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HomeMy WebLinkAbout0298 CASTLEWOOD CIRCLE 19F Cas�letuood Ci.ek Town of Barnstable i , r Regulatory..Services ' Thomas F.Geiler,Director4.5 MAM '' BARNSTAIRA sj !/ Building Division , .-Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.townbarnstablema.us `i t Office: 508-862-4038 Fax: 508 790-6230 PERNIIT# C;b FEE: $ SHED REGISTRATION 120 square feet or less I, 298 Castlewood Circle H)zanTiiG Location of shed(address) Village Georgina. L. Barboza _ 508-778-1135 or 508 564-1784-cell.[ ,. Property owner's.name Telephone number � .2 2731031 Size of Shed Map/Parcel# Si ature Date Hyannis Main Street Waterfront Historic District? Np Old King's Highway Historic District Commission jurisdiction? No Conservation Commission(signature'is required) . Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF.YOU ARE WITHIN THE JURISDICTION OF ANY OF THE' ABOVE COMIVHSSIONS,THERE MAY BE'A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COM USSION'FOR DETAILS, THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:042506 M01R TGA G-' llVSPE'C Tl0lV Pl A]v APPLICANT: BARBOZA TOWN: HYANNIS LOT 122 i g/.59, Ljj -_-- N} #2 9 8 -- L. T 3 88.6 N OF 1,1,40 LOT 124 � � ��`o�,����\sTE�Facy��� ' c STEP JH DOYLE v � 4 7559�F ` IVD FLOOD PANEL: 250001 0005 'C FLOOD ZONE:."C" DATE MAP REVISED: 08/19/1985 i HEREBY CERTIFY THAT THIS MORTGAGE INSPECTION PLAN HAS BEEN PREPARED FOR: DATE: 05/26/10 SCALE: 1 30' CAPE COD FIVE DEED REF:.23459-320 PLAN REF: 197-97 THE LOCATION OF THE DWELLING SHOWN DOES NOT FALL'WITHIN A SPECIAL FLOOD HAZARD ZONE. PER TAPED INSPECTION THE DWELLING APPEARS TO CONFORM TO THE LOCAL ZONING BYLAWS IN EFFECT THE STRUCTURES SHOWN ON THIS MORTGAGE INSPECTION PLAN ARE LOCATED BY TAPE SURVEY AT THE TIME OF CONSTRUCTION NTH RESPECT TO HORIZONTAL DIMENSIONAL SETBACK REQUIREMENTS ONLY. NO INSTRUMENT SURVEY WAS PERFORMED AND LOCATIONS SHOWN ARE APPROXIMATE OR IS EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER MA GENERAL LAWS CHAPTER 40A AN INSTRUMENT SURVEY IS NECCESARY FOR PRECISE DETERMINATION OF BUILDING"LOCATIONS SECTION 7. REFERENCE DEED SUBJECT TO AND WITH THE BENEFIT OF ALL RIGHTS, RIGHTS OF WAY, AND ENCROACHMENTS, IF ANY EXIST, EITHER WAY ACROSS PROPERTY LINES. YANKEE LAND EASEMENTS, RESERVATIONS AND RESTRICTIONS OF•RECORD, IF ANY THERE SHALL BE, AND INSOFAR SURVEY COMPANY INC. SHALL NOT BE HELD LIABLE FOR DAMAGES RESULTING FROM ANY USE AS THE SAME ARE OF LEGAL FORCE AND'EFFECT. OF THIS PLAN FOR PURPOSES OTHER THAN MORTGAGE INSPECTION. TELEPHONE: 508-428-0055 YANKEE LAND SURVEY COMPANY, INC FAX: 508=420-5553 40 Industry Road, Morstons Mills, MA 02648 yankeesurvey©com cost,net www.yankeesurvey.com 80885 JM Town of Barnstable Permit# o Regulatory Services in Fee41 anfrrsjronrissuerlerre T 4a b ,619- �m�q Thomas F. Geifer, Director . e Building Division, Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable,m_ a.us Office: 5 08-8 62-403 8 Fax. 508'790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Yulirf,Nifliorif Red X-Press imprint Map/parcel Number Property Address IfAs Ir— l oa- �j Y'. t �/U�I/, j / 0 b Q r' J /Residential Vague of Work 3 IYfinimum fee oFS35.00 for work under S6000.00 ` Owner's Name & Address C;11/4. Contractor's Narne .� 9 S "/r 7V t1 Telephone Number Home'Improvement Contractor License#(if applicable) , 7w o ruction Supervisor's License#(if applicable) A Pr /� } Workrian S Compensation Insurance Check one: ❑ I m a sole proprietor, FEB-14 2092- . . ❑ am the Homeowner I have Worker's Compensation Insurance ,- TOWN OF BARNSTABLE Insurance Company Name e J CdN lJ 01-1 /1/s .' Workman's Comp. Policy# VV C � 7 / R D 7 _ Copy of Insurance Compliance Certificate must accompany each permit. . Permit Request(check box) ❑ Re-roof(hurricane nailed) (stripping old shingles) All construction debris will'be taken to ❑ Re-roof(hurricane nailed) (not stripping. Going over. .. existing layers of roo fl k /Repliacernent e #of doors Windows/doors/sliders. U-Value 9 / (maximum .35)#of windows *Where required: Issuance of this permit does not exempt.conipliance with other town department regulations,i.e.Historic,conse,Ration,etc.. Note: Property. Owner must sign Property Owner Letter ofPermi.ssion, S` A copy of the Home Improvement Contractors License & Construction Supervisors License is required, 'NATURE: •-�--� 'Pf,ILES\jc0RMS1buildingpe,—,nii.fo n kEXPRrSS.doc The Commonwealth of Massachusetts Print Form71 Department of Industrial Accidents " Y Office of Investigations I Congress Street,Suite 100 r Boston,MA 02114-2017 _. www mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): O&U y 5c7e_16L4,S Address: DcL've, , City/State/Zip: � Phone#: K &�n V y _ ��c�� (� �� f � Are you an employer?Check the appropriate box: Type of project(required): L I am a employer-with �L 0 4. ❑.I am a general contractor and I employees(full and/or part-time):* have hired the sub-contractors 6. ❑ construction 2.0 I am a sole proprietor or partner- listed on the attachedsheet. 7. Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp.insurance.$ . required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.[:1 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 employees. [No workers' 13.❑ Other comp. insurance required.] . *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional,sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy andjob site information. Insurance Company Name: Cf-Gc�N mv," Policy#or.Self ins.Lic.#: J �J o 4-� Expiration Date:_ Job Site Address: If C City/State/Zip: #/ Ih S -ea Attach a copy of the workers'compensation policy declaration page(showing the policy number and dpiration 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 gpder the pains and enalties*erjuLy that the information provided above is true and correct 77 Si pure: Phone#: *(9 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.Buildin ,Department 3. City/Town Clerk 4.Electrical Inspector. 5.Plumbing Inspector 6.Other Contact Person: Phone#: OP ID:JV ,�lCURD' -DATE(MMYDDrrm �.,r....� CERTIFICATE OF LIABILITY INSURANCE 10104111 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{8), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of"policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s. PRODUCER 401-769-0500 NAB Hunter Insurance,Inc. 401-769-9502 PHONe (A(C No): 389 Old River Road,P.O.Box 1 Manville,RI02838-0001 ADDRESS: C T YIE D MOONA-1 ENSURE S AFFORDINGCOVERAO£ NAICIA INSURED Moon Associates Inc. - INSURERA.-National Grange-Insurance Co 14788 Renewals By Anderson INSURER e:f3eacon Mutual Insurance Co. 1137 Park East Drive INSU"KC: Woonsocket,RI 02895 INSURER D: INSURER E: . INSURER F:. - - COVERAGES CERTIFICATE NUMBER, REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE EIEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, EF INSI TYPE OF INSURANCE POLICY NUMBER - MPIIUDDIYYYPY EEP LIMITSLTR. . GENERAL LIABILITY EACH OCCURRENCE $DAMIAGETURE 1,000,00 A X COMMERCIAL GENERAL LIABILITY MPS26619 0911♦3111 0411fi112 PREMISES Ea oau $ $0D,00 CLAIMS•MADE OCCUR. MED EXP(Any om person) $ 10,00 Lni PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE S 2,000,00 GERL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S 2,000,00 POLICY PRO- LOC $ AUTOMOBILE LABILITY COMBINED SINGLE LIMIT B 1,000,00 A X .ANY AUTO BI S26619 09/16111 09/16/12 (Ea awdent) . BODILY INJURY(Perpemn) S ALL OWNED AUTOS BODILY INJURY(Per accident) i SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NO"WNED AUTOS S S UMBRELLALIAB X OCCUR EACH OCCURRENCE 11 A 1,000,00 EXCESS LIAM CLAIMS-MADE CUS2fiB19 - 09H6111 09f16112 AGGREGATE i ' DEDUCTIBLE $ ' x RETENTION 10000 $ WORKF"COMPENSATION I WC STATU-T OTH- AND EMPLOYERS'LUlBIL1TY B ANY PROPRIEroPjPARTNER/EXECUTIVE YIN WC- WC 47 731 830427 10161111 10101112 E-L.EACH ACCIDENT $ 500,00 OFFICERIMEMBER EXCLUDED? (Mandet6ryIn NH) E.L.DISEASE-EA EMPLOYE $ 54D,00 If Yea,dA3c1 b8 antler DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,00 ITL osscRIPTKIN OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 10%AddFJ*ml Rvrmft Salrodula,N mom spaed le r"We") - - CERTIFICATE HOLDER CANCELLATION DEPARTM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE JMLL BE DELIVERED IN Department Of Administration ACCORDANCE WITH THE POLICY PROVISIONS. Bldg.Contractors Reg.Board One Capitol Bill AUTNOR¢,EDREPRESENTATIVE Providence, RI02908 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) `The ACORD name and logo are registered marks of ACORD Ofiice ofGonsumer Affairs and' usiness'Regu tiot5 l U hark Plaza=Suite'' t 70 Boston,'.Massachlasets:02I11.6 . F ,,kk Horne Improvement C ntrac�toi Registration ReAistralwrt 11$$3S Tyt1e Rr va10 C,0Poratton E�glirttion 7%24RfI13 Ttl� 2Sa8tt DAMES MOON .k 1137 PARK EAST.DR. WOONSOCKET,RI 02805 �;,�� �,. `tlpdote Address snd rsturn rasd h9Ar1.rxsson for cdan�c. Address 11 Rini) { Pmplajmcas LoW Card �r fS yoriq:,0a<gd;7t9 ,. �'� nitica'a'fLon u�i��►`�`atr°'"`g`�1a(ior��� a� r 1 aritss or rsgcsirnimn valid Cbt indi�&tul x HOME Ih1PROVEMENT CONTRA befar tbs eipirstraa dais. It faind rctum tp Reglstrat;ori; 119S3b Type ' gtficeo[ConcuarAfiar%andHusi'nessReiilatioc fspintion ,71Z 613 Pr—te Coiporat(an 10 Park Ptaru:Suits 51711 e�rso n socINC; -1r, NY. lAM,ES MOOtt .t 9 i37 PARK EAST OR ��yy, •�xr }�M vVO01dSOCKET 9182895, �, I udrnecreisry ,, i�ioE ski lr<I wuhoul ak natdre K r ._ .� � c 1 � • - ate,• <. k Ba ,6f Biffldi i;; teguhit ohs l i d StAtf • enS �C��+�ra p t upervison,; Lice 0' T y:��,x ,,` �..,waa ie' '�k.�.+->.i ; �• � �s' + � :x �,? ".� ,�',., r�.p fir �'G�^�}Y,�+,'�e + �, sa lt5 fr '.� K•t-a +'§:s - ICQC1Se. S .. � � t { + ,r Y4 ° ''`' ,•,.':� �° +` J .t . 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