Loading...
HomeMy WebLinkAbout0376 OAKLAND ROAD ,_ J TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION OR Map-.90I Parcel Application 7 Health Division Date Issued Z-'0751—tT Conservation Division 7 Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village OwnerT�,.,,r9 `��nc�.,�1 Address S`mC_ Telephone ' 3�GN Permit Request �r��hcr�� 1z�.. ii- / � cc//-J.,•r Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type 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) 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 Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/boal stove:=-'❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: W1.�Xisting O.new`'size_ P Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 4M - Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ r" pp _ --a Commercial ❑Yes ❑ No If yes, site plan review# FE Current Use Proposed Use APPLICANT INFORMATION ..(BUILDER OR HOMEOWNER) - Name Telephone Number Address P® Box 52 License # West Dennis, NfA 02670 Cell (508) 280-6964 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Y SIGNATURE YzA DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME . INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL •y FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Y Massachusetts -Department of Public Safety Board of Building Regulations and Sta• ndarNs r Construction Supci- isur License: CS-058633 MIC 1HAEL J M CCAR PO BOX 52 W DENNIS MA If267; _ U.. )1 lit ` 4 J •�� Expiration Commissioner 04/10/2016 V Off ce of Consumer Affairs and Business Regulation r 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 169393 Type: Individual Expiration: 6/16/2015 Tr# 238121 MICHAEL MCCARTHY MICHAEL MCCARTHY - -- -�-- P.O. BOX 52 ------- — --- --- WEST DENNIS MA 02670 ------- ---- __.__ ✓ Update Address and return•card.Mark reason for change. Address Ej Renewal Em to ment Lost Card SCA 1 E3 20M•05/1 i ../ I� p y 11 ` •F� i n 1 The Commonwealth of Massachusetts Department ofIndustrWAccidents Office of investigations 600 Washington Street Boston,MA 02111 iimmniass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EleeWcians/Plumbers Applicant Information Please Print Le ' 1 t ><ke McCarthy Construction Name(BusinesslOcganization!Individual): PO Box 52 West Dennis, MA 02670 Address: City/State/Zip: CS1pA§##3 HIC-169393 Are u an employer?Check the appropriate box: Type of project(required): 1. I am a employer with_ 1 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and(or part-time).* have hired the sub-contractors 2.❑ I am a sole propridtor or partner- listed on the attached sheet;# 7. []Remodeling ship and have no employees 'These sub-contractors have S. ❑Demolition working for me,in any capacity, workers'comp.insurance. g. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its. I0.❑Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers`comp, c.152,§I(4),'and we have no 12.Q R frepairs insurance required.]t employees.[No workers' 13. er comp.insurance requited,] *Any applicant that checks box dl 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 nrst submit a new affidavit indicating such. tContraetors that check this box must attached an additional sheet showing the name of the sub•contractoms and their workers'comp.policy Infimnation. lam an employer Mal is providing rporkers'compensation htsurance for rrry employees Below is the policy and job site Information, Insurance Company Name: •�•� ����-� Policy#or Self ins.Lie.#: VWL 1rcr-(0110'G" �' Expiration Date: Job Site Address: City/State/Zip: t Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). t Failure to secure coverage as required under Section 25A ofMGL c.152 can lead to the imposition ofcriminal 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 it day against the violator. Be advised that a copy of this statement may be forwarded to the Office of i Investigations of the DU for insurance coverage verification. I do hereby certify e pa a enalUes ofperjury lliat the Information provided above is trite and carrecb Signature: Date: rhoneM. Official use only. Do not write in this area,to be.rompleted by city or town officlaL } City or Town: Permit/Lleense# - Issuing Authority(circle one): k 1.Board of Health 2,BuildingDepartrnent 3,CltylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6,Other Contact Person: Phone#: TE CERTIFICATE OF LIABILITY INSURANCE °A07110/2014 07/1o/zola 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 endomement(s). pN�p PRODUCER 01962-001 NAME:CT Bryden&Sullivan Ins Agcy of Dennis Inc IUC.No.Ext: (508)398-6060 ,No.: (508)394-2267 _ PO Box 1497 �S{ ss: So Dennis,MA 02660 — IN R AFFORDING COVERAGE NAIC# IN URERA: A.I.M.Mutual Insurance Company 26158 INSURED INSURER B: Michael McCarthy Construction Inc INSURER _ PO Box 52 INSURER D: West Dennis,'MA 02670 INSURER E: _ I 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 WI-11CH 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. ILTR TYPE OF INSURANCE POLICY NUMBER NN%)A'� LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PR MI E aoccurrence) _ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 3EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ �POLICY J RC0j �0C AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ i Ea accident) BODILY INJURY(Per ANY AUTO person) _ ALL OWNED SCHEDULED _ AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS �— NON-OWNED PROPERTY DAMAGE $ AUTOS (Par P accide ___ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE - $ yyoRKKDEEERRDgg ppMM RETENTION $ yy�gT TU TH $ AND pEMPLOYEETRpPS��lpq1A�BTiLNIETRY� X TORY LAM ITS A CER/MEMBER EXCLUDED?ECl1TNE Y N . q �oI �Y N/A VWC-100-6017656-2014A 7/17/2014 7/17/2015 E.L EACH ACCIDENT $ 500,000.00 (Mandatory In NH) rE:L:DlSi�E-EA EMPLOYEE $ 500,000.00 DESCR ON OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Workers Compensation Coverage applies to MA employees only. CERTIFICATE HOLDER CANCELLATION Thielsch Engineering 196 Francis Avenue SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cranston,RI 02910 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE n'A ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD gsc��i Town .of Barnstable Regulatory Services • se ,MASK s„�: craw.Scala,erector , . .0� t , ,,,,�. Buule�u�`Dioisioia W . Tom Perry,]&Un ng Commissioner 200 Mam.Ste4 Hyanms,.MA 02601 w"town,barnstabte m = Office: 508462-4039 Fax: 508-790-6230 Prnpe y QwnerMus:t.- Complete-and si T6 Section .If Us n SA Builder e%c f stlb ct property to act`b behalf, lie=eby autbwnze: A j� {� in all matters.relative:to work authorized by Js building permit application for. -Ae Okd-n- Acldress•Of� fl� t.:. . foot fences and alarms.are the r+espon t t',yQf tl e�applicant Pools ,are not to:be. or utilized:.iefo e:fea me s insralle- and all final 'cos pe�fo anc1 accept . v Sieaature of Owner Signat=,Df Appluaat uJ�i to k-+ D - L - riiat Name Punt Name D t Q:PORMs:OwNWERMS ONMIS r.�► T Assessor's Office(lst floor) Map,; Lot Permit#� ���9 . _1--R— Conservation Office(4th floor) Date Issued /1— 9,5 ,/Board of Health(3rd floor)(8:30-9:30/,1:00-2:00)� 6rP 1c r Fee �7 d •( /Engineering Dept.(3rd flooi House#1 :2 Planning Dept. (1st floor/School Admin. Bldg.) y RARMARLE. Definitive Plan d by Planning Board 19 e 9. - y ED N1R�A � r TOWN OF.BARNSTABLE Building Permit Ap ication t Project Street - Ns376 LS/ ./Village /Owner Q✓ Address i jai_ ) ,Telephone aroQ i /ermit Request . t Total 1 Story Area(include 1 storygarages&decks) square feet } Ii Total 2 Story Area(total of 1st& 2nd stories) square feet /Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached. Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name V Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. i ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO r SIGNATURE DATE / /19 �-3 BUILDING PERM DENIED FOR THE FOLLOWING REASON(S) L 1 ^^7 FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. r r• ADDRESS VILLAGE r y • OWNER _ a . DATE OF INSPECTION: FOUNDATION '! FRAME INSULATION 4 FIREPLACE E ! IN ELECTRICAL: ROUGH FINAL ~ PLUMBING: ROUGH FINAL GAS: f. ROUGH FINAL r ' FINAL BUILDING DATE CLOSED OUT. ASSOCIATION PLAN NO. t TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION lease print. . DATE S= .cJs r/ JOB LO CATION 7 /1 k - Number Street address Section of town "HOMEOWNER" ./Op Name Home phone Work phone PRESENT MAILING ADDRESS S :, City town Sta .e Zip code The current exemption for "homeowners" was extended to i dwellings of six units nclude owner-occupie. or less and to allow such homeowners to engage an in- dividual for hire who does not possess 'a license, provided that the acts as supervisor, owner DEFINITION OF HOMEOWNER: Persons) who owns a parcel of land on which he/she resides or intends to re• side, on which there is, or is intended to be, a one to six family dwelling, attached or detached structures accessory to such use and/or farm structures A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Offic: on a form acGP-ptAble to the Building Official, that he/she shall be res onsi? for all such work performed under the buildingermit. p (Section 109.1.1) The undersigned "homeowner" assumes responsibility for compliance with the St Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department :aid inspection procedures and requirement: and that he/she will com w' said p c dures and requirements. HOMEOWNER'S SIGNATURE J APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Coda Section 127. 0, Construction Controlq 6 q HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which a building permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that if Home Owner engages a person(s) for hire to do such work, that such Home Ownex shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for . licensing Construction Supervisors, Section 2. 15) . This lack of awarenes often results in serious problems, particularly* when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home "Owner- actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, man communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. C1P� . : The Town of Barnstable MONMAM� $ Department of Health Safety and Environmental Services °r 1659. �`° Building Division 367 Main Street,Hyannis MA 02601 Office: 508 790�227 Ralph C,rossen Fax: 508-775-3344 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME H"ROVEMENT 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. Type of Work:4�� Est.Cosy Address of Work: Ov�ner.Name: Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job der S1,000 wilding 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: Date Contractor name Registration No. OR Date er's name t The Commonwealth of Afassachusetts Department of Industrial Accidents oficeofloveSUIZAARS 600 Washington Street Boston.111ass. 02111 Workers' Compensation Insurance Affidavit ;�nhc:int.�". . .. _ _�—..•..._ ..-----.. � _...Please PR11VT l�ihly .�..-...-._..�...,. ,.:�,,.r.,�.-.._.,..,,.�.-- ` formation• V name• aY'>o f'�A �'�r>zd/r✓SCJh �c ir// s 1 am a homeowner�/performing 'FYI all w �ork myself. ❑ I am a sole proprietor and have no one working in any capacity i:...t.'pv°B• -" ,�)'Y�i?..ss�a+5•'.w+c�'wt re�.0 ms.�w: ...`�,.,.... ...... r.:; ..:•. -. a,.�,..��uyg� :.."':.�'s�3?�L_�"'"'_,_.�'�y"'.!�•e+�"'...,,..oi 1 am an employer providing workers' compensation for my employees working on this job. company name• addre, city: phone#: insurance co polio•# ..z . .�; ..,-•»T,Eaypgfj*!�-..:.. Y.y..�i.sr•v.a....�+rrn..•�;..-�.r.srs,rx.,.,...:. n..,._ ., ...., , _«aws_.-^.....:..........w....., o-.. L'1 1 am a sole proprietor,general contracto r homeowne (circle one)and have hired the contractors listed below who have the following workers' compensation po Ices: comJ►am•n•tme•C'���—������ �::� �`��\y}-' address: \C,� V\ 2—A�6 0 phone#: L(—'5 ^ 9,b insurance co. S 9— Q AR—\ nolicv # �_ ,^5= : - �fCF[r«:-.y...-.71+vo-=s-r,�-1•-"'�TgCS';e.� �t�-3s.._e•"'s-s�.,��„•?;RF�rsry! +sy�+':�c�".ayR;. ,'F •rfar• _..wa-:--•^."?ca �•-ate_-..._._..�- - .._. 't' company name• address: city phone#• insurance co policy# :Atiach additional`slieei if neeessa ���.:}_� e?+•�"t. 7 F+a. i. �F.;; .s.'i4_' : «.�:iY. 'y' '—r�r"or�+ .�'�� Failure to secure coverage as required under Section 25A of NIGL 152�can lead to the imposition of criminal penalties of a fine up to$00.00 and/or one.cars*imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the D1A for coverage verification. 1 do Iterebi•Fen ift under the pains and penalties of perjun'that die information provided above is true and correct. Signature Date Print name ��/r�110 /�,�v/��an �/Phone# 7'officialnhdo not write in this area to be completed by city or town official permit/license# rIBuilding DepartmentLicensing Boardcheckmmediate response is required QSelectmen's Office `• �ticalth Department b contact person: phone#: nUthcr Im'ised 3195 P1A) '