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Home My WebLink About0107 SEA VIEW AVENUE (11) Feu) Ave--,, 02 v i 1 w►��«�s Yz-RbO� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel , Application # ,�Po r6-7 Health Division Date Issued Conservation Division :' Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board ° /IlZ?/it Historic - OKH _ Preservation / Hyannis Project Street Address A m- Q!�t- j,1.I'i pi-t-4 Village (n LLB Owner + W-✓) ✓l Address Telephone J O'J6- im+- Permit Request RE..- We e-_V_ ST(I ICJ �I-' 2�-tZoo� 3a-1l2oow� �� ►mot � � , „�.,� �..-. .-.. �,.,, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new (-�.� Zoning District Flood Plain Groundwater Overlay Project Valuation 03rS C� Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family. ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing _ new Half: existing new Number of Bedrooms: _ existing —new Total Room Count (not including baths): existing new _First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn O'existing-=0 na__ size_ Attached garage: ❑ existing ❑ new size Shed: ❑ existing ❑ new size _ Other:. Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# c� 'Current Use Proposed Use - - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name d &A-s CPnr2DS,,y S Telephone Number 50�-1-1a —3/�05 Address M n;ry 54, iAi ;4 ) Sr License # 740 5 :1 0,5 a_y i Lz_2-, N A . (aS SS Horne Improvement Contractor# Worker's Compensation # u3c,7336,�,9—M ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE LAJ [SATE - FOR OFFICIAL USE ONLY APPLICATION# f :DATE ISSUE® -MAP•/PARCEL NO. _ ADDRESS VILLAGE OWNER 6 `t DATE OF INSPECTION: ;FOUNDATION �; <� �: ._ - r FRAME _`INSULATIONI_=' } FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL F GAS; ROUGH FINAL r . ,- • FI_NALBUILDING <� _DATE CLOSED OUT ASSOCIATION PLAN NO. t . 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/Blectricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizationllndividuall: 'n) R6 5` CO-(Ld? Address: City/State/Zip: . Are you an employer? Check the appropriate boz: Type of project(required): . 1.�I am a employer with�_ 4• ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.0 I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have 9. ❑Demolition working for me.in any capacity. employees and have workers' [No workers'comp.insurance comp.insumce.# 9. .❑Building addition rern,irvd.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑-I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp, right of exemption per MGL insurance required]t c. 152, §1(4), and we have no 12.0 Roof repair employees. [No workers' 13.❑ Other comp.insurance required] «Airy applicant that checks box#1 must also fll out the section below showing their workers'compensation policy information, t Homeowners who submit this affidavit indicating they a=doing aD wow and thin hirs outside contractors must submit a new atndavit indicate such. tConhacton dud check this box mast attached an additional sheet showing the name of the sub-contractors and state y�hether or not those entities have employees If or sob conhactors have employes they mast provide their workers'camp,policy number. .ram an employer that is providing workers'compensation insurance for my employees. Below is the poFicy and job site information. Insurance Company Name: * /V-0411 p,,,,r--f (,f7 Air s Policy#or Self-ins./tic. C13,3 &9" Expiration Date: 3 p p Job Site Address: / U�' S z -V i Ci /State/Z' �s{ze v l l ty iP ,P1 4. Qa&sS- Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Feilm-e to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of crimmal penalties of a fme up to$1,500.00 and/or one-year m4a somment, as weIlas civil penalties in the fowl 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 parrs and enalfies ofPerjury that the information provided above is true and correct Sitmatr re: Date: , p / Phone#: '�;D y9-6 FrOlther only. Do not write in this area to be completed by city or town ofj'zciaL n: PermitUcense# hority(circle one): Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector son: Phone# I l Client#: 12032 2BISHOPRICST ACORD,. CERTIFICATE OF LIABILITY INSURANCE OA I E(MMA)DIYYYY) 07/13/2011 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). VHODUcbm NIA I NAME: Dowling&O'Neil PHONE FAX aC Nu E,I:508 775-1620 we N,: 5087781218 Insurance Agency E-MAIL ADDRESS: 973 lyannough Rd., PO Box 1990 1NSUREMS)AFFORDING COVERAGE NAIC 8 Hyannis, MA 02601 INsuHEH A:National Grange Mutual Insuranc INSURED INSURER B The House Carpenters,Inc. INSURL:H C 1112 Main Street,Unit 18 Osterville,MA 02655 INSURER INSUHEH E: INSUHEH F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUB.IECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE OD UB POLICY NUMtlEH POLICY EFF POLICY EXP LTR INSR WVD (MMIDDIYYYY) (MMIDDIYYYY) LIMITS A GENERALLIA6ILIIY MPJ3369M D310912011 03/09/2012 FA(:Hl)C(:IIHHFNI%F $1000000 UAMA61-IORFNIFI) $500 000 X COMMERC-IAL GENERAL LIABILITY PKF MI:;F:; Fa nrr.I mrnrr. CLAIMS-MADE 51OCCUR MED EXr(Am we uwcun) $10 000 HI•R:;ONAl R AI1V IN.111HY $1 000 000 GENEnALAGGREGATE s2,000,000 hl-M Ac;OK1-i;AIFIIMII APPI1h PFN: PHOWICIS-(;OMPIOPAWi $2,000,000 POLICY F'K T LOC $ AU I OMOU"LIAMILI l Y COMBINED SINGLE LIMIT (Fa arnnrnt) $ ANY At IO BODILY INJURY(r'w pt,I—) $ ALL OWNED SCHEDULED HOI111 Y IN.IIIHY(Hrr,vtlnrnt) $ A1110:; All if l:; NON-OWNED PROPFK 1Y UAMAIiF HIRED AUTOS At I I O:; r`w nuciJnu( $ $ UMtlHELLA LIAH Occurt EACH(J(XAIF:F:FN(;F $ EXCESS LIAR HCA AIM:;-MAI)F AGGRFi;AIF $ DED I I RETENTION $ A WORKERS COMPENSATION WCJ3369M 3/09/2011 03/09/201 X '1ORY 1mll^ fFaH- AND EMPLOYERS'LIAMILI I Y Y I N ANY PHOPF:IF IORA1AR.INFWFXF(;I11 IVF�� E.L.EACH ACCIDENT $500 0OO OFFICER/MEMBER EXCLUDED? 1 N I N I A (Mandatory In NH) L,, F.I.1)I;;FA:4--FA FMPI OYFF $500 000 I(ynz,JnauliLn unJw DF:;CKIP I ION OF OPFRAI ION:;Mlnw I I I I E.L.DISEASE-POLICY LIMIT $500:000 UESCHIP I ION OF OPEHA I IONS I LOCA I IONS I VEHICLES(AMIch ACONO 101,Adddlonal Hamarks Schadula,If mina spaea Is raqulrad) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Steven J. Bishopric, I11c. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1112 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Suite 18 Ostervllle,MA 02655 AUII HOWLEDHHIEPHESENIA IIVt: I @ 1988.2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S83561/M83560 LS1 ._............. _-- ,p� �!e �a�r>rnzarecueal� o�,/�aaoac/Zuaetta � -\ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation — Registrations i1684_61 Type:,, 10 Park Plaza-Suite 5170 Expirationr;;2%23F2013: Supplement Card Boston MA 02116 THE HOUSE CARPENTERS'2IN.0 w WILLIAM SCHMIT _, f 1112 MAIN ST UNrT / - OSTERVILLE,MA 02ti$5. 5' Undersecretary Not vali thout signature '�' Nla�sachu��ttx- Dchar-tnlcnt of Public Safct. Bu:u'd ()IBuildill Regulation~ and Standards �J Construction Supervisor License License: Cs 76571 WILLIAM L SCHMITZ 66 CARAVEL DR HATCHVILLES, MA 02536 cam_� • j Expiration: 9/9/2013 ('onnnissi;ncr Tr#: 3843 !I I I ' Town of Barnstable Regulatory Services F DABN6TAH13, s , MARS. Thomas Thomas R. Geiler,Director t6s¢ t ` Building Division Tom Perry,Bnilding Commissioner 200 Main Street,Hyannis,MA 02601 WWW-town.barnstable.ma.ns Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 1M6N Art 4L ash of the subject property ell hereby authorize_ 'M C I lll- i-�S� � ,�S to act on my behalf; in BZ=tters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. Signature of Owner Signature of Applicant Peter Print Name Print Name �- a-b I I Date Q:FoxIVE:OWNERPERMBsIorPooLs 1 b L f " �• ul 11 lid!' ow f IN Oil IlL rr g - �;- �y y . W �°" "' i j s _ _ ;.�,.;=..,e._..�..a �.,. ...�_.,_,.,,:{, .� j.R.._=.z�� .��_...,�. �;se.�.t.-,.:a 1 L�f✓'/ _7 f --AT, 1`�„�.gC �.,� #"`""'-Y'-'u•"—•{�"_"_f. 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