Loading...
HomeMy WebLinkAbout0128 HORSESHOE LANE 0 la r hor a v TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map t7 Parcel Q'7 cl Application # Health Division Date Issued Conservation Division Application Fee L Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village Owner ,���.GYX/ r'/�f� Address Telephone ,7�ia Z Z,�Q y Permit Request l ��'i��,� ,g "l � /��✓� ��//����� 6�'z�d /9r .;�,�e� �75 ;?�0`e- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project,Valuation A�Z, 00 Construction Type_,(����� Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family .;k- Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ANo On Old King's Highway: ❑Yes XNo 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 , CD 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/cpal stove 0 Y ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑`pewize_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: (a 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 JAW Telephone Number Address License Home Improvement Contractor Email Worker's Compensation # Gz DO 5� Zf ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE 42A 19DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION '. FIREPLACE 1 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 's GAS: ROUGH FINAL FINAL BUILDING P DATE CLOSED OUT ASSOCIATION PLAN NO. Town of]Barns'table gegulatory Services se RIAAK Riehard'V.Scab,Director Building Division Tom.Perry,Building Commissioner 200 Main Sheet,Hyannis,•'MA 02601. vmy.tosva Barnstable ma-as Offi6e: 508=862-4038 flax: 508-790-4230 I'roperty Owner Must Complete-'and sign This Section zfUsin A B�Jlder ,.as.4ner.9f+the°:subject pznpeny hereby at#6Hze to act an my behalf, , m all matters rehaive to authorized by.this bgding.permit appkation for. {Ad.dress df . . "-1'0'01.feiiLeS and ala='are' he respona�jy of-the=applicant. Pools are:n6j.jo be:filled-6r uf'ihmd_before,-fence-is:installed and 0 finaf e pections are perfonued and accepted- Xo Sig�aatxue of.Applicant Nair Print Nanrae . . Date Q:FoxMs.ow>-"> Sscormx)Ls `� 9-:13oard Massitc11usett;; f P,ubiic Safety of Building Regulations .and Standards Construct ion SuI crcisur ..License: CS 100988 HENRY E CASSBA 8 SHED ROW y WEST YARMOLftrH i Expiration. Commissioner '.- 11/11/2015 " i z Office of Consumer Affairs and Business Regulation 10 Park Plaza Suite 5170 Boston, Massachusetts 02116 Home Improvement Contradtor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2016 Tr# 259188 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE SO. YARMOUTH, MA 02664 '.Update Address and'return card.Mark reason for change. SCA 1 20M•05/11 - n'Address ❑ Renewal Employment Lost Card _.__._ _-... ._� — .... _ .............. (;Flee a�C�/A"JOCGC Xcwe 0 License or Office of Consumer Affairs&Business Regulation registration valid for individul use only UVOME IMPROVEMENtICONTRACtOR before the expiration date: If found return to: egistration: 1,53567 Type: Office of Consumer Affairs and Business Regulation xpiration 12/15/20:16 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSULATION iNC HENRY CASSIDY 18 REARDON CIRCLE g �- S0.YARMOUTH, MA 02664 Undersecretary Vvalid wi ut sign e The Commonwealth of Massachusetts AN _ Department of.Industrial Accidents -_ Office of Investigations r - I 600 Washington Street Boston; AM'02111 f www.mass.gov1dia r i' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): S XII/ Address: V, City/State/Zip: �kVftr)ti' vi PAA-, Phone #.:. j i1 Are you an employer? Check th-e-appropriate box: Type of project(required); I am a employer with 4. ❑ I 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 - ship and have no employees These sub-contractors have 8. ❑ Demolition " working for me in any capacity, employees and have workers' 9. Building addition [No workers' comp. insurance comp, insurance.# g "repairs or additions We are a corporation and its 10: required,) 5.. � ❑ �? ❑Electrical officers have exercised their' 3.❑ I am a homeowner doing all work 1 l.❑ Plumbing repairs or additions myself o workers"comp.--, rightYof exemption per MGL - Y P 12.❑ Roof repai rs insurance required:] t c.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 seciion below showing their workers'compensation policy information: t Homeowners who submit this aff davit indicating they are doing all work and then hire.outside contractors must submit a new affidavit indicating such. +Contractors 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, I am an employer that is-providing workers.'compensation insurance for my employees. Below is the policy and job site 1hformation, Insurance Company Name: UK j LAA/A �,hrlkv&L�: p .y _ � - //,,,, Policy#'or Self-ins. Lic. #:: . cl e to� �1 6 Expiration Date: �/ l "✓ _ Job Site Address: e A1141 ity/State/Zip: d � 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 imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and.a fine of up to$250.00 a day against the violator, Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insura'rw.%coverage verification. ` I do hereby certify d the pai an penalties of perjury that the information provided above is true and correct. Si nature: Date: Phone#: Official use only. Do not write in this area, to be completed by city or town official. City or Town; Permit/License# Issuing Authority (circle one), 1. Board of Health 2, Building Department 3. City/Town Clerk 4: Electrical Inspector 5. Plumbing Inspector . 6. Other CAPECOD-27 BDELAWRENCE �oRO CERTIFICATE OF LIABILITY INSURANCE F776i3012015 ,MMIDD/YYYY) fAS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS iCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES !% BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT.-BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT; If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed, If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT NAME: t Ro ers&Gray Insurance Agency,Inc. PHONE Fax g A/c o Ezt arc No: 877 816-2156 434 Rte 134 EMAIL � ) South Dennis,MA 02660 E-MAILDDRE s: INSURER($)AFFORDING COVERAGE NAIC# INSURER A:Peerless Insurance Company-see LIBERTY MUTUAL INSURED" iNSURERB,ATLANTIC CHARTER INSURANCE GROUP Cape Cod Insulation,Inc. INSURERC: 18 Reardon Circle INSURER D: South Yarmouth,MA 02664 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. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 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. INSR TYPE OF INSURANCEADDLISUBR POLICY EFF POLICY EXP LTR POLICY NUMBER` MMIDDIYYYY MMIDDIYYYY LIMITS A. X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR' CBP8263063 04101/2015 0410112016 DAMAGE TO RENTEIT— PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JE� LOC - PRODUCTS-COMPIOPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY.INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIREDAU70S AUTOS Per accident $ ^. $ UMBRELLA LIAR OCCUR EACH OCCURRENCE - $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ - DED RETENTION$ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE N I A WCE00431901" 06I30/2015 -06/3OI2016 OFFICER/MEMBER EXCLUDE E.L.EACH ACCIDENT $ 1,000,000 07 (Mandatory In NH) ; E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below - E.L.DISEASE•POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (CORD 101,Additional Remarks Schedule,`may be attached If more space Is required) Workers Compensation includes Officers or Proprietors - Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. r• - r ` CERTIFICATE HOLDER. CANCELLATION ` SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod Insulation,Inc THE EXPIRATION DATE THEREOF, NOTICE WILL'BE DELIVERED- IN ACCORDANCE WITH THE POLICY PROVISIONS. 18 Reardon Circle South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION, All rights reserved, ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Assessor's office(1st Floor): Assessor's map and lot number �Y ;;;ALL �# Board of Health(3rd floor): ® (,� ��y�,�E+� o„ Sewage Permit number b *�v 17L Engineering Department(3rd floor): �• �� �BVi Ei1li'/4!. B mpkBIL House number 10 9, F.S� YOWN REG'U�'�' Definitive Plan Approved by Planning Board 19 aY a APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO R EHD rd L - 'f !J 6�CJ /-90/I*,31?L=/z r 3 TYPE OF CONSTRUCTION 19 17 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location / X/e/I 'L= Proposed Use ID G!/L—',LLJ r7 7 Zoning District Fire District O GT L N11,(" 6,61 WiA(e Name of Owner ,4NN MOLL 0V Address lld/t x tr rAae JAB C?&i11Y&n1W1Ce f Name of Builder �/ �///� kAA 1/ Address a � � AWjk 1 C=f 44AIC% H21MVeNl' 14411-CJ Name of Architect Address . Number of Rooms /!!��� o0yh- Foundation /J L UL f1 Exterior a�11 ^ � Roofing AS'/ i1e T ,QA 1 el Floors /�. Interior ;2 Pe-/1LL t Heating [r� .r /.(d T A C/t- Plumbing Fireplace /lwa C� Approximate Cost p D v 477 Area 4 O Chi - ' Diagram of Lot and Building with Dimensions Fee - %' 0� B) ry y � �uu,(E Na (worPl"n r l°o1z`H ° OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name r v Construction Supervisor's License 00 5-s �.2 MOLLOY, ANN REMODEL & BUILD No 33270 Permit For DOEMFR Ingle Family Dwelling Location 128 Horseshoe Tana (T of 4� Centerville Owner - Ann Molloy Type of Construction Wand Frame Plot Lot t I ? Permit Granted October 10 19 89 ' Date of Inspection 19 Date Completed 19 r t is' •«i i. �.yvu, - Assessor's office(1st Floor): Assessor's map and lot number Board of Health(3rd floor): �� �f w'" � � ♦� Sewage Permit number C) Engineering Department(3rd floor): Bsar,asaLc House number i639' \e� Definitive Plan Approved by Planning Board 19 ��YPY, APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only Cr TOWN OF BARNSTABLE BUILDING INSPECTOR U n APPLICATION FOR PERMIT TO 6CM© 62 L /J r -7` c fi o TYPE OF CONSTRUCTION 19 9 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location •f"` A/e/1-r - .r4 y 4r- ,LW, �' f�/�J P V17 4,' Proposed Use D G!/L- L.L/ ,n Zoning District Ci Fire District Ott l;hrri1u c /r.1:4-n utaet �- Name of Owner Address 1101K S L- fAae kAl C1-,4166`nal4c-' Name of Builder 0111///7 crrAA V Address A W A I L 1 4/.l'A)C Md,fAA21 ' 14414 f Name of Architect Address i Number of Rooms !?��1) /?00n,s Foundation 13)- Ue- Fl Exterior A i ^ al�� � Roofing el(li t T 1 c ` Floors ( Interior Heating r go T A 12 Plumbing Fireplace /Y v A/ t'� Approximate Cost Area 01100 Cff ✓� -01 o e Diagram of Lot and Building with Dimensions Fee 40, i 4 3 - , I i r oil , 1)^ ti r � �G CID , f OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ,' y f✓/ ,c'�t�.® Construction Supervisor's License 0.D MOLLOY, ANN A=207=079 REMODEL & BUILD No 33270 Permit For DORMER Single Family Dwelling Location 128 Horseshoe Lane (Lot 9) Centerville Owner Ann Molloy Type of Construction Wood Frame Plot Lot Permit Granted October 10 1989 Date of Inspection 19 Date Completed 19 PERMIT COMPLETED 1/1/�'T/