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HomeMy WebLinkAbout0463 ELLIOTT ROAD 41 15"'1 Z!64 f;Y 4 My' �'IURV,7WO'�Uvl,P M, R4 T sm P" SJ MOM- "AS- �Y a VIEW xa -vtw 114 4,TP I Y­ ilk W-rWi mv""j 15 iF , - !P�,�,� `�� PT TNRUA %115, A gig! MOM M Nr 1k, �',w one w"-BnP Ku 7, 1 P, nm, 'J 'jJ q '1010A NEW MSMIMIP, "M 4K PIM wow-"u- w-w A-My Shn A a- MMYmom T Q M -X �J 1.ME,,,�t —CA" � .",, " ;_ . "''i 1:e`, -�., — ��p 14Y q, MEIN Max Y�4�R A140 A 1K ;iT out NAlw­ell, yon MOF z "Mi 'Mi in-qm­ A, w,­, 4 Mum gj W! MOWN& Al P41 .41 t4 gp 41, i got Anh;�, "fl J J: -woo MMM its? ThIT"nN "AN U 5T _aYKTM-q` Rtr� -DWI "f,'v- I _'N ",,,W 7,i _)qv It 1,�, P V MOM NO f"'M lot pool SQJ -qn .1 �)V)"�, , "i �&"" wl�V My"* j. MIN Z VI'K T gg WIN _vy vwl,­ r mom Tv 1,2 F N wag Ed jh` gj= lw,�j I'mm u, "I ON? 97 OWN 0 gwo TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION j TOVI j l PP • BARNSTABLE MaP � � Parcel Application #! ?�I / O IN Health Division ;%z "':Y' Date Issued Conservation Division Application Fee Planning Dept. Permit Fee 1 0 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address _3 �� �T �. C_�-J4c r y N�( A 6a 3 Z Village Owner (�AU(1 ci Address 4 (10 3 C 1 1i r01_ f�10 . Telephone &bj) Permit Request (7 k r Cc.A ( ^.> J Q-) fl" (A w4ti h= L (3 " R 1,Lei 0 (3 0 6 W +_0 A,,,) �..> �� CO PPnbA V 2- c Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation o. �k,`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 Central Air: ❑Yes. ❑ No Fireplaces: Existing New Existing wood/coal stove: _0 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# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name :1-D Telephone Number Address 1✓0 o 14 ` a S� License # l 7 M A, 0 7 7 1 Home Improvement Contractor#, l Email • e 2'(l q ( Worker's Compensation # U Y 1—a y ALL CO STRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE L" DATE ` L��! FOR OFFICIAL USE ONLY APPLICATION # r" DATE ISSUED MAP/ PARCEL NO. I ADDRESS VILLAGE i - k OWNER i DATE OF INSPECTION: 3 FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: - ROUGH FINAL FINAL BUILDING i DATE CLOSED OUT ASSOCIATION PLAN NO. f Town of Barnstable Regulatory Services s r Richard V.S=%Director Building Division Tom Perry,BuOding Commissioner 200 Main SbvK IIymik MA 02601 www.town.barnstaeie.ma.ns Office: 508-862-4038 Fax: 508-79"230 Property Owner Must Complete and Sign This Section If L sing A Builder as Owner of the subject propeny hereby authorize Retrofit Insulation to act on mybehalf, in all matters m1a ive to work authorized by this building permit application for: (Address of Job) *'*"-fool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final Tspectmns ace performed and cepted. igpature o Owner S' of App' t Prim Name Print Name Date 2�1 Q:r-0RMS:0WNW=MTSS10WWLS The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Stree4 Suite 100 Boston,MA 02114-2017 .-' www mass.gov/dia NZ'orkers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information f PIease Print Legibly Name(BusinessfOrgani2ation/Individual)'_ 1Z���a { rl an) Address: o 1 o S City/State/Zip: MtAq Phone#: Are you an a ployer?Check the appropriate bare vA 71 0 Type of project(required): 1, m a employer with employers(full and/or part-time).* 7.. Q New construction 2.Q I am a sole proprietor or partnership and have no employees working for me in S. Q Remodeling any capacity.[No workers'comp.insurance required.) 3. I am a homeowner doing all work t 9. Demolition ❑ g myself[No workers comp.insurance rzquired.] 4. I am a homeowner and will be o 10 Q Building addition ❑ hiring contractors'to conduct all work on ray property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprie tors with no employees. 12.Q Plumbing repairs or additions 5.Q I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.Q Roof repairs These sub-contractors have employees and have workers'comp.insu►anc e.t , er LtJL��97ltC��• L �J 6.®We art a corporation and its Officers have exercised their right of exemption per MCsI,c. 14. -l 15'4§1(4),and we have no employees.(No workers'comp.insurance required.) t ;Any applicant that checks box M must also fill out the section below showing their worlars'compensation policy information. Homeowners who submit this afndavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContrwtors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities bave employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer thatisprovidmg workers'compensation insurance for my employees Below is thepolicy and job site information. Insurance Company Name: f j Co . Policy#or Self-ins.Lie. :_ �,� (f S-,;L e) Expiration Date: 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 MGL c. 152,§25A is a criminal violation punishable by a fine up to S1,500.00 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 D1A for insurance coverage verification. !do hereby cvtyy ander t1i p and penalties of perjury that the information provided above is true and correct Si attire: Date: Phone 4: (S.7�-k 4,S (0 4 (o Of,facial-use only. Do not wVe in this area,to be completed by city or town offidaL City or Town: PermWl icenst Issuing Authority(circle one): 1.Board of Healtlr-.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector b.Other i Contact Person: Phone#: i t Oj5ce of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston,Massachusetts 021-16 r� . Home Improvement or Registration — = � Registration: 160461 t ,` Type: Private Corporation "fy`= ily�`l Expiration: 7/29/2018 TrO 289184 RETROFIT" INSULATION, INC. JOSEPH REILLY -=- P.O. BOX 105w�` SEEKONK, MA 02771 `_ :• ��. Update Address and return card.mark reason for tbtangL a_.•,�. f sca 1 2oM o5ny �] Address �Renewal � Employment ❑ Lost Card OjMce of Consumer AfWes&Business Regulation License or registratlou valid for individual use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registratlon;�;:''1g0461 Type.• Office of Consumer Affairs and Business Regulation "''�'�" 10 ParkPlaza-Suite 51.70 Expirdtlonr 71a912018 Private Corporation , s:.; Boston,M6A.02116 RETROFIT INSULAT,•`!05N09:� ' 11- JOSEPH REILLY f=�'= grl 644 RODMAN ST «.` ..: '� r. ��-ti • --- FALLRIVER,MA 02721 .•i" T3ndersecretary ili&valid without signature c • r Commonwealth of Massachusetts ' Division of Professional Licensure .. t Board of Building Regulations and Standards ConstructigasIW i r Specialty CSSL-102771 " ', "„ ffx�pires: 06/05/2019 1 i JOSEPH J RE-ILLY. PO BOX 105 SEEKONK MA W771'.. G01 Commissioner V RETAINS-01 RBLACKI �... CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYYj 811112016 THIS CERTIFICATE 1S 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. if SUBROGATION IS WAIVED,subject to the terms and Conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu ofsuch en dorsement(s). PR06ucER License i 'i78.0862 CONTACT HUB,International New England NAME: 222 Milliken Boulevard o E n;(508J 576.1971 Fall River,NIA 02722-9946 6 MIAIL a No:(508)678-F750 ADDRESS: INSURERS)AFFORDING COVERAGE NATO# INSURED INSURER A:Selective Insurance Company of South Carolina 119269 INSURER a:Star Insurance Company 118023 RetroFit Insulation,Inc. INSURER C: PO Box 105, INSURER D: - Seekonk;MA 02771 INSURER E: 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 t lOTW1THSTANDING ANY RELIUIRF-MENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEN WITFI RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN ISSUBJECTTOALLTHETERMS, EXCLUSIONS AND CONDITIONS OF SUCH POJACIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1NSR LTR TYPE OF INSURANCE D POLICY NUMBER L Y EFF POLICY EXP - MMIDDlYYYY MMiDD LIMJTS a X CDMMERCUti GENf3RAL LULBtLlfY EACH OCCURRENCE 5 1,000,000 CLAIMS-MADE F91OCCUR n S21876.53 08/15/2016 08/15/2017 PREMISES(Ea'occurrence 5 y 100,060 MEOW(Anyone wson) S 5,000 PERSONAL&ADVINJURY S 1,000,000 GENE AGGREGATEIJMITAPPLJESPER GENERAL AGGREGATE S 2,040,000 OTHER:POLICY a JECT Lac - PRODUCTS•CAMP/OPAGG $ 2,000,40D OTHER AUTOMOBILE LIABILITY COMBINEDdSINGLELIMITMe g 1,040,ODU A ANYAUTO ASIOOI8200 d81i112018 0811112017 BODILY IWURY(Par person) 5 ALLOWNEO �( SCHEDULED AUTOS AUTOS I BODILY INJURY(Peraccident) 5 x HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE S Par accident X UMBRELLA,LW3 S OCCUR EACH OCCURRENCE S 1,006,010 A EXCESSLIAR CLAgAS.MADE S2187653 0811.512016�08/1512417 AGGREGATE S, DED I X I RETENTIONS Q S 1,QOD,QOD WORKERS COMPENSATION l PE R O.TH- ANG EMPLOYERS+LIASILnY STATtFI E I ER B ONYPROPMETORIPARTNERID{ECUTNE YIN COM201 0810212016 08102/2017 E,L EACH ACCIDENT $ 1,000,000 FFICER7MEtuI9EREXCLUDEO4 NIA (Mandatory'In NH) E.LOISEASE-EA EMPLOYE S 't,000,000 1F yyeess.describe under / - D25CRIPTION OF OPERATIONS below E.L DISEASE,POLICY LIMrr $ 1,000,000 DESCRIPTION OF OPERAT1ONS1 LOCATIONSI VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached irmero space Is required) CERTIFICATE HOLDER i CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE National Grid THE EXPIRATION DA-rE THEREOF, NOTICE WILL BE DELIVERED IN §0 TJVashingtgn Street ACCORDANCE WITH THE POLICY PROVISIONS. Westbarough,MA 01581 AUTHORIZED REPRESENTAnvE- ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Assessor's map and lot,. number1:.....<.�G,� :c :.....: EPZ. 7 IC SYSTEM MUST BE LED IN INSTALLED COMPLIANCE Sewage Permit number :. .............. ...............`....:.................... € WITH TITLE LE 5 ENVIRONMENTAL CODE AND ' �Q�oFtHETo�o . TOWN' OF, ` BARN��o' IONS Z 'EAUSTAELE; i I 9 opYa,� 3. BUILDING .' INSPEC_T.OR O iG39. 00 �? APPLICATION FOR PERMIT TO ....... .... .................................................. ......... .... ' TYPE OF CONSTRUCTION .......1!. ................................................ ....... ....................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for �apermit according to the following information: Location ....7.. ........U 'e '.. ....... t14�..�z -Q ......... i. '°v....................................................................... ProposedUse ................ 4. .........................G ...... ..................:......................................... ..............Fire•District ..............................................: Zoning District .............:............................................ ............................... Name of Owner .! d. ..!�L ! L..g..1.4C�.LY?nn ........Address ....��JG... v'1� n...l` ....:.............1..:.. ...- . #i /G% CName of Builder ....... ... ..........................Address ... .......................V.:.....G U Name of Architect ........ .. ...................Address ................................................ Number of Rooms ..............�1 Foundation ..... ... � � ... .... .......................... ............ . .................................................... Exterior ...................................................................................Roofing ........ . . ...,1 �`�l'....�� '�.... Floors 6 Y4. Q �1'7�-eQ e�/ li►'�e� L i ....interior ...... 'J��• ............... v �...'rG...... Heating ........Plumbing 14 .J1� ........ ......................... Fireplace ...........................A Approximate Cost p ...............................:....... pp �. .�........... Definitive Plan Approved by Planning Board --------------------------------19________ . 4,3,0%rea ,991�C/?�?�...�-...v2. ........ Diagram of Lot and Building with Dimensions Fee .../. Cr... ... SUBJECT TO APPROVAL OF BOARD OF HEALTH '"il ulOe�G� LO• d�l�t � ���p� 'V Al y i tA I w ` �21 I hereby agree to conform to all the Rules and Reg lations of the o n of Barnstable regarding the above construction. aName ................................. ............................ HIRSH, DAVID & REE o ..�3�.2 5.. Permit. for�..?'WQ,..S.tSazy........... F ' Single Family.. W�.1.�7Lxig............... r 463 Elliot Road- Location ' .......... .............................. ...... Centerville Owner David & Ree...HirSi1................ , r^ �,r'. ` ,�. ` // -Frame �; �� i✓ ;. w � � . . - .. Type oConstruction r ....... .............................................................. .!, �. �., _ - . - •t ;Plot .:.......................... Lot .............:................. J P rmit.Granted ....April ......' �19 81 Date of Inspection ...........:........... . 5 q ry. L•�- I .. _ Af Date Completed .............. ,,T�/•,��19 PERMIT REFUSED ' ti .. r�..... ........................................................... } f ... .. r !App oved ............................... 19 < r i ......................._ {� .... ... .................................. t . P 'y i f, E' A k, PLAN SHO r FOUNDA TION LOCA TI 3 C 5 JV TZ`le V /L.. LE HAS � ' . OWNED BY: SCAL E DATE x NORMAN GROSSMAN --------REGISTERED LAND SURVEYOR t F I HEREBY CERTIFY THAT THIS FOUNDATION IS LOCATED . ON TH1E LOT AS SHOWN AND CONFORMS TO THE TOWN r OF a4;pA45,r4WjF ZONING REGULATIONS REGARDING i SETBACKS FROM STREET LINES AND LOT LINES . -$ 2 ��;>;. r / NORMAN GRDSSMAN R.L.S. DATE G /� i r � TOWN OF BARNSTABLE Permit No. --------_ Building Inspector »n� Cash . oO�0VAI OCCUPANCY PERMIT Bond No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ...................................................... 19...... _ ...........................................................»._. ..___......._._.......».___ Building Inspector .4v-. � -"'£-'.• ..;^.-.. _...r.nn ro� w � .. f�,.. �+.•r: ...•-,p,��i,� �� /J✓���.....,,'-, -. daJ+�cix!a .. >.«;�`e ,+�e..w r _ 'l �f I Assessor's map and lot number V 7 {17 Sewage Permit number:7 ...A3.... ... .t. ... . °f7HEr° 'TOWN OF BARNSTABLE t Z MUMBLE" i 1639. Ar, BUILDING 1NSPECT:OR APPLICATION'FOR PERMIT TO ................................................ ................ ........................................................ TYPE OF CONSTRUCTION 4' N: . ...........19. .... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .."?/0.3 .....: .. ......���t?� ............................................ . .................. Proposed Use ..............Y410.�. Zoning District ...........................................................................Fire District ......................................,...........,. . A "l � ..�..l4�Cr.IG/Y ........Address ....� �.. 1` ... Cam- 'Name of Owner ....... ......... .... .... No of Builder .h..:.T1 ......... . . . .... ..........................Address ...���./��/'�' .. :.... /4 ^ •. `-' Name of Architect ...... ............ .....Address > . Number of Rooms ............. .....................................Foundation :.... .............:.. . .......................... 15 Exlerior ............................:...............................:.......................Roofing ........ ..... ....... ..... tr ..... f� �0 Floors ,... .. -'ee .. ....lnterior° /............iyG -z- . <. ,lei �e-�-�— Q Heating .... / ..% .... ...................` Plumbing ....'.. .........:........................ , Fireplace ...........Z. .......... ......................................................Approximate�CoO :... � � ll' Definitive Plan Approved by Planning Board ___ 19--------________. . �,C Area f Diagram of Lot and Building. with Dimensions '* Fee +� - ... . SUBJECT TO APPROVAL OF BOARD. OF HEALTH. czh ` : ,a he`r_eby,agree to conform to `.all the Rules dnd Regulations of the Town of Barnstable regarding the above construction. ? y: Name ....... ....................�. HIRSH, DAVID & REE ...............................�... .l .. o . .........,. ._..A...= 227— "14 No ... Pei for ...TWP..�tQXY......... Single Famijx...pKpj'j.jjjg............. . Location ..463...E..l . ... ................ ............... .......... Owner ...Pcjyid..&...Re ...... ... . . .................. ramp.:..................... ,Type of Construction .....F ....................................................................... ........ Plot ............................ Lot ................................ Permit Granted .......A.pri 1/21...........19 81 Pate of Inspection .............. ...........19 Date Compl&ted ..............c.......................19 PERMIT REFUSED ................................................................ 19 ............................................................................... ............................................................................... ..................................................... ........... ...................... Approved ................................................ 19 ............................................................................... ..............................................................................