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HomeMy WebLinkAbout0093 LONG POND CIRCLE Lillr. o Y TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Cl Parcel O3S Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address /iL c /e Village Owner Address �fr,44" Telephone P'7 7/7 Z Z.9— Permit Request Sr t 5'2- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ?OD, rs D 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 *o, 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:,U existing U new size_ LL7 4 r Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other;- f k Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ M.T Commercial ❑Yes ❑ No If yes, site plan review # Ln Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name PB Co �.� a� Telephone Number Y '— Address/� �jZOo� License # l G D 9 Roe Home Improvement Contractor# ,/ _4_-3c5 L 7 Email Worker's Compensation #,W�2 D t' -7/ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 6 71/_r-" FOR OFFICIAL USE ONLY APPLICATION# - - - DATEISSUED MAP/PARCEL NO. L ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL I`Y PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 4 DATE CLOSED OUT ASSOCIATION PLAN NO. i OWNER AUTHORIZATION FORM .{ (Owner's Name) owner of the property located at 3 16� Con& d j C (Pr party Address�h � Z ` (Property Address) herebY.authorize - Q, 12. YS v (Subcontra ) an authorized subcontractorfor'RISE Engineering,to act on my behalf to obtain.a building permit and to perform work on my property. X Owner's Signature r t9 — ao� Date. N ;, Mass.,c:husetta -Uepariment of Public Safety . ..Board of Building Ragulations'and.Standards Construction Super`isor License:CS 100988 HENRY E CASSIID ' 8 SHED ROW. q WEST YARMOiT`THr: 02 , Expiration commissioner 11/11/2015 �G- Office of Consumer'Affairs and Business Regulation 10 Park Plaza - Suite 5170; Boston, Massachusetts 02-1.16 Home Improvement Contractor Registration $^ Registration: 153567 ` Tvpe:. Private'Corporation Expiration: 12/15/2016 Tr# 259188 CAPE COD INSULATION, INC ` : ' t '•; HENRY CASSIDY 18 REARDON CIRCLE ` ' - SO. YARMOUTH, MA 02664 " ' fUpdate.Address and return card.Mark reason for change. SCA 1 ..,r 20M-05/11 E Address Q Renewal E j Employment 0 Lost Card , &X e t 111.soascoeultI a1a&jjcccX,,jeffj r Office of Consumer Affairs&Business Regulation License or registration valid for individul use only UVOEM IMPROVEMENT CONTRACTOR before the expiration date.{If found return to: egistration '.153567 Type: Office of Consumer Affairs and Business Regulation' xpiration 12/1¢/201.6 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSULATION tNC HENRY CASSIDY 18 REARDON CIRCLE SO.YARMOUTH, MA 02664 Undersecretar Y N vaIid.wi ut sign e r The Commonwealth of Massachusetts Department of Industrial Accidents Y Office of Investigations f - t 600 Washington Street' . F 'I Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): (_,li/ r Address: Gf� V ' City/State/Zip: 4 M, Phone #: Are you.an employer? Check th appropriate box: Type of project (required): ' . am a. eneral contractor and I.. 1. I am a employer with 4 I❑ g 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner listed on.the attached sheet. 7:"❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity.- employees and have workers' [No workers' comp. insurance comp. insurance. $ 9. Building addition required.] 5. ❑, We area corporation and its 10.0 Electrical repairs or additions officers have exercised their 3.❑ I am a homeowner doing all work 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs I - insurance required.] c: 1.52,§1(4), and we have no ' f� employees. [No workers' 13: OtherU 41 0 comp. insurance required.] *Any applicant that checks box 41 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. +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. n. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. r ;.� Insurance Company Name: �Ajt� r i •�. ' 'n v � Policy#or Self-ins. Lie.#:' tAL5-00' 1.. , 1 -.. Expiration Date:-' Job Site Address: V� 4'!1 C/�G�G� City/State/Zip: 00 z Z _ 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 . covera e 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#: 14W9Z 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#: 'F CAPECOD-27 BDELAWRENCE A�CORO DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE , 6/30/2016 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. 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: Rogers&Gray Insurance Agency,Inc. PHONE FAX 434 Rte 134 A/c No Ext: AIc Na:(877)816-2156 South Dennis,MA 02660 EMAILADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Peerless Insurance Company-see LIBERTY MUTUAL INSURED INSURER 8:ATLANTIC CHARTER INSURANCE GROUP r Cape Cod Insulation,Inc. INSURER C: 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. ILTR TYPE OF INSURANCE D LSUBR POLICY NUMBER MMIODY� MMIDDIYYYY - LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ W1,000,000 DAMAGE RENTEU--. CLAIMS-MADE OCCUR CBP8263063 04/01/2016 04/01/2016 PREMISES Ea occurrence) $ 100,000 MED EXP(Any One person) . $ 5$000 PERSONAL&ADV INJURY" $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRO- GENERAL AGGREGATE $ 2,000,000 X POLICY 0JECT LOC PRODUCTS-COMPIOP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) .$ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATIONOTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE WCE00431901 06/30/2016 06/30/2016 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory In NH) E.C.DISEASE-EA EAPLOYEE $ 1,000,000 If as,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES-(ACORD im 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. 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 18 Reardon Circle ACCORDANCE WITH THE POLICY PROVISIONS. 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 I CAPE COD MSULAT.I0N IIII0.01A13 SIANl1 SPRAY SULAAl SUSPINOIp Ti! - - YA OURIYS INSUTATIiION CIIlIN03 - 1=800-696-6611 P Town of Barnstable h Regulatory Services r Building Division I.1� 200'Main St - I 0 Hyannis, MA 02601 Date: W €ci Dear Building Inspector ector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the.property'listed below. Cape Cod Insulation did this-in accordance to the.specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village Insulation-Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings .. Slopes Floors ( ) ( ) ( ) ( ) ( ) Walls ) ( ) ) ( ) ( ) iv e r� Gvor 0 ro Sincerely 2Hr E ssi r, President Ins ation, Inc. , p oe (1st f loor): ap and lot number d ... .d .............. . . ... 37 I y0F THE 1p�I th (3rd floor):. ffi` { mit number ..... . !.Ca..........:................ Z BABIISTI►DLE Engineering Department (3rd floor):. .- - �a MMa g � p 2639• House"number ................................. :.......�. ...........:......... .. OY AYa�9 a 6 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 Q. ........ 11 '`�, TYPE OF CONSTRUCTION A.IkC4: 0I ..... .... Xl !N . ...��!/�C:'�l/U ll. .......................................... • ....................19.. .� -TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location L(7....*35......L.ukj.....?a.�.P........CiR.4.1.° .....I........... .F..:............................................................................ ProposedUse W �l//)A . 1.�?.�...........PS lr..........�..'..... .�...... .......................................................................... Zoning District ....................................................Fire District ....................... Name of Owner �..r�.� ...� !�e ICG,�...........................Address i ?.. T jV 4A4 .Z �01,1 A ,A Name of Builder fi97/ .Ad eq. .....................................AddresJ ..q.)gep..PiagZy! Name of Architect /..!I.l..�4l?� `C.0 .�7 5(J,L. ...................Address 4 4*4./&K1)d'4 � i rIJY.✓✓Y�l i .Number of Rooms ......Se-Ve. PO.(, fa.p.............. ti�...........................................Foundation ..........................................�....... r C tJ /4 bpl�,�s /��f�r Q� / YI!�. Exterio. ...... ..f....R.n:.............p...............................................Roofing !� ...............................b!!�.(�:Cg.....�..........`......�.. Floors 1� �1aG ,..(��!(��.L..::.........................................Interior6.q. aZ�G ......................................................... Heating //... /../..,!.'.. .............:...................................Plumbing ... I� .S....:........................................................ ( / Fireplace �C.. /.1ip l A�..c .................................................Approximate Cost ! 0�..�S V f ............ . ........ .................................. .. . - . Definitive Plan Approved by Planning Board --------------------------------19-------- . Area . ........ Diagram of Lot and Building with Dimensions Fee .. _.--- SUBJECT TO-APPROVAL OF BOARD OF HEALTH I � y 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 tl l. !��........t`.t... Construction. Supervisor's License .... �US.r�r......... .k D, SCOTT A=209-35 EFIEL .�, Permit. for ...Addi.tlon............ Single_,Fg.Mily...D.Wa11ing.... Location .Lot. U5..,,..._9.3...Long-P.ond..Circle Centervi l 1�.................................. Owner ......Scott..Wakefi.Q.l.d..................... Type of Construction ...1''.>r aMe.............. ~ Plot ............I............... Lot ............... ................ Permit Granted ..... Sept. 24,..........19 87 -,'Date of Inspection ....................................19 Date Completed ......................................19 1RCf�c�/ ell I } jo C6 se Ost floor): �, TEm MUST BE �✓Assep and lot number ... ..6. ............ 4 r �� y FTHEBoar (3rd floor): i � G ,� ,� '� �s®���.�����Sewit number ....,,�.`.7n.�.�./.(�........................... WIT `T���.�C�oOD AV � in Department 3rd floor `°': ' �� �� �o ` rwa Engine, g P ( ): �+' N ,sue House' nur f,er ..........................................7..�........................ I�, . `� L F 0'Ep MPv.p\0� DGl6 APPLICATIONS PROCESSED 8:30-9:30 A.M, and 1:00-2:00 P.M. only A P P 0g ®WN OF BARNSTABLE owastable conseiTtLaA car:A6DIJ I L D I N G INSPECTOR o -�.�IT ............................. TYPE OF CONSTRUCTION A.9 A/........�r.... X�S !�5....../?,0/C i))ti`� ' J TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..I.A.T.. ..3. ......L4.At.C�..... aDt.a........ .11� ��.....�........... ...M. ...................................................... Proposed Use . .e'SI.L?�!#6..'..... .1.! f°. ..... ..+!>!i. .... �N1G �^f�}.......................... ....................... ZoningDistrict �....................................................Fire District ..............................................A,' ................ ......... ..............Name of Owner G.d.Xi.....�kegj.(.0" ...........................Address ��9 H�!?Yi21'�1�....��. L�'0�1� .... ........� Name of Builder /'�`�! .....................................Address Name of Architect ���L!Al?Ty��ySC�G....................Address / 1....!!!�^..s��ad'4 � �P u✓�G j�1 Numberof Rooms ...... ...........................................Foundation PUs/.14v................................................................ Exterior ...... �A.f� .....4.!. PbpAl-wg...............................Roofing p, l .�....�....1..�. ��j� ..... h N.�.l�[ .. � nn /. � azl Floors .....l�tr'�j��..�1!�[.'�./..............................................Interior .mil ............................................................ Heating !.'.. ..................................................Plumbing ... tr .S............................................................. Fireplace (°.. /I.l�'��Al�.r.................................................Approximate Cost-.."l..®.q/...pz .... ................................... . s Definitive Plan Approved by Planning Board ---------------------_----------19________ . Area .. .. . ....... Q�............... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH t U� �5a < <d 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. n I ,�,� Name '.! �7�!�...... ........................ Construction Supervisor's License .....0�4r'rr WAKEFIELD, SCOTT No ..31227. Permit for ... ... ....o.n........... j Dw. i.ng........ ....... . .... Location ... *.3 5 R3 L. .. ..Pond Circle 4......... ... ................ r. ..................C.ent.er.y.i: ..... ..................... Owner ....Sc....o...t.t.......W.a...k#g ... ...................... Type of Construction ..T-KJMIP... . .................. .............................. ..................... Plot ............................ Lot ................................ Permit Granted .. September 24, 19 87 ...................................... Date of Inspection ....................................19 Date Completed ......................................19 I I �j 3 EaG�of 9 o P/ Bic 16 Pe r ,)STiAlC- LDEC of r_- .' 33 8 343s _/L.�� j��T1L YSTEI-n ( 1 3 q -37.7 ,��cAj f(.. -Tc)3 tcBA t A po!.1 E� L . I 3\ 34-S I \34�) II 2c 6oC S. i�'1r ± 39.t 39.� 387 - 3 .5Pea ) B 1 3w. 3 1 31. 3B- GNP R 43. 1 W �q � �93 Lam^':.. '•` .�, Ira 4 'R f DDT Co u e- tv v ST w C4_7C 40. �. 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