Loading...
HomeMy WebLinkAbout1676 SANTUIT-NEWTOWN ROAD /� �� � ��� �� . .j ._ '� i a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel � Application #A— Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis II 11�� Lii i Project Stre Qt AN �/Address 1��� ��� nJ �(/(� TOW Village �'�(, N OF BARNS_fABr_� Owner_ G� �Clj�l�I�AG��i Address Telephone Permit Request &V- L 70 , - cmawliwe- �4V 9- 2-1 clo�e�_T Square fee : 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation `/ Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 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 If yes, site plan review# Current Use �No Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) _ Name l Telephone Number Address I 2dW1MCJV_dJ2) License # V Home Improvement Contractor# Email ` Worker's Compensation # CF ob ALL CONSTRUCTION kBRIS RESULT G FROM THIS PR EC�(Tp�WILL BE TAKEN TO SIGNATURE DATE 1 FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE 5. + OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 4 The Commonwealth of Massachusetts Department of IndustrialAccidents h' Office of Investigations M l Congress Street,Suite 100 J' Boston,MA 02114-2017 www.mass gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Cape Cod Insulation Address: 18 Reardon Circle City/State/Zip:South Yarmouth, MA 02664 Phone#:508-775-1214 Are you.an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with 48 4. ❑ I am a general contractor and 1 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' insurance. 9. ❑Building addition comp.[No workers' comp.insurance P• required.] 5. ❑ We are a corporation and its 10.171 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their I LF]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 13.0 Other Weatherization employees. [No workers' 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. 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:Atlantic Charter Policy#or Self-ins.Lic.#:WCE00431902 Expiration Date:.,,,6/30/2017 Job Site Address: 164U City/State/Zip: kl,i 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 pains and penalties of perjury that lire information provided above ' true and correct. Si Henry Cassidy �,�q�� -� a e: �:w����..-.� �,� Date: Phone#: 508-775-1214 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#' CAPECOD-27 KDOYLE CERTIFICATE OF LIABILITY INSURANCE FDA 0TE 3 / 03/30/2017Y) 017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must 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 ACT Rogers&Gray Insurance Agency,Inc. PHONE FAX 4 O Rte 134 A/C No Ext: A No: 877 816-2156 South Dennis,MA 02660 �p?fissa mail@rogersgray.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Peerless Insurance Company 24198 INSURED INSURER B:Safetv Insurance Company 39454 Cape Cod Insulation,Inc. INSURER C:Endurance American Specialty Insurance Company 41718 16 Reardon Circle INSURER D:Atlantic Charter Insurance Com an 44326 South Yarmouth,MA 02664 INSURER E 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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY'EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR R/O CBP8263063 04/01/2017 04/01/2018 DAMAGE TO RENTED occurrence) $ 100,000 EMISFJ MED EXP(Any one erson $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑wT LOCH PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO 6232707 COM 01 04/01/2017 04/01/2018 BODILY INJURY Per Person) AUTOS ONLYX SCHEDULED 1,000,000 IRE pN py�/�Ep -BODILY INJURY Per accident $ X AUTOS ONLY X AUTOS ONLY (ROa.' nl AMAGE $ $ C X UMBRELLA LIAR X OCCUR EACH OCCURRENCE 2,000,000 EXCESS L1AS CLAIMS-MADE R/O EXCl0006635001 04/01/2017 04/01/2018 AGGREGATE $ DEC) I I RETENTION$ Aggregate $ 2,000,000 D WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WCE00431902 O6/30/2016 OW0/2017 E.L.EACH ACCIDENT 1,000,000 FICER/MEM EXCLUDED? N/A andatory In�Ij 1,000,000 If yes,describe under E.L.DISEASE-EA EMPLOYE $ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 11000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached It more space Is required) Workers Compensation Includes Officers or Proprietors. Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE For Informational Purposes THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE G ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Massachusetts Oepartment of Publlo Safety Board of Building Regulatlons and Standards License; CS-100988 Conatrvotlon Supervisor, " HENRY E CAS•810Y� 8 SHEO ROW ' ,f,n, ' I % oil l ` F WEST YARMOV;TH ,$' +{ •I ;. i Expiration; Co missloner 11111/2011 t b e Office of Consumer Affairs and Business Regulation 10 Park Plaza -' Suite 5170 Boston, Ma d,�i usetts 02116 Home Improvem:5:Ce-y1ractor Registration Type; Corporation �' �;, - x• Registration; 153587 Cape Cod Insulation, Inc Expiration' 12/14/2018 18 Reardon Circle So. Yarmouth, MA 02664 a Update Address and return card, Mark reason for change, �i 20M•06lit ' �e�arrr��conruea�C/c oyo�aaoac/uaeCA " Office of.Consumer Affalra&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only i Trhe; Corporation before,the expiration date. If found return to: " Expiration Office of Consumer Affairs and Business Regulation gg�� 12/14/2018 10 Park Plaza•Suite 5170 Boston,MA 02116 .ape Cod insul ienry Cassidy 1 8 Reardon Ciro C�R.CG•Qw� 30.Yarmouth, Undersecretary Not v d w 19 t r , Town of Barnstable Regulatory Services Rich"V.scab,Dh-mtor ins¢;,• B"ding Division Tom Perry,Scolding Commissioner 200 Main Sorel Hyaani%MA 02601 www.town barastable.Rta.us arcs: 508-862-4038 Fax: s08-790-6230 Troperty Owner Must Complete and Sign This Section Ifs , r Urs h pan -,zs)Ownerof1dies&jecrpmpeny lml:y atuhor&e ` Q� to act on my bebalf, is all.mamem relative to work aunhoiized'by this building pem it application for. {Address of Dols} "Pooh fences and alarms are the responslik.of the applicant.Pools are not to:be filed or ttized bef or stallod e fence is in and all final ections are performed and accepted: .aturre of Owner Signature of.Applicaat �lla js�i�ucn Prim Name Print Name Date Q.FORMSAU+NERPF MISSlONPOOT.S TOWN OF BARNSTABLE } CERTIFICATE OF INSPECTION PARCEL ID 024 036 GEOBASE ID 1250 ADDRESS 1676 SANTUIT-NEWTOWN ROAD PHONE COTUIT ZIP LOT BLOCK LOT SIZE I DBA DEVELOPMENT DISTRICT CT i i PERMIT 47474 DESCRIPTION CERTIFICATE OF OCCUPANCY PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: PROPERTY OWNER Department of Health, Safety .ARCHITECTS: and Environmental Services i TOTAL FEES: BOND $.00 CONSTRUCTION CASTS $.00 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE PI * STABLE, + MASS. Ep�Cl BUIL N BY DATE ISSUED 07/17/2000 EXPIRATION DATE o PARCEL ID 024 036 GEOSASE ID 1250 ADDRESS 1676 SAN`€UIT-NEWTOWN ROAD .PHONE COTUIT ZIP LOT _ SLOCK LOT SIZE DSA DEVELOPMENT :PERMIT 42221 DESCRIPTION ADD 2SDRMS/G,ARAGE SRWPT 95-.17l9 PERMIT `HYPE I ADDI TITLE BUILDING PERMIT ADD'I J.°I.ON ..Department of Health `iS'afety CONTR:AMORS` PROPERTY OWNER ARCHITECTS:S: and Environmental Services 10TAL FEES: $144,58 THE BOND $'00 CONSTRUC`ION COSTS $43,640,OU ; 434 RESID ADEi/4LT/C0NV 1 PRIVATE :P.;,°`i'. M ` •F . BUILDING DIVISION BY DATE ISNJED 11/04/1.999 13MRATION DA',PV THIS PERMIT CONVEYS NO RIGHT TO OCCUPY.ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN-, CROACHMENTS 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 MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OFTHIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED.; FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND . WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (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. BUILDI §PECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS mole 2 2 2 •�S '/ / • 3 C 1 HEATING ECTIO PPROVALS ENGINEERING DEPARTMENT OARD OF HEALTH 2 OTHER: L ��iY I. SI PLAN REVIEW APPROVAL WORKS ALL NOT PRO EED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS :. TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. y t. S 1 S k' r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ' SEPTIC SYSTEM MUST Map ®g? Parcel f'o INSTALLED IN COMPLIA%cd mit# Health Division `" . 17 l 9� WITH TITLE 5 DateLrssed IENVIRONMENTAL CODE AND Conservation Division ` T�3WN REGULATION'.3 Fee% =U Tax Collector Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis , • i rb F s` Project Street Address /!`o Village 00 kw Owner 1Jo- b/sh&M -Address 41ew `dIOJ . ,a lt?/w/r�0�.�s Telephone Permit Request 'addlh16n y ems1k. ch',On 9/ olu CQQ2 gleg g Square feet: 1 st floor:existing ����l1proposed 7 2nd floor: existing A lZ ti proposed Q Total new 7W' Estimated Project Cost �"l foning District /U S Flood Plain ll0 Groundwater Overlay Construction Type /P&JU (r uL Lot Size Flo SOU S l` Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ! Two Family ❑ Multi-Family(#units) Age of Existing Structure X9 Historic House: ❑Yes k No On Old King's Highway: ❑Yes 4rNo Basement Type: d(Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) A-la Basement Unfinished Area(sq.ft) Number of Baths: Full: existing _ 1 new Half:existing new Number of Bedrooms: existing 0 new Total Room Count(not including baths): existing new \9 First Floor Room Count Heat Type and Fuel: 4,Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes 4 No Fireplaces: Existing New Existing wood/coal stove: ❑Yes No Detached garage:14 existing g new size/ z Pool:❑existing ❑new size Barn:❑existing ❑new size T— Attached garage:❑existing ❑new size Shed:❑existing ❑new size A. lc Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes KP No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name /UaCULL Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE tic- ` ` DATE `l 7 FOR OFFICIAL USE ONLY T S.PERMIT NO. DATE ISSUED MAP/PARCEL NO. 44! _ ADDRESS VILLAGE P OWNER" DATE OF INSPECTION FOUNDATION:% 4 ?-`i • 1 I , FRAME 6 _ Cs INSULATLOI o FIREPLACE _ . :7 ELECTRICAL:, ROUGH FINAL PLUMBING: -ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING' DATE CLOSED OUT F ASSOCIATION PLAN NO. JAN 04 '00 12:57 ARCAD IA REALTY BB°��/:.ig A_.�_/� .... � �1 1 T 1 '� �i7�✓ � ..-- r_... DAtF'IM,lV1�P7Tw P ,.,...,,,a...�.. ....a..... 7 Q ?v CERTIFICATE OF L r _._. �.__,{.._.......�... ._.— <�...,. :..._ .. T111S CEFiT►P/II ATE: 1S iS�UF.0 AP, A ?4A1'•.,�.�,...,.;11NF0F1Q06•.;C--...,. IluCtr, F.' I h_.� c.__.. .. ,....,.. A q IIdI�gPIA3¢bTtO�i Air+i A Gxa2�i:1 Insurance 11«ertr L',c pN xTENO 01E �k AND CONFERS NO KIOHYS uPQN THE CEATIFlCATE :i n Y HOLDEF1" TM18 CERTiFiCAT9 DOES NOT AMEND. F. %)X .137 �' ALTFA TN£ cov aar�x.:�i*tip sv T►a Po"C" 1 .iJU4w'• t p4.+elo I.hl 4 the I1ll�fd�: 1N$11JAEAS AFFORDING COVE11A01 fnilc ;r#xvaeA A E•sSurdnCe Company of America cha,al Role ' rNeL+nLna Nnrthern Insurance ComWy, of. Nowlork" A Rolfe Construction {; 0 Box 864 INtluas�a I ands MA. Q260I it PC'C1GItS OF IWSWAANCE'LISTED BELOW MAVF.eE6N ISSUED TO T j E INAUSED NAMU 0 As-,VE FOR!},.E POLir;v 05PIC'j 11`40!C-A7F1) rYC]TIYITMSiOt�fjINC NY(f;0U1PoETAFNT. IEFiMOp CUri171"rj<�N•iJF Aivf (:,>t.i7nAG' OR U 'H>`P 0Q4vKr4T`PPT,, ;,E�, EIT Yi,',�.Vr+i;;�i '%il$ C'kH'11r�(:Ai'E M,%Y 9E I�'tiUL•.t7 dT'� ' AY Pi:`kITA+k_TWS 1115UAANCF NiFQ�1')c I:Sr rMf rGe.C,r6S CiE�C;n+E f7�iEAfIN t.^:itJ i.1FC` 'fi A ,.. t r+f: T°�;+[ ;:`IC;i.1:5;Cfr,< hair Ct:1ND:r!;)n 3 O,E k;0; i )CICk:5.Agr;;Af;CiATE LIMITS.kidWM WAY rt.AVs..BEEN rtEC7A Cf.'J BY .AID C(AfMi I- T1MlOtEM1UpAMGE PGIi�:'rNUrABEA a ICt�rG4!/I8Cfi4r.'.y y,■^^.1♦L��I/�••� .w�..�—.—_—_..._..w.w„w.�.,,�_.— W�I,.a'1®Y lAIIG X:., v.21A2'Y1EA1tDieTt`..ti- �•M.A..Y....P.«-•-•-.L--W-1..1.•:..r._f...+/..��.... t,M11 f� 1� y + A '.�IAMtf pIClAi..QE'NE.RAULIAN(LITY t i Fiftf UA+y+AO((Afly S,no+i'a! 13 1 ... . 1 GL.AIa"M g I X',`6CCV6+ C MFiY FXP(Arrp'and ydrtdll) {f 500Mtom j ?f f4S4NAl b AQY 116.lL+RY R I f 19ENERALAaOAG:0AIL Od„'+,AQ4ASOATE6IMITAPPLif16Ylm.!;SCP 31045642 107/11/99 07/It/0() i �a t7i,.'Y5 CG«IP,cPAaC b 1ow : I:OI ICY i 12CI AU1YtMOMs MAtiA.m 1 04111 ;>NHi a I.,!N, i')tr h1111 I�n d1i'U(t+ltl) AIL VYPN!'U AVIVrY ( j Nocm Y I1V.,v"v ?.f I i i 4Per(A�d0f11 ,isC"j0QVE0 AUTOS I iTRED AyTQ% _ i dQO)L Y+NJUPIV ++ON GWNLD:AU.TOO . •, „ 'p6ic;�+'LRTY CtAMA4G j INH dCC+OYnii .. OARACti L1ANL1Tx AU'10ONLY'EA AC(,+UCNf .• i ' ANY AVTQ I I psHtN TMAN , CA ACC. 4. I i AU TO ON V ArJV: S CLAIMS MADE ! A30HtC�ATC f 11iQtIGTIMLC. ; , -- +M01TttIMR1 CelRa�4lTi"AND ( VNY iA :tMIY>i GA IM4.QTN1er!'1t"UTY I IaI cNCl1AC:IflE+VY >f.,�(V��(T}T�' '�'_t ! i OIA AV•EA ErKPt.114e 5.� 1 f ;TW 98553538 id/Oi,`99 L. / �.. '+seA,e•Fo.,_Y,:M+r1 s . OW pMA+:rdt of QVEAJI7MJ!y OCAYiQNO(VE/1rCLEaNxCtc+i,S��ab�Dt�O jr thDOM MiNTMCC AL PROM%QW) NTtst1'�AYE MdLC?�A r��fflONA1,+N9u�+tya; N�Uf3EP1 t9Y'iA CANCELLAT V4 640W:0 AM Y.Q}'lfilr Aticiv(')EyCRiLEG 000Vf:1 lie.Atit'Gi,:GU APJP�CyPIt'fYlii 81{/KA f? 1a 07 ShmBri QA19 tHONf.V`'. n,C($SVING UtAVAEN'rtILL CHODRA'v0A YQ MAIL�V 011Y8j NiRCM `�eW, OH'Ly IRoadNpTiCFTPYwH+.AAfiN+G1YE�IOLgf'i9NkMtvlOTNif.G`I.Au',IA10ACYoW4CSMALi' 11 � .. . `, I , t LI t't, Kk Q l b 4 5 ,MP06%NQ obt QATSUM�'1N LIAW.11Y OP ANY KINL!UPON T!f£I141309 C�1I'0 A✓INTI IDA is AC()An An3a.gtirp71.�..._ �..�. T.—_......._~.,.�...�� _._._,.« . ..v _,— ---�_ �•..., ;, �)itDdRkIIE� t9.�..; MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2.0 (c C Checke ,by/Date CITY: Hyannis STATE: Massachusetts HDD: 5973 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 11-4-1999 z DATE .OF PLANS TITLE: COMPLIANCE: PASSES Required UA = 136 Your Home = 136 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value �UA _,. CEILINGS _. 728 30.0 0.0 i '26 WALLS: Wood Frame, 16 O:C. 556 15.0 0.0 43 GLAZING: Windows or Doors 63 0.400 25. DOORS 21 0.350 ,. 7 FLOORS: Over Unconditioned Space 728 19.0 35 -- -----.-----71------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with-the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load' if appropriate has been determined using the applicable Standard Design Conditions found ' in- the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections 780CMR 1310 and J4.4. Builder/Designer Date , MAScheck INSPECTION CHECKLIST Massachusetts Energy Code ._..MAScheck 'Software Version 2.0 DATE: 11-4-1999 Bldg. Dept. Use " CEILINGS: [ ] 1. R-30 Comments/Location WALLS: [ ] 1. Wood Frame, 16" O.C. , R-15 Comments/Location WINDOWS AND GLASS DOORS: [ ] 1. U-value: 0.40 For windows without labeled U-values, describe features: #Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS [ ] 1. U-value: 0.35 Comments/Location �:. FLOORS: 1. Over Unconditioned Space, R-19 t: Comments/Location AIR LEAKAGE: ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations or installed inside an .appropriate air-tight assembly with a 0.5" clearance from combustible materials and 3." clearance from insulation. VAPOR RETARDER: _.. [ ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: ;,* [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. DUCT INSULATION: [ ] Ducts in unconditioned spaces must be insulated to' R-5. Ducts outside the building must be insulated to R-8.0. DUCT CONSTRUCTION: [ ] All ducts must be sealed with mastic and fibrous backing tape. ' Pressure-sensitive tape may be used for -,fibrous ducts. The HVAC, system must provide a means for balancing air and water systems. F TEMPERATURE' CONTROLS: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating - — and/or--eoolin input to- each zone or floor shall beprovided-;­ HVAC -- - - -- g p EQUIPMENT SIZING: [ ] Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in sections 780CMR 1310 and J4 .4 . MISC REQUIREMENTS: [ ] Refer to 780 CMR, Appendix J for requirements relating to' swimming, pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems. ----NOTES TO FIELD (Building Department Use Only)------------------------ - I i i ..- 1 WA[(.1LIGi c wir k 608.428.6191 o esigns i ` .ocy.v��z•ro i - �: Ii� i i _ F t �wttaserm�elWs�y-,,T-� I 'M -ftowu-lf _._ - 3 � 9 � U n..y our.ma uyow.ey ae.o..w ro.rai ode�r.nelr eww.<r.'omy way o r p—e . . — _ -gq�rae mu:.Tf+9uu - i 10I Z< q _�- d14•0191 .. _.-ale^-una�oena_a•lawul:'. @u%tom Ir-nFrnr-rrt�raq-=- (Resigns 1`` P•le 9eu' i uyom•by m.CU.ue my.nnyo uy pron�eue I 8 • ,. ' 'YvuRt.LYNC WINSLFJ r7r -. Fn -- y-A FFONf ELD/71TON. �- -S�IG1tt�F1t1/11Y10N _. - - .REhR Es6v,�'itON RINE T ' 11..•W Yw�1'ME. - ' .. .�-!101 3ktH'.G1i: i1'R� ulrHS .. '. • • 4 ' r w 1 �1-,,,--,- �........ B I 7•mkv+'us'ao°-a... 505.428•6191 �I I I c r evltn p i.� C�3ustom < I � i a esigns P I _:tamz t P.1LL Y ` r co F,9n�p 1999 9esrr vrO' W, N' F z r ns Q x 6,yo-i1 oy DC ply n y P.on.n.°r a ESTIMATED PROJECT COST WORKSHEET Value LIVING SPACE square feet X$55/sq. foot= Y200 4/4 GARAGE (UNFINISHED) z V square feet X $25/sq. foot= 6600 PORCH square feet X$20/sq. foot= t DECK square feet X$15/sq. foot= OTHER square feet X$??/sq. foot= Total Estimated Project Cost g990915b & Department of Health Safety and Environmental Services ��. P Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Cressen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT , HOME IMPROVEMENT CONTRACTOR LAW. SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: Q01dlhon '' AW) D" eA-L q2f2ye Estimated Cost k v Address of Work: /��� Al'e'-wkwl) Owner's Name: Date of Application: �� y I hereby certify that: Registration is not required for the following reason(s): Work excluded by law oJob Under$1,000 Building not owner-occupied ,Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MaROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR . Date ' Owner's Name q:forms:Affidav The Commonwealth of Massachusetts Department of Industrial Accidents office of/oYesffootfnos 600 Washington Street Boston,Mass 02111 v4 Workers' Corn ensation Insurance davit name 31)e//Q k S h&" location Ab whaw 'ed, city phone it 9�T / I am a homeowner performing all work myself. ❑ I am a sole vrovrietor and have no one worlds in anv capicity %//% / // /////%%/////%/%///%%/ //////////////O////% .1///// /%/////%///G/%/%%%/////�'///�/// /%/,%%///%//ITE,ff/11/1/1 ////G//%/////O%//�WIZINE///%/%%%//, I am an em 1 rounding workers'comnpensation for mq employees,working on this job. P oYerP :.... :.:.:..;::...::.::.............. .:......... ... .:,:.:,......::.::::;:<:,> cum anv name: a . : :: <:::...:.: : .<:.....:.; : :», ..>, ;%;/:: : > . n .::insurance co. ❑ . I am a sole proprietor,general contractor, o ' cle one)and have hired the contractors listed below who have the following workers' compensation poli g :::.:;:.::: :. :. cum anvname: ::.....:.:.,. :._.;:.. .. .::::::.; . .................................... sddress. :..::.::.........:.::...... ......... ..........:....... ............................ ::::::::.:::::.:::.:::...:.:....::.::::::::::::::.::::::::::::::::::::::.::::::::::.:::..::.::::::..::::.::.:::....................:.:............ ................ cih* :....................:::.:..::.::......:::............ ...........:.:..................p ................................................................................................................................ anv�nameXXX :> ... :::;. address. city.:.. .. <;a.. .............................................. .:.:::::::.....::..:::.:::::::.::.:::.:::::::.::::.;.;.:.::;;::. ><: ;. ........ ... ..:.;:.>::»;::«:>:«;?:;«:;:.:.:».;:.:.;::::::;;:.;.:::.::::::........;:.:;;;::;::;:...;:.:<::....:.....::»<::;::<::> ::» :.:.:.;.:. olio► "tit 1141 Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal pendties of a fine up to$1,500.00 and/or one years'ilnptisomneat as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do hereby certify the pains penalties of perjury that the information provided above is tru,and correct Signature -� Date Print name ` 1WIl �Ishlw Phone# official use only do not write in this area to be completed by city or town official city or town.: permit/license i# ❑Building Department ❑Licensing Board ❑check if immediate response i,required ❑Selectmen's Office ❑Health Department contact person. phone#; ❑ u.�-- (tamed 9/95 PJA) % - 367MainStreet,Hyannis tee. peg Office: 508-862-4038 Raiph Crossen Fax: 508-790-6230 Building Commissic HOMEOWNM LICENSE EXEMPTION Please Print JOB LOCATION: lea number sttea/{ 4��/y village RO,7IiO YIl\Git-. S•M lLI •/I ILK/1 �Ijs / / y�0 acme home phone d work phone s CURRENT MAILING ADDRESS: A1e whwq i� /V/7 dwitown `ode The current exemption for was extended to include owner-ecctmied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license, that the mmer acts as mu vi=or_ DEFINMON OFHOMEOWKM person(s)who owns a parcel of Land on which he/she resides or intends to reside,an which there is,or is intended to be,a one or two-family dwelling,amcbed or detached structures accessory to such use and/or fsnm structures. A ptnson who cwasnuets more than erne home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Officdal on a form acceptable to the Building Official,that he/-he-hall be=an-ible for ail such w irk rer&med under the building rermit. (Section I09.1.1) 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. Signanfigof1flomeowna Appmvai of Building Official Note: Three-f unfly dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWKMIS ipICEIViiP'TION the Code states that: Any ner homeow pafosming work for which abodding permit is required shall be exempt from the provisions of this section(Section 109.1.1-Lkertsing of coastracaon Supervisors);p��that if the homeowner engages a person(s)for Mm to do sack work,that such Homeowner small act as supervisor." btltttes of a supervisor(see Many hOZOOM ners who use this cx=gmon are unaware that they are assuming ragwnsi ... pervi Appendix Q.Rules&Regulations for Uansing Construction Supervisors.Secdoa Z cam our 1 Boasdlack o cannot proceed aaat_ rest the serious problem particularly when the homeovma lists uaiicatsed Persons. Suppvisor is Wtimareiy trsponsible. unlicensed person as itwould with a licxased Supervisor. The homeowner actingas To ensure that the homeowner is fully aware of his/her responsibiliti=maaY communities require.as part of the permit application.that the homeowner testify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form cut emly used by several towns. you may care to amend and adopt such a fonnlcertification for use in your community. Q:FORh1S:E.YEMM N .. _.i L.�..! -i .. .. . �w PART AL RELEASE OF EASEMENT COMMONWEALTH ELECTRIC COMPANY, formeriy known as Br:z--zards Bay Electric. Company, a corporation duly organized under the laws of the C;oninionvvealth of Massachusetts and having a principal place of bu:31ness at One Main Street, . Cambridge, Middlesex County, Massachusetts, for considerador► paid, and in consideration of$500,00, does by these presents release to: SHEILA DISHMIIN, as ovaier and as remainderman, and to MARY C. ROGERS, as holder of a life estate, both of 1 1 1 I Newtown Road, Barnstable (Cotui-t); Barnstable COUT)ty, Massachusetts, those rights acquired in a, certain easement from Manuel Duarte and Ann Duarte to Blvz.ards BayElecic k3oinpany, dated May 11. 1916, and recorded Aqt.h Barnstable County Registry of T)eeds in Book 360, Page 447, and those rights acquired in a certain easenient from. i Tlysses A. Htill to Buzzards Bay Electric Company, dated F'ebniary 12, 1915, and recorded in said Registry in Book 360, Page 445, upon, over, under and across land in ,Santuit, Barnstable, Barnstable County, Massachusetts shown as Assessors Parcel 35 on .Map 24 and !0 more particularly described in a deed dated.July 19, 1995 and recorded in said Registry in Deed gook 9761, Page 19. N o O This Partial Release of Easement affects only that portion of the Company's Casement as is specifically set forth in this instn.intent;,all other rights'not so V) specifically released hereunder are reserved. �t For recording irifartrrattorr setting forth the sticcession. in i.rtterest of t:'c�rr�n�t;n�yr�r.ttkr Electric Company to Buzzards Bay Electric Company, reference is he.rotiy r1riar1r, to the following documents, deed dated Novei7jtoer 19, 1920 recorded t;i Book 378 Page 26, deed dated January 31. 1972 recorded in Book. 1600, Page 312; and Change of Panic Certificate dated March 6, 1981 recorded in Book 3297, Page 295; all in Q Barnstable County Registry of Deeds. IN WITNESS WHEREOF, COMMONWEALTH ELECTRIC COMPANY has caused these presents to be signed, acknowledged and delivered in its name acid behalf as a sealed instni.ment by James J. Kea-ne, Jr., its Vice Presi_d- � t; - Energy Supply Find Engineering Services, hereunto duly authorized this 30'k day of July, 1999. COMMONWEALTH ELECTRIC COMPANY By �► mes J. Ke tce Presid - Energy Supply aril Engineering'Services i x ILL ° M I I s I wa � w ca t � , IL,?{"•. .3.F:�"'P d'.� �� 0� ���,,,;Y.._.�S:� l"Ji 1.��-.. Y...O W--j COMMONWEALTH OF MASSACHUSETTS Plymouth, ss. July- ej 1999 Then personally appeared the above named James J. Keane, Jr., Vice President - Energy Supply and Engineering Services as aforesaid,,and acknowledged the foregoing instrument to be the free act and deed of COMMONWEALTH ELECTRIC COMPANY, Before me, n James R. Weaver, Notary Public _ My commission expires: December 16, 2005 f:\WF.AVBRJ\BARN&TAB\R$LBASES\SOSHORE2,WPD eARNSTns�e oc ur�iY REGISTRY OF DEEDS A TRUE COPY,ATTEST F.MEADE REGISTER a NOV 19 '99 10:37 ARCADIA REALTY P. 1 ffajuix -016 ar ivi7C% cti /"tat r y j NOV 19 '99 10:37 ARCADIA REALTY P.2 1 �woTMRTIFI ,� ` LI Ii.,TY INSURANCE111MI99yJ I THIS C614TIPICATE IS ISSUED AS A ieAT-"Efi Of INFORM [ON arcs A. Gra'au1 Fnswonce Agency, Inr--. ONLY AND CONFERS NO R)OHTS UPON THE CERTIPI AT$ I HOLDER. 'T►ms rERTIFiCATC, nOES NOT AMInIND,.EXTINI 0 , Box 337 ! ALTER THE ;.OVERAGE AFFOP4000 BY THE PGLiCiES BE Ow E: stor.:s Mills, MA 02643 �. INSURERS APFORDIN.G COV0AGE �UR6RA The'Providence-MutuaI Fire .Insuranc-p Ct1. mss kl'...Hwblin . .. _... . �y Box 61 i msu (A� •...__ _....,.=.....__ ... 9 stony Mills MA 02646 i it-0iuREP 0•' �� 1 Pa!CIE QF!N$URANCELIS=EDUEi-OWHAV SEEN iS!aUEDT¢'rH INSUP.E0NAMEGA50-TtFL1FI THE -Of.',C;YF°E's'OGIr;�,i;�°FCy, n�TYNIT;iyTA Y REOUIREMENT• TERM OR r.Cr::),T rN GF ANY i»,:N7'? A(;T OF,UTI'Efi DOCk)MENT N rM, :10Z,-,E:T T'D VVH;UPI rp5 GER7,F;(';r."tw :.fAl' t3F Y PQfIT'AIN.Trif IN$UF1ANGF,gpfOW jt•G BY TMG PP'-.(41 5 OFSrFil3 hiE?CiN 19,lJ9IEt!,r3 A"", T,�F TERN,' "-.;dr!IJ,81CNE,yND Cr}NOMONS Or .rCIE:;,AGGREGATE L;WS�,ric,WN MAY HAVE HEE,4'RCL';I:CEU dY P.4 CLAIMS. POLiCT t0fiCtIVf I POLICY fAP:AA'iON _ nPCOFNAURANCE �- POLiC1'NUMbfR Li Ml1Q p1AU!ARLiA81U{NRNG�tUGCtJAAEVC: I i ; jv e t !-Xi ORNEAAI L:ADI,,TY ' i �, I r1RE G�MAc R(Ary nne Iirel, 1 SV(�1;UV/4) I .,LI�AtU MAD! �XX OCCUR 1 tt 00 11P VlJ0 ,.�..,. I PLR`:r]NA(,b AGL tN-1.1101v i Xyx�clud J _ I G&rv4PAL AGOPEOA'ri" y4V4;W�ta`' aLNl.4t�GpiO�TBRIpt!TAPPLIitPYR� PPAb'dCTs GQW01011AC. �W; —'aalcT ;RR L 1 AG$ 01 0 00058h9 4)9/Zll'9�} ( 09/21/UU AV'r01dOlILlLiAOkRT I i rAd,,160atnlCi.EOIAlT U ANY AUTO i Cn ycuur") Aht OWN&DA4708 I t er;►rED�leoAIJTos (par t,:.I,usr (ParNreOnf N NM AUTO! { 9C30iLY IIiJuRr NJN'OY h%jD AUTOS ! i(►v arnfoomd — .- I I ,•A�OPLA7� TIN.MAUr �i .' '�. •y' A17Tr r.F,a 7ANYAUTO I. 4' CAA;fl { { PWO QICC�1:9{dA•RTr'!. � � ` � EAC+•PrralNkFN%i i r: C.=VA :��CLAIMS MA01 AGGREOATk .... ..) 's,.._.. . .._ 4- CL�NiCYISiB Ie E: I�'tr01 tltlM�MAAI10P'I ANp : � T,7rit'LIMITS I ;,EF! , +rr�YB 6Itl4rTf ;„ i E t kML'I4 JLCwIDENT i G.,..03CA9C'•EA EMP:a'i& E L DIS4a$e pciwi4y LIMIT i - 'a i I gPTKW DT 09►tMA1>iINBK ocgrloMMrBale>BBrTrxCLu51oNS AGaitO ar[ryaomig N1lSPMAL PAr7VIS10N6 r! i "• J•„ npo;AT>m MOL601 CoirONAi.INeVAev:INB4�a Lmb i CANCSLLATION C f ,/ l�l� V...-.- ,� I Y#t0U:0ANYOPThEAUGJE.PtSCRIIDYPPtl•.:+<:rm'•:64GANCEL1AopBROAr.I+ttdrvtgaTf{aV is I7�s2uCldn r J ! N-wtowrl RQA,I ✓r I� /�E'l�i'�£.tt; h, +'C� OAYi.1118R101,T..t JBSU(NC INSVACA WILL.FNDEA'a0R 10 MAIL —. tae rs wl rrTgro MA C ! NOTICE TO THIS i; ICATP Wtr NOLOEA Naha;p TOTME LFFr,VVT FAILURfi7 r)JO fgoLI I t .! / f CYI ���1J tty�L.11� W impose NO O&Li0d1Ti0N OR LIAORIFV Of ANY K1N0 uPON TN4 INSuIIIR,IT$AGWS OA 5�SSO�S lap txr7 AIARIP @NTATIYiS. I ` ��._ I: AM!0 tA(► A94N7 TIC( ti ACORP CQAP'OAATION 190 eering Dept.(3rd floor) Map UZ4 Parcel 034, "—permit# 2 3 (o 4 S House# 0Z `7(g 1?�--Date Iss Q Board of Health(3r„floor)(8:15 -9:30/1:00-4:30) �`7 *k ee Conservation Office(4th floor)(8:30.- 9:30/1:00-2:00) R Planning Dept.(1st floor/School Admin. Bldg.) BIKE Definiti oved by Planning Board 19 �0 • BARNSTABLE. 059. 6: TOWN OF BARNSTABLE f Building Permit Application treet Address IO 7� 0 Village Ca r � Owner Address 156 "— Telephone Permit Request First Floor / GNU square feet Second Floor square square feet Construction Type 4 _ Estimated Project Cost $ GAG d Zoning,District Flood Plain Water Protection -- Lot Size Grandfathered ®ems ❑No Dwelling Type: Single Family p'— Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes Q),DFe On Old King's Highway ❑Yes [moo Basement Type: ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing_� New Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing_ New First Floor Room Count Heat Type and Fuel: ❑Gas ]'Oil ❑Electric ❑Other Central Air ❑Yes •e'No Fireplaces: Existing New Existing wood/coal stove ❑Yes pro Garage: ©'leiached(size) �f e Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) " ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name 14A 0,11 Telephone Number s C7�4 — 51700 0 Address //L�S�U ee License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. AL ONSTRUCTION,DEBIIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO e5�(/11,lCO SIGNATURE DATE BUILDI G PERMIT DENIED FOUR THE FOLLOWING REASON(S) L¢llJ� FOR OFFICIAL USE ONLY = PERMIT NO. DATE ISSUED I " MAP/PARCEL NO. ADDRESS VILLAGE - , r `•_. OWNER DATE OF INSPECTION: FOUNDATION - e FRAME r ' INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 4 • J 1 DATE CLOSED OUT f ; ASSOCIATION PLAN NO. t , Y .. ��ie �anvrr�aizuiealC�i o��i�Cad1ac�uc6eC . a F DEPARTMENT OF PUBLIC SAFEi', CONSTRUCTION SUPERVISOR LICENSE Nuober•, Expires: Restricted To 00 i MICHAEL A SANTOS u; 103 PICKEREL COVE R0 BASHPEE, MA 02649 07.ei„� Zl HOME IMPROVEMENT CONTRACTOR Registration 124127 Type DBA Expiration 05/15/99 Apcon —Michael Mi' hael A. Santos ADMINISTRATOR ` 4830 Route 28 - -• --. Cotuit MA 02635 1 T 1 I ' � �� C I � II)) � 6 F The Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph CrossenBuilding Coma Fax: 508-790-6230 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 requirements. Type of Work: " Est. Cost Ao re—Z) Address of Work: 16 lee (I T-,za Owner's Name Date of Permit Application: o �� I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under 51,000. 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 ap ply for a permit as the agent the owner: ' Date Contractor Name Registration No. The Cununonlrealth o,rAfassachusctty Del,trrinunt of Industrial Accidents �� Ol�ceal/ayestlgatlons • = 600 1114-01hr,"loty Street '• •�Via:-, _ Workers' Compensation Insurance Affidavit -. ._�i6n:._ . .__. Plcnse PRINT 1e�1�?j,_..�'""""'•"_."_"_..'......_..._._r.----__ -• �Iilicnnt infornM _ name, X;CC)Al location- city �. 6�f t i 7 /�G'/� `&ine ❑ I am a homeowner performing all work myself. ❑ 1 am a sole proprietor and have no one working in any capacity (�am an emplover roviding workers' compensation for my employees working on this job. cnm tanv name: /�Y6 address: * ,)() eT d . city ( 6 A4/4— nhonc tt• . ....... n. .�...—.....�.�..!•..aa•+n._.���.w.+r..ate..—........w..w�.�r..�aw�r ._. ..� . .._.. f I I am a sole proprietor. genera! contractor. or homeowner(circle one)and have hired the contractors listed below who ha•, the following workers' compensation polices: cmmnam• natne* add resc. city nhonc+[• incurancr rn nniier to cmmnanv nitnr: addrescr rin: nhnne fit• insurance co policy 0 Attach addid_n21 sheet if necea_iaryr %{ -^+�' ••�y.'_ -�•.:, tr:.� '�'��"•�•w -r•-1 ' '� '--"— ^•—' Failure to secure covcrace as required under Section:SA of 111GL 152 can lead to the imposition of criminal penalties oifinc opt 0 S1S00.00 andiur one cars'imprisonment-is well:ts civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement mat be fonvnrded to the O1rce of Investigations of the DIA for coverage verification. I do herehr ccr,ift•tinder the pains and penal'-"s ojperjuty Ilia,the information provided above is true and cvmct. Signature Date Print name ���� Phone# ' ofrciai use only do not write in this area to be completed by city or town ofllciai T� cite or town: permitilicense it rrtluildinp Depanment i Ucensing hoard t check if immediate response is required 05eleetmen's UlTce (:31leaith Department contact person: phone q; rl Other. c. • 1 fir. _ �; . i � �tce Toan>nnanuieal� a�'✓�.aaaaclzuaef°.'' DEPARTMENT OF PUBLIC SAFEi'i CONSTRUCTION:SUPERVISOR LICENSE Nu�ber >m: ]Expires:- ~ , ? `_Restr'i_cted To' .00 x NICHAEL A SANTOS PICKEREL COVE RO . MASHPEE, HA. 02649 �r °J� Vavrmeonweal/�g�✓l�«,a�«�r� �: HOME IMPROVEMENT CONTRACTOR Y Registration 124127 r ' Type - 08A Expiration 05/15/99 Apcon Mom' hael A. Santos r t 4830 Route 28 ADMINISTRATOR Cotuit MA 02635 i COTUIT q SURVEYOR'S CERTIFICATE. PLAN OF LAND a O 1) I CERTIFY .THAT THIS .PLAN .HAS BEEN PREPARED IN CONFORMITY WITH THE RULES AND REGULATIONS LOCATED IN. OF .THE REGISTRY OF DEEDS OF THE COMMONWEALTH W CO TUIT MA.OF MASSAG"HUSETTS. LOCUS PREPARED FOR.• 2 -I CERTIFY THAT'THE PROPERTY LINES SHOWN ON .THIS PLAN ARE THE LINES DIVIDING EXISTING OWNERSHIPS AND THAT THE LINES. OF STREETS AND WAYS SHOWN ARE THOSE OF PUBLIC OR PRIVATE STREETS SH L IL D1A1OR "WAYS-ALREADY .ESTABLISIIED AND :THAT NO. NEW LINES FOR : DI IDN OF 'EXIS ING OWNERSHIP, OR FOR NEW WAYS. YS ARE SHOWN. � . MERITH/441 7 JUL Y 9, 1998 / PA UL A . E'W, P.L.S. AT IDETAIL• NOT 'TO SCALE 6 59, A.M. 24135 N/F LOCUS MAP ALDINA SOUZA' IC IRON �� R ;• - -PIPE DEED: `69721089 : r �'i �' FND - �► L C.B./D.H. --'`" A RD TEE (FND) - �+ N77 27 - • 49 5 TUBE 67 �,, 63 PLAN REF. 10 1 p�, C.B "DISC I3 & 3,27195 CA . - (FND) REs ZONE. .,RF, iA FLOOD ZONE C r R IG 0 _. ODE rr11` 'T - UPOLE L1 . .. O 1 I ,..-- 5 _ _ .. �z M A - S r r- A.M. 24/81 I 22 o: T,_ 1 SHED w _: N/ ., GEORGE &-ELIZABETH SOARES IRON _ GAR. DEED. -9643 333 PIPE A. M 4 36 (FND) STAKE r o .3 AREA= 6 328E SET , . N F ,/ I MARY. C. :ROGERS, & STAKE' . SHEILA DISHhfAN , 6 FND DEED.. .9761 019 .....•,..:.... .,... STAKE _ I O U 5 1 (SET) N 1�76 " ZVIw - bA.M. . 24/8� - `c l NIF DEED.-BO 6/210 EA CCI . I `b tj { I „� - I1> �I A.M. 24137 co Ih'ON - -= - N/F w DETAIL . I C.B./D..H.rPIPE - -- - - RALPH JACKSON (SET) DEED.- 93011109 z (FND) .-�-: - - -_NOT TO SCALE I _-_- LEGEND. HOUSE C B CONCRETE BOUND CATCH BASIN tz 0.58' UTILITY POLE ` a TREE (FND) FO UND C.B.(FND) IJPOLE )129 DETAIL: TREE �. NOT TO SCALE a — 60. 00 C.B(FND) N87 38 39 E (OFF) (TIE) J 7•z4 IRONPIPE C.B. H. m_ (FND) ti (SET) ti YANKE'E' SURVEY CONSULTANTS GRAPHIC SCALE 40 INDUSTRY ROAD . UNIT, 1, � 20 0� ro ao ao IRON c� o PIPE P. 0. 80.E 265 O (FND) MARSTONS MILLS, MASS. 02648 (.. IN FEET ) TM 428—0055 FAX.- 420—5553 1 inch 20 ft. J11 51618 GM