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HomeMy WebLinkAbout0034 CIRCUIT AVENUE CA"( Town of Barnstable *Permit#a� PERMITExpires 6 m hs ra iss� ate Regulatory Services Fee MAS�nsNar 163 1 2013 Thomas F.Geiler,Director Building Division TOWN OF BARNSTABLBm Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 32Y e0 Property Address 4-3� 12C u s'7— jqv(�' @ Residential Value of Work �7�io 00•&0 Minimum fee of$35.00 for work under$6000.00 c � Owner's Name&Address /J� -� /'t i C CA(Qm51�9--) >Y1 j Old Ly- 'X Contractor's Name �✓ L Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) C� 3 ❑Workman's Compensation Insurance Check one: [Q'I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# 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 roof) ❑ Re-side , 4- #of doors 2-2/Replacement Windows/doors/sliders.U-Value 0,SO (maximum.35)#of windows ' Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: _ � �✓�Q/ CAUsers\decollik\AppDataV oral\Microsoft\Windows\Temporary Internet Files\Content.Outlook\QRE6ZUBN\MRESS.doc Revised 053012 �, � J716�QOOlL71[OtZIQL[7�1C Q�C�IZ�� ISeCI."r �.,-�,.�..w...,s-_-..q-.-T-...-.,.:.-.`. ....._�.__ .._._�_.--•_•---^-_._:..,._...,..-.....�.-- Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: istration: t&w5 Type: Office of Consumer Affairs and Business Regulation Iration:;z215�_ individual. 10 Park Plaza-Suite 5170 Boston,11A 02116 DALE C.DAVIES DALE DAVIES { 23 NEWTOWN RD. SANDWICH,MA 02563 Undeseerety Not valid without signature Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991m)of enclosed space. Massachusetts -Department of'Public Safety Board of Building Regulations and Standards Comt;uctiun SupervRor License: CS-076391 DAL&C DAMES Failure to possess a current edition of the Massachusetts 23 NEWTOWN ROAD ' r, State Building code is cause for revocation of this license. Sandwich MA 02363 For DPS licensing information visit: www.Mass.Gov/DPS ` Expiration Commissioner 03123/2015 , ITheCommonwealth 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 Applicant Information 'l Please Print Legibly Name(Business/Organization/Individual): �� C L��L/BLS Address: 23 /V L� City/State/Zip: SA o0bla ll A4,f o Z�70,3 Phone#: 7?L/- 2 3 ZQ /00 Are you an employer?Check the appropriate box: 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. I am a sole proprietor or partner- listed on the attached sheet. 7. A Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp.insurance.: 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑ 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. :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 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 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). 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 certify under the and penalties of perjury that the information provided above is true and correct Si ature Date: 6.6 b, X 'J Phone#: '7 7 V- Z3 y - Z-8 Ap Official use only. Do not write in this area,to be completed by city or town off iciaL 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#: sAxvsrnsts, +' , 3 9. Town of Barnstable Regulatory Services Thomas F.Geller,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 3 as Owner of the subject property hereby authorize C to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job), igna a Owner D t c fie, fie , o Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.'b dook\QRE6ZUBN\EXPRESS.doc Revised 053012 CB/DH (FND) PARCEL ID: 324/120 N 00, a. PARCEL ID: 0 324 111 MH PARCEL ID: �� oo v / \, 324/088 `S`30 c,° 2�,CIV ab \p' AREA=.19 ACRES NEW / • • CONCRETE \ _- --_ — ,�• TUBES —_- #34 EXISTING a -APPARENT / - -_ DWELLING TAKING <� \\ — PARCEL ID: 324/089 IN, \� _ _ o i 1c \ w CB/DH F (FND OFF) \ MON. WELL PREPARED FOR: 4, BERT ROGERS FOUNDATION (AS- BUILT) CERTIFICATION #34 CIRCUIT AVENUE, HYANNIS, M.A. MAY 28, 2010 JOB# 1236 SCALE: 1"=20' PLAN REF: 152 81 & 184 109 DEED:24082 22 ASSESSORS MAP 324 PARCEL 88 rt - ��IHOFn�ss � P.O. Box 2428 MacDougall Surveying ZONING: "RC" 20-10-10 FLOOD ZONE: "B" �� 9� & Associates o EDM D �� , I CERTIFY THAT THE CONCRETE TUBES- ON THIS PLAN o A. a EXIST ON THE GROUN44S SHOWN STONE y Mashpee, Ma. 02649 b N0.28980 � po '� ph. (508)419=1086 Srr..� �� E� fax. (508)419-1087 —5'�j1J.'VLAN email: macdougallsurvey PROFES IONAL LAND SURVEYOR DATE Ocomcast.net l � l i Plan Of. Aqv st.in. g Building Location.,.. for Jodi -Becal 34 Circuit Road Hya nnis, A Scale: 1" _ 20' February 16, 199$ l��s • 10� .0 Ll.63' Area 8,372--� Sq. Ft. , o All 5 Qo{ �7 r , 166a00, s �� . t6k \14. 70 R'o 19. 77' , y 8.22' . 18. . O �o NSLOV`J SPOFFORO No.23M U) A &c M Land ; Services, Inc. IST SUIR��`° 33 Old. Main Street South Yarmo t u h, MA 02664 (508) 3.94-2723 Fax 394-9642 Dwg.No. _96090 Town of Barnstable oF1"E'°w Regulatory Services ti M Thomas F.Geiler,Director BAR MASS. » Building Division 9 s �'OTFp MPS a' Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 COMPLAINVINQUIRY REPORT Date: Rec'd by: r/'dcJ e)Cr try Com p laint Name: f o ' Map/Parcel �30? e Location Address: ,;� �, tJ Originator Name: o/ M Ay C Street: Village: 'State: Zip:. Telephone: Complaint Description: de L- % Q r e. ezvi met( FOR OFFICE USE ONLY Inspector's Action/Comments Date: IfInspector: Additional Info.Attached i e TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map L Parcel 077 a Application # ZiO I Health Division X Date Issued Conservation Division Application Fee Planning Dept. Permit Fee 100 Date Definitive Plan Approved by Planning Board PI Historic .- OKH _Preservation /Hyannis Project Street Address 3 Village Owner 4 Address Uabw L Telephone I J�• ���3 c eon {'Y1;S _ rM 018 2L, r Permit Request kecAGo 9!2�� ai c eI t� OV � o-fi 2 0`X Z6` Square feet: 1 st floor: existing g4proposed 0 2nd floor: existing —" proposed Total new Zoning District / Flood Plain Groundwater Overlay Project Valuation 000, Construction Typewa � Lot Size7.Iq Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family SI Two Family ❑ Multi-Family (# units) 9 Age of Existing Structure I W r Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) 1 -3 2-0 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 Boom Count; ` ' .4 Heat Type and Fuel: ] Gas ❑Oil ❑ Electric ❑ Other cD1 Central Air: ❑Yes XNo Fireplaces: Existing New Existing wood/coal stoV6, ❑:des ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑existing ❑ new size _ Barn: ❑ 1xisting :W newq size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes to If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) -- Name 1WU Telephone Number Y Address �� : tdc 1 I] License # 0 �o 0v► V� A4ft OZV- 1 J Home Improvement Contractor# Worker's Compensation # We _ `15 q 8OS- ALL CONSTRUCTION DEBRIS RESULTING FRO. THIS PROJECT WILL BE TAKEN TO Ul- SIGNATURE DATE i s. FOR OFFICIAL USE ONLY t APPLICATION# t ti . DATE ISSUED 1, MAP/PARCEL N0. ADDRESS VILLAGE OWNER Pr DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING r �- - r � to P � r to F DATE CLOSED OUT +�� _s .a ASSOCIATION PLAN NO. 4 _ f Town. of Barnstable* Regulatory Services Thomas F. Geiler, Director Building Division P Thomas Perry, CBO,Building Commissioner T 200 Main Street, Hyannis,MA 02601' www.town.ban stable.ma.us,.. Office( 508-862-4038 . Fax: 508-790-6230 PLAN REVIEW Owner: P—a G-� S Map/Parcel: Project Address 34 C/2c U•/ I � Builder: ��`P �COC_tC The following items were noted on reviewing: Lt— POST 7-0 S � UIL P— QQi Reviewed by:_. PO--,A Date: QID=:Plarvw i 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 Applicant Information Please Print Le ibl Name(Business/Organization/individual): seo Address: (0 aL 1-71 City/State/Zip:O�t V M A -02625 Phone#: 56? `7 2 S--70 ' Ar you an employer?Check t appropriate box: Type of project(required): 1. ] I am a employer with m 4. ❑ I a a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition mp. t [No workers' comp.insurance co insurance. 10.❑Electrical top airs or additions required.] 5. ❑ We are a corporation and its 3.El I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption. er MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and rightw we have no ME]Other employees.[No workers' 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. leontractors 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 the policy and job site information. �/p ,�,.. ,,. Insurance Company Name: Policy#or Self-ins. Lic.#: W"/✓ IJ ' Expiration Date: 06 ZZ" 10 Job Site Address: O �Yl'.1111 h P_ _City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy rum r 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 S 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 Investieations 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. Si ature z Date: 6 �/��c) — Phone#: 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#: ....,'..».,..s.,,..„M. °A'7�/`" °°""'ILITEO TUa,&iM 14/200CERA B ( NCE . A-C©R®TM 9 a.AODUCEIR z.. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE GERMANI INSURANCE AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 908 MAIN STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. OSTERVILLE,MA 02655 COMPANIES.AFFORDING COVERAGE CO ANY SAFETY INSURANCE INSURED COMPANY SCOTT PEACOCK BUILDING& REMODELING B AIG AMERICAN HOME ASSURANCE CO. PO BOX 171 COMPANY OSTERVILLE, MA 02655 C FCOMPANY p GQICERAG�S S i THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUE H E S.,.. N A M E D 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 B Y 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. CO TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000 A X COMMERCIAL GENERAL LIABILITY CP00001152 07/05/09 07/05/10 PRODUCTS-COMP/OP AGG $ CLAIMS MADE D OCCUR PERSONAL&ADV INJURY $ OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Anyone fire) $ - - .MED EXP (Anyone person) $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS - BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY r, $ NON-OWNED AUTOS (Per accident) --- - PROPERTY DAMAGE'" ,.$" GARAGE LIABILITY - AUTO ONLY-EA ACCIDENT $ - ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $. UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM f $ WC STATU- OTH- - - - - WORKER'S COMPENSATION AND TORY LIMITS ER B W C 007-45-4805 06/22/09 06/22/10 EMPLOYERS'LIABILITY EL EACH ACCIDENT • $ 100,000 THE PROPRiETOw I INCL - '.. EL DISEASE-POLICY LIMIT $ 500,000 PARTNERSIEXECUTNE OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ 100,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS CERTIFICATE HOLDERGANGELLATION % SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL JATTN.: SALLY 10 DAYS WRITTEN rNOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY TOWN OF BARNSTABLE OF ANY KIND UPON THE "COMPANY ITS AGENTS OR REPRESENTATIVES. FAX 508-790-6230 AUTHOJ00EP REPRESENTATIV GIGJIL4'K� ,�l.HL� ACORD 25 S 1/95 . . f License: CONSTRUCTION SUPERVISOR Number: CS 094500 r Birthdate: 07/22/1962 Expires: 07/22/2010 Tr.no: 94500 Restricted: 00 JAMES S PEACOCK PO,-JY 171 c, OSTEVILLE, MA 02632 Commissioner e I f� ✓7ze Z��runzo7uuea . o�✓C�a�,ac�uaeCta Board of Building Regulations and Standards License or registration valid for individul use only � == HOME IMPROVEMENT CONTRACTOR = before the expiration date. If found return to: Registratiorf:, 151853 Board of Building Regulations and Standards Expirati6n:=::74'7 Tr# 271501 One Ashburton Place Rm 1301 Type., Private Corporation Boston,Ma.02108 SCOTT PEACOCK BO LDING&REMODELING INC t ff JAMES PEACOCK l 1046 MAIN STREET"SUITE 7,. H OSTERVILLE, MA 02655 ^"� Administrator Not valid without signature i 05/11/2010 08:24 817814570397 QUANTECH 41294 P. 002/002 ....� ... ... ... . �..r �..., i rcn�. 5uu lea 7625 P.2 Town of Barnstable Regulatory Services as.ae""j'e Thomas V."Mr,birodor %o; Building Division Tom PcM,Building Uwndssioacr 200 Main Strcet, Hyunnis,MA 02601 Office: 508-562-4038 Fax' 509-790.6230 Property Owner Must Complete and Sign This Section If Using A Builder -as Owaewf the subject property Paw 6K hereby authorize�kk to act on my behalf, in all matters relative to work authorized by this building permit application for: _ Ale, (Address of Job) S 5 5V tur Owu G✓ , I Date Print Name r PEA _. • • Q:RdRMC:oRMRRF'f:RMiS.CIQN f ' HYANNIS J LOCUS . s1• z LEWIS G Q . " CIRCUIT U BAY CB/DHF AVE. O N. (FND) �. PARCEL ID: 324/120 HYANNIS HARBOR 00 PARCEL ID: / C\ o PARCEL ID: 324/111 MH /: 0 324/091 LOCUS MAP z P� 7 S o , O � - � PLAN REF: 152 81 & 184/109 � k. _ TITLE REF: 24082 22 _ ^ {+ 4.. EL ID: MAP 324 LOT'88 27.2 PARCEL ID: �� �� ZONING: RC SETBACKS: 20 F=10 S-10 R r O O, , - / /w/ .- _ ' h• 324/088 FLOOD ZONE: B AREA= 19 ACRES -.—0. .00" 6—DCOMMUNITY PANEL: 250001\ _ �¢ DATED:07/02/92 jg oo CERTIFIED - - - - 9, (S I ED DECK) PLOT PLAN' 34 , HOWNG _. DE - '`PROPOS_ - - ` APPARENT a�' - _ '' _ _ 4� 1�•�� Q ., _ 4- TAKING � EXISTING LOCATED AT:,• - _ _ A Q � �' DWELLING .Q, R 34 CIRCUIT AVEN UE 24/089 HYANNIS, ,MA o 3 E. •�`� — O c PREPARED FOR: r j IN, 9 \ SCALE: 1`20' � \\ WV � D4 cB/DH`, APRIL 19, 2010; (FND OFF). MON. r WELL MacDougall: Surveying Associates o? EDWARD P. O. Box 2428 GRAPHIC SCALE A. , sTONE Mashpee Ma. 02649 zo o 10 zo ao eo No.28980 r ® PH. fax �508�419-1086 508419-1087 ( IN FEET ) a� email: 1 inch = 20 ft. \v macdougallsurvey@comcast.net SHEET 1 OF 1 J 1236 I ,....._.�...:.�:ram, t I i - ... I II i i , -41 ------ ,L� - _VX1779 wxa a, _���nxl� - - —to r�LVt7T� sss uvour I 4 I 4