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HomeMy WebLinkAbout0153 HORSESHOE LANE `17 -e. 4 F TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map pp O'tD�7 Parcel Application to r6 /r Health Division -` ��: Date Issued Conservation Division Application F Planning Dept. a Permit Feeo Date Definitive Plan Approved by Planning Board /�eh3 Historic - OKH _Preservation/ Hyannis T Project Street Address 3 1�f��S I10t--. Village 1( <11 �- own er Tit mas ' - loy c_e 11 AddressO 3& &14en Nv'�- C:',,cJe AJ,,) Telephone 50% '7 7 1- � `� 3uz a- FL 33-(3 Permit Request l -1 �0 t< ��: U�( C.6A 51 ru re,D ki JL e_ 1Xc S4'^Q +ri n/\ t t A\ ��� CV-j iAS kill .--W J-9_ 5 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 b vk5 Grandfathered: ❑Yes ❑ No --If yes, attach supporting documentation. Dwelling Type: Single Family 1 Two Family ❑ Multi-Family (# units) Salt UDER Age of Existing Structure Historic House: ❑Yes R�o On Old King ighway 0 Y9 o Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other ' Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.fti Number of Baths: Full: existing new _ Half: existing f new Number of Bedrooms: 3 existing Onew W cr Total Room Count (not including baths): existing Jam" newer_First Floor Room Count Heat Type and Fuel: as ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes Alo. Fireplaces: Existing A_New Existing wood/coal stove: ❑Yes 'ko 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 - SLna(_e vx<<V Proposed Use 5CilnnQ. _ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) -Name I�. 7_"'pye zJ Telephone Number Address 19`� �<nS1'kWe_ IIGO< " License # (�S- 6U(®y3 411*-S Mk Home Improvement Contractor# 103-75 7 It Err, f jug L yA S, ec, Worker's Compensation # ?ODY 1 V 361 o?0/_3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO a,rrrpa /IJ 71 SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# # DATE ISSUED ` r i MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: ' FOUNDATION _ VC ?O1//7 P� .t FRAME INSULATION - FIREPLACE - 'r ELECTRICAL: ROUGH FINAL t PLUMBING: ROUGH FINAL GAS: ROUGH FINAL 'f FINAL BUILDING B��I j DATE CLOSED OUT ASSOCIATION PLAN NO.- t Map, Page 1 of 1 Town of Barnstable Geographic Information System New Search Home Help Parcel Viewer Custom Map Abutters Map Size ® 1 Zoom Out I EI fl1 I I®In JP(, Turnmap layers on/off by selecting check boxes below 207122 207130 ;�• N 183 9pq N 170 [ Town Boundaries J 20712g F Road Names ,r v d N:100 - 2N 1707123 r Voter Precincts } 13 Ell:.. Map&Parcel Numbers k ti [ Parcels - 207124 ti 0 N 153 r FEMA Q3 Flood Zones(Current Maps) t; Not for official flood hazard determination. a 15 AE(100 yr Flood) ' 9 AO(100 yr Flood) A 2071ze VE(100 yr flood w/wave action) 4 N 152 X500(500 yr Flood) 207125 N 137 FEMA Preliminary May 2013 Zones(subject to change) 1_ Expected Adoption Summer 2014 ®AE-100 year flood AO-100 year flood ' 0 45 Feet zD7,z7 .n ta4 VE-Velocity Zone , 0.2%Annual Chance Flood Open Water Set Scale 1" JPedztl Photos ��' , I MAP DISCLAIMER Copyright 2005-2010 Town of Barnstable,MA All rights reserved.Send questions or comments to GIS BdrnstableMA v1,2.4743(Production] http://66.203.95.236/arcims/appgeoapp/map.aspx?propertyID=207124 6/3/2013 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Sprinkle Home Improvement Address: 199 Barnstable Road City/State/Zip: Hyannis, MA 02601 Phone #: 508,775-1778 Ext.10 Are you an employer?Check the appropriate box: Type of project(required): 1.[XI am a employer with 10-12 4. [],1 am ageneral contractor and'I employees(full and/or'part-time). s 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.: required.] 5• ❑ We are a corporation and its 10.0 Electrical repairs or additions �. 3.❑ I am a homeowner doing all work officers have exercised their 11:❑ Plumbing repairs or additions myself. [No workers.'_comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and,we have no employees. [No workers' 13. tFter 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 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 information. Insurance Company Name: A.LM Mutual Insurance Co. Policy#or Self-ins.Lic.#: 7004943012013 Expiration Date: 1/01/2014 Job Site Address: 5-3 City/State/Zip: Cfid:::K_rc(,(11F� / 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 insurance coverage verification. I do hereby c ins and penalties of perjury that the information provided above is true and correct. Sianature: Date: Phone#: 50A 775-1778 Ext. 10 . 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 Contact Person: Phone#: SPRIN-1 OP ID:DS .4CORiO` w,tE(MMroolrrYY) CERTIFICATE OF LIABILITY INSURANCE 12121/12 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), AUTHOR12ED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the'policy(les)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 endorseme s. PRODUCER Br den Sullivan Ins Agency Phone:508-775-6061 �E;CONTACT 88 Falmouth Road Fax:508-79 -'1414 PHONE E, N.J. Kelley A.8ullivan�l ; AIC EA�SS: INSURER(S)AFFORDING COVERAGE NAIC 0 INSURER A:Associated Industries of MA INSURED Sprinkle Home Improvement Inc. INSURERS: rn 199 Bastable Rd Hyannis,MA 02601 INSURERC: INSURER D: 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 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. wLTRR TYPE OF INSURANCE ROM -OR POLICY POLICY NUMBER EFFMID POLICY EXP LIMITS GENERAL LIABILITY d - - EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO PREMISES Ea NTErence $ CLAIMS-MADE F—IOCCUR MED EXP(Any One Pew) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO I ILOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accdenrt $ ANY AUTO. BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ . HIRED AUTOS ' ��EO g Paraoddent UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESSIJAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- TH AND EMPLOYERS'LIABILITY TLIMITS A ANY PROPRIETOR/PARTNERIEXECUTIVE YIN N WC700490012013 01/0111$ 01/01/14 E . EACH ACCIDENT $ 500,00 OFFICERIMEMBER EXCLUDED? N I A (Mandatory In ) DISEASE-EA EMPLOYE $ 500,00 H ea describe under E.L:DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Rensaft Schedule,H more apace,is required) CERTIFICATE HOLDER CANCELLATION SPRNKHO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, .NOTICE WILL BE DELIVERED IN Sprinkle Home Improvement,Inc ACCORDANCE WITH THE POLICY PROVISIONS. Margo Mack 199 Barnstable Rd. AUTHORIZED REPRESENTATIVE Hyannis,MA 02601 Kelley 'SullivanA ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010106) The ACORD name and logo are registered marks of ACORI) Unrestricted -:Build•alga of any use grouP which contain less th;;ti 35,000 CubliC feel (991m3)of ^vlassacnusetts - Department o=Puw1c *, CIICIOSed SPaCe, } . moares,o= Budding•R.eguiations and Standards _ 4'rn.rrurtii,Cnc��u4p0c6r���i��.qq,r BRAD K SPRINKLEL Failure to 190 LOTHROP5 LANE' Possess a current edition of the Massachusetts W BARNSTABLE AN state Building Code is cause for,revocation of this Incense. Fnr OPS Y : Licensing information visit: www.Mass.Gov/pps 10/08/2013' Offiee of Consumer Affairs&Basidesa Regatatioa License or registration valid for individul use only . ME IMPROV CONTRACTOR before the expiration date-Af fo%und return to: V-9 tration: 103751 Type: Office of'Coasumer Affairs and Business.RegulaUon � Explration: 7/9/2014 Pmrate Corporatror 10 Park Plaza°-.Suite 5170 Boston, SPRINKLE HOME'I VEAA INC. Brad Sprinkle 199 Barnstable Rd. Hyannis,MA 02601 Undersecretary Not.valid witho signature SHEr Town of Barnstable Regulatory Services NAM Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstabi e.M.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder . w, `� ,as Owner of the subject property hereby authorize Sprinkle Home'Improwment to act on my behalf, in all matters relative to work'authorized by this buii1ding permit application for: �sha e_ .,�a.r►� -(Address of Job) 5igna r Date J o ce - � Print Name If Property Owner is applying for pe, it.please complete the Homeowners License Exemption Form onthe reverse side. (1•F(1RMR•i1WNF.RPF.RMtCC1(iN , SEPTIC SYS Assessor's map and lot ,number+ ! '".l..a�.��...........�'A,. INSTALLED STALL ��� ��� _ *THE E T ED 1�y Comp"', Sewage Permit number ......................`��,?..... 10 WITH TITLE ENVIRONMENTAL House number .............. ...........'. { ImAek s-e Aaa.sTen LE, i i63q. \00 mxt a TOWN ,OF rBARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..:.1.. ) �S..... tir! ........................ ` TYPE OF CONSTRUCTION ... ......... '....�.q....................19�v TO THE INSPECTOR OF BUILDINGS: The undersignned hereby applies for a permit according ^to�the following information: �n (� Location .......15 3.......1:�.��...... f...... ,�1....�.. .-,.....:............. ...Ltr .......1":`.1... ..................... Proposed Use ..... . .. .� . .. .. .. . . ..�.... ... r. �llYiz-.t' 9'' 'y'..:.... Zoning District ................ �.........................................Fire District .,...... ..... ................................... \ ......... h. �1�TI Name of Owner o.�.�.�� ,......\./.�.1.\.t �.:......Address ..:�J�...\r��1��.... ..'�j...... � 5a,3 MAIN �zx Name of Builder" R0.1�. ��":.�.V)U. .X-A&.........Address ................................ . Name of Architect ..................................................:Address................... ............... .................................................................. 2 �\ p Number of Rooms .......'?...................................................:Foundation A-0...�Fh\xs-lb.....ejrj F...... Exterior .C�-�i , ._.........................................................Roofing ................................................ Floors W �-,- - ... !�l �!`,.... F� '.....Interior - v1 ................................................ ............ .... Heating ... ��GZ ►� .........................Plumbing ..........N .............................................................. Fireplace. ........ ................:................... - :' ...........Approximate Cost ....: �.. .Q.x...� .................. 440 Definitive Plan Approved by Planning Board ________________________________19_ ____. Area ...........vf����... ............... Diagram of Lot andC Building with Dimensions �!�� L ee ` e S oo ............ ...................... SUBJECT TO 7OFOF HEALTH i 3� 1y 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... . k A—* .............. Construction Supervisor's License ..O . ....... WOLSKY, SUMNER No ...279.24. Permit for ..;ADDITION............ Single Family Dwelling ................................................................................ Location .....153 Horseshoe Lane - ................................................:.......... Centerville .................................... .......................................... Owner .. Sumner Wolsky ................................................................ Type of Construction-' Frame ...........;........... ........................................................................... Plot ......................... Lot'- ............................... 7 May 24, 85 '.F � � .� .• .. � Perm it,.,,�Gra nted .................................... 1,9 Date of. Inspection ........................................19 Date Completec/4-:n_.A.41........ ...... . if,i Assessor's map and lot number: 1���". .` ..........)1, .. v F THE Wes,,.Permit number ..................... ,��.�" ,fi S Z EARNS TABLE, House number ......................f,......... ..... 'moo 1639 m� TOWN OF BAR TABLE . W BARNS TABLE INSPECTOR APPLICATION FOR PERMIT TO ....a..�,�. � 1. C. ............................................... {{ ' � 1 �I of n'1 1'!!t=\.i..�N ..............TYPE OF CONSTRUCTION .................. ........ , ....r.............. ........................................................... :...y. ..................19 �' .� TO .THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... .]. `? ...... 4 '�.t ?'c=��; � ...... C` .. ':��':. ;;;�, ;�; ,...��C...... .� ..................... 7. Proposed Use ......�fr I �"It � . .. f ) '. f:�.r-'..........................t f .................................... 4 -- Zoning District ................ ......... ...........':............................Fire Distract .. ...C.. ....�:: ...................... _ Name of Owner`". ?.�)..l ......Address .... . �.... „��•�� ;.—`"``<,.. C!; 1�.� �;ti��i Name of Builder` .........Address .......................�t _ t- 1 L Nameof Architect ............................... .....Address............................... .................................................................................... Number of Rooms _ � ............................Foundation � Exterior -: `� =ti•CC .......................................................Roofing '. "� . ', ? ::.):..................................................... Floors :::...i......................i . t=� .��r.............Interior ` ..�\ i-: \� .......:........................................... Heating ...C.. ..`...`......Ct 1........................................................Plumbing ..............\�C .............................................................. —)7?. 1 Fireplace ........ .tn................................................................Approximate. Cost ..... ....................................... Definitive Plan Approved.by Planning Board --------------------------------19-------- . Area ........................................... Diagram of Lot and Building with Dimensions 11��s�s d u� L 1 a� Fee ` ' SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 I } � 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 s N V) '- -........... Construction Supervisor's License . 'r ..? . - . 79OL ` � | � No Permit for . `.......S.ill ..ZaumiIlC..Welling.—. Location ......l5.3...B)mro.ealzoe..I^arua........... ' ------' Ue............................. Owner .....S.uonezc'WoJ'aky........................... Type of Construction .....���g� .......................... ' ' . --------------------------' ' F1ct ............................ Lot ................................ � ' Permit Granted --D8ay—�4.[-----lV 85 , Date of Inspection ------------lg Date Completed ------------'l9 / U � - , � ~ � ` ` ~ . - ` | ' � � SPRINKLE HOME IMPROVEMEN 199 Barnstable Rd. - Hyannis, MA 02601 ---ter o� 2>X 1_D pT�_ . ���_'(YM -� l Z"` O.C.. • .B.0 _4 1�GsT T'(e5 T �t:.r:) Xzr c�a �aA h., r�c, (3olr5 - STACrG.e wn- 5hcy — r I r o I E a 2 - i -. - - - ^X'' �. C'T Iz pc ,n s ng :� Ip" Soma 'Cu[,e5 or _ � Y t � � �rf=f�L �"ti'L-rae5.e.1 v�,=C a�-`5,p•�'�.3�z 7�3^fi�K '2•�i_i;- 17"