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1805 SERVICE ROAD - Amnesty & MULTI-FAMILY
f I A r I( G� �r ©���� NO. 15 2 1/3 0 �D� ,�S�I��C�:��a l � _ _ - } �, ,. �� �� ��� i Loll i 4 4 C i f i f i f f i I F G I 1 i r w � i - Amnesty, Program kf a; rei,r Helping to make affordable housin possibl .e " r t A 't�c�lr�r J ` -'own ® stable i +Certificate of Compliance.� This certificate indicates acceptable minimum habitable requirements per Massachusetts State Building Code f and Town of Barnstable zoning ordinances in accordance with the Amnesty program.: ' I Owner Karen Machado ,':,. . W.::B ariistable Location.:. 1805•:Service;'Road,•: . Ca aci o exceed Two: •eo le': "" .�. OneB�-d�don � .. VIA!`rS!die{I•rueru�i�. :I r ... P_ ctor In se ' ,ls , Yrw 1 u 1 � ST 1 i J SaL ra) v t F n , r 'L ..._ ...... u ��ur c•' w 1. • 't a ., .. .. ... ...r , .:,...r. .. ........ ......+ ...... ��+Y•� ... /yam[ 4� 00 /V� MAP� :Q ��9. 1 G 4 I= 5 ...... ::.,.•... .r a ...� A... .... .. .... .: ..I.. I (� 5 ^ m rYY -K 1 n 1 - �ZHie ,� Town of Barnstable Building Department - 200 Main Street &UMSTABLE. * Hyannis, MA 02601 MASS. (508) 862-4038 1639• ArFD MA'S a Certificate of Occupancy Application Number: 201201216 CO Number: 20120.1.44 Parcel ID: 194008WO1 CO Issue Date: 12103/12 Location: .1805 SERVICE ROAD Zoning Classification: RESIDENCE F.DISTRICT Proposed Use:. SINGLE FAMILY HOME Village: WEST.BARNSTABLE Gen Contractor: PROPERTY OWNER Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: Building Department Signature Date Signed HE �t > ti Town of Barnstable o� Building Department - 200 Main EL"MSTM14 * Hyannis, MA 02601 9� se39. (508) 862-4038 RFD MA'S A Certificate of Occupancy Application Number: 201201216 CO Number: 20120144 Parcel ID: 194008WOI CO Issue Date: 12/03112 Location: 1805 SERVICE ROAD Zoning Classification: RESIDENCE F DISTRICT Proposed Use: =SINGLE FAMILY HOME Village: WEST BARNSTABLE Gen Contractor: PROPERTY OWNER Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: Building Department Signature Date Signed TOWN OF BARNSTABLE �tNE _ - Buliding 201201216 * BARNSTABLE, * Issue Date: 04/30/12 Permit 9 MASS. QpA 163y. �� Applicant: MACHADO KAREN M rFC MAC A Permit Number: B 20120963 Proposed Use: SINGLE FAMILY HOME Expiration Date: 10/28/12 Location 1805 SERVICE ROAD Zoning District RF Permit Type: AMNESTY W/CONSTR RESIDENTIAL y Map Parcel 194008W01 Permit Fee$ 35.00 Contractor PROPERTY OWNER Village WEST BARNSTABLE App Fee$ 50.00 License Num Est Construction Cost$ 6,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND CREATE A ONE BEDROOM AMNESTY APARTMENT IN BASEMENT THIS CARD MUST BE KEPT POSTED UNTIL FINAL MAKING A HALF WALL TO WHOLE.CONSTRUCTING A BATHROOM INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: MACHADO,KAREN M BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 1805 SERVICE ROAD INSPECTION HAS BEEN MADE. W BARNSTABLE,MA 02668 r- Application Entered by: RM Building Permit Issued By: �1 s � THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR.PERMANENTLY. ENCROACHMENTS ON PUBLIC.PROPERTY,NO SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.-STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC ISEWERS MAYBE OBTAINED FROM THE6EPART4ENT OF PUBLIC WORKS:THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE'APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE'SUBDWISION RESTRICTIONS. L. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED-PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). a 5.INSULATION. Q 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OIL DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). Rzl NO BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS �- 2 2 ` i� 2 f 3 1 Heating Inspection Approvals Engineering Dept Fire Dept WF57' P'JVZ 2 Board of It 4 / a� j k; TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 1� Map 19 y Parcel 06 9 - WON Application # Health Division Date Issued 3� Z Conservation Division Application Fee S� Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board �. 19 Historic - OKH _ Preservation /Hyannis Project Street Address I �QS S rO +CQ_ C(6 Village We-SA �Cg_rnbAZ-bW__ Mft 62-C,6 ' Owner ) a.wn 1' a,. ,CZAR Address 1 G5 �SfN 1� rzCk, Telephone Li- 6y 7 a I Permit Request r z2`� C� 0 car o^^ 0_Cnn.9_S1)2J Cn_ t &11r,- '/Z OAtt A �0c1 wP4 Square feet: 1 st floor: existing /(,51tproposed*OA 2nd floor: existing 1154� proposed Total new Zoning District Flood Plain Groundwater Overlay (APIL;" Project Valuation o0-0• Construction Type Lot Size 319 Nc.rc Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Er"_ Two Family ❑ Multi-Family (# units) Age of Existing Structure 1 8 Historic House: ❑Yes U-Ndo On Old King's Highway: ❑Yes ®-N—o Basement Type: ❑ Full ❑ Crawl Ck/alkout ❑ Other Basement Finished Area (sq.ft.) Ias( Basement Unfinished Area (sq.ft) Spa S� Number of Baths: Full: existing new 1 Half: existing I new 6 Number of Bedrooms: 3 existing 6 new 11'5 Total Room Count (not including baths): existing new First Floor Room Count y Heat Type and Fuel: was ❑ Oil ❑ Electric ❑Other Central Air: C9'Y'es ❑ No Fireplaces: Existing Q New 0 Existing wood/coal stover;;❑Yes) 3-Ko t i Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: 0 existing Ubew size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # a6 Recorded cv Commercial ❑Yes 3' o If yes, site plan review# Current Use ilkvi�C Arta, Proposed Use 6KK,-a�t APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name C, 6 Telephone Number ' 1_7'j E 3Cv W 9 0— r Address 1 gbs Ser v�C Z Q. - License # 5 Li 2_7 Sa�SO 1 ,P krnb tr w 7.74 7 W-e Sk- ��.r n S�ab LE kh 6ZLA-9 Home-Improvement Contractor# Jb9-- —` I Worker's Compensation # Ct)XwC CIO ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO TO�v `�um�O -- O��>✓rv�t� Qn� 8e_ i-vs i ,n I. Old VyjAAL_ SIGNATURE �OVWA MD_,_Aa� DATE ad �2 FOR OFFICIAL USE ONLY t APPLICATION# , 3 DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE ' OWNER ' i4 I '1. DATE OF INSPECTION: FOUNDATION ' FRAME INSULATION FIREPLACE k ELECTRICAL: ROUGH FINAL j 1 PLUMBING: ROUGH FINAL y GAS: ROUGH FINAL i •. s FINAL BUILDING ©f� �I �i-�1�►'k i DATE CLOSED OUT i ASSOCIATION PLAN NO. . ' ' � •r The Commonwealth of Massachusetts Department of Industrial ial Accidents Office of Invesfigadons. 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Blectridans/Plumbers APPHeant Information Please Print Le 'bl Name(Busdwss/organizationdadividval): -Address: 1�USel i� City/State/Zip: BZ,14$ Phone.#- 7 )Are you an employer? Check the appropriate bog: a of project(required):., 4. I am a en Type P ] ( Q ):. 1.❑ I am a employer with ❑ general contractor and I ❑ . employees(full and/or part-time).*. have hired the sub-contactors 5 New construction 2.❑ I am a'sole proprietor or partner- listed on the'attached sheet. 7. ❑Reinadehng- ship have no These sub-contractors have employers8. ❑Demolition working for me is any capacity. employees and have workers' ' addition [No workers' comp. inshTrance comp.insurance.$ 9: Building required.] 5. ❑ We are a corporation and its 10.❑Electdcal repairs or additions 3.D-T'am a homeowner doing aIl work officers have exercised their 11.❑Plumbing repairs or additions myself[No workers'comp. right 6f exemption per MGL 12.❑ mi Rnofrepa insurance required.]t c. 152, §1(4), and we have no . employees. [No workers' 13.❑Other comp.iT,suraace required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have ernployees. if the sub-contractons have employees,they must provide their workers'comp.poficynumber. Ian an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.# Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page,(showing the policy number and expiration date). Faihtre•to secure coverage as required under Section 25A of MCL c. 152 can lead to the imposition of ci:i n penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct S_gnature: Date: -2- Phone#: `l, 'R 3 6- 60'�C/ I 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#: I Town of Barnstable �pP THE ropy Regulatory Services Thomas F.Geller,Director BARNsm,,m E, 9, MARS. Building Division Tom Perry,Building Comnussioner . 200 Main Street; Hyannis, MA.02601 R my.town.barnstable.rna.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION y� Please Print DATE: �d / �I a— G y J ��•_ JOB LOCATION: I�OS J�<V �CPi W 'JGIJ NcSI�G�L �"If� � (�g number street village "HOMEOWNER"; name home phone# work phone# CURRENT MAILING ADDRESS: C"A O Zbb9'� city/town state zip code The current,exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow)-_omeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF ROn-MOWNER PersDD(S)who owns a parcel of land on'which he/she resides or intends to reside, on which there is,or is intended to- be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be. responsible for al] 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 rr-clWyernents. Signature of HDmebwner 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. HOMMOwNER'S EXEMPTION The Code states that: "Any homeowner perfomvng work for which a building permit is required shall be exempt from the provisions of this section(Section Io9.i.1-Licensing of consttuction Supervisors);provided that if the homeowner engages a parson(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homcowa ns who use this exemption sic unaware that they are assuming the responsibilities oCa superosor(sec Appendix Q. Rules&Regulations for Licensing Construction,Supervisors,Section 2.IS) This lack of awareness often results in serious problems,particularly when-the homeowner hires unlicensed persons_ In this case,our Board cannot proceed against the unlicensed person as it would with a licensed supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by v——caret amend and adopt such a form/ccrtification for use in your community. s, °FYHer 2 Town of Barnstable Regulatory Services suss.MAS& iE Thomas F. Geiler, Director ��'Arb ,�a•�� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable_ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property owner Must Complete and Sign This Section If Using A Builder M1 / C , as Owner of the subject property hereby authorize to act on my behalf, in all.matters relative to work authorized by this building permit application for: 8US '(U�ce : lens t2 (Address of rob) Signature of Owner Date Print Name If Property Own6r is applying for permit please complete the Homeowners License Exemption Form on th:e reverse side. REGULATORY AGREEMENT AND DECLARATION OF RESTRICTIVE COVENANTS THIS REGULATORY AGREEMENT and DECARATTON OF RESTRICTIVE COVENANTS,is made this 3-d day of February,2012,by and between Karen M.Machado of 1805 Service Road W Barnstable,MA 02668 and its successors and assigns(hereinafter the"Owner"),and the TOWN OF BARNSTABLE (the -Munidpality"),a polincal subdivision of the Commonwealth; WHEREAS the Owner has been granted a Comprehensive Permit under Massachusetts General.Law Chapter 40B and local regulations by the Zoning Board of Appeals to permit the creation of an accessory apartment in an owner occupied dwelling which will be rented to a Low or Moderate Income Person/Family(hereinafter "Designated Affordable Unit");and NOW THEREFORE,in mutual consideration-of the agreements and covenants contained herein,and other good and valuable consideration,the receipt and sufficiency of which is hereby acknowledged,the parties agree as follows: I. PROJECT SCOPE AND DESIGN• A The terms.of this Agreement and Covenant regulate the property located at 1805 Service;:Road W Barnstable, MA 02668 as further described in deed recorded herewith as Barnstable County Registry of Deeds Book 24025.&Page 18. B. The Project located at 1805 Service Road W Barnstable,MA 02668 will consist of one accessory apartment unit which will be rented to an eligible low or moderate income individual or family(the"Designated Affordable Unit"or the"Unit"). C. The Owner agrees to construct the Project in accordance with the terms of comprehensive permit Appeal No. 2011-011 and any plans submitted therewith and all applicable state,federal and municipal laws and regulations. Said permit is recorded herewith as Barnstable County.Registry of Deeds Book 2_tv(,j I(*& Page D. The Owner agrees to occupy the principal dwelling unit located on the property as their principal residence in accordance with the terms of the comprehensive permit. II. THE OWNER'S COVENANTS AND RESPONSIBILITIES: A THE OWNER HEREBY REPRESENTS,COVENANTS AND WARRANTS AS FOLLOW: 1 In receiving the comprehensivtpermit to create the Designated.Affordable unit,the Owner agreed that the Designated Affordable,Unit shall be set aside in perpetuity.for the public purpose:of providing safe and decent housing to persons<eaming at or below 80%of the area median income of Barnstable Metropolitan Statistical Area(MSA)and that the'.Designated Affordable Unit shall be deemed to be impressed with a:public trust. 2. The.Designated Affordable Unit shall be rented in perpetuityto a household with a maximum income of 80%of the Area Median Income(AN)of Barnstable MSA and that rent(inch x6g utilities)shall not exceed an amount that is affordable to a household whose income is 80%of the median income of Barnstable MSA- In the event that utilities are separately metered,a utility allowance established by the:Barnstable Housing Authority shall be deducted from the rent level. 3. The Designated Affordable Unit will be retained as a permanent,year round rental dwelling unit•with at least atone-year-lease. 4. The Owner:has the full legal right,power and authority to execute and deliver this Agreement. 5. The execution and performance of this Agreement by the Owner will not violate or,as applicable,has not violated any provision of law,rule or regulation,or any order of any court or other agency or governmental body,and will not violate or,as applicable,has not violated anyprovision of any indenture,agreement,mortgage, r s mortgage note,or other instr unent to which the Owner is a parry or bywhich it or the Owner is bound,will not result in the creation or imposition of any prohibited encumbrance of-any nature. 6. The Owner,at the time of execution and delivery of this Agreement,.has good,clear marketable title to the premises. 7. There is no action,suit or proceeding at law or in equity or by or before any governmental instrumentality or other agency now pending,or,to the knowledge of the Owner,threatened against or affecting it,or any of its properties or rights,which,if adversely determined,would materially impair its right to carry on business substantially as now conducted(and as now contemplated by this Agreement)or would materially adversely affect its financial condition. B. COMPLIANCE The Owner hereby agrees that any and all requirements of the laws of the Commonwealth of Massachusetts to be satisfied in order for the provisions of this Agreement to constitute restrictions and covenants running with the land shall be deemed to be satisfied in full and that any requirements of privileges of estate are also deemed to be satisfied in full. Cv LIMITATION ON PROFITS 1. The Owner agrees to limit his/her profit by renting the Designated Affordable Unit in perpetuity to a household with a maximum income of 80%or less of the Area Median Income (A14 of Barnstable Metropolitan Statistical Area(MSA)and that rent(including utilities)shall not exceed an amount that is affordable to a household whose income is 80%of the median income of Barnstable MSA. In the event that utilities are separately metered,a utility allowance established by the Barnstable Housing Authority shall be deducted from the rent. 2. The Owner shall annually deliver to the Municipality and to.the.Monitoring Agent,as designated by the Town Manager,proof that the Designated Affordable Unit is rented,tle..tenant's income verification,a copy of the lease:agreement and the rent charged for the unit or units. Such information shall also be forwarded to the Monitoring Agent within 30 days of the.occupation of the dwelling unit or units by a new tenant. The Owner shall notify the Monitoring Agent,as designated by the Town Manager,within;thirty,(30) days of the date that a tenant has vacated the Designated Affordable Unit. III MUNICdPALITY COVENANTS Am usPONSIBIuna 1. The MUNICIPALITY,through the monitoring agent designated by the Town Manager agrees to perform the duties of verifying that the Designated Affordable Unit is:being rented in perpetuity to a household with a maximum income of 80%or less of the Area Median Income(AMI)of Barnstable MSA and that rent (including utilities)shall not exceed an amount that is affordable to a household:whose income is 80%of the median,income.of Barnstable MSA In the event that utilities are separately metered,a utility allowance established by the Barnstable Housing Authorityshall.be deducted from the rent. IV. RECORDING OF AGREEMENT.- Upon execution,the OWNER shall immediately cause this Agreement and..any amendments hereto..to be recorded with:the Registry of Deeds for Barnstable Countyor,if the Project consists in whole or in part of registered land,file-this Agreement and any amendments hereto with the RegistryDistrict of the Barnstable Land Court(collectively hereinafter the"Registry of Deeds"),and the Owner shall pay all fees and charges incurred in connection therewith. Upon recording or filling,as applicable,the Owner shall immediately transmit to:the Municipality evidence of such recording or filing including the:date and instrument,:book and page or registration number of the Agreement. 2 V. GOVERNING OF AGREEMENT• This Agreement shall be governed by the laws of the Commonwealth of Massachusetts. Any amendments to this Agreement must be in writing and executed by all of the parties hereto. The invalidity of any clause,part or provision of this Agreement shall not affect the validity of the remaining portions hereof. VI. NOTICE: All notices°to bce given pursuant to this Agreement:shall:be in writing and shall be deemed given when delivered byhand or when mailed by certified or registered mail,postage prepaid,return receipt requested,to the parties hereto at the addresses set forth below,or to such other place as a party mayfrom time to time designate by written notice. VII. HOLD HARMLESS The.Owner hereby agrees to indemnify and,hold harmless the Municipality and/or its delegate from any and all actions or inactions bythe Owner,its agents,servants or employees which result in claims made-against Municipality and/or its delegate,.including but not limited to awards,judgments,out-of-pocket expenses and attorneys fees necessitated by such actions. VIH. ENTIRE UNDERSTANDING• A. This Agreement shall constitute the entire understanding between.the parties.and any:amendments or changes hereto must be in writing,executed by the parties,and appended to this document. B. This Agreement and all of the covenants,agreements and restrictions.contained herein shall be deemed to be for the public purpose of providing safe affordable:housing and shall be deemed to be, and by these presents are,granted by the Owner to run in perpetuity in favor of and be held by Municipality as any other permanent restriction held by a governmental body as that term is used in MGL Ch. 184,Section 26 which shall . run with the land described in deed recorded herewith as Barnstable County Registry of Deeds Book. 25656&Page 112 and shall be binding upon the Owner and all successors in title. This Agreement is made for the benefit of the Municipality and the Municipality shall be deemed to be the holder of the restriction created`by this:Agreement. The Municipality has determined that the acquiring of such a restriction is in the public interest. The Municipalityshall not be subject to the defense of lack of privity of estate. The covenants and restrictions contained in this Agreement shall be deemed to affect the tide,to the property described in deed recorded herewith as Barnstable County Registry of.Deeds Book 25656&Page 112. IX. TERM OF AGREEMENT-. The terra of this Agreement shall be perpetual,provided,however,that the Owner of a Designated Affordable Unit or Units mayvohmtanlycancel the granted Comprehensive Permit and the terms and restrictions imposed.herein. Such.cancellation shall onlytake effect.after: 1)expiration of the lease Berms entered into between the Owner and Tenant occupying said unit and 2)notification by the Owner of said dwelling to the Zoning Board of Appeals of his/her desire to cancel the Comprehensive permit upon a date certain and the recording of said notice at the.Barnstable County Registry of Deeds or Barnstable County Registry of the Land Court as the case may be,thus rendering said Comprehensive Permit void. Upon the cancellation of the comprehensive permit,the property which is the subject matter of this restrictive covenant shall revert to the use permitted under zoning and the restrictive covenant shall be rendered void. X SUCCESSORS AND ASSIGNS: A The Parties to this Agreement intend,declare,and covenant on behalf of themselves and any successors and assigns their rights and duties as defined in this Regulatory Agreement and the attached comprehensive permit B. The Owner intends,declares,and covenants on behalf of itself and its successors and assigns (i)that this Agreement and the covenants,agreements and restrictions contained herein shall be and are covenants running with the land,encumbering the Project for the term of this Agreement,and are binding upon.the Owner's successors in title,(it,are not merely personal covenants of the Owner,and.(iii)shall bind the Owner,its . successors and assigns and inure to.the benefit of the.Municipality and its successors and assigns for the term of the Agreement. XI. DEFAULT: If any default,violation or breach.by the Owner of this Agreement is°not cured to the satisfaction of the Monitoring Agent within thirty(30)days after notice to the Owner thereof,then the Monitoring Agent may send notification to the Municipality that the Owner is in violation of the terms and conditions hereof. The. Municipality may exercise any remedy available to it. The Owner will pay all costs and expenses,including legal fees,incurred by the Monitoring Agent in enforcing this Agreement and the Owner hereby agrees that the Municipality and the Monitoring Agent will have alien on the Project to secure payment of such costs and expenses. The Monitoring Agent mayperfect such alien on the Project by recording a certificate setting forth the amount of the costs and expense due and owing in the Registry of Deeds or the Registry of the District Land Court for Barnstable County. A purchaser of the Project or any portion thereof will be liable for the payment of any unpaid costs and expenses that were the subject of a perfected lien prior to the purchaser's acquisition of the Project or.portion thereof. XII. MORTGAGEE CONSENT The Owner represents and warrants that it has obtained.the consent of all existing mortgagees of the Project to the execution and recording of this Agreement and to the terms and conditions:hereof and-that all such mortgagees have executed.consenvto this Agreement. IN WITNESS WHEREOF,we hereunto set our hands and seals this:i:day of Eebruaiqei 2012. OWNER BY: Signature Printed: k -JZ tN iA C hlt-S e- COMMONWEALTH OF MASSAaA.)SETTS County of Barnstable ss: Onthi Erd day.of. e I r v Y 012 before methe undersigned riotarypubhc;personallyappeared K ct r e n M- f Ct G h Cis d ) ,.the Ownerss),,proved to me through satisfactory evidence of identification,which were MA O r t v e v 5 L t Ctt� $�A s d 1 ,to be the person(s)whose name(s)is signed on the preceding or attached document and aclmowledged to be that he/she signed it voluntarily for the stated purposes. Public i Printed: b L_ bAb J<tU`v75 k i. My Commission Expires T I ( ' CINDY L. DABKOWSKI r Notary Public COMMONWEALTHOFMASSACHUSETTS ` MY CommisSiort Expires February 29.2016 TOWN OFBARNSTABLE BY: 4TO WN A_ 'AGER COMMONWEALTH OF MASSAC HUSEM County of Barnstable,ss: On this (Aayof 2011 before me;th undersigned notarypublic,personally appeared thd'Town Manager for'` own of Barnstable,proved to me through satisfactory evidence of identification,which were paY ru'Or,6,14- ,to be the person whose name is signed on the preceding or attached document and ackaovGledged- be `the/she signed it voluntarily for the stated purposes. t �� Notaryll6blic Printed �f?IF. `Gti;`yr;L{. - � 4 My Commission Expires: �' �;�_ SH FIEE��v oau Notary.Pubkc COMMONMALTH CO USISAEQttiSFTY� My'Corrawso n&*a A�RarCb 2C1S. 5 i Bk 26076 P:9 15 7 0 —1Z-201 i 01 = iT BA F i &%RN9rAI=F 's MIS a " Town of Barnstable Zoning Board of Appeals Comprehensive Permit Decision and Notice Comprehensive Permit No. 2011-013—Machado Chapter 40B Comprehensive Permit Summary: Granted with Conditions Dater October 12, 2011 Applicants: Karen M. Machado Property Address:' 1805 Service Road West Barnstable, MA Assessor's Map/Parcel: -Map 194, Parcel 008-1N01 Zoning: RF Zoning District Recording Information: Deed Reference: Book 25656 Page 112 Date Application Filed. September 23, 2011 Date Hearing Opened October 12, 2011 Date of Decision.(Closed):. October 12, 2011 Property Ownership: The applicant is Karen M. Machado, who is the owner, occupant of 1805 Service Road West Barnstable as evidenced by a deed recorded in the Barnstable County Registry of Deeds on September 1, 2011 in Book 25656, Page 112. A copy of which has been.submitted#or the record. Relief Requested: Ms. Machado has applied for a Comprehensive Permit pursuant to Chapter 40B of the General Laws of the Commonwealth of Massachusetts, and in accordance with.§ 9"15 of the Code of the Town of Barnstable, more commonly termed the"Accessory Affordable Apartment Program". The permit is sought to allow for the creation of an affordable apartment-accessory to_a single family home as provided for-in the Code of the Town of Barnstable and restricted to being affordable housing for qualified persons as required under Chapter 40B. The zoning relief necessary for this Comprehensive Permitto be issued.is that of a variance to Section 240-14 (A) Principal permitted uses in a RF Zoning District to permit.an accessory apartment unit within the lower level of the dwelling. The issuance of this Comprehensive Permit would allow for a separate, approximately 900 square foot, one bedroom accessory affordable apartment. Locus: The subject property is a 0.78-acre lot located at.1805 Service Road West Bamstable, MA. The lot was developed in 1988, with a Cape Cod style home. The Living area of the dwelling is approximately 2,021 square feet. Town of Barnstable,Zoning Board of Appeals Decision and Notice,Comprehensive PennitNo.2011-013-Machado Site Conditions The lots is served by well Water,Gas and an on site septic system. The Town of Barnstable's Health department reviewed the application, and approved a total of three (3) bedrooms for the entire property. Procedural & Hearing Summary: A site approval letter was issued for the property by Town Manager John C. Klimm on September 7, 2011 in accordance with MG Chapter 40B and 760 CMR 56.00. Notice of the site approval letter was sent to the Department of Housing and Community Development in accordance with the requirements of CMR 760 56.00. An application fora Comprehensive Permit was filed at the Town Clerk's Office on October 1, 2011. A public hearing before the Zoning Board of Appeals Hearing Officer was duly advertised in the Barnstable Patriot on September 16,2011 and September 23, 2011, and notices were sent to all abutters in accordance with MGLChapter 40B. The Public Hearing was opened on October 12, 2011 at 6:00 p.m. by the Hearing Officer Laura F. Shufelt. The applicant, Karen M. Machado was present at the hearing. Cindy L. Dabkowski, Accessory Affordable Apartment Program Coordinator was also present. Laura F. Shufelt read the proposed conditions to the ap licam Ms. Machado consented to.the conditions..Ms.Ms. Machado gave testimony as recorded in the hearing minutes filed with the Town Clerk The Hearing Officer opened the hearing to public comment. No;one spoke. The October 12, 2011 hearing ea rn was closed b .the hearing officer at g y g 6 30 p.m.., On October 12, 2011 the hearing officer granted comprehensive:permit No. 2011-013 with conditions. -A written copy of this decision shall be forwarded to the Zoning Board of Appeals.as required by the Town of Barnstable Administrative Code Chapter241, section 11. If after fourteen (14) days from that transmittal the Members of the.Zoning Board of Appeals takes no action to reverse the decision, this decision shall become final and a copy shall be the filed in the office of the Town Clerk. Findings of Fact: At the hearing on October 12,2011 the Hearing.Officer made the following findings of fact: 1. The applicant is Karen M. Machado who is the owner:and occupant of the property located at 1805 Service Road West Barnstable. Ms. Machado is requesting a Comprehensive Permit to allow for a one-bedroom accessory apartment within the lower,level of the dwelling as an accessory affordable apartment.The allowance for the unit as an.accessory affordable unit qualifies for the "Accessory Affordable Apartment Program(AAAP)." 2. Karen M. Machado was granted title to the property by deed recorded,in the Barnstable County Registry of Deeds on September 1, 2011 in Book 25656 Page 112. 3. On September 7,2011, a site approval letter was issued for the property by Town Manager John Klirnm, in accordance with MGL Chapter 40B and 760 CMR 56.04 (4). Notice of the site approval letter was sent to the Department of Housing and Community Development, in accordance with the requirements of 760 CMR 56.04 (2), and no issues were communicated from the Department on this particular application. 4. The proposed accessory affordable unit is approximately 900 square feet in living area and is located within the lower level of the Cape Cod.style home. 2 4 r Town of Barnstable,Zoning Board of Appeals Decision and Notice,Comprehensive Permit No.2011.013-Machado 5. The applicant was informed that the AAAP unit shall meet all applicable health and building codes to be occupied and that the Building Division and Fire Department will also be inspecting the unit for compliance with all applicable building and fire codes. 6. The house is served by well water and private on-site septic. The proposal has been reviewed by Thomas McKean, Health Director, and he has approved a total of three (3) bedrooms at the property.:. 7. On May 9, 2011 the applicant Karen M.Machado signed an Accessory Affordable Apartment Program affidavit that commits, upon the receipt of a Comprehensive Permit, to the recording of a Regulatory Agreement and Declaration of Restrictive Covenants, in a form satisfactory to the Town Attorney, at the Barnstable County Registry of Deeds. These documents restrict the unit in perpetuity as an affordable rental unit. 8. The applicant is aware that the affordable unit shall be rented to a person or family whose income is 80% or less of the Area Median Income(AMI) of the Barnstable Metropolitan Statistical Area (MSA)and agrees that rent(including utilities) shall not exceed 3.0% of the monthly household income of a household earning 80%.of the median income,adjusted by household size. In the.eventthat utilities are separately metered, the utility allowance established by the Town of;Barnstable shall be deducted from rent level so calculated. 9. According to the Massachusetts Department of Housing:°and Community Development;as of August 31, 2011.,6.65%<of the tow'n's year round housing stock.qualifies as affordable housing units. The town has not reached the statutory minimum of affordable housing.under MGL Chapter 40B Section 20-23 or its implementing regulations. 10. The Town,of Barnstable's Comprehensive Plan encourages-the adaptive use of existing housing stock to create affordable units and the.dispersal of these units throughout Barnstable. Summary: The Nearing Officer ruled that the applicant Karen M. Machado has standing to apply for a Comprehensive Permit under MGL Chapter 40B and.the Town of Barnstable's Accessory Apartment Program. The proposal was deemed consistent with local needs because it adequately promotes the objective of providing affordable housing for the Town of Barnstable without jeopardizing the health and safety of the occupants provided all conditions of the Comprehensive Permit are strictly followed. Conditions: Hearing Officer Laura Shufeli ruled to'grant Comprehensive Permit No: 2011-013 with conditions in accordance with MGL Chapter 40B and Article II of Chapter Nine of the Code of the town of Barnstable, more commonly termed the "Accessory Affordable.Apartment Program" to the applicant, Karen M. Machado who is the owner of the,property located at 1805.Service Road West Barnstable. As seen on map 194 as parcel 008-W01. This Comprehensive Permit allows for a one-bedroom apartment unit in accordance with the following conditions: 1. Occupancy of the affordable unitshall not exceed two(2)people. 2. The total number of bedrooms on the property shall not exceed three (3). 3. The accessory unit shall NOT At anytime be occupied by a family member of the owner. 4. All leases shall have a minimum term of one year and have provisions that require the tenant to provide any and all information necessary to verify eligibility with the AAAP 5. On May 13, 2011, the applicant was sent written copy of the inspection findings, submitted for record,that the unit must meet all applicable health and building codes to be occupied 3 Town of Barnstable,Zoning Board of Appeals Decision and Notice,Comprehenshv Pennit.No.2011-013-Machado and that the Building Division.and Fire Department will also be inspecting the unit for compliance.with all applicable building and fire codes. 6. The house is served by well water and on site.septic. The application was reviewed by Thomas McKean, Health Director. He has approved the site for no more than three(3) bedrooms for the entire property 7. All parking�orthe accessory apartment and the principal dwelling shall at all times be on-site. On street parking for all structures and uses on this property is.expressly.prohibited 8. Lodging or renting of rooms is prohibited for the duration of this Comprehensive Permit. 9. To meet affordability requirements, the rent charged (including utilities) shall not exceed 30% of 80% of the median income for a household for the Barnstable MSA (adjusted for family size). In the event that utilities are separately metered, the utility allowance established by the town of Barnstable shall be,deducted from rent level so calculated. 10. AAAP Coordinator shall be the monitoring agent for the.accessory apartment. Annual monitoring shall include verification of tenancy, affordability,and compliance with;Housing Quality Standards(HQS).The cost for HQS monitoring shall be covered by the homeowner. The fee for the initial monitoring of affordability and annual certification inspection of the accessory unit shall be the same as the Health Department fee for the rental registration program. 11. The applicant shall apply:for a building permit forthe accessory unit,.whether the unit is new or pre-existing: Before issuing an occupancy permit and certificate of compliance,.the Building Commissioner.shall determine that the unit conforms to the approved plans.as submitted with the building.permit application and meets state building and fire codes.The " Health Division shall determine that the dwelling is incompliance with applicable on-site wastewater discharge requirements.- 12. The applicant may select her own tenant from the prospective tenants supplied by the Administrator of the Ready to Rent List. The.tenant must meet the requirements of the Accessory Affordable Apartment Program. The tenant's income shall be reviewedand approved by the Growth Management Department. The<applicantshall work with the AAAP Coordinator to provide necessary information and documentation of tenant income eligibility. 13. The unitshall be rentedon an open and fair basis to an`income-eligible individual. Whenever a vacancy occurs, notice shall be given to the Growth Management Department and the applicant shall request potential tenants from the administrator of the Ready to Rent List. The applicant shall pay all fees associated with accessing the.Readyto Rent List. In the eventthat the Ready to Rent List is not inceffect as of the date that the Building Department issues its. occupancy permit, the,applicant may select the tenant after open and fair marketing, providing that documentation of the same is given to the AAAP Coordinator and the AAAP Coordinator Approves the tenant.selection process: 14. Should the accessory affordable apartment become vacant the property owner shall immediately notify the.Accessory Affordable Apartment Program''Coordinator. The property owner shall also notify.the AAAP Coordinator of their requestfor potential tenants from the Ready to Rent List administrator. 15. Every twelvemonths the applicant shall review the income eligibility of the AAAP unit tenant. No later than a year from the date of issuance of this Comprehensive Permit, the applicant shall file with the AAAP Coordinator, as Monitoring Agent, an annual affidavit stating the rent charged and income of the unit tenant. The property owneran d/or tenant shall provide the 4 Town of Barnstable,Zoning Board of Appeals 'Decision and Notice,Comprehensive Permit No.2011-013-..Machado AAAP Coordinator any additional information deemed necessary to verify the information provided in the affidavit. 16. Upon any report from the Monitoring Agent that the.terms and conditions.of this permit are not being upheld, the Zoning Board of Appeals or its Hearing Officer may hold a hearing to show cause as to why this permit should not.be revoked. 17. This Comprehensive Permit shall not be transferable to any other person orentity without the prior approval of the Hearing Officer or Zoning Board of Appeals. This decision;the. Regulatory Agreement and Declaration of Restrictive Covenants and all other necessary documents shall be recorded at the Barnstable County Registry of Deeds 18. Should ownership of the subject property transfer the permit holder identified herein shall notify the AAAP Coordinator and provide,within 60 days of the date of transfer, the.name and current contact information for the new owner of the subject property. 19. This Comprehensive Permit shall be exercised, all conditions met, and the unit,occupied within twelve (12) months of its issuance or it shall expire. Ordered: Comprehensive Permit number 2011-013 has been;granted with:conditions. A written copy of this decision was forwarded to the Zoning Board of Appeals as required by the:Code Chapter 241, section 11, of the Town of Barnstable Administrative code. If after fourteen (14) days from that.transmittal the members of the Zoning Board of Appeals takes no action to reverse the decision, this decision shall become final and a copy shall be filed in the office of the Town Clerk Appeals of the final decision, if any, shall be made to the Barnstable Superior Court pursuant to MGL Chapter 40A, Section 17, within twenty (20)days after the date of the filing of this decision in the office of the Town Clerk. The applicant has the right to appeal this decision as outlined in MGL Chapter 40B, Section 22. Laura F. Shufelt, Hearing Officer Date<Signed., I Linda Hutchenrider, Clerk of the,Town of Barnstable, Barnstable.County, Massachusetts, hereby certify that twenty (20) days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision has been filed in the office of the Town Clerk. Signed and sealed this day of_-I:>z c__ 2b j ( under the pains and penalties of perjury. Lind utchenrider, TownC er 5 �TNE 1 Town of Barnstable Regulatory Services ELAMSTMUEy� MAS& g Thomas F.Geiler,Director i639. �� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 April 23, 2012 Ms. Karen Machado 1805 Service Road West Barnstable, MA 02668 RE: Application#201201216 Map: 194 Parcel: 008-WO1 Property at: 1805 Service Road, West Barnstable, MA 02668 Dear.Ms. Machado, This letter is to follow up on an application to construct a one bedroom amnesty apartment at the above listed property. Unfortunately,the application can not be approved at this time. As previously discussed over the phone, your Comprehensive Permit#2011-013 was approved for an approximately 900 square foot apartment but the application was submitted showing a 1221 square foot apartment. If this office can be of any further assistance please do not hesitate to call. I may be reached at 508-862-4033. Sincerely, Robert McKechnie Local Inspector J J SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. X ❑Agent ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. F�eceived by(Printed Name) C. too el i ery ■ Attach this card to the back of the mailpiece, t/,� Mk :or on.the front if space permits. cro D. Is delivery address different from item 1? ❑Ye 1..Article Addressed to: If YES,enter delivery address below: �No 3. Service Type [.v ' ...j!kDertified Mail 0 Express Mail .�1 %6 G ❑Registered. ftetum Receipt for Merchandise (/ G ❑Insured.Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2.-Article Number - -- -- - - - - (Pansfer from service 1 7006 0810 0000 3524 6192 .PS Form 3811.,,February,2004 Domestic Return Receipt 102595-02-M-1540rviceTM , ■ RECEIPT r0l .' only, nJ at � ! tf7 t� •� � - 1. M Postage $ p0 Certified Fee C3 0stm C3 Return.Receipt Fee. Here (Endorsement Required) tM Restricted Delivery Fee r-1 (Endorsement Required) �O l7 Total Postage&Fees. p Sent To Nl h- Sereai,Apt.No.: :=--`--- c or PO Box No. 1�� ........................ City,State,ZIPF4 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 •Sender: Please print your name, address,and ZIP+4 in"this box TOWN OF BARNSTABLE BUILDING DIVISION 200 MAIN ST. AYANNIS,MA 0260f Certified Mail Provides: ■ A mailing receipt (—reiaa aoea eunr'008£-0=1 Sd ■ A unique identifier for your mailpiece • A record of delivery kept by the Postal Service for two years dem- a Cer�tlf�Mail�may ONLY be combined with First-Class Maile or Priority Mail®. ■ Certified Mail is not available for any class of international mail 9 NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. 48 For an additional fee,a Retum Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811�to the article and add applicable postage to cover the fee.Endorse mailpiece'Retum Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is ■For an additional fee, delivery may be restricted to the addressee or addressee's authorized agge�nt.Advise the clerk or mark the mailpiece with the endorsement Restncte9ciivery". t If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IIIIIPORTANT:Save this receipt and present it when making art inquiry. Internet access to delivery Information is not available on mail addressed to APOs and FPO& I a�TME Town of Barnstable Regulatory Services BAMSTABM yb MASS. �, Thomas F.Geiler,Director 6 i639 g . Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 April 23, 2012 Ms. Karen Machado 1805 Service Road West Barnstable, MA 02668 RE: Application#201201216 Map: 194 Parcel: 008-WO1 Property at: 1805 Service Road, West Barnstable, MA 02668 Dear Ms. Machado, This letter is to follow up on an application to construct a one bedroom amnesty apartment at the above listed property. Unfortunately, the application can not be approved at this time. As previously discussed over the phone, your Comprehensive Permit#2011-013 was approved for an approximately 900 square foot apartment but the application was submitted showing a 1221 square foot apartment. If this office can be of any further assistance please do not hesitate to call. I may be reached at 508-862-4033. Sincerely, Robert McKechnie Local Inspector � Town of Barnstable ""'Permit Of z Tp� �, •�, Expires t ewths r m issue date Regulatory Services Fee IARIYS'rABLE, Thomas F. Geiler,Director 7 MASS. 1639• Building Division plFb MA'I a Tom Perry, CBO, Building Commissioner J, 200 Main Street,Hyannis,MA 02601 N www,town.b ariis tab le-.ma>us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red.\-Press Imprint Map/parcel Number Property Address Bac�3SCklp�e ❑ Residential' Value of Work 1-, C,00 400 Minimum fee of$25.00 for work under$6000.00 Owner's Name &Address fCac-o =}" ADATO Contractor's Name lo�Qic zo-i Tel ephoneNumber Home Improvement Contractor License# (if applicable) ❑Workman's Compensation Insurance - PERMITRESS Check one. SEP _ 3 Z008 V ❑ I am a sole proprietor ❑ I am the Homeowner (� I Have Worker's Compensation Insurance TOWN ®� BAR�STABL� Insurance Company Name D0V3 kyjti 1 IQeA Workman's Comp.Policy# ��14 Da!�79 0 t ` Copy of Insurance Compliance Certificate must be on file. Permit Request(check.box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) r�4-Re-side + AQ%m (e1P1e1eeMeK i- , Replacement Windows/doors/sliders. U-Value AOV (maximum..44) "Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. t ***Note: Property Owner must sign Property Owner Letter of Permission" A copy of the Llome Improvement Contractors License is required, ; 5:;?' rTs SIGNATURE: ..,� C/ A r Q:%? ILESTOPMSIbuilding permit forms\EXPRESS.doe Revise020108 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 1 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A_ licant Information `^ Please Print Legibly Dame (Business/Organization/Individual): • Address: , � szYee c'. City/State/Zip: (}S�eQ�►I1e . 06�� Phone.#: 0� �`dL► 3 il�� [2. .re—you employer? Check the appropriate box: Type of project(required): [ I am a etuploycr with 4. [] I am a general contractor and I 6 New construction employees (full and/or part-time).* Ve wed the shb contractors ❑ 1 am a•sole proprietor or partner- listed an the attached sheet 7. ❑ modeling ship and have no employees These suh-contractors have g, ❑Demolition loyees and have workers' waujcing for IDe in any capacity. emp _ $ mtt 9. ❑ Building addition [No workers' cornp.• sanre comp.t a ct orrice. ❑ 5. [l We arc a corporation and its 10. $lcctrical rcpaus or additions rtgtnr�]3.❑ I am a homeowner doing all work officers have exercised their IL❑Plumbing repairs or additions , myselL [No workers' comp. right of exemption per MGL 12.0 Roof repairs t c. 152, §1(4), and we have no Ce I 13.❑ Other incrtran employees. [No workers' comp,insurance required.] Any applicant that chmks bar,#1 taunt also fill out the section below showing their workers'conipcnszErn policy int'orrnation t Humcownen who submit this affidavit indicating ffiey are doing aII work and thm hire outside conirxctars must submit anew affidavit indicating such ,Contractors that cbork this box umst attached an additional sheet showing the name of the sub-contiadrn's and stain whcthcr or not thosd entitics have unployas. if the sub-c hactms have employees,.they mutt providb thccis woricrss'mTrrp.policy number. I am an employer thaf is providing workers'comp ensatio rt insurance for my employees Below is the polity and job site • information. ii .. lnsnranca Company Nam c: 0 vJ I� -- 0 Of k 1 — Policy#or Sclf-ins.Lic.#: W C A O�� 7 � 9 0 1 1 Expiration Date: ► )64 Job Site Add=!;: 0� .5•2204-f2 20 City/5tatc/Zip: W, B eos'+k61e 6aiq66 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to sccuac coverage as rcquu:cd under Section 25A of MGL c. 152 can lead to the imposition of rrinib al penaltics of a fine tip to S 1,S00.00 and/or one-year imprisonment, as.wcII as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Bc advisrsd fhat a copy of this statcmcrit maybe forwarded to the Office of 1nvr_stig1LtiOnS of the DIA for insurance coverage verification. I do hereby certzf un the p ins•and penaldes of perjary that the information provided above is true izn.d correcL Si c: Date: a — Pho,nc t� SO —I RO ✓ s`&6 — O j7 ird use only. Do not write in this area, to be cor"pl-ted by city or town offcciaL City or Towa: Permit/License# Issuung Authority(circle one): 1.Board of Health 2.Building Department 3. City/Towu Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Phone#- 2BISHOPRICST Client#: 12032 DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 08121/08 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ,ouCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE )Wling&O'Neil Insurance HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. jency '3 lyannough Rd., PO Box 1990 NAIL# /annis, MA 02601 INSURERS AFFORDING COVERAGE INSURER A: Acadia Insurance iURED Steven J. Bishopric, Inc.A/O Chestnut INSURER B: 1112 Main Street,Unit 18 INSURER Col Osterville,MA 02655 INSURER D INSURER E. -------------- OVERAGES EEN ISSUED TO THE INSURED THE POLICIES OF ANY REQUIREMENT,TERM INSURANCE LISTED T EL OF ANY CONTRACT OR OTHER DOCUMENT WITDH RESPECTOTO WHICH OLT IS CERTDIFICOATE MAY B ISSUED OR NDING MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LILY EFFECTIVE POLICY EXPIRATION LIMITS aR DD' TYPE OF INSURANCE POLICY NUMBER - EACH OCCURRENCE $1 000 000 R 12/08/07 12108ros CPAO04717019 DAMAGE TO RENTED $25O 00O k GENERAL LIABILITY PREMISES a ccurrence X COMMERCIAL GENERAL LIABILITY MED EXP(Any one person) $5 000 CLAIMS MADE Fx-1 OCCUR PERSONAL&ADV INJURY $1 000 000 X BI/PD Ded-250 GENERAL AGGREGATE $2 000 000 PRODUCTS-COMP/OP AGG s2,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: PRO- P LOC OLICY JECT .. COMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY _ (Ea accidenO ANY AUTO BODILY INJURY $ ALL OWNED AUTOS (Per person) SCHEDULED AUTOS BODILY INJURY $ HIRED AUTOS (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) AUTO ONLY-EA ACCIDENT $ GARAGE LIABILITY EA ACC $ OTHER THAN ANYAUTO - AUTO ONLY: AGG $ e EACH OCCURRENCE $ EXCESSIUMBRELLA LIABILITY I AGGREGATE $ OCCUR ❑CLAIMS MADE $ $ DEDUCTIBLE $ RETENTION $ WC STATU- OTH- A WORKERS COMPENSATION AND WCA025879011 07/19/08 07/19/09 X E.L.EACH ACCIDENT $5O0 000 EMPLOYERS'LIABILITY ANY PROPRIETORIPARTN'IER/EXECUTIVE. E.L.DISEASE-EA EMPLOYEE $500 000 OFFICERIMEMBER EXCLUDED? E.L.DISEASE-POLICY LIMIT $500 000 - If yes,describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS + ` Operations performed by the named insured subject to policy conditions and exclusions. cnM v _ I - CANCELLATION CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE C NCELLED BRE TF{E,EXPIRATION Town Of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR O MAIL _J1L DAIS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE L ,BUT FAI�UJ2E TO 40,50 SHALL 200 Main Street Hyannis, MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UP THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED R PRESENTATIVE, MAK © ACORD CORPORATION 1988 ACORD 25(2001/08) 1 of 2 #53186 °f I E� Town of Barnstable.. 0 Regulatory Services 9B '$ Thomas F.Gener,Director $ATFD i- A� Building 3D114sion; Tom Berry, 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 hereby authorize- STE0610 21S I' FQ2 C' to act on my behalf, in all matters relative to work authorized by this binding permit application for: . (Address of Job) Signature of Owner Date Print Name QFOP zv?S:O WNERPEPUMISSIOT� j T� -Com � luE ✓l��aal� Board of Building Regulatio and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 106141 Board of Building Regulations and Standards " - Expiration: 7/22/2010 Tr# 270447 One Ashburton Place Rm 1301 Boston,Ma.02108 .9. e Type: Private Corporation STEVEN J. BISHOPRIC INC. Steven Bishopric 1112 MAIN ST UNIT 18 q OSTERVILLE, MA 02655 Administrator Not valid without FignaWre V Y •Q TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ` Parcel Permit# Health Division �!I �� q�=i�j s Date Issued Conservation Division [A� 1A, Application Fee dv Tax Collector A 9 Permit fee 1 Treasurer Planning Dept. E iN�GBEPTiCSYSM Date Definitive Plan Approved by Planning Board UII MTO..3f OFISIMMOMS Historic-OKH Preservation/Hyannis Project Street Address S f,cPm �-_ K60'O Village I P,'S-r 6A")T9ik& Owner Address A0 swic— owp-D Telephone BOSS— g""101 V Permit Request EX24Ain F.XfS_NV6- 2 'V, — Square feet: 1 st floor: existing j 6_67� proposed 2nd floor: existing aQ proposed ® Total new 0 Zoning District Flood Plain Groundwater Overlay Project Valuation 6.,60® Construction Type _WOOD Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family U3**' Two Family ❑ Multi-Family(#units) Age of Existing Structure D Historic House: ❑Yes Flo On Old King's Highway: ❑Yes UWo Basement Type: ❑Full ❑Crawl Q�?GValkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Q Half:existing�_ new 0 Number of Bedrooms: existing_ new 0 Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ErGas ❑Oil ❑ Electric ❑Other Central Air: VKes Cl No Fireplaces: Existing New Existing wood/coal stove: ❑Yes XI.No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed: 2'existing ❑new size 10 Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes W<o If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name S'ff V W _T&S*0PP,1e _LvG Telephone Number Address 111(2._ AA0-)Na5t- sut"r2. '1 V License# OL47 q! _Sl OSM��2Zg. AW (94( EE Home Improvement Contractor# Idol Worker's Compensation# yjzC 'gO ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ) P 5&_ ILA TWA) CA- (� Sr � SIGNATURE !� DATE f�/IIL��{ FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED { MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: j�r / FOUNDATION FRAME INSULATION t FIREPLACE ELECTRICAL: ROUGH FINAL W r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING n � _ DATE CLOSED OUT ASSOCIATION PLAN NO. A ` Steven J. Bishopric, Inc. 508-420-3165 BUILDING&REMODELING Fax: 508-428-4841 Email 1112 Main St., Unit 17-19, Osten7itle, MA 02655 sbishoprio,@stevenjbishopric.com August 17, 2004 Robin, At 1805 Service road we are proposing to redeck the existing deck removing 5/4"X 6" pressure treated decking and installing 1" X 4" mahogany decking. We also propose to add approximately 468 square feet to the existing structure. The existing deck is 144 square feet. This deck is approximately 7 feet off the sloping grade. The new deck will be tiered to get down to grade. The deck construction will be pressure treated framing, mahogany posts, mahogany handrails and balusters. Presently there is not a traditional handrail system it is diagonal pressure treated lattice fastened to vertical pressure treated posts. t We propose to close the deck to the ground using 2"X 2"square cedar lattice privacy panels. Please call if I can offer any additional information. Steven Bishopric The'Carom an 'ealth of Mass usetts . - ,D pa,•tment of lndustr,.i�ayr) ceidents' ' 660'yTrasington Street - Boston;Mass, J • ' ,4Yorers'.C m ensation,,jnsurance A#fida'it-General FL' .y lr •"'• .. AA 5 Solfi M , address: ` /u, ,, i•. .« •h _ • . _ ate. . tlBailE2 g Fstablishmeat work site iocatiosi fis11 address d have no onb ' $gsiness Type; ❑Retail ❑ReuT�ludin R a Autos n.a sole k oprietor an •'. []pace[�Sgej Cm g -eal'8st e, . ❑ e r ,.,. yrorling in anf capacity. to'ees full art time ' ❑Other I ant an em to er with ///%%/////%%// //////%//s �o%%s working on this job.. , %//%% /////�loyer,PzovMin v�Azher compeasation for my ,y, i,'„'.,;„ 't.. a'. +•; !r r .t.. + t ' w3j,l'•;1:'?;jt�,t:•' :�1t•. t. r�y''•:. Alil t �.. .{.i. •}-,;;•, ' :t• t' •tt• ��:•„t'i:��i�'tt}�r ,;,, �.t• i '"t ' fits .CJ t+'ti: , '•r.•• '' '1'�' •., +,!w'�t t�!1' t�•.ti.'i' '•' '7 t'r':r•�'.l l.:t v. ..,.f'' „5� r t,.�' S r:. 'Cj•fln ,nyet-''•t.t. . •,•7r+►;{ '$;t:••ti:•it t•,.•.:•lx.'�:;.1!? :(,�'..' �•,.i;• :r 'J '•'i.3J•••tj;rt b:,s< 1t}�h4f.,.trf.a'7•r{'- +'l •' �t t +• :. ,$ .S + , .. '1'+ . 't •,.t••, ",f j.. %., •;•. Jw....t••!,'r �'.• i.;;r r,S.• .. . 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't .' • •� .-• t.''\, �' t ,, t�1. r„tt''r•'t', ,t' 1.:, ,r4j •j% ,Ctl''t';',•„r'i�p,t�'�4''' �'�:.rr'ft•y•,' j, ',:�„:+/t•'.r.•ts:.,+._••a •+', '•,Cr ftt•••�'.jhtt„�::t�1;�'•f•�t,e•1,j:''s t�i�a;�s4;',��•�tp,+,1i,a••.}�'t;5,c:J L'''•r'1f•' :tr'{L��i:tett.•,,'''•}yy.tt',••r+•„Yy�j't•t1:a'•a,•;'i',/�:•'.`:i i.+'�'.:�,1a_'rJ;'•t:5!1',.'„.:..fjS fiv• e�i"'!ii;�r.�'.•Alt •''�y . 4: , -f.k ] �� +,.",i;;;a:;; r.•: :,.J' a to si,500,00 an or insiir-anGTai{tt',• osifloaotcrim�nalist��rirsofatzn up a ainst me, I understand that�I Failure to secure coYerage requited under Section 7iA of MGL TO can lead to the imp f t nt as well as ctxilpeuelties in the fof m of g STOP WOE OF'R and a'r10n°i cationo0 e'day g one yeas'imprisomn copy eiUs statement? Y be forfrazded to the Office of Investi atlom of the DTAfor oot'erag r under t e p ' s andpsnalties b p erf u that the inf ormadon provided above is free a � ed I do hereby ee f3' . Date , �iFF.a� ' ' � • . hone# ��= 4�'316.�' ' '`_ . Print name _ de not write in this area to be completed by city or town ofticia� [Building Department officia]usf o�Y perniftllicenae# ❑Licensing Board city ortaQvn. ❑Selectmen's Office QHuslth Department [3•checkif itnmeaiRte reSpomn is required (]Other-_ phone:�; contactperaon: ' ttevisedStpt7A03) _--- srfo • ' . Information and Znstructfons- , eralLaws•c'hapter 152 section 25 requires all employers to provide workers' eompens tio>x far their. Massachus. the f°isw'° an employee is.defined as every person in.the service of another under any contract CWPl.yees: As quoted'fcom . o express.or.0 e� oral or wzitten. e, er is defied iudzvxdual'p- r ersl4, association, corporation or other legal entity, or any fwo or rmgre of An emplo3' in a joiztt ent rise,and including the, zepresentatives of a deceasedynTloyer, or the-receiver or the foregoing engaged. ' arbsershi association or other legal entity, employing employees. 'Howevei•.the owner of a trustee of an indtind 'p p' ocau ant bf the Awe *Boos a bf �otlinore than three apartments and•who resides therein, or the;• p dwelling house haYing• ersbi s to domaintenance, cou&Vction or repair work on such&W&img fiouse 6r on the grounds or soother Who.employs.P hn g gppjrteoa at thereto shall not becausa pf such employment.be deemedto be aii employer= 1 ' . • . ter 152 gectabn 25 also'sfates fhat'every state*or lacal lieensing•agenoy shall withhold the issuanco or renewal . MCL chap Y applicant Of a license or pe1'?�f to operate a busines$or to construct buildings in the.cor�imoz�wealth for.an �a licant who has not xoduced er acceptab'le'evide�ce of compliant a with the ins' o any contracgfor the of pyublzc.work unt�q k of it's of tical subdivisions shall enter u, ? coznm0nWbalth nor;any• P Y acceptable eye Bence of compliaAce with the insurance requirements of this chapter have;been piesentecl to the contracting . , - authority: 901, SRI ON. . , .,, Applicants . • ies to our situation. Please Please�6 �e w� ems"eonp msatit aff&avit conpletely,by checlang the box that appl, „ y supply comnpany,pane, address and phone numbers along with a certificate of insuxance as all affidavits maybe submitted to the Departrnent-of 'ndustrlal A.ccidents•for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affi&'nt sbouldbe returnedto the city or town that the application for the permit or license is being not the peparhnent 6�T dustnal kcdid ts. Should you have any questions regar&g'the'"Iaw"or if'you are requested, a.wo>kgs!.compensatianpQli lease call theDepamtd=t at the niuz�ber liste ;�elovY. , required to O$tain p ' / ' ' ' , • ' City or Towns . � ' � ,ace at the tiattoni of the easebe sure that the affidavit is cbnTlete andprinted legibly. The Departa=thas provided a sp Pl a ff vit f�•you to 01 out in'the event the Office of Investigations figs to contact you xegardii�g the applicant Please e erirut/license number which wM be used as a reference number, The.affidavits maybe retmued tq. be;sure to fi11m ttli maid ements havebeenmade,• `, ': ` ,. . . the D&parfinentby. or FAX unless othez:arrang .. . ations would like to thank you in advance for you cooperation and should you have auy questions, The Office of Iuvestlg • . .. _ Please do nothesitate to give us a caTL , / agent's address,telephone and fax number: • ' 1 ' . The Dep • . . . • - The Commonwealth Of Massachusetts Department.of IndustrialArdrIents . . Bf1�ce of i�es��ens . 600 Washington Street Boston,MR. 02111 fax m (617)727-7749 t 4 t (h�K vttlTim� ; tixz BOARD OP BUILDINI'a REGULATIONS t =License: CONSTRUCTION SUPERVISOR . _:Nmmbor:*CSL. 047928 f BirthddW `09126A948 i y ^Expires_?09/29l2005 Tr.no: 2537 4 r Restricted`00 STEVEN_J BiSHORRIC _ ,. MARSTONS MILLS MA:02G48 Administrator x ; ./itC V/6'!�7/YI24YL!//PQ�A�L O�✓l�Gl�6�LU6C� _ Board of.Building Regutatious and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration: 106141 One Ashburton Place Rm 1301 lug Expiration: 7/22/2006 Boston,Ma.02108 Type: Private Corporation STEVEN J.BISHOPRIC INC. Steven Bishopric 1112 MAIN ST UNIT 18 ,, OSTERVILLE,MA 02655 Administrator Not val• ithout Sig ature i °FSHE1p Town of Barnstable Regulatory Services • snxxsrnB� Thomas F.Geiler,Director MAM 039. a��� Building Division rfD MP'� Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Fax: 508-790-6230 Office: 508-862-4038 Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property hereby authorize D�Cyf.D to act on my behalf, in all matters relative to work authorized by this building permit application for: ti905 5crv� (Address of Job) AL`1 0 Signature of Owner Date Print Name RPERM Q :FORM SO WNE ISSION pRYHE r0�,. Town of Barnstable Regulatory Services 9 Ms�i s,�+ Thomas F.Geiler,Director �iOTFp�,`lA,� 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 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: )(K/1J Q) tXiSjJ& 'l ecr_ Estimated Cost ,k 0 Address of Work: S 2gV)CG Amp Wg.,; (�W-r)ML f, Owner's Name: XARW AAM1)0 Date of Application:V I/bg I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME 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: G mll W1 Dale C ntractor Name Registration No. OR Date Owner's Name Q:forms:homeaffidav -57 &-,e Vic ey- .. •9-� { /. FIED PLOT_ PLAN CERTI • �' W� B�,ys��r3G .. . •CATI O N .T.. �o �' Nov,Zo /9B7 DATE y. SCALE . . ... .... N6 •loT PLAN"REFERENCEWOV of3717 7'9. . PAwv1A1(s- .. . ED 1 LLEY No. 26100 � , . . . . . . . .� ISTER��� ss��MAI Lw��� I CERTIFY THAT THE .. • SHOWN OS LOCTED.ON THE GROUND N EREONHIS AAND HATITCONFOR AS SHOWN.H N I MS TO THE SETBACK REQUIREMENTS OF' HE TOWN OF WHEN CONSTRUCTED. DATE, NOY ?0198.7, ,G � f REGISTERED LAND_ SURV R �osa•,� $'.D�'Aiy�TT� ��- PETl77o�/E7�s ' Town of Barnstable -THE do Regulatory Services Thomas F.Geiler,Director • anxxszABM 9 i6 9 Building Division �pTEG ►�° Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www..ttoow—nn.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT# �7 1 FEE: $ SHED REGISTRATION 120 square feet or less kA ��J,�� McS c�COIe n-A Location of shed(address) Village c�c� m tend Me c.hac6 5OC -1- y -`7Di1�1 Property owner's name Telephone number Nq - ODe-- 6J 0 l Size of of Shed Map/Parcel# �1 Signature Date Hyannis Main Street Waterfront Historic District? NO Old King's Highway Historic District Commission jurisdiction? NU Conservation Commission(signature is required) PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 /67. 87 s. La7- N LoT tfI CERTIFIED PLOT PLAN LOCATION . .�/�3T• STGE' SCALE . ./." 4.�... DATE NOv-. PLAIN REFERENCE/. B�7NG •�oT tN 0' BN g EDV' RDV4 No. 26100 �c C SjER�S�� I CERTIFY THAT THE .L'�.sTjNG SAL LAB SHOWN ON THIS PLAN IS LOCATED.ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF 4 , N.ssT�07. • •.. . . . .WHEN CONSTRUCTED. DATE REGISTERED LAND_ SURVE OR i J The commonweattb of 01am6acbegettz TOWN OF BARNSTABLE In accordance with the Massachusetts State Building Code, Section 108.5, this CERTIFICATE OF INSPECTION is issued to . . . .TEACHING TOTS Teri Gould. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � BU Q'Certtfp that I have inspected the . . . . . . . .ILDING. . . . . . . . .. . . . . .. . . . . . . . known as . . . . .. .TEACHING. . . . . . T. . .OTS. . . . . . . . . . . . . located at , , , , 1805 SERVICE .ROAD in the , .VILLAGE of WEST ,BARNSTABLE Count o BARNSTABLE . , Commonwealth of Massachusetts. The means of egress are sufficient for the following number of persons: BY STORY BY PLACE OF ASSEMBLY OR STRUCTURE Story . . . . . . . . . Capacity . . . . . . . . . Place of Assembly or structure Capacity Location Story . . . . . . . . . Capacity . . . . . . . . . Story . . . . . . . . . Capacity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , , , , , 20 children . . . basement USE GROUP I-2 . . . . . . . . . . 1.0382 . . . . . . . . . . . . . . _ ,September 1.2 , .1995 September 12 , 1996 . . . . . . . . . . . . . . . . . . . . . . . . Certificate Number Date Certificate Issued Date Certificate Expires The building official shall be notified within (10) days of any changes in . . the above information. Buil g Official R Assessor's offioe (1st floor): - uu !„ THE� T Assessor's map and lot number ..................... .................... �o o� e�Q ♦� Board of Health (3rd floor): q� j� Sewage Permit number — ! `� ' Engineering Department (3rddoor): ,y 1639• Housenumber �" f�OS............................... ....................................... I APPLICATIONS PROCESSED 8:30-9:30 A:W and 1:00-2:00 P.M. only TOWN OF , BARNSTABLE BUILDING INSPECTOR) wc,-- l ( ► ter° APPLICATION FOR PERMIT TO ....................................... TYPE OF CONSTRUCTION ....... C7 .. ` '`>, --fi' !'.+. ............f....�c2 .......SZ . !/............... ........................... 19 TO THE INSPECTOR OF BUILDINGS:, \ The undersigned hereby applies for a permit,according to the following information: Location �OT / SF2l/ C'F.... ..�.......4 7... .4�2/l.{�T 3/�...................:.....i........................... ........................................................ �� t Proposed Use ................�.................................................................................................................. ...............xpv .......... 4 �! ..........Fire Distri�t �' "a"'�._ Zoning District .��............�...... ........... ....................., .......................................................,...................... Name of Owner,--.!,`•'t cl 6 V k(5—(Tt CSC ._ Address ........... I,"!T....� /...................I.............................................Address ................................................................:................... Name of Builder ... Name of Architect �.1 � ( �i Address................ Q. ........ ............................... .. ............... Number of Rooms �oy2 �� �rle ......................................Foundation ............................................ ............................... Exterior .....-779 Y L/I �(i�G 1 ( 1(5 ! /I �-'-/ s` C /......................................r../`..........................Roofing ............ , .�..`.�y.. .................. FloorsInterior ........................................:..........................5......... ...... Heating t '<�.!...(�1 ... � :...0� Plumbing 2.....'�. ..................................... ............. r ,................. P Approximate .�1 ��� + Fireplace .................,................................................................%-�oximate Cost .............................j................................. I� Definitive Plan Approved by Planning Board --------------------/--------19-------- - Area ..../4. ............./ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH/ !� Y 1 a OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS w I hereby agree to conform to oil the Rules and Regulations of the/ own—of-Ra nr stable regarding the above construction! Name ... .. Construction Supervisor's License O �....:....,J • �(O� 77 J COOK, CRAIG & DEANETTE e A=194-008-1iW00 �: Id sli 194-008-000 ' t No „31459. Permit for .....1 z...Story Single Family Dwelling .......................................................................... Location .......Lot. ...#1. .........180.5. . ....Servic. . . ..e Road ..... .. .. .. . . .. . .. . .. ....... .... West Barnstable ............................................................................... Owner Craig & Deanette Cook ........................................................... Type of Construction ....Frame. ... .. ................................ ........................................................................... Plot ............................ Lot ................................ t nted December 1 , 87 Permit Gra .......................................19 Date of-Inspection ....................................19 =r Date Completed ......................................19 TOWN OF BARNSTABLE E SIGN PERMIT PARCEL ID 194 008 W01 GEOBASE I_D 37240 ADDRESS 1805 SERVICE ROAD PHONE W. Barnstable ZIP - LOT 1 . BLOCK LOT SIZE i DBA DEVELOPMENT DISTRICT WB PERMIT 15819 DESCRIPTION TEACHING TOTS PRESCHOOL(4 SQ.FT. ) PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $10.00 BOND $.00 CONSTRUCTION CASTS $.00 ' 753 MISC. NOT CODED ELSEWHERE * iARNSTABLE. • � MASS. OWNER GOULD, THOMAS A & 1639. A� ADDRESS REGAN TERI L ED M1� 1805 SERVICE RD j W BARNSTABLE MA ,11 YILDI -V'IS I DATE ISSUED 06/12/1996 EXPIRATION DATE /� The own of Barnstable permit no. i ;, . Department of Health, Safety and Environmental Services ' /S�/� ' H"f:, KAMM = Building Division date 6-/a-9L 367 Main Street,Hyannis MA 02601 fee Application for Sign Permit 00 8'. f,✓o i Applicant: %C1?=L Assessor's no. /9 41 o >o J Doing Business As: Telephone Sign Location street/road: /eD 5 3 2 V14e 9cJ 0, Zoning District 9 Old King's Highway District? yes no Property Owner Name: �/��-L -t 6 X4S (r0Jld Telephone y,R 0 -,5/39 Address: Village L✓- ��'U '�`�G!� Sign Contractor Name: 015 C 00/J f_ S i G'�j S Telephone &,ol_ G/S Address: 1y MO GO R Village w �a,rrl 5�o 6 e- Description � Diagram of lot showing location of buildings and existing signs with dimensions, location and size of the new sigr to be drawn on the reverse side of this application. Is the sign to be electrified? yes no ?/ (Note: if yes,.a wiring permit is required) I hereby certify that I am the owner or that I have the authority of the owner to make application, that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinances. Date Signature of Owne onze agent Size (sq. ft.) 3, 7!5' Permit Fee A/6 Sign Permit was approved: disapproved: Date Signature of Bu' ding Official 0 • y y u � 1 to \L rrEa Z`" H-W L U � rT LC x U ro v� 117014N OF Pear wl;rnv,( E A5SE55OR5 MAPS 194 LOT'S Wlb� $CO 3roa ZON,lNG: L �~ 5ET6ACKS: FRONT-- 30'S1DE5�ISM REO,Rs Ig' + �� `r 3% w 14 LJT 14? - - e- 140 _ __ _ � - - _ evU e 87 IGR I ll eL. ` I ir d UOT Q— ISO -02 V,/, 'Ile " M��w ,' �a Lbw►T� .�-,_;-� _,SITE AlD_ EWAGE PLAN C EGENO LOCUST. I,OT CPO U�SEeoa r^Ao w. CONTOUe5 (EX15T.) ---- g \_ (PROP,)--o----0-- --. REFERENCE: (,Cp 3y617 A` CONC.BOUND m co PREPARED FOR TEST HOLE Al-r ri�il 11CTi__G � � SCALE : W, DATE (I 1 �TMe rq� The Town of Barnstable • sARtvsTnsM • 9e� ' Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner May 29, 1996 Office For Children 109 Rhode Island Road Lakeville,MA 02347-1349 Re: Teaching Tots Preschool 1805 Service Road W.Barnstable,MA To Whom It May Concern: The doorway marked"C"on the enclosed diagram will satisfy the requirements for a second means of egress during the proposed construction at Teaching Tots Preschool. Should you have any further questions,please feel free to contact me. Sincerely, Ralph M.Crossen Building Commissioner RMC/km enclosure ICA NO' ---� to Tin �L y w J n X. I TOWN OF BARNSTABLE SIGN PERMIT PARCEL ID 194 008 W01 GEOBASE ID 37240 ADDRESS 1805 SERVICE ROAD PHONE W. Barnstable ZIP LOT 1 BLOCK LOT SIZE DBA `DEVELOPMENT DISTRICT WB PERMIT 12576 DESCRIPTION TEACHING TOTS PERMIT TYPE BSIGN TITLE SIGN PERMIT CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $10.00 THE BOND $.00 CONSTRUCTION COSTS $.00 753 MISC. NOT CODED ELSEWHEREBARNgrABM * ; KAM OWNER GOOLD, THOMAS A & i639' ADDRESS REGAN TERI L ED MA'I 1805 SERVICE RD B I ING DIVISION W BARNSTABLE MA �=- Y LD l lA.BY DATE ISSUED 01/03/1996 EXPIRATION DATE TOWN OF BARNSTABLE ,y SIGN PERMIT �'AI k ^IB �4 00 W01 GROBASE ID 37240 ADDRESS` 1805 SERVICE ROAD PHONE y:Y W Barnstable ZIP LOT 1 .. BLOCK. LOT SIZE DBA {DEVELOPMENT DISTRICT WB PERMIT 12576 DESCRIPTION TEACHING TOTS PERMIT TYPE BSIGN TITLE SIGN PERMIT" CONTRACTORS: ` Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: BOND $.00 CONSTRUCTION COSTS $.00 753 MISC. - NOT CODED ELSEWHERE '* E�►xI9s1'ABI.E, +' _ MA83. �► OWNER GOULD,, THOMAS A. & 039. A�0 ADDRESS BEGAN TERI L 1805 SERVICE RD B LDI G DIVISION W BARN STABLE IAA DATE- ISSUED 01/O3/1996 EXPIRATION DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. EN CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED.PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU ELECTRICAL,PLUMBING AND MECH- (READYTO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. } POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 .: 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER:' SITE PLAN REVIEW APPROVAL I I WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. . i BUILDING PERMIT d . The Town of Barnstable .� Department of Health, Safety and Environmental Services i Building Division dace /✓/9� 1"9. �� 367 Main Street,Hyannis MA 02601 / fee /D ed Application for Sign Permit wo Applicant: 6'0vd Assessor's no. Doing Business As: %��C/tiv� /� Telephone 4;D' �6 Sign Location street/road: /£,os` Servi- ce Rcf. Zoning District Old King's ITighway District? yes no Property Owner Name: %?17-/ Telephone Address: /8-0S S-&rv%ee /'c/ , Village �-6a, s/a6 Sign Contractor Name: Telephone A. . ,ril e►ag�areSS: Description Diagram of lot showing location of buildings and eszsting signs with dimensions, location and size of the new sign to be drawn on the reverse side of this application. Is the sign to be electrified? yes no (Note: if yes, a wiring permit is required) I hereby certify that I am the owner or that I have the authority of the owner to make application, that the information is correct and that the use and construction shall conform to the provisions of Section 4-3 of the Town of Barnstable Zoning Ordinances. 96 - � - Date Signature of Owner/Authorized Agent Size (sq. ft.) /s / Permit Feet d- o Sign Permit was approved: disapproved: j- - � Date Signature o cial A- .0 H -T N G 0. 'R �sc H- OOL Wh;}e she,4 rAc+cam( C-) i IVI a3IGaeb� 3rc,cKet : Pres5,urC'fres,4rA x 2w",b_ Cplaf(: )VATv—AL 4" � L.R.: � y 1 yy' w � p n, a � r I -to,. 11 t i GOULD •J A Y ~ 1 Nt � r �' 'ter\`� , � . 1\ } .• tfi� ''� ✓� 3,• .. ��� ', �� ��� 4 G v i ��`j q y �r i��� /` ' 'r � . •, r TO"N OF P,AQNSTAt3LS ASSESSORS MAPS 194 LOT'S I N$ $CO SETBACKS: FRONT-- 30'5JOES s 14' REAR 6 Ig' T D /J co U a I _ Gr e:04�0PA _ vo 1 /Z (off 1 LOT 2 o /o - — 47 ND_ SEWAGE PLAN LEGENo: LOCUS'' �o EduTE G�,reoct f^� CONTOUES (EX1ST. \ \_ (POP,)—�--�-- _- REFERENCE: �Cp� 316 7 A R CONC.BOUND cB �� PREPARED FOR 'PEST HOLE /�Ir C � IJCT`i_G SCALE : "zW, DATE: !i I SPR Notes 07/20/95 COURTESY VISIT 00-36 Teaching'Tots, 1805 Service Rd., W. Barnstable, 194/008. • Proposal: Day Care Center. • T. Gould presented staff with proposal& plans. • HP restroom installed. • Seek to expand from six to twelve children. • Free standing sign at end of driveway. • Change of use would require septic system inspection. • Will meet with Health Department staff re: septic system. No town water to site. • Basement more than 50%below grade. • No walk out basement. • No direct access out of basement. • No cooking proposed. • Only parking in driveway. • Manual pull alarm system. • Low density electric heat. • Will operate on pre school schedule with a.m. & p.m. snacks. • Sign will be accepted/denied upon review by Building Commissioner. • No SPR issues. Must meet Health Department issues. 4 `OFtHE i� The Town of Barnstable BARNSTARLE.o�•� Department of Health Safety and Environmental Services MASS 039. �0 plFO na+" Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection Ll k rf---2 ° Location 4��0� �(,(.P ��--G�� Permit Number Owner C)y Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: L N AT S W,oss 6 tj weu S ERNS 1 z Please call: 508-790--6227 fforl reeinspection. Inspected by Date CA-' 006P, 7'D/ CA, Assessor's Office(1st floor) Map �`9�1 Lot J Permit# q, 3 Conservation Offices(4th floor) \-- `fA�S`�j Date Issued 01;� Boa nd of Health(3rd floor)(8:30-9:30/1:00- 2:00) 913-5 a Engineering Dept.(3rd floor) House , pd� �" �� T BE CE Planning Dept. 1st floor/School Admin. Bldg.) WITH .P ( g•) ����A Definitive Plan Approved by Planning Board 19OONLIEN ND fN REGU OWN OF BARNSTABLE Building Permit Application Project Street ddr Village (.A,-)). ar-n 4 M4. Owner hom7 S 4. 6-6c"14 Address /K06' :5crvFce, Q8 . Telephone O�_ yob " �/3 (CodkK :'4- — 0 aa 'Permit Request MOW" --P n i s h rQ 9.76' o-YO ha scrne_,7� a-re a o vi& rcm o ve, c,, rl on I o bea-,-:n tialI fo ma/we_ a., Care- -(' e, 5-90 5 •,7 ' . ei �'o 1- Q r Total 1 Story Area(include 1 story garages&decks) / square feet Total 2 Story Area(total of 1st&2nd stories) square feet Estimated Project Cost $ /,�-a D Zoning District Flood Plain Water Protection Lot Size 1-1 3 5_6 Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Aj dd f) /WmJ, Commercial Residential Dwelling Type: Single Family _ Two Family Multi-Family Age of Existing Structure c l e.a.rs Basement Type: Finished Historic House Nff Unfinished t Old King's Highway XJ4 Number of Baths a a Va No.of Bedrooms 3 Total Room Count(not including baths) First Floor Heat Type and Fuel 1-. A . fir/S Central Air X!f Fireplaces A14 Garage: Detached. Other Detached Structures: Pool Attached Barn None !/ Sheds Other Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 9C�rns+ SIGNATURE /'`��-�-t- DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY .a PERMIT NO. #9538 DATEISSUED Aug. 4, 1995 MAP/PARCEL NO. 194.008.TO 1 _ K ADDRESS 1805 Service Road VILLAGE West Barnstable, MA 02668 OWNER Thomas A. Gould & Teri L. Regan f DATE OF INSPECTION: FOUNDATION , FRAME, 1 INSULATION 'FIREPLACE ' ELECTRICAL ROUGH FINAL F 1 1 PLUMBING: ROUGH FINAL GAS: ,, RQU;GH FINAL FINAL BUILDING.:: - t F..'i• n': a DATE CLOSED OUT .155 ASSOCIATION-PI AN N;p I . 11%02'94 17,02 $`8177277122 DEPT IND ACCID o P. tME Conunonitlea�t�i o/ )Wa..1_4ac1zusetb ' .JJaPartmenl o�.,)`,:du�,fria[✓dcccdentd 600 WUnyton Stm E .James J.Campbell &ton, ii madwA 02111 Commissioner , Workers' Compensation Insurance Affidavit I. 4N1k5 14� �ro 6,1G with a principal place of business at: (ccrisr"izia) do hereby certify under the pains and penalties of perjury, that: () I am an employer providing workers' compensation coverage for my employees working on this job. Insurance Company Policy Number () I am a sole proprietor and have no one working for me in any capacity. () l am a sole proprietor, general contractor 4A=qomeowner�(circle one) and have hired the contractors listed below who have the following workers' compensation porcies: Contractor Catnpanyilgolicy Number Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number 1 am a homeowner performing all the work myself. I underst<rsd t`:t_-copy of&is statement will be fo.vrarded to cite Office of investigations of the DIA for coverage verification and that failure to seal coverage is rec ed under Section 2SA of MGL 152 can lead to the imposition of criminal penalties consistin¢of a fine of up to S 1,500.00 and/or, years' impraonrnent as well as civil penalties in the form of a STOP WORK ORDER and a fine of S 100.00 a day against me. Signed this � day of �g 0,5 / , 19 55 tuensee/Permittee Building Department Licensing Board SeIeetmens Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION ------------------------------- Please print. DATE JOB. LOCATION ��S SGrViCe, 1�j 0-ril5+C Number Street address Section of town "HOMEOWNER" . � _. : --:•::.. :..... . . 1 '�omn /� 6-6u yan-313�rl 7.7/.70 Name Home phone Work phone :- PRESENT MAILING ADDRESS_ I F�0 v TC,e ?'' = tt1` 5C2.► nS+able MOL, [S h� City .town State Zip code The current exemption for "homeowners" was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an in- dividual -for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Persons) who owns a. parcel of land on which he/sh i • es � _ side, on which there is, or is intended to be, a onetoisix familycdwelto re attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official on a form acCept*able 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 Stat Building. Code -and other applicable codes, by-laws, 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. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. L_ . HOME OWNER'S EXEMPTION f The code state that: "Any Home Owner performing work for which a building permit is required shall be exempt ,from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that if Home Owner engages a person(s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for licensing Construction Supervisors, Section 2. 15) . This lack of awarenes often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home "Owner actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities,. man communities require, as part of the permit application, that the Home 'Owner certify that he/she understands the responsibilities of a supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such 'a form/certification for use in your community. i A �N4CAP / CL ° The Town of Barnstable • a►�-ram. peg Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-775-3344 Building Commissioner For office use only Permit no.Date Se""" —q 6 , 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-era=ng owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: Est Cost Address of Work: Se ry G Rd, GJ. &c rAsIr—WL trA. Owner.Name: I h M0 (Too tC Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000 Building not owner-occupied =O«mer pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor name Registration No. OR Date Owner's name st a►xrrsrnBM • The Town of Barnstable �� Department of Health, Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner July 26 1995 Thomas Gould Teaching Tots. 1805 Service Road West Barnstable, MA 02668_ Dear Mr. Gould: Please be advised that the proposed free standing sign for Teaching Tots must be reviewed by the Building Commissioner in order to be accepted/denied by the Town of Barnstable and the proposed expansion of the facility must meet Health Department requirements. Please notify this office upon installation of said sign. If you have any questions, please feel free to call. Respectfully, Carol Ann Ritchie, Site Plan Review Coordinator coverlet 5/17 Town of Barnstable FOR OFFICE USE ONLY Acti m 1Xv Br. Application for Site Plan Review )cation -gal Description: ;sessors Map and Parcel Number. M Ae 191.1 1,nf5 1- operty Address: 10 a S Seri T c e . C-j &e rn s f bl c M q wner of Property / A vu licant ante: ';h a MA 5 -t e r ISOJ ld Name: j CAC i4 i 0 C- 1 QT S ]dress: Address: o 'r V"C c: 2& (7a imA ui�4�6,8 lone: 5-o Phone: -P R- `/0— /C/9(1 a�ineer Agent ame Name ddress: Address: lone: Phone: .orar<e Tanks Utilities Zoniney Classification xisting Proposed Sewer District umber. Number. 00 Public Flood Hazard: ze: Size: N' Private Groundwater Overlay: 4/1 Bove Ground: ti� Above Ground: N 4 Fire Pi ct r Lot Area: Sq.FL nderground: ✓" Underground: Wat AIV Number of Buildings ontents: &P Contents: )V-� Public: Existing: Private: ;/ Proposed: ,, irking Spaces Curb Cuts Fire Prot' � Demolition: -2quired: Existing: Electrical Total Floor Area -ovided: Proposed: Aerial: ;/ Residential: ii-Site To Close: 0 Underground: Office: fT Site: Totals: j Gas Medical.Office: Natural: �_Commercial: Historical District: Yej/) Propane: (Specify Use) .// Wholesale: Area of Critical Environmenta60) Concern Astutional: :.0 E.A Yes Industrial: -oject within 100' of Wetland Resource Area: Yes/6 Do C' I � D C a To be reviewed by the Building Commissioner Zoning District: 01d King's Highway Regional Historic District: Peted in National and/or State Register of Historic Places: rimeter setbacks: Front: ; 0 Side: Rear. Lot Coverage: Type of Use (Zoning): Flood Plain Zone: Elevation: Number of Floors: It Floor Area: 5 g U 7 %6 First: 7 5 Second: Other (Specify): Parking Requirements: Required: Provided: Handicapped Spaces: Are there Assessory Buildings? /VL) Accessory Building Floor Area: Please provide a brief narrative description of your proposed project mTw, +P, no 0 ex-4 t cre, f f(IOjAw_ •Pee- Ir) yJ z,"It- ( �. L4_)J1 _ i ' l�le e (J[xn i a d lu ure ra&i del o F �h�tl'.n : I���s�m�n� 0.recL a.n� 64- nv,l - log LJJCAt1 }u (VI(AXC, Gnu eCSL`i 5�_ rE)".nl CLnc-' nI(,ce_ t 'fh� rd j2 6 t' y J'- LI r r✓f tJ G. I assert that I have completed(or caused to be completed)this page, the Site Plan Review Application and the checklist at the back of the application and thg to the best ofmy knowledge, the information submitted here is true. Signature Date 6; TOWN OF P�AfzNSTAl3LE ASSESSORS MAPS 194 LOT'S I WO $CO ro B '3a ZONIJJ 7 : r 5ET8ACCS: FRONT: 90'SJDES F IS' REAR s ig' � �3 c � - OoLJTF-- 148--- _— — _ J _ fir. -bp ^ _ r •,\' \� CA 1 -- L0 VIC AV It¢ �'�, Ohl `6�,•i� ��6' �f3�JZi�'r'1 : •'/_?. ' ,. :. — ND_ :SENA69 PLAN LEGEND: LOCUS : �pr `� ¢du�E G SfeNt " W.AD W E1 A�- CONTOUeS (EX1gT) ---- (PROP,) REFERENCE: W 576 7 7 A' CO.NC.BOUND Cg �/� PREPARED FOR TEST HOLE SCALE : °y$ 0' DATE 0 - e SPR Notes 07/20/95 COURTESY VISIT �00-36 Teaching Tots, 1805 Service Rd., W. Barnstable, 194/008. • Proposal: Day Care Center. • T. Gould presented staff with proposal& plans. • HP restroom installed. • Seek to expand from six to twelve children. • Free standing sign at end of driveway. • Change of use would require septic system inspection. • Will meet with Health Department staff re: septic system. No town water to site. • Basement more than 50%below grade. • No walk out basement. • No direct access out of basement. • No cooking proposed. • Only parking in driveway. • Manual pull alarm system. • Low density electric heat. • Will operate on pre school schedule with a.m. & p.m. snacks. • Sign will be accepted/denied upon review by Building Commissioner. • No SPR issues. Must meet Health Department issues. 4 Assessor's office(1st Floor): 1 q# v 6 b ` Assessor's map and,lot R tuber O *THE >o` SEPTIC SYSTEM US u ;� .w Conservation INST'ALLEOIN OMPLI Board of Health(3r'dfloor): • Sewage Permit number '0 � ;k) WITH TITLE 5 � a �o rua Engineering Department(3rd floor): ENVIRONMENTAL CODE 'a79' House number / TOWN REGULATIONS Definitive Plan Approved by'Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2-00 P.M.only TOWN OY BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO � � /r` TYPE OF CONSTRUCTION CQ < 19 � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Ir Location Proposed Use "/ [� Zoning District ! Fire District i Name of Owner -war 60060, Address 05777 �(//_ r Name of Builder /� �`�C��� . Address Name of Architect Address Number of Rooms / (jj.o Foundation Exterior �w Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost 00f a Area Diagram of Lot and Building with Dimensions Fee I� �{ CD , i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of BarnstaTregarng7theZae;construction. Name — Construction Supervisor's License �( /q GOULD, THOMAS { No 35664 PermitFor BUILD ADDITION Single Family Dwelling Location 1805 Service Road West Barnstable - Owner Thomas Gould Type of Construction Frame .. Plot Lot Permit Grant February 18 , 19 93 Date of gspecti'��l�'�✓ 19 i + 5 r i �I r Date Completed - 19 L` n 'e s AS-Se SSofU f `1 \ pAaee I bwo 1 t5T O ! — Pl A,%3oaK (-t+7 �o �J C 'a1 d. L A '" ►�`� ?A(Z«L i I ga j AMJ3OoY 'LI)7 4 Pb. ox, a S tox�y �G O� T014N OF F,I,,ew';rA5Ls ASSESSORS MAP' 194 LOT'5 B Wb� Fco ZONING : N SETBACKS: FRONT= 50`51DE5=103- REAR n 15' �. �co _,1 - - 14? t_ —_ o E eVI Gr✓ �o�,a _—_ _ 144 —- ._. — _ - M-- 7.51 I.r r _ - o Q`' \/Bel 'y •° / p ``f /J:''; s�• . J o _ i0 1 _SITS... - N.D- SEWAGE LEGEND: PLAN CONTOUES (E)(157-. \� LOCUS!. r I 06ofe G SEe✓a VTAV REFERENCE: �Cpl' '57677 a CoNr— BOUND CB PREPARED FOR 7E5T HOLE - SCALE : - DATE l O/� Assessor's Office(1st floor) Map Lot . Iwo/ Permit# 7 Conservation Office(4th floor) LC k, Date Issued / 97 Board of Health(3rd floor)(8:30-9:30/1:00- 2:00)PK' Z �Fee Engineering Dept.(3rd floor) House#1 Planning Dept.(1st floor/School Admin. Bldg.)' " O�Tl0' 01nT T B;A Defi ' lan Approved by Planning Board 19 hNVIRO K TOWN OF BARNSTABLE ,A� 1"`4 r Building Permit •Application(9 \ l Project Street Address Village Owner V,o \ i, o u Address Telephone �p - Permit Request Co 7` ''�\ (x A 0� •o w Total 1 Story Area(include 1 story garages&decks) ` q C. square feet Total 2 Story Area(total of 1st&2nd stories) square feet Estimated Project Cost $ Zoning District F Flood Plain Water Protection Lot Size y" 5 Co Grandfathered ? Q Zoning Board of Appeals Authorization Recorded Current Use tl A�_k C A SLR_ . Proposed Use Construction Type W DO A F S'A fr\ rP - Commercial tA A Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure o Basement Type: Finished Historic House A- 13 Unfinished Old King's Highway N- A Number of Baths 1;11 No.of Bedrooms Total Room Count(not including baths) First Floor L Heat Type and Fuel G fl5 Central Air i_lk A Fireplaces ,y,q Garage: Detached Other Detached Structures: Pool Attached Barn 'N A None Sheds ��A Other _ Builder Information Name !} .S \ Telephone Number Address License# G `5 S 0'3^-k e� e,y •\`\1� A . -1-6 ''� =L Home Improvement Contractor# \0CsG�l a C o M e.0 k ; N\ V Worker's Compensation# * A,O'A \- �; � ti 1���, P 'tip�� 51 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO {t liz,_N\ SIGNATURE AU414illaAAIV122DATE '1 Q BUILDING PERMIT DENIED FOR THE LLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. A I DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: �( FOUNDATION ` FRAME �&�, INSULATION lw FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT', r SOCIATION PLAN•NO. `Op 114E TO The Town of Barnstable O� BARNSTABLE. ' Department of Health Safety and Environmental Services MASS. t639• �0 prEDMA�a Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection 2E-E—�, Location 180 f-, �� C� 1G� Permit Number Owner (3 �- !� Builder One notice to remain on jobsite, one notice on file in Building Department. The following items needcorrecting:uS op -r-V162,L'L-V'�?V ' r U g S I\JL cr:+ J/a J� Please call: 508-790-6227 for reeinspection. Inspected by Date ��. Z6 , q TrJ4JN OF P�A2NSTAFLE ASSESSORS MAP'd 194 LOT'5 I Wib co$ ZONING : OF � SETBACKS: FROtvT: g0'SIoES p I'S' REAR I°9' Ccc w o _ — I�oUTF � ��eVI G� 87� i ► �. Ol:. 1 e 1 CA VAC'A'KIT lelo 41. A� 1 ` /o ,..— ND_ $ENAGE PLAN LEC�ENO: LOCO$ : �pr QduTE GG SEeoct F^k7 CONTOUeS (EXIST.), -- REFERENCE: .0 'O (PROP) o. o- 7A CONG.BOUND N CB PREPARED FOR: TEST HOLESCALE : I"ti 5D' DAT E (i r Rs,,s X,,z T>RtI[.hl q MitMiRGWa M tfsN f- F'awra_xSrl--_..._. Wr `T q.pucAvoon _ __-Rxn�t[TTn>Y3LAN Z .ZaIL RAIIIRvr. _ � iw4tII1GL0.r✓fIr�ST _ L_ w - - lAe.16T rtAh41a4\VI �. Y PL :40' ' C10 fY%I�W/'RMiMCR\9tT• 1 M+N.."6altAx-La.V>a I. 177 i NOTE-ALL DIMENSIONS-MUST BE VERIFIED By CONTRACIORAT BUILDING scale Dare 508.428.6191 a evlin @Ustom / U esigns / - I' II All R,ghtS Reserved rved it -..R-AKIZC R.mtrJ(r ou tnun� _.._._--___._.._.. SU(, ... ........ ..._ .. ..---. ... -. ._ _._____ -- R I � nil ' Stow`to saalcw _ ._..: .. .. — s __ -go Llu _ _ . I Z LEFT Et�//�-StON U 2 ''Z I}dt�.11 prebmmary Vans and Lay.—by D[Dare for the It of Ihe,r customers only Any.'he'use IS I-111y prohierte a 1� Y ' 4<.O<IN4 MIMnIMi[04 1I1�<c P�Y�vpp<s i L <O4i1.pAIJ - nwM.ynt[R OH I ✓<ualan5 xm 14�La•S 1.(e_.. . bIx.9 PT51LLW/ � :� "CO4C Sun ; ---1.I�RenCi 4.- . rMU:n l.p SUFF.�W vLNT we Tw"An.lanRl]_... SQFFII' r2 LT_A1L(1'i,r o•) ___ Stu=nErm�:L•�-_zap:_.. i . ... .. enaarcen wcra a --�"- tC N 'G'FRNC4UNR I m SCJ1[ IMI£ �O 508.428.6191 o evIsto @Usto[ � m o esigns 1 copyright 01996 All R"Riqghts e l �, bi = : < o i "Nf=\Y 9na G0-lA4M � SUU P47 P1pKl•GU<f 1 y� r al Q 1 � 2 �.NOLE•ALL DIMENSIONS MilSf BE VERIFIED BY CCVTRACIOR AT BUILDINGhehminary Runy and ra yowxOy OC.D.are rer[he 4[<of tnu r.<u[tem<n only.Any otner use n 51n<tty Proni else 1.' L .'.;;V HOME IMPROVEMENT CONTRACTOR . -i _ :Registration' 108672 > -,Type . :DBA -7 j x� Erpiration 08/21/96 Aw� Z�rtOcan F. '. 4, e= _ F. Stanley Dean Stanley !f9vi-Z9 Capt. LijA Rd ADMINISTRATOR �,. ,Centerville MA 02632 ! . �` The Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations,.renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Est.Cost Type of Work: —r Address of Work: D ` A Al d Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEM 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 e owner. I hereby apply for a permit as the agent of the 1 —,:5? 3 ���Registrat�ionNol Date. Contractor Name OR Date Owner's Name The Cunrnionlrealth of Massachusetts Department of Industrial Accidents ' �•! OlAceolla�estlgaUoAs • 601) H'ashin,-tun Street Burton,Mass. 02111 Workers' Compensation Insurance AlMdavit A.nnls^ttt tn6.�..atir:.• . . .. . . - Please PR11VT'le tblv _= name, location- Cite, phone 0 1 am a homeowner performing all work myself. 1 am�'a.�sole proprietor and have no one working in any capacity _ ram:.___._ I am an employer providing workers' compensation for my employees working on this job. comp!q} n•tmc• nhnne#- C insurance co Cm ^'\ M r v^e tom` Q to, t;i, np Iin•tt �C b�1� - `� �k 1 am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: comnam• name• address: city: phone 0: insurance c.► policy# -^ -� :..: . ...--.�.. __.. .v n•✓;.c:..:�-?-r!'?";�!ree;�s!?*+�F• "f'airs+a!�rpS�?ef_r�;;+.Y:T'+�R_'fXa�+�"q„'_"t`►.-•'•�'M. - --.^s! mliam• name: address: city phone 0, in�ur�nce co policy## .Atiach additional'sheetifaecessa -�?:•+�7: '1 s,«t.'w.��^ awrrf; -` .s" cart. i ���M . �, .M��, Failure to secure covcraee as required under Section 25A of MCL 152 can lead to the imposition of criminal penalties of a fine up to 51.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Once of investigations of the DIA for coverage verification. A l do herehr m •rrnder VP ► nit era ies of peduq•that the information provided above is true and correm Sisnaturc ate Print name — �= �- Phone# AA 2F'7S4� C,, `official use only do not write in this area to be completed by city or town official + city or town: permit/license#1 rnBuilding Department Licensing Board check if immediate response is required ❑Selectmen's Office (311ealth Department contact person: phone##; rnOthcr (revised 1-95 PIA) . Y 1j L+- y x p,THE TO TOWN OF BARNSTABLE 31459 - � Permit No. ................ BUILDING DEPARTMENT F aiaan TOWN OFFICE BUILDING Cash M/ �� r6}9• /_�/n �EUY HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Craig & Deanette Cook Address Lot #1, 1805 Service Road West Barnstable, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. June 17, 88 19................. �................ ................. BuildingInspector 7 CONTINUATION OF ROAD BOND DATE BUILDING PERMIT # �J The undersigned owner/contractor hereby agree to maintain their road bond in force until the following work items are completed to the satisfaction of the Engineering-Section of the Department of Public Works. loam and seedshoulders as soon as weather permits. other (explain) /1(��'� ti' e) DP L`vA/ LOCATION Z �/ S ��c/r G lc D, t,✓, �A�N, ? S G ED net/Contractor NGItr' ING AU HORIZATION �`fi0y17N" tTll OF`BARNSTA LE MASS'4CHUSETTS v1-i7 llecelnber 1 87 lip/.l OrtiA j� O DATE 19 fi PERMIT ,- VP �I s lA. :Tackeon ADDRESS 75 .O1d .To'17 rRd: W��L`rj$8l�rfl>le 046099 iE AP LICrpp�rt Z�` awe (NO ) ISTRF,E T) -ty{./) �'C V � 'f" SICONTR S`L'IC E NS Ei : 7a�Y v� S t rifedAv 1, r try 4. ERMITt�p� �Bv'iYc� darelling n e .f iiu dwl)1Llxla ;`0 ML pjr " (' ��I/ sTORv _. OWE"LLING UNITS ?h� �.-,-�aYi ,�i� r1:fad .l7yYpgA/;IMPROVE,MENTI NO. (PRO.POSED USE) �: s ['ATloN1 " 1805° Service Road, West Barnstable DISTRIcr— '"RF2 (STREET)ETyIEEN` AND (CROSS. STREET) {CROSS ,ST STREET) LOT.. SUBDIVISION LOT BLOCK SIZE, .-S - - BUILDING.IS TO BE'." FT.'WIDE BY FT. LONG BY FT.,IN HEIGHT AND SHALL,CONFORM IN CONSTRUCTION TO'TYPE. USE GROUP ___BASEMENT WALLS OR FOUNDATION `"REMARK Sewage i` 6-949 .; r, ;l BPEROND AREA OR G 70..000 FEE VOLUME 1OS6 3(�,: ft. ESTIMATED COST +$ 84 SO.: (CUBIC/SQUARE FEET) " owNER Craig &"'Deaiiett6 Cook C Ibs l BUILDING DE PT. i ADDRESS:' P•:'O. Box 459 North 1. I.;:: );;;,. BY 1 •C. ) ltr)'3Ht,c s f t,.t .. - - 1 `. THIS'PERMIT%.,CONVEYS'NO'RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY"0R..i, "'ti PERM,ANENTLY:'ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED, BY`THE 'JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND L'OfATION OF PUBLIC SEWERS MAY BE OBTAINED 'FROM:THEIDEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES.NOT RELEASE THE APPLICANT FROM THE CONDITIONS .:,!_:"OF.ANY.APPLICABLE SUBDIVISION RESTRICTIONS. I M1N1ML':d.'OF THREE. CALL APPROVED PLANS MUST BE RETAINED-,ON,_JOB.AND THIS WHERE?APPLICAe LE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN" PERMITS 'ARE REQUIRED FOR t:;?'4".;`'AL'L';CON$TRUCTION WORK: ELECTRICAL, :PLUMBING AND MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS: t a OUNDATIONS OR"FOOTINGS. , x at 2 ;'PRIOR TO:COVERIN-G STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL ! %± +Y+ ,•E'r;MEMBERS(READY.TO LATH). FINAL INSPECTION HAS BEEN MADE. i J 9:.FIN'AI: INSPECTION BEFORE jf OCCUPANCY. POST THIS CARD SO IT IS, VISIBLE FROM STREET :.'BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 ry 2 2 3 - �^J HEATINC !NSP :CTING APPROVALS REFRIGERATION INSPECTION .APPROVALS ENGINEERING,.' ' :, OTHER 2 2 .>' SA sr I f � 96 -- - RD OF ALTH "YORK`SHALL NUT`PROCEED UNTIL THE PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD INSPECTOR HAS APPROVED THE VARIOUS WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY TELEPHONE STAGES:OF CONSTRUCTION. OR WRITTEN NOTIFICATION.PERMIT IS ISSUED AS NOTED ABOVE. i87 87 65�1 1 �4. � 7v r�• � �joJrJ /Op r.s ^Q N Lo T � r r a ^° 1 I / - CERTIFIED PLOT PLAN LOCATION SCALE . .�.�� Q.�... DATE Nam.?4 1997 PLAN REFERENCE e 1L . 3-7.1 7 7 `9 PCT,�:"vG 4_ o LLEY No. 26100 ,c GIS1ER``� a� L LA �� I CERTIFY THAT THE .G isT!n�G �uM1��y'7o.v SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF .WHEN CONSTRUCTED. DATE REGISTERED LAND SURVE OR td Oa ` Assessor's offioe (1st floor): C 0 0 � SEPTIC SYSTEM MUST BE r Assessor's map and lot number ............................:.............. wN$TALLED IN COtMp Board of Health (3rd floor): G ' WITH� � _1 fO •w Sewage Permit number .................� 1. .13ENVIRONMENTAL CO 9TsnLE, Engineering Department (3rd floor): a GAS TOWN REGUL.A►TI rasa House number ..lo..D:�......................... ° OYAyd�e APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR -1 ,w 1 ,� APPLICATION FOR PERMIT TO ................... .................................................................................. .................... TYPE OF CONSTRUCTION ........ ............. .........................1.. ........... ....:.. ............. LO TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according //tot1 the following information: Location ... T. �..........SIZf/!G3 ..../�K 1. (� ... i. ............................................... ProposedUse �� .................................................................................................................................. ............. ..................... Zoning District ...........� .- ...................:........Fire Distri r ...........+�..................... Name of Owne Go j&.l1^. ..Address T:.0,.....!". /Q ,�j� r Name of Builder Ir.. .... ...................Address ...� OL�.:..0...e"" ��'' ..........�..................... ............ /,/` I Name of Architect ..... t.......................Address .................................................................................... Numberof Rooms .....................�......................................Foundation ................. ... .... ................... . . ................. Exterior ..............`. ......t-1. .................................Roofing .... f��/( <. .. Floors (/ / 4•!• •`•. ...... ...•••••'•.••: .v..............Interior .............................. .........................t;,......................... Heating ....... w .. ... 1. ...............Plumbing .............2............................................................... , Fireplace ................J...............................................................Approximate Cost .................... 0).ODD. .................... Definitive Plan Approved by Planning Board ________________________________19-------- . Area ....1....Q. ...................I Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS L I hereby agree to conform to all the Rules and Regulations of the eta e reg r ng t e above construction. Name Construction Supervisor's License .... ............................... r, OZ16O � COOK,, CRAIG & DEANETTE 3 14 5 9.. Permit for ..... ...Story.......... ............. ........... Location ...Lqt....#.I......... ...]Road West Barnstable .. ............................................................................... Craig & -Deanette Cook Owner .................................................................. Frame Type of Construction .......................................... ................................................................................ Plot ..............i............. Lot ................................ -Granted .....December.,'1- '9 8 / ,Permit .......I............... ... ......:1 -inspection .;2- Date of , ...... .1 .............. ........19 Date Completed 19 fil U., *ell GI L'i - - I . . I . : : . ; i : . . � : � : . I s � ; : ; ; � i i . I . : : : : . : : : . : I � : ! � ! i . : . � ; ; ; : : . ; : : : : ; : t : 5 : ; . .. . : : . : . . . . s ! : ; : . i . . . : , .... i ! : :. : � : ; ..... � ; ; i : ! i ; : ; ; � : : ; i i : , : � : i : ! , : z : : . ; . : : : . : , : : 1-I � . : ; I . . . . . ; : : . . � ; . : ! : ; ! . : : : . 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