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0421 SCHOOL STREET
_ yap.- �G��z s7�� 7 ;311Y1 os E TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION r Map �Z d P7?,41ov L-J ff� ��pp �s Permit# 601:�if z t V.j#r' V Td�. �F Health Division .. q�Y S t E_ Date Issued 9 , ,e, Conservation Division ri V3 `r=Y"r� `�,�J; ?Q Application Fee Tax Collector 6/a�`03 �� Permit Fee :0- a Treasurer Planning Dept. EXISTING SEPTIC SYSTEM Date Definitive Plan Approved by Planning Board UMMMTO,.�.90F=ROOMS Historic-OKH Preservation/Hyannis Project Street Address y2 / SC o c T . Village /a a Owner /eu 016L e� lL(G/* YCP ✓ T% Address -3-5 9 -Sc-,44 ac. 5 l_-- Co7U (7—.{ Telephone 5-0 f 2, s'2-2Y oZ�3 Permit Request CO a' S 77c-u �-s�o o� o� 3 aC /6 !,� 4, /CW,4 f' ; 3 g X ��� ' �--� A--� • T� � SSE.—5 d � A-c c E5 S ST�I ,� s P� Pc.� 6/20 0 3 •SF 7 'Y1l Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new T I$ Zoning District Flood Plain ✓ Groundwater Overlay ` Project Valuation So oa Construction Type , Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation: Dwelling Ty Single Family � Two Family 0 Multi-Family(#units) Age of Existing Struc �A- Historic House: ❑Yes ❑No On Old King's Highway: O Yes 0 No Basement Type: ❑Full ❑ wl ❑Walkout Cl Other/uZA 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: 0 Yes 0 No Fireplaces: Existing � New Existing wood/coal stove: ❑Yes ❑No Detached garage:O existing ❑new size Pool:O existing ❑new size Barn:❑existing O new size Attached garage:O existing ❑new size Shed:0 existing ❑new size Othe : Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑Now If yes, site plan review Current Use Proposed.Use . Y BUILDER INFORMATION Name Telephone Number ._O S`(q o r?- Address Sq+r-)P License# n -7 (a!Ci Home Improvement Contractor# 3 cYM 4? Worker's Compensation# _56(6:�' ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO � (�� SIGNATURE Qom. - DATES Z�� 7 s } FOR OFFICIAL USE ONLY r w_ PERMIT NO. DATE ISSUED MAP/PARCEUNO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: • .i FOUNDATION FRAME -i i INSULATION. FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ?, GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r OFZHE roy, Town of Barnstable do y Regulatory Services * r BAMSTABLE. ' Thomas F.Geiler,Director 9`bA,f 3 ` Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 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: r 16A Estimated Cost —.5-6 od Address of Work: 2 ( sc 0 /0% o Ltitq- Owner's Name: RD �Fu—T ��4'7'1Z-[G t4 /y!C r 7— Date of Application: ') 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 pernut Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: 7 LlZ 16 `/ <J0 / goad S Date Contractor Name Registration No. OR Date Owner's Name Q:forms:homeaffidav r' _ The Commonwealth of Massachusetts Department of Industrial Accidents - 600 Washington Street Boston,Mass. 02111 Workers', Com ensation.Insurance Affidavit-General Businesses �i///%%%%%%�%��///O -•"^^•� •.74 wp. �>T?+:sbs.• >r.,r-to�,A.r y,+w•. .. .. � :-w -�—•.::i"..Adal , address: �-2 .. C_4Ht'/L.0 Arts 54Z P A , state: zip-0 Z1��4 • phone# < O ? S� b�/ (7 c:i! v— work site ^on full address : 2( S G p � C..o lT • am.a sole proprietor and have no one Business Type: El Retail❑RestaurdntBaAatYng'Estaiilishment working in any capacity. ❑Office[] Sales(mcluding.Real Estate,Autos etc.)' ❑I am an em to er with em to (full& art time): ❑Other �I am an employer providing workers' compensation for my employees working on this job.. t:. \t :.4.'rti '!f': _. '•iP•' •+5^'�: ::1' M• Id+ 'iy'1'•f' .�. com•-ari-'•Yi9fne• -'' •.,: •�� -.ry'+- cii v' Tihone Insurance.CO'' am a sole proprietor and have hired the independent contractors listed below who have t> e following workers' .compensation polices: - •:..:•i.n .._:::.:� i� ,�,�j Qom, ��• y.naM •:1 (]ram :•y,'• siddresse. • .1 -::r,.: •:i" dry. •!`f.: .y`:...: '.(.>:•f�;i;•• insiirsnce c Aill- 10 coin`en. nea�e _ _ • Cf7"�' :phonE ' r•i -y,:. •.�,+: .:r.:, '.irk:. •>+ i••'L, .y•... .�+ insurance�eb:•�° Do Ic.x, - Fallure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment 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 g copy of this statement may be forwarded to the Office of lnveatigations of the DIA for coverage verification. I do hereby certify under thepains andpenalties ofperjury that the information provided above is true and correct. Signature Date Phone'# Print name 5 official use only do not write in this area to be completed by city or town official city or town: permft/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (rnrbed Sept Mi 9YR - Information and Instructions Massachusetts General Laws chapter�152 section 25 requires all employers to provide workers' compensation for their. employees: As quoted from the law', 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 definned 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 haying not more than three apartments and who resides therein, or the.occupant of the dwelling house of another who employspersons to do.maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such en�ployment.be deemed to be an employer. MGL chapter 152 section 25 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 p ace table evidence of compliance with the insurance coverage required. Additionally, neither the coi�nonwealth nor.any.of its political subdivisions shall enter into any contract for the performance of public work until ith the insurance requirements of this chapter have been presented to the contracting acceptable evidence of compliance w . authority. 0/0 Applicants Please fill in the workers'compensation affidavit completely,by checking the box that applies to your situation..`Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department-of Industrial Accidents for confizmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit.or license is being requested, not the Department Of Industrial Accidents'. Should you have any,questions regarding.the."law"or if you are required to.obtain a:workers' compensation policy,please call the Department at the number hsted:below. . City or Towns . Please be sure that the affidavit is complete and.printed legibly. The Department has provided a space at the bottom of the ll out in the event the Office of Investigations has to contact you regarding the applicant. Please affidavit for you to fi ense number.which will b�e used as a reference number. The.affidavits,may.be.returned to be sure to fill in the permit/lic the Departmentby mail or FAX.unless other arrangements have been made. The Office of Investigations would hike to thank you in advance for you 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 WIN of li"Sff98fiens 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext.406 I . n Town of Barnstable �0�.�{iE TpkM o� Regulatory Services STAB q � Thomas F.Geiler,Director s6g9 A, Building Division prED � Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 . www.town.b arnstable.ma,us Fax: 508-790-6230 Office: 508-862-4038 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property 5'° o act on my behalf, hereby authorize all matters relative to work authorized by this building pernvt application f or: (Address of Job) 7 7 y ate Signature of Owner . PrintName r..zna t„tc�(1WNERPfiRT'IISSION j ✓1ze Paiiazo,wreall�i o�/�aaoacluaeQo BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 067659 Birthdate: 12/20/1960 Expires: 12/20/2005 Tr.no: 12628 Restricted: 00 JOHN A HANSON 353 CARRIAGE RDA E FALMOUTH, MA 02536 Administrator Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 130009 Expiration: 12/13/2005 Type: Individual John Hanson John Hanson 353 Carriageshop Rd. East Falmouth,MA 02536 � � Administrator /as ossor's map and 'lot number.®. ........ ..................... SEPTtc vT °? I3E. IANCE `Sewage Permit number ............'l..�./.�......... a ., 3 a AR "F # STATE •� C.,ODE AND TOWN ' Y REQ.0 i. A �Py0Z7NEr��o T.OWN.' OF BARNST� ' E i BARNSTABLE, oY INSPECTOR a,�� - BUILDING APPLICATION:FOR' PERMIT TO OAC, a M f,/yy ' TYPE OF CONSTRUCTION ........W-0.0. . / ..f% ..'rl C4, ...................... ./....... ............19.7<... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a� permit according to the following informations: Location G.Q.;�.. ...... �' c9 Q..,/..... � . . :.Q:T..f,�.�T.......1./..�<:FZ..0 ................................... ProposedUse .... ?. ......./..... t.f. y.......�.�. .4 .,oe $2 ..................................................................... > Zoning District P............ ...........................Fire District .....5. .c9.p..G!.. .T.............................................. Name of Owner ...Address .60.X......a s,z ..... •........ Name of Builder /`'"'' Ps�l.....d /.4.l.0 Cr.Z�` Address ...... .•............ T / Name of Architect �t.fad..../..���er�c,F!v............................Address cak`,t�4/'I T P.�Ir.....ec(.........Oely e .... (tc.r S Number of Rooms ..............//...............................................Foundation .A.w:'.t ......... .................. Exterior ........ Qlzq(............................................................Roofing .19fehaIr............................................................ Floors ...... ...............................................................Interior Sh�CI..�l a..<•:.!�...'C..4i1©.c�sad /'4�/1.� ........... f ! Heating ....FO.rt.C..C-kl.....mp....../t1.!9.Teo!.....................Plumbing y.....<vm.r.....At,e-r. .............. Fireplace ................0- a.c........................................................Approximate Cost .......���..P...4.1�0..r .q......................o? ..... Definitive Plan Approved by Planning Board -------------------_-----------19________. Area ........91�................... :�f..... Diagram of Lot and Building with Dimensions Fee .rf.......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH �• 0 Y' -- _ v ® wee 66 OrsPo,S1;L EP11 i41l Z A z a —�2, I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ................ r.� McNutt, Robert R. III s ' ;, i y N 17345 1 1/2 story.............. Permit for .................................... single family dwelling (see Appeal '#1974r38) i '+ r `tzl School Street Location -t T COtuit Owner Robert R. McNutt, III ..................................frame.................... Type of Construction r' �*'' �r'•, Y Plot ............................ Lot ................................ ✓ �- ,T Permit Granted .........October 1 ......19 74 Date of Inspection/� ;�/� .:. 19 ©Ir re cokwo\ f �. Date Completed .. ./� �.�� ........:....19ol Jr PERMIT REFUSED �s ................................................................ 19 _ �, - ,�►,, , * .............................................................................. t `'� -M1 `Q is '"' .............................................................................. ! 00011, *mil.................................... ...................................... lop ......................................................... ............. r!. • i/'• ...� �'• t � Approved ................................................ 19 +� ............................................................................... - r-..,tip � •�,.a..."; ,� --As-4essor's map and lot number ..... " 9 Sewage Permit number ................... .. ......:............ .. °fT"Er°�° TOWN OF BARNSTABLE BAHBSTABLE, i "6 9 BUILDING INSPECTOR D MPY h• APPLICATION FOR PERMIT TO •! ?/ra;. ..:....../` rfisr .... m.i.l/.........I TYPE OF CONSTRUCTION ........ r?. ...,...� ...S7.r?�^ !....... ..�. .,�?.?'........6-y.. .................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according"t6 `the following information: Location 4n T.. .ryJ.��.............. <, r..1.::.... �:....:....:�?��.r� .......:�/.. ........................................ C r ProposedUse .... i...��. ;z,�..X.yt�,:..P. .,../-:::r.,. ............................................"......................... Zoning DistrictC............�!-.Q.........................LFire District .....Co.T..4<!..�,T............................................... Name of Owner tY�`' .......%.... ! �1� ��,!l.tr. T C ..Address ,/ . ..x...... ....... .�4 . ,? ....-?,..,f ........ Name of Builder .t.�:..�{' / /t ,,�%�fr/�! ,..>..T,. �1 Address . f�� ..ti ..5:2......C,,L ...rX............ Name of Architect ..U.l../..../.. A.. ..ici..........................:..Address :ar'.,�ct,/'r�t.1 f®.!!:e......� c�. Number of Rooms .............:�...............................................Foundation ......... r" ..7-!F............... Exterior ......................................................";..Roofing 4S� h. a.1.1 ....... t 41 n Floors ( .�.r,,n. (..Interior �.' ... �. ..�r.... .<!.z,. .. 1.....1'�t.:^ ° ........... ................. L; � / /ter Heating <.:.n..�..^ / /gal....(r.lf?.7.r. !.............. Plumbin fir, , . .....`�.....?: .r ..........:.T.._....c:,: .............. g P,......:..... Fireplace ............... :........................................ ,..,..Approximate Cost .............'y.. !?•r,.. r}. ............... ... :... . . „Definitive Plan Approved by Planning Board _______________________________19________ . Area .........,M14......... ......... Diagram of Lot and Building with Dimensions Fee �:. .... .................... SUBJECT TO APPROVAL OF BOARD OF HEALTH `70 _. �S Cu�.9 ,c 7 . V/ 12 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. p ' Name . �!! •:�- :../ ;/!•r �I�•/ .-: ............... k 1� McNptt, Robert R. III 17345 1 1/2 story, No ................. Permit for .................................... s,inle family dwelling .............................................. Location. School Street ..................................................... s Cotuit _ ................................................... Owner ...............Rober. t...R....McNutt. . . ...III ....... .... ........ ... .. . ...... . ...... Type of Construction .........frame................................. ................................................................................ Plot ..... Lot ................................ ,1 Permit Granted .........Gf:ober,..1............19 74 Date of Inspection ....................................19 a Date Completed 19 a PERMIT REFUSED ................................................................ 19 ; ............................................................................... .....................................:......................................... r ............ . ......................................................... I i I i Approved - rl ............................................................................... i ..................... ......................................................... i f r � FEE .• 03 c a TOWN OF BARNSTABLE, MASS.03 J Ada .0,d 4 19 0 w q m o•� THIS IS TO CERTIFY THAT A PERMIT IS HEREBY GRANTED TO t V in > o C bpcs.�•+ (PROPERTY OWNER) (ADDRESS) bor~ 3 TO ..........................................................................................._................................._....____.................................................................................................................................................... (BUILD) (ALTER) (REPAIR) y.Gy � ......................................._....._............................................_..........................................._._ ..........._................. ..............................................................._................__. ...._.__-_ C G (TYPE OF BUILDING) (APPROXIMATE SIZE) w oa LOCATION ........................_..............._..........._..._..... ............................._._ ..............................................................................._.............................__............ V y (STREET AND NUMBER) (VILLAGE) 'ss� NAME OF BUILDER OR CONTRACTOR __.. ..._...._._.................................................................................._.................................._.......__............__--- APPROXIMATE COST d 4) boos I HEREBY AGREE TO CONFORM TO ALL THE RULES AND REGULATIONS OF THE TOWN 1. � 4 OF BARNSTABLE, REGARDING THE ABOVE CONSTRUCTION. Cu a) a " _ __..........._.._.. _..._................................................................. M d a to (OWNER) / `� (CONTRACTOR) , CIS O 00 .. --_......_.........._._............_._.�..................._................._.............................................................. BUILDING INSPECTOR a Subject to Approval of Board of Health. do 7� t J FEE TOWN OF BARNSTABLE, MASS. 19 0 00 0•� THIS IS TO CERTIFY THAT A PERMIT IS HEREBY GRANTED TO D CD c, _.......................................................................................................................................................................... ............_........................................................................._....... _� O ,••, (PROPERTY OWNER) (ADDRESS) �0 � 0 b ,,a TO ..........................................................................................._............._ ::......_.._---•.......................................... Op ...................................................................................................._..�_ A (BUILD) (ALTER) (REPAIR) C G (TYPE OF BUILDING) (APPROXIMATE SIZE) Op LOCATION ......................(STR[ET.AND.NUMBER).................................. ..............................................................(VII............... ............................_._..........._..._._.�._� �JJV/LL .. O LLAGE) NAMEOF BUILDER OR CONTRACTOR _.._.___...____----_----_-----------__.._...__..._......_....................__._............... ........_...._........_.Its Ih (u 0A APPROXIMATE COST �y 0 m03 I HEREBY AGREE TO CONFORM TO ALL THE RULES AND RE13ULATIONS OF THE TOWN �'� I.. OF BARNSTABLE, REGARDING THE ABOVE CONSTRUCTION. at oM > a "� _......._........_.................................._......................................................................._ ......................._........................................................................................................................... tl d C y (OWNER) (CONTRACTOR) dnW d 0 0 r) or) BUILDING INSPECTOR Subject to Approval of Board of Health. ���>s'r���� V Assessor's map and lot number ... 0. .� .V...... r Y Sewage Permit number .............V-,p.... .......................... �FTHET��y� TOWN OF BARNSTABLE S BAMSTADLE, Mb O YPY a' BUILDING INSPECTOR APPLICATION FOR PERMIT TO .........�..AV...S 71 ±:.R---T........?'.I....... sCt//?. s.. ./�r.................................. TYPE OF CONSTRUCTION vl.l..Q..�t.. ................ ......... I. y L ............ `"""'..`'� �1........19..�.l. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby pplies for a permit according to the following information: Location ..... .�..7.......u� 3.. ............ ..�1.9.Q... ............. 1............ ck.7 . !......::sl:.. .f. :........................... ProposedUse ....0...lZ.'..x...........Cfgz�..........t... N. ...........5.j d . .. e.................................................... Zoning District ....f� s........ . ...... . ...................Fire District ....... A..l.''. ............................................... Name of Owner ...� ... ..�.. �. Address ..�-j.9..?5...... .2........ �.�.'�.T..... '�..�5,........ Name of Builder ... .... '� . . . ... ....1�.+�..Address .�. ..... ........r 3.T..Y..�l .... �s. .5..�.... Name of Architect ..... t/vp9,iti...............Address ..........� a.S ............. GE.` Number of Rooms .................../.............................................Foundation .. ......................�...... 4. .4 .......:,ff z:-t......... Exterior .................. ..............................................Roofing .. ..r.. .C!..'p. ........................................... Floors ! .? ' !.. N.l ......................................Interior ... .1?..�:..k"...... rD..�.`!...... Heating .............. ..V.........................................................Plumbing .............../ �..�. ... .......................................... Fireplace .............: ... ...................................................Approximate Cost .........- �/..Q...G..d..�..0.�........................ 440 Definitive Plan Approved by Planning Board ________________________________19________ . Area G Diagram of Lot and Building with Dimensions o a Fee ......... . ...... . ................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 9z '00S4 � U { S \. I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. • �� Name .........�.�G��k^s�...��...................... .......... McNutt, Robert III No�, 17 507.... Permit for .....garage................. .............., 9- .. .............................................................. f `�' LSchool Street Location ................................................................ Cotuit ............................................................................... Owner Robert McNutt, III HK Type of Construction fr .................................................................. am ............ .am.e...................... .................................................................I.............. Plot ............................ Lot ........f235............... Permit Granted .,, December 27 74 .........................19 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED .. .............................. 19 .. . .. ............... .�� .7.5 .............................................. 'A ... 7.r.9AT................ .477- y Approved i ............................................................................... ............................................................................... Assessor's map and lot number ...r....:.......: Sewage Permit number ...............-I........................................ 9 ��QyOFTHET��y� TOWN OF BARNSTABLE i BA"ST"LE, i "6 9 BUILDING INSPECTOR O'FaM APPLICATION FOR PERMIT TO .............!�.:.................................................................... TYPE OF CONSTRUCTION ................ ` !" :.. ........19.t! TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location r_ '...�... .............. ..... ..::........:.......•.......?.. .................^......�..`................ (.. ..................................... Proposed Use ' �.............. ' " V• 7 Zoning District .....!....r .....................................Fire District ' ._ Name of Owner �' A ................Address ...... s ........ ................................................. y.!. ..... !r.... Name of Builder ...::.�..:...?... .::.: /I `r!/%s'.t .Address .� . � .. .. :...4'.:::..:.....1��. c.: ... Name of Architect I;� . 7, ..............Address ....:.............,......,......................... :............ Number of Rooms .................... ...........................................Foundation ........:.. Exlerior ....................:...t .............................................................Roofing ...........t..f.... +.. °...... ................................................ Floors 'r . J / .Interior y ............0�.? f..................................................................... Heating ..... '................................................Plumbing Fireplace .:.............:... ...:..........................................................Approximate Cost . :.......��,..�....;� Ct. ..... ..................................... Definitive Plan Approved by Planning Board ________________________________19________ . Area .� .. Diagram of Lot and Building with Dimensions Fee �' o ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH / } i L• _ �, ✓� - 1 i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name •,!„G .....!.............. ........ .. a McNutt, Robert III 17507 garage No ................. Permit for .................................... Location l. c ►pQ1 .Street .......................0.91,1A it........................................... Owner .......... RQb�rt„McNutt„III Type of Construction ...........f.T.AMP..................... ................................................................................ Plot ............................ Lot .........#235.............. Permit Granted .......December 27........19 74 ......... Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... 1 'Assessor's offioe Ost floor): THE Assessor's map and lot number ..�, ,<S ...... �o 0 4 Board of Health (3rd floor): `O�Q ♦� Sewage Permit number .................................................... Z 11aaa9T11DLE ! Engineering Department (3rd floor): '°o MAG& eta House number APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE i BUILDING - INSPECTOR APPLICATION FOR PERMIT TO .... � TYPEOF CONSTRUCTION ............... ,J ... ,....4 ........................................................................................... 117 .....��� . ........ ..------....19 .7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location L o 7 �.3. 5.....S�.�l.vc?... ........5/'..0 v.?<�i.� ........... ��.5'.`1...................................................................... ................ ProposedUse ....C:�ze.............5?G/1 .q..P......................................................................................:............................ Zoning District ...../.!.... .�:.......... ..q.........................:......Fire District ..... 7............................................. Name of Owner I 7........Address ........> Ir Name of Builder Address ........................................ Nameof Architect ............/...................................................Address .................................................................................... Number of Rooms .............. ..............................................Foundation .....C.(7-- T... 1. ........................................ Exterior .............. .................................................Roofing ......._�9,5. .z ...!.../........................................... Floors ...................... ........ ...... !rr nterior .....C,. .... r...:�-,.....err'✓...................................... Heating ................ fur., P ........Plumbing ......................................................... J. Fireplace U v P Approximate Cost ... ..�... <J ............................ ........... ..... ............,......................... Definitive Plan Approved by Planning Board -------19________ . Area ..... g `�.......................... Diagram of Lot and Building with Dimensions Fee yy ............................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 22 64 2 CA - ' � L, OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ���..ti�...,r�:..F............ .�........ ..... , .. Construction Supervisor's License .O.l..l>..�?...0..�....... MCNUT-', ROBERT R. A=20-125 . Ko 30476 Permit for ..Build Garage. . . . .. .. .. . .. .. Accessory to Dwelling ............................................... �.�.................... .......Location # ........3- ...School. . . . ..Street .... ..Lot. ......... .. .... ........ . .. .... .. .. Cotuit ............................................................................... Owner Robert R. McNutt .................................................................. Type of Construction Frame .......................................... ............................................................................... Plot ............................ Lot ................................ Permit Granted ....... March 3 , 19 87 Date of Inspection ....................................19 Date Completed ......................................19 I ,Massachusetts Department of Environmental Protection Bureau of Resource Protection -Waterways Regulation Program W045876 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Simplified,Water-Dependent, Nonwater-Dependent,Amendment G. Municipal Zoning Certificate Robert McNutt Name of Applicant 421 School Street Shoestring Bay Cotuit Project street address Waterway City/Town Description of use or change in use: Private recreational boating. To be completed by municipal clerk or appropriate municipal official: "I hereby certify that the project described above and more fully detailed in the applicant's waterways license application and plans is not in violation of local zoning ordinances and bylaws." (Z.LI2 2 0 ri to of Mu icip I Official Date ignature of Municipal Official Title City/Town CH91App.doc-Rev.10ID2 Page 6 of 17 Vyl `� Sy Massachusetts Department of Environmental Protection Bureau of Resource Protection -Waterways Regulation Program W045876 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Simplified,Water-Dependent, Nonwater-Dependent,Amendment G. Municipal Zoning Certificate Robert McNutt Name of Applicant 421 School Street Shoestring Bay Cotuit Project street address Waterway City/Town Description of use or change in use: Private recreational boating. To be completed by municipal clerk or appropriate municipal official: "I hereby certify that the project described above and more fully detailed in the applicant's waterways license application and plans is not in violation of local zoning ordinances and bylaws." Printed Name of Municipal Official Date Signature of Municipal Official Title Cityfrown CH91App.doc-Rev. 1002 Page 6 of 17 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Waterways Regulation Program W045876 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Simplified,Water-Dependent, Nonwater-Dependent,Amendment B. Applicant Information Proposed Project/Use Information 1. Applicant: Name E-mail Address Mailing Address Note:Please refer to the"Instructions" City/Town State Zip Code Telephone Number Fax Number 2. Authorized Agent (if any): O Name E-mail Address �� � q �� Mailing Address NO MO. City/Town State Zip Code -4777272 k�v Telephone Number Fax Number C. Proposed Project/Use Information 1. Property Information (all information must be provided): Owner Name(if different from applicant) Tax Assessor's Map and Parcel Numbers Latitude Longitude � N& 0 N Street Address and City/Town State Zip Code 2. Registered Land ❑ Yes ❑ No 3. Name of the water body where the project site is located: Sti3�e n'g;Ba 4. Description of the water body in which the project site is located (check all that apply): Type Nature Designation ❑ Nontidal river/stream ❑ Natural ❑Area of Critical Environmental Concern ❑ Flowed tidelands ❑ Enlarged/dammed ❑ Designated Port Area ❑ Filled tidelands ❑ Uncertain ❑ Ocean Sanctuary ❑ Great Pond ❑ Uncertain ❑ Uncertain CH91 App.doc•Rev. 10/02 Page 2 of 17 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Waterways Regulation Program W045876 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Simplified,Water-Dependent, Nonwater-Dependent,Amendment C. Proposed Project/Use Information (cont.) Select use(s)from Project Type Table 5. Proposed Use/Activity description on pg.2 of the "Instructions" Private recreational boating. 6. Is the project a pre-1984 existing structure AND less than 600 square feet? ❑ Yes ❑ No 7. Is the project a post-1984 existing or new structure, less than 300 square feet AND water dependent? ❑ Yes ❑ No 8. What is the estimated total cost of proposed work(including materials&labor)? $10,000 9. List the name&complete mailing address of each abutter(attach additional sheets, if necessary).An abutter is defined as the owner of land that shares a common boundary with the project site, as well as the owner of land that lies within 50' across a waterbody from the project. Benedetto, Robert R 193 Kensington Park, Irvine, CA 92606 Name Address Name Address Name Address D. Project Plans 1. I have attached plans for my project in accordance with the instructions contained in (check one): ® Appendix A(License plan) ❑ Appendix B (Simplified License plan) ❑ Appendix C(Permit plan) 2. Other State and Local Approvals/Certifications ❑ 401 Water Quality Certificate Date of Issuance ® Wetlands 3-4118 File Number ❑ Jurisdictional Determination JD- File Number ❑ MEPA File Number ❑ EOEA Secretary Certificate Date ❑ 21 E Waste Site Cleanup RTN Number CH91App.doc-Rev. 10102 Page 3 of 17 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Waterways Regulation Program W045876 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Simplified,Water-Dependent, Nonwater-Dependent,Amendment E. Certification All applicants, property owners and authorized agents must sign this page. All future application correspondence may be signed by the authorized agent alone. "I hereby make application for a permit or license to authorize the activities I have described herein. Upon my signature, I agree to allow the duly authorized representatives of the Massachusetts Department of Environmental Protection and the Massachusetts Coastal Zone Management Program to enter upon the premises of the project site at reasonable times for the purpose of inspection." "I hereby certify that the information submitted in this application is true and accurate to the best of my knowledge." Applicant's signature Date Property ro �o signature(if diffilInt than ap cant) Date 11/20/03 Agent's signature(if applicable) Date APPLICANTS FILING A SIMPLIFIED APPLICATION STOP HERE CH91App.doc•Rev. 10/02 Page 4of 17 iMammehusetts Department of Environmental Protection DEP He Number WBureau of Resource Protection-Wetlands s _ RA Form 5 0 Order of Conditions sE3-4„s� DEP a"9- Massachusetts Wetlands Protection Act M.G.L. G• 131, §40 and Town of Barnstable Ordinances Article XXVII A. General Information Sk 17347 Ps 158 08.7202 Important: From; 07-28-2003 a 02 2 25P When filling out forms on Barnstable the computer, Conservation Commission use only the tab key to This issuance if for(check one): move your cursor-do ® Order of Conditions not use the return`key. C! Amended Order of Conditions To: Applicant: Property Owner(if different from applicant): vs�=4 Patricia P. McNutt. Name Name 359 School Street Meiling Address Mailing Address Cotuit MA 02635 City/Town State Zip Code Cityrrown state Zip Code 1. Proiect Location: 421 School Street Cotuit Street Address CttylTown 020 125 Assessors MapvPlat Number Parcel/Lot Number 2. Property recorded at the Registry_ of Deeds for: Barnstable 8990 24 County . Book Page CsrGificts(if registerere WA—) 3. Dates: 00 March 24,2003 June 24,2003 JUL 1 5 2 Data Notice of Intent Filed Date Public Nearing.Closed Date of Issuance 4: Final Approved Plans and Other Documents(attach additional plan references as needed): Site Plan June 20,2003 Tide Date TMG pate Tttle Date 5. Final Plans and Documents Signed and Stamped by: Richard Bertram. PE Name 6. Total Fee: $60.00 (from Appendix B:Wetland Fee Transmittal Form) - Wpaform5-doc-rev.7rt1/03 Pogo 1 of 7 Bk 17347 Pg159 *87202 Massachusetts Department of Environmental Protection DEP File Number. Bureau of Resource Protection -Wetlands WPA dorm 5 - Order of Conditions sE3-4118 Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and Town of Barnstable Ordinances Article XXVII B. Findings Findings pursuant to the Massachusetts Wetlands Protection Act: Following the review of the above-referenced Notice of Intent and based on the information provided in this application and presented at the public hearing,this Commission finds that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that apply: Q Public Water Supply Land Containing Shellfish Prevention of Pollution Q Private Water Supply ® Fisheries ® Protection of Wildlife Habitat n Groundwater Supply Storm Damage Prevention 6a Flood Control Furthermore,this Commission hereby finds the project,as proposed,Is:(check one of the following boxes) Approved subject to: ® the following conditions which are necessary, in accordance with the performance standards set forth in the wetlands regulations,to protect those interests checked above.This Commission orders that all work shall be performed in accordance with the Notice of Intent referenced above,the following General Conditions, and any other special conditions attached to this Order.To the extent that the following conditions modify or differ from the plans, specifications,or other proposals submitted with the Notice of Intent,these conditions shall control. Denims because: Q the proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations to protect those interests checked above.Therefore,work on this project may not go forward unless and until a new Notice of Intent is submitted which provides measures which are adequate to protect these interests,and a final Order of Conditions is issued. ❑ the information submitted by the applicant is not sufficient to describe the site,the work,or the effect of the work on the interests identified in the Wetlands Protection Act.Therefore,work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides sufficient information and includes measures which are adequate to protect the Acts interests,and a final Order of Conditions is issued.A description of the specific information which is lacking and why it is necessary is attached to this Order as per 310 CMR 10.05(6)(c). General Conditions (only applicable to approved projects) 1. Failure to comply with all conditions stated herein,and with all related statutes and other regulatory measures,shall be deemed cause to revoke or modify this Order. 2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any iniury to private property or invasion of private rights. 3_ This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal,state,or local statutes,ordinances, bylaws,or regulations. Wpafo�d--a.my.711..103 Mae 2 of 7 t11 1te�C j P9160 �872i72 Massachusetts Department of Environmen PrQ DEP He Number: Bureau of Resource Protection -Wetlands Ot WPA Form 5 - Order of ConditionsE4118 Prod DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §4D and Town of Barnstable Ordinances Article XXVII a. Findings (e©nt.i 4. The work authofned hereunder shall be completed within three years from the date of this Order unless either of the following apply: a.. the work is a maintenance dredging project as provided for in the Act;or bt the time for completion has been extended to a specified date more than three years, but less than five years,from the date of issuance. If this Order is intended to be valid for more than three years,the extension date and the special circumstances warranting the extended time period are ;3 4 forth as a special condition in this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this project shall be clean fill.Any fill shall contain no trash, refuse, rubbish, or debris, including but not limited to lumber,bricks, plaster,wire, lath,paper,cardboard, pipe,tires,ashes,refrigerators,motor vehicles,or parts of any of the foregoing. 7. This Order is not final until all administrative appeal periods from this Order have elapsed:or if such an appeal has been taken, until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Order has become final and then has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land,the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. In the case of the registered land,the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done.The recording information shall be submitted to this Conservation Commission on the form at the end of this Order-. which form must be stamped by the Registry of Deeds,prior to the commencement of work. 3; Asian shall be displayed at the site not less then two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection"for,"MA DEP"] "File Number SE3-4118 " 10. Where the Department of Environmental Protection is requested to issue a Superseding Order,the Conservation Commission shall be a party to all agency proceedings and hearings before DEP. ill Upon completion.. of the work described herein,the applicant shall submit a Request for Certificate of Compliance(WPA Form 5A)to the Conservation Commission. 12. The work shall conform to the plans and special conditions referenced in this order. 13, Any change to the plans identified in Condition#12 above shall require the applicant to inquire of the Conservation Commission in writing whether the change is significant enough to require the filing of a new Notice of Intent, 14, The Agent or members of the Conservation Commission and the Department of Environmental Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours to evaluate compliance with the conditions stated in this Order,and may require the submittal of any data deemed-nec s;ary by the Conservation Commission or Department for that evaluation. Wpaf0rm5.dw•rev.711IA03 Pape 3 d 7, Bk 17347 p" 161 �$721Di2 Massachusetts (Department of Environmental Protection DEP He Number Bureau of Resource Protection -Wetlands WPA Form 5 - Order of Conditions SES-4118 .� PrvvldedbyDEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and Town of Barnstable Ordinances Article XXVII B. Findings (cont.) 15. This Order of Conditions shall apply to any successor in interest or successor in control of the property subject to this Order and to any contractor or other person performing work conditioned by this Order. 16, Prior to the start of work,and if the project involves work adjacent to a Bordering Vegetated Wetland, the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging. Once in place,the wetland boundary markers shall be maintained until a Certificate of Compliance has been issued by the Conservation Commission. 17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully stabilized with vegetation or other means.At no time shall sediments be deposited in a wetland or water body.During construction,the applicant or his/her designee shall inspect the erosion controls on a daily basis and shalt remove accumulated sediments as needed.The applicant shall immediately control any erosion problems that occur at the site and shall also immediately notify the Conservation Commission,which reserves the right to require additional erosion and/or damage prevention controls it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of work line has been approved by this Order. see attached Findings as to municipal bylaw or ordinance Furthermore,the Barnstable hereby finds(check one that applies): Conservation Commission ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw specifically: Municipal Ordinance or Bylaw Citation Therefore,work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides measures which are adequate to meet these standards,and a final Order of Conditions is issued. ® that the following additional conditions are necessary to comply with a municipal ordinance or bylaw, specifically: Article 27 of Town Ordinances Municipal Ordinance or Bylaw Citation The Commission orders that all work shall be performed in accordance with the said additional conditions and with the Notice of Intent referenced above.To the extent that the following conditions modify or differ from the plans,specifications,or other proposals submitted with the Notice of Intent, the conditions shall control. wpefo mS.dor•rev.7111/03 Pape 4 of 7 Bk 17347 P9162 437 . 2tD2 SE3-4118 McNutt Approved Plan= June 20,2003 Site Plan by Richard Bertram,PE Special Conditions of Approval I. Preface Caution:Failure to comply with all Conditions of this Order of Conditions can have serious consequences. The consequence may Include issuance of a stop work order,fines,requirement to remove unpermitted structures,requirement to re-landscape to original condition,inability to obtain a certificate of compliance, and more. The General C2n#Mons of this Order begin on page 2 and continue on pages 3 and 4. The Special Conditions are contained on pages 4.1,4.2 and 4.3 if necessary.All conditions require your compliance. II, Prior to the start of work,the following conditions shall be satisfied: 1. Within one month of receipt of this Order of Conditions and prior to the commencement of any work approved herein,General Condition number 8(recording requirement)on page 3 shall be complied with. 2. It is the responsibility of the applicant,the owner and/or successor(s)and the project contractors to ensure that all conditions of this Order are complied with. The applicant shall provide copies of the Order of Conditions and approved plans(and any approved revisions thereof)to project contractors prior to the start of work. Barnstable Conservation Commission Forms A and B shall be completed and returned to the Commission prior to the start of work. 3. General Condition 9 on page 3(sign requirement)shall be complied with. 4. The Conservation Commission shall receive written notice 1 week in advance of the start of work. 5. The Natural Resources Dept.shall be notified at least 21 working days prior to the start of work at the site, to inspect the areas for shellfish. If deemed necessary by the Shellfish Constable,shellfish shall be removed from the work area to a suitable site and/or replanted at the locus following construction. The foregoing measures for shellfish protection shall ensue at the expense of the applicant. III. The following additional conditions shall govern the project once work begins. 6. General conditions No. 12 and No.13(changes in plan)on page 3 shall be complied with. 7. The Conservation Commission,its employees,and its agents shall have a right of entry to inspect for compliance with the provisions of this Order of Conditions. p.4.1 ¢ta 17347 P9163 087202 8. This permit is valid for 3 years from the date of issuance,unless extended by the Commission at the request of the applicant. 9. Herbicide,pesticide and fertilizer use is discouraged on lawns within Conservation Commission jurisdiction. If fertilizer is used,only slow-release low-nitrogen fertilizer shall be applied. Over-fertilizing shall be avoided. 10. There shall be no disturbance of the existing salt marsh. 11. No creosote-treated or CCA-treated materials shall be used. 12. Deck plank spacing shall be at least one half inch. 13. No dredging(including but not limited to effects of propeller wash)is permitted herein. 14. The seasonal storage of floats shall be at a suitable upland site. Floats shall not be stored on banks,marshes or dunes. 15. Lateral access stairs or ladders shall be provided. 16, Float stops shall be used to prevent the grounding of the float on the substrate. The following special conditions in italics shall govern boat use at the approved pier. These conditions shall continue over time. Note: For purposes of this Order of Conditions,the term"pier" shall refer not only to the linear pile-supported structure,but also to any of its components or appendages such as the float(s),ell,tee,ramp,outhaul piling,etc. 17. Boats shall only be berthed at the float. 18. No boat shall be used or berthed at the approved pier such that at any time less than one foot of water resides between the bottom of the boat and the substrate. 19. Nothing larger than an 18 ft.Aqua Sport with a 180 hp outboard shall be used or berthed at the pier. 20. The approved design pier shall be constructed once the necessary licenses and permits are in hand. 21. Any desired pier lighting shall receive prior approval of the Conservation commission or Department. 22. Work on the pier shall ensue mid-tide rising to mid-tide falling or as otherwise necessary to prevent the grounding of the work barge on the substrate. p.4.2 ak 17347 P91 b4 087202 IV. After all work is completed,the following condition shall be promptly met: 23. At the completion of work,or by the expiration of this Order,the applicant shall request in writing a Certificate of Compliance for the work herein permitted. Barnstable Conservation Commission Form C shall be completed and returned with the request for a Certificate of Compliance. Where a project has been completed in accordance with plans stamped by a registered professional engineer,architect,landscape architect or land surveyor,a written statement by such a professional person certifying substantial compliance with the plans and setting forth what deviation,if any,exists with the record plans approved in the Order shall accompany the request for a Certificate of Compliance.At the time of the request for a Certificate of Compliance an Qdated sequence of color photographs of the undisturbed buffer zone shall be also submitted. P.4.3 Sk 17347 P�165 �87202 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP Re Number. MASS WPA Form 5 - Order of Conditions sE3-4118 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 PrmMed by.DEP and Town of Barnstable Ordinances Article XXVII B. Findings (cont.) Additional conditions relating to municipal ordinance or bylaw: see attached This Order is valid for three years,unless otherwise specified as a special condition pursuant to General Conditions#4, from the date of issuance. Date This Order must be signed by a majority of the Conservation Commission.The Order must be mailed by certified mail(return receipt requested)or hand delivered to the applicant.A copy also must be mailed or hand delivered at the same time to the appropriate Department of Environmental Protection Regional Office(see Appendix A)and the property owner(if different from applicant). Signat r On y� Of Day Month and Year before me personally appeared u MK A. L4.da- , to me known to be the person described in and who executed the foregoing instrume SOD r. acknowledged that he/she executed the same as his/her tree act and deed. Notary Public My Commission Expires This Order is issued to the applicant as follows: d ,•, ��� ��; A. ❑ by hand delivery on by certified mail,rr m eceipi�,�dque5f ((yy]] Date Date wpwom,s.dw•rev.5/12/03 Pape 5 of 7 8tc 17347 P s I66 087202 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP File Number: = VVPA ®pm 5 - Order ®f Conditions SE3-411e 9 Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and Town of Barnstable Ordinances Article XXVII C. Appeals The applicant,the owner, any person aggrieved by this Order, any owner of land abutting the land subject to this Order, or any ten residents of the city or town in which such land is located,are hereby notified of their right to request the appropriate DEP Regional Office to issue a Superseding Order of Conditions. The request must be made by certified mail or hand delivery to the Department,with the appropriate filing fee and a completed Appendix E: Request of Departmental Action Fee Transmittal Form, as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this Order.A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant. The request shall state clearly and concisely the objections to the Order which is being appealed and how the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act, (M.G.L c. 131,§40)and is inconsistent with the wetlands regulations(310 CMR 10.00), To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations,the Department has no appellate jurisdiction. D. Recording Information This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the land is located,within the chain of title of the affected property. In the case of recorded land,the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions.The recording information on Page 7 of Form 5 shall be submitted to the Conservation Commission listed below. Barnstable Conservation Commission BARNSTABLE REGISTRY OF DEEDS WP6f0m%5.d0c•rev.7111/03 Pape 6 of 7 . ► A 0F1►E Town of Barnstable . *Permit# pErpires 6 months from issue date Regulatory Services Fee , 6<�) • MRNSTABLE, rMASS. Thomas F. Geiler Director ` r i639 ' �lED Mph Building Division �, I lj Tom Perry, CHO, Building Cornmiss►oner 200 Main Street, Hyannis, MA 02601' www.town.barnstab)6.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 :.' y-Z,.i i ❑Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name& Address 1 r 1 OeAAJ '�__ ' Contractor's,Name' SC".' S � Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) co ❑Workman's Compensation Insurance .Check one: 0-1 am a sole proprietor 0 I am the Homeowner ® I have Worker's Compensation Insurance Insurance Company Name c'a Workman's Comp. Policy# 'Jcc 'R—V P-a lac Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check _ox �. Re-roof(stripping old.shingles) All construction debris will be taken to Ej Re-roof(not stripping. Going:over existing layers of roof) EJ Re-side #of doors Replacement Windows/doors/sliders. U-Value 4 (maximum .44)#of windows *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- re aired. SIGNATURE: QAWFIMES1FOR Ibuil .ing permit formsTXPRESS.doc ' .. B....:__J n A;1 to t License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10-k2r k Plaza-Suite 5170 Boston,MA 02416 i 1 Notvalid withmt signature ar HgME/ cons, mer RO EIW Business r r Ex rs 91strat►on V 1 ENT CONT s►Hess R?gulatioa j '. JO p►ration B/2 01149 RACTOR r . 5/2 r P.DUNN r� 012 Individual 1 1 _ John p r 1 Unn. ; 80 MARIE AN VRW CENTERVILLE Mq 632ts :" t I � � r g=:- iViassachusctts - Dcpartmcnt a oard of Building of Public Satct� B Construction Supervisor►L censernd`trc)s 3 License: Cs 14007 Restricted to: 00 JOHN P DUNN BOX 924/80 MARIE ANN-TERM ... CENTERVILLE, MA 02632 Expiration: 5/25/2612 ('ununissiuncr Tr#: 24061 The Commonwealth of Massachusetts I ,; Department of Industrial Accidents Office of Investigations IC,;°' ! t � j 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeRib}y Name (Business/Organization/Individual): 1-1 N V C 1P-� ("C.U� f l' f\JP� �C-1. I Address: gal&— City/State/Zip: (iU2t)1��,CL, Ilk 6G Phone #: Are,you an employer?Check the appropriate box: Type of project(required): 1.94.am a employer.with _ 4. ❑'I am a general contractor and I 6: ❑ New construction employees(full and/or part-time).* have hired the sub-contractors, 2.❑ I am a sole proprietor or partner- . listed on the attached sheet. Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10:❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I LF Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.]-t employees. [No workers' 13.0 Other comp. insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees..Below is the policy and job site information. Insurance Company Name: �-_C f i z� fJ� Policy#or Self-ins. Lic.#: � pS loU(( Expiration Date: °n— C1 Job Site Addres4�II LJC:fi v'`C' City/State/Zip:Q-,�tT 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 hereb certify under the pains and penaltdes of perjury that the information provided above is true and correct. Signature- Date: Z-- 0,;�' l PhoneT 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#: ja Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"—every person in,the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other,legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or.to construct,buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if. necessary, supply sub-contractor(s)name(s),address(es)and phone numbe (s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry,workers' compensation insurance. If an LLC or LLP does have, employees,a policy is-required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations,in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture, (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call.. .The Department's address,telephoneand fax number: The Commonwealth of Massachusetts Department.of Industrial Accidents Office.of lnvestigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-WSSAFE Fax # 617-727-7749 Revised 5-26-05 www.mass.gov/dia Town of Barnstable ` Regulatory Services • f i • EtABNSL'ABL.E, • .. v uAas g Thomas F. Geiler,Director E1659- Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us 'Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property. authorize ' t{t,) c��N ►.� to act y Ja on my behalf, bereb in all matters relative to work authorized by this building permit application for: (Address of Job) 'rl a-avct Signature of Owner Date Print Name If Property Owner is applying for permit please complete. the Homeowners License Exemption Form on the reverse side: ii Town of Barnstable Regulatory Services Thomas F. Geiler, Director asp Building Division Tom Perry,Building Commissioner 200 Main-Street, Hyannis, MA.02601 www.town.barrnstable.ma.us Office: 508-862-403 8 Fax: 508-790-62301 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state rip 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. DEFINMON 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 cons"cts 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 1 o9j.l -Licensing of construction Superyisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." lvlany homeowners who use this exemption an unaware that they are assuming the responsibilities of a supervisor(sec Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. 1 To ensure that the homeowner is fully aware of his/her responsrbilitiu,many communities require,as part of the permit application, that the homeowner certify that hclshe understands the responsibilities of a Supervisor. On the last page of this issue is a.form currently used by seyeral towns. You may care t amend and adopt such a form/certification for use in your community. "I CERTIFY THAT THIS PLAN CONFORMS TO THE RULES AND REGULATIONS OF THE REGISTERS OF DEEDS." DATE: SEP. 29, 2003 CAPE& ISLANDS ENGINEERING 800 FALMOUTH ROAD, SUITE 301 C MASHPEE, MA 02649 Locus T. : v 4 LOCUS jT�;tTIC�L COTUIT QUADRANGLE • AR B�DGB SCHOOL STREET G &U-O.B ExIgTtNC +ELF-2.9' R�R4P PROPOSED L-8.3' 35 Y x 12'RAMP b Q 1•. ItUB.1' EL--2+9' +EL,-1 ELF-0^, L,8.2' HOUSE 421 3.r MAP 20 t+ PROPOSED 8 I '6' PARCEL 125 8'x 10'FLOAT 4• PROPOSED 28'i- I WOODEN + EL,-2.0' EL1-3.6' + EL- o .� I_ L WALKWAY JLK L0.9' EL--2.0' :o N �N 6' M 8.6' 1 ELr0.4'. +EL,-2.9' W 3 W 'EL,4 4' 10 LL 1".9 5 OWNER/APPLICANT: �G�9, .�j M�2� � L-9,1' ' 3 x McNUTT,PATRICAI F. �� IEL 0. ��.s lvv9 6.7' 359 SCHOOL STREET +EL'-2.2' COTUIT,MA 02635 G7 .8' +EL-1.3' rti L'.3' 9L6. +EL--2.3' + %vw 'EL, W'` 1. 4 O BENEDETTO,ROBERT R. 193 KENSINGTON PARK or rl,Iss IRVINE,CA 92606 �� 90 WCHARD. � . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . E2 A -' • A c7r oTE upL s'O E . ►....•. . . . 20 10 0 20 40 ELEVATIONS ARE BASED ON MLW SCALE: 1" =20' SHEET 1 OF 3 SEPTEMBER 29,2003 PLAN ACCOMPANYING PETITION OF ROBERT McNUTT TO CONSTRUCT&MAINTAIN A WOODEN PIER,RAMP&FLOAT IN SHOESTRING BAY, COTUIT, MA CAPE&ISLANDS ENGINEERING MASHPEE,MA I I "I CERTIFY THAT THIS PLAN CONFORMS TO THE RULES AND REGULATIONS OF THE REGISTERS OF DEEDS." DATE: SEP. 29,2003 CAPE& ISLANDS ENGINEERING 800 FALMOUTH ROAD, SUITE 301C MASHPEE, MA 02649 v w ¢ Q ¢ � x o 00 a � o0 � o a °3 H O MHW � O o N i a C) c� O 6��>RICLHARD\ e oo w �. GERI P.A?JD 29894 \� NI a r♦ire f q 3 , x� wl • ROBERT MCNUTT CAPE & ISLANDS ENGINEERING SHEET 2 OF 3 SEP.29,2003 MASHPEE,MA ELEVATIONS ARE BASED ON MLW l - "I CERTIFY THAT THIS PLAN CONFORMS TO THE RULES AND REGULATIONS OF THE REGISTERS OF DEEDS." DATE: 5E-P.. 29, 2003 CAPE & ISLANDS ENGINEERING 800 FALMOUTH ROAD, SUITE 301 C MASHPEE,MA 02649 8'-011 V x 10" SKIRT 5/4 DECKING 1 SPACING 2"x 6" JOISTS @ 2'-0" 12"x 30" STYROFOAM 211 x 411 SKID 1/2" GALV. 5/4 DECKING BOLTS FLOAT SECTION SCALE: 3/8"= F-0" 3'-0" 2"x 411 HANDRAIL 2"x A`Tll 411 x 41l I POSTS BRACES 31-011 �^ SPIKE DECK 3/8" GALV. TO STRINGERS 5/4 DECK I LAG BOLTS 3'1 x 61' 3/4" SPACING 211 x 6" 5/4 DECK DECK EL.6.5' 211 x 6't CROSSBRACE 211 x 011 F� SECTION STRINGERS �..;. Llwyf"° n� S AL ?.���aA.%8- 1l-0rr 3"x 811 Sr' - �t0 Y 411 x All ,�;T,;:•,; v SPLIT CAP POSTS HTM EL.2.8' MLW EL.2.3' 12 1 1 3 4 51 SCALE IN FEET . . . . . . . . . . . MLW EL.0.0_ ELW EL.-0.5 PROPOSED BENT SECTION SCALE: 3/8"= F-0" ROBERT McNUTT CAPE&ISLANDS ENGINEERING SHEET 3 OF 3 SE p. 29,2003 MASHPEE, MA ELEVATION ARE BASED ON MLW l "I CERTIFY THAT THIS PLAN CONFORMS TO THE RULES AND REGULATIONS OF THE REGISTERS OF DEEDS. DATE' SEP. 29, 2003 CAPE & ISLANDS ENGINEERING 800 FALMOUTH ROAD, SUITE 301 C- MASHPEE, MA 02649 HGY�L, Laus T. s / - . v LOCUS COTUIT QUADRANGLE ELF- . +EL,-3, SCHOOL STREET . _ �.7,EU-0.8' +ELF--z.9• �XrSr,NGR'rRAr PROPOSED 35 Y x IT RAMP FA ItUS r EL,-24,9' o +EL-1 EL 01 U8.2'. HOUSE MAP 20 421 hft PROPOSED 8 1 : , ' 13�r PARCEL 125 8'x 10'FLOAT PROPOSED WOODEN W WALKWAY l�10.9' EL-3,6' + EL- :� M L�3;V. FL' 0 4 EL�-2.9' W WL 4 4' h q a b2V419 5. ' L,9., OWNER/APPLICANT: Et10. �s 5.9. McNUTT,PATRICAI F. .�� lvw. 6.7'. _ 359 SCHOOL STREET EL-42' a COTUIT,MA 02635 EL,4:3' L23; ( I9L6• EL�-2.3'. + lvw ELF-L8' IEU ' L 1' oq O jj BENEDETTO,ROBERT R. 193 KENSINGTON PARK IRVINE,CA 92606 20 10 0 20 40 ELEVATIONS ARE�BASED ON ML'W SCALE: 1" =20' SHEET 1 OF 3 SEPTEMBER 29,2003 PLAN ACCOMPANYING PETITION OF .ROBERT MCNUTT TO CONSTRUCT&MAINTAIN. A WOODEN PIER, RAMP&FLOAT IN SHOESTRING BAY, COTUIT, MA CAPE&ISLANDS ENGINEERING MASHPEE,MA 1 "I CERTIFY THAT THIS PLAN CONFORMS TO THE RULES AND REGULATIONS OF THE REGISTERS OF DEEDS.". DATE: SEP. 29,2003 . CAPE& ISLANDS ENGINEERING 800 FALMOUTH ROAD, SUITE 301 C MASHPEE, MA- 02649 3u wQ � a 3Q O QW a p O O O � O • .O .9 I£ MH W -09 o O wa u s, " , o I .I ►� O • , I 01 ,I w :I z > ✓X&A&A� E~ o O _\ x JAV 19ec9a 60 xl wl . 1LICENSE P.LAA1 NO.' q 9 407 Approved by Department of Environmental Protection O .. � Date. 2 67 � - ROBERT MCNUTT CAPE & ISLANDS ENGINEERING SHEET 2 OF 3 SEP.29,2003 • MASHPEE,MA ELEVATIONS ARE BASED ON MLW rp' "I CERTIFY THAT THIS PLAN CONFORMS TO THE RULES AND REGULATIONS OF THE REGISTERS OF DEEDS." DATE: 5ER. 29, 2003 ' ------------ CAPE & ISLANDS ENGINEERING 800 FALMOUTH ROAD, SUITE 301C MASHPEE,MA 02649 81-011 as "x 10' SKIRT 5/4 DECKING V SPACING 2"x 6" JOISTS @ 2'_0" 12"x 30" STYROFOAM 2"x 4" SKID 1/2" GALV. 5/4 DECKING BOLTS FLOAT SECTION SCALE: 3/8"= 1'-0" 3'-0" 2"x4.r HANDRAIL 4"x 4" I 2"x 4-1 POSTS BRACES OfIL `^ SPIKE DECK 3/8" GALV. TO STRINGERS 514 DECK I LAG BOLTS 3"x 6" 3/4" SPACING . 2"x 6" 5/4 DECK DECK EL.6.5' 2"x 6" CROSSBRACE ' 211 x 8f' SECTION STRINGERS -Ott 4 x 4 _ 311 x 811 0 1v ,�,� ir•Fi,, `2 .."�" _ POST - SPLIT CAP HTM EL.2.8' MLW EL.2.3' SCALE IN FEET . . . MLW EL.0.0_ ELW EL.-0.5 LICENSE PLAN NO. 9 9 L 7 Approved by Department of En*mmenW Pin C . Date. PROPOSED BENT SECTION APR 2 8 SCALE: 3/8"=1'-01.1 ' ROBERT MCNUTT Q CAPE ISLANDS ENGINEERING SKEET 3 OF 3 SEp. 29,2003 1* r MASHPEE, MA ELEVATION ARE BASED ON.'MLW `� - - i •��` Q`t 1 I .fin /� vn •�•: l`�, •' t CotatL AA V�i LT 11IcULA Rib $. " G� EOB -2.3' t I ECG 2.9' U` � G RIP n'4P PROPOSED U 3'X I2'RAMP ` n SCHOOL ST. Is 35' �)\ 2 9' �1.8' I -0.1' PROPOSED o f EbG o i I ; , 16' B rT,.WOODEN WALKWAY Lxal r I -—— EL. 6.5 [3/4 DECK SPACING] PROPOSED 8,I wi S X.10 f; „ a , TIV .NO.42,1 FLOAT —— — i � 28' 1 a.1 r � ,{ 13 -2.0' 2.0' of / 3 j 28' -2.9' 3, a, SALT BD , SHOESTRING BAY MARSH EOG 0.0' I I 15.9' EOG I IBVW -2.2' I 2 00, 1 I 4.9' -2.3' BVW U BE RTB,.N'U r� . 16' 10, 29324 ' 2 BENTS chi 8' O.C. s, N YX PROPOSED DECK EL.6.5 [3/4"SPACING] 2 AMP 8'X 10'FLOAT'T `.... 3°6 PROP SED .SEASONAL DOCK z^X 8° LOCATED IN TR GERS MiffEL.2.3 M;.W EL.o.0 COTUIT,MASS. ------�-------- --------------------------------------------------- PREPARED FOR ROBERT McNUTT 10 0 10 20 so 2003 SCALE: l" = 10' 4"X 4"PILINGS DATE: JUNE 20, FILE: 225MA school st CAPE & ISLANDS ENGINEERING SUTTE 30 c PROFILE OF PROPOSED SEASONAL 800 F:�LMOU SS.022664, �[5081477-7272 PIER,RAMP & FLOAT MASHPEE,MA