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HomeMy WebLinkAbout0054 ROOSEVELT ROAD .-� r a f FT HET Town of Barnstable *Permit# 0 ISM p? C Expink,6 m r m sue ' SS PERMITRegulatory Services F BAMSrABLE, 9� M' N 22 2015 Richard V.Scali,Director p�E ►�, " 112111s ulV OF BARNSTABL.E Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not valid without Red X-Press Imprint Map/parcel Number Property Address 5 Ll O 0's C., Co 7—c'0 Residential Value of Work$ 3 sQ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Uj/ t1'1 n mo-m,A& t Contractor's Name C/ �5 C a/T Telephone Number Home Improvement Contractor License#(if applicable) (o C2 G a-� Email: Construction Supervisor's License#(if applicable) 5 ' 07 6 6_3 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance / Insurance Company Name %/►� c/TUfg'(,.� Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ;® Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken toQ'JyVLr7J ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) 54-"'T ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum .35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License& Construction Supervisors License is r ired . SIGNATURE: G"� QAWPFILESTORMS\building permit forms\EXPRESS.doc Revised 061313 1 r 1 - 3 �zHE lti Town of Barnstable Regulatory Services anxxsrA8M Mass. Richard V.Scali,Director rFDMi•�A Building Division „ Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must - Complete and Sign This Section If Using A Builder " as Owner of the subject J property hereby authorize., C G-S 1,✓C l L �5-1'5 to act on my behalf, in all matters relative to work authorized by this building permit application for: i __��j �dc�s�y�L✓Lam. C'c�y�; , (Address of Job) ""Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled'or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date k Q:FORMS:O WNERPERMISSIONPOOIS Town of Barnstable ' Regulatory Services �QF me roiry,� Richard V.ScaIi,Director Building Division 1A MASS. Tom Per Building Commissioner MASS. Perry, g 9 � i6 0�39- � 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: - - number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. _ The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &ReguIations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit fomis\EXPRESS.doc Revised 061313 DGfacils Page 1 of 1 S Licensee_Details ... .... Demo•ra hic Information Full Name: STEPHEN W CRESWECL , Gender: Owner Name: ; .. - License Address Information •: . .: ` '.: . Address: Address 2: ; City: CENTERVILLE . State: MA ipcode:. 02632 Country: United States . ;License Information .. •,;:' License No: CS-076536. License Type: Construction Supervisor Profession: Building Licenses "Date of Last Renewal: 10/23/2013 q Issue Date: Expiration Date:. 8/27/2015 License,Status: Active TodaysDate:' 1/21/2015 1 Secondary License:. Doing Business As: Status Change: License Renewal - .. Prere uisite Information - . No Prerequisite Information', Disci line No Discipline Information Doeurimentum _ http://elicense.chs.state.ma:usNerifleation/Details.aspx?agency_id—1&license id=265485& 1/21/2015 f Wit: .. .. ... pjid ,E':MI:'a.S AlId 561 It 'I ff l±t6S Ha M N111Ial°LS .: �r►st.�aslRS ua+elrnstsucrl .. spksptteis pus uoileinal�Ouwl!s BB;a p eog , uauj3se€� s#IasnelaSeytl . a#t-Soltelncf.ia. }.-., . . - ' OV Office of Consumer Affairs:and Business Regulation 1 O.Park Plaza- Suite 5170; Boston; Massachusetts 02116 Home:Improvement Contractor ReOst>;:ation :Registration:, 160627. Type: Individual �� Expiration: 8/S/2016 Tr# 253341 STEPHEN W. CRESWELL w i STEPHEN CRESWELL?. , �r �. 195 PINE ST rr. — CENTERVILLE, MA 02632 Update Address and'retiirn:card N ark reason:for'change. SCA 1_0 20M-05i11 ,Address . It Employment :� Lost Card �innt�zr�-�rrrcall�r��`llr.�;crr�uttlts . .:Office of Consumer Affair's&Business Regulatio n License or registrationm valid for diVidul use.only -_ .. fix _tVOME IMPROVEMENT:CONTRACTOR before the expii°ation date. If found return to;; `_2egistratfon 960627 :Type. Office of Consumer Affairs and Business Regulation Expiration 8/8/2016* Individual 10 Park Plaza-Suite 5170 MA 02116, STEPHEN W.CRESWELLI F STEPHEN CRESWEL, f F 195 PINE:ST GENTERVILLE,MA 02632_n Undersecretary:, Not valid without signature ' The Commonwealth of Massachusetts Department of Indus* al Accidents Office of Investigalions 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit:-Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LegibljK Name(Business/Orgmization/tndivid ial): . ✓� Gc't�1cS �c 6<�y Address:_ p'ti PPS 2 City/State/Zip: �D� P02/j /1��" Phone#: `>e, Are you an emplo er? Check the appropriate box: Type of project(required): 1. I am a employer with 4. 0 I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' [No workers'comp,insurance comp. �rrance 9. Building addition in required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.0 goof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑ Outer comp.msurance required.] *Any applicant that checks box#I most 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 mast 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: / U f UW4, Policy#or Self-ins.Lic.#:_ ty C 3 7 0.20 7 Expiration Date:_ z Job Site Address: iw) City/State/Zip:_ co Ty/ l M 10" 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 thepains and en ' ofperjury that the informrdionn provided above is true and correct Signat IFe — /%i�� \Date /or`� I l Phone#: © —7 3 7 J 5� 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 S.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 confuznation 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 Iaw 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 Q<ffb= of JXwestigatio.As 600 washi4on Street Boston,MA 02111 Tel,#617-727-49GO cxt 406 or 1-8.77-MASSAFE Fax#617-727-7749 Revised 4-24-07 www,mas.5_govfdia CERTIFICATE OF LIABILITY INSURANCE 101/05/2JMM/DD/YY`VY1 015 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. I.HPOR ANT: if the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION 13 WAIVED, subject to thB terms and conditions of the policy, certain policies may require an endorsement, A statement on this certificate does not confer rights to the cortiflcate holder In Ileu of such endoreement(s). PRODUCER NAME: PAUL SCHLEGEL SCHLEGEL INSURANCE BROILERS INC PHONE 508-771-8381 508-771-0663 A/C,No.Eat. (MC,Na)• 34 MAIN STREET ADDRESS: SCHLEGELINSURANCEQGMAIL.COM WEST YARMOUTH MA 02673 INSURERS)AFFORDING COVERAGE NAILS INaUReRA:NGM INSURANCE COMPANY _ 14799 III:IIIRED INSURER a:PROGRESS ICE Mt Ccnstruction INSURER c:AIM MUTUAL 2 Ahab Road _ - INSURERD: INSURER E: - Yazmouthport, MA 02675 INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 1 H S IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 1^IDC/tTED. 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. E X-LUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. iLTR — TYPE OF INSURANCE LIMITS -- LTR INSq VND POLICY NUMBER (MMIDDIYYYY) (MMIDD/YYYY) _ A OVIERAL LIABILITY MPP0601V EACH OCCURRENCE f 2,000,000-UAWGIE To RENTED -_ X COMMERCIAL GENERAL LIABILITY 05/18/201 05/18/2015 PREMISES(Es occurrence) 5500,000 CLAIMS-MADE ®OCCUR MED EXP(Any one person) f 10,000 PERSONAL S ADV INJURY S 1,000,000 - GENERALAGGREGATE- f 2,000,000 GE'J'L AGGREGATE LIMIT APPLIES PER: - - PRODUCTS-COMP/OP AGO s 2,000,000 -- POLICY JPEC- LOC S 19 AUIOMOBILEIJABILITY 04287439 03/28/201 03/28/2015 (Es accident) s -- 1300ILY INJURY(Per person) S 250,000 ANY ALTO ALL OWNED SCHEDULED - + BODILY INJURY(Par accident) f 500,000 _ AUTOS X AUTOS - HIRED AUTOS X ANUTOSWNED - - (Per accident) f 100,000 -- f UMBRELLA LIAR OCCUR EACH OCCURRENCE f — EXCESS LIAO CLAIMS-MADE AGGREGATE f _._ DED RETENTION f f 7/CRMERS COMPENSATION W(.-378929OT iWO7/2014 10/07/2015 TORY LIMITS ER O C !ANO EMPLOYERS'LIABILITYYIN AN'r PROPRIETOWPARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT f 100,00O CF`CEPJMEMBER EXCLUDED? El(Mend rtory In NH) E.L.DISEASE-EA EMPLOYEE f 100,000 - R yes.deserlbo under DE 3CRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT f 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H more space Is required) CIERTIFICATE HOLDER CANCELLATION' ?ETER FIELD PC) BOX 16 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN rCHTUI T MA 02635 *' ACCORDANCE WITH THE POLICY PROVISIONS. - AUTHORIZED REPRESENTATIVE 0198 201 ACORD CORPORATION. All rights reserved. ACORD 25(2010105), The ACORD name and logo are reglstered marks of ACORD , The Commonwealth of Massachusetts 1� J . DepartmentiM oflndustrAccidenfs, ��� 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/Orgm zationgndividnalY Address: /9,S IV14 e • oT City/State/Zip: CP/'I re'11ff( /"l4 Phone#: Are you an employer?Check the appropria b Type of project(required): 1.El am a employer with 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6 ❑New conshuction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity, employees and have workers' [No workers'comp. insurance comp.insurance.1 9. ❑Building addition required.] 5. [] We are a corporation and its 10.❑Electrical repairs or additions ha ve,ave exercised their 3.❑ I am a homeowner doing all work o 11.❑Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.[,� of repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required] *Any applicant that checks box il 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 hue outside contactors 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-contactors have employ=,they mast provide their workers'comp.policy amnber. 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-insMic�-#: won Date' �b-Site Address: e/ Q_63.SeLe i L� �Ciiy/5 e/Zip:�- (1 Sj l�vlIn 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$1,50D.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 au"a and penalties ofperjury that the information provided above is true and correct �'S_i at[r>=e�:. �`'_`"4 Date:_�F/���/_• l Phone#: Of 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#: . a . -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 fi1su ncC. requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Also be sure to sign and date the affidavit. The affidavit should Accidents for confirmation of insurance coverage. gII 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 f - 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 BE 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 shoe-Ad 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 ourt 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 bran 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 CGmmonwc alth of Massachusetts Depaztment of Induldal Accidents Office of Westigations 600 washftooa Strut Boston,MA 02111 Tel.#617,727-4900 c�xt 406 or 1-8.77-MASSAFE Fax##617-727-7749 Revised 4-24-07 wvuW.m=.gov7clia R I S E Division of`Fhielsch Engineering,Inc. 1341 Elmwood Avenue ENGINEERING Cranston,Rhode Island02910 May 1, 2013 N ZP Thomas Perry, CBO U3 Town of Barnstable O Building Division 200 Main Street ; Hyannis, MA 02601 . , Re: Insulation permits C:) m Dear Mr. Perry, This affidavit is to certify that all insulation work completed for 54 Roosevelt Road has been inspected by a Building Performance Institute (BPI) certified Professional. All work performed meets or exceeds Federal and State requirement. Sincerely, Erik Nerstheimer Supervisor of Installations, BPI certified Building Analyst Professional and Envelope Professional, RISE Engineering, a division of Thielsch Engineering, Inc. 1341 Elmwood Avenue Cranston, RI 02910 401-784-3700 800-422-5365 •Fax 401-784-3710 ' TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 039 133 GEOBASE ID 2409 {{ ADDRESS 54 ROOSEVELT ROAD PHONE (423)279-91781 Cotuit ZIP - I 4. LOT 3 LC36 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CT i PERMIT 19019 DESCRIPTION SINGLE FAMILY DWELLING (PMT.#15497) i PERMIT TYPE UILD TITLE NEW RESIDENTIAL BLDG PMT j CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services � TOTAL FEES: BOND $.00 CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY * BARNSTA MARS. I OWNER TROMBA, MATTED ADDRESS 1705 ROUTE 37 � #A_8 BLOUNTV I LLE ; TN BUILD NG I BY DATE ISSUED 11/04/1996 EXPIRATION DATE v r i •4.rti:i ?�;t7/,,C, TI^? .C. t. •(1�i. 46 n•>>l., y ,�ti{".p S';�1�'•`C".i^.Vet` ;iC.• +Yv '`_l";\i•�'t'j...t,`. f •'�' ° , ii.�Y'.`:`;l't-1 t'.1 e i`i. E. r y C •' C ) tt u,l 1 R, r T •li 1 ` {, ; ` ''` Fi,r� ,__�.:...:.�+\-�l!1v.1. Is:.E.r_.a- -="�'►.%+fy' • err.��ll� t,,.�. r iJ oaf s`'. )i 17 I''+y, .�C j' 3�. i'4 �..,ru - t -„t L r 4 .I� -24. _%•:. . .r � � '�• , tr S ay ' .y� .��/yrp \ '< - ; !�yy��3�3•�rr..a�;i� •yyIf l._ �gg',� TTTiii h Lrf� +► ���•�y.L t, �' .� � � M � ... .._14 �.- :Y3L1A �!q3Y�j!° L, )'fir ,k.tw�'p sr_,�fr :� � �Ff:'s'.f•Re Yrh'\"�"L JD' W39 rt •j3 tom'--C?1.�ASE• Alii�r2E�S b4 ?�Ii�WL1(' LT ROA— -1 . �' ,+r�J�IF is 4''.3 �'T y 1 LOT L '3t �3Lr>jU'_,z LC)T Sa T�. _ . uBA DEVELOPMENT DISTRICT :PEZtiIT l -3 9 r DESCRIPTION SINGLE FAMILY L�DdELLINv '(SRW.PMT.#9 3=?L ?! PRR'N41:1T TY:PR BUILD TITLE NFW RESIDENT-1 AL BLDS -PM`1' CONT1:—;<; ;1k L,A� �`.�`7.PIi 1�)TC x Department of Health, Safety: ARC 41TE{-T : and Environmental Services `JTA;:, RE S $378.20 $1 ` 01�1 �'C1N "'fi1J� �.iON 00L'-,!TiS '`'. 000.00 d Q� f. 1 ?. :I.Nf()LE [FAH '140I j.F. T1KTA`.HFD i 11Rf ATE P "* ! * BARNSPABq. LE. e� 'T'I�(M&A, "MAT,>_r:+) 11.1_)1)n'�S� 170 ROUTE .3 �. toBUILDING°DIVISj N BLt.�iJi�`l'V'ILLE; �!4 BY• � ti '-Tr,' .•r 5UED. 0��,'4` , i; 1J F;:I�1R�1?'IOP: DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN= 4 ' c;ROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS 'PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. .:- MINIMUM OF FOUR CALL INSPECTIONS REQUIRED APPROVED PLANS MUST BE RETAINED ON JOB AND FOR ALL CONSTRUCTION WORK: THIS CARD KEPT POSTED UNTIL FINAL INSPECTION WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU ELECTRICAL,PLUMBING AND MECH- j (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. ! 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. ~ POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELEgIMPAL INSPECTION APPROVALS — Vw i 3 1 HEATING ECTION APPROVALS ENGINEERING DEPARTMENT 2 10'131'9(2 .B ARDOFHEALTH - OTHER: SITE PLAN REVIEW APPROVAL NTH 1 WORK SHALL NOT PROCEED UNTIL" FOR BY q THE INSPECTOR HAS APPROVED THE STI�UEf � - VARIOUS STAGES OF.CONSTRUC Mi3NTHS fSF HRXL — INDTIF:CA' TION. ...w.Y:":..i N01 ED AS P. ` . iti� z ;TI H a _J Assessor's Office{1st floor) Map,,. e3 9 Lot :1 3 3-4 Permit# Conservation Office(4th floor) Date Issued 9 4 1 Board of Health(3rd floor)(8:30-9:30/'1:00-2:00) a Feed Ca4�'7$ y Engineering Dept.(3rd floor) House �° 4�� Planning Dept.(1st floor/School Admin. Bldg.) ,. , it r SAP . Definitive n oved by Planning Board _ 4 7 f ;19 � 3 �;t ��e TOWN OF BARNSiABL Building Permit Application ` ° '' ,�' ProjeJeA s �Zl F005 , � E I i Village Owner MITLO 2aY96-� Address /ZD NAM N,1k Telephone 7, .3 9/M - 76 / 7 Permit Request rC4J 6 772 UC i x 3 C ,we- Total 1 Story Area(include 1 story garages&decks) square feet Total 2 Story Area(total of 1st&2nd stories) square feet Estimated Project Cost $ /�,;7, any . 6T Zoning District Flood Plain Water Protection Lot Size_ -3 �S-i3 S. Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use _ Proposed Use ,Q f 5►-p e P Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure — Basement Type: Finished / Historic House Unfinished t/ Old King's Highway -- Number of Baths Z No.of Bedrooms Total Room Count(not including baths) 7 First Floor :5-- Heat Type and Fuel kjt /9 Central Air Fireplaces Garage: Detached. Other Detached Structures: Pool Attached Barn None Sheds Other J Builder Information Name Telephone Number :L9 —40 7 Address -/hWX 1j, L)&Z License# D/Z 6-573 Home Improvement Contractor# �0 86 Worker's Compensation# C Z J z 5- 3 7'•¢ ez� NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGN,&0 DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL-NO. i ADDRESS VILLAGE ._ • f i OWNER " DATE OF INSPECTION: FOUNDATION FRAME -�� ,✓, INSULATION 2S lig!�92 FIREPLACE. i ELECTRICAL: ROUGH FINAL 91 ; PLUMBING: ROUGH FINAL ..; l GAS: ROUGH FINAL ' FINAL BUILDING -744(e w - k - i DATE CLOSED OUT ASSOCIATION PLAN NO. + k ' LOT 30 Op 0 0 0 � ti LOT 31 LOT �sso 1 . 24 � o V �O, LOT 32 LOT 23 FLOOD ZONE "c"_ . FO UNDA TION CERTIFICA TION RES ZONE- TO AN COTUIT SCALE.,1"=30' PL.REF.-36608 C ELEV N�A LFN Y THAT THE ABO VE YANKEE SURVEY CONSULTANTS ION IS LOCATED ON of P. O. BOX 265 UND AS SHOWN, AND ��gN �A��q ��' cy UNIT 1, 40B INDUSTRY ROAD ITION now_____ PuL o MARSTONS MILLS MASS. 02648 TO THE ZONING LAW MERITHEW N ' REQUIREMENTS OF No. 3 9� o� TEL: 428-0055 ARNSTABLEFAX 420-5553 X LA A. M EW DATE.719�96 JAB 50959FND NUMBER______ MYER R. SINGER ATTORNEY AT LAW (508) 398-2221 26 UPPER COUNTY ROAD P.O.BOX 67 FAX (508) 3981 1568 DENNIS PORT,MASSACHUSETTS 02639 May 10, 1996 Mrs. Wilma Tromba Mr. Matteo Tromba 4972 Weaver Pike Bluff City, TN 37618 Re: Lot 31, Land Court Plan 36608-C 54 Roosevelt Rd. , Cotuit, MA Dear Mr. & Mrs. Tromba: Attached is a letter dated April 29, 1996 from Mr. Ralph Crossen Buil ding Commissioner for the Town of Barnstable, that Lot 31 is a buildable lot from a zoning perspective. Mr. Crossen's letter is based on and limited to the facts and information in my letter dated April 29, 1996 to him, also attached. My letter to Mr. Crossen was for the limited purposes set forth in paragraph two of Addendum A of the Purchase and Sales Agreement, dated April 1, 1996, between you as Buyer and Thomas F. McAndrew, Seller for the above referenced lot and is not to be used or relied on for any other purpose or by any other person other than Ralph Crossen. Very truly yo sr, MRS/ko r Enclosure MYER R. SINGER ATTORNEY AT LAW (508) 398-2221 26 UPPER COUNTY ROAD P.O.BOX 67 FAx (508) 398-1568 DENNIS PORT,MASSACHUSETTS 02639 April 29, 1996 via FAX: 508-790-6230 Mr. Ralph Crossen, Building Commissioner Town of Barnstable 367 Main Street Hyannis, MA 02601 Re: Lot 31, Land Court Plan 36608-C 54 Roosevelt Road, Cotuit, MA Dear Mr. Crossen: I am writing to request a determination from you that the above-referenced lot is buildable for zoning purposes as a nonconforming lot exempted from the current minimum lot size provisions of the Town of Barnstable Zoning Ordinance. I have been informed that Lot 31 as shown on Land Court Plan 36608-C (copies of Sheets 3 and 4 of the plan are attached) was originally created by a subdivision plan submitted and endorsed in 1973. Lot 31 was released from the Planning Board covenant in a release recorded in July 1978 and was conveyed to G. Richard Barry on May 15, 1979. Since that time, Lot 31 has been held in ownership separate from that of the adjoining lots shown on the plan (Lots 23, 24., 25, 30 and 32) . In March 1973 the Town of Barnstable increased minimum lot size requirements for zoning purposes to one acre. According to records at the Barnstable Registry District of the Land Court, Lot 31 was conveyed into ownership separate from that of adjoining land within eight (8) years from the endorsement of the original subdivision plan and has been held in such separate ownership since that time. The Lot has a recorded release from covenant. The Buyer requests a written determination from you that Lot 31 is buildable. Thank you for your attention to this matter. Very truly yours, MRS/a Myer R. Singer Enclosure ,.,.. ....,. <_... ...: ... ..,... ... .,, '.. a .Y.'.::. ......t' ._ .... .>:,M.,. :1 h It ...via - The Town of B . „MMAN4 . arnstable NEJAM �0� Department of Health Safety and Environmental Services AD1'0`p Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Fax: 508-790-6230 Ralph Crossen Building Commissioner April29, 1996 Mr.Myer R. Singer Attorney At Law P O Box 67 Dennisport,MA 02639 Re: Lot 31,54 Roosevelt Road,Cotuit,MA Dear Myer: Under the circumstances,you have described to me, Lot 31 is a buildable lot from a zoning perspective. Sincerely, Ralph M. Crossen Building Commissioner RMC/km { APR 3 0 1r�� I - C C •(D CO ' - - Q C cu U) a C Q235#Asphalt Roof Shingles _ JL W W E a f C = S - � o � E _... J U 77. IE Red Cedar Clapboard 1x6 Comer Boards � � ❑❑❑❑❑❑❑❑ EO 1x8 Water Table ❑❑❑❑❑❑❑❑ ❑❑❑❑❑❑❑❑ V • O Front Elevation - - _ Dare: 05-13-99 Scab: .3H611, . . SMet E-1 Revisions: Date: 64' 20' 22' 22' N 4' 6'6 6'6 T 11' 11' IN-20 L.F.WaI Out Half Wall — — — — — — — — — — — — — — — — — — — — — 2868 K< L-i C LL N I— — — — — — C14 — — — — Ctb _ _ _ _ _ _ _ _ _ _ _ _ _ _ — — — — —I O1 C v I. 4G"Frost Walls Wood Basement Windows ROP TO TOP OF FLOOR DROP 56' I O 'T fn _ O O o _ _•r_ ',. _ �' BEAM POCKET .' -._ .- - t":L ------------t -f-== .- - 3 12'Laney Columns "3-2x10 Beam-.Flush Frame WF10X26Stee1 - _ BF1A POCKETI 'x 'x 'Foongs Beam �. 1 GARAGE f W.Basement Windows f 8"z 4'6'Concrete WallsI — —_ — — — — — — — —- 16'x 10"Keyed Footings - _ I8•xg•ConeteWalls II 8•x g•Concrete Walls— — _ — _ — _ — _ I I C — — — — — — — — — — — — — —I - _ — — _ _ - O L _ _ _ _ _ _ _ _ _ L _ _ _ _ _ _ I- _ _ _ 16'6"OPENING DROP 1' .O 11,10 a 14'. 13 _. 54 228 Drawn: Che&ed: - _ NAL "- — Date:05-13-96 Scale:3/16"=1' .. . . _ - Sheet: F-1 - I Revisions: Date: 64' _ �14_ 28 15'4 O x 01 C34 C15-5 - - FWG6068 zo O MASTER BDRM LIVING- DINING m m 9 O o u . 3068 K-4 _ 310 118 4'- 4'8 cu .. CW14. - - _ CU oW 0 0 GARAGE C14 5� MASTER BATH KITCHEN ENTRY C14 C14 c u iv Desk I I C C135 C135 I I 0 m C35-CTC3 _ m 306g�K-2 - V L23 4-3—�k-2'8—.'�-4' - - - - - — - - - - — — — — - - 37 ` 1'11 l3' 37-1�2'3 6111- 4'6 a 4,6 3' t=- 11'2 11'2—�I a �5'6------�1'11-I —67 -I� 912 3'10--'f�--9' I 28' 64' Drawn: Checked: NAL Date:05.1396 Scale:3116--1 SheeC A-1 - Revisions: Date: g t I 142 14'4 13-6 22' 7' T2 T66'101-8-6 6' p1 m 7 LL CW24 - - C14S-6 CW24 o__ - - - - -- OPEN BELOW C BEDROOM BEDROOMo co ui a _ - - - - = m _-B Wstered Rail -6K 4._ - - - cu 4 _ ...-_ - .. HALL _.. - BaWstered Rail ._ ._-. . BATH <. E r z _ Oak Staircase voth Bala Rail stered OPEN BELOW L - - 1 14' 9'4 4' J. 9.6 4'10 224 - Drawn: Checked: NAL Date:05-13-96 - Scale:3116'=l' Sheet: F-1 235#Asphalt Roof Shingles � c o o P777 rn o _ 7L m a -. _ Whit e e Cedar Shingles C = cu -A. -White"Cedar Shingles TG6�se, cts cas cs _ _- _ r _ E _ Deck b Owner er _ U cu E - U ear Elevation o Oime: 05-1396 .. M—L E-2 Re�isims' U O C . .. - cc C y� k t3) O I C U8 w/U3 Rakes m � r N 42 cn Etm t cu White Cedar Clear Shingles J U C 4 - 1x6 Comer Boards Deck by Owner E - O - Right Elevation o ' _ U O ._ - — Drawn: Ch,tlteG RAL . - Data: OSt396 s BeL E-4 Ridge Vent C p) C 1x8 w/1x3 Rake y ) E � fY LL (0 c — D ... White Cedar Shingles - •� Q ,� cu J U • N Deck by Owner — E f0 _ .0 E O - H Left Elevation a ' •o ChoCked : 05-13-M Sheet E-3 I I 2x8 K.D.Rafters 2x10 Ridge 1/2"CDX Plywood Roof Sheathing 15#Asphalt Roof Paper 235#3-Tab Fiberglass Roof Shingles 12 Scale 1/4"=1' 12 • 4+/- 1x8 Ledger Board Brac Z 12 1x8.Brace 2x10 K.D.Rafters 0 1/2"CDX Plywood Roof Sheathing W 15#Asphalt Roof Paper Q 235#3-Tab Fiberglass Roof Shingles p 5 3 2x8 Ceiling Joists Z Z Q E Z 3 2x10 Floor Joists 16 O.C. c 3 3/4"T and G ULC — - Glued and Screwed m 'v " 2x4 Kneewall < $ Fireblocking 1x8 Pine Fascia Z E _ o m 1x8 Pine Soffit = 2x4 Plates _ w 2"Aluminum Venting d c 2x4 Studs 1/2"CDX Plywood Wall Sheathing Tyvek Housewrap r White Cedar Shingles 5"T.W. 4) E O 2x6 P.T.Sill = 2x10 K.D.Floor Joists 16"O.C. 3-2x10 Girt 1/4"Sill Seal _ 2x6 P.T Ledger 3/4"T and G ULC Subfloor Spaced and Bolted 16"O.C. Glued and Screwed .. 2x6 P.T.Deck Joists 3 1/2"Concrete Filled Lalley Column 8"x7'6"Poured Concrete Walls O Double 2x8 P.T.Box Joists s- 5/4 x 6 Decking Asphalt Damproofing 10"x 36"Poured Concrete Sonotubes O 3 1/2"Poured Concrete Floor a 8"x 10"x 16"Keyed Poured Concrete Footing 8"x 7'6"Poured Concrete Footing Section A-A S-1 Com~nweaP ft{i of Mamachu6etb 2apartment 01 JndudfriaL,./d dLnb 600 Wdlunyton James J.Campbell &.&ton, Maaachu nlb 02f f f Commissioner Workers' Compensation Insurance Affidavit (lleeuseelp-mim") with a principal place of business at: (cuyistee�zie) do hereby certify under the pains and penalties of perjury, that: I am an employer providing workers' compensation coverage for my employees working on this job. v ZS" Insurance Company Policy Number () I am a sole proprietor and have no one working for me in any capacity. O 1 am a sole proprietor, general contractor or homeowner. (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number () I am a homeowner performing all the work myself. I understand that a copy of this statement will be forwarded to the Office of Investigadons of rho DIA for co%Trage verification and that failure to secure coverage as required under Secdon 25A of MGL 152 can lead to the Imposition of criminal penalties consisdn¢of a fine of up to S 1,500.00 and/or one years' imprisonment as well as civil penalties fn the form of a STOP WORK ORDER and a flee of S 100.00 a day against me. Si ned this day of _1-14cl 19�/� Lice nieV P m-itte&Q Building Department Licensing Board Selectmens Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 TOWN OF BARNSTABLE BUILDING PERMIT # S£9Z0 V1 `1In103 Ier3No+ss+wwa� SE9ZO VW M103 i101`dLlLSINIWOV I 3NY1 1n33NtlNl £t '9 Q ""°m:t� auEl VAU841 cjn "�� SONIOV91 d SviomN <77;;_ soutpe6el 'd SEj043TN J 00 , SONIOd9tl1 Stl10HOIN of pa�au;saa::` � PS6T/91/LO L66T/9T/10 £59ZI0 SJ 86 a;at¢PgilrB aalidz3 - __, :;jaqIaN + ? atdz3 /ST/LO uotge 3SN33I1 SOSIAORS°N0IIJUISH03 — 1df10IAI0NI - adAl j toml u014e11sTBOS (. 11311S II191d JO 11111bdd30 8013tl81N00 1N3W3AOadNI 3WOH I j Io _ - - - - Restricted To: 00 00 - None License or registration valid for in lA - Masonry only . use onl y y before expiration date. If found I Failure to possess a sorroat 16 - 1 5 1 Faeily Noees maa,aohrsnera r return to:One Ashburton Place Rm 1301 + _ C"o 1s caa"for revocation � BOS on Ma.02 of th%a/icanas. I OF tNE 1p� a : . The .Town of Barnstable - EARNsrABM • 9eb MAS& �' Department of Health Safety and Environmental Services ArEo 61 Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner, April29, 1996 Mr.Myer R. Singer Attorney At Law PO Box 67 Dennisport,MA 02639 Re: Lot 31,54 Roosevelf Road;Cotuit,MA"; Dear Myer: Under the circumstances,you have described to me,Lot 31 is a buildable lot from a zoning perspective. Sincerely, '00000< Ralph M.Crossen Building Commissioner RMC/km APR 29 'gs oe:22 MYER_R_SINGER P.2/4 y MYFI2 R. SINGER ATTORNEY".4'T 7,AW LI6 UFFE,1,C01C'NTY ROAD (508) 398-2221 P.o. xsoa 67 FAX(508) 398-1568 DENNIS rox T, NIASSACILUSEIrTS WWII) April 29, 1996 via FAX: 508-790-6230 Mr. Ralph Crossen, Building Commissioner Town of Barnstable 367 Main Street Hyannis, MA 02601 Re: Lot 31, Land Court flan 36608-C 54 Roosevelt Road, Cotuit, MA Dear Mr. Crossen: I am writing to request a determination from you that the above-reterenced lot is buildable for zoning purposes as a nonconforming lot exempted from the current minimum lot size provisions of the Town of Barnstable Zoning Ordinance. I have been informed that Lot 31 as shown on Land Court Plan 36608-C (copies of Sheets 3 and 4 of the plan are attached) was originally created by a subdivision plan submitted and endorsed in 1973. Lot 31 was released' from the Planning Board covenant in a release recorded in July 1978 and was conveyed to G. Richard Barry on May 15, 1979. Since that time, Lot 31 has been held in ownership separate from that of the adjoining lots shown on the plan (Lots 23, 24, 25, 30 and 32) . i Xn March 1973 the Town of. Barnstable increased minimum lot size requirements for zoning purposes to one acre. According to records at the Barnstable Registry District of the Land Court, Lot 31 was conveyed into ownership separate from that of adjoining land within eight (8) years from the endorsement of the original subdivision plan and has been held in such separate ownership since that time. The Lot has a recorded release from covenant. The Buyer requests a written determination from you that Lot 31 is buildable. Thank you for your attention to this matter. Very truly yours, Myer R. Singer MRS/a Enclosure i APR 29 '96 08:22 M'YER_R_STHGER P. 1.'4 NIYEP P. INeJEF� .. T OIZNEY AT LAM (508)398-2-121 F'.U.BOX 67 1)L0SN h;' FORT, FAX COVER SHEET For your: DATE: L � j�q(�, Information TO: ��. d�9sS .'► Approval C�v+ CAD/$44c Action I FAX: 50 g"- t✓-1��3 O Comments RE: L.o+ -? Number of Pages to Follow. MESSAGE: 1 r � ..g, U6 z� i 4*,*So L L Ada r 09" �� .y_21 6 a tb 3 d a _ _ .. s 00 240 _ 5� ` y�J Oq\\ � � � •. �d -tea� � v �, ` Q ���'� al �J. `` y��o 0a. � AN �0�9• j�3 r . i�5 0� ' 3 v� � � ® ILw� SOic •Oe t ?4 - - y v oL ty Ch PAR. sco% of 'Ohl$ Pion RCS feel to un inch (see sAee1 �3 �l APR 29 '96 O5:25 MYER_R_SINGER P.4/4 S HFF7 4 Of 4 lip' 0 20 I tiQ I 49 35 r o b n i►M c � .4 It o ro ' s f' 52 ti a .54 b yr �t r ggTy.O tq a� r C4 v s 1 ` v J p 04P 54 a� G h 'h 1 14r 6 n 55 Sea f I ' I I A Scolc of thisfeet to on onch CALL A.M. FOR DATEV-2�' TIME P.M. M , -e-r :S , PHONED OF �-- RETURNED P H_O N E YOUR CALL AREA CODE NUMBER EXTENSION SE CALL MESSAGE 1hliLL CALL'- AN Q CAME Z'a SEE YOU ; WANTS TO S I G N E D live SaI' 46003 ` NOTES IAPR 19 '96 13:19 MYER_R_SINGER P.2i2 I%IYER Fes. SzNaE a ATTORNEY AT LAW (508)398-2221 i:e UPPER ICOUN`Y RpAy FAX(508)398-1568 P,0.BOX 67 DENINF18 FORT,MASS ACR USLTTS 026313 April 18, 1996 Mr. Ralph Crossen _ Barnstable Building Commissioner Barnstable Town Hall Maim Street Hyannis, MA 02601 I RE: Lot 31 (#54) Roosevelt Road, Cotuit Dear Mr. Crossen: I have been requested to determine from the records at the B rnstable Registry District of the Land Court it Lot 31, as shown �,e have been informed is known as oosevelt Mass. is currently or has been in commonowners zp in st +with any adjoining Land. Lot 31 was owned in common with Lots 23-, 24, 25, 30 and 32 as of October 21, 1977. Lot 31 was conveyed to a G. Richard Barry on May 15, 1979. Lot 30 was conveyed to a flax Paola on October 23, 1978. Lots 32 and other lots were sold to a Robert Crossman on July 12, 1978. i Very trul yo s, i I///M R. S ' g MRSlerl ViA f x 771-1282 cc: Sandy Cotter, Realtor Walsh Realty 610 West Main St. Hyannis, MA 02601 i I I L �01 ,qr,_ j of 4f COTUIT BENCHMARK. /! a $RUC °- y TOP OF TAGEOLT #205 / r.: MiU PH moo- 3 ON HYDRANT r �� to ELEV.=100.50' (ASSUMED)�� , (— / , LOT 30 '� �o�tss�o�' Q POND LOCUS °' ~ EIctE OAD 199, 95 LOT 25 LOC&15 MAP �O a PLAN REF. 36608C SH. 3 RES. ZONE RF / 1 FLOOD ZONE- "C." ti' P"z� 96 TO TWN WATER A V_4 ILA RLE o— 1 LOT 24 97 GAR i F \ ~ PROJEC T L OCA TIOIV . 190 r \ \ \ 54 ROOSEVELT ROAD - CO TUIT, MA. i APPLICANT. AIICI� LA �ADINO,S _ LOT 31 �o AREA= 23,458_:�- S-F I YA NKEE SUR VE Y CONSUL TA N TS P. O. " BOX 265 I UNI T 5, 403 INDUSTRY ROAD MARSTONS MILLS, MA. 02648 PH. (508)428—0055 — FA X(508)420—5553 SCALE. 1»=20' ��DAT�- 5/8/96 ,• REV.- REV.- - LOT 32 JOB NO. 50959 =SHEE1 OF 100 TOP OF FOUATDATION _ 20 MIN. ! . 10, MIN. CONCRETE COVERS 4" SCHEDULE 40 P. V.C. MIN. PITCH 1/8 PER FT. 2"LA YER OF - 1/8,.-1/2» REQUIRED 'I6" MA / ✓ � , , � CONCRETE COVER WASHED STONE 93 6' MAx 4" CAST IRON PIPE RISER ^ , , ,i •, , , (OR EQUAL) MINI4UM CLEAN SAND 12„ �i�i i PITCH 1/4 PEP, FT. RISE MIN. I iI FLOW LINE EL.= 90. 50 INVERT i 10 14 aow aeav+r MIN. 91.50INVERT �z 0 ° o o ° o 0 0 CAS BAFFLE LEVEL o 0 0 0 0 0 0 ]N E5RT. l I El.= 91_00 INVERT INVERT °" ° 0 0 0 0 0 0 0 ° °o ° ° 0 EL.= 91.25 EL.= 80.DISTRIBUTION 75T /j�D T j jr]ETL.=j�9j0_50 0 0 °°o o ° ° o o ° i L/1�11 L1BCJ 1 1 Ol'V INVERT 0 0 0 0 0 0 0 0 0 0 0.0 0 0 0 0 TO BE PLACED ON FIRM BASE 6'" STONE � — 90 0 0 o 0 000 0 ° ° o ° ° ° o �8. 00 ( OR MECHANICALLY COMPACTED EL.---- 0 ° ° ° ° 0 -L' —_— BOX t --1500--CA'L L ONS SEPTIC, TA A;nT' TO BE WATER TESTED 40 IF MORE THAN ONE OUTLET J� \ _ PLACE IC 6" STONE OR SOIL ABSORPTIO_f��MECHANICALLY COMPACTED 3/4" TD 1-1/2" O O 6YASHED STOATS ,S YSTE I S> - - , !\ INSTALL 2 TRENCHES 40' LONG, 4 WIDE & 2' DEEP S E W A C DISPOSAL SYSTEM j-I BOTTOM OF TEST HOLE OR USGS PROBABLE WATER TABLE ELE V. = 8 4. 00 NOT -TO SCALE NO OBSERVED T41ATER TABLE ( 5/9,/96) ELEV. 84_00 NOTE.- EXCA VATE TO 13' TO CONFIRM MED. SAND_ SOIL CO\%DITIO_NS OBSERVATION HOLE I ELEV=_96" - - ! PERCOLATION RATE _5 MIN./ INCH AT _60_ INCHES . OBSERVATION HOLE 2 . ELEV. =-97?_ 3 j DEPTH HORIZ TEXTURE COLOR j MOTT. OTHER DEPTH IHORIZ TEXTURE COLOR AfOTT. OTHER 0"-12" 0/A SANDY LOAM IOYR512 0"-12" OIA SANDY LOAM* I10YR5/2 I j ti 12"—36" B LOAMY SAND 10 YR5/6 12"—36 ' B LOAMY SAND �10 YR516 GENERAL NOTES 136"-144 CI MED. SAND : 10 YR6/6 PERK 36"-138' C1 MED. SA11 O 10 YR616 1) ALL ff"ORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. j TITLE 5 AND THE TO WN OF _ BARNSTABLE—_ RULES AND . NO WATER, NO WATER REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2) ALL COI�ERS TO SANITARY UNITS SHALL BE BROUGHT TO j TYITHIN 6" OF FINISHED GRADE. DATE OF SOIL TEST MAY 9, 1996 SOIL TEST DONE BY BRUCE G. MURPHY R.S. 3) ALL' COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN WITNESSED BY: ED BARRY 10 FT. OF DRIVES OR PARKING AREAS. H—20 LOADING SHALL BE P ti 86cf I DESIGN CAL C ULI TIONS. USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. NUMBER OF BEDROOMS . 3 4) ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL GARBAGE DISPOSAL No BE MORTERED IN PLACE. TOTAL ESTIMATED FLOW ' f 5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH ( I1 Q-_GAL./BR./DAY x --a_ BR.) 330 GAL/DA Y DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO REQUIRED SEPTIC TANK CAPACITY 1500 GAL C+ OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. SOIL CLASSIFICATION . 1 6) UTILITIES SHO WN ARE APPROXIMATE ONL Y, EXCA VATION CONTRACTOR DESIGN PERCOLATION RATE 5 MIN./IN. IS TO CALL 'DIG- SAFE ' AT 1-800-322-4844 AT LEAST "72 HOURS i PRIOR TO COMMENCING WORK ON SITE. 'EFFLUENT LOADING RA TE . . . . . . 74 GAL/DA Y/S.F. 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS LEACHING CAPACITY (AREA X RATE) 496 GAL/DA Y SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE' RESERVE LEACHING CAPACITY . . . 496 GAL/DA Y 8) PARCEL IS IN FLOOD ZONE-- C — - 2@(40-1-4O*' 4-1 4X. 74X2),L(4OX4X. 74) _ 9) LOT IS SHOWN ON ASSESSORS MAP 36 _ AS PARCEL 133_ JOB NUMBER_ 50959_. SK 2 OF 2