G72E�4Gr Floors ..A..P0yw6,0D..5._ad............................................Interior ..U.���lf��(!�.�Ir..,........................................ }seating .... .`' .........................— L- . .................... .Plumbing .'�./N!Azv I ........................................................... \ ` Fireplace =.............................................................Approximate Cost..... l.Q .d ..............�....................... Definitive Plan Approved by Planning Board -----------_-------------------19'________ . Area ..1-1`?.4'.!G� ....... 'Diagram of Lot and Building with Dimensions Fee ...... ....:S.d............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH V / i o kb I hereby agree to conform to all the Rules and Regulations of the To of Barnstable regarding the above construction. Name .. ,/ ................`.. � ................. t ,^kLEXANDER, C. ADD TO DWELLING f No ..�3449 Permit for . . .............................. & BUILD A SHED �7....C.................................................................... Location ...Accessory...to...Dwelling..... ..... .. .... .. .... Place Road ........................................... Owner ................... ......................... ........... ...... Type of Construction- Frame ...............................z........... ................................................................................ Plot ...... Lot ..... . ...................... ..... ............... 81 Permit-Granted ..tSeptember •11 .................................. f..19 Date of Inspection ...................................1.19 Date Completed ........... :J 9 J1. PERMIT REFUSED ..............................9........................ ...... 19 T ................................. . .....................I..................... ................................................................................ ........................................................ .............. ................................................................................. Approved ......... ............... ................ 19 .......................................................... .................... ................. ....................................................... Assessor's map and lot number ..,3.!5.::...... .......�.,n j THE . cF toy Sewage Permit number o Y- ,..•+^� B8BB9TADLE, i - House number ...l..,?. 1...... ... . ��..t.. Qom- ... !"�. ��„ 9�p N Le . '°TE'p MAY Or TOWN .OF BARNSTABLE BUILDING INSPE-CTOR APPLICATION FOR PERMIT TO .... v4, TYPE OF CONSTRUCTION Oft ... .1-(X ..��U >t................................ ................\:...... ..!....!..........19....... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..d l C-CZ ,l�J�Ac E...Q...D....... .-7 T.( 1 .t .�................:........:... �• i l �t�Z/1L�Y ,�Pr� ProposedUse ...�:...... ...... ................. ..r............... , .................................. ............................................................................ r ZoningDistrict .... . ..........................................................Fire District .............................................................................. Name of Owner . ..t.... �. .! •1 �1��� ..................Address .�........C v...Z%, 5 .. !/. Name of Builder 6� `� �'`� ' .. "........Address ....... S A� Nameof Architect ..... ... ........ .............................Address .................................................................................... Number of Rooms ...............................:..................................Foundation j....�C�E.... 101 /�S �0 1�G G(�41�r� p1 ��/ � 4L L��J 9?. / �4 r /��lr � Exterior .... ..(.... ............... ......f..................�1..�.. �.....Roofing ................ i Floors •.... J�..f�t),/ff1/.�.. ,1 ............................................Interior t� //(��� .. .>.-............................,. Heating -r- 1 t r j Plumbing /.!... y�............................................................. Fireplace ..}„y, d \,1-.............................................................Approximate Cost ....1 i,QW......................��....................... Definitive Plan Approved by Planning Board ________________________________19________. Area ....... Diagram of Lot and Building with Dimensions _ Fee ...... .................. i SUBJECT TO APPROVAL OF BOARD OF HEALTH nv f 6 ao I hereby agree to conform to all the Rules and Regulations of the Town-of Barnstable regarding the above construction. Name ..... .......`.... .................. ................. ALEXANDER, C. A=35-101 `V No 23449 permit for TO DW�,Z,ZNG....ADD.............. & BUILD SHED Location .ACCes - to„1)WQ.,J'ling w� { 3.oyst r PF.1a e...�A.ad................. . Owner Cot '.it. ........................ ........................ Type of Constr ction,, ...Er.a r .......................... Plot ............. . ...... .4. ....Lot ............................. i Permit Grantee . Sete er ll, pq 81 Date of Inspe ion ... .. ...................19 ' Date Completed .......... .... ......................19 PERMIT RE US D ...... ....... ' ............ ... ..��..�.z-............ 6 .. .... �. . . ........... . .. ... .. �........ ............. .. :............................................. Approved ................................................ 19 ............................................................................... ............................................................................... L�r= j r= r 5 I'1 Jf✓,ice Pll�li 1 U71•_I q i 13 D U/C I G• V U 1.I bEl ice. 2.7 z I.:L. ,c t i/1 P1 Ts .-.�.- I�JILD11,(l� nldlJ-C(�l.l - ,� � �` \'1 / ,y 'r •_,� / cEM I IJ[_ TO PLE5L:I J \(L /.-[� ' 1 IV of 28674 1 1n Q�STS��o� /47 MqN l,cg r-ti � AI t N L �> CERTIFIED PLOT PLAN RA RcE L 8"-caYSTE Fc�r '1a Cc5rL_J T._. IN SCALE, / r'a a, DATE : E G l .rTEivA//IV�� I CERTIFY THAT THE CUUT - SHOWN ON THIS PLAN 19 LOCATED Eo19TERED REGISTER ILD ' 9-3 0:4-r ON THE GROUND A3 INDICATED CIVIL LAND ,►Q� N0. „_....,...,_ , ENGINEER 8URVEY04 DR.AY� , ..� _- 712 MAIN 'STREET CM.iY '" H YA N I S, .M A S S. SMUT.4.0f DATE f G. LAND SURVEYOR +t `5 OYSTER PLACE ROAD LANDING COTUIT SCALE: 1: INCH _ 40 FEET' THIS SKETCH QUITE ACCURATE AS PER OUR ROfiD.DESCRIPTION -- tv µ , - FROM �— - -- TOWN OF BARNSTABLE i r, RogerV. BUILDING DEPARTMENT 287 0coAn Street. 367 MAIN STREET HYANNIS, MA Q : HyamiasMA02601 Phone: 775-11-20 SUBJECT: Bulldllig Per lt•#23444 (C. Alexander) FOLD HERE DATE - Ftb r ' 161 1 MESSAGE Please `contact this office re the addition to the dvjellirg loWted on tPyster place Roads Cotuitomed by C. Alexander. - Al d E. Martin Asst. Aldg. Insa*. DATE - - REP'LY .. - +SIGNED - Ne7•RMI RECIPIENT: RETAIN WHITE COPY,RETURN PINK.COPY 4 •. - PRINTED IN U.S.A. SENDER: SNAP OUT YELLOW COPY ONLY.SEND'WHITE AND PINK'COPIES WITH CARBON INTACT. \ p - . School ^ - Locus ` N Colon a Bay } E LOCUS„M' W3- SCALE—�00't ASSESSORS 5'PARCEL 101, o VINFEMA FLOOD ZONE VE (EL 14) ,22 r 12� HOWN ON COMMUMTY PANEL'#25001C0583J ryDOWN8 _> 0 DATED 7/16/260 4 o`� Ji r p�15T,0 F 8 i � � rr I TDP 33 O S �%�� °� k E2 \ LmN ; 10 20 1� 5 ,[1 LAWN y EXISTING CONDITIONS -. SITE PLAN OF *33 OYSTER PLACE ROAD . ... COTUIT, MA PREPARED FOR LAURA DAVIS DATE. APRIL 30, 2018 J , off 508-362-4541 fax 508-362-888D downcapaxom 2-�� BAY owa cope eainferiag,iac w scale:l zo' �pPL civil engineers -/ G� land surveyors 0 ,0 20 - 30 40 50 FEET _ �. 939 Main Street ( Rfe 6A) DCE #16-318 YARMOUTHPORT MA 02675 , 6-718 , N m� O O W O z zWWg� � J W O a u z N Us m WC i = I I V ' I oil tank Q I I ' I I ' I I + I I a enng f eneg. Deck Living Room Storage ti I I I I i I L— — --J I I , I - UP Ic ecmg i weer — Dining Area ""T e.nnng 6 dry utility a. Bedroom I e,,,T,ng Clos. Kitchen a«t, I enng iv ounng I - - Roo(Deck M.Bedroom «eT. Bath N I 0 I -,enng Sun Room �n • _ 2 Entry ,tin9 m.Dath - I I\ T-1 - CL Q cauang butic-me I \ � • 6 ' O f Z )2'-C' 20-0- Q 32'-0' a � W c O EXISTING EXISTING O SECOND FLOOR PLAN FIRST FLOOR PLAN 1/4"=1'-0" 1/4"= V-a' 0 Ur 6 19 Z W _ r N a ~ w 0 'l,j ®fie a W • �!✓+ DATE:05/03 1 2018 • '1 SCALE: AS NOTED DRAWING#. - F7� r E1 - 2 q; I � to m m� 0 Nd d2 M > o Z Z� e �a o ° Iz � Q 1+1.,q EY15 T.ROOF 1*/-1? L 0 N 1tJ• O .t O U _ 68°DRHDR _ 67 WDW HDR SECOND(LOOP SECOND FLOOR SECOND FLOOR -- -- CEILING HT.®I:BCHEN 69"WDW HDR M M TE r- r-_I F NMNG ROOM FLOOR DECK BEYOND __ ®® MINGROOMFLOOR- FIRST FLOOR FAtST FLOOR FIRST FLOOR -- SUN ROOM FLOOR I -- EXESTING DMUNG LEFT SIDE ELEVATION FRONT ELEVATION Z o IZ a 12 a BOT.OF RAFTERTML .. CEILINGHT.®MBR CENNGHT.®M8R Z --- -'- U) .7'DRHDR 6'T'WDWHOR _ ? Z EIB Lij - LIMNG ROOM CEILING SECONDFLOOi WDW HDR®UMNG ROOM W ® ® a u LLI a ® p J c9 s EM L v le Z a m — LMNG ROOM FLOOREmu= ~ DECK FIRST FLOOR N fIRSi FLOOR \ O �/ a X Q M F 17 W U ' W � as-O° I+N a DATE:05/0312018 _ EXISTING i EXISTING RIGHT SIDE ELEVATION REAR ELEVATION SCALE: ASNOTED 114,=1'-0• � - I/a".=1'-0" DRAWING ri: ' � r a E2 - 2 /n m� O N a f- Q% of p o f zO z r J O dau �z o i 0 r-------------------- � _ �Qo = a I j V 1 I I ai t: k Q I I i 44 ' I I r•j�' I ydw' 9". -bng e.rnng Deck Living Room Storage I I t UP I G. r Ldped d9_ 7 exbt. Dining Area a%1 dry Utility song . clos. Bedroom I e>��=�ng Kitchen I Roof Deck M.Bedroom Bath F1 � z I O rc Sun Room n ur Entry t Ery In.bath I 1\ CL O raunng Wdc-ms 'N' J1 a N � cn z Q o � W o O EXISTING EXISTING O SECOND FLOOR PLAN FIRST FLOOR . PLAN a w 1/4"=V-0" 1/a"=I'-o" p s U' v m z � W Y U) Q o X w r U W - a - DATE:05/OS/2018 SCALE: AS IJOTED DRAWING M E1 - 2 CNN y N Z cb Q dz M v > o z E Jw0 QaU I, 12o O Q I+hl q EXI5 F.ROOP 1+/-1° O N Us m � Q j — - 6B'OR MDR 6'T WDW HDR a ono ova .SECOND FLOOR SECOND FLOOR SECCNDFLOOR _ CEILING HT.®IJTCHEN — 6'3"WDW HDR EMS Rmfl i F[ — LIVING ROOM BOOR .DECK BEYOND -- a ®® LIVB+G ROOM FLOOR --— FIRST FLOOR FB=ST FLOOF. FIRST FLOOR SUN ROOM FLOOR 1 2O'-4' N/-I EXWNG EXSTING ' LEFT SIDE ELEVATION FRONT ELEVATION Z 0 s w 1 - _ a BOT.OF RAFFER TAIL CEIIWG HT.®MBR CRING HT.G A/W Z __ _ 67'WOW HDR O ; Z ® o a Q Q _UNNGROCMCENNG W 0 \ SECONDFLCOR- - _- I I _ •A �. WDW FOR 0 LPANG ROOM V W u LLI MR 11PIP a ® O 6 J 0 0 � z W LIM GROOM FLOOR ~ -_-DEC, y_ y FIRST FLOOR -- _ -_ FIRST FLOOR \ 0 I a x o � W U 40-0' I+/-1 a DATE:05/03/?0lR EXISTING EMTING RIGHT SIDE ELEVATION REAR ELEVATION SCALE: AS NOTED I/f=I'-w 1/4'=I'-X DRAWING N: E2 = 2 y to ry Z n D dz m 0` o o� W F FXISTING ————————— 4L Q N Zo N r WUz m I I an rink t F'< a I I V I I � I I d I I 1 I I ianng casang z Deck Living Room I o g N Storage I I I I I I — — ——- I I I t I xist.w3w) xue>_s (exut.wdw) (replace exunng wdwsl open vp vi I-R. UPI V Q O ZD funs. IMI DW tzi a.®er P :D Utility nmv cabla railing m ig O ———— ON 2 Dining Area Kitchen e.�at. i.z,• Kitchen © Bedroom ndry s ovaced ` proposed ? + 3 I Bath Roof Deck N M.Bedroom Re-do Nbber roo0 R cl e-7 1/2" en I O ± Sun�oom t I REP D O .n O I eno•ing ®vr rc Bath O Entry proposednv Ci y/rm P di O A pacy wall O !�{1.1/ •waG toilt-ina I I\ �� ' (ernr,.wdw) (umt.wdw9 (keep exuCmg wdvn) !/ _7 _jam I0-o^ Z 20-01 r(,.-¢ Z Q (+/-)EX15TING 12-01l 20-C t.' C ~ J (+/-)EXI5FING (+/-)EXISrING '�. F F tl 10 � Q 0 0 PROPOSED PROPOSED SECOND FLOOR PLAN FIRST FLOOR PLAN W a O 0 1/4"= 1,-0" 1/4"=1�_Dn J a tL EXI5TING WALL- r .� p w - NEW WALLS 1 U) O bf u~i d EXTERIOR DOOR It WINDOW SCHEDULE o O KE„ UNIF FYFE ROUGH OFEMNG MANUFACTURE NOFE5 Q OA (3)CJJDH-2422 DH-TRIPLE MULLION 7-4 1/4"X a'_4^ MARVIN-NO GRILLE IO n tl O G068 e SLIDER G'-O"X G'-1 O 1/2" MARVIN-NO GRILL O a INTERIOR R DOOR S C H E D U L E DATE:05/03/2018 KEY UNIT TYPE ROUGH OPENING MANUFACTURE NOTES SCALE: AS NOTED , tO 2'-V PT.HAND 5W NG 2'-8"X 1 1" 50LID CORE NAA50NITE �. I'-8" RT.HAND SW NG I'-10'X CUSTOM- 5H0Ri DOOR DRAWING 2'-2" LEFT HAND 5W NG 2'-4"X G-I I" 50LID CORE MA50NFTE 1 Al - 2 rn N m obb O m o z $ Zgin � o e U 1. 12 O m EXIST.ROOF ° N O o m � a z U - - 6'S'DR HDR 67 WDW HDR a NEW M.M2VIN 4:'SIJDER NEW PRIVAC" .J. NEW PRIVACY WAIJ. FFH A', DECK P F5 O 'A',/ I CABLE RAIL NO RE-DO RUBBER ROOP _ SECONDfLCOR SECONDROOR SECONDFLOOR CEILING HT.0 j JTCHE- � �I AZEC CORNER 5D5. - AZEC CORNER 505, 63"WDW HDR EXIJTI F (MATCH EY.IST.) (MATCH EX,STJ EXIST LIDER- -LIVING ROOM FLOOR DECK BEYOND -- ®® LNNG ROOM FLOOR- FIRST FLOOR fEM FLOOR FIRST fIOOT: SUN ROOM FLOOR --- ° 15'-5° I+hl 20-4' O° N/-1 FASTINGHWSE&DECK EXISTING FIRST FLOOR/W/RE-DONE ROOF DECK EASTRIGFITST FLOOR EXISTING HOUSE W/RE-DONE ROOF DECK - PROPOSED PROPOSED LEFT SIDE ELEVATION FRONT ELEVATION Z O N 1 o� 2 - a _ N � BOT.OF RAFTER TAIL CEILING M.®MBR CEIUNG HT.®MBR Z e T'DRHDR 6'T'WDW HDR ® /� • ~ 0 Em AZEK DECK P05T5 TT= W/CABLE RA LINGMill 4 a ` p 95L�-�ml -LIAIJGROOMCEOING W Q W SECOND FLOOR -- SECOND FLOOR /A WDW HDR®LIVING ROOMrd V ® � � a m W u ❑ REPLACE(51 EX15T.DH'WOW5 a WITH LARGER DH W0W'5 O J IL W C U) w p LIVING ROOM FLOOR _DECK H b a FIRST FLOOR FIRST FLOOR \ O 0 ' U a 40-Cr IH-I PM EASTING HOUSE EAVNG SHED EXSTING LIVING ROOM FASTING DECK a DATE:05/03/2018 PROPOSED PROPOSED -- RIGHT SIDE ELEVATION REAR ELEVATION SCALE: AS NOTED 114—V-0' 1/4'-I'-0' DRAWING#: A2 . 2 r' F7 m to N mu� O N (+)-)EXISTING 0 ` ZR0 a4 --------- G �D0 =a a cxnang z ,n Living Room e. n o s Zp "g Storage N S + - I I I I I L_ _ —_j I I I I I I r-3 u2• I I x,st.w'dw) x'se� (exm[.w.lw)I _ (replace exixmg wdwsl open up to I-R. 'True 16' x O fun,. UGllty - nav able radmg Qi e''n9 ining D Area e . exst. 11, s" Kit chen nd © Bedroom D 6 aced N p apoeee o N o m N E Bath p s Roof Deck N M.Bedroom /� o - g ° �® a s G•e-da rubhar roo5) I� G'-7112' IDI Sun Room I o 9 REP � m ,n o exe:mg �1e Bath O Entry V propoeed Ca \ privacy wall (exnt.wdw) (e..u:.wdw) (keep--j wdv e) Iaa 2'-3 $12' N fA Z 2aa Z - Q (+N EXISTING 12'-Cl 2a-a' O ~ J I+/-)EXISrING (+/-)D(ISrING r F a V PROPOSED PROPOSED Q SECOND FLOOR PLAN FIRST FLOOR PLAN W c 0 1/4"= 1'-0" 1/4 1,_p„ J - Q U- n EXISTING WALLS J O O IS tL NEN'WALLS - 7 � � O H y n- EXTERIOR DOOR WINDOW SCHEDULE c O KEY UNIF rYPE ROUGH OPEN,NG MANUFAC PURE NOPE5 Q h ® (3)CJUDri-2422 DM-TRIPLE MULLION 7-4 1/4'X 4'-4" MARVIN-NO GRILL M CL © GOGB n SUDER, G'-0"X G'-1 O 112n MARVIN-NO GRILL v W W a, I NTERIOR DOOR S C II E D U L E DATE:05/03/2018 KEG UNIT TYPE ROUGH OPEN,NG MANUFACTUkE NOTES SCALE; AS NOTED 1O 2--C" KT.HAND 5W NG 2'-8"X I I" SOLID CORE MA50NITE I'-8" RT.'HAND 5W NG I'-1 d'X CU5TOM- SHORT DOOR DRAWING#: ` 3Q 2'-2" LEFT HAND SWING 2'-4"X G'-I I" SOLID CORE MA5ONITE Al - 2 N z ^N o > R o Z z � o �� U �o 2 2 O 1'/H 9 E%15 F.ROOF h/-1'� X � O I o to a a r _ 68"DR HDR NEW -- -- MAENIN 5'SLIDER NEW PWVACIWALL Nny PP.IVACY WAJL .AZEK DECK P05(5 O ,A,,CABLE RAIUNG J RE-DO RUBBER ROOF SECCfJD FLOOR SECOND FLOOR SECOND FLOOR _- CEIIWG Hf.®I:RCHEN A2EC CORNER BDS. AZEC CORNER BDS. 6'3'WDW HER _ E%ISTII SLIDER (MATCH EY,15T.) (MATCH ffX5T.) EX5TI WIDE?—LIMNG ROOM FLOOR OECKBEYOND ®®7r— Big LINNG ROOM FLOOR FIRST FLOOR FM FLGC�'. FIRST FLU SUN ROOM FLOOR 9'-B' ('/•I 20-4—h/•1 2'-0' 1+/-1�20-0, I+FI ` E:45TING HOUSE&DECK EMSTING FIRST FLOOR/W/REDONE ROOF DECK EatSTRJG FEdT FLOOR EMTING HOUSE W/RE-DOME ROOF DECK ` PROPOSED PROPOSED LEFT SIDE ELEVATION FRONT ELEVATION 1/4—F-9' 1/4—1W" w 0 t O rn 7 12 12 o 4 e h BOT,OF RAFTER iA1L CELLPIG IT.®MBR CEN11G Hi,®MBR Z U i 0 z e7'DRHDR 67 WDW HDR FL mLlj FM AZEK DECK PO5T5 0 Q W/CABLE RAILNG as > L11*G ROOM CENNG W O UJ SECONDFLOOR __ -- sEcoNo FLOOR ,w C J -— WDW HDR O UMNG ROOM V ® J b T 1+FI � � a W W REPLACE(5)E%iST.DH'WOWS a 0 WITH(3)IAkGER DH N'OW'S O '4 w G ■ till W Hill F .UMNG ROOM FLOOR DKK:]L a FlRSi FLOOR -_ -- FIRST FLOOR ` O O a Q f9 1 w a ESSTING HOUSE EMS PING SHED FASTING lMH'IG ROOM ESSFWG DECK ` DATE:05/03/2018 PROPOSED PROPOSED RIGHT SIDE ELEVATION REAR ELEVATION SCALE: AS NOTED 1/4'=I'-0' 1 µ'=i'-0" DRAWING#: c� A2 - 2 1(1 to N ` N N V Q Z M o o ZLS ' (+/-)FXI✓TINE //� ..I 12 O ' --------------------� O �Z o ® '. I o D. 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NF.LV PRIVACY WN.I. AZT DECK P05 1-5 O - W9 CABLE RAILING j RE-DO RUBBER ROOP SECOND FLOOR SECONDFLOOR SECOND FLOCK CEILING HT.6 MCI-LD AZEC CORNER 5D5. AZEC CORNER E05. SY WDW HDR F1 EKll�- SLIDER (MATCH EY.IST.) (MATCM1 Ek'•STJ ®M Ew STI / LIDEif NMNG ROOM FLOOR ®® LIVING ROOK FLOOR DECK BEYOND AMT FLOOR FIRST FLOOR FIRST FLOOR SUN ROOM O FLOR'• ___ -°20-4 I+/-i -O" l+/-I - 20-0 IH-) L L ' FASTING HWSEA DECK E)ASTING FEEST FLOOR/W/REDONE ROOF DECK E?1STRNGFRST FLOOR E?%RNG HOUSE W/REDONE ROOF DECK PROPOSED PROPOSED LEFT SIDE ELEVATION FRONT ELEVATION Z 0 w r 12 a p 12 DOT.OF RAFTER TAIL CEDRNG HT.®MBR --CENNG Hi.®N•BR Z 6TORHDR _ - BT'WDW HOR - — F 0 0 iiii DECK Wl/C Q f.1 Q W/CABLE RAJLNG)UNG aQ > LIWNG ROOM CEILING W Q w SECONDFLOOR- _ SECONDFLCOR WDWHDR 0 LIVING ROOM v J EH' '2 r Q ❑ REPLACE(S) DH\MOWS j WITH(S)IARC—GER Ot'f WDW'S O IL w NEW W O LIMNG ROOM FLOOR ,w DECK y N Q,• FIRST FLOOR -- -- FIRST FLOOR ` O O I -- a � F .I n U 0 Ie-0' 1+/-1 I+FI w T- a ' E`0.1TING HOUSE E1,iSi1NG SHED FISTING LhBNG fbOM ES4BNG DECK '. DATE:05/031 2018 PROPOSED PROPOSED RIGHT SIDE ELEVATION, - REAR ELEVATION SCALE: AS NOTED 114-I'-T 1/4—I'-U' DRAWING B: A2 - 2 / s� r N O X Q zj F (+/-)Fk5TING --------------- I N —k 1 I 1 �nnng e.unng z �a I Deck z Living Room o s ( song Storage N I I I + I I I I 1 I I I zut.wdw) zue� (exist.wde)I (replace�nsnng wdwsj ' open up to I..P �- r UP 1 G' O fain. _J N N I I DW cel a_ge P V 4 --1 Utility .. �wv cable radmg Q� �s:ing — ———— " Dining Area I DN enay. Q --/.2g° Kitchen O Bedroom I 1 I elect. I I eno. tovaced N proposed C - 3 ® I Bath c ? 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INTERIOR DOOR SCHEDULE DATE:0.5/03/2018 KEG UNIT TYPE ROUGH OPEN.NG MANUFACTURE NOTES SCALE: AS NOTED 1O 0-G" PT.HANG 5W NG 2'-8"X I I" 50LID CORE MA50NITE I'-8" RT,HAND 5W NG I'-10'X 76570M- 5HOitT DOOR DRAWING$t. .3O 2'-2" LEFT HAND SW NG 2'-4"X n-I I" SOLID CORE MASONITE o Al-2 N m � Z wa a ' O o m Vt d u l4� 12 12 Q ly-1 q Ems T.ROOF 1+/-1° =O N O I o m � a d'B'OR NDR 6'7'WOW MDR NEW M.ARVIN G 5LIDEK Fml NEN'PFU'JAC"'WAI.I. NEW PPIVACY W1W. AZT DECK.PO F5 O N'1 C'A13E RAILING . RE-DO RUBBER ROOF SECONDFLOOR SECOND FLOOR __ SECOND FLOOR CEILING HT.4 INCHEN AZEC CORNER EI AZEC CORNER BD5, 6'3"WOW HOR DmT71 SDDER (MATCH EY.tST.) (MATCH EXIST.) ®® -_— EX�5T1 WIDE? 00 7F— im _LIMNG ROOM FLOOR ®® LISMIG ROAN FLOOR - __ DECK BEYOND __ FIRST FLOOR FIRST FLOOR FIRST FLOOR SUN ROOM FLOOR -— 19'-5' H/-I 20-4" 1+/-I i 2'Q 20-0" 1 1 FdSTING HOUSE A DECK E?7STNG FIRST FLOOR/W/REDOFIE ROOF DECK _ E)SSRNG FIRST FLOOR EMiTING HOUSE W/REDONE ROOF DECK ` PROPOSED PROPOSED LEFT SIDE ELEVATION FRONT ELEVATION Z N 12 _� _ 12 a y � BOT.OF RAFTER TAIL CEILNGHT.OMBR - CEILINGHT.OMBR Z U) --— --— O Z e7'DRHDR 67'WDW HOR O {{,,,. � r f ®® o EK.DECK P05T5 Q 0 W/CABLE RNLNG Q a > A2 LIW�G ROCMA GEEING W G w SECOND FL07R_ -_ SECONDFLOOR WDW HDR O LINNG ROOM V r ❑ REPL4CE(5)LARGER DH WOWS a N1TH(3)LARGEk DH NTnA'5 O J s W MIMIV U O DUNG ROOM FLOOR DECK y W a FIR9 FLOOR -- -_ FIRST FLOOR ` O O I Q ^ LL a U W � 40-0' W-I I+/-I 1 G'-C' (+/-) Ix M71NGHOUSE EISTINGSHED E13TNG LIVING ROOM WSTNGDECK a DATE:05/03/2018 PROPOSED - PROPOSED RIGHT SIDE ELEVATION REAR ELEVATION SCALE: AS NOTED 1/4=1'-(r _ 1/4=1'-0" DRAWING##: A�> - 2 i 1 1 a I N N a z z n a Q m N O N z F W e ¢ V - N O N U 0 m H a _ S ❑ ®® ❑ < t SECOND FLOOR 1 SECOND FLOOR ft AZEK DECK POSTS W/CABLE RfLILING M A _DECK WING ROOM FLOOR _UVING ROOM ROOR LE DECK LI hNG ROOM FLOOR FIRST BOOR - AZEK DECK POSTS —-- iW/CABLE RAIUNG I0-50NOTU,,—'F I 'SQUARE'LATTIU J SQUAR' ACE YCAU TO GRADE-I YCAL AZEK DECK POSTS WCABLE RAIUNG 10150NOTUBE— TO GRADE-TYPICA L 4 (TYPICAQ I L.J I I - I g g• p/-I L-1 +a. N/-1 I G'-O' N/-I -.W-) L J REPLACE EXISTING DECK EXISTING SHED EXISTING UMNG ROOM REPLACE EXISTING DECK PROPOSED PROPOSED - LEFT SIDE ELEVATION ' REAR ELEVATION v4'•=ram•' ( - 1 - 1 U I G- rwsc��g Crawl Space Living Room Y U b exlstmg Q LLI z Shed + N _ Z Q DN F O T.16 DGEFrBD. 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Z m <� p Q y O i mx >N �¢ or. � Approved by: Z —Wa Permit#; — l Gt (7 e a O N of Ln W¢ O i 2 ❑ ®® ❑ SECOND FLOOR SECOND FLOOR ❑ ❑ AZEK.DECK P05T5 { W/CABLE RAIUNG M D_EC_KNyING ROOM FLOOR __LIVING ROOM FLOOR DECK __ L MNG ROOM FLOOR Fit IRST FLOOR _ AZEK OECK P05T5 W/CABLE RAILING I O'SONOTU E-+ 'SQUARE'LA T1Q4 (TYPICAL) I I TO GRADE-ITYgCAL AZEK DECK POSTS I I 'SQUARE'LATTICE 4_0 I I W/CABLE RAILING 1 O'50NOTUBE-r TO GRADE-TYPICAL I I I I - (TYPICAU I I L J L J 16'-O' (+/-1 IH-) L J REPLACE EYJSTWG DECK EXISTING SHED EASTING LIVING ROOM REPLACE EXISTING DECK PROPOSED PROPOSED LEFT SIDE ELEVATION REAR ELEVATION 1/4•'=1•-O• - N - - Z O 99 S2 C UP I G' J fn . i cxiscm e+nsti�q. ace Living g Crawl S Room Y � P 9 M exlstln Q W b � 9 I V Shed+ T� I ❑ � a C F .T,16 LI DGE. BD. - - _ - DN 3' I Dj 25` F C• __ ID O J P .1 6 LE GER D. z z iJ N replace REPLACE EXI5TING DECK 2<6 P r.Df CK JUST!®I 'O. ex15tdn,3 sting W in (TO MATCH HOUSE) 50LIC BLO KIN Q IDP WT O Deck Sun Room (� P.T. 2)2; 'S V Z _- - - - - - -- _ - - Z - W r - O _ _ AZEK DECKING V ON O P T.D CK J I57 O 6'O (TO MATCH UPPER DECK) �I.I j Q L__ ____J O Uj 6 V � U) P.T.6%6 PO5T5 TO I O'SONOTUBE O (BOTTOM TO BELOW FROST LINE) P.T.3)2 105 F USE SIMPSON POST ANCHOR TYPICAL e._ Iw (+/-)EXISTING _____ \\\ DN N W d — P,T.6X6 POSTS TO 10`50NOTUBE `TIE INTO EXISTING CORNER W ECADICK lE RqG O O L_____J Q(BOTTOM TO BELOW FROST UNE) C* ' UBE'5IMP50N P05T ANCHOR,TYPICAL Q /7 a PROPOSED SHED DECK & FRAMING 201-V 20-0' D (+/-LAUGN TO EXISTING ALIGN TO EXI5TING a F 1/4-=1'1Y • DATE:03/14/2019 PROPOSED FRAMING I� L /L f l PROPOSED SCALE: AS NOTED /'1 LV _ DECK PLAN ua•=r-a' � 4 DRAWING#: 6.'ti4i dvr'a.4ir.L �' Al - I f 1 N N S.Bd. COTU/T fnd. SCHO L — 8AY S T. LOCUS IAN LOCUS MAP SCALE ' 1"= 2000Fz 1 ZONING DISTRICT - RF N ro i j C.Bd.fnd. 0 YIS T E R SCHOOL 0) - Pk ,4 C.Bd.f nd. S T, N o �C.Bd. fnd ro 00 Edith M. Henderson -� S48°�2' , M 69.97° E� S.Bd.fnd. C.Bd. C.Bd. z Ni s L C.Bd.f nd. ' set ..fnd. hI 1.89 . S 640 25 07�� E 163,71 ' O , .9 O , o PARCEL A" wS.Bd.fnd. z cj 6 28,395 ± S,F To M.L.W. C. L.C.Bd.fnd. N62037'30"W 125.85' n9 sef� ° C.Bd S set Iron Rod ' w set N40°3 ), " 0 8388, C.Bd.set ,,0° Nail '00 O set O N o °oe � 0 y r < . C06L S.Bd. � F 'PA R C E L B�� } � G fnd. `a�9��0 �� 20,355 ± S.F. To M.L. �x�opa tiSF� W. 9s-� �+ 9�� ' �2� r o op o,� py •�� ti Drill Hole o �O et �' Drill Hol s e set / ..r 41 S.Bd.fnd. �y +C`X ON ` IZt N P C 01 I certify that this plan has been prepared in conformity with the rules and regulations of the Registers of Deeds of the Common— wealth of Massachusetts. Date r Registered Land Surveyor i TOWN OF BARN STABLE PLAN OF LAN D PLANNIN:13 BOARD IN APPROVAL UNDER THE SUBDIVISION COT U IT BAR N S T A B L E M ASS. CONTROL LAW NOT REQUIRED. FOR DATE -. FREDERIC P. CLAUSSEN ..... DRAWN BY R.S.J. ------------ �_ , DATE' MAY 33 1976 ,,, pllF�iiF ,qs CHECKED BY R.PB. RUI3ERT G SCALE ' 1" = 400' 9; BUN�K78 , 0' 4d so 120' 1 Na 8420 q O IST,f CHARLES N. SAVERY INC. " REGISTERED CIVIL ENGINEERS & LAND SURVEYORS Reserved for Registry use, 712 MAIN ST. HYANNIS,MASS. IN27602�