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HomeMy WebLinkAbout0094 RIDGEWOOD AVENUE y TIP � . Cape Save Inc. t 7-1) Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 sUIL01 1C ``` ` 5/29/17 JUN TOWN 0� Thomas.Perry CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 RE: Insulation Permit 17-1139 Dear Mr. Perry This affidavit is to certify that all work completed for 94 Ridgewood Ave,Hyannis has been inspected by a third party Certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey f Ail�e � an Town of Barnstable N -*,, i ' 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-17-1139 Date Recieved: 4/20/2017 Job Location: 94 RIDGEWOOD AVENUE,HYANNIS Permit For: Building-insulation-Residential Contractor's Name: WILLIAM J MCCLUSKEY State Lic. No: CSSLA02776 Address:. West Yarmouth, MA 02673 Applicant Phone: (508) 398-0398 (Home)Owner's Name: BUCKLER,BRUCE Phone: '(774).278-1927 (Home)Owner's Address: 34 BERRY AVENUE, WEST YARMOUTH,MA 02673 Work Description: Add R-19 and R-30 cellulose to the attic_.Add R-19 fiberglass to the basement.Air seal the attic plane and basement with expanding foam. Total Value Of Work To Be Performed: $51000.00 . Structure Size: 0.00 r 0.00 0.00 cn Width Depth Total Area .� r` rr, . 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: William Mccluskey 4/20/2017 (508)398-0398 Applicant _ Date _ Telephone No. Estimated`Construction Costs/Permit Fees Total Project Cost : $S,OQO.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 4/20/2017. $85.00 X} {-XXXX-XXXX- Credit Card. w 0299 ...,...... .........,, ....... ....... ...„.......... . Total Permit Fee Paid: $85.00 r' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION r 3 Map Parcel l Application Health Division Date Issued ' 27—/'.S r� Conservation Division Application Fee Planning Dept. Permit Fee (o® -.d Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address /// K w©®0 -i2,_ s5 Village 5 Owner k&) ��' G��� Address &60ex Telephone Soq-�-� 5977 Permit Request ghowe- /pUfC 6+ we PLI -/-14 1110 61z Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio&4 klt)I ckJ Construction Type i•-0ug �✓dU#u-� Lot Size 5.,;LQ 5k Grandfathered: ❑Yes ❑ No If yes, attach supporting documgn,`tation. Dwelling Type: Single Family p�-- Two Family ❑ Multi-Family (# units) ^ Age of Existing Structure Historic House: ❑Yes 4415 -On Old King's+Highway: :❑Yes Basemen+Type: II ❑ Crawl ❑Walkout ❑ Other t Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Y; Number of Baths: Full: existing new Half: existing new�­j Number of Bedrooms: existing —new Total Room Count (noLLJ includiinn baths): existing new First Floor Room Count Heat Type and Fuel: Oil ❑ Electric ❑ Other Central Air: ❑Yes i9..Alef Fireplaces: Existing New Existing wood/coal stove: ❑Yes E h o 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 (BUILDER OR HOMEOWNER) , / Name ��� �✓ Telephone Number o� d�7r d 6 � Address 3 1 dr. G9� License # (GCS '%( Home Improvement Contractor Emaily O�� i�`� 7.� t�(��� ,co^ Worker's Compensation # C066-56-0 56 l311V J01,f* ALL CONSTRUCTION DEBRIS RESULTING FROM THIa PROJECT WILL BE TAKEN TO SIGNATURE DATE IX3 ` FOR OFFICIAL USE ONLY APPLICATION# i DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING .t DATE CLOSED OUT a, ASSOCIATION PLAN NO. • �N of M� �0?3V DONALD S�cyN CE U �71ONCEVICZ y AIAP 32 p No.20487 is z.3'99 2. - FSS/ON L J _ v u �/ PORCH ov , .$'K 'TCH IH aFM,Iss �i2OPO.Sp POOR A1.T �C.4T"lAV o OONALD cyc 4..54 4VAOG 4P, A VO, g W` o MONCEUICZ 90 GISRE r Donald W. Moncevicz, P.E. Civil Engineer 40 Pond Street West Dennis, MA 02670GfJ' .� O y i .� rSi Q� e , J � r - } � o P�� ��d-�c, 1•f �?�4 t=n�✓yi� -)�3rz� L-77 4."e.w t=l owt -51 r i _ 4L Town of Barnstable Regulatory Services nsass Richard V.Scali,Director 1639. '�Eo►ru►'�' Building Division Tom Perry,Building.Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, 4eilea- S'; ��� e� ,as Owner of the subject property hereby authorize )4�1-427L j�,� to act on my behalf, , in all matters relative to work authorized by this building permit application for. (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. -'' Ze Signature oflOwner nature of t Print Name IV=Name Date Q:FORM S:O WNERPERNIISSIONPOOI.S Town of Barnstable Regulatory Services �oFTKE roty,4 Richard V.Scali,Director Building Division t Tom Perry,Building Commissioner asAss. 4Q� 1639. ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable ma us Office: 508-862-4038 ' Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: — — JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- 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 Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code gn p ty p g and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner 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 the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." s • Many homeowners who we exempfion,are�unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations.for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner 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 t amend and adopt such a form/certification for use in your community. Q:\WPF=\FORMS\building permit fomis\EXPRESS.doc Revised 061313 Dep�nfln�ur�al�4cciderz€s . •� ke of Tstve zg�iaxs. 600 WasAbivorc Street :- .Bosto74 ham[02J11 i • xJww_m�ssgavldi¢ Workers' Compensation Insurance AMdaviL-BtaZders/Con4xacfor&lIIectricians/Plmnbers Appficant Information Please Print Le gffily R 1 Name( 1org im b&idn D.. "App 1,J 64k, O-q Mdiess:-32 - C�Cy/Sfa#elT�p: {-•ea`�ti��.e, t�'I �3 Pjlone#: �D��b`�— � c'���Q Are yotz au employer?Check ffie appropriate bow. e of ro ect 4. I am a Z`SP P I ( : 1.❑ I am a with c ❑ general contactor and I � ( or part--fie).* Ise hied die sob- 6• L�`��cousiractian 2_[Q I am a sole prBprietor or partner- listed on the attached sheet 7. Q Rt�adeaag ship and have no employees' These sob-co�-auto.rs have g_ wozdag fnr me is any capacity. employees•and have workers', [NO world='comp.insfn•�mce comp_incr CC 9- El B�Idmg addifinn ' regoired j 1 5. El we are a corporafion and its 10.❑Electrical repairs or additions 5.ElI am homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself[No workers'comp: of exemption per MGL 12.Q Roof repairs in�ereqlin-ed,jt c..152, §1(4),andwe have no employees.jNo warkQS' 13•❑Other _ comp.ins t regviredj ' *Any.applicaat that chocks box#1 mast also iM ovt Sic section below showing Sieirwo6=,compensation policy mfhnnation. f Hemeovvaeis who submit this afndavit mdicatiag they iris doing aU work and then him outidz comma must subm t a new afbdavi t indieaiing such fCodoidnis that check this box mast aftachcd an additional sheet showing Sic name of the sub-=Xt-t m3 andxbd--gthcfficr or not these ratifies have coPIoyces-If the s- coabactnrs have a ployeq they mvstprovide their wotices'e3n3p.policy r Cc lam an arpIayer dzaf is pruKLErzg workers'carnpamadon hz=zranry faring ernpL7yam Below is tb,.e poFiry,mzd job sites znfornzadon- Insoz-ance Company Name:y j d c � /W Policy#or Self-ins.Lic.#:: "f� /� irafion Date: • Job Sit:e Address: L7 /l'J �/✓ We�P Cftyl 1 ' Attach a copy of the Workers'compensation policy declaration page(showhzg the poTicyntmmmabe and a lion date). Failure to secure coverage as requited ender Section 25A ofMGL c.152 can Iead to the imposition of eamal penalties of a fine up to$1,500.00 andlor one-year imprisonment;as weII as civil penalties m the farm of a STOP WORK-ORDFR and a fine of up to$250.00 a day against the violator. Be advised that a copy of this staiameutmap be fnrw�arded to fat Office of Iuvestigaiions of the DIA for insurance coverage v�fication. I do her, the penalties afperlury tFzat the inforazafioa pravided above is and correct S �� L I3aiE: • Phone a — 6,�l Ofjzcirrl use only. Do not write in this area to be coarpldfed by aty or town 017zdxZ City or Town' - Permitll�icense# Tsimka Atrthodty(drde,one): L Board of Health 2.Buil3mgDepartrueizt 3. CifylTown Clerk 4.Elect ric aInspector S_Plumbing Inspector 6 Other Cgnfact Person• - Phone " litf0rIl1atiQIl and Ma ecacrhi setts General Laws chapter 152 reggaes all employers to provide wo±ers'camp=sahaa for their employees. ' Pursuant to thiis siatlrte,as=Tfoyee is defined as"_every person in the service of another rider auy contract of hire, express or implied,oral or w&teo_" An employer is defined as'an individual,partnership,association,corporation or other'legal entity, or any two or Marc of the f n-egomg engaged in a joint enixprise,and including the legal represertatives of a deceased employe:;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartinm s and who resides therein,or the occapart of the dwelling house of another who employs persons to do maintenance,construction or repay work on such dwelling house or on the grounds or buRdmg appartmant fheret o shall not because of mach employment be deemed to be an employer." MGL chaptnr-152,§25C(6)also states that"every state or Loral Hcemmng agency shall withhold the issuance-or renewal of a license or permit to operate a business or to construct buildings In the common-Wealth.for any applirantwho has not produced.acceptable evidence of compliance with the ins-aranre coverage required." Additionally,MGL dnpla 152, §25C()stems`Neither the cunanoawealfhnor any of its political subdivisions shall enter into may cantaet fir the performance of public work u o±U acceptable evidence of compliance wifh the m m.7a ce rep ezrts of this chapter have been presented to the contacting aUhorhy." Applicants Please fill out the workers' compensation affidavit completely,by ch liking the boxes that apply to your situation and,if necessary,supply sab-conizactor(s)name(s),address(es)and phone mmnber(s)along with their certfficat:(s)of insmsnce. limited Liability Companies(LLC)or Limited LiabiIity Partnerships(LLP)with no employees other than the members or p artaers,are not regtm ed to cant'workers' compensation io=nce. If a a LLC or LLP does have_ employees, a policy is regded. Be advised flat this affidavit maybe subm_�to fie Department of Industrial Accidents for confmn ation of in.¢rnance coverage. Also be sure to sign and date the affidavit The affidavit should be resumed to the city or town that the application for the pemait or Icense is being requested,not the Department of lndnsb ial Accidents. Should you have any questions regarding the law or if you are required tb obtain a workers' compensation policy,please call fbe Department at the rammber listed below. Self-insarrd companies should enter their self-insurance licenseuamber on the appropriate line-: City or Town Officials Please be sure thud the affidavit is complete and printed legibly. The Departmeat has provided a space at the bottom of the affidavit for you to fill out is the event the Office of Investigations has to contE ct you regarding the applicant Please be stye to fill is the per =license munber which will be used as a reference number. In addition,an applicant that must submit multiple pcunwlimnse applications in any given year,need only submit one affidavit indicating current policy infoz 3 a Dn(if necessary)and under`Job S:fto Address"the appliamt should write"all locations in (city or town)_-A copy of the affidavit that has been officially s m:Lped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is an file for furore permits or licenses. A new affidavit must be filed out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venue 'CLe. a dog license or pem dt to bum leaves etr_)said person is NOT required to campy this affidavit- The Office of I vestig cations would Irke to tick you in advance for your cooperation and should you have may questions, please do not hesitate to give us a call Me Departmenf's address,telephone mid fax nTnnbtz- This Gommonj ae lth of Massachu== Deparfmmt of la&mizial Ac;Udmts - Bo MA 02111 Tf.L#617=727-49GO ext 406 or 1-M MA-SSA E Fax 4 617-727 7749. Revised.4-24-a7 ��fdia: - R , NOTICE NOTICE TO ` = TO i {z EMPLOYEES �� `��� . �� /a� EMPLOYEES The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22, & 30, this will Giveent you notice that I (we)have provided payment to our injured employees under the above mentioned chapter by insuring with: Associated Employers Insurance Company NAME OF INSURANCE COMPANY P.O. Box 4070 Burlington, MA 01803-0970 a ADDRESS OF INSURANCE COMPANY WCC-500-501 31 1 4-201 5A 03/24/2015 -03/24/2016 POLICY NUMBER r EFFECTIVE DATES PO Box 355 Chagnon Insurance Agency Inc West Yarmouth, MA 02673 (508)807-0380 NAME OF INSURANCE AGENT ADDRESS PHONE Appleton Construction 37 Baird Way Centerville, MA 02632 EMPLOYER ADDRESS 01/16/2015 DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be"given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY r HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER »- e�rlxxr/uua3 i ,� License or registration valid for individul use only �Icc�TGcU�rrn7rtvrrtuerz�l�n�C�il�: . before the expiration date. If found return to: A._ Office of Consumer Affairs&Business Regulation ° OME IMPROVEMENT CONTRACTOR Type. Office of Consumer Affairs and Business Regulation egistration: e, 03218 Suite 5170 pBA .� 10 Park Plaza- xpiration 7/.6I2016 Boston,MA 02116 M > APPLETON CONSTRUr TIUN� i Peter Appleton � �i. # s4 j. 37 Baird Way Centerville,MA 02632 s,. 'find " . valid with Sig ature Massachusetts -Department of Public Safety _ Board of Building Regulations and Standards Construction Sgpen-isor - License; CS-005414 - PETER J APPLETbN 37 BAIRD WAY_ CENTERVILLE MA 02632 jr Expiration J.G.• - - - Commissioner 06/08/2016 ' .,•r"��.,,_,�„-..,,n,,,�...�.r."•. -yam.,r�,� r"" •'/,. .,,i/�(,Ct06[LCILUAG�.C.b - .«:.:1-- _ �an.,T&arrzm�fYirc���r/f-a� License or registration valid for individul use only Office of consumer Affairs&Business Regulation before the expiration date.,If found return to: �t OME IMPROVEMENT CONTRACTOR Type: Office of Consumer Affairs and Business Regulation egist[atron 103218 '" 10 Park Plaza-Suite 5170 expiration 7L6/2016 3 DBA Boston,MA 021.16 APPLETON CONSTRUr TION � } Peter Appletoni 37 Baird Way Scretary Centerviile,MA 02632 F, Und { �' -=-t valid with sig ature Unrestricted-Buildings of any use group which contain less than•35,000 cubic feet(991M )of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DP5 Licensing.informationvisit: wwW.Mass.Gov/DPS>' QUITCLAIM DEED I, Charles W.Buckler,of 181 Elliot Road,*Centerville, Massachusetts for consideration of one dollar($1.00)paid,grant to Charles W.Buckler, of 181 Elliot Road, Centerville, Massachusetts 02632, and Bruce Buckler of Valley.Brook Road, Centerville, Massachusetts 02632, as Tenants in Common, with QUITCLAIM COVENANTS the following described parcel of land with the buildings thereon situated in Barnstable (Hyannis),Barnstable County,-Massachusetts, together with the buildings thereon, , being LOT 14 shown on plan of land in Hyannis,Barnstable,Massachusetts,belonging to Ernest S. Bradford,Ralph H. Bodman&r Frederic F. Scudder,filed in Plan Book 36, Page 53,of the Barnstable County Registry of Deeds,more particularly bounded and described as follows: WEST -F 'by RidgewoodAvenue,there measuring Fifty(50)feet; NORTH I by Lot no. 13,as shown on said plan, there measuring One Hundred(100)feet; EAST by Land of R.H.Rodman et al,theremeasuring Fifty (50) feet; and SOUTH by Lot No. 15, as shown on said plan,there measuring` , One Hundred(100) feet. Containing 500 square feet of land. The above conveyance is made subject to and with the benefit of all ri ht's,�ri, , hts of wa g g Y easements,restrictions and reservations of record insofar as the same are in force and applicable. The.streetaddress ofthepropertyis•94RidgewoodAvenue,Hyannis,MA 02601 i DE D r, I, Maribeth King, as Execu rix of the Will of ' Margaret C. { Simonson, late of 94 Ridgewood Avenue, Hyannis, Barnstable County, Massachusetts, by power conferred by said Will, filed with the` Barnstable Probate Court, Docket Number 96P-1868-EP-1, and by every other power, for consideration paid'of Sixty Thousand ($60,000 .00) Dollars, grant to Charles =:W. Buckler, of- 181 Elliot' Road,, . Centerville,' Barnstable County, Massachusetts, individually, with QUITCLAIM COVENANTS the land in Barnstable (Hyannis) , Barnstable County,. Massachusetts, together with-the buildings thereon, being LOT 14 shown on plan of land in Hyannis, Barnstable, -Massachusetts, belonging to Ernest S. Bradford, Ralph H. Bodman & Frederic F. Scudder, filed in Plan Book 36, Page 53, of the Barnstable County Registry of, Deeds, more .., P. particularly bounded and described as follows: WEST by Ridgewood Avenue, there measuring Fifty (50) fee; NORTH by Lot No. 13 as shown on said plan, there measuring oo� One Hundred (100) feet; a 92 EAST by land of R.H. . Bodman et' al, there measuring -Fifty (50) feet; SOUTH by Lot No. 15, as shown on said plan, there measuring ,e One Hundred. (100) feet. Containing 5,000 square, feet of land ° The above conveyance is'made subject to and with the benefit of all, rights, rights-of way, easements, - restrictions and reservations,'of record insofar as the' ame are in force and .applicable. For title see deed from John D. Simonson dated December 24, .1985 and recorded in Book. 4866, `Page 250.,, Witness the execution hereof under seal this 27th day of May, 1997. - Kind, as•-E�ce_ct�rix -