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HomeMy WebLinkAbout0030 CRESTVIEW CIRCLE 13 _ Q TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel - Application"'# C �7 Health bivisionr`C1.� bate Issued ' . t Conservation Division Application Fee °.z PlanningDept Permit Fee Date DefinitivePlan Approved by Planning Board Historic OKH Preservation/Hyannis Project Street Address Village A na63 -64 01 OwnerT/�,�cs&t, ��C��Y1 Address Telephone ��-P Permit Request 7e - _7WJ4 Q���& - Square eet: 1 St floor: existing proposed 2nd floor: existing p osod Total ne w W Zoning D s 'ct' Flood Plain -/d. ee ater erl:ay Project Valuatio Construction Type Lot Size Grandfatho If yes, attach supporting documentation. Dwelling Type: Single Fa 0 Two Family (# units) Age of Existing Structure Historic o, On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑Craw ❑Walkout7 1 1 C) Basement Finished Area (sq.ft.)` nfinished Area Number of Baths: Full: existing n Half: existing new :- w Number of Bedrooms: e ' ting _ w N a Total Room Count (not including bath existing new First Floor Room CLnt Heat Type and Fuel: ❑ Gas it ❑ Electric ❑Othe ° Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ exis ' g 0 new size—Pool: ❑ existing ❑ new e — Barn: ❑ existing ❑ new size_ Attached garage: ❑ isting ❑ new size _Shed: ❑ existing ❑ new size Other: Zoning Board Appeals Authorization ❑ Appeal # Recorded ❑ Commerc' ❑Yes ❑ No If yes, site plan review# Curre Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �O« y ` � C Telephone Number 5C& 7 O � l Address _ - d License # e5 7OHome Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �/ FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO: ., ADDRESS VILLAGE `OWNER .:DATE OF INSPECTION: FOUNDATION FRAME INSULATION r FIREPLACE ' ELECTRICAL: ROUGH FINAL } PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING i DATE CLOSED OUT ASSOCIATION PLAN NO. U� k� �� ��� �o*"MEr ToWn of Batmstable Regulatory Services ' + :. xsrnar.E, : •. Mws,S. Thomas F. Geiler,Director ; 9�'OT 019. - Building Division ' Tom Perry, Building Commissioner .200 Main Street, Hyannis, MA 02601 www.town.barnstable.m2.us Office: 508-862-4038 ,. f Fax: 508-790-6230 Property Owner Must Complete and Sign This'Sectiori If Using A Builder as Owner of the'subject property hereby authorize e7S to act on my behalf, in all matters relative to work'authorized by this building permit application for: ' (Address of job) Q Signature of Owner D e Print Name } s { f If Property Owner is applying for permit please complete the•Homeowners License Exemption Form on the reverse side. Town of Barnstable HE Regulatory Services • =wxxsres ` Thomas F.Geiler,Director - Building Division YQ pT����A,� �O Tom Perry,Building Commissioner 200 Main Street; Hyannis,MA 02601 www.town.barnstable.ma.us )ffice: S08-862-4038 Fax: 8-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number Street vi age "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to i elude owner- ccu ied-dwellin s of six.units or less and to allow homeowners to engage an individual for hire who do not pos ss a license,brovided that the owner acts as supervisor. - DEFINITION OF HO • NELl Y` ° ! �y k Person(s)who owns a parcel of land on'which he/she resides or ' ds to reside, on which there is,or is intended to be, a one or two-family dwelling, attached or detached structur ace sory to such use and/or farm structures. 'A. person who constructs more than one home in avvo-year pe ' d shall n t be considered a homeowner. Such . "homeowner"shall submit to the Building Official on a fo acceptable the Building Official, that he/she shall be responsible for all such work performed under the%boil ennit. (Sectio 109..1y:1.). The undersigned"homeowner"assumes responsibil' for compliance with the tate Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that she understands the Town of Barnsta e Building Department minimum inspection procedures and require ents and'that he/she will comply with sai rocedures and, 1 �• �• - , y requirements. , Signature of Homeowner Approval of Building Official , Note: Three-f dwellings containing 35,000 cubic feet or larger will be required to comply ththe State Building Code Sec ' n 127.0 Constrtiction Control. HOMEOWNER'S EXEMPTION The Code states at: "Any homeowner perfomvng work for which a building permit is rLquircd shall be exempt from the p visions of this section(Section 1 .L I-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to d such work,that such Homc cr shall act as supervisor" Many h coronas who use this exemption are unaware that they are assuming the responsibilities of s supervisor(see Appendix , Rules&Rcgulati for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particula y when the hom wner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. a homeowner acting as Supervisor is uhimately responsible. o ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the omcowncr certify that Wshe understands the responsibilities of a Supervisor. On the)ast page of this issue is a form currently used by several towns. You may care t amend and adopt such a forrn/certification for use in your coirnnunity. f r-� ACORD,. CERTIFICATE OF LIABILITY INSURANCE Ro� 06-11-2009 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HARTFORD FIRE INS CO/PAYROLL ASSOC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 250760 P: (877) 287-1316 F: (877) 287-1315 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 308 FARMINGTON AVE FARMINGTON CT 06032 INSURERS AFFORDING COVERAGE INSURED INSURER A:Twin Cit Fire Ins Co INSURER B: S PERRY TENTS CORP. INSURER C: 11 MARCONI LN INSURER D: MAR I ON MA 02738 INSURER E: COVERAGES 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 THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR -_ POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE POL/CYNUMBER DATE MMIDDIYY DATE MMIDD/YY - LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $ CLAIMS MADE OCCUR MED EXP(Any one person) $ _ ` PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO- tOC JECT AUTOMOBILE LIABILITY - ` - COMBINED SINGLE LIMIT $ ANY AUTO - - (Ea accident) 'ALL OWNED AUTOS BODILY INJURY, - S. SCHEDULED AUTOS (Per person). HIRED AUTOS `' BODILY INJURY $ , NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ .AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR F1 CLAIMS MADE - AGGREGATE $ - S DEDUCTIBLE - $ RETENTION $ '. ,. ,. $ WORKERS COMPENSATION AND X WC STATU - OTH- - TORY LIMITS EH__ A EMPLOYERS'LIABILITY 76 WEG PR5 2 4 2 1 0/1.5/0 8 1 0/1 5/0 9 E.L.EACH ACCIDENT $10 O 0 0 0. E.L.DISEASE-EA EMPLOYEE $1 0 0 r 0 0 0 E.L.DISEASE--POLICY LIMIT $5 0 O 0 0 0 OTHER DESCRIPTION OF OPERA TIONSILOCAT/ONSIVEH/CLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Those usual to the. Insured' s Operations . RE: Event 07/20/2009 CERTIFICATE HOLDER ADDITIONAL INSURED,INSURER LETTER:' CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE(10 DAYS FOR NON-PAYMENT)TO THE CERTIFICATE Mar Mahan HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO y OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 30 Crestview Circle REPRESENTATIVES. c-rtter- MA 02632 `C AUTHOR/Z EPRESENTAT/VE / ACORD 25-S (7/97) ACORD CORPORATION 1988 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 Legibly Name(Business/Organization/Individual): � Address: City/State/Zip: C\ ` C�/W_ Phone.#: Are you an employer?Check the appropriate bog: Type of project(required): 1 I am a e to er with a 4. ❑ I am a general contractor and I mP Y _1-C�- 6. ❑New construction employees(full and/or part-tims).* 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 workingfor me in,an capacity. employees and have workers' Y p t3'• � 9. ❑Building addition [No workers'comp.insurance comp•insurance. 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 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 employees. [No workers' 13.[�Other comp.insurance required.] c *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 subrnit 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-contractor;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. D Q Expiration Date: N 4S Z) t Job Site Address: �� C%e5��� cwc\., City/State/Zi ,. C MAca(o. 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 WA for insurance coverage verification. I do hereby certify under air enalties of perjury that the information provided above is true and correct Si afore: M=b /cal Date: a6 Phone#: S -7 Ll f� ( 7 0 7f 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#: Information and Instructions 1 Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as`.`...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representative's of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the. dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed_to be an employer." 4. MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies*(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each ! year.Where a home owner or citizen is obtaining a license or permit not related io any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, ' please do not hesitate to give us a call. The Department's address,telephone-and fax number: The COrnmonwealth of Massachusetts Department of Industrial Accidents 0mce of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-977 MASSAFE Fax#617-727-7749 Revised 11-22-06 www.mass..gov/dia Cpl,ttficate of flame,Resistin Ce Manufacturer Number Speffy Sails. Date of Manufacture 353 $-Se -05 = � 11. Marconi.Lane Marion,'MA'02738 (508)748-2581 his is to'certify that the materials described have been ' 4 "flame-retardant treated or are inherently non-flammable and were supplied to: . Nance: S Tents C- Marion State: MA Certification,is herby made that: The articles described on this certificate have been treated with a �' flame-retardant approved chemical and that the application of said chemical was done in.conformance with California Fire Marshal Code equal.to or exceeding NFPA 701,CPAI 84 Method ofApplication: Coated Fabric Color,T _and"- Wei ht Navy ', polyester 7.2 , oz. Descri tion offtent Certified:— -- - - 32x50 ft. Pole Tent flalrine-EtetaPdelnit Oro.ee"r tDsod alill'Ddot BeRerlrtoved Y Washing,And is Effective For'V he Life.Of The Fabric Name of Applicator of FR Finish Signed If Kolon ,1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Sa2 OS-lQU Parcel", 4I319 / Permit# 9 Health Division_ .?� G6 ��2 .� y 4w^' Date Issued_ Conservation Division M D� Fee' Tax Collector..//.�, �'��� FER v 3, Application Fee _:�-0 6--r7 Treasurer EXISTING SEPTIC SYSTEM Planning Dept. Date Definitive Plan Approved by Planning Board // Approved By Historic-OKH Preservation/Hyannis If n°Zr Af bvAm c, 42 VA or, • . o�e� Project Street Address So G,re��v� � Village Owner 9 P)Vy Vy1 RIRaw Address :�o C_ces+vLc,,,)- <�itrg\°_ Telephone 9�210 `7-71 LI JA Z'3 Permit Request b D e u-e-kd,� 'tk,� \3►+s P rnt �w T o �4 G y�� work- (Doi- Permit Request 'Lono, t4 ��w t3n-A-V,. Perot--► -a Ci Square feet: 1 st floor: existing O D proposed `—' 2nd floor: existing — proposed Total new Valuation l)©o Zoning District Flood Plain Groundwater Overlay Construction Type LJcgoo EL^v-% Lot Size 14;, 6(2., Grandfathered: ❑Yes ❑No If yes, attach supporting documentation Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure CI Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑ No Basement Type: Full ❑Crawl O Walkout ❑Other Basement Finished Area(sq.ft.) &o to os9'o �,�s.t-d- Basement Unfinished Area(sq.ft) I _5Op Number of Baths: Full: existing new /' Half: existing new Number of Bedrooms: existing new Total Room Count(not including bath s):.existing new First Floor Room Count .� Heat Type and Fuel: )d Gas - ❑Oil ❑ Electric ❑Other Central Air: - 'Yes 0 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:2 existing -0 new size Shed:O existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION - Name�,� � rn. rnw the Q Telephone Number Address ph;t N-ve-u.q 1;,VV ' License# fi e1\,94 81 I'll ` E � -IMIA Home Improvement Contractor# Worker's Compensation# 19 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TORJwbS-h4C�l� `�►�ws • SIGNATURE hA, DATEFlu .� _�_ FOR OFFICIAL USE ONLY PERMIT NO. r. _ DATE ISSUED MAP/PARCEL NO. r r ADDRESS ~~ VILLAGE ' OWNER r DATE OF INSPECTION: ' FOUNDATION i FRAME " i INSULATION FIREPLACE r ELECTRICAL: ROUGH -, FINAL PLUMBING: ROUT FINAL ~� GAS: ROUE I 0 FINAL' FINAL BUILDING r r 0 O DATE CLOSED OUT ASSOCIATION PLAN NO., 1 r TME'ati Town of Barnstable Regulatory Services MASS& Thomas F.Geiler,Director 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. 4 D Type of Work: QP>s-e_\b!e Estimated Cost oZ© 000 Address of Work: Sin Ca--e-S-zy u` ,. G t f_1-e_ C^ey-,�g Owner's Name: M(A y M 4 k v%�� Date of Application: n2 �2�oG I hereby certify that: Registration is not required for the following reason(s): 7Work 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: —4 ci `7 Date Contractor Name Registration No. OR Date Owner's Name Q:forms:homeaffidav �t r Town of Barnstable ° Regulatory Services srrsr+si. . ' Thomas F.Geiler,Director 1i AM `eg 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 Property Owner Must Complete and Sign This Section If Using A Builder I l "l y4'IZt-J Hp4 14"4� ,as Owner of the subject property hereby au ooze ���lr (,oPJ 4AD to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) v Signa a of Own Date Print Name Q:FORM&OWNERPEPOMSION c Permit Number .MECcheck Compliance Report 2000 IECC NIECcheck Software Version 3.2 Release la Checked By/Date TITLE: Gym/Workout room CITY:Barnstable STATE:Massachusetts HDD: 6137 CONSTRUCTION TYPE: Single Family DATE: 02/27/06 DATE OF PLANS:Feb. 25 2006 PROJECT INFORMATION: Finish part of basement for workout rm.&bathroom COMPANY INFORMATION: Jeffrey in. Conrad 535 Phinneys Ln. Centerville,Ma. COMPLIANCE:Passes Maximum UA= 149 Your Home=120 19.5%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1:Flat Ceiling or Scissor Truss 950 19.0 0.0 48 Wall 1:Wood Frame, 16" o.c. 894 13.0 0.0 71 Window 2:Wood Frame,Double Pane with Low-E 24 0.034 1 Window 3: Vinyl Frame,Double Pane 2 0.033 0 Furnace 1:Forced Hot Air, 85 AFUE _ COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 2000 IECC requirements in MECcheck7Version 3.2 Release la. Builder/Designer Date a 27 i P ap T"E'° o� The Town of Barnstable BARE. =MASS. a, Department Department of Health Safetyand Environmental Services 7 +619• °ffDMAip Building Division 367 Main Street,Hyannis,MA 02601 office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: hk\ 1�1\ �� Map/Parcel: �_5 2 C� i y Z 2- Project Address:30 Builder:-J. C-,onrcz, r The following items were noted on reviewing: l C.c,Y,c, �o nc3A— 1,�1nc- s e�ln�e � � YY� Qc �,nv� �cR� l � I Reviewed by: Date: — (� F r e � q:building:forms:review o�Ew �pA4.9 — 13� z) 1 /0 io l 4-3 4-3 I(0, 6e�l'Z I I 42 v �'O VOID AT►p�.j /4. �A Id 4Tb141 4F �t � •`� soy p�6►.1 S'-Aa SJ'3'D V 1 S)0�! sEra��us I 110 MA? ?5�. � 51`g�z� fjk� cE,eTi, A ��AAI THAT T,L/---- F V,4W r1DV 0C,1 T/C.C/ GE�T�Y.�/ll �N�/A, ill f f _ Y ,5,�/OWN yE,eEO.�/CO�/OL Y.5 fit//T/� SCE L G— /�' �' 0�1 T� .c�,�R iv 199g.CEgU/.�2E�-JENT-S of 7-,411 ,B�e�JSI-Q �6 ,C�G'A TES Lsi/Ty/mac/ Ty F,Coa�PG4/�! f7e- 5d5 PG. 7h; ,9,4 xT�,eE Al><E Tf//S P.C�I.v/S �t/aT BASSO O//Apt/ ,eEG/sTE•2EO Leo sU.el�EYa� O.c.zSE'TS Sh�aL��Y Sh�ULI� it/�T 8� AG�.L./C�� c�i3' S l� ,BIJ�LDS-UC Cp /a�G. l/.SEp 7,251 Assessor's Office� 1st floor Map Lot Permit# Consewation Office 4th floor. Date Issued Board of Health Ord floor Engineering Dept. Ord floor) House# 130 /,',u.ec_ "M BUST BE IA MANGE Planning Dept. 1st floor/School Admin.Bldg.): Definitive Plan Approved by Planning Board '— /y 19 E AM To r:.. A licationss• essed 8:30-9.30 a.m.& 1.00-2.00 .m. 4 TO NS o(� - ��` �S TOWN OF BARNSTABLE Building Permit Application Itrreessy Villa'e Fire District114 Owner Address Telephone -27 l - 1 a yb Permit Rc uest:1 u z.C. WC14 Iq 7 r Zoning District kC — t Flood Plain Water Protection Lot Size 6r 610 x Grandfathered Zoning Board of Appeals Authorization Recorded Current Use W/, , Proposed Use Construction Type �f 1 Atx,- Eaistine Information Dwelling Type: Single Family Two family Multi-family Age of structure Basement type -y Historic House Finished Old Kings Highway Ar 0 Unfinished \� �yNumber of Baths e- No.of Bedrooms Total Room Count not including baths First Floor eat Type and Fuel 6 AY, JVL Central Air Fireplaces 04 �ZCe Garage: Detached Other Detached Structures: Pool �� Attached C. 4q Barn None Sheds Other Builder Information Name 86 � Telephone number Address �} q- License# 00 Home Improvement Contractor# �— Worker's Compensation # WC-1 31Z 22O 17.9 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 TIES & S PROTECT WILL BE TAKEN TO( �� d I `-0— 15110 4,<Sy Project Cost Fee d6,� ° �7 SIGNATURE DATE 41 BUILD PERMIT DENIED FOR THE FOLLO G REASON(S) BPERM T FOR OFFICE USE ONLY ADDRESS VILLAGE - OWNER ? -� .` - 1 i i -•r DATE OF INSPECTION: FOUNDATION FRAME .6 �_C9` i , I � - r .-. •� { INSULATION FIREPLACE -+ r a ELECTRICAL: ROUGH FINAL ` PLUMBING: ROUGH FINAL GAS: ROUGH FINAL "r 1 � j - • - FINAL B + i DATE CLO ASSOCIATI3 '; € x J>=5 i 6'n1 -DATA OPEN 51�1G-7, FAMILY 3: .$EI.'ea�M�' I I o 5PQ� \ �.o 6,AZF3AIyE (01M1 )EZ- 1 I \ \ ::.I?Al Lam( Ft_oW 3 x 10 � a 7,'30 1rPo I 1 a 13�'��4 \ I \ I — s��(-I c TANK- 33o X l So/• 445 G� I � � � � \ �—_ US G: 1000 (;;A DI SPn;A PIT l- laooL: 51 D c WdLL AP.---A .= 1 P 8 51= l I 1 J S2 _Ig 1 —..i. - ern„ p D�k's TOtAL DAILY Sri/ ( 2G a LA`M oN. 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I - �' I Df:.oP t1•• -fLc�n T.P of rcUoo.r.o N. I I I I i cuT FcDrL,a Toor?- f,j'+ Imo•_ �. ,•�; 2-fU 10•• o" R,O Gt JC NT i � �,•r �.S EAL-T4P� A.Sp uaLc SHWGLES 10. VEwx GOG- [wood uRJT--,c. a 14. ,`CS'CaTH.E02sL { - .I �� - ✓ � '/2- s..,ce-Gouc I _�,Ell.l r-�[s� � I III c5��-�p[oTLcr 2'Al2.f L.C+, 3�.Cc � �, ��„ YE NTI/�iG GRIP-EOIsE __ -Rao FI"3R..cc.. s :nj p,x or,_o -K•'�o FI?�¢EGus ri-,�,...� �xs EAscls. � \ &1yiw Gc�T:e.2s tna,w-,Spa• FFIT F'u rL21"r- i70D Fu22:Nv CL i(o' /e'F.C.4FIEET rzoc,1 �u►Y.+S CLAX dc.E_ 97ur�,s 1.0461, ROUSE CYTERIO R S7000 2e4STox Blra S CD 2Y�® 2a- ,p1� /�• v r I Co'Fl Pircc Gus Iusu,.+Trc. 6 I- '_(2~nnx 9uE4TUIN(� 12'• o' � 2•0 . 11'.g•. 14•-4• �� �yhJE K \V rLpr7• Mau F ti, i I N.C.S111fJGLES "MIEA f� { _FIN ISFi FL.002 j =AfJ r) 5COEg; ' PI-Y SUPa FLOOrc . L i r1 N - _. __. fI - Y- 1 .. i �2Y.42'9 j P:r. 1i.Ca $1 LL ON 91 lL F 1(..L ANGl•i02•-- .Er ij't.4- ��?�� •I I f � � � i BA /A 6 If u�� � � -•min V NS � i �"1. f; CANG2 wau.' °I Id• —10'w WALJ- jL.EOR\JAu.- U• .!� IB FooT I NG� of - ,lz' o t I Cowin s —1>lvnp PamF 9Et1.:Tfl G¢F: }4HE T p 3"'i-•'�',O^1GrLyL6l3 u - 16'Yco^ Fo�2'u1G� 6A( F- r3UILDlNG C.o Irlc. CENTERVII-LE- - /nA5fi.._._ (L i .��e �c�u»rnnruecrlf� c ✓j�a.;.;ac�u•;ef� DEPARTRENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Humber: Expires: Restricted To: 00 BRIAR T DACEY 62 FERHBROOK LH CEHTBRVILLE, HA 02632 � I (fOm.monwealM of MaijacLielb aUIParfrnenf o1Jnc1u-1fria[✓HccicLnfe '. 600 1/Vas�irt9fon �fraef James J.Campbell lboifon, Maijachtujeffi 02J J f Commissioner Workers' Compensation Insurance Affidavit I, -El? /fl,v 7. (Ilcensee/petmittee) with a principal place of business at: (2 FA-)-TF e-✓ f LL.E -41A Dot 6 3 X (City/State/Ilp) do hereby certify under the pains and penalties of perjury, that: () 1 am an employer providing workers' compensation coverage for my employees working on this job. L18C,e-7Y MOTOtt 1AJ5. 6,eoaP ICI 3iaa�o /7Fo13 Insurance Company Policy Number () 1 am a sole proprietor and have no one.working for me in any capacity. O 1 am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number t () I am a homeowner performing all the work myself. I understand that a copy of this statement will be forwarded to the Office of Investigations of the DIA for coverage verification and that failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties consisting of a fine of up to S 1,500.00 and/or one years' imprisonment 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 ;2- `? day of L vtC�,,�cc 19 Licensee/Permittee Building Department Licensing Board Selectmens Office Health Department TO VERIFY COVFRACF INFORMATICIN rAI I • A t -7_-7-)-r-nnnn vnn-r A n 4 SUBCONTRACTOR'S INSURANCE ENGINEEER: BAXTER & NYE ENG: (L) FIREMENS FUND - S30MXX80564866 (W) LIBERTY MUTUAL - WC1312595563023 WELLER & ASSOC: (L) NAT'L GRANGE MUT.- MSP45246 EXCAVATION & SEPTIC: ROBERT J. OUR (L) U S F & G - 1MP30109550901 (W) U S F & G - 771521695 DECO CONSTRUCTION (L) TRAVELERS - 660364K8342 (W) LIBERTY MUTUAL - 312446298044 FOUNDATION: BAYSIDE FOUNDATIONS: (L) COMMERCIAL UNION - ABR406267 (W) LIBERTY MUTUAL - WC1312201785044 WELLS: DENNIS SCANNELL (L) TRAVELERS - 660873E5627COF92 (W) WAUSAU - 151300062926 CELLAR/GARAGE FLOORS: MICHAEL BROWN: (L) AETNA - MP0023672849 FRAMERS: ROBERT DORRER: (L) TRAVELERS - W680526K991TIA9 (W) AETNA - 006C0023972416C MICHAEL DUFFLEY: (L) COMMERCIAL UNION - NBF821356 (W) LIBERTY MUTUAL - WC1312492127024 MASON: SHERMAN, WAYNE: (L) COMMERCE INS CO - N60689 (W) WAUSAU INS - TO BE ASSIGNED ELECTRICIAN: CHAVES ELECTRIC: (L) HANOVER INS. - LHN2964649 (W) MISCELLANEOUS INS CO. - 0708878 91 1 PLUMB & HEAT: WHITELY PLUMBING: (L) TRAVELERS - 660365K1782COF9 (W) EASTERN CASUALTY - POLICY IN MAIL ALARM SYSTEM: BALTIC SECURITY: (L) FIRST FINANCIAL - FF0131 G400831 (W) COMMERCIAL UNION - CB0743379 CENTRAL VAC: VACUUM ROUSE: MERRIMACK MUTUAL - SBP1608045 A INSULATION: MAP INSULATION: (L) AMERICAN STATES - 02CC326435-3 (W) U S F & G - 7711099932 SHEETROCK: MEL REED: (L) WORCESTER INS - CB817530 (W) COMMERCIAL UNION - CBH557387 INTERIOR TRIM: DAVID'S REMODELING: (L) COMMERCIAL UNION - NB F821442 M & R CARPENTRY (L) MARYLAND INS. GRP- SCP30235965 (W) CIGNA PROP & CAS.- C80049997 OAK INSTALLER: ROBERT BUDDEN: (L) NORTHERN ASSUR. - NBF528652 PAINTING: CAMPBELL PAINTING: (L) TRAVELERS - 1680251K4083COF (W) AMERICAN POLICY - WCC 186604 GARAGE DOORS: ALL CAPE GARAGE DOOR: (L) U S F & G - BSC14667590301 (W) COMMERCIAL UNION - CBH573757 STORMS & GUTTERS: ALUMINUM PRODUCTS: (L) AETNA - MP0021014146 (W) AETNA - JC89258880 OAK FINISHER: AMERICAN FLOORS: (L) TRAVELERS - 680 342W754-0 CARPET, VINYL & TILE: CARPET BARN: (L) VERMONT MUTUAL - SBP6507393 (W) PHOENIX INS. - 6NUB476J652794 TILE INSTALLER: TONY AVERINOS : (L) ASSURRANCE CO. - CFP26528977 (W) HARTFORD FIRE - 77WZCY2409 WIRE SHELVING: CAPE COD CLOSETS: (L) U S F & G - BSC146983441 APPLIANCES: KITCHEN APPL MART: (L) FIREMENS FUND - AZC80453098 (W) HARTFORD INS CO - 77WZNB1603 MIRRORS & SHOWER DOORS: L & M GLASS : (L) COMMERCIAL UNION - CBR409003 (W) U S F & G - 0071439933 LANDSCAPE & SPRINKLER: COY'S BROOK: (L) COMMERCIAL UNION - ABR345850 (W) CIGNA COMPANIES - C41138178 DRIVEWAYS: NORTHERN SEALCOAT: (L) MARYLAND CASUALTY- EPA18716945 (W) THE PHOENIX - UB387K530 A f 1 TOWN OF BARNSTABLE [PARCEL CERTIFICATE OF OCCUPANCY ID 252 051 022 CEOBASE ID 43467 (• ADDRESS 30. CRESTVIEW CIRCLE PHONE ZIP - LOT . 43 & 43 BLOCK LOT SIZE __ )DBA DEVELOPMENT DISTRICT HY PERMIT 31849 DESCRIPTION PERMIT TYPE . BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services . TOTAL FEES: [ TOTAL $,00 Ox11HWE CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY . 1 PRIVATE P`.... �. * BARvNS.TQAQBLE, G' f `• . i639. BUILD N VIA ON I BY f DATE ISSUED 06/29/1998 EXPIRATION DATE ;t y ^. r��►r�< T yJ�; t i �s et 4. fJ':,. iL'Jf�� + .ii1�..tii� i .u�.:t'atk• AlDDRFSS 30 CRES"1T?:EW i„IRCt:,E P110 R ZIP ;� T �t: Bl aOC LOT SIZE ' DSA DEVELOPMENT D t STEMC' 11'Y PERMIT 28941. I SC;h',.CF`I ION SIN 3LF, F&M.I LY DWELLING NG (SEW.PMT. 95--6-1-5) PERMIT TYP9 WILD 'l.'1`I'TY-K N?W RESIDENTI AID 13LDG PKI' . r' ItC'.t'C?R�;: I3C:tLII�CxNi Department of Health, Safety )AttC,1IITE ,'T'S and Environmental Services QX)N TRUCTION CO:i`VS $84,700.00 i 101. cSINGLE. FAM H NE 1)E`l '14Fi'� I. P:.,TVATFt 1' �* ,�sARivsrAsi.E, ► - s BUILDING DIVISION BY DATE IS' EID 02/17/199H EXKRATI:CN .DX11? t 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 MAY BE 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. l 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 bCCU- ELECTRICAL,PLUMBING AND MECH- 'a (READY TO LATH). FANCY IS REQUIRED, SUCH BUILDING SHALL NOT.BE. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. y' 4,FINAL INSPECTION BEFORE OCCUPANCY. BUILDING INSPECTION APPROVALS,,'- PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS s� 2 2 2 A"�� :e 3 1 HEATING INSF946CTION APPROVALS ENGINEERING DEPARTMENT 2 BOA13D OF HEALTH OTHER: SITE PLAN VIEW APPROVAL -WORK SHALL NOT PROC D UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS �otF D O BY BUILDING PERMIT C,c) { ............ F, - • .o.. n a + /�S a '� a A� �.�x3 6 n IRV lip -16 • a 1. �.� ..:-�� � • � • y .mil' s •�' N` � � a\ �•� I •� t �•4 ��� I�� �____ � � .-.._..Mom. .. 1 .�'.�.„...,.� /' w ! bTF AFL NEw �, ,s is7 ,, e�l•�r�LF'w Ya%� 'i �_,71i��-tw�..__.c�n(o���rvte+�'_wt�LL _ s - � � • d �.y k ..�*r` 6• ter. + / a�. t a +r`. ,v.. ,. r� _. _ SGALL �/y .=_ I� �ooT _,. ..._. _ _3RSFM��N�. !\oc��- `���N•. 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