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Home My WebLink About0040 VANDERMINT LANE / � V G2a'�G��"`�`Y��1 V 1'1'�" �YI E� J ��- JS S6 � -Z�� `�� TOWN OF BARNSTABLE Building INE 201507275 BABNSTABLE, * Issue Date: 10/29/15 Permit y MASS. �prFO 9..A� Applicant: Permit Number: B 20153045 Proposed Use: SINGLE FAMILY HOME Expiration Date: 04/27/16 Location 40 VANDERMINT LANE Zoning District RC-1 Permit Type: RESIDENTIAL INSULATION Map Parcel 250059 Permit Fee$ 35.00 Contractor MCCARTHY,MICHAEL J Village HYANNIS App Fee$ 50.00 License Num 58633 Est Construction Cost$ 1,500 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND WEATHERIZATION THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: WIGGIN,MAUREEN E BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 40 VANDERMINT LN INSPECTION HAS MADE. HYANNIS,MA 02601 Application Entered by: PF Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET;ALLEY dR SIDEWALK OR ANY PART THEREOF,:EITHER TEMPORARILY,OR PERMANENTLY ENCROACHIIAENTSONI?UKICPROPERTYiNOI SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.'STREET OR ALLEY GRADES AS WELL ASDEPTH SAND LOCATION'OF PII13 C SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.,THE ISSUANCE OF THISTERMIT DOES NOT`RELEASE THE APPLICANT FRONT THE CONDITIONS OF ANY�APPLICABLE1 DIVISION-.- RESTRICTIONS. MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1,FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS TA 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION, 5.PRIOR TO COVERING STRUCTURAL MEMBERS(FRAME INSPECTION). 6.INSULATION. 7.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUM G A CHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VAR STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION I NO STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NO AV CC S TO GUARANTY FUND(asset forth in MGL c.142A). 1 r a a BUILDING INSPECTION APPROVALS PLUMBIN E I APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 3 1 ting Inspection Approvals Engineering Dept Fire Dept 2 Board of Health TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 25-6 Parcel 05 T01':'�"1 O F)ARNSTABLE Application # 2—d��v � Health DivisionDate Issued Conservation Division Application Fee • w Planning Dept. Permit'Fees Date Definitive Plan Approved by Planning Board 0 i t'r t S IFC)N Historic - OKH _ Preservation/ Hyannis Project Street Address `tC, `Ancp cr&%. - 1— Village s Owner Address Telephone Permit Request 4- Cc IL L,< Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ul/ 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 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# e Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Mike McCarthy Construction Telephone Number PO Box 52 Address West Dennis, MA (12670 License # Cell (508) 280-6964 C�5Q�� C-169393 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �J�7 /I r f FOR OFFICIAL USE ONLY APPLICATION # i DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME a INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. `t Town of Barnstable Regulatory Services Rcbard V.Sc*Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www town.barnstable na.us Office: 50.8-86244)38 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Usin ABuilder Y Qu rv� W, ,.:s^-- of the subjecr propeny herebyauthorize C on.iny behalf, in aU matters relative to 46 authorized by this building permit application for. (Address of-job)- J�� "-Pool fences and alarms are the responslilty of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. 1 q Signature of Owner Signature of Applicant Print Name Print Name Date QXOxMs-OwKERMERMlsstoMPoaL4 �r Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supen'isor License: CS-058633 MICHAEL J MCC CR PO BOX52 W DENIMS MA 0267 Expiration Commissioner 04/10/2016 Office of Consumer Affairs and Business Regulation. 10 Park Plaza Suite 5170 Boston, Massachusetts 02116 Home Improvement Contactor Registration Registration: 169393 Type: Individual Expiratio/�AP/2017 Tr# 264961 MICHAEL MCCARTHY MICHAEL MCCARTHY r --- P.O. BOX 52 --- WEST DENNIS MA 02670 ---- Update Ad ess and return card.Mark reason for change. )M os/i1 Address Renewal j Employment 71 Lost Card The Commonwealth ofMassacliusetts Department oflnflustrial.Acchlents J I Congress Street,Suite 100 Boston,MA 02114-2017 www.massgov/tfia Workers'Compensation insurance Affidavit:Builders/ContractorsMectricians/Pl►irribers. TO BE FILED MTH TiIE P)'RMTTING AUTHORITY. Applicant information lease Print Le ibl Mike c a y Name(Business/Organization/Individual)C PO B Address: West Dennis, MA 02670 e - City/State/Zip: L-586W#: HIC-169393 Are yoy an employer?Check th�propriate box: tL'!�7/ Type of project(required): 1. 1 am a employer with employees(full and/or part-time).' 7. El New construction 2.O I am a sole proprietor or partnership and have no employees working forme in 8. (�Remodeling any.capacity.[No workers'comp.insurance required.] 3.❑1 am a homeowner doing all work myself fNo workers'comp.insurance required.]1 9• ❑Demolition 4.01 am a homeowner and will be hiring contractors to conduct all work on my prop".ro I will ]0 Q Building addition ensure that all contractors either have workers'compensation insurance or are sole I LE]Electrical repairs or additions proprietors with no employees. 5.❑I am a general contractor and 1 have hired the sub-contractors listed on the attached sheet. 12.[:]Plumbing repairs or additions These subcontractors have employees and have workers'comp.insurance.? 13.Q Roof repairs. 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.dOlher 152,§1(4),and we have no employees.fNo workers'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 contractors must submit a new affidavit indicating such. tContractors[hat check this box must attached hn 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. I nm an employer that is providing workers'compensation insitrance for my employees. Below Is the policy and fob site information.Insurance �Company Name: /p f Policy#or Self-ins.Lic.#: VW(,—)C4—EiG r 71 S6 ;.n N Expiration Date: ),,I Job Site Address: J, „s— City/State/Zip: /GI}7 It 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 MGL e. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DiA for insurance coverage verification. I do hereby certify tin 1l aJ s and allies rjury flint theinformation provided above is true and correct. Si ahlre: Date: Phone#: 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 Health 2.Building Department 3.City/Town Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMPAGE A.I.M. Mutual Insurance Company 54 Third Avenue, Burlington, Massachusetts 01803-0970 800 876-2765 NCCI NO 26158 POLICY NO. VWC-100-6017656-20146 PRIOR NO. , VWC-100-6017656-2014A ITEM 1. The Insured: Michael McCarthy Construction Inc. DBA: Mailing address: P 0 Box 52 FEIN:"-*`*3862 West Dennis,MA 02670 Legal Entity Type: Corporation Other workplaces not shown above: See Location 2. The policy period is from 12/15/2014 to 12/15/2015 12:01 a.m.standard time at the insured's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers'Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of liability under Part Two are: Bodily Injury by Accident $ 500,000.each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ 500,000 each employee C. Other States Insurance: Coverage Replaced by Endorsement WC 20 03 06 B D.. This Policy includes these Endorsements and Schedules: SEE SCHEDULE 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Classifications Premium Basis Rates Code Estimated Per$100 Estimated No. Total Annual Of Annual Remuneration Remuneration Premium INTEA 0712979 INTER SEE CLASS CODE SCHEDU E Minimum Premium $550 Total Estimated Annual Premium $29,332 GOV GOV Deposit Premium $7,748 STATE CLASS MA 5479 State Assessments/Surcharges - $28,601.00 x 5.8000% $1,659 This policy,including all endorsements,is hereby countersigned by — `- - 12/15/2014 Authorized Signature Date Service Office: Bryden&Sullivan Ins Agcy of Dennis Inc 54 Third Avenue PO Box 1497 Burlington MA 01803 So Dennis, MA 02660 / WC 00 00 01 A(7-11) F��W Includes copyrighted material of the National Council on Compensation Insurance, user!with IN.narmimtinn.