HomeMy WebLinkAbout0697 SCUDDER AVENUE �114E r 0— 2 — 5
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Application Number...!..........................':....'.........�..............
* BARNSTABLE, RR
.P MASS. $ Permit Fee.................................Zoning District...'.`.F.-(..........
i63q �0
RFD IiAA'1 A
TotalFee Paid............................................................... ......
TOWN OF BARNSTABLE Permit Approval by.................................On...........................
BUILDING PERMIT
Map....... ��.....................Parcel.....Q..6—L...........................
APPLICATION
Section 1 — Owner's Information and Project Location
Project Address q77 5_c u dd a- Ave— Village f)-
Owners Name Z131ti'A� n-.N t L L
Owners Legal Address 2 a 1 1<11kLi! Air- f?y u55 0 rL 1) 5'v t�L 5 o
City P-(s p N 0VL 0, State Zip M p 0
�l,�NCfLS I�c,o
Owners Cell# 5 p -2.54 y 9 Z 7 E-mail SC 0 � rj c I 1 I L L 1*► M� 1
Section 2 —Use of Structure
Use Group ❑ Commercial Structure over 35,000 cubic feet
❑ Commercial Structure under 35,000 cubic feet
)P_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 ❑ Foundation Only
Other—Specify t:Vt. rju'V-i V1,JV01,S{4N 6✓Ovk
Section 4 - Work Description
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Last updated: 12/1/2020
Application Number....................................................
Section 5 —Detail
Cost of Proposed Construction 0)l d 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
0"Pliumbing ❑ Gas ❑ Fire Suppression
Heating System ❑ Masonry Chimney ❑Add/relocate bedroom
Water Supply ❑ Public ❑ Private j
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 updated: 12/1/2020
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Application Number... ..I.......:.... ............
Section 9-Construction Supervisor
Ntnne Ri'L kSri-1 C-1 r`t— Telephone Number-b/7-
Address 2 a/cd-Fb r'zSl'( } City 44 1 h o-i State k4,. Zil 1 0 /19¢9
License Number License Type CS Expiration Date 1 2
Contractors Email tit kC Q P4-r na.y Co ns 'u C}7ov�.c o.�y cell# 6 /7, 2"-9.1,-9
I understand my responsxbilitics under the rules and regulations for Licensed Construction Suparvisov in accordance with 780
CUR the Massachusetts State Building Code. I understand the con.�tniction inspection procedures;suceific inspections and
documentation required by 780 CUR and the Town of Barnstable.Attacb a copy of your license.
Signature � Rate
i
Section 10-]Home Improvement Contractor
Name b&s ki t �i nS7�7vG aH Telephone Number
Address/D_5' d a t S,� City /act w b h State M a . zip D z 4<0 4-
Registration Number 14 191;- Expiration]late
I understand my responsibilities under the rules and regulations fbr Home Improvement Contractors in accordance with.780
CMR the Massachusetts State Building Code. I understand the construction inspection procedures,sc)ecific Inspections:sud
documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C...
Signature -0fz012d.Date
Section 11-Home Owners License Exemption
Home Owners Name:
Telephone Number Cell or Work dumber
I understand ray 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,si lecitac inspections and
documentation required by 780 CMR and the Town of Barnstable.
Signature, Date
APP LICANT SIGNA�'URM
Signatw-e Na j Itate 9 z) Z 0
Print Name— t L 1C*/4r Telephone Number (017 S'J 7-'9-PO
E-mail permit to. /l (P d-Par h C 0 14 S AUCf-)01,, r "1(-4
r Last undated: 111152ot R.
Section 12 —Department Sign-Offs
Health Department ❑ Zoning Board (if required) ❑
Historic District ❑ Site Plan Review(if required) ❑
Fire Department ❑
Conservation ❑
For commercial work,please take your plans directly to the fire department for approval.
Section 13 — Owner's Authorization
I, ,�_ � a-ti LL , as Owner of the subject property hereby
authorize U b.?r-Nn..1 to act on my behalf, in all
matters relative to work authorized by this building permit application for:
(Address of job)
Signature wner date
Print Name
II
Last updated: 12/1/2020
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washingtoiii Street
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit; Builders/Contractors/Electrci11 ans/Plumbers
Applicant Information Please Print Legibly
g, J ^
Name(Business/Organization/Individual): C(3fiY na" UPS l�Lt nt?,ST7 o e h t ati: rl
Address: 12 3
City/State/Zip: A)rt uj h o /�z, 444-Phone,#: 617 Z¢-3 -3,�-
Are you an employer? Check the appropriate.box: Type of project(required):
I.v-`I am a employer with 40 4. I am a general contractorand I 6. New construction
employees(full and/or part-time).* - have hired the sub-contractors
2. I am a sole proprietor or partner- listed on the attached sheet. 7.w _Remodeling.
ship and have no employees These sub:contractors have 8:. Demolition`
working for in any capacity: employees and have.workers'
com insurance.$ 9. Building addition
[No workers' comp.insurance p
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 1 L Plumbing repairsor,additions
myself ' right of exemption per MGL
y �o workers comp. 12: Roof repairs:
insurance required.] t e. 152, §1(4),and we have no
employees. [No workers' 13. Other'
comp..insurance required.]
"Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractorstmust submit a new affi davit`indicating`such:
tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities'have
employees. If the sub.-contractors have employees,they must'provide their workers'comp,policy number,
lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: LIAdr:� LCT f i.a. .t
` Policy#or Self--ins'. Lic.# lv 53!s 612 8:�- a 0/07 ;Expiration Date:
I Job Site Address: 6,97 Se K dWd,, Ild City/State/zip;.//V&Yln S, "a,
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 imprisonmcht,.as.well as civil penalties in!the fori m of a STOP WORK ORDER and a.fine
of up to$250.00 a day against,the violator. Be advised that a'copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
1 do hereby certify under the pains awnd,peAnalties of perjury that the information provided.above is true and correct.
4 Signature: Date; 49/ZO,A C7`
Phone#:;
Official use only. Do not.write in this area,to be corlipleted.by eity;or tiiwn`official.;,
City or Town: Permit/[acense#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical'Inspector 5.Plumb_ing Inspector
6,Other
Contact Person: Phone#:
�` ' ►.$ Town of Barnstable Building
Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept Posted
�MAR%63 Until Final Inspection Has Been Made.
e,�..,�
wud Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit
Permit No. B-20-2993 Applicant Name: EPERNAY DESIGN&CONSTRUCTION LLC. Approvals
Date Issued: 10/29/2020 Current Use: Structure
Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 04/29/2021 Foundation:
Residential Map/Lot: 287-062 Zoning District: RF-1 Sheathing:
Location: 697 SCUDDER AVENUE, HYANNIS Contractor Name`:-,,EPERNAY DESIGN & Framing: 1
Owner on Record: GRIGGS,ELLEN W TR CONSTRUCTION LLC.
2
Address: 201 KING OF PRUSSIA RD STE 501 ' __.Contractor License: 146912
RADNOR, PA 19087 i Chimney:
Est. Project Cost: $35,000.00
Description: UPGRADE BATHROOMS& KITCHEN REPAIR DECKING- MAIN HOUSE Permit Fee: $228.50 Insulation:
Project Review Req: F Fee Pad $228.50 Final:
Date: 10/29/2020
`'`��,,��CYJ•�sVv�.� 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 six months after issuance. Rough Gas:
All work authorized by this permit shall conform to the approved application and the approved construction documents for whichIthis 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`and codes. Final Gas:
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained ope,n'for public inspection for the entire duration of
the work until the completion of the same. i _ ___�_ __ �—` f Electrical
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service:
Minimum of Five Call Inspections Required for All Construction Work: f
1.Foundation or Footing Rough:
2.Sheathing Inspection Final:
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough:
5.Prior to Covering Structural Members(Frame Inspection)
6.Insulation Low Voltage Final:
7.Final Inspection before Occupancy
Health
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final:
Work shall not proceed until the Inspector has approved the various stages of construction.
"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