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HomeMy WebLinkAbout0504 OAKLAND ROAD 50q O&gjand RcL Town of Barnstable n, v Building Post This Card So That�it is Visikile From the Street A"r""roved"Plans Must b`e Retained on .ob an R f"'s Card Must be Ke't� a o8' Posted BARMTASM LIntIIFinal Inspection Has Been Made .. ` � ° - Where a Certificate of Oceu anc=is Re aired" cli�Buildm sFiall Nof be Occu ied until a Final Ins ectiokh sbee�n made Permit Permit No. B-18-1936 Applicant Name: KELLY, ROBERTA F Approvals Date Issued: 07/10/2018 Current Use: Structure Permit Type: Building-Pool Above Ground Expiration Date: 01/10/2019 Foundation: Location: 504 OAKLAND ROAD,HYANNIS Map/Lot 272-061 Zoning District: RC-1 Sheathing: T Owner on Record: KELLY, ROBERTA F x3 Contractor te, Framing: 1 Address: 504 OAKLAND RD Contractor. 2 a HYANNIS, MA 02601 Est Project Cost: $300.00 Chimney: Description: set u of above round 15'x48" pool �g Permit Fee: $ 125.00 p p g � U, Insulation: E;eek Paid $ 125.00 7/10/2018 Final: REVIEWER'S NOTE; MUST MEET SETBACKS, RIDGID WALL"AND Date REMOVABLE LADDER REQUIRED tIKV, k �� Gas a r�%ir/L Plumbin g/ Project Review Re 4 j q: Rough Plumbing: i Building Official # Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within siz,months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction document346r which this permit has been granted. All construction,alterations and changes of use of any building and structures,shall be in compliance with the local zoning by laws a9' codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or,;road and shall be maintained open for public inspe,von for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Suildmg and FreOfficials"are provided on this'permit. Service: Minimum of Five Call Inspections Required for All Construction Work: r " ' 1.foundation or Footing - � � �� Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection S.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department ��- Building plans are to be available on site Final: '��` All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 9 p Application Number.........1.�............ ....................... r BA81VbZA8I�. + (0 r + , MAMPemit Fee.......................................Other Fee.................:...... �T, Total Fee Paid. .... '......... . ................................ JUN 15 0 TOWNOF BARNSTABLE 1018 PermitAppro`mlby.....E° ... .G.............on...7 e �� �v�n���. ...... ............_ IC,A10 � BUILDING PERMIT ¢ '] Map.... .., ........... .................... APPLICATION Section 1 — Owner's Information and Project Location Project Address 5®4 0" lal- l Vfl age A.4a n! s Owners Name KO bd Owners-Legal Address _51) q Q air 1drd City4q5 State l� ZiP L0 0 Owners 6eH E-mail L-S T D 6 6n T(c-) ceJWIC,j5 ✓1 Section 2—Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet Commercial Structure under 35;000 cubic feet Single/.Two Family Dwelling . Section 3—Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish`Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar ❑ Renovation Pool ❑ Insulation Other—Specify Section 4-Work Description V. T Act Tmds�7J921)1$ Application Number.................................................... , Section 5—Detail Cost of Proposed Construction 6 300 Square Footage of Project Age of Structure Dig Safe Number #Of Bedrooms Existing Total#Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas -❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply Public Private ❑ — - - Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility. I am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required . Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last undated 2/92018 so y ����a . _ . .; ,_. . • F.. p. A3 ��:G A `i r ... : . . . ,:. : r /_3.r 00 y: r \ Y h o T o ti �� 1. o G 0. . h , , sy-o e y / ; v !to �'.�.a- : ,. �� is . -.:: ;- -z - ..c: aq- a as jy , _ _ _ , �,, - l. �.. ,. ..� 4""_.' _ . :.-._. „. . . /3.6 00 . . . - .. : i p w �:. � . g. �r=.: ti s« ; x .q�� �, RTI IT E.D PL1.OT PI. A 'N - ~ 30 > �,.?k is 7.3 SCALE: DATE T �—.- R-E F.E R: ENE:`E. % .� .vg G,o--- is-- . .: Sao iv v v.v:, A. o. G.4.c�a s /s- 7.� ,c.�.t�S c-3 oa.� 0 6. y r `s7_ p A T E.; . :. .. O� 1. . REG LAND_ SG;RYEY R. t H`EREBY CEft;_TtFY THAT :_THE BU'tlD:tNG p n W N, 0 N:; T h 5 ? t_ A ,11IN I S t_ A'C A T E D O N THE GROUND AS 5H0:WN ;HFER-'EOtV' AND � � I. TH'AT . tFEs' .yoT" CON_f_.O,RM TO" THf �gN�FMASs 1. 9p�. ZQ:NtN:G 8',Y lAW5:: Of TH-E TOWN OP A-i �� - o� 3, � s�A�&G�W H E N C.O N 5 T R U , T E D -jO5EPH M d AM,JR x.„ _ --_ ,A- TABLE_ SURVEY CaNSt� LTA_NTS, 1NC F� ¢*�� Z. �� WEST_°,Y A R:M O tl,T H,,Iu1 A S 5 �`� Sub _. -... .. _. .._ . - - - . , . _ —r . ,. m -,. _ . y L .-<_ . _ , _ E� u . -, }.: rk 3 ' r 3 - - v _3 r t 3 w iw M.. ... .4'f u \gyp. Read, understand, and follow ., -- XPi:mstruct�ons carefully before tagin ' and`usin' this roduct. 9 9 P xs W WPW WM Og B@(&b r J - ,r. Al W. �GF t - 'For dlustratt purposes only Accessories may not be provided with pool A fi �. a • 611A (3];�' Read, understand, and follow alFinstructions carefully'before installing and using thjs prod "'t. L c E UZI x f ' E RV a k0., w ' - r µz ` , For, us purposes may, Don't fotget to by the other Me Itltex products:pools,pool � Duo V)a;"Uc!!o,Continuous i"'Oduc.Wwoverawt tnwx rest+vea e rtgY to c mile spetificeLcum skid 4pjmareace.,M4104 mm s+u1t to"daltes to#ho lnftnw4b"wn"t w►Yiit Pt nottt nom � � [ 1NOW.WSW � t � is s St � � M Read, Understand,ran 1 Follow w all lnstr ictioni ii4 lly`hiii re ` Installing ancimsing this Product. " _�wy■s`i■ S �j For itiustrativ purposes . �t. .� F r, u li ' Y "'s :l"f3S1[$IE' 7 7u l3'tt3S2, •. '^'d1 $"i, .�Y'{"rt txv�rd i} tF T °,a-.P,. x''.,r i w°is 4I' U �,a rIYL. �d. r Y WI ;D :0 © D © 0 The Commonwealth of Massachusetts Department of Industrial Accidents Off ce of Investigations 600 Washington Street Boston,MA 02111 www.mass.govIt is Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly 9 Name(Business/Orp nizatimvbdiviiddua/t): D F. Address: 5� �G —llG� /�1004/ City/State/Zip: OU'►�1 lS ��1 / Phone#: 50r 7^2s Are you an employer?Check the appropriate bon - . Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I_ 6. ❑New construction employees(full and/or part-tine). have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed m the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition 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.] officers have exercised their 11. Plumb' repairs or additions 3�I am a homeowner doing all work ❑ � P [N myself o workers'comp. right of exemption per MGL y p 12.❑Roof repairs ;,mumce required.]t c.152, §1(4),and we have no 13 El other - . —employees.[No---workers'- --- -- - - - --— comp,insurance required.] *Airy 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 afdavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the smb-onntractors and statt tyhether 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 the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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 tine 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 the pains and penalties of perjury that the information provided above is true and correct: Si mature: Date: (— Phone#- COY --775-— 8 official use only. Do not write in this area to be completed by city or town official City or Town: Permit/Liceuse# 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#: V Application Number........................................... Section 9—.Construction Supervisor Name Telephone Number Address City State Z License Number License Type Expiration Date Contractors Email Cell# I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Section'10—Home Improvement Contractor Name Telephone Number Address City State - zip Registration Number. Expiration Date I understand my responsibilities under the rales and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Buuilding Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11=Home Owners License Exemption Home Owners Name: Telephone Number 7 75 - V y 7 3 Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed.Construction Supervisor in accordance with 780 CMR the Massachusetts Stage Building Code.I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. ,Signature, Date, %s-- U!8 APPLICANT SIGNATURE Signature ® ,�.�a � Date 6 —/J__A U/1 J Print Name ALO b 6r-IZ- A6//V Telephone Number, ®�• 7�� �� E-mail permit to: 5 %D 6,619 I? CiJMC _57 )6 T T n..+-.....i..a-.3.1 mnn1 o Section 12—Department Sign-Offs Health Department © Zoning Board(if required) EI Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation For commercial work,please take your plans directly to the fire deparbnent for approval Section 13—Owner's Authorization L , as Owner of the-subject property hereby ° authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) ' Signature of Owner date Print Name 'I Last vadit&-2/92018 4 . _ . .. . �..: - .. ,.-. -. -T - _ ,. yr:a*r p, .. _ _ 5. ♦ _ i' h O T" - /� of o L O . � -roey ,,/ 1 U LcfO 0 7) �2.4f 0_ - ?_ ,i .G. O - ,� /_S` ,r' _ - F. M r I _'.\ - - a Y-. -:. _ :. `: �` U~ .�. .- - /3,.6 GO ' C� - _._ - - " : EE �tT I F I EID PLOT P L A LQCATt.ON i- ., ,��: - SCALE "~s-`3y ATE 1 ,:9 Et E'F E R'E N :`E 3 c%cry t o " %s s _ (, = , S uJ.v; v.v.. G.Q.c o G� ,,cla _ s /s' . - . <'.�'.t�s boa - �o�_ �, ``s7. O4A'T/E j RE. LAND: 5t7 _RVE`Y0R t HEREBY CERTIFY THAT THE 8U`.ILOtNG 2 HnWN' 0 _rh ! S PLAN 1 ' t_ OCATED - 0N T H E G`R O U N D A S `5 H O W N '-- E£R`E O:-IV A ;N D 11 .sti"�C/oT" CON.P...O R M T 0," T H:E - t!1�F MA T H`A T t F abE �. S0 ZQ:N1N.G 8:Y I: AWS: 6F :-TH.E. TOWN OF: ; fir... b , .,re_c%s..TA3G�W H E .N C.,O N S T R U C T E 0 ", \. .: .. _ . o MJOIYAIi BARNSTABLE.: SURVEY CONSULTANTS, 1N`C �'RQ $ ... ST: W'E 5 T Y A R..M 0 U T H M A 5 S �0 � 4 ..4 1., .. . , -- . i. 11 � " .,. . ... . I Town of Barnstable Building �w Post=T.hisCardSo That rt is,U�sibleiFrom the"Street ApprovedPlans Mustkbe,xRetamed onJob and this..Card Must be Kept + flARNSI'AtiS.E.. v a .._ M" PostedUn#il'FlnaClnspectionh , R W,here a,Certificate of Occu anc. �s Requ�red3 such Bu�ldmg shall Not,be Occup�edunt�1 as Fina1 Inspection hasbeen made Permit . „�.�+k„ aan;',. Permit NO. B-18-1929 Applicant Name: Approvals Date Issued: 06/22/2018 Current Use: Structure Permit Type: Building-Shed-Residential-200 sf and under Expiration Date: 12/22/2018 Foundation: Location: 504 OAKLAND ROAD, HYANNIS Map/Lot 272 061 Zoning District: RC-1 Sheathing: Owner on Record: KELLY,ROBERTA F Con,tractor`Name� ,, Framing: 1 Address: 504 OAKLAND RD y aR S Co t actor License A 2 40 HYANNIS, MA 02601 i x Est 1ProJect Cost: $0.00 . Chimney: i Petrt fee: $35.00 Description: 1OX16 SHED Insulation: T°a� FeePa►d $35.00 Project Review Req: Final: Date 6/22/2018 �E - Plumbing/Gas Rough Plumbing: PIP a � Building Official Final Plumbing: J., , This permit shall be deemed abandoned and invalid unless the work aut�hozeby this permit is commenced within sixmont s after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which the permit has been granted. All construction,alterations and changes of use of any building and structures shall bbg in compliance with the local zoning by laws end codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or"road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. � Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire®fficials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work 1.Foundation or Footing Rough: � �.�.•.,; �. , Fes. �� �.������-. - 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection S.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: `Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department ° Building plans are to be available on site Final: ti All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of.Barnstable SME '� Regulatory Services r0`ti Richard V.Scali,Director r % E AMSTABL% „AM g Building Division QED 39. � Paul Roma,Building Commissioner ��„+'�•Op y 200 Main Street, Hyannis,MA 02601 AN 1 www.town.barnstable.ma.us AO 2018 Office: 508-862-4038 f� -Fax 508-790-6230 PERMIT , — — ' . FEE: $35.00 SHED REGISTRATION - RESIDENTIAL ONLY ' 200 square feet or less �o y Dad ahc� aac� ar�r� Location of shed(address) Village �- Property owner's name - Telephone number Size of Shed Map/Parcel# Signature r Date Hyannis Main Street Waterfront Historic District. Old King's Highway Historic District Commission jurisdiction? ,O You must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS.. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN T ' Q-forms-shedreg ^ REV:06/20/16 r 5TQ � r n 1- 1 cvm� sr, � a Legend o, r w b Parcels _ � Railroad 2 77 Town Boundary # 96 + Ra' oad Tracks # 0 Buildi ngs ° Painted Lines Parking Lots 272969 Paved :. 272104. #514 p. `" f un aved #545 , Driveways 0 Paved 4 '. F ;Unpaved "... `. a Roads 0 Bridges' , ., M Paved Roads Un paved v ads Streams Marsh Water Bodies. f \ \ ti �r t: 272183 453 n ,s'i��181 ��� �•, ,�� 4 `R 't 272017 2721P2 #490 u # 2 f 272013 ' O a .�• .................................. . Map printed on: 2/7/2017 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit adequate for legal boundary determination or representations of Assessor's tax parcels.They are Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA 026oi O 42 83 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 5o8-862-46�4 reflect current conditions,and may contain such as building locations. s k. Approx.Scale:finch= 42 feet cartographic errors or omissions. gis@town.bamstable.ma.us Town of Barnstable '1 ,wa t < • rd�So:That,t.as.vis�ble:;:Frorn'.the..Stree �`- , roved Plans Must;be.Retamed on Job anc�.this;Card Must be.Ke t , F µxixsrw�i8; Poper it st - ade . . "._ .. r.Posxed �'y .W.kere a..Cert�ficate df Occ ane'�is Re u�red:such I3urldm sball�Notbe;Occu ied until at;Final�lns,eetlon�has been made Permit No. B-17-1589 Applicant Name: Carl Rebello Approvals Date Issued: 06/05/2017 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date' 12/05/2017 Foundation: Location: 504 OAKLAND ROAD, HYANNIS Map/Lot 272 061 Zoning District: RC-1 Sheathing: Owner on Record: KELLY, ROBERTA F Contractor Name Carl J Rebello Framing: 1 Address: 504 OAKLAND RD Contractor`License .CS-084358 2 ki HYANNIS, MA 02601 � u' Est Protect Cost: $2,909.00 Chimney: Description: Attic insulation &air sealing £? �' Permit Fee: $85.00 Insulation: ., Fee � Project Review Req: Attic insulation &air sealing � Pa'd $85.00� Final: a to 6/5/20 17 Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within si onths after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and theapproved construction documents forwhicFi this permit has been granted. All construction,alterations and changes of use of any building and str' ures sh�all�e in compliance with the local zoning by I awand codes. Final Gas: This permit shall be displayed in a location clearly visible from access streetio'r road5and shall be maintained open for public mspectton for the entire duration of the W work until the completion of the same. + �, f �N r - Electrical The Certificate of occupancy will not be issued until all applicable signatures b�y the Bw dig and,FireOff cials arse provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work. air 1.Foundation or Footing a Rough: r 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed final`. 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final:' "Rersons;contracting whh unregistered contractors do.not have.access to the guaranty fund'.'(as set forth in MGL c.142A). Fire Department " i� Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT II / / EM ALT—L ,SEA Town of BarnstableIT-, " 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-17-1589 Date Recieved: 5/23/2017 Job Location: 504 OAKLAND ROAD,HYANNIS Permit For: Building-Insulation-Residential Contractor's Name: Carl J Rebello State Lic. No: CS-084358 Address: Swansea, MA 02777 Applicant Phone: (508) 567-4109 (Home)Owner's Name: KELLY,ROBERTA F Phone: (774)836-2566 (Home)Owner's Address: 504 OAKLAND RD, HYANNIS,MA 02601 Work Description: Attic insulation& air sealing °uy wa --4 r, a t,i Total Value Of Work To Be Performed: $2,909.00 - tn - `0 5. Structure Size: 0.00 0.00 0.00 M, Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Carl Rebello 5/23/2017 (508)567-4109 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost: $2,909.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 5/23/2017 $85.00 Paypal Paypal ....................._.................................................................................................................................:................................................................_........_:........................................................................... Total Permit Fee Paid: $85.00 v �� �� k ffli THIS r F1' �I x �., i TO 0 ? •.` RN #T ;8J CAPE SAVEQ Weatherization 508-398-0398 December 14, 2011 Town of Barnstable Thomas Perry CBO / Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permits Dear Mr. Perry, This affidavit is to certify that all work completed for permit application#201100874, Status A, Parcel 272061 at 504 Oakland Road,Hyannis,Permit type: RADD, and issued on 2/24/2011 has been inspected by a certified Building Performance Institute(BPI) Inspector. R-18 Cellulose insulation was added to the attic.Walls dense packed with R-13 cellulose insulation. Basement sill insulated with R-19 fiberglass batts.All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map I 2ZZ Parcel Application # Health Division Date Issued oZ 1 Conservation Division -Application Fee d Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address T �L AA Q AD Village N yAxw s s= Owner O Z i1 A,C LAJ Address 4 ^� Telephones Permit Request - 6 <1-A Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation* Tbc,® Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family a Two Family ❑ Multi-Family(# units) Age of Existing Structure I q(A — 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/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 CW6 �54�16/ (BUILDER OR HOMEOWNER) Name W Atck-n Telephone Number --� s 31 L OR Address ffik �11p`— "d A-,w License # Z I G Home Improvement Contractor# I y 113 Worker's Compensation # (.kJ C._ A L 'I ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Z j 4 FOR OFFICIAL USE ONLY r, APPLICATION# DATE ISSUED " 3 MAP/PARCEL NO. ADDRESS VILLAGE ; _ OWNER DATE OF INSPECTION: " FOUNDATION FRAME INSULATION 4 '� FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ti GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. , I1' vff ee of 1nves#ga&m 600 Washington Street Boston,MA 02111 www.masagov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers APD-Hcant Information Please Print Legibly Name(Business/organization/mviduai): 1 e i+ ia-----�.L.+� �l t' ' ." ' CAC tE Address: - i Ci /State/Zi : - atilO Phone#: Are you an employer?Check the appropriate box: 1.al-am a employer with l . 4. ❑ 1 am a general contractor and I Type of project(required): employees(full and/or part-time).' have hired the subcontractors 6. ❑New construction 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 working for me in any capacity. employees and have workers' [No workers'comp. insurance comp.insurances 9. ❑Building addition 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 insurance required.] t c. 152, §1(4),and we have no 12.0 Roof repairst,�{ 3a.❑ I am a homeowner acting as a employees.(No workers' 13. Other :� d general contractor(refer to#4) comp.insurance required,) Any applicant that checks box#1 must also fill out the section below showing their workers,compenmod�ohq id b,,,d. t Homeowners who submit this affidavit indicating they ale doing all work anti theft hire outside.conuactm.must submit a new affidavit indicating sucb: tCoattactors that check this box must attached an additional cheat showing the name of the"-COM�and state whether or not those entities have employee& if the sub-aoanactars have employees,they must provide than wotkers'camp.policy number. I an an employer that is providing workers'compensation insurance for my employees Below is the porky and Job she infonnatiam Insurance Company Name: ir' 4A a-T i S I Ivy UL C r Policy#or Self-ins. Lic.#: tz, Ogg -q 7 n q S Expiration Date: IJd ,.j_ Job Site Address: q O -1C LAVID 90 City/Statetzip:_ ,r� � 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 cert+ijy ender the and pe of pedury that the information provided above is true and correct i u 1t O leial we only. Do not write in this area,to be completed by city or town offlciaL City or Town: Permit(License# Issuing Authority(circle one): I.Board of Health 2. Building Department 3.City/Town Caerk 4.Electrical Inspector 3.Plumbing inspector 6.Other Contact Person: Phone#: III ACC>RH CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ 11 L..� 11/1/20ro10,, : THIS CtRTIFICATE 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 NAMEACT Shannon Sperrazza Risk Strategies Company PHONE (781)986-4400 AACX N :(781)963-4420 15 Pacella Park Drive EADDRES -MAILs:ssperrazza@risk-strategies.com Suite 240 PRODUCER 00018476 Randolph MA 02368. INSURERS AFFORDING COVERAGE 1 NAIC i3 INSURED INSURERA:Seneca Specialty Insurance Co i INSURER a.Keating Group Ins Services f Michael McCluskey, DBA: Cape Save INsuRERc:Chartis Insurance _ 7 C Huntington Ave INSURER D: INSURER E: South Yarmouth MA 02644 INSURERF:. COVERAGES CERTIFICATE NUMBER:CL1011132675 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, j EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. i ILTR TYPE OF INSURANCE N D I I POLICY NUMBER MMfD EFF MM,DO� LIMITS j GENERAL LIABILITY j I ( - j EACH OCCURRENCE ;$ 1,000,000 X j COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED i PREMISES Ea occurrence $ 50,000 A CLAIMS-MADE I X 'OCCUR IhAG1002608 110/16/2010 10/16/2011 U I MED EXP(Any one person) is 10,000 PERSONAL&ADV INJURY $ 1,000,000 i I i I GENERAL AGGREGATE i$ 1,000,000 GE N'L AGGREGATE LIMIT APPLIES PER: i I ( i PRODUCTS-COMPIOP AGG $ 1,000,000 I X POLICY ;PRO + LOC I i i $ I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT _�ANY AUTO I I6208200 ill/6/2010 41/6/2011 (Ea accident) $ 1,000,000 BODILY INJURY(Per person) "$ I ALL OWNED AUTOS XX i j ( BODILY INJURY(Per accident) $ SCHEDULED AUTOS I — �- PROPERTY DAMAGE HIRED AUTOS j (Peraccident) $ NON-OWNED AUTOS X '.UMBRELLA UAB OCCUR ; EACH OCCURRENCE ;$ 1,000,000 EXCESS UAS ',-1 CLAIMS-MADE i AGGREGATE is 1,000,000 DEDUCTIBLE i i j } !$ B I RETENTION $ { 023578601 40/16/2010i10/16/2011i I$ C WORKERS COMPENSATION chael McCluskey x WC STATU- i ;OTH-i AND EMPLOYERS'LIABILITY Y/N j i TORY LIMITS ER 1 ___ (ANY PROPRIETOR/PARTNERIEXECUTIVE I 9 excluded from coverage' i E.L.EACH ACCIDENT '$ I OFFICER/MEMBER EXCLUDED? yE N/A I 500 000 i(Mandatory in NH) 9930951 110/21/2010 10/21/2011(E.L.DISEASE-EA EMPLOYE$ 500,000 If yes.describe under i; L + DESCRIPTION OF OPERATIONS below { i E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Issued as evidence of insurance. Contractors-Executive Supervisors or Executive Superintendents. CERTIFICATE HOLDER CANCELLATION (508)790-2425 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Housing Assistance Corp ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Ruth 460 West Main Street AUTHORIZED REPRESENTATIVE Hyannis, MA 02601-3698 Michael Christian/SMS `''"''4 % 'f• " ACORD 25(2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025 poosos) The ACORD name and logo are registered marks of ACORD I . < r en _,.� s,, Office of Consumer Affai s and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 164432 Type: Supplement Card Expiration: 1 016120 1 1 CAPE SAVE WILLIAM MUCCLUSLEY 8201 S. HQURD CT CHAPEL HILL, NC 27516 Update Address and return card.Mark reason for change. Address Renewal Employment i" Lost Card %t.L �cavrtr:�n;=.•��x_fz�l�•��',.l�assr,!'�rr�sct�•d:3 i 1 r Office of Consumer Affairs&Business Regulation License or registration valid for individul use only r HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to; ;, Office of Consumer Affairs and Business Regulation ^' Registration: 164432 Type: 10 Park.Plaza-Suite 5170 Expiratlorlc.,1002011 Supplement Card Boston,MA 02116 CAPE SAVE WILLIAM MUCCLUSLEY: . { '� .7C HUNTING AVE.: - °�-S.YARMOUTH,MA 02664 Undersecretary Not valid wit ou signature �l.tt.Ffi'ltlleif�, Department of public "Atj'% " Board of 131tildint-, Rt'-nit ttilrrn• and '�Tmldards .. _-.:;".r'.id''..e;.C.. . �ia"z.`t.�,.,$Gr • ?t;'Y3t.. ......... ..�..> . 41icense: CS SL 102776 Restficted tr). IC _ r•„�„ '.PAS'!: •. I WILLIAM MC CLUSKY 37 NAUSET ROAD . ' WEST YARMOUTH, MA 02673 Expiration: 6/2812013 ri=: 102776 EA Town of Bax nstable Regulatory Services STAB/ Thomas F. Geiler,Director 'TE1 MA.IN, SiAldina Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,M-A 02601 ,Aiv-vs,.town.barnstable..ma.us Office: 508-8 62-403$ Fax: 508-790-623 0 Proper,, Owner Must Complete and Sign This Section If UsinLy A Builder . r as 0- ner of the subject property hereby T authorize ) ; P i ? to act on my behalf, m all matters relative to work aut4ori7',,ed by this building permit application'for: (Addxr-ss of Job) i Ature of C)V& Date C I- �E T4 L) Pant Name t If Property Qvwner is applyin�'for pen- it please complete the Homeowners License Exemption Form on the reverse side. , •ter- § .. Q:FOR AS:0VYN R:ifSSiO*3 R