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0014 MARRICK COURT
y l�} gc�rr-iG �C �Dtca--�- o o , . c ,r .. .� _� , �. y, .. ., ... ._. � n v .. ... .. .. -. �.. :. '�` ... .� - � '. .i .. � o ,. � , �f :-.. .. � G c � .� q�,.. v � - .. o - _ Po - .. - � C .. �. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Z I`SC Map �^� Parcel Application # Health Division Date Issued /�30l1 led- Conservation Division Application Fee. Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village &"r rjrll2 Owner �_n C_I Address Telephone `�6y-►7d� Permit Request ��t1.�r,z.�,... 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 Grandfathered: ❑Yes ❑ No If yes, attach sub�6rting documenWation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) r_.. Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's H' hway: _Z3 Yeses 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: ❑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 _ MkkA4eCavt y Construction Telephone Number PO Box 52 Address West ]Dennis, MA 02670 License # Cell (508) 250-6964 CS-L-58633 14 IC 469393 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE /b. t FOR OFFICIAL USE ONLY ti F 1 ' 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. '1 �1 Massachusetts - Department of Public Safety Board of Building Regulations and Standards { Construction Super�'isor License: CS-058633 MICHAEL J MCCAR PO BOX 52 s W DENNIS MA 16264 I 1 Expiration Commissioner 04/10/2016 b1&J1jaC11?Y1t1jte1'ff/ /tj, x Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 169393 - Type: Individual Expiration: 6/16/2015 Tr# 238121 MICHAEL MCCARTHY MICHAEL MCCARTHY -- ------ _ --�- ------ P.O. BOX 52 -------- — -- WEST DENNIS MA 02670 ------ _ Update Address and return-•card.Mark reason for change. /' ❑ Address ❑ Renewal Employment Lost Card SCA 1 Ei 20M•05/11 ../ The Commonwealth of Massachusetts Department oflndustrialAccidents Office of Investigations 600 Washington Street Boston,M4 02111 ivivimnass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Blectrici,,iw Plumbers Applicant Information Please Print Le ' I f eke McCarthy Construction Name(Business/Organizationflndividual):- PO Box 52 Address: West Dennis, MA 02670 City/State/Zip: CSIpa§Q3 HIC-169393 Are u an employer?Check the appropriate box: Type of project(required): 1.Grl am it employer with _ 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole propridtor or partner- listed on the attached sheet,t 7. ❑Remodeling ship and have no employees These sub-contractors have 8. n Demolition working for me in any capacity, workers'comp,insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its l0. Electrical r required.] officers have exercised their ❑ repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I L[I Plumbing repairs or additions myself.[No workers'comp. c.152,§1(4),'and we have no 12.[1 R f repairs insurance required.]t employees.[No workers' �° comp.msurancerequired.] 13.Q'Other *Any applicant that checks box#1 most aiso file oat the section below showing their workers'compensation pot icy intbrmadon. t Homeowners v&o submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the subcontractors and their vwrkers'comp.policy information. lam im employer ilia(is providing(porkers'compensation insurmtce for my employees 1leloip is ilia policy and job site lnformallon, Insurance Company Name: �Ji✓v� Policy#or Self-ins.Lie.#: VWL 1w-tan 11t,;G "1,4 Expiration Date: Job Site Address: y k,,_L C4, 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 Section 25A ofMGL e.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 i 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 cerWfy the pa a enallles of perjury that the information provided above to true and correct Si tune: Date: I� tr Phone M. Of leial use on y Do not sprite in iltis area,to be completed by city or toipn offklaL } City or Town: Permit/Lleense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#t :�,a►e Ro o® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/1012014 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 01962-001 NQOTACT Bryden&Sullivan Ins Agcy of Dennis Inc NC.No.Et): (508)398-6060 ,No.: (508)394-2267 PO Box 1497 �"Sss: So Dennis,MA 02660 -- INSURER AFFORDING COVERAGE NAIC# INSURERA: A.I.M.Mutual Insurance Company_ 26158 INSURED INSURER B: Michael McCarthy Construction Inc ---- IN URER C: P 0 Box 52 INSURER D: West Dennis,MA 02670 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. NO'PWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER OCCUMENT WITH RESPECT TO 'AI-IICH 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 INSR YVI/D POLICY NUMBER MM/DD/YYYY MNI/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ PREMI E occurrence) _ — CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ —___— GENERALAGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ )OLICY F UECT —�OC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident �I ANY AUTO BODILY INJURY(Per person) $ALL OWNED SCHEDULED L AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS P accident) $ $ - HUMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ yyp I KDDEEERRDgg ppMM E�RETENTION $ yy�gT 7� OR $ gANNyD EMPLOYt:RS'LLIgA�BTINLIETY X YIN X A LIAMITS OER A I OFFICER/MEMBER EXCLUDW&?ECUTNEa N/A VWC-100-6017656-2014A 7/17/2014 7/17/2016 E.L.EACH ACCIDENT $ _ 500,000.00 (mandatory iin���NH) E.L.DISEASE-FA EMPLOYEE $ 500,000.00 D9�sCR�A�ON 1PERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Workers Compensation Coverage applies to MA employees only. CERTIFICATE HOLDER CANCELLATION Thielsch Engineering 196 Francis Avenue SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cranston,RI 02910 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located a p p Y t ck rye ck (Property Address) Ct4/0-c YV'1l4U KA, blce32 (Property Add ess) hereby authorize (Subcontractor) an authorized subcontractor for'RISE Engineering, to act on my behalf to obtain a building - permit and to perform work on my property. Owner's Signature Date r s. map and_lot num ...... ..... a�.:..... � j 1� GY C QyOf THE To�� a" p sewage Permit number .......... SEPTIC .f......�..:................... . INSTALLED NCO . . � r B 9T LE,;i Y House number ... ..........r.. ....R ....... ....... = �z ^. . ....................... WITH TITLE ,, tv3q.a\00°j E V NTAL COD TOWN OF . BARN�ST GULATIONS � 4 RUILDINS ANSPECTOR APPLICATION FOR PERMIT TO Build Siri le Famil Dwell ........ ................"Y. ............ 149........................................ TYPE OF.,CONSTRUCTION ,.....::....WOE.d...fx'ame......................................................................................... Nove.mber. .......................19. 80 .......... ....... .. le TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..............tot...IS...Ma.rr ak..Court.,...Cent.eruille..................... Proposeduse ......Sing.le- Family...Dw.elling................................................................:........................................... Zoning District .......RQ9;.14 Mt.1 1................................. .Fire District .:.. ................ Name of Owner .....jwu...K.....Smith............................Address ...........13==.tCAble............................................... Name of Builder ...JAMe.9.-.K.....eSII1a.n............................Address ..........Baxnatable................................................ .Name of Architect ................................................;...:...............Address .................................................................................... Number of Rooms ........... ...........................:........................:Foundation' .. 0..Ure.d...C.onre .e..................................... Exierior ..C490.gard & wh cedar. sh ngles.....Roofing ..........Asphalt...,Zhingles.......................6........ T;tx 4x_1tbx4 a: x hardwood Drywall , Floors ............................................6.............Interior ......................,............................................................. .. Plumbing Heating .... �C.#r a,�.......... g ��? s. ........:......................................... Firepp ..Approximate"Cost 35 QQQ lace ..::.............One:.,.................................................... ............ .,. . . ..................:.............. . ... Definitive Plan Approved by Planning Board,__ ________ _____:.__:__-__19 -------- Area ........ g Building Dimensions �4 ` Fee ............. ..��......... Diagram of Lot and Buildin with Dime SUBJECT TO APPROVAL OF BOARD OF HEALTH 4EjX2s_ 'Bow. ^,� k I hereby agree to conform to all the. Rules and Regulations of the Town of Barnstable regarding the above construction. NameC ........................ H H, JAMES K. 22729 ............�.Pedr"mi One Storyt for .................................... -is S Sin7,,1e-Vami1y Dwelling ............ ............................................................... Location ....Lot #16 14 Mariick Court....................................:........................ Centerville ............................................................................... �7 K. Sm L Owner ......James........... ith .................................... Type of Construction .................Frame......................... ............................................................................... Plot .............................. Lot ................................. December 4', 80 Permit Granted ...............................:........19 06 Date of Inspection .................................:--19 Date Completed ....... .... ................19, PERMIT REFUSED ........................ .. ............................ 19 FN. ...... ............ ....... ........................................... ............` ............................................. ........... . . ......... ........................................ ........... .... .................................... - ' CApprov(id .... .............................. 19 J C) C- .............. .......F/;�................................................. ........................................................... L TOWN OF BARNSTABLE Permit No. ______-_--- Building Inspector Cash --------------- �e o �' 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. .....................................................1 19......__ ..................................................................._.__......._......._.............. 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