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HomeMy WebLinkAbout0139 LONGFELLOW DRIVE o c . 0 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �'%*N Parcel t- o b Application Health Division Date Issued 3 12 Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic _ OKH _ Preservation / Hyannis Project Street Address im Village Owner Address f=_`%.o"-rZ ,aN u6 Telephone -56m-'1a fl3\s e_ +.., z c.. . `.6_ Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation C>C) Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family W,***' Two Family ❑ Multi-Family(# units) W Age of Existing Structure �5 Historic House: ❑Yes ❑ No On Old KmgYp,Highway:r ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Others Basement Finished Area (sq.ft.) Basement Unfinished Area (sq. ft � Number of Baths: Full: existing '5 new Half: existing neW_. °T' Number of Bedrooms: 3 existing —new Total Room Count (not including baths): existing 'J. 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# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number !s�o%- ;;3-?. - "Q3 4%H Address '3,*A License Home Improvement Contractor# "q i Z! Email Worker's Compensation # a��3 co3ti� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO T e SIGNATURE DATE 1 l� A FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r r Massachusetts Departmen of Pub1"tc SafetI Board of 5WIding 11"Wations'ancl Standards- Comtruc6on Supenictrs specialh License.CSSL-102778 CONOR D MCUA,MY 39 SWCONSET DRPV SAGAMORE HEACI€ J1 s,t Expiration Comrnis'sionPr. .08119120.16 ' ��fr, 'if�rxrrunrrrrarrr//l r�C?tlr,r..rrr�rrtiJlJ , - Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before.the expiration date.If found return to. istration 111251` Type: Office of Consumer Affairs and Business Regulation: . xpiration: 311f2016 Partnership: 10 Park Plaza'-Suite 5170 Boston,MA 02116 CON-SERVE ENERGY CONOR .MCINERNEY'-`` 376 ROUTE 130 SUITE C ,7 a_ SAN(]+NICH,MA 02563, Uodersecreta.ry Not valid without signature The Commonwealth of Marssachusetts' Department of'Indusiriul Accidents Office of In vestigutions 600 Washington Street Boston, lVlA 0.21: 1 www.mass.govldia Workers' Compensation Insurance Affidavit: :BuildersIContractors/EtectriciAns/Plumbers Applicant Information Please Print Lep-ibiy Name(Business/Organizationnndividual> ConserVision Energy Address: 376 Route 130 Suite C City/State/Zip': Sandwichi MA 02563 ['hone #: 508-833-8384; Are you an employer?Check the appropriate box: Type of project(regwred): I.[ I am a employer with 8. 4. ❑ .I am a:general contractor and 6. Q<New construction.:. employees(full And/or part have lircd ttre sub-contractors 2,❑ I am a sole proprietor or Panne r- listed:on the attached sheer. € [�;.Remod,ehng ship and have no employees; These subcontractors Piave 8. ❑,Demolition. working for roe in any capacity: workers' comp.insurance. Building addition [No workers"comp::insurance- 5. El Nve area corporation:and its required.] officers have:exercised their 101.n Electrical repairs or additions 3.El am a homeowner doing all work:. right:of exemption per MGIr l I.❑ Plumbing repiitrs or,additions c. 15" ] .and we ha�,e no Roof repairs airs'. myself. [No.workcrs comp_: § O, 12U p insurance required,]t employees. CNo workers' l3 .Other..:Weatherization comp. insurance required.;] 'Ally applicant that rhecks box A! Must also:fill out'die section.bclow showing'their workers'compensation;PO key.infi rotation: . t Homeowners who submit this utidavil indicating they are doing all work and;thcn hire outside contractors must.subni%a'new dfFidavd:iiidieating'Suc.h!: lContractors that check this box'riu►st attached an additional sheet shciwing the name of the and!hair wotkers`romp.policy iarormat on. tam an employer that is providing worki°rs'compensafCon insurance for my:emplotzees Below is the;policy;and jo#sate information. Insurance Company Name: CS&S/WORKCOMPONE 6011316349 03/;11/2015 Policy#or Self-ins. #:: Expiration Date - Job Site Address;' _ City/State/Zip: . Attach a copy of the workers'compensation policy declaration page-(showing thepollcy number and expiration date):` Failure to secure coverage::as required under Secfion 25A.'of.MGL c. 152 can lead to di imposition ofcximinal penalties of a:. fine to$1,SO0.00.:and/or:one=year imprisonment as well as civil penal ies irr the form of a STOP VJgRK ORDER and a,>•iiie of up to$25.0.00 a day against the Violator:: Be advised That a copy of this statement may be foi vardcd'o tI Off cc of Investigations oi'tlae DIA for insurance coverage vcrifcatian. /do lrereb fJ''. der fh p 'ns nd penalties of perjury that the.infurniatidn provided above tic true and correct`, Phone#_ 0 ial:ase only: Do not write'm this area, to completed by city or town:nfficivL City or'Towna .. Permit/.!icensc; tssuing;Authority.(circle one):. ;1.Board:'of Reaith I. wilding Department.3.City/Town Clerk; .4..Elecfrical. nspector 5 .l'lutnbing inspector 6.Othet' Contact'"person: Phone,.'#• i r DATE(MWDDXYYY) A CERTIFICATE.OF LIABILITY INSURANCE 0311712014 THIS CERTIFICATE IS ISSUED AS A MATTER INFORMATION ONLY AND:CONFERS NO RIGHTS UPON THE CERTIFICATE;HOLDER.THIS CERTIFIGATE DOES NOT AFFIRMATIVELY ORNEOATiVELY;ANIEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. TNIS,CERTIFIGATE OF INSURANCE OOf5 NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),A D.REPRESENTATIVE OR PRODUCER,AND THE ERTIFICATE"HOLDER. UTHORIZE C IMPORTANT: If the certificate holder is an AODITIONAL:INSURE4,.the poiicy(ies)must be endorsed. If SUBROGATION IS WAIVED,subiect to the tarns and conditions of the policy,certain policies may require an endorsement, A statement on.this cert(flcate doss not:confer,rights toahe certMcate holde�an Ileu of such endoisemer+t(s}. ..CONTACT PRODUCER NAA1E: - CSBStWORKCOMPONE PHBNE ... FAX PO BOX 946580 (A/C,No,Ed): (A/C,Hoi: MAITLAND,FL 32794-6580 :.Phone-877.724.2668. _ INSURER(S)AFFORDING COVERAGE ... - NAIC0 Fax-877-763-5122 Continental Casualty Company. 20443 INSURER A! - INSURED - :INSURER Bt .. .- ..._ CONS ENERGY INSURER c:,_ 376 ROUTE'130 Continental Casualty Company'. 20443 SUITE C INsuaea D SANDWICH,MA 02563 INSURERS:Continental Casualty Company:: 20443 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER THIS iS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED Br L.ELOW HAVE BEEN ISSUED TI THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY.REOUIREMENT,TERN'OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT'TO;WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THEdNSURANCE AFFORDED BY THE POLICIES DESCRIBED HERE(N it SUB JEC1 TO ALL TF4E TERMS;EkCLUSlON5 AND CONDITIONS:OF SIJCH,POLIGIES.lltilr[S SHOb!!N MAY HAVE BEEN REDUCED BY.PAID .. L - LUdiTH LTR TYPE OF.INSURANCE' - INSR WML POLICY NUMSER MMI� - hiMW GENERAL LIABILITY _ EACH OCCURRENCE. 51,000000 COMMERCIAL GENERAL LIABIL{TY DAMAGE TO RENTED' $300,000 PREMISES(Ee occurronceJ CLAIMS-MADE OCCUR. MED EXP(An ane ersoh $1 O;000 A ' Y N 6011316335 03/t:W014 63h 12015 PERsoNAL a.Aw INJURY $1,000,000 GENERALAGGRL-GATE $2,00000 GFN'L AGGREGATE LIMIT APPUIES PER: PRODUCTS•COMPIOP AGG $2,000,OQO POLICY PRO- LOC. JECT COMBINED SINGLE LIMIT $1,000,000 AUTOMOBILE LIABILITY - (Eeaccktent} BQDILY INJURY,(Per puraenj' LrAU D scNeouLEo N N 6011316335 03f 11I2014 03/111T01;5 BDOILY INJURY(Per accldenl) AUTOS- TDS. NON"OWNEO: PROF'CRTY OAMA6E HIRED AUTOS (Par:ecdA UAB OCCUREACH OCCURRENCEIAR cLAIMs-MAC:... N N 601.1 52 03111/2014 03/1112015 AGGREGATE000 RETENTIONS 10,000WC STAT •MPENSATION: - ,TORYLIAIlj�" ERC. AND EMPLOYERS'LIABILITY - $1 OO,OOO ANY PROPRIETOR!PARTNER7EXECUTNE Y(IJ N, ' N 6011:315349 03/11/2014 03111120:15 E.L.'EACN ACCIDENT E )FFICERttvIEMBER EXCLUDED? $100;000 '(Mnnoatery to NHi . . E.L.DISEASE,-EA EMPLOYEE it yes,desalbe under. DESCRIPTION OF DPERATIONS b01ow E.L.:DISEASE•POLICY LIMIT DESCRIPTION OF.pPERATION51 LOCATIGNS 1 VEHICLES(Atlas Jr,CORD 101,Add,tiwlal;Rer+tarRi Sd+edule,d miss sEace is rBqukedj, Cerilheate Holder.Is added as an additional insured as provided in he blanket additional'insured,®ndorsernenfi, CERTIFICATE HOLDER CANCELLATIOk, Rise ng neenng SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1341 Elmwood AVe.: THE EXPIRATION GATE THEREOF,NOTICE WiLI BE DELIVERED IN: CranStOn,RI O29111: ACCORDANCE WITH THE POLICY PROVIStONs ;. AUTHORIZED REPRESENTATNE . . ©1988-2010 ACORD CORPORATION. All rights reserved ACORD 25:(2010lOS)' The:ACORD name:and 1 o.are re istered marks of ACORD.' aacaass og g b r OWNER AUTHORIZATION FORM Off-a Zt Zb oar of properly located at G - -,'-J- > lam, f?�� 32- hereby authorize ConserVision Energy,to act on my behalf to obtain a.buiidirg permit to perforrn%,dt on my prop". Owner Signs ®ate �!r / v 1 Assessor's map and lot number . ...Q..r�.:f/.t ® . M HE repTiC SYSTE OO - o�y wage Permit number .........................................:.............. 0 �LEU iN C o� INS'f A TIC1-E II STr^ �� WITH 1 ®DE �N 2 3T"LE, i House number .... - -�......: .. y .... SANITARY C 9po rb ..... T VzEGUI.A IONS. i°�awava�e TOWN OF BARNSTABLE BUILDING ' INSPECTOR APPLICATION FOR PERMIT TO ..:.. _ 9. g�. Vd`'I....... ,�Y. ......................:.......... TYPE OF CONSTRUCTION ........ lJv�... 7 .................................................................................. ............... ..........19.�. TO THE INSPECTOR OF BUILDINGS: The undersi ed hereby applies for a permit according to the following information: ' Location / . . ..... .� .3. ......... !v�/ .6w.. �'�:...... ............................ ProposedUse . � .....,lad/--1........................................................................................................................... Zoning District ......... /T 0 ................... ..%L..J...• .......Fire District ....1.................................................... �..J f�......�`£ lr.� A/_01CT/S Name of Owner ..I...:/..e... ,"�AJ /!�/.1�.14� Address Name of Builder ,. . �°'�...frf.. /.. . /.......Address ..GP. .... .. Nameof Architect ........:.........................................................Address .................................................................................... Numberof Rooms ..........0. lel!..........................................Foundation .........................:.................................................... Exterior ....................................................................................Roofing ..........................................................:......................... A r -�� �. ..............:...:............................Interior .....................:..............................................................Floors ............chf Heating ......1,(QT... .......................................Plumbing P d Fireplace ..................................................................................Approximate Cost .......••..•C". D.©.. Definitive Plan Approved by Planning Board ________________ J� ----- ---------19--------. Area ......./.�... �e ...................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the To n of Barnstable regarding the above construction. Name .......... ....... ...................... DeBenedictis, M. ; 20818 T "'`1 emodel garage No Permit for to bedroom ............................................................................... Location ... . Longfellow Drive i Centerville ............................................................................... i M. DeBenedictis = Owner .................................................................. frame Type of Construction ............................... , 4 ............................. ............................................... # ` Plot ............:............... Lot .......... 1 Permit Granted ...........Novembe.r .,15.....a 9 78 i ^ Date of Inspection ........../..........................19 , �/Date Completed ......... ...................,.......19 • PERMIT REFUSED 19 .� t % ............................................................................... 1 ................................ ........................................... _ ............ . • 1 ........................ i Approved'. ............................................... 19 I w .................. ................................................... ; ................'.............................................................. Assessor's map and lot number ..t............................. Q Sewage Permit number ........................................................ ' �'� Z BAWSTAD House number ........... ....�.�.�`............. fir....... 90o rb a 39• �0 TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........... .... ^' � y ................................:..............................:........................................... TYPEOF CONSTRUCTION ..................................................................................................................................... .......................tl..... ...............19.D TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for la permit according to the following information: Location / LQIV( E6W !X I v', . ,. ..... :.... ....r'/ �..!. ... .......... _ , Proposed Use ........... .......................... .. ......................................................................................................................:..... + Zoning District .................f 7.............. ....... .. .. ..Fire District ... ..................................................................... Name of Owner .. r ,:.. f',c�/I7��c ..�.a.Address .....��QrU�,��",L� I /1'....� ... Name of Builder .??ALJA.../ �F//�F/te a/=/"......Address ..!��+ //`7�, �/�1 // Ffi��!�".�� ..... F. ;,� Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ") V Foundation............................................. .............................................................................. Exierior ....................................................................................Roofing .................................................................................... Floors ..., ! .. C...............................................Interior .................................................................................... .................... .:.............. Heating ........ ....i7 ...:..:............................................Plumbing ......... ........ .......................... ........................ Fireplace ..............n..................................................................Approximate Cost ..... r................................................ a Definitive Plan Approved by Planning Board -----------____---------------19________. Area .......& ...................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH R .R I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..:, � ' �� DeBenedictis, M. A=189-112 no ` 20818 i,�� No Permit for ,, remodel garape.f ................. .... to bedroom ......................................................................... ..... r Location Longfellow Drive Centerville ............................................................................... M. DeBenedictis. Owner .................................................................. Type of Construction .........frame ................................. i .................I................... .................................. iPlot ............................ Lot ................................ Permit Granted ....... ovember.,15.........19 78 Date of Inspection ............s.......................19 Date Complete .................19 i PER T REFUSED ..................................... ...................... 19 ................................. .. .. ......................... ............ .�J�� . ..................................... .. ....................... .................................................... . ....................... ved ................................................ 19 ............................................................... .........................................