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G a..•... o ..- 1 ii52. r"! ,,. .,'f .rJ l , , Y vl� i,...... .,..t,.. .,, ,. , ,.. ._„ .. .: _...._ ,a _, f _.. ,. ...r.,,.,, ,.,:, t'�' •`fir^,,; 1 3{ 4 ( I :III G rtt y� t C l r.. r. a,r ,5 e t t. �ti t i ! 1 1 l '• t.�} tt. Y 4 , , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION p ace � � F C Application # Health Division Date Issued 00�� Conservation Division Application FeS AX) Planning Dept. Permit Fee fi �CQJ�d L� Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village Owner Address Telephone �A�o Permit Request �t1 Square feet: 1 st floor: existin propose ,2nd floor: existing" posed ��s�tal new Zoning District Flood Plain Groundwater Overlay Project Valuation • yCw 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: �es ❑ No Basement Type: ❑ Full rawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new A& P _J Half: existing Z new Number of Bedrooms: existing Onew Total Room Count (not including baths): existing new CeD First Floor Room Count Heat Type and Fuel: `Las ❑ Oil ❑ Electric ❑ Other Central Air: aes l❑ No Fireplaces: Existing ® New Existing wood/coal stove: ❑Yes to 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 ppeals Authorization ❑ Appeal # Recorded ❑ ..._, W Rt Commercial es ❑ No If yes, site plan review# Current Use s.� � � Proposed Use �� ' x-. APPLICANT INFORMATION (BUILDER OR HOMEOWNER) ;v Name Elf • t& lephone Number Address License # yaS AIA , Home Improvement Contractor# Email Worker's Compensation # � ALL//CONSTRUCTION D RIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C 1�U�1 Q A—, ct_l�� SIGNATURE 3 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. r ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE - , I ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r FINAL BUILDING DATE CLOSED OUT I ASS pIATION PLAN NO. The Corranonweah%of Massachusetts Department oflndustrial Accidents Office of Invesfigafions 600 WashhWon Street Boston,MA 0211-1 kii www.mass gov/dia Workers' Compensation Insurance Affidavit:Btgders/Contractors/Elecfricians/Plmnbers ApOicant Information P Please Print Legibly' Name(Bnsiness/Oro nization/IndividuaI): a - Address: ufl►i-- ✓ �P� 66y `�- 2 2 • City/State/Zip: ►rl G�c� Phone#: Are on an employer? Che k the appropriate box: F6. E�] of project(required): 1, am a employer with ® 4. [I I am a general contractor and I employees(full and/or part time). have hired the sub-contractors New construction 2.0 I am a sole proprietor or partner- listed on the attached sheet 7• ❑Remodeling ship and have no,employees 'These sub-contractors have g• R Demolition working for me in any capacity. employees and have workers' [No workers'comp.incttrance comp.insuranceJ 9. 0 Building addition required.] 5. [] We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeownerof have exercised their doing all work 11.❑Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 171 of repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13. Other comp.insurance required.] s. tee.. 12C.. *Any applicant that checks box#I must also fiIl 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 anew affidavit indir2�nu such. $Contractors that check this box must attached an additional sheet showing the name of the soh conhzetors and state whether or not those entities have employees. If the sub-contractors have employees,they nmst provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is thepolky and joh site information. Insurance Company Name: Annco . Policy#or Self-ins.Lic.#: Expiration Date: � Job Site Address: /GU C /State/ ' �Y Zip: 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 crmvnal penalties of a fine up to$1,50.0.00 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 her certify der th p and allies ofperjwy that the information pravided above is true and correct Si ature: Date: / Phone#: Official use only. Do not write in this area; to be completed by city or town ofjiciaL f City or Town: Permit/License# Issuing Authority(circle one) I.Board of Health 2.BuildingDeparfinent 3.CityfTown CIerk 4.Electrical Inspector S.Plrzmbing Inspector 6.Other Contact Person: Phone#: -Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"_..every person in the service of another tinder 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 jo t enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an indium pariner�hip,association or other legal entity,employing employees. However the owner of a dwelling house having t more than three apartments and who resides therein,or the occupant of the - dwelling house of another who emp ys persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurte t thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states at"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to opera e a business or to construct buildings in e commonwealth for any applicant who has not produced accep ble evidence of compliance with the' rance.coverage required." Additionally,MGL chapter 152, §25C(� tes"Neither the commonwealth nor - y of its political subdivisions shall enter into any contract for the performance f public work until acceptable evid ce of compliance with the insurance.. requirements of this chapter have been prese ted to the contracting authority." Applicants Please fill out the workers'compensation affid vit completelyt= 1 � g the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), ad ess(es)and per(s) along with their certificate(s)of inc�lrance. Limited Liability Companies¢LC) Limited Liaerships(LLP)with no employees other than the members or partners,are not required to carry wo ers' compecc. If an LLC or LLP does have employees, a policy is required Be advised that s affidavit ubmitted to the Departrnent of Industrial Accidents for confirmation of insurance coverage. Also be sun and date-the affidavit_ The affidavit should be returned to the city or town that the application the permnse is being requested,not the Department of Industrial Accidents. Should you have any questio egardin or if you are required to obtain a workers' compensation policy,please call tame Department at th numberlow. Self-insured companies should enter their self-insm-ance license number on the appropriate line. City or Town Officials t Please be sure that the affidavit is complete and printed It ly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office o vestigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which e used as a reference number. In addition, an applicant that must submit multiple permitllicense applications y gr ea year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site ddress" e applicant shoud write"all locations in (city or town)_"A copy of the affidavit that has been offici y stamped marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file r future permits r licenses. A new affidavit must be filled out each year.Where a home owner or citizen is ob i g a license or permi of related to any business or commercial venture (i.e. a dog license or permit to burn It s etc.)said person is NOT ed to complete this affidavit. The Office of Investigatio ould like to thank you in advance for yo cooperation and should you have any questions, please do not hesitate to gi e us a call. The Department's address,telephone and fax number. nI CommQnwealti-of Massach etts Department of Industdal AcicA-d - Office Of lavestigatimas 600 Wasbhgtou St=t Boston,MA 02111 r Tel.#617-727-494-0 ci t 406 or 1-8-77-MASSA-FE R Fax#617-727-7749 evised 4-24-07 w .mass_govldia A`0R& CERTIFICATE OF LIABILITY INSURANCE v.TE(M DDNYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s. PRODUCER CONTACT Rogers&Gray Ins.-Dennis Branch 434 Rte 134 PHONE 508-398-7980 FAX 877-816-2156 South Dennis MA 02660 EMARE IL - mail@rogersgray.com INSURERS AFFORDING COVERAGE NAIC If INSURER A:Netherlands Insurance Company INSURED EFWINSL-01 INSURER B:Excelsior Insurance Company EF Winslow Plumbing&Heating, Inc. INSURER C:Peerless Insurance Company-see LI 18333 8 Reardon Circle INSURERD:ARROW MUTUAL South Yarmouth MA 02664 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:486128512 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 POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MMIDD/YYYY MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CBP9919974 2/1/2014 12/1/2015 EACH OCCURRENCE $1.000,000 CLAIMS-MADE X❑OCCUR DAMA R N PREMISES Ea occurrence $100,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO- JECT 7 LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: B AUTOMOBILE LIABILITY BA8218494 12/1/2014 12/1/2015 EaaccidenMarLTW $1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS X AONO WNED R Y DA A $ XIPer acddent C X UMBRELLA LIAB X OCCUR CU9918875 2/1/2014 12/1/2015 EACH OCCURRENCE $2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DED X I RETENTION$10,000 $ ER 'ER' EMPLOYERS'LIABILITY Y/N X STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,000 OFFICERIMEMBER EXCLUDED? ❑N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Plumbing&Heating Contractor Central Vacuum is a division of E F Winslow Plumbing&Heating Inc. Certificate holder is an additional insured with respect to general liability when required in a written contract or agreement. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TOWN OF BARNSTABLE ACCORDANCE WITH THE POLICY PROVISIONS. 200 MAIN STREET HYANNIS MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD • S Lj Massachusetts - Department of Public Safety Board of Building Regulations and Standards r Construction Supervisor License: CS-049405 tir:r rs r , IRS DAVID C ANDER `SON 34 WINCHESTEI DR ` SO DENNIS MA 660 Expiration Commissioner 09/10/2016 f ffice of Consumer Affairs& Business Regulation License or registration valid for individul use onl ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: '`ter m Office of Consumer Affairs and Business Regulai <T egistration 132379 r Type: 10 Park Plaza - Suite 5170 Expiration'-1=8/20,5,j. Supplement Card Boston,MA 02116 r E.F. PLUMBING & HEATING'CO';INC z �- "" DAVID ANDERSON �% 8 REARDON CIRCLE SOUTH YARMOUTH, MA 02664 Undersecretary Not valid without signature 12/24/2014 11:00 FAX 15083624200 JensABahrawy U 0001/0001 12/24/2014 09:53 15087715652 EFWINSLOWDESIGNSTUDO PAGE 01 Toga of Barnstable Regulatory Services '"�'�' ` Thomas F.Geller,Director Building Division Tom ferry,Building Commissioner 200 Main Sheet,Hyannis,MA 02601 wwwAi wu.barustable.ma,us Office: 508-862-4038 Fax: 508-79M230 Property Owner Must Complete and Sign This Section If Using A, Builder I'✓ Te NS /`t . �Qh�'au� , as Owner of the subject property hereby authorize. P)AII-4W Qkod F(str/iesIC�!/ to act on Amy behalf, iu all matt=relative to work authwized by tbis build petAoit ' (Address A Job) **Pool£ es and alarms are the responsibility of the applicant. Pools are not t b filled'or d before fence is installed and all final inspec ' m are p rax�ed and accepted. S' a o Signature of Applicant r/ ..w P ' t N e Print Name Id 1,4111 , Date Q:kORMS:oVPN&RPEP,KSSZONI''W S 6/2012 r VL , f< r , 17 S' � r > fe i•T y a' +f_.r j{ � i� � "� 9".Ci �.,: �11 'Yi���.J��� `�'� �.�.{v�';y„'� � .�1" i 47 1. .� T'w!' 5 � Cie :. < dv� ♦ ���. .fit OA . 411 N q - t�. �1 .Pf. T.f tt„ p;��' V ��yr'3,�'^'R• .1 .- r 2001 . 053 young• ' Glint young r artist in wood conceptual sketch 2/28/01 and other media 2'7" �:iiiiiwwiiii:::•.:�:•. k`� Hand carved mahogany sign hung on existing bracket. ' Black bacground w/23k Gold Leaf lettering,coves and motif. scale: 2"=V' ©young design 2001 i/ shop/studio:376b rte.130,sandwich,ma mail:p.o.box 71,forestdale,ma 02644 (r email: yungdzyn@gis.net 508 833 8877 2001 , 053 Town of Barnstable ' Old King's Highway Historic District Committee SPEC SHEET FOUNDATION SIDING TYPE COLOR CHIMNEY TYPE COLOR ROOF MATERIAL COLOR PITCH . WINDOWS COLOR SIZE TRIM COLOR DOORS COLORS SHUTTERS COLORS e1mac GUTTERS COLORS TIN DECKS MATERIALS ' GARAGE DOORS COLORS �. SKYLIGHTS SIZE COLORS �\ 2 A SIGNS COLORS t()V1IN,O�BS �y�G4-4�1Y 0 � FENCE COLOR NOTES: Fill out completely, including measurements and materials/colors to be used. Four copies of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plans, when applicable. SPECSHT Revised 11198 �,f yAsAitssor's offioe (1st floor): -":-­AsseAr's m6p, and lot number 97. ���— pf THE tO Board o{, Health (3rd floor): { Sewagea Permit number .....�.:.�..:..r .................................. y TT Cp MW{�i�W' 1©TO����G'� Z 11ABD9TGDLL, as ;ineering Department (3rd floor): vo r atb39 •� yFuse number ........................................................................ 0 39 of APPLICATIONS PROCESSED 8:30-9:30 AM, and 1:00-2:00 P.M.'only TOWN OF BARNSTABLE BUILDING INSPECTOR r ::.:... ...:z APPLICATION FOR PERMIT TO C2.kf ...... ��S✓C 1S ,lc� al TYPE OF CONSTRUCTION .........'A 'd ..... .......11-'.�1� ...... ��................1971.._ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies/for a permit according to the following information: Location .......��. .S z'......./..`��/!�.... T:.. .�i3/o�.J.... j{ G............................................................... ......................... Proposed Use ..I......................2•°�.® ........ Zoning District . ..�' Fire District ... *5� r�' �.................. ............................ ................................................. Name of Owner ...AddresJ.:. ?` Clb :....0 ....,....,.. Name of Builder �- � ..G« //' A �.i................Addres y/2SlO Name of Architect .............. .«`. .. .. -..,....Address Numberof Rooms ................ ...........................................Foundation ......... ....................................................... CAA �:o �� c / �` I Exterior .........��..!�.............�...✓.f.{....'`..��................Roofing .... .�1..4?� Floors v t 1Z / .. ..14 ....Interior ......./ , Heating .....f%CJ:4 jc/..er.4 .........:..... 5........Plumbing ......................... ......................................_.._.....—." _ �T �:'�.`..................................................A �..�............ ego - Fireplace ......................... Approximate Cost ..... Definitive Plan Approved by Planning Board ________________________________19________ . Area ........... .................!...... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations4the/To ` of le regard ng the boveconstruction. Na ........ . ............... .. Construction Supervisor's LicenseYo.z9 .... FRANK.LIN-, MYERS p 3 4189 permit for •••Renovate Commercial Bldg ............................................................. Location 3252 Main Street /n3s" 1V'/' Barnstable .....................................................................I......... Owner ....Myers Franklin , . .................................................. Typo)of Construction •.• Frame 4 I -Blot ............................ Lot ................................ Permit Granted ....March 1 ................19 91 Date of Inspection .......- ......19 ` Date Completed ...... ..../(;1 .............. ..19 l t l I 1 a • j View - With Dimensions PLAN 2 4=2x .2 Stair stringers, 10" tread, 715" rise 4x4 pt rail and deck,post to grade; �-- anchored to 8"x36"sono tubes. 0lx} bolted ledger With joist>hangers(typ)` 3•sr joist i16"0:c:with 5/4x 6"P;T..Decking noo.`ax 4' double 2x10 beam, bearing on and.bolted to shoulder cat i t'. 6x6 posts, anchored to 10"z36 concrete filled song tubes on spread footings P First floor entrance landing below, on grade 2x6 joists, 016".oc.,wlth SAx6 pt.decking..8.61ted ledger and hangers. (Bearing on same`10"tubes) P T..2x2" baulsters,5"o.c; with.,U4 railings. 6 36" P s 4 ,001 iz,©/ � View , With Dimensions 3D STAIRWAY r 4,; ol .r- �.. ,„ems.. � .,,,..•�- u' 'w`.w. .. .' +K',+. - W..X.`r, `L4k t` tw „ j �F i ��r #;..�. _ �_,r, ��r A�• ,#,ter _ _. + 't.'t'�.��. _ .+'° ��} �},�'""-�y"' ^S'i.r-- -"„vrt'+.. r _r�. t _ .... 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'' � t� }yam�..� r � � .. r -• � #� I y { 9 i 1 i 14 rk • t 6 - y 2014-12'03-1225 " ! 12/19/2014 Page: ►3o.R,�ST�.g� F I<aR1JR ^:L K�-�.r7i' i LOCUS I''AP � / ' Z,a cc, _ Lq?�N b t N SU _ _ t [--I A'\ SiTREET (ROUTE GA\ ) - j I h + ' AECEIVEDy m _ --- — -- --- ------------ - - SI A-T _ D ! N 71.1 1f EV,STREET, P.O. BOX 119, 1A)MOL711 PORT, 1f.4SS4CHC'SF_7-fS 0267 (508) 361-8131 CONS'CTLNG&DESIGA7 E.NGLNEERS• CHYL & STRC-CTC,4L P R 1�-FAA R E D ,r-O R. --- - — REGISTERED PROFESSIONAL LAND SURVEYORS � � ) }� ( Cv PROPROFESSIONALPL.4NAING& DESIGN I\1 I L. F' S F !'��j A�J (� L_ I 1 `� --- - ----- — --- CC\'STRC%CTIO.\%1 t4,N;4 G E,lfE,''T REG. LAND SURVEYOR REG.ENGINEER SCALE: ( 4t - t G ��^ DATE: p�G, 3� � � 9�0 REV.No DATE REv'SON oESCRiP KI-N CHECKED o _ W W Z o , i w ti W o Qz > W W \� - i I ! � <,. f i `y o, i I a L, LU It 4Z ICI ' II it �y p I a N Kl w " LU cc - -- 4 I � O a- w W V1 z W W j F '— - K : , T I I, 1 J I I -- - - 77- - _ - _-- _ f : - — r -� - = _ i -- -- - _ ' y _ -- ------- --- - - 7-7- - - - ccl LZ ,o rL. ----------- 12, DESIGN: —FFI/IWI DRAWN: IV�I . � I CHECK: FILE#: DWNG#: t^� b — T