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Home My WebLink About0189 PARK AVENUE TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 1 S7 Parcel 03/ 601 Application Q61Q a�� Health Division Date Issued L .Conservation Division Application Fee Planning Dept. Permit Fee ` Date Definitive Plan Approved by Planning Board8-/12 Historic - OKH _ Preservation /Hyannis Project Street Address g`� Par,k�/7,✓tom, Village Ceti l` lip— Owner.. //, hale Address Pemk ave Telephone Permit Request n,4A ft. l��3 ltAr J1,� 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 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 ❑ 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 Centel 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: v a Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ (7 Commercial ❑Yes ak<o If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION w `n C64 (BUILDER OR HOMEOWNER) Name Telephone NumberJO 1Z /roL-ly Address Yl� 1_' l% rCOI. License # Ioo ! Home Improvement Contractor# Worker's Compensation # 9XA <"TI-5 5N ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE \ _ 9 FOR OFFICIAL USE ONLY \ %,APP CATI N# DATE ISSUED i MAP/P RCELNO. ADDRESS \ ' VILLAGE ƒ • . . . , . 7 OWNER / DATE OF INSPEC20k } � . ƒ FOUNDATION ƒ FRAME INSULATION FIREPLACE 7 ELECTRICAL: ROUGH FINAL ' j PLUMBING: ROUGH FINAL. '» ` GAS: ROUGH FINAL- FINAL BUILDING - { \ ! ■ • � ( . - \ DATE CLOSED OUT = ASSOCIATION PLAN NO. ' � . y . ( i OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at (Property Address) G�eFr / . (Property Address) y authorize hereby t VO(Su co actor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. s' ; a "Owe is ignature Y ` Date _ t �2r V � �� .r• •• t� �#r. a .! A- r NOV 2 .3} 4 . f4w ,. 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Coplractor.Registration Registration: 153567 . Type: Private Corporation n - Expiration: 12/15/2012 Tr# 206433 � E r-� CAPE COD INSULATION'; INC HENRY CASSIDY u i 455 YARMOUTH RD. HYANNIS, MA 02601r.i' — ;Update Address and return card:Mark reason for change. Address Renewal Employment Lost Card DPS-CAI 0 50M-04/04-G101216 _ Ottice�,e��C a�` umer Affairs us ne Regul tion License or registration valid for is uividu!.use on!y HOME fNfPROf�l�i�� before the expiration date. If found return to: Registration: 153567 Type:. Office of Consumer Affairs and Business Regulation Expiration: 1211 5/2 01 2 Private Corporation 10 Park Plaza-Suite 5170 a Boston,MA 02116 OD INSULATION INC HENRY �qr 455 YARMOUTH HYANNIS,MA Undersecretary t slWsiture y` Massachusetts- Department of Public Safecv Board of Building Re;;ulations and Standards Construction Supervisor.License License: CS 100988 HENRY CASSIDY 8 SHED ROWu.. ' WEST YARMOUTH:, MA 02673 - s Expiration: 11/11/2013 Commissioner' Tr#: 7620 I tcuyer .s h craX ,Ln�' . e'z1tJa: �v_ Cli®nt#: 4597 CCINSUL z�CO" '�3 CERTIFICATE OF LIABILITY i�d �7�/ (MI1rUL)1y'mj S 1/2U11 1 HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY.ANO CONFERS NO RIGHTS UPON THE CERTIFICATE HQLOER,THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFfQRDE�D.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. IA'11ORT asANT:If the Gartificate holdt:r is an ADOITIQNAL N ISURED,the policy(ies)must Ue andotsed,if SUBROGAT OWN JS RIVED,subject to the tun and conditions of the policy, Cerlaill Policies may require an endorsement.A statement on this certi ct;alh Cale hold lar Ill Ileu (A Such endorsernent(S) - ficate does not confer riUhfs to the Y 11UUUi;L:K CONTACT Ruj)urs a Gray Ina. -50. Dlynnis NAME_ Margaret Young PHONE— ....... ;31 Rolarc 134 508-760.4602 NAIL Exr: )58 2102__-. r o.box 1601 ADDRESS: YoungmaCragersgray.Gon1 -- PRODI)CE SUU(I)Dennls, NIA U2660-1GU'I CUSr0N16RIDe• ___ --- '- ----- INSURERIS)AhFORDINGGpVERAGL Ir;SUnhU --------- - NAIL+t (-ip,a Cod Insulation Inc INSURERA:Peerless Insurance —�T - 18333 455 YarnTOuth Road INSURER 5:Ohio Casually Insurance Company -" - Hyannis, IVIA 02601 INSURER c.Atlantic Charterinsurance ' INsUKERD:Commerce Insurance Company 3 4754 INSURtft t uVEh 11 C _ CkRI-IFICATE NUMBER E) I I 1 rf-t r 71 I E POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ADOV REVIS O OR THE EPOL ICY PERIi)U ti '1 AINDING ANY REQU IR!_MENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS t'F.K I Irl(:A1 F MAY BE ISSUED OR(VIAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT I'D ALL.THE I'ERmS. 'I:M.L1SKIN;;AND CONt)I"PIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IRSR IK ! 1YVE OF IN9UtV1NUk POLIGYEFF .POLICY CXP SR o POLICY mM1 D/Y 0 MMIOOIYYYY LIIYIn s A UtNkw r_LaalLrrY CBR8263063.. 04101/2011 01101(201 EAcrl c)ccut IfNcr 51 UOU 000 X iu Ihlcnt u`'cry I ANI3CGE D TC RENTE `-��-- Plr 510Q UOU r'I-,r.r rvwl7n I x VCC4R a---.-- m lku ow.kNly - -- ------_ — - PERSQwk.a.NOY iNJUKY 0,U00,000 -.__._.-..,._._____--.._ .- GENERALAGG.R.eQATE lia :v yF_22—,,00000_,,0000--00-- ---.--__- S D I Auroniueu.EUAtiu.lTY I' 11MMBCKVMK 0410112011 0410IJ201 i COMBINED SINGLE LIMIT .AN: AUK'I (Eaamaenl) �1.OQO Q00 _---_.__ ,:i1 ObvN0irl°,V70$ BODILY WJURY(Per person( S 5C'I-u-[iUt.tU AO r0S BODILY INJURY(Par a,x.lugnl) y ..x I: ;:u:,v I CrS PROPERT Y DAMAGE - —T--'- ! - (Par accwwv) . B uritAa s X UU01254514645 4101/2011 041011201EACHoCCURf.FNCcLAQ LAU —1.,000;000 -- .__. .. ClAIN11 NtiDF. AGGRFGAI't Y1 OQO OUO . IA Ol ll:I Il)I.[ IX I+r I r N l,uN I, 10000 -------.-'___-__-._ -'- ---- _ - 'RURNkIis CONIPLNSAI'ION 4 I AI D LrirLOYER5'LIABLL.n-Y WCA00525902 6/3012011 06/30/201 X wC sTATu- OTH. YIN Y II LI S nN Phl YNItI0FVPAHTNL-*F CtCUTNE�N� ' -- �!. rFli.tWhtF.MUth EXCLUDE-01 L...:. NIA E L.EACH ACCIDENT $50U,UOO ,4Atlltulury In Nll( ' - .----.—.......- 1 vnuur - - r ... .. E.L.DISEASE'EA EMPLOYEE $500,000 I111tRIPI ION Q 0PI` AI IONS helnav ""-"- F.I_.DISEASE POL ICY LIM11 t500,000 I I r I ut:aCnit'IION ur urtltnnUNS I LOCAIIC)N$I VEHICLES(Attach ACORO 101.Adtlpional Ramams Schaquk,4 mory space is(rquircq) - WnrkarS Comp Information Included Officers or Proprietors (Sep Attached Descriptions) CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Pa ment ` SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICC WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. • AUTHORIZED REPRESe M'ATIVk A. C�1988-2009 ACORD CORPORATION.All rights reserved, . ACORO 25(?009IOJ) 1 of 2 The ACORD name and logo are registered marks M ACORD AS68575BV168179 MEY The Cornrnorthiertl-h of fassachusetts r _ Department of Industrial Accidents ' Office oflnvestigations 600 Washington Street Boston, MA 02111 �y www,mass.gov/dia ' Workers, Compensation Insurance Affidavit: Builders/Contractors/ElectricianslPlurnbers Applicant Informatdon' Please Print Legibly Name (Busincss/Organization/lndividual), EU 5V Address. City/State/Zip: AL Phone #: 0 ' l Art you an employer? Check-th appropriate box: Type of project (required): 1.X I am a employer with A 4. ❑ I am a general contractor and 1. 6 ❑ New construction _ eiriployees(full ancUoz Oact-time).* have hired the,-sub-contractors _. _ -. 2. I am a sole proprietor_or partner-' Listed on the attached sheet. 7.• ❑ Remodeling (U These sub-contractors have g Demolition ship and have no employees workingizl for e in any capacity: employees and have workers' ." 9. E] Building addition No workers' comp. insurance comp. insurance.) S. We are a corporation and its I0.[]Electrical repair required. s or additions 3.L� I am a homeowner.doing all work officers have exercised their l LE] 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 13.[] Otber6 .Pa4 4 �e�tlrn, employees.:[No workers' -, J �--- � comp.insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy Wormation. t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such. lConaractors that check this box must amchcd an additional sheet showing the name of the Sub-contraclors and state whethar or not those entities have employees, [f the sub-contractors have employees,they must provide their workers'comp.policy number, , I urn an employer that is providing workers' eo nip ensation insurance for rny:empfoyees. Below is the policy aird job site inf"orrnatior-L 1 _Insurance Company Name: l �ti�j'r( (� �•�� Zlla—.- t ? 1��— Policy # or Self-ins. Lie. 9 O Expiration Date: (0 3G Job Otte Address: ,_ _. 6aCity/State/.Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number:and expiration date). 1 ailure to secure coverage as required under Scction 25A of.MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1.,500.00 and/or one-yeas unprisonrnent, as well as civil penalties in.the form of a STOP WORK ORDER and a fine of up to $250.00 a day agairist the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of[he DIA for insurance coverage verification. I do hereby certify ui e pa and penalties of perjury that the information provided above is tree and correct. Signature: Date: Phone#: ' _ O 7 5 " Official usee only. Do-not fwrite in this area, to be completed-by city or town official ' FermiULicense# — ,City orTown; , .issuing A,ith0rity (circle one):, 1, Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector b. Other_ Contact Person: Phone#: t CAP Ec®� INSULATION YIBSB GLASS SEAMLESS SPBAYEOAM SUSPENDED ' BATTS DMy- INSULATION COMM - 1-600-696-6611 Town.of 13A✓NS��►�� ,. Regulatory Services Building Division Address - Address 2 Date: It z - Dear Building Inspector F ^ 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 , �1111,7"'t O, TooZ t -tPU ire o� r� Insulation Installed: Fiberglass .•;Cellulose R-Value . Restricted Unrestricted. Ceilings Slopes k ' ( )' Floors Walls )n (. ) ('YAWS �{Y rn,c.(-f.{ti ( � ✓�p/.l Y'G� ', 4i/ I_ S Y q G to in r A Y _ 1Q i•: enry E a idy r sident 0 03 f011 ape C d Insul ion, Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION a 2- 3 Map ®c� 7 Parcel_(�J'`''60 Permit# / Health Division Date Issued Conservation Division Fee Tax Collector y� Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village _L4 -n Ilia Owner ;/ �, leda 11z lira d�2!1 � Address Telephone 7 7-5-- Permit Request_ S'7X Square feet: 1 st floor: existing proposed 2nd floor:existing proposed Total new Estimated Project Cosh c-=o Zoning District Flood Plain Groundwater Overlay 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 ❑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:O 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 BUILDER INFORMATION Name `�Z �,�, /D/��/'(� f7llj1der 5-Telephone Number Address -3S'/ 42,6 License# Q a—?_e 7_ - S rO A)S Ri LL S,iVA-. Home Improvement Contractor# a2 D Worker's Compensation# 0,4,lg2 e_1 � � ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY F PtRMIT NO. r DATE ISSUED MAP/PARCEL NO. r ' ADDRESS VILLAGE ^ i OWNER DATE OF INSPECTION: f e FOUNDATION , FRAME - INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL 1 PLUMBING: ROUGH FINAL t GAS: ROUGH FINAL ' y: x FINAL BUILDING SSA • .. t. DATE CLOSED OUT { ASSOCIATION PLAN NO. Assessor's map and lot number ..... ...........P TIC SYSTEM "T B INSTALLED IN COMPLIAIDE Sewage Permit number0�..� WITH ARTICLE [I STATE aG SANITARY .CODE AM IM *'THE Tory TOWN O BARNS • • r Z BAE39TADLE. i A "ABEL 6 q O M a' NUILD'[NG INSPECTOR 'EPY APPLICATION FOR PERMIT TO ......sml.jk.,'...Tllsl'M.1... V42 ......................... TYPE OF CONSTRUCTION r±{ Jer.Y...........®...................19.7 TO .THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...1. .o/.....��r)� /�!��'w.c.:... .. 4 `�'/a-!I IL�. t. n �........ ................................................................................................................ Proposed Use .,.. m.L..} .... re . Q iiC Add S.kgwcv-..... ►?.............................................Fire District ..................................................................Zoning District ..^..�..................... ` n �i Name of Owner .t/`C�!...W i.A 3:�:...,YQ.W.-.0.............Address ! $l. 4' !^(,2....6'�w..� 4r... ...... ..... .......... Name of Builder Q.Kxtj.... 1U.S1.... :...........................Address rQD.... 1 .��....... ... �4A.tJ /. ............ Nameof Architect ..:..N.Q.! ...............................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exierior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ...................................................I..............................Approximate Cost .........1�,a. Definitive Plan Approved by Planning Board ---------------____-----------19--------. Area ®.. :... � rya 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.Town of Barnstable regarding the above construction. Name ........................... v Toole, Dr. William � 17304 .y�o ,'^.—.-- Permit —� .�� ....... / v dwelling --------------------------' Locationl89 Park Avenue ---------------------' 6mnterv1lla . ,__________________,_______ Owner ^---Dr. William O'Toole ------------------' frame | Type of Construction -------------... -----.--.—.----------------.. Plot ............................ Lot ___________ ' . . Permit Granted IL lg 7� ' . � Date of Inspection � Date Completed ' PERMIT REFUSED � ~ .---.'-----.----------- 19 ^ � ' -------~...----------.--.---.. --..--.—...—.--------.-------.. ' ` ^ ..�—.--�.�_----..,-.~--~—.—.—.— . - ' .. ..'�—'---��.---.------..—.-----.. � � Approved --------------- lQ �............ ' .— --------~..—.-----.—.-- ` ----------------.---.. ' � |