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HomeMy WebLinkAbout0290 SEA STREET ago sin sr � � wl OFaFt4E'Tl it=y ty � � , f .' y L4 R 3 1 b�[if 1. E t aland ComrnercialtBuilder a � EA fIZATtON,S -UI °q s '1l v ,MA � March 15, 2014 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main Street Hyannis, MA 02601 RE: Insulation Permits Dear Mr. Perry,. This affidavit is to certify that all work completed for permit application#201305095;Status A; Parcel 306089 at 290 Sea Street, Hyannis, MA; Permit Type RADD and issued on 12:00:00 AM has been inspected by-a certified Building Performance Institute(BPI) inspector.All work performed meets or exceed Federal and State requirements Sincerely, Michael McCarthy McCarthy Construction � _ J i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATIO q,� Map Parcel Application # Health Division ". ` Date Issued co t Conservation Division Application Fee Planning Dept. ermit Fee 3 Date Definitive Plan Approvedy g b Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address �;L/U Village Owner la Address oN�-- Telephone ?�G Permit Request 1511 Cf-(/kn IM, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type 1CCy Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family U/ 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 om Count 1— ca Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other W kAJ CD Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wo d/coal stgve: 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: C:) n 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 r, mom McCarthy, unatmethm Address PO BOY 52 License # West Venn IS9 Cell (508)280-6964 Home Improvement Contractor# C L- HIC-169393 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 7I3 I �y. f FOR OFFICIAL USE ONLY } APPLICATION# DATE ISSUED MAP PARCEL NO. ADDRESS VILLAGE _ a -OWNER4. :5 c Zw Rew DATE OF INSPECTION: FOUNDATION ,. jf FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL A FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The,Cammtmysmlth of Massachusetts Deparment of Indlusirial Accidents QKwe of Investigations +600 Washington,Street Boston,MA #21.1I wrew.massgo ldia Workers' Compensation Insurance Affidavit: Builders/C;o ctors/Electriciansd%mbers Applicant Information ;1kA Mceskrthy CoustructiomMease Print Legibly Name(sinsmexslorgatioa/Individual): PO Box S ,. Address: Cell(50$�Z$0-69b!� , CSUsM633 City/State./Zip: Phone#: Are you an employer?Cbeck the appropriate box Type of project(required): . am a co 1._El I am a employer with 4 ❑ I contractor and I 6_ []New boa loyees(full and/or part-time).* have aired the sub-contractors 2. I am a sole propr for or partner- listed on the.attached sheet. 7- El Remodeling strip and have no employees These -oontractors have 8. ❑Demolition e and have workers'. working for me in any capacity. °'per 9. ❑Building addition [No workers'comp_inswance comp.insuratnee_I 5. ❑ We are a corporation and its 10_❑Electrical repairs or additions required-] officers have exercised their 11. Plumbing 3.❑ I am a homeowner doing all work ❑ bi g repairs or additions myself [No workers'camp_ right of exemption per MGL 12❑ repairs insurance required.]F c. 152, §1(4} and we have no 1, employees [No workers' 13. ther comp-insurance required-] ;Azy:applicM&SI checks box#1 mast also fill out the section below showiuz flL&wows'oomPensatiaa P©kT ia€arMXtJ - Ekmuwsvnm who submit flm affidavit i&csting they ure domg all waalt end then hue oaW&comxactors mail sabwi s new affidavit indicating sack_ ZCantractors Saar check this.boar must attached as addmnnal.sheet showing the name of the sub-courtx camas.and:state whetlm ornot tbare entities have employees. If the WVcontmctars bave employees,they mast provide their workers'comp.policy number. I am an employer that is providing workers'congwasddan insurance,jar rrry employeaL Below is thepolic arcd job ate informal an. Insurance Company Name: Policy#or Self-ins.Luc.#: Expiration Date: Job Site Address: .9-7 c) City/State/Zip: V1, Attach a copy of the workers'compeuzation 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 vioWor. .Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA coverage verification_ . RR I do hereby certify a t poi a realties of irry that the information pravi&d above is hue and correct e: Date: 34 Phone M Official use only: Do not write in this area,to be completed by city or to"M effrciaL City or Town: PermitUcense# Issuing Authority(tdrele one): 1.Board of Health 2.Biding Department 3.CigfFown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• 6 o- l 5 OWNER AUTHORIZATION FORM t �. CeAn, j is) (Owner's Name) owner of the property located at v (Property Address) (Property Address) hereby authorize r (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. 04 Owner's X Date t i 4 i j d1/e`�poawntootcueaNz.o� aaaac/c�aeCGi, License or registration valid for individul use only Office of Consumer Affairs&Business Regulation g _= OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: ;.,169393 Type: Office of Consumer Affairs and Business Regulation - — xpiration:,-;_6/1.6%201-&, Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 MICHAEL MCCARTHY MICHAEL MCCARTHY� x, � c y r i 6 RANGLEY LN. SOUTH DENNIS, MA 02660 -'>"'' - a Undersecretary Not valid without signature i I r Massachusetts -Department of Public Safety Board of Buildin g Regulations and Standards i. Construction Supern'isor License: CS-058633 - ' MICHAEL J Me CAR1?HY dam� PO BOX 52 W DENNIS?,AA 070 f Expiration Commissioner I ' 04/10/2014