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HomeMy WebLinkAbout0079 TROTTERS LANE z-I\l . A 11 ,/ s is mi p,, n*lot number .. .�. )....L..:l..•. O D1l 9GAk 7,;c1-7-r SEPTIC SYSTEM MUST" !3E l S� � 8NS`fiRLLE® I�! CCP Sew ermit number ............................ .. wi r I �', LIAMCS S 1 Aft 1�����r � TOWN' OF BARNSPT�ABELE d�Q�O�TN E i BAHBSTA►ll L • ;b Y.��O� BUILDING INSPECTOR °ia i •�� °r I — °�- ' VA APPLICATION FOR PERMIT. TO ...... .Vk'A.... Cw C�Yi��J'rJ I t............................................................... TYPE OF CONSTRUCTION l ......?,�� .��:................................. .... ,7.—.2 G............................19 2. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for as permit according to the following information: Location ..�KRTI.(.t....l.Y..f? r�-�`,S/rr�Y1.r.. k�r' !..dy..../. .J����...................................................................................... Proposed Use .....1�.pp f~5.1 c?t.GN4.1!. .1...... I k{J. y............................................................................................. ZoningDistrict ........................................................................Fire District ............:................................................................. Name of Owner -,E 11.Q!/p� l)U e...l�Dt�v�Grp.......................Address .. +5.. /'.d.¢.J..S1.f!l ....... Name of Builder ........ C .a-.}'.►!!..�..:..........................................Address ........45..4:.lM.G..:........................................................... Name of Architect ..4r6&Tra-c�.....................................Address .../.dd .4�`.".. .. Q� .�.QkS, iMGa���itl.:............ Number of Rooms .l I-....�3...........................................................Foundation .... ...6U.1'<'ol....C.Cp1?.G.d'>a .:....................... Exterior .... '.IcF.�i.!'?0.4-r .°..................................................Roofing 4f.11aw ................................... Floors ....9�.!' 5....C... .�+.�1!S.�krc�...�g Gk,(dr�a w ....Interior ........Oft-y 1/a-.1.1.:...................................................... Heating �'l.J> I.O�L!.'^�..f y41...211TG r....................Plumbing .....C��l'.6..r....................................................... 4 d� Fireplace ...�1'.....��..�1......�.w..........................................Approximate Cost ....��1.O.d.....0 ............................................. Definitive Plan Approved by Planning" Board_.___ti_____________._______19________. Area ..� .r�......... 3 Diagram of Lot and Building with Dimensions Fee C . SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. ............................ ......................................... --� _ � Inovative Builders 9518 two story . � family dwelling -..z� ---.',-,__------------- �� Trotters Lane 2 ' ~. ~"= -.-..--..~-----~-------.. " . ' 0Waratonm Mills � ` �.---------.----_-.---------. Imovative Builders Owner -.-------_---_--__.�___- ` ' frame ' ' � Typo of Construction. .......................................... . ' ' .-.-.--.^-.-,--.-----..~.--------- . ` #lJ ' ' Plot ............................ Lot ................................ . - � ^� �� �7 � Permit Gnxntyd -- ---]g Date of | ' /-.-..lg ` ' � Dote Completed ...30��.?��-----l9 . ' - PERMIT REFUSED r . ..---._-..-.-,.---.---.—... 19 ^ . .---.~.--^.' '� .......,_..~-..------ - ` ...-,.---..`.-~-..~.+.._.-._---.---- - -._-_---.._----.--..--...-..~..-' � . . ~...-......-.-^........-.^.....-..-......—. . . . � � � Approved ................................................ 19 � m ' � --------.~---,...-...-..-...-.-- � ` ----.-----------..-.-.-~---.-, ` | | ' ` �� 3 6 ' 3 "C h' T! / 77_ _ .7 o IN, DAT/ON ` \ nn O Gj /7307 • Ted S`FG, 00 i 7T�Ci T T CAS L A,/'v/E- gp�'&;T� ��FQ ao kVa KT a P. I sumlKIS `} No•84" • �7h�STl�a, ° CERTIFIED PLOT PLAN NEW CONSTRUCTION ONLY : F PYA, 'S ;T �A' 1A ma`s TOP: OF FOUNDATION IS= FEET IN 7 ROADS ABOV LOW POINT OF ADJACENT �i���.���� �� • SCALE: I DATE , �� 7�7]. L D EDGE ENGINEER/NG CO lf - CLIENT,-___D^/__ I CERTIFY THAT THE Le)"f 124-714 EGISTEREO REGISTERED SHOWN ON THIS PLAN IS LOCATED CIVIL I LAND JOB NO. `► ON THE AROUND AS INDICATED AND j ENGINEER SURVEYOR DR. BY. fl CONFORMS TO THE ZONING LAWS MAIN OF BARNST BL , MASS. 33 N0. MAIN ST 712 ST. CH. BY k_-____a '- 50. YARMOUTH, MASS. HYANNIS MASS SHEET OF f1/►Tr -- - _u _ _. :�Evr -_.riiu 3tiPf VC'tUN I I TOWN OF BARNS TABLE BUILDING PERMIT APPLICATION C IV UF BARNSTABL, Map V� Parcel _ ► ._ ., Application # FJZ Health Division 35 Date Issued Jo Conservation Division Application Fee Planning Dept. DIVI�73i j` � Permit Fee �J Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project St Address y VillageA/A Owner Address wet--- Telephone D - �- 15b-I Permit Request GZ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 2 Construction Type r u�a kfA Lot Size / Grandfathered: El Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family�0 Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full I ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new / Total Room Count (not including baths): existing new. First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: i Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) ,Name l' f tD s /ll��/��i9�i l�l� Telephone Number --47tg 7,75✓/2, /`f Address ,Lk ,LP,/ A Zazl License # U D 4 E Home Improvement Contractor# /J Y S 6 Worker's Compensation ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO v4mAa Zo/O SIGNATURE DATE j !i r FOR OFFICIAL USE ONLY - APPLICATION# DATE ISSUED MAP/PARCEL NO. 1 ADDRESS VILLAGE OWNER ' t N . DATE OF INSPECTION: " srvFOUNDATION��:�"�;,u+rc..r �p�rat_=.u�•a�J. FRAME .,- r iINSULATIQNr, FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 4 GAS: ROUGH FINAL FINAL BUILDING s DAT.E...CLOSED OUT ASSOCIATION PLAN'NO. t '1 Dcparrillcrll id Public lalcl� I3uart) ul lit�ililito, I:c,uLtliun.� :uld �l,lull:�rtls Qonstruption Supervisor License LicLn �1� 11'I�y ri HENRY CASSIDY d SHED ROW WES;1 YtARMOUTH, MA 02673 r•. `?� • �' Expiration: 11/11/2013 /`rC% �C�� L y�G(�'�l-ll�E'i l.•'1�` >��G' Gr:1' Gl..- ('' 1 Off1Ce of Consumes Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachuset-ts 02116 l Lome Improvement Contractor Registration Registration: 153567 Type: Private Corobratiorl Expiration: 12/15/2'014 Tr# 233031 (,API- COD INSULATION, INC HENRY CASSIDY -- --_........_.---.. _...___... 18 REARDON CIRCLE SO. YARMOUTH, MA 02664 _-............._......._.._..._..._........ ... ............. __.._....._. ._.. ._.. Update Address and return call. Mark reasun I'm,chenge. 17 Address EI Renewal l._.I 1!;ml.tluynluul I I I.usl Card rr�• (/'��rrrrrcr*rrr('r'�r�(�(:l(:(�trFJ:ur(7"rt(,u>!f1 N uliirr ur Consumer Afl;iii:s Business Itegulaliou License ur registration valid for indi�idul use unl} '• IOME IMPROVEMENT CONTRACTOR befure the expiration date, if found return to; vyistwtiun: 153567 Type: Office of Consumer Affairs and Business Regulation 10 I'ark Plaza-Suite 5170,Expuanun: 12/"15/2014 Private Corporatic•u - Bustun,MA 02116 Id iCI.ANl.11)N CIRCLI ;10 i'tti 00LI111,MA 02664 Uudersccrelary Ovid, witho t oat re The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 ; www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers AamGcant Information Please Print Legibly Name (Business/Organizadon/Individual): /', lD� /� 7�p Address: , City/State/Zi : Phone #: j /Are you an employer Check the appropriate box: l. I am a employer with__�' 4. ❑ I am a general contractor and I Type of project(required): employees(full andttor part-time)." have hired the sub-contractors 6. ❑ New construction i 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition I working for me in any capacity. employees and have workers' ! [No workers' comp. am ranCe comp. insurance.t 9• ❑ Building addition required:] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required] t c. 152, §1(4),and we have no 3a.❑ I am a homeowner acting as a employees. [No workers' 13.JZ Other general contractor(refer to#4) comp,insurance required.] �AnY applicant that checks box#1 must also fill out the section below showing their workers'compcusatio0oficy information. t Homeowners who submit this affidavit indicating they are doing all work and then him outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the nano of the sub-contractors and state whether or not those entities have cmPloyea. If the sub-contractors have employees,they must provide their workers'comp.P cY ofi number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: �,Cj,S/�� <<,122 J�� Policy#or Self-ins. Lic.#: �,>lfJ/j ,, � � Expiration Date: " _ Job Site Address: /� ,`s City/State/Zip:u'�" '(� ��Y� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi nder pa and penalties of perjury that the information provided above is true and correct t natc: /76 It---2, P honc 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): L Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: CAPECOD-27 _ MYOUNG CERTIFICATE OF LIABILITY INSURANCE — DATE 7/812DrcYYY) 7I812013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu Of such endorsement(s). — PRonucER License PC-514062 CONracr Mara g NAME: g ret Young Rogers&Gray Insurance Agency,Inc. PHONE FAX - 434 Rto 134 IAIC No.Fxt), 5Dudl Dennis,MA 02660 EMAIL AoOREss:myoung rogersgray.com INSURERS)AFFORDING COVERAGE NAIC II INSURER A:PEERLESS INSURANCE;COMPANY Ir;;ulcEu INSURER13:COMMERCE INSURANCE COWIP_AN_Y Cape Cod Insulation,Inc. INSURER C:Evanston Insurance Company •18 Reardon Circle INSURER D:ATLANTIC CHARTER INSURANCE GROUP__ So(I[IT Yarmouth, MA 02664 INSURERE: — ^-- INSURER F: COVERAGES _ _ _ CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CER I'IFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL 1'HE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ INSR ----`-- AUDL SUtJR POLICY EFF POLICY EXP LrR _ - — _rYPE OF INSURANCE —INSR WVD1 POLICY NUMBER MMIDD/YYYY MMIDOIYYYYI LIMITS�^ UENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 _D A X ClCIv1AGE70 RENTED OMMERCAL GENERAL LIABILITY CBP8263063 4/1/2013 41112014 pREMISEs Ea ocaue _ $ 100,000 CLAIMS-MADE L�J OCCUR MED EXP(Any one perWill $ 5,00 PERSONAL&AOV INJURY $ — 1,000,000 GENERAL AGGREGATE T 5 2,000,000 OEN'LAGUREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG S —_2,000,000 i 1I �I — POLICY RCSiT_L—LLOC -- — $ - - AUTOMOBILE LIABILITY Ea BINEDaccident)SINGLE LIMIT-- $ 1,000,000 I B ANY AUTO 13MMBCKVMK 4/1/2013 4/1/2014 BODILY INJURY(Per Poison) $ALL OWNED X SCHEDULED BODILY INJURY(Per acGdanl) b AUTOS _ AUTOS X HIRED AUTOS X NON-OWNED PROPrRT-Y I19M__E f __ AUTOS k PER ACCIDEN X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 R C EXCESS LIA _CLAIMS-MADE XONJ453512 4/1/2013 4/1/2014 _ AGGREGATE _ oED-I X 1"RETENTION$ 10,000 $ _ WORKERS COMPENSATION WC STATU- O_TI-I- AND EMPLOYERS'LIABILITY I- I _ D ANY PROPRIETOR/PARI'NER/EXECUI'IVE Y/N WCA00525904 6/30/2013 6/30/2014 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N 1 A ----- -- (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1.000,000 It yes,dastnba under OtSCRIP12N OF OPERAI'ION5 below E.L.DISEASE-POLICY LIMIT $ -- 1,000,000 UESCRIP rION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Workers Compensation includes Officers or Proprietors. Addtional Insured status is provided under the General Liability when required by written contract or agreement with the Certificate Holder. i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ' AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Sep 191-2013 14:38:BB 904 379 S1SS -> 401 784 3710 Bank of America,N.A. Page 003, . t i OWNER AUTHORIZATION FORM i I, 1L(L'x- VU �,5 ^ S ' (Owner's Name) owner of the property located at c (Property Address) a b (Property Address) 11 hereby authorize 5-)- ✓ (Subcontra r) an authorized subcontractor for RISE Engineering, to act C n my behalf to obtain a building E, permit and to perform work on my property. .l 1 Owner's Signature r Date } i SEP 09/19/2013 THU 14:49 [TX/RX NO 94481 Z 003 CAPE CO INSULATION It9tA049i StAMEESS SGAATSGAM 9DSVENDED 5.../ PARS OURi95 INSUtAiION D91tIN0l f f_. ...(� 1-800-696.-6611 9� Town of Barnstable vj Regulatory Services ;- Building Division 0' 200 Main St Hyannis, MA 02601 Date: ///d�j Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BP•I) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village ./ Z."/ I? dST7l/�S Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) (1X Ct, Ltno)s Slopes ( ) ( ) ( ) ( ) ( ) Floors ( ) ( ) ( ) ( ) ( ) Walls ( ) ( ) ( ) ( ) ( ) le jeal, Sincerely He y E Cas y Jr, President C e Cod I ulation, Inc.