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HomeMy WebLinkAbout0057 GROUSE LANE �J_-- � � ���s� a �I TV �PE CONSTRUCTIOW CO. LLC 546A Higgins Crowell Rd,WEST YARMOUTH,MA 02673 PHONE, 508-778-0111 FAX 5W778-5010 e WMNW.TUPPERCO.COM Date: Town of Barnstable Thomas Perry CBO 200 Main Street Hyannis, Ma 02601 (508) 790-6230 fax V v p Re: Insulation Permits Dear Mr. Perry This affidavit is to certify that all work completed for permit application # 150 1 -Z 5 �- Issued on Fj has been inspected by a certified Building Performance Institute (BPI) inspector. All work performed meets or exceeds Federal and State requirements. Sincerely, Permit,#: Address: O {,�S 2 [lin Richard Tupper License # CS-69058 r , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION � Q ~� ) Map � 0 Parcel � �=�f f� Application #� V a C; r a & �- Health Division Date Issued �' P Conservation Division Application Fee � .. . Planning Dept. .ij'a' " Permit Fee ®O Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address Village (' Owner0 Address [45 Arc2a � IEJC',i�T�,VIh IS Telephone IJ 77 Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3� 14Construction Type n 7,60v) 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) 10 E R Number,of Baths: Full: existing Z 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: XGas ❑ 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: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION 1 .M1` (BUILDER OR HOMEOWNER) Name"4 y Q.r Telephone Number �I Z �r� f� I (C � � � Address .License# � 5 Home Improvement Contractor# �O Worker's Compensation #U JOL6ca J 1&14L' A ALL CONSTRUCTION DEBRIS RESULTING FROM T IS PROJE TWILL BE T KEN TO OA 4"10,1105 ell a� a SIGNATURE 1 DATE 4 -' FOR OFFICIAL USE ONLY Ef . APPLICATION# DATEISSUED MAP/PARCEL NO. . ADDRESS VILLAGE OWNER x. DATE OF INSPECTION: FRAME _- t�, INSULATION ,. . FIREPLACE ELECTRICAL: ROUGH FINAL - I PLUMBING: ROUGH FINAL GAS: ROUGH FINAL 't FINAL BUILDING s r DATE CLOSED OUT `F` ASSOCIATION PLAN NO. mass save r Ii'ARTH�IPNIN6 collnumn PERMIT AUTHORIZATION FORI1111 f , I, SERGIO CALLE owner of the property located at: (Owners Name,printed) ` 57 Grouse Ln HYANNIS (Property Street Address) City) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed , below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. - owner's signature _ �Y0� Date v FOR CSG OFFICE USE ONLY ' Conservation Services Group has assignedthe following`Mass Save Home Energy Services Participating Contractor to the above referenced ro'ect:. Participating Contractor ,"- - Date `y • e . 54 • r J n + t . , r e V - ' ,:. t, .`•.�_ For OfRce Use Only Rev.12132011 "* 'Ire Co.mmon wealth o usetts 1?epartmeni of lnd istrialAccidents: 52 0f five of Investigations . 40 Wtts titigtota tiPeet . Bosifon, Q2111 Workers' Compensation Insu ran"ee Aff davit.` e>!ilde slCm�nt � €aryl> leetric ans/Pluaa�b r Applicant Information Please.Print Iesaib! Name.(Business/Organization4tidividua}) - - IT per._Con 'trtlC. .iOri Ct3. Address; 546A H►ggPns C.rowe#! Rd fifty/State/Zip; West Yarmouth, MA 0 2.5 7 3 Phone#= 5 0 8-7 7 8 .011.1 ~ Are,yo�a eniployer?Check the.a rotsriate lamx_: E;.. a of ro ect ae diced TyP P � ( 4 ) r l._Q 1"am;a employer with ram : �'.l am a general contractor and;1 6 New construction: employees(full and/or part--tirne)� have hired ihe:sub,contra�tors 2-❑ i.am a sole proprietor or partner _ .listed�n ilie a.Mthed sheet:.t r 7. Remodelin ship and have no employee_s These°sub-contracforshave: 8. .Q Demolition: workingfor me in any capacity. °workers'comp lnsurandte . P }. E Building addition: ' [No workers"comp.insurance �:;1NLe are a corporation and its . required..] o�cershave exercised their. `iO:Q Electrical repairs or additions 3,❑ 1 aril a homeowner doing all`wprk, „ nght of exempbon.p`er MGL 11.0 Pluz Bing repairs or_additions myself. [No workers'comp. c. 4 52,.§1.0);and wehave ro 12.0 Rvof repairs insurance required.]I employe1.es. [No workers 13.[ Vll Other Patherizati4p ' comp.,insuranc required j:. __. *Any applicant that checks!sox#1 must also fill out the sects�n:,&e}otiv showing iheiv workers'compensation Iwiicy intotmation: ' 7 tInmeowiier5 who submit this affidavit indicating they are doing ail"Tk,and then hire outside contractors iiidst submit a nett/affidavit indicating such, 'Contractors that check this box must attached an additional sheet showing"the name of the sub-contractors and their evoakets coinp,pohc};information: I am ran employer that is providing workers'coanpensadoai insurance.,for:my erWloyees: Beloit/is the policy_anat job's site iaaforrtataioat.. - _. Wu.rand Company`Name AEIC , Policy 4 or,Self Ins:L.sc #: `WCC:_ 5 0 O.55 9 3 012:01'4A Explrauon.:Datea all Job Site Address`Wt!� L Cit}/StatelZip n MA Qp�Q I Attach a copy of the workers'.compensazson policy declaration a sltorvin the.policy,nu ber and ea iratioaz date P {, g P Y P Failure to:secure coverage as required under Section 25A of MGL c:1�2'.:.can,lead.to the imposition of crimina9':penallies ofa. .fine:up to$I,5©0'O(3'and/or one year imprisonment,.as�ve11.as civil penalties in the form of a STOP Wbkk OkbEtk and a xine ofup to$250.00 a day against t}re violator:`.Bd advised that a copy of this°'stateriieitt rna)~'be forwarded o the Office of ' Investigations oft/e;DiA forinsurance.coverage verification.!" Ldo hereby certf under te jatteiafoauroielGoee is trcxe and correct 4 iRn Lure: s { r - T ate (5 0 8) 7 7 8-.0111.'� 1'horae#. - O acical ruse ord. W trot write in this'iare to`l>'e car. feted li ca-� Y � nP Y ty©r toaiaa offacres/ , City.or-Town: •_ �erinat/fl.icense#:: . Issuing Auttlor;ty{circle one)''; iAbard:ofUeaith 1%ildang; epart aaen#�3 Caty/`I'oBvaa Clerk 4: iectrical I aspector-5..Pl M€ ing Inspectoe ' &Other. Ct?ntact Persoai: 6 • rF 'i ACORH C ERTI F I A.6 8 L� l�t; INSURANCE , � DATE IMMIDDIYYYYj' ,1211/2015 THIS CERTIFICATE IS ISSUED AS A:MATTER:OF INFORMATION ONLY AND CONFERS NO RIGHfS UPOhI THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY'AMEND; EXTEND•OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOVtt, THIS CERTIFICATE OF iNSURANGE HOES NOT"CONSTITUTE A'CONTRACT B.ETWEEtd'THE IS INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE:CERTIFICATE:HOLDER: IMPORTANT: If the certificate holder is an ADDtTIONAI-INSURED,the Oolicy(ies)'Must be:endorsed: If SUBROGdIION IS`4PIA;11>:D,subject to the terms and conditions of the policy,certain.policies may.require an endorsement. A statement On'this certificate does not confer rights';o'#he. certificate holder in lieu of such endorsements) PRODUCER _. -. ._..:.... .. ...... .CONTACT NA M : Lora FitzGeraid Southeastern Insurance Agency PHONE (508)997-6061 A/XC No (508)990 2]31 439 State Rd : E-MAIL :DDREss:Ifit2�southeasternins.com P.O. Box 79398 • iNSURERS)AFFORDINGCOV ERA GE _ :NAtC9 - North Dartmouth <MA 02747 NrSURERAArbella ProtectibIj Insurance 1413b0 L4$URED - -. .. . . - „ • • :iNsuRERaAssacated Employers. ins. Co::. `::.. Tupper Construction. Co LLE " iNsuasao,a. 79, Mid, Tech Drive:. ' iNsuRER'o:::,. w r s• _ Unit. 13: - -• .INSURER Ea. - West Yarmouth MA 02.673'_ INSURER F _.., f ' • _.... COVERAGES , CERTIFICATE NUMBER.2015=1 RI tflSlOiY'NUfNBER.. THIS IS TO CERTIFY THAT THE POLICIES.OF INSURANCE LISTED BELOW HAVE BEEN ISSUED fO',THE INSUREQ NA(b1EQ ABOVE FOR"iTIE POLICY PER(Oa INDICATED,:tdOTVV1TMSTANDING ANY REQUIREMENT,TERM OR CONDITION QF ANY GONTRAGT f3R OTMR DOCUMENT:VJITH RESFEGT'T0'N!F{tGll TI;$ CERTIFICATE AIAY BE-ISSUED OR MAY?ERfiAI ;THE INSIIRANC! 4FFORDEi3 BY THE'.PULICI€S DESCitfBEO )iEREtN I5,5USJEGT t0 ALL':tHt T£ItflA ; EXCLUSIONS AND CONDIT10I3S OF SUCH POLICIES:LIMITS SHOWN MAY laAVE:BEEN REDUCED RY:PAID CLAjMS. r AODL U6R. .. , 'LTR{. TYPE OF INSURANCE.__ POLICY NUMBErt MM�POLICY rymEFF .POLICY GENERAL LIABILITY - • -' ):-. .. t X COMMERCIAL GENERAL LIABILITY ) to A z / FR^MiSES' acrcurrence i'== 100,000' A CLAIMS MADE X�OCCUR' 1500008Z43 13%1/2034 �1:1/1/2015 MED ESP fPny ct a cets a J Y RSCi VRL 3 it l?Y�- 3, Q,00{I't3D `,1ER-:L.AfivREGATE i's 2,:,4®C),Ooo . GEIV•LAGGREuATE LIMIlAPPUES?ER -t - PRO- t i PROwciS•OmmoP'AGn 5. 2 j'OD0,0410 - I.X POLICY 'LOC -.#,. - - AUTOht08iLEL1ABlq'h!. jr C jFjNEOSINCLE'.UMIT - - (EA-L - nti 5 1 QUO- 0 ANY AUTO- AL r OCDILv t 1)URY(P8 Pusan S ALL-OIIuNEO SCHEDULED W J r r X D20009389 80DlLY.lN UR (Pe acada J"s. AUTOS: Q AUTOS: 2/1/2014 2/1/2015 v ' { NON-OWNED iitREu`AUTC3S AUTOS �... f �t� -Two!�Gc I 1 t Unnsuzd rcionsiE)sprtaa I v' 250' OQO ,! UMBRELLA LiA6' j —�.EXCESS.LIAB. EAC-H:Cr=RRENCE A Clrtii AS 11AuE S PCCREGATE I: DED #RETENTIONS 600058368: 1/.1/201413/1/2015 $ WORKERSCOMPEN8ATION S .ANDEMPLOYERS`LIABILITY - a ANY PROPR"TOR1PAR h3ER1EXECUxIV� OFrICERfNE.gaER EXCLUDED?.. 'N.i A _...,., ... E1.EACH ACC DENT t�Tk}- 1-ADO 'O00 (Itlandat*in NH) =500a5910120i4A - 0/3/2014,110/3/2015 d ' 1f gges:tP25cr.CA[r7du {(—E t�fSEASE EA tt#P'OYE,S 1,0004000 DESCRIPTION OF OpEfcAT10N5't>ntta E DisI Ass, POLICY L�#I, 1. 000 .Ot)0 d 1 DESCRIPTION OF OPERATI(jNS Ito]A'f16N51 VEHICLES Attach ._:._.. - t ACORO iOT;Addd•ortal:Remailcs ScAedule, more sPece.is`reQwreq)'. _. .... . CERTIFICATE HOLDER .W ,CANCELLAT#ON -SHOULD ANY OF THE ABOVE.DESCRIBED POLICIES BE CANCELLED BEFORE =THE EXPIRATION .'DATE 'THEREOF, N0110E -VAQ,,Eiji, DELIVERED IN I0F.ORMATION PURPOSES,:ONLY` ACCORdA;dCE WITH THE POLICY PROV)SIONS. TAPPER CON8TRUCTIO2d Co LZC S46 'A HIGGINS CRbWELL'RQAD r AtJTHORIZED'72EPRESEiVTA WEST. YAPm6bTIi, MA 026:73,. LOra Fitz d/Li3h > , „ ,• Gera1 ACORD 25(2010/05) iNSO?5r�ptnrjain " 01 98$'-2010 ACORD CORPORA I If1N. 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Assessor's map and' lotnumber �� .� �' (�/� `r 7� 7 7(j�' Q. 1f Se.�'vageermit number .........................:.............................. SEPTIC SYSTEM MUST INSTALLED' IN COMPLIANC 33ARNSTAI1LE. i WITHARTICLE House number .............:�...... .'.5..�................................... OII ST 'o ,"b a �° ATE O 39• �0 4� r SANITARY CODE AND_ TOWNo�ara L M C TOWN OF BARN hit s= !%3 01 �' BUILDING INSPECTOR mi r_ APPLICATION FOR PERMIT TO ..±..........00.fj..3TRI') ..... mm ............................................................ ' TYPE OF CONSTRUCTION ........Lb.O.0-0.....FR4.m1w.................. to ............. 4.... �............19 .. B TO_,THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information:6 ' °t cafan ...... ....6 Avv5 .. ? ........WA R. . N T / e �!N� ............ p � Proposed Use .......�.Il . .�.�:....T!uT.P?Npa A.IV.9....4.01P.MlAr ................. ZoningDistrict ... ... ............................Fire District ..............4...................................................... ' " Name of Owner .....+�......... ..... ..". ..........1...........Address ....��. ...�?.............................. �......��..:�:!............ Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address ....................:................................................................ Number of Rooms ..... .........Foundation 6.0HG It f Exterior .........W3.0.0............. ........ ....................................Roofin ................... ........................................ :...Interior Floors C�!(YM�lV7 ................................................ ..................................................................... Heating ..................................................................................Plumbing ...................... Fireplace ...................................................................................Approximate Cost .............. .................................... .. ............ J aXa6 Definitive Plan Approved by Planning Board -----------_______-----------19________. Area ..... ....... �......................:* Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH NY I hereby agree to',conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name e4.. .........I 0strokoloviezv James t3 , ge NoP370 .... ........... Permit for .... ara............................. 57 Grouse Lane Location .................o................... ......................... West Hyaninisport .............. ................................................................ Owner ......James 0.a trokolow.i.cz................................. ................... . .... frame Type of Construction .......................................... ............................................................................... Plot ............................. Lot ................................July 5 78 Permit Granted ........................................19 Date of Inspection ....................................19 'Date Completed ........ ...19 PERMIT REFUSED ................................................................ 19 . ...........................................0................................... .............0................................................................ A* .......... ........................ ..........................ei.1............. .......... ............................................................ Approved-......... ...... 19 . . .................................. ............................................................................... .............................. ................................................ / °& � $~'~h number ........................................................ ' House number ..................... ................................. MM ����� Q`F � � � �� � � �� �]� � � �� �"� ��» �� �� P� �� ]� �� ��������u �� � 0 �N INSPECTOR �� �� �� �� ��� NN � N�N� N ������ � 0N �� ~ - �= ~� m ���� mw��� � m���m ���� � �� m� ��- � FOR PERMIT TO ----.�.`.�° IL^=-- .----_....—.--.--_—.---^- . ' TYPE OF �_ --.,/..�.—!�—..�.�x�!�-----_—_—.--.--_,^,.__.__._.____ ' � !������ � ~ —'--'— '- 'i`---- TO THE INSPECTOR OF BUILDINGS: ^/ The undersigned hereby applies for o permit according to the following information: ' - ` � h) n --�`� /� ��^^"���.��19..��. --.i&'.e.S�-_,u��/9~��/�.��..�~��____._.________________. / -_ Proposed Use .......�.7��^P-..AoTo���A��;=—�4��}—.�./'u��^�� ,_~,,____._,___,,.___.____.__ Zoning Dis thct ............... .......................................................Fire District .............. +�/f..---.—.----.--.--,_,... / | Nonne of Owner .....~T4.`��x�—�.���..±/�'����'�\K-l=.—A66,eu —.�~�..��. ..»A��L..r^AJ'. .y������...��' ' ~ Name of Builder ----------------------'A66neso ---------..—..----..---.—.-----. Nome of Architect ----------.-----------.Ad6res ---------.----------.----____ Number of Rooms ----------------------Foun6ohon ----- /����~� --__._______.. Exlehor ............ ���� ...............................................................Roofing -----.. ��____,,______,_ Floors ----..�!���� -----------------|nkerior ------_—________.___________. Heating -----------.-------------_._.Mum6ing -----.--_____,___,___~____~_.. _ / Rnez|oce '--------------------------App,oximoteCon ............^—�^'��..��.��,___,,____.,,. � ~ Dof��ve �on by Planning Board Anao lA-__'. — �------. � j / � Dio' om of and Building with Dimensions ____,g ee __' _ _ ____ \ \ � `SU8JE[T TO APPROVAL OF BOARD OF HEALTH ` " - . � . \ � ' � 1 �� � / ` | . , . ` - | hereby agree to conform to all the Rules and Regulations of the Town of Barnstable rogon6n0 the above construction. . 49 � ^^ Noma . ��--..l. .:—..����—�.:--.—... / | ' � � . omtrosolmwzez» James � �W3�� No —'�—.--. Permit for .............................. � Garage --/1L----....-----------------. ` � 57 Grouse Lane � Locution ------------.--------- � [ -W° mport --------------------------'' James Omtrmkolmvimo Owner .---------------------''v frame ° Type of Construction .......................................... � � ----'—^--'------'-----------'' , r/m ,'. � Permit Granted/ "".= of Inspection" . ' - Date . 7 ' . . � ! __._.. -------. lA ......................... ---- � —'--'' —''T'7 -----' ' .............................�~-----,—.-............................................. / � ----.—..—.--.—....-----....----..- � ^ Approved l9 `� � ---------------- ----------------^^'^----^^--^' �------------~---.----.~..—...— | - '