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HomeMy WebLinkAbout0408 MAIN STREET (HYANNIS) (13) ST- .01 _ - - - T Fi e� C•�� - -- - i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 1;)_(0 Application # Health Division Date Issued Conservation Divisions Application Planning Dept. Permit Fee L, Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis C�'✓ F�0 O Project Street Address L/000 ]'laf� Sl Village Al NNr s Owner *0 MAo. i Address o (`hex AS-d Telephone �`D'� Permit Request N o yi'8j I t­TER'ib2 5",QMSV kz2p�i9c� xr r-," Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ib00 000 Construction Type 1,) A 6?,Ime, Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure 70 Historic House: ❑Yes �lo On Old King's Highway: ❑Yes ❑ No Basement Type: �_F'ull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) 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 Room Count 3 Heat Type and Fuel: Gas ❑ Oil ❑ Electric ❑ Other ` ` y ;7 n Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑-Pes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: Lllexisting 13 new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: _ _4 165 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial a<es ❑ No If yes, site plan review# =current Use � i C Proposed Use ,2iE APPLICANT INFORMATION _ - (BUILDER OR HOMEOWNER) Name U� C ' ��`— Telephone Number Address License # q0) l.] N�#ALZ< . MA . W& I Home Improvement Contractor# Q 3 �; Worker's Compensation # LA/ 1)01 �b� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE C DATE c F FOR OFFICIAL USE ONLY 3 'r APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME !x INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL r • PLUMBING: ROUGH FINAL , 'r GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED,OUT f > ASSOCIATION PLAN NO. ' t , er r Town. of Barristable Regalatory Services sPr` gc� Thomas F. Geiler, Director :6:3F9, Building Division Thomas Perry, CBO, .Building Commissioner /J 200 Main Street, Hyannis,MA 02601' w".town.barns-table.ma.us DU I 'Offcec 508-862•-4038 Fax: 508-M-623C FLAN REW Owner Map/Parcel: r0 2 Project Address Builder.- The Mowing item* g were noted on reviewing: ot.L g-Te7 U"I a 2 t= 77�-4 -7 Regiewed by: r—wc Date: OP ID: DS CERTIFICATE OF LIABILITY INSURANCE DAT 1011 DIYYYY) 10/14111 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(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 508-775-6060 - CONTACT Bryden&Sullivan Ins Agency "AME' 88 Falmouth Road 508-790-1414 a°NN Ext t aC No): Hyannis,MA 02601 E-MAIL Kelley A.Sullivan ADDRESS: PRODUCER PURIT-1 - - CUSTOMER ID#: INSURER(S)AFFORDING COVERAGE NAIC# INSURED Puritan Clothing Company' - - INSURER A:Chartls Four Hundred Main Realty LLC INSURER B 77 Old Yarmouth Realty LLC Drawer 730 INSURER C Hyannis, MA 02601 INSURER D: INSURER E: INSURER F: - - - COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS XP LTR TYPE OF INSURANCE SR fVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS GENERAL LIABILITY - - - - • EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY D AGET6- O PREMISES Ea occurrence $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS'-COMP/OP AGG $ POLICY PE O LOC - $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS ' BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ $ UMBRELLA LIAB x. OCCUR EACH OCCURRENCE $ . EXCESS LIAB CLAIMS-MADE AGGREGATE $'` DEDUCTIBLE $ RETENTION $ - • $ - - WORKERS COMPENSATION - - WC STATU OTH- - AND EMPLOYERS'LIABILITY - TORY LIMITS ER A ANY PROPRIETOR/PARTNER/EXECUTIVEYI" WC001659021 02/01/11 02/01/12 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A - - (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $. 1,000,000 If yes,describe under - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION BARNS-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL, BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. Building Dept. 200 Main Street AUTHORIZED REPRESENTATIVE Hyannis,MA 02601 Kelley A.Sullivan ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD a3(1SSl 31da N011d011ddd The Commonwealth ofAfassachusetts". Department of In Accidents y a Off of Investigations 600 Washington Street "1 Boston, MA 02111 www.mass.gov/dia C I Workers' Compensation Insurance Affidavif: Builders/Contractors/EIectricians/PIumbers &pplicant Information Please Print LeObly r anization/IndividuaI : N�d''1✓� r moo''� 11aIIle usincss(O ) S+ Address: I n City/Mate/Zip: OzzoI Phone#:` —SOf_ 5 , -Y- �53 Are you an employer? Check the appropriate box: Type of project(required):, ]. I am a employer�ritit 4. ❑ I am 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 orpartrter- listed on the attached sheet $ �•. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for.me in any capacity' workers' comp. insurance. 9: .❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its I0.❑Electrical repairs or additions required.} officers have exercised their right of exem tion per MGL I I-❑ Plumbing repairs or additions 3. ❑ 1 am a homeowner-doing all workp myself. jNo workers comp. c. 152, §L(4); and we have no 12.❑ Roof repairs insurance required.] f. employees, [No workers' I3.❑ Other comp.insurance required.] " *Any applir_int that checks box#1 inust also fill oul thcsection below showing their workers'compensation policy.information. t Homeowners who submit this affidavihindicating they an: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-ContractDrs and their workers'comp:policy information. i I am an employer that is providing workers compensation insurance for my employees. Below it t1ie policJ+and. Job site jirzforncation. , 1 ,l Insurance Company Name: C `,1C�`(T� S . Policy#or Self-ins."Lie: #: C �0 1 �5 Qa•.\ Expiration Date: 024 Job Site Address: '`7� ��'� _54' ---- - i "City/State/Zip: ��d1,1.i i Attach a copy of the workers'. pens: policy declaration page(showingthe policy number and expiration date). _ j. Failure to secure coverage as required under Section 25A of MGL c. I52 can lead to the imposition of criminal.penalties of a fine up ll to$1,500.00 and/or one-year imprisonineni; as we as civil penalties in the form of a STOP WORK ORDER and a fine 1 of up to$250.00 a day against the vio)ator. Be advised that a copy of this statement may be forwarded to the Office of, I Investigations'of the DIA for insurance coverage verification. i I do hereby ce fy under Lhe airs andpenalties ofperjury drat the information provided above is true and correct Date: Si D ature: Phone#: v 1 official use only..Do not write in this area, to be completed by city or town offcciaL j City or Town: Perm WI icense 9 Issuing Authority(circle one): l I. Board of Health Z: Building Department 3.City/Town Clerk 4:Electrical Inspector 5: Plum bin Four Hundred Main Realty P.O. Box 2652, Hyannis, MA 02601 • 775-2400 October 13, 2011 Town of Barnstable Building Department This is to certify that Gary C. Graham who is an employee of Puritan Clothing Co. of Cape Cod, Inc. is covered for Worker's Compensation per the attached insurance certificate while performing work for 400 Main Realty. Very truly yours, 7 Laura Davis Controller o r ti 'Town of Barnstable 6 ` Regulatory services t �' ► �. Thomas F. Geller,Director ' Building Divisions Tom Perm,Building Counnissianer 200 Main Itmr-t,H3mn: is,MA 02601 www.town.barnstable ma.us Office: 509-862-403 8 Fax: 508-790-6230 PnY Pro e Chvter Must . . Complete and Sign This. Section If Using ABuilder I, �f Cl��� . ���`✓ , as Owner of the subject.proPerty hereby azs(horize �/�9 v— to act on my behalf, in all r]nati-Prs relative to work authorizcd by tbis building permit 2-PPECation for. (Address of Job i 5ignatuxe of Owner D2te Pnnr Name If Property,�Zeris applying forpermitplease cowP Lte. the Homeowners License Exemption Form on the reverse side. 4 Dcp u'tmcrrt of`Public B6ard of Burldin . . ze„ ,unions aConstructione nd Sta radar• s ' License: CS 42 Sprvisor License 246 ro`. - Restricted,to: 00 a GARY C "GRAHAM 66 BRAN_`WAY HYANNIS, MA 02601 �' u�i �ioncr Expiration: 3/20/2012 7r#: 18292 , Rested to; s 00 00- Unrestricted 1 G-1 2 Family no Failure to possess a Ma current edition of thssachusetts State Buildin is cause for revocation de of this e lice ' Refer to: VjWW.Mass.Gov/DpS [�C a rs&B si;i s, R gzula n Office o onsum r A . HOME IMPROVEMENT CONTRACTOR Type Registration. ,-23659 Expiration. -3/25/2013 Individual Ga Graham E t3 t F Gary Graham ` 66 Brant Way Hyannis,MA 02601 �yv. Undersecretary License or registration+valid for individul use only before the expir%ation date. If found return to: Office of Consumer Affairs and Business Regulation .10 Park Plaza-Suite 5170 Boston,MA 02116 a �_ Not v id without signature t Massachusetts Department of Environmental Protection Bureau of Waste Prevention • Air Quality 100137307, Decal Number BWP AQ 06 Notification Prior to Construction or Demolition Important: A. Applicability When filling out PP Y forms on the computer,use only the tab key A Construction or Demolition operation of an industrial,,commercial, or institutional building;or to move your residential building with 20 or more units is regulated by the Department of Environmental Protection cursor-do not use the return (DEP), Bureau of Waste Prevention-Air Quality Control Regulations 310 CMR 7.09. Notification of key. Construction or Demolition operations is required under 310 CMR 7.09(2)ten (10) days prior to any work being performed.The following information is required pursuant to 310 CMR 7.09. B. General Project Description 1. a. Is this facility fee exempt-city,town, district, municipal housing authority, owner-occupied Instructions residence of four units or less?❑Yes ❑✓ No. 1.All sections of b. Provide blanket decal number if applicable: Blanket Decal Number this form must be completed in order to comply with the 2. Facility Information: Department of 400 BIULDING Environmental Protection a.Name notification 1408 MAIN ST. requirements of b.Address 310 CMR 7.09 h annis IMA 1 02601 c.Cit /Town d.State e.Zip Code (508)775-2400 poraham@puritancapecod.com f.Tele hone Number area code and extension Q.E-mail Address(optional) 12,000 12 h.Size of Facility in Square Feet i.Number of Floors j. Was the facility built prior to 1980? 0 Yes ❑ No k. Describe the current or prior use of the facility: OFFICE/COMERCIAL 1. is the facility a residential.facility? ❑ Yes ❑✓ No �o m. If yes, how many units? Number of units -O 3. Facility Owner: �N 400 MAIN REALTY LLC �O a.Name �o P O BOX 2652 1 b.Address HYANNIS MA 02601 1 -(0 c.Cit /Town d.State e.Zio Code, O (508)775-2400 f.Tele hone Number area code and extension) q.E-mail Address(optional) a CHRIS GRAHAM �Q h.Onsite Manager Name ag06.doc-10102 BWP AQ 06-Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Waste Prevention,• Air Quality 1110013730T ��` Decal Number BWP AQ 06 Notification Prior to Construction or Demolition E General Statement:If B. General Project Description (cont.) asbestos is found during a Construction or 4. General Contractor: Demolition GARY C. GRAHAM operation,all responsible parties a.Name must comply with 166 BRANT WAY 310 CMR 7.00, b.Address _ and Chapter HYANNIS MA -� 02601 Chapterer 21 E of the General Laws of c.Ci /Town d.State e.Zip Code the Commonwealth. (508)737-6420 This would include, f.Tele hone Number area.code and extension Q.E-mail Address(optional) but would not be limited to,filing an CHRIS GRAHAM' asbestos removal h.On-site Manager Name notification with the Department and/or ¢ ' a notice of release/threat of release of a C. General Construction.or Demolition Description - hazardous substance to the 1. Construction or demolition contractor: Department,if applicable. IGARY C. GRAHAM a.Name 66 BRANT WAY b.Address HYANNIS MA 62661 c.Cit /Town d.State e.Zip Code (508)737-6420 f.Telephone Number area code and extension g.E-mail Address(optional) CHRIS GRAHAM h.On-site Manager Name 2. On-Site Supervisor: CHRIS GRAHAM On-Site Supervisor Name 3. Is the entire facility to be demolished? E] Yes ✓] No N 0 4." Describe the area(s)to be demolished: �0 12' BY 4'AREA TO INSTALL STAIRCASE N - O 0 5. If this is a construction project, describe the building(s) or addition(s)to be constructed_: BUILD STAIRCASE FROM 2ND FLOOR TO 1ST FLOOR 0 �a �Q ag06.doc•10/02 BWP AQ 06-Page 2 of 3,111111 Massachusetts Department of Environmental Protection ■ Bureau of Waste Prevention • Air Quality 100137307 BWP AQ O whV Decal Number Notification Prior to Construction'or Demolition C. General Construction or Demolition Description (cont.) 6. a. If this is a demolition project,were the structure(s)surveyed for the presence of asbestos containing material (ACM)? ❑ Yes ❑✓ No If yes,who conducted the survey? b.Surv6vor Name c.Division of Occupational Safety Certification Number 7. Construction or Demolition: 11/14/2011 12/30/2011 a.Start Date(mm/dd/yyyy). b.End Date(mm/dd/yyyy) 8. a. For demolition and construction projects, indicate dust suppression techniques to be used: ❑ seeding ❑ paving wetting shrouding b. If other, please specify: ❑ ❑✓ ❑ covering `❑ other 9. For Emergency Demolition Operations,who is the DEP official who evaluated the emergency? a.Name of DEP Official b.Title 6.Date mm/dd/ of Authorization d.DEP Waiver Number. D. Certification I certify that I have examined the GARY C. GRAHAM =o above and that to the best of my a.Print Name -o knowledge it is true and complete. GARY C GRAHAM The signature below subjects the b.Authorized signature -N signer to the general statutes . CONTRACTOR =o regarding a false and misleading c. Position e 0o statement(s). IGARYC. GRAHAM d:Re resentin 10/31/2011 �co e.Date(mm/dd/yyyy) 0 �d �Q ■ ag06.doc•10102 BWP AQ 06•Page 3 of 3■ o Aq w , - U ZQ W Z o Q w SECOND FLOOR PLAN NEW STAIR SECTI❑N . Q UW z z ll / W o 2�8'XN4 0 EXISTING P MING: I I O 394 MAIN 390MAIN.. 388 MAIN SQ. � � -��2XI2,16"O.C. 00 I � a- � 2,858 S8' 660 S8' ® .3,349 . _ /_ 00 .O A 2 FRAMING ARGUND OPENING(NEW) - /� I o FLOOR PLAN MAIN STREEr I % l I l NEW STAIR OPENING . .EGRESS 'A'-'B' = 119' - / � 0