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HomeMy WebLinkAbout0085 GROVE STREET T pc TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma �0 Parcel' 40 p ) =Application - .Health Division ' Date Issued Conservation Division ' Application Fee . Planning Dept. _' Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation/Hyannis Project Street Address crqO V,:f— ,S '� — Village 0to t� Owner Lfir E 11 c V\ �C_ Address Telephone Permit Request ►C r- c t lx�c_ c d l a c�c� '�5 a�� Or� �Ot Square feet: 1 st floor: existing '700 proposed 0 2nd floor: existing 16 proposed � Total new Zoning District Flood Plain Groundwater Overlay Project Valuation /DOo Construction Type Lot Size 0,36 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Cr Historic House: ❑Yes Yo On Old King's Highway: ❑Yes S'No Basement Type: ©"Full C6 Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) 700 Number of Baths: Full: existing Z-- new D Half: existing new Number of Bedrooms: 3 existing .0 new Total Room Count (not including baths): existing new First Floor Room Count S Heat Type and Fuel: ❑ Gas- Boil ❑ Electric ❑ Other Central Air: ❑Yes Q No Fireplaces: Existing AL New Existing wood/coal stove: ❑Yes M No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: a Zoning Board of AppealTN uthorization ❑ Appeal # Recorded ❑ N-.r, °�' C" Commercial ❑Yes o If yes, site plan review# Current Use ��� 6C u�c� v—C_._ Proposed Use r- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ?/eco Cu C_ ,o Telephone Number �� y �`� 1�0 Address / ZtAx— �, J License# S �03 �-�o _ I'� �� /'� 62 Co Home Improvement Contractor# Z_ Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Bq_n,\: �4 vt5- {cam 5 T / /om SIGNATURE 111� DATE FOR OFFICIAL USE ONLY ,APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE � r OWNER 4 r DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ' r = y ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL t FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massach usetts _ Department of Industrial Accidents ' 15 Office of Investigations - 600 Washington Street t Boston, MA 02111 s� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/IElectricians/Plumbers Applicant Information 4 Please Print Legibly r Name (Business/OrganizatiorAndivi dual): , w Address: 6S-1 T J-C (< City/State/Zip: l0,115 �I 1 1 () Phone #: (� �Z� 3 3 90 A�rou an employer?Check the appropriate box: Type of project(required): 1. am a employer with 4. ❑ I am a general contractor and I 6 ❑New construction employees(full and/or part-time).* have hired the sub-contractors - _ 2.El I am a sole proprietor or partner- listed on the attached sheet. 7. [Remodeling These sub-contractors have g, Demolition ship and have no employees working for mein any capacity. employees and have workers' 9 ❑Building addition No workers' comp. insurance comp. insurance.$ 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] 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.] *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 thepolicy and job site information Insurance Company Name: 0 i�0S KS C1 agxce.- 08 Policy#or Self-ins.Lie.MA\ L WC' l y ➢ 1 l 0 Expiration Date: � `f Job Site Address: 2Sit l7 'L S City/State/Zip: GrCS oVLV" t 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 thepai..sand enalties ofperJury that the informationprovided above is trueand correct. Signature: Date: 3 Z O o Phone#: 3 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 M I From: 03/25/2010 15:53 #422 P.001/001 ACC> CERTIFICATE DATE(MMIDDNYYY) OF LIABILITY INSURANCE 3/25/2010 PRODUCER (781)986-4400 FAX: (781)963-4420 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Risk Strategies Company ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 15 Pacella Park Drive HOLDER: THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 240 Randolph MA 02368 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:NOrGuard Insurance Co M L Construction CO Inc INSURER 651 River Raod INSURERC: INSURER D\ Marstong Mills MA 02648 INSURERE: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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 OFSUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS R D'L POLICY EFFECTIVE POLL Y EXPIRATION POUCY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY MI PRE RENTED Ea urranee $ CLAIMS MADE ❑OCCUR MED EXP(Any one arson) $ j PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ POLICY p MECT El L.00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $ (Per person) HIRED AUTOS NON-OWNED AUTOS BODILY(Per accident) $ (Per accident) PROPERTY DAMAGE $ (Paraocldent) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ A WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN Chael Lea X WC STATU- OTH- =y is included ANY PROPRIETOPJPARTNER/IXECUTIVE�in coverage - E.L.EACH ACCIDENT $ 100,000 OFFICERWEMBER EXCLUDED? L'.:._I (Mandatory In NH) WC126418 03/19/2010 03/19/2011 E:L DISEASE-EAEMPLO $ 100,000 If yes,describe under SPECIAL PROVISIONS below. E.L.DISEASE-POLICY LIMIT $ 300.000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS Sasued as evidence of insurance CERTIFICATE HOLDER CANCELLATION 5 0 8-7 9 0-62 3 0 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION TOT/7n Of Barn6tabl@ DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRnTEN Barnstable Building Department NOTICETO THECERTIFICATF HOLDER NAMED TO THE LEFT,RUIT FAILURE TO DO SO$HALL 200 Main Street Hyannis, MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE . Michael Christian/SMS ✓� ACORD 25(2009101) 01988-2009 ACORD CORPORATION. All rights reserved. INS026(200e61) The ACORD name an I d ogo are registered marks of ACORD ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- AND TWO-FAMILY DETACHED,RESIDENTIAL CONSTRUCTION (780 CMR 61.00) (� Site Address: ` Applicant Name: A�5(�V cfi0�. r-- print /r,�n`k Ltiae- t L_eb.+Y Town:. o Applicant Phone: g�r-� Applicant Signature: Date of Application: ' NEW CONSTRUCTION: choose NE of the followhig two o tions 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE- AND TWO-FAMILY BUILDINGS MAXIMUM MINIMUM Ceiling or Slab Option 1: Basement Q Fenestration exposed Wall . Floor Wall Perimeter AFUE ' HSPF - SEER U-factor floors R-Value R-Value R-Value R-Value and De th R-Value National Appliance Energy R-10, Conservation Act(NAECA)of .35 R-38 R-19 'R-19 ' R-10' " 4 ft 1987 as amended,minimums or rester as a lieable Note: This form is not required if you choose either of the two versions of REScheck as listed below. ❑ Option 2: REScheck Version 4.1".2 or later variant software analysis must be completed (780 CMR 6107.3.2) REScheck—Web which can be.accessed at ht p_/owww energycodes.�),ov/rescheck/ ADDITIONS OR.'ALTERATIONS TO EXISTING BUILDINGS:OVER.5 YEARS OLD* *Buildings under 5 years old must use option#1 or#2 in New Construction section above: Complete the following formula to determine the % of glazing: (a) Gross Wall & Ceiling Area equ4ls " Formula: (100 x b a) � t --SF 100 x % of glazing b a (b) Glazing area equals SF If glazing is 400/6 use the chart below, If glazing is > 40 % proceed to"SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM Ceiling and Basement Wall Slab Perimeter ❑ Fenestration Exposed floors Wall Floor Basem R-Value o U-factor. Value R-Value R-value R-Value. and Depth .39 R=37 a R-13 R-19 R-10 R-10, 4 feet a R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area(i.e. not compressed over exterior walls, and including any access openings). SUNROOM-An addition or alteration to an existing building/dwelling unit where the total" glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fill out Consumer Information Form (found in Appendix 12-0 P) r F T�1E i Y Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division —Thomas Perry,CBO 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 E �rn as Owner of the subject property } hereby authorize Ye VC-- ldh4,to act on my behalf, f in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Nalne If Property Owner is applying for permit,please complete the Homeowners License.Exemption Form on the reverse side. _C:\Users\decollik\AppDataU ocal\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\4STGU5QO\EXPRESS.doc Revised 090809 Yl tssachusetts - Depm tmentof Public Safciv'. Bo.ird of Building Regulations and Standards Construction Supervisor-Lice nse License: Cs 80386 Restricted,to: 00 #; MICHAEL P LEARY :rr' 651 RIVER RD MARSTONS MILLS, MA 48-11 Expiration 7/15/2011 Commissioner Tr#: 17707 `; ,. ✓fie omimoouuealClz o�✓�aaaae�iuoe�!a: . `",. .,. Board wilding Regulations and Standards License or registration valid for mdividul use on HOME IMPROVEMENT CONTRACTOR before.the expiration date. It•found return to: f l; Board of Building.Regulations and Standards Registrai.ion: 135592 One Ashburton Place Rm 130i i Expiration 4r22/2010 Tr# 268968 i r , Boston,Ma.02108 !I ype ivate Corporation' � � MI,L.CONSTRUCTIONtCU IN 1 1' MICHAEL"LEAfY 651 RIVER RD. MARSTONMILLS,WA 026 8 Administrator Not lid iti ithout sign re . 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