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HomeMy WebLinkAbout0018 TANAGER ROAD� /'3 ��r..ss� 1;p - - - - -- -- � �M TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # aD13 60 Q3 7 Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit FeeQ Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address \0\ (� Village Owner _ Address N670ZNv\Lj-f­ R� Telephone n \ n Permit Request CQ. 065f= ]f\ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation W� GV 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 _ „? 4� Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal'stove: ❑=Yes q-.No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ newD 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 C `iver a Telephone Number ' W_�3_�"' Address ��16 il.011��c !�U SlniC License # Sct,rAui 1 , /AAA 6A. s3 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE I I w 3 FOR OFFICIAL USE ONLY s APPLICATION# DATE ISSUED t MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL x PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Print"_Form { Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual):CONS ERVE ENERGY INC. d.b.a CONSERVISION ENERGY Address: 376 ROUTE 130,SUITE C City/State/Zip:SANDWICH, MA 02563 Phone#: 508-833-8384 Are you an employer?Check the appropriate box: Type of project(required): 1.® 1 am a employer with 6 4. ❑ 1 am a general contractor and I employees(full and/or part-time). * have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling shipand have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity, employees and have workers' comp. insurance.' 91 ❑Building addition [No workers'camp.insurance p• required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all'work officers have exercised their I I.❑Plumbing repairs or additions myself. [No workers'comp: right of exemption per MGL 12.❑Roof repairs insurance �..re uired t c. 152,§1(4),and we have no q _ employees.[No workers" 13.91 OtherWEATHERIZATION comp,insurance required.] Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit 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: SELECTIVE INSURANCE COMPANY OF THE SOUTH Policy#or Self-ins.Lic:#:WC7956539 Expiration Date;3/15/93 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. 1.52 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 ce!pjl under the Lains and Eenalties o er'u that the in ornrat/pn provided above is true and correct. Si ature Date• il 0 11:3 Phone#:508-833-8384 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1..Board of Realth 2.Utiilding Llepartnient�3.City/Town Clerk 4.Electrical Inspector 5.Plumbing inspector 6.Other Contact Person: Phone#t f, Client#:68880 CONSER ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM100AN" 03115/2012 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.it SUBROGATION IS WAIVED,subject to the terms and conditions or 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 endorsemengs). PRODUCER CONTACT •NAME: Rogers&Gray Insurance Agency,Inc. PHONEF tAlc,No_Ext) 508 398-7980� j(AIC ADDRESS: No) 434 Route 134 E McAii - — -- -.-. South Dennis,MA 02660 _ INSURER(S)AFFORDING COVERAGE NAIc a 508 398-7980 i INSURER A:Selective Ins.Co.of the South INSURED - ,....+.INSURER B:'—''----_.— . -•1-. Con-Serve Energy,,Inc. — 376 Route 130.STE C INSURER C:�— ---- INSURER D: T Sandwich,MA 02563 i----'-- — fINSURERE. h t INSURER F: 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 CONTRACTOR 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY.PAID CLAIMS. _ .:..—_. LTR TYPE OF INSURANCE - I SUBR POLICY - POI.-'Y EFF POLICY EXP - - _ it�,$R•,W1(g_ POLICY NUMBER _ MMID� ��IT1M�MIDO LIMITS A GENERAL LIABILITY X S2011299 3114120x_12!03114 120 .EACH OCCURRENCE !$1 000 000 X COMMERCIAL GENERAL LIABILITY 0 ENTED R Ea occu,rer ce) =$100 000 CLAIMS-MADE X OCCUR 1 f (MEO EXP(Any one:poison) $10 000 I--PEERSONAL&ADV INJURY 1$1,000 000. GENERAL AGGREGATE ts3,000,000. GEN'L AGGREGATE LIMIT APPLIES PER:' _.. PRODUCTS-COMP16P AGO `s3000,000• X POLICY' PRO-JECT LOC — $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMB d ANY AUTO BODILY INJURY(Per person) 1:$ ALL AUTOS UUTTO OWNED AUTOS SULED - BODILY INJURY(Per accioem)I:$ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per acGdem $ $ { A UMBRELLA LtAB X OCCUR X S2011299 3/14/2012 03114/201 EACH OCCURRENCE 1$1 O_.00,,000 X EXCESS UAB CLAIMS•M_A_pE AGGREGATE 43,000,000 DIED I X RETENTION SO A WORKERS COMPENSATION WC7956539 0 311412012 03/14/2013ARTNR X }WC STATU- OTH AND EMPLOYERS LIABILITY Y/N YLIMaV-'_ ER--' ANY PROPRIETOR/EXCLUDE/EXECUTIVE ESL.EACH ACCIDENT •$10O 000 OFFICER/MEMSIER EXGLUDED? � NIA � .. ..... (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100 000 tt yea,deacnbe under # f4 DESCRIPTION.OF OPERATIONS babes. E L.DISEASE-POUCY UMIT i s500 000 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space is required) " Excluded officers under workers'comp-Conor and Courtney McInerney. Blanket additonal insured coverage applies under CGL. CERTIFICATE HOLDER CANCELLATION Thielsch in En eerinHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Engineering,Inc.tnc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 195 FranciS.AVe. ACCORDANCE WITH THE POLICY PROVISIONS. Cranston,RI 02910 AUTHORIZED REPRESENTATIVE 198114610 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S788991M78898 DOR VMassachusetts -Department of Public Safety Board of Building Regulations anti Standards < Constructi)aSulieni4urSp daliy t License°CSSL-102778 -, CONOR D MCINF;iRNEY " f L 39 SIASCONSETDRIVEr7 SACAMORE BEACH MA 0[2562 E cpiratron Commissioner, 08/19/2014 =r �Q Office a(Coun,ei'�`d'1'fairs `Sussrie�s f `uia `r License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR I before the expiration date. If found return to; ` Registration a1.71251 Type: x Office of Consumer Affairs and Business:Regutation �; Expiration- ,3f1l201�4 Partnership 10 Park Plaza-Suite 5110 ` Boston,MA 02116 C SERVE ENERGY ! f' CONOR MCINERNEY a 376 ROUTE 130 SUITE*.C., --'fir SANDWICH,MAO2563 Fwr'ty Undersecretary --'' '1hot valid wttLout signature �_ v OWNER AUTHORIZATION FORM t, toAM.R � C&TA (Owner's Name) owner of the property located at S T-A N A D&fl WET 14Y"N tq PMT —MA- 0 Gff (Property Address) } (}property Address) hereby authorize S IC1 Y"1 C-?Y�`' l� (Subc ractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work.on my property. Owner's Signature Da - D c c c aIV NOV 9 1012 I Assessor's map and lot number ... .�. �(J ... SEPTIC. Sy INS t ST 1N ALLED I MUST BE 4y Sewage Permit number ........... s WITH A N COMPLj r NC SA,"dlTq Y ICLE II SrA riE �. Tod f , D Ow� QOFY"E ° TOWN. OF 'BARNST"N " T HAHBSTL11L • - r" 2639. BUILDING INSPECTOR APPLICATION FOR PERMIT TO .;....... TYPE OF CONSTRUCTION c v ......... .F}................1......19.�... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby pp:lies for a per it according to the following information: r '. Location ............ .........�.......... :..... al .............: .................. ..X.. ........ ......... ............................. ............................................. ProposedUse ..... . f ... ..... ...............................................Cf �� ...�'......... .......�(:....... ........ Zoning District ...�� Fire District Yy/ ?�................ .......... ... Name of Owner .... ... . . ...............Address .......... .�... .. .. Name of Builder ��L/. , ..��.......... ........ ........................Address .......................,...... Nameof Architect ..................................................................Address ........................................................ .......................... Number of Rooms ...... Foundation itJ C ...... ............... . /.. . ,. ..... . .... .... ... ..... ............ t7,,;......... Exterior 1...................................... Roofing FloorsG < ,............... ........./.... .... .G..:�......,.............................Interior .............:..... .1�.. ......��.�. ........................................ Heating .....................'C.........................................:...............Plumbing .................: ........ ................................................ 0-0 Fireplace ..........................!/ .............. Approximate Cost ............�L�' ....:p ...... f................ ...... R Definitive Plan Approved by' Planning Board ______________________________19_______. Area ........ ......................... Diagram of Lot and Building with Dimensions Fee .. ........................................ ..:-.................................. SUBJECT'TO APPROVAL OF BOARD OF HEALTH ' r 10 T o I hereby agree to conform to all the Rules and Regulations of tPeTn of Barnstable regding the above construction. Name .........................:......... ............ Wright, Joseph r 1872 storage shedNo ........................ 4 ............................................... .......... , Location ........15 Tanager Road 1 West' HY.annis ort . ..................................... ....................................... , Owner ..........J9seph.,Wright.....::......::. Type of Construction ...........frA...ine...................... .... Plot ......... Lot ............:.................... O 76 Permit Granted ........ ctober 12 19 Date of Inspection .......... ....... .................19 z Date Completed ..` ..../. 19 PERMIT REFUSED ...... ....................................................... 19 ............................................................................... Approved ................................................ 19 a ' ..........'..:.......................................:.................. .............................................. .�.r .� -•,-+ •--y.. } ...,;.w na.f.-... "�.,.t.r-s.a ...�J .....�, „c.»c....r,::;i"+i� 1 < :_.. ,.,..��.r..;. •`r ..r�.s.,r^r�:'*--+�w.::.y-..,...hr:.-+.-., Assessor's map and lot. number �.... .4 ..�.0 f . Sewage Permit number .................. A �!1�.... ...,,..................... T"Er°�° TOWN OF BARNSTABLE Z 339SHSTSItLE, i MAGIL 2639. .. BUILDING , INSPECTOR owa�a' APPLICATION FOR PERMIT TO .......... �,......r�c!,....�%`./(...Q�l .................................................................. ...... TYPEOF CONSTRUCTION ................... L.C ��..`......................................................................................... �r 7f TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: .Location Proposed Use ....... .0 F.:.:1��� ... :.../.....::.�..��.� .��!.t.�.� ...:.'l L✓t.. .�tC.�...........:.:!�.............� ........ ......... r i y ./........`.......................Fire District ..!.:... ..�.................... Zoning District ... ......................... .............; Name of Owner .... .......... ..Address ............................................................. ... . .. . : .... —<.2 �r t ,p , �/CC Name of Builder 1...1:. ...................... /��J( CGlvc ......:........................Address ........................./............................................�.................. Name of Architect ........... ..C...............................................Address .................. ......:.......................................................... 1, Number of Rooms ... 0..................................................Foundation (�lsL�/C 7 • `Yr C', /(............. ...................................................... ............::... Exierior Ll ...Roofing , �` :..................................................... .............................................................. ..... ......... Floors �C i'�C .Interior .............-..........................</ �...................................... .. ���L ..........................................'.Plumbing GG`7� .� Heating ...................................................... .................... .. ... ............................................ ............... ......... .� C-C Approximate Cost r�� .Fireplace Definitive Plan Approved by Planning Board ________________________________19________. Area .......................................... Diagram of Lot and Building with Dimensions Fee `'"""":.......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH fi w r ` J I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. i Name ..... .. .......,...t....................................................... Wright, Joseph A=268-22 18723 storage shed No ................. Permit for ..... .................... .................... . . *.......:...................................... Location ........A-Y..Tana.g.er..R.oad......................... .... ........ . .... .. ...... West BXNKKXX Hyannisport ....................................................... ....................... Owner ........... �# .... Joseph Wright...................... Type of Construction ..........................................fra me ......................:.....a....... ................... Plot ............................ Lot ' Permit Granted ......October 12............jt....................19 76 Date of Inspection ....................................19 Date Completed. ............/...........................19 .PERMIT REFUSED .......... ......... I.... ..... . ,J, 19 ........ ...... ........... ............. ... ................... .. ............. .. . .. ........ . .... .......................... ....................... ............................................... ......................... Approved .................................................. 19 ............................................1.................................. ............................................................................... TOWN OF BARNSTABFE BAUSTULS, i "°9 n war a• BUILDING INSPECTOR � APPLICATION FOR PERMIT TO ..... ��.... .G.! �. � TYPE OF CONSTRUCTION ......iY� ......... ?-........ -.-,�q4t.......t.�� �.....C�l� .. ..... ..... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..1..,3 .... , ..�-�s?�a?! el !q ..............L f/., .....�y .................a J- .............................. t/ ProposedUse .... ..... ................................�: :a................................................................................................ ZoningDistrict ........................................................`.....................Fire�District ................................................................::............. Name of Owner <! /�M .lea�2t�: :a , �': (�ddress .................................................................................... Nameof Builder ... .. . ..............................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ...../..........................................................Foundation .lOiyrzq /-;: l . pc �t.... .. ................ /� Exterior J1�. ( ................:.......................................RoofingL-��.............................................................. ............ Floors ... ....................Interior .................................................................................... .................. Heating . ............0............................:..................Plumbing .Xr!''?-��.� ............................................................ p ..Approximate Cost "... ............................................ r Fire lace ..jC..�.�!Y.4-:?.e..,........................................................... .........0..... i-F Difinitive Plan Approved .by Planning Board ---------------_______-------19________. AI Diagram of Lot and Building with Dimensions ,� d LQ 1 as un LL O � CL J ¢ ,..........- s ul LLJ _ nCt -� d < tY. LL "•% \ LLO O LLJ O a Q � w o ii LLI D W w I V) _� _j _j a l�l Q O < 0 C z� o OL Er Q c u d T_ Z0 � _ < � O I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. .. ... ... ..y:..... ...... .... ........................... Wright, Joseph & Margaret 14. OTC 31 19?1 ; i 10 397 tool shed t No ................. Permit for .................................... 1 f Location . . .......Tanager..R.oad..................... r West Hyannisport Owner ...........Joseph & Margaret M. Wright ...................................................... Type of Construction frame .......................................... ................................................................................ Plot ........................ Lot ................................ r Permit Granted June 14 19 71 Date of Inspection ....................................19 pp Date Completed ......Q..=>p...7 ....19 i PERMIT REFUSED ................................................................ 19 f ................................................................................ ............................................................................... Approved ...............................................................................