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HomeMy WebLinkAbout0033 PARTRIDGE WAY w d . a 9 4; TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION C a �8�Map � � Parcel CJ �� � Application Health Division Date Issued Conservation.Division Application Fee Planning Dept. >. Permit Fee Date Definitive Plan Approved by Planning Board CJ lI2f. Historic - OKH _Preservation / Hyannis Project Street Address �� .Qi �►�'� Village CmAcy,114L Owner �� Address Telephone d Permit Request (rA kb5e,­fib l�o� Q.c�° o% t c kf� 1� AA Squ reteti sf floor: exists g proposed 2nd floor: existing proposed Total new Zoning District Flood Plain yGroundwater Overlay Project Valuation Construction Type C Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 63/ 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 .71 a 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: YesE;LJ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ Qi N size Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes uAo If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION g(BUILDER OR HOMEOWNER) Nate Telephone Number �,v�°` 7S ' 1214 . r Address 5y License Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ZSIGNATURE DATE 411,b-z' FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE s .. 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. OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at. . (Propelty Address) .x (Property Address) herebyauthorized' ns (Subco ctor) an authorized subcontractor for RISE Engineering,to act on my behalf,toceobtain a building permit and to perform Work on my property. . y , V Owner's Signature' a. q 'Date w ` a to - •. v 1C 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement'Captractor Registration Registration: 153567 " t Type: Private Corporation Expiration: 12/15/2012 Tr# 206433 �R CAPE COD INSULATION, INC 0"r� 17. HENRY CASSIDY 455 YARMOUTH RD. � E. HYANNIS, MA 02601, 4 ) Update Address and return card.Mark reason for 'change. Address Renewal Employment FLost Card DPS-CA1 0 50M-04/04-G101216 HOMe jCo mer�Affairs usjn l t License or registration valid for i;d riu!-use ce!,f f� before the expiration date. If found return to:. Registration: 153567 Type: Office of Consumer Affairs and Business Regulation Expiration: 1. /15/2012 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 - 0D INSULATION' INC �. 1 HENRY CASSIDY = /,;!' 455 YARMOUTH HYANNIS, MA 0260=1"_'r's - + Undersecretary • t alid ith t si ture - r}t.y. . Massachusetts- Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License License: CS 100988 d HENRY CASSIDY 8 SHED ROW. WEST YARMOUTH', MA 02673 � c Expiration: 11/11/2013 Commissioner. Tr#: 7620 A. r Ki,yret.'S. &..(;ray'.LRs. h'a<)d: vv_ - Client#: 4597 CCINSUL A r,AD- CERTIFICATE OF LIABILITY IN OAl'CkN1Iv11UOaiy,; 5� � 7/01r'1U11 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),AUTHORtZEEp REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTAN If th' e certificate holder is an ADDfTIQNgL INSURED,the poll )y ;:;I must he Endorsed,If SUBROGATION IS WAIVED,subject to tnr tcnnc and conditions Of the policy, certain Policies in lieu of such l:ndonernent(s). may require an endorsement.A statement on this certificate does not confer rig his to the c1:11dicdtE holiJcr rItUUUCCR - COPffACT Royals a Gray Ilia. -So. Dennis Name: MargaretYaung •i.3•{RUI.ILG 134 Ph16NE —•-----•_..,.:_..:.. . E hlA0.exi 508-760 4602 —_ _ 4 _ tM`'Nod. SUtl �5£3 2102 r o HoX fool AgoRESs YoungmaCWragersgray,com SOUtn.Dennis, NIA 02660-16011 IfiSUncl7 _.....__..______..__.,_.._._.._._..__.._.__.._ ,__— INSURER(S)AFFOROINGCOVErtAGL , .. NAIL N CaPa Cod Insulation Inc INSURERAI Peerless Insurance �— - '18333--- •455 Yarmouth Road INSURER 5:Ohio Casualty Insurance Company HY41I is, NIA 02601 INSURERC-Atlantic Charter Insurance — I111UREIt0 Commerce Insurance Company 34754 :,U4CftA4c _ CERI IFICATE NUMBER: REVISION NUMBER: t.0 1 17.cR I Ii=Y nn 1 I TI IE POLICIES Or INSURANGE LISTED BELOW RAVE BEEN ISSUED TO THE INSURED NAMED At1GVE FOR THE P OI.ICy PERIi)U I 4 r:i,tYvn ri5l Atv1.)IrvG ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS !'kn 1IHCAI E MAY BE I5SUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL,THE TERMS. I:.u.u151iIN5;ANU COtVt)fl'IONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1(d5R - 1 iH 1'YI'E OF INSulQktict� POLICY EFF POLICY E•XP SR O POLICY NUMBER IVINVOWY NwDorYYYY LIIYIfI s q tNtlG L LIABILITY CBR8263063 0410112011 04101.1201 t;ACrIQCCUKRCNCt: 51000 000 XI\O.l\ICK\.AL vtNL.lvu t_Iht)1t.I IY DANTKGET0URENTE) ' - - - PRCId15F.5 .t P, C 1I 11 0 UUU 1 I: I ( Y u uulaultl y5.110U_ ._.....__. GENERAL AGGRC-GA'fe- $z,DQO,000 1..:1.1.•:CI::hECR r E L N111 11PPLte PER. PRQOUCIS COMPrC 1'ACi i r- I�-I' " D AII10IN OIL.I:LIABLUTY 11MMBCKVMK 0410112011 04/011201 'I CDtvIBINEO SINGIE LIMIT' f'- ll/1C1 (Eaacaaanlj �1�D00000 _ AiI Omst;O AUI O$ I BODILY INJURY(Par pery,n) i R �'---- . .. BODILY INJURY(TPoru.x.�Wvnll f PROPERTYDAMAGI_ ' X IVVN�;.lY41V1-,11;\U'I'(S`i _.__.___.—.___..:_� ........_.... --- ti w¢]RCLlA uAn occ�r� 0001254514645 410112011 041011201 EAcrl occut�I^u Nc(; m'I 000 000 LX.;LJ5 - _ y 11000 006 i X�I;rlrNurnv 1 100UU ------•-•-------------- -___._---------- - V 11901A ;Hs CUMPtNSATION - - AhUFhtPLUYERa LJALitLn-Y WCA00525902 613012011 06/30/2012 X �y�STKTUJ O1H- , •I,1 r'n'1YhUt OFJI':VtTNL:IJtiXECUTIVE�YIN.. i..Phil tWN4:hILihF(NtiI:LUI)GO'' L..:_:..1 NIA ..:,; -" E L.FACH ACC i150D,DDD 1hU INwlury In NH) - _. - - 1 tr,o 1 'r:nba ontint ' E.L.DISCASE kA LhIN1.0YEE $500,000 I f 1 .Nlal if IN l.N l)PF R,1111 INS heln,v e.L.DISEAsr POLICYun1n_ 000,000 : I ucSCnlrltuN ur urtlW(IONS I LOCATION*I VEHICLES(Attach ACDRO 1I)1,Atltldional Rwlnarl<s Schwclulw,4 morr Space IS.rnquirrgJ Workers Cofnp Information Included Officers or Proprietors (Set:Attacht:d Ddscriptions) CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Pa ment SHOULD ANY OF THE A90VE DESCRIBED POLICIES DE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIvE J (01988-2009 ACORD CORPORATION:All rights Ie diWd, ��' tD`o('009r09J- 1 of •tThe ACORD name and logo are registered marks of ACORD ttfi8575/M68179 MkY r Tile Commonwealth ofMassaclzusetts Department of XndustrialAcciden>.s 1 Office of Investigations t fi 600 Washington Street �. /' Boston, MA 02111 y www,rnass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electl-icians/Plumbei-s Applicant Xnforination r Please Print Legibly Name (Business/Organization/Individual):_CA T, C a f 1 Address: r• City/State/Zip: Phone #: so 7 7 J�- ) Z Are you an employer?Check th appropriate box: am a employer with Type of project(required): �_ 4• ❑ I am a general contractor and 1 •� + have hired the sub-contractors 6. ❑New construction employees(full and/or part-time). Y 2.❑ 1 ain a sole proprietor-or partner- listed on the attached sheet. 7. ❑ Remodeling shipand have no employees . These sub-contractors have 8., ❑ Demolition working for me in any capacity. employees and have workers' comp. insurance.1 9• ❑ Building addition [No workers' comp. insurance P• , required.] 5. ❑.We are a corporation and its - 10.❑ Electrical repairs or additions 3.❑ I am a bomeowner.doing all work A officers have exercised their 11.❑ Plumbing repairs or additions myself. (No workers' comp. right of exemption per MGL° 12.❑ Roof repairs insurance required.j t C. 152, §1(4), and we have no employees. [No workers' 13.❑ Other(�f�e4 Li Al Z t L c comp.insurance required.] 'Any applicant that checks box#I 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 ouLside contractors must submit a new affidavit indicating such. lContractors that cheek this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those enti tics have employocs. If the sub-contractors have employees,they must provide their workers'comp.policy number, f am an ernp toyer that is providing worlcers',co nip ensation insurance for my employees.' Below is the policy and job site inforrnatiorz 'Insurance Company Name:_ At L41T« Policy# or Self-ins, Lic. #:-4)(-A Wr s9 O t Expiration Date: (0 7G Job Site Address: City/State/Z1p:0A619_�""�'`r 4A�Z_ Attach a copy of the workers' compensation olicy declaration page(showing the policy number arid.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 certify u e pa' and penalties ofperjury that the information provided above is true and correct. Si nature: Date: ' Phone#: o 7 �S L/ T Official use only.' Do not write in this area, to be completed by city or towel pfficiaL . City or Town; Permit/Lic.ense# 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 AS LE OF - 'INSULATION • irn ,- 3 £lie ; Jh '. ' ; ' T _ • FIBERGLASS SSAMSSSS SP"YFO" SUSPENDED ' - BATTS OUrTESS INSULATION CEILINGS ' - - 1-800-696-6611 Town of Barnstable Regulatory Services. Building Division - t 200 Main St Hyannis,-MA 02601, ' Date: Dear Building Inspector Please accept this Affidavit as`do' 6mentation 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 Troperty•Address - .` village, �'i��ry (1-33 L J Insulation Installed: Fiberglass Cellulose, R-Value,-. Restricted Unrestricted Ceilings ) ( V,0) Slopes Floors ) R Walls Sincerely f my Cass Jr,'President ' ape od I lation,Inc. • R Assessor's map and lot number .:21 .. . La@.. . ' ��) • �Gi!® `. SEPTIC SYSTEM MUST BE Sewage Permit number'"..; a.::Sa�v. ...f/Lt/.s.. . e A INSTALLED IN COMPLIANCE WITH`ARTICLE If STATE , A QyOF THE T TOWN O F B A R N S TA►r ��` cE AND TOWN Z',9AHBSTABLE, i 1MAM 639. BUILDING ', INSPECTOR �0 ppY a• • a•7:rf APPLICATION' FOR PERMIT PTO . .... �. ..... .. .:��:9:�!:?G-�.:..... .......................... TYPEOF CONSTRUCTION ............. .. re t-r�9 .:.:: ............... ' ................... ....................... i. .... . . . . ................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according•to the following information: Location ......... ��. . s71 a-1� f .....�a-,Y— ...... .. \ , � i.:�::. ............. Proposed Use ........� ......... 1�s�-i,.............. •.......... .. ....... \ f.,�.... .. .. . ....� �,, Zoning District .... ...................................................Fire District ...�•��" . ..1..... � _"t�,.�.��..., ..�.A.. �... I Name of. Owner ANIS.Vvv�:... 4? �:�C���.......Address ...........e .. . \NjZ+......................................... .............. v. .. Address `t,�... . . ......... Name of Builder10. Nameof ddress ..................::................................................................ Number of Rooms ...... ...................... ....i C ... J•Sk. ...... Exterior :*Ll...... ......I Floors C'�la A....��.>...................Roofing ...... �......._.J� �`�. ...............................:..... .�.. .................Interior .....:..::... . ............................................. .../.... fil ... .. . . ..r Heating : r. .tV ►................:...................................:.....Plumbing ..... ......................................................................... Fireplace .........qoL--*k„............................_....................... :Approximate Cost � 5�� ? ....................... Definitive Plan Approved by Planning Board ___________________________19________. Area.... ................ Diagram of Lot*and ,Building with Dimensions Fee ?15'. / SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 I Zts i �. 1 I hereby agree to conform to all the `Rules and Regulations of the Town of Barnstable regarding the above construction. .. Name ... ........................... .....:.... .. .. �---�,..,� 18799 Fred Schofield 208 68 No ... 199.... Permit for .Add',N Dwelling.. location,...33..Pagtridge.•Way.............:............ ....................•0estservU-Le..............- .................. Owner Type of Construction Frame ^ •r .... 5 •.••---.••. l "Plot .... 208 Lot ..........:68 Permit Granted ....Nov 8. ........ 19 76 _ 4 v Date of Inspection7j�y�..© : ' ...:19 Y Date Completed- ' PERMIT.REFUSED 4 :• ..... ................. ................................... 19 ....................• • ..... •.......•...........•.................. + ~� �u • {�• • ••1 ..... �.....`...................... • 'l + • _.. .,f.� •. - - ...................................... _ * - • • ,.\..� • • •' ............................................................................... �. •• l ' • Approved ...............................................................................