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HomeMy WebLinkAbout0702 PHINNEY'S LANE �o � �� � �v �. � _ e —. .. y �..� '. I - .. ,,. -. _ - - � ',:� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map LS'lParcel- 3.. _ Application # o d( S/) Health Division { Date Issued Conservation Division Application Fee Planning Dept. ��:a Permit Fee Date Definitive Plan Approved by Planning Boa"r'dN! Historic - OKH _ Preservation/ Hyannis Project Street Address 7c0jql-_ PA�A lle� S Cole Village 6.e.47�t" ( ,,Ile Owner -S"tS'c.'2 ll�a -7.. /— Address To S� Ife4m, G✓15���/d'►� Ool�q3 Telephone 6-0 ��d- L `7 .sc Permit Request CPR?/Y Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation$CO�j�uO 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 'q �-3 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: )d 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: 3 existing _new Total Room Count (not including baths): existing .5 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:X 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 r APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name `G c�o� L� �O Telephone Number Y66 -I f 3 Address hb C ,Y � License # 6:_ d 56�_73 f SG,414-;G 14A CO���'� Home Improvement Contractor# IDB�'�� Email �.�L2nn©X®�.54���r-�S�c, I%s ��_Cor� Worker's Compensation # (�2-ZUi3 ` 10obV70y -ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO jdGt i-v,Gt�.T � w SIGNATUR AA A DATE f di 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 Y FINAL BUILDING .� DATE CLOSED OUT ASSOCIATION PLAN NO. f r� �ellQrfti1P71t Of�IlfrllSfTlU�f�C[�e71� , R Office oflnvesak oyzs ' 600 Washington Street. BOstOn,Mai 02111 _ } www.mass govlffa Porkers' Compensation Insm-ance Affidavit:Biulders/Contractors/Eledricians/Plmnbers Applicant Information A Please Print Legibly' Name( � el atG AM rm/fnrl;viriiiaT;; � - �( S _ Address: f o 130 t I P a city/se/zip: il./i4 Phone#: S ���8—it/3 Are you an employer?Check the appropriate bo:c ' 1. I am a employer wig f 4. 0 I wn a general comtrac6or and I Type of protect(required); employees(RE and/or part time). 6• New construction, � ' have hired suh-coutrac�nrs ❑ 2.Q I am a sole proprietor or partner- listed on the atiarhed sheet 7. fj'Retnotag These snb-coniracbors have I ship and have no.e�mployees 8. �'DemoIition - wo for me m employees and have'workers wDi �y� 5'' cum fimmince-t 9. '0 Building addition [No workers'comp.iustuance . , P- � • rcqaired�] 5..0 We are a corporation and its 10.0 Electrical repairs or additions 3.[] I am a homeowner doing all work officers have exercised their I I.[1 Phimbing repairs or additions myself [No workers'comp. °. . rigiat of exemption per MGL 0 I2. Roof repairs . insarance requhrd.j t c.152, §1(4),and we have no = employees.[No workers' 13.D'O@ier comp-in m reQnfied-] ffi *Any applicant that checks box#1 must also fM oid the section below showing tbcjr worita' eos�on policy m infoalib�mP o t Homeowners who submit this affidavit indicating they atz doing all wo&and thin hire outside eontrectms.nmst submit anew affidavit indicating such. Contractors thatc heck this box most 'atlach�d rm additional shed shnwme the aa*ne of the�and stale whether or not those entities have . empIoy •If the sub-conhaetars have �P�3 ,tfic mast provide their worl¢ss'camp-policy m:anbcr. I am an employer the is providing workers cor�ematYon buz,7-mtce for my employees. Below is the porky mid job site ', informmYnn, Insurance Company Name: t/'1/P�={[off ��G� �✓tS�i aa�e�'Co^rc.�5 Policy#or Self-in's.Lic.# 'lei 2 Z U 1 L110d-P 7 06 r Expiation Date: / .10lG' _ rob.Site Address 7N, y/StateJT.ip:�e'�?l/'li��/2.Af4 0ol )— Attach a copy of the Workers'compensation policy declaration page(showing the policy number and expiration date). 1'a>7ure to sectn:e coverage as required Bader Section 25A of MGL e.152 can lead to the imposition of criminal penalties of a f=Up to$1,50.0-00 and/or one-year impriso=ent;as weIl as civil penalties in the form of a STOP WORK ORDER and a tine of up to$250.00 a day against the violator. Be advised that a copy of this statumetrt may be forwarded to the Office of Inv o estigati ns of the DIA for insurance coverage veufacahon. I do hereby pains mtd pwafiie s of pmjwy that the information providesi above is r5-rce and correct S, Date: Phone# C, Official use only. Do not write in this area to be conpkfed by city or town ofjTrTTT City or Town: ! 5 ' PermitlLicense# Lwoing 9.uthority(circle one): ..... .. ._.. ._....._..._ .. .. __ -.. ...._ 1.Board of Health 2.-Barking Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6 Other contact Person: phone#: Information and Iustrue 'ons M&cr�metts General Laws chapter 152 rcgMi=all employers to provide workers' ensation for their eTUPIoyees. parguiautto this statute,an.employee is defined as"_.every person in the service of- er under any contract ofhire, express or implied,oral or written." An employer is defined as"am individual,partnership,association,corporation r other legal entity,or any two or more of the foregoing engaged in a joint entmTrise,and inalading the legal repres of a deceased employer,or the receiver or trustee of an individual,partnmship,association or other legal ty,employing employees. However the owner of a dweIling house having not more than three apartments and wh 'des therein,or the occupant of the - ons to do maintenance on or air work on such dwelling house dwelling house of another who employs pens mP or on the grounds or building appzrfenant thereto shall not because of employment be deemed to be an employer. MGL chapter 152,§25C(6)also stains that"every state or Iocal Rc agency shall withhold the issuance or renewal of a license or permit to operate a business or to co buildings in the commonwealth for any applicant who has not produced acceptable evidence of cdmpli ce with the insurance,coverage required" Additionally, GI,chapter 152, §25C(7)stains"Neither the c onwealth nor any of its political subdivisions shall enter into any for the performance ofpublic work until table evidence of compliance,with the kmiran cd. requirements o this chapter havu Been presented to the c authoiity." Applicants Please fill out the rkers'compensation affidavit comple ,by chwlang the boxes that apply to your situation and,if necessary,supply ntractor(s)name(s), address(es) phone numbers) along with their certificates)of ins-Lu nce. Limited .1 Y Companies(LLC)or L' dity Partnerships(LLP)with no employees other than the members or partners, not required to cant'workers' eosation msurm nee. If an LLC or LLP does have employees,apolicy is re Be advisedthatthis Yitmaybe submitted to the Department of Industrial Accidents for confirmation f insurance coverage. be sure to sign and date the affidavit The affidavit should be retuned to the city or to that the application fur a permit or license is being requested,not the Department of Industrial Accidents. Should have any questio gardi ag the law or if you are required to obtain a workers', compensation policy,please call a Departmment at a number listed below. Self-insured companies should enter their self-insurance license number on th appropriate ' e. City or Town Officials T Please be sure that the affidavit is comple printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the e e Office of Investigations has to contact you regarding the applicant Please be s=to fill is the permi icmise n which will be used as a reference number.,In addition, as applicant that must submit multiple permit/license P. t�tr in any given year,need only submit one affidavit indicating current policy information(if necessary)and under Job Si ddress"the applicant should write"all locations in (city or town)."A copy of the affidavit that has b officially ped or marked by the city or town may be provided to the ' applicant as proof that a valid affidavit is fie for ermits or licenses. A new affidavit must be filled oa each year.Where a home owner or citizen is o a license o mmit not related to any business or commercial venture (Le. a dog license or permit tc bum Ieav etc.)said person is required to complete this affidavit The Office of Investigations would llm thank you in advance for cooperation and should you have any questions, do of hesitate to a us a call pleasen give The Department's address,telephone G d fax number e Comxanweeth of Massacli . Depad ment of industrial Acctdenzts Office of Xxivesfigatio= GQ:Q�asbingtan Strut _ $oAou=MA E1211I TeL 4 617 7` 7-4900 at 406 or 1-977-�I .SSAFE Fax 9 617-'27-7744 Revised 4-24-07 mamgov/diva cfTMErq,,� Town of Barnstable °* Regulatory Services Richard V.Sc4 Director ' '. 6;u�A,1 .. Building Division Tom Perry,Building Commissioner........ ' .........._......_....__.__........___ . .. ...... ......... ._... 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 ¢t Property Owner Must Complete and Sign This Section If Using A Builder Sg 4G 2� ,as Owner of the subject property hereby authorize >,� f • Y -S�� ;��l��G � • 5 to act on my behalf, in all matters relative to work authorized bythis building permit application for. (Address of Job) , ' • *'Po 0- 1 fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. S' tore of Owner tore of Appk F Print Name Print Name Date Q:F0RMS:0WNFRPERMISSI0NP00L4 Town of Barnstable Regulatory Services °FTH r°ity Richard Y.ScaIt Director . Balding Division Tom Perry,Building Commissioner %659. �� 200 Main Street, Hyannis,MA 02601 wwwtown.barnstable.ma.us Office: 568-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE E UMPTION --- -- Please Print DATE: JOB LOCATIOK n shzet village 'HOIvIEOWNER': name home phone# work phon CURRENT MAILING ADD S: cityhnwn state up code The current exemption for"h eowners"was extended to include owner-occ ied dwellinis of six units or less and to allow homeowners to engage an indi uai for hire who does not possess a license,provided tha&e owner acts ass ervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of Ian. on which he/she resides.or intends to reside,on 'ch there is,or is intended to be,a one or two- family dwelling,attached or detache structures accessory to such use and/or farm sqActures. A person who constructs more than one home in a two-year period shall not be onsidered a homeowner. Such"homeown 'shall submit to the Building Official on a form acceptable to the Building Official,that she shall be re onsible for all such w6rk Derformed under the building ermit. (Section 109.1.1) The undersigned`.`homeowner"assumes respo ibility for compliance wi the State Building Code and other applicable codes, bylaws,rules and regulations. _ The undersigned`homeowner"certiftes that he/she derstauds own ofBarnstable Building Department minimum inspection procedures and requirements and that he/she will comp with d procedures and requirements. Signature of Homeowner Approval of Building Official •Note: Three-family dwellings co 35,000 cubic feet r larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S ON The Code states that: "Any meowner performing work fo which a building permit is required shall be exempt from the provisions of this section tion 109.1.1-Licensing of co ction Supervisors);provided that if the homeowner engages a person(s)for hire to do ch work,that such Homeowner sh ct as supervisor." Many homeowners wh use this exemption are unaware that they a assuming the responsibilities of a supervisor (see Appendix Q,Rules&Re ations for Licensing Construction Superviso ,Section 2.15) This lack of awareness often results in serious problems, 'cularly when the homeowner hires unIicens persons. In this case,our Board cannot proceed against the unlicensed person as it would with a Iicensed Supervisor. a homeowner acting as Supervisor.is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities, any communities require,as part of the permit application,that the homeowner certify that he/she understands the respo ibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and dopt such a form/certification for use in your community. Q:\WPFILES'TORMS\.bw1dmg permit form EURESS.doc Revised 061313 4 kt P De artment of Public Safety Massachusetts- P 1 }'t Board of Building Regulations and Standards- Cunstructinn SI'T�O"5" License: CS-055731+Af 4 ARD ,l i J LENNbX t RIC14 i PO BOX 480 ich MA 02< 563 Sandw, Expiration 11I0712016 t Commissi6ner t i Y .t ' P ", Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Horne Improvement Contractor Registration Registration: 108642 Type: Private Corporation Expiration: 8/20/2016 Tr# 256343 BENABBY INC/ DISASTER SPECIALIST`'`:`". RICHARD LENNOX Box 480 Sandwich, MA 02563 — Update Address and return card.Mark reason for change. scat 0 20na0ertl Address ❑ Renewal Employment Lost Card �e�nsunevnrveall�v���r.ttnc�ua�,lt.; Office of Consumer Affairs&Business Regulation License or registration valid for indivi dul use only OME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: egistration: -'108642 Type: Office of Consumer Affairs and Business Regulation Wxpiration...8120f211ti Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 BENABBY INC/DISASTER SPEC.MIST RICHARD LENNOX :• 9 Jan-Sebastian Way Sandwich,MA 02563 Undersecret ry Not valid without signIfute a ' 1 • i i i r4� CERTIFICATE OF LIABILITY INSURANCE 5i28i2o 4 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(les)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(a). PRODUCER NTANAME:CT Chriatian Barber, CIC The Oceanside Insurance Group PHONE (508)775-0500 AIC No•(509)790^7955 ADO•MAIL ADORE 52 West Main Street INSURERS AFFORDING COVERAGE NAICU Hyannis MA 02601 INs RA�lautilus INSURED INSURERS Arbella Protection Insurance Benabby, Inc. , DBA: Disaster Specialists INSUR C:Zurich-American Assigned Risk P. 0. Box 480 INSURERD: 9 Jan Sebastian Way INSURERE: Sandwich MA 02563 1 INSURER COVERAGES CERTIFICATE NUMBER:CL1452803290 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, INSLTRR ADULBUOR L MIIOIMDY TYPEOFINSURANCE POLICY NUMBER R D/YY M YYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PR DA I3E ToSES a occurrence) $ 100,000 A CLAIMS-MADE F OCCUR X ECP200533812 6/1/2014 /1/2015 MED EKP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 X POLICY F.,PROT LOC $ AUTOMOBILE LIABILITY FEE ce a INGLE LIMIT1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ASNEOX71 U �� 02001156901 /1/2014 /1/2015UO ATTO X BODILY INJURY(Per accident) $ NON-OWNED PROPtATY DAMAGE X HIRED AUTOS X AUTOS P race ent $ PIP-Basle $ 8 000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAR X CLAIMS-MADE AGGREGATE $ 1,000,000 DED I I RETENTION$ X FXBOOOIO06 /1/2014 /1/2015 $ C WORKERS COMPENSATION WC STATU- OT - AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORIPARTNERJEXECUTIVE E.L.EACH ACGDENT ^ $ 11000,000 DM ndatory in NH EXCLUDED? � N t o 6ZZUB4102P70-014 /1/2014 /1/2015 ( ) E L DISEASE-EA EMPLOYEq$ 1,000,000 if yes,dessriba under DE CRIPTION OF OPERATIONS 4elow I I E.L.DISEASE-.POLICY LIMIT $ 1,000,000 CPL X ECP200533012 6/1/2014 /1/2015 1,000,000 A Bailees MCP200533812 6/1/2014 /1/2015 250,000 DESCRIPTION OFOPERATIONS)LOCATIONS l VEHICLES(Attach ACORD 101,Additional Remaft Schedule,Ifmore apace Is required) - - - - -- — - - — Workers Comp cart to follow directly from insurance carrier. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE C Murray CIC/MC ACORD 26(2010/05) ©1988.2010 ACORD CORPORATION. All rights reserved. INS028 onfnns)m Tha Antlpn nama and Innn am mnkfarart mnrire of arngn - --- • - �. .,, GV1V U ;Uc. ;D0 PM PAUE 4/004. Fax Server I , A�R�® CERTIFICATE OF LIABILITY INSURANCE 0DATE 1-09-2015 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(tes)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 OCEANSIDE INS GROUP NAME: PHONE FAX 52 WEST MAIN ST A/C tL Ext: C No HYANNIS,MA 02601 EMAIL INSURER(S)AFFORDING COVERAGE NAIC# I NSUR ERA:AM ERICAN ZUAICH INSURANCE COMPANY INSURED BENABBY INC DBA INSURER8: DISASTER SPECIALISTS INSURER C: P O BOX 480 INSURER 0: SANDWICH,MA 02563 INSURER E INSURER F: V T U E V! 0 NUMBER, THIS 1S 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. INSR ADD SUB LTA TYPE OF INSURANCE INSR WVD POLICYNUMBER (POLICYMDDI FF POLICY EXP GENERAL LIABILITY DDIYVYY LIMITS COMM ERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE❑ OCCUR P EMIS SI Ea Dect enw, $ ME EXP(Anyone person) $ PERSONAL B ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $, POLICY JECT LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY $ M81(VED SINGLE LIMIT $ ANY AUTO a aocldenl ALL OWNED SCHEDULED BODILY INJURY person) $ AUTOS AUTGS NON-OWNED - BODILY INJURY(Per accident) $ HIR ED AUTOS AUTOS �OPERTn AMAGE UMBRELLA LIAB $ OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE DIED RETENTION$ AGGREGATE $ WORKERS COMPENSATION $ ANDEMPLOYERS.LIABILITY X WCSTP.TU- pTH_ ANY PROPRIETOR/PARTNER/EXECUTN VlN TORY LIIAITS ER OFFICERMtEMSER EXCLUDED? N/A(Mandatory in NH) 6ZZUB 01.01-2015 01-01.2016 E.L.EACI{ACCIDENT $1,000,000 II yes,describe under 4102P700 E.L.DISEASE-EA EMPLOYEE $1,000,000 nDOPERATIONS below E.L.DISEASE-POLI Y LIMIT $1,000,00Q DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) ERTIFI A E HOLDER A ELL T SHOULD ANY OF THE ABOVE DESCR7;POL�ICIESCANCELLED BEFORE THE EXPIRATIONNOTICE WILL BE DELIVERED IN ACCOPOLICY PROVISIONS. AUTHORIZED REPRESENTATIVE • ACORD 25(2010/05) The ACORD name and logo are registe©dgmark slof ACORD CORPORATION.All rights reserved. JL AAv i v re u vi 1J41 JLJLa 4R)JLG , T ,teea Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 308-862-4038 Fax: S08-790-6230'x 4 �� y ___ F.Y ti s.._. - _ Ra14111 C1,'ossen kr 3 Building Commissioner '; L ;>i T0W-N OF BARNST;AkLE SOLID FUEL STOVE PERMIT Date: _.I ' Fee: 2 T�1y K®weer: Phone: �°779 �d { �Address:��� UAW K�. 5 C.�1J C�6� vi�� � Village: •{ 1��((`���,, o Map/Parcel: 12,5`/ S Date:- /3 v Stove A. New/qjd=iant B. Type: Circulating C. Manufacturer: -MAV lS TiwbuSTI S _ Lab. No, SM► L ��3 D. Model No.. Chimney A. New �UiSting (If existing,pleascloofi�' to of lastRcleanrn _'elf- /Ll�l` �'� N H. Flue Size 1 C. Are other appliances attached to Flue? >� D -Pt&hb Type and Manufacturer - --� E:- Masonry: Lined/Unlined Hearth A. Materials: P Lc� B, Sub Floor Construction: Installer Name: k Address: 0) P9i h2 f�W GTMtA 12 Phone: -Lf Location of Installation.- APPROVED BY; Please make checks payable to the Town of Barnstable +This constitutes an official stove permit after inspection,photographed, and approved by the Buddft Inspector Sbve.doc �i I I I I ( I I i I I i I = i -- _._ i ✓Assessor's Office.(1st floor) Map �J Lot �� Permit# f , . ✓ Conservation Office(4th floor) 6/ i L{ 1'4 S _ Date Issued ,/ � y 1 Board of Health(3rd floor)(8:30-9:30/1:00-2:00) -.`j gw ? Fe• 6 ®d En ineerin De t' 3rd floor House IL Planning Dept.(1st floor/School Admin. Bldg.) 8�a ��` ;���° 'v b�. RMSTBLE. Definitive Pla pprove by,Planning Board 19 ® �� f6,9. TOWN OF-BARNSTABL ���� Building Permit Application Project Str _70AL Village �nr cn�ru ti Owner l o4-DTo,,� M. Address 7D� did/n�Nc�t L.anr-c Telephone .Permit Request }nQ L e E.noraL -nI� �xiar�iv� lJrc�. I ��Cpt�pCa w�rla /►!mow t r L get t* 0«it, ,4&ur y30 6� f 'Total 1 Story Area(include 1 story garages&decks) 3 a square feet Total 2 Story Area(total of 1st& 2nd stories) square feet Estimated Project Cost $ 2 ,r3 — Zoning District R 1 Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use r Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No. of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other n Builder Information Name [g I ,,v Telephone Number - C�- Address P. 40 ` License# D O' Home Improve Contractor Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS R QUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO w rhrA.y-_ it ., SIGNATURE BUILDING P MIT DENIED FZi�<O LOVAG ON(S) i FOR OFFICIAL USE ONLY PERMIT NO. #5797 r DATE ISSUED .June 15,1995 MAP/PARCEL NO. 251.225 ADDRESS 702 Phinney's Lane r- VILLAGE Centerville, MA 02632 - +' OWNER Timothy M. Feeny DATE OF INSPECTION: `. FOUNDATIQN ' FRAME a ; INSULATION FIREPLACE ELECTRICAL: ROUGH : .FINAL . . PLUMBING: ROUGH -FINAL 1 r GAS: ROUGH`' FINAL FINAL BUILDING .. /. . t ATE CLOSED OUT- /ASSOCIATION PLAN NO. ;r SPINNAKER REACH CONSTRUCTION P.O. Box 596 Mattapoisett,Massachusetts 02739 508-758-2056 Job: Timothy M. Feegy 702 Phinney's Lane Plan Ref 375/20 Centerville,MA Job Description: 1. Remove existing 15'x 10' deck and footings. 2. Construct with all new pressure treated yellow pine approximately 430 sf of deck on new concrete block footings. Frame to be 2 x 8 PT with 5/4 x 6 PT docking. Railing, footing and frame details on the details page. 3. All fasteners and hardware to be galvanized. 4. All work to be plumb and true, and in accordance with local and state building codes. Total Cost: $2,895.00 f % LOT 48 lc� LOT 49 �1 is DECK � ==HSE_=- � O--__ 12' EASEMENT 4,, �o RES. ZONE.- 'RD1 This MORTGAGE INSPECTION Plan is For FLOOD ZONE.' "C" Bank Use Only TOWN: _CEY_M' ILLE'------------- REGISTRY OWNER: TIMOTHY—Af_ FEENY DEED REF: _M05,,1323 --__--BUYER: _REFINANCEr__ DATE: _5Z994 ---------------- PLAN REF: _375�20 1"= 40 _FT. I HEREBY CERTIFY TO BA YBALVI�� QB-TGA QQR __ ______THAT THE BUILDING � tH OF YANKEE SURVEY SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN AND THAT ITS POSITION DOES ____ CONFORM PAAUL ti� CONSULTANTS TO THE ZONING LAW SETBACK REQUIREMENTS OF THE S y 143 ROUTE 149 TOWN OF ___BARNSTABLE _—AND THAT A$ 8'088 c MARSTONS MILLS, M 02648 IT DOES_ NOT _ LIE WITHIN THE SPECIAL FLOOD H ZARD q o �` AREA AS SHOWN ON THE H.U.D. MAP DATED_11985 fC��ER� TEL: 428-0055 Cammunitv—Pane # 250001 0005 C °Hac u�ao s THIS PLAN NOT MADE FROM ANJNSTRUMENT PAUL A. __ERI EW P ----- SURVEY NOT TO BE USED FOR FENCES ETC. 14718 BJS i i V f i j k x Tlril; -00!w i t ' i 36 T1 0 NEV-) D► >< l8 - d Foorrr;r, !,u�ot;trl. . Y • �r o - tlS� ;—�— CUn1ULCf� G:LDCJt7 iic�EG !,�1T,4 tCrY_*.i�T�. 4 1 �1 fit, P1 PT PT r c ffi + 1,--- - -�- Assessor's m9p and lot number ..'(, :/��; Sewage Permit number ...................��....................... fw�L ?"ET°�yo 'TOWN OF BARNSTABLE i BARNSTABLE. i °teML a pYae�� O,UILD,ING INSPECTOR r _ APPLICATION FOR PERMIT TO �f. ............. ..... ......c�.. js� ... TYPE OF CONSTRUCTION. ... . . ..... ....I..... .... .. ......... ............................... .......... .`� .........1 TO THE INSPECTOR OF BUILDINGS: The undersigned `hereby applies for a permit according to ee following information: Location ....�r ./... .••....1.....� .. ` ... .... . ... 1�,.,�� C�y�r'..... ,7 .. Proposed Use ... . lc � ..... . �/../..f.e��`•• .................... ZoningDistrict .......... ;........ ... ...............................Fire District .......... ...�.......................................... ...... Name of Owner ............ ...1�.. ..... yl - v. ...�...AddressJ. .., ��� ...... ............... Name of Builder I r -....`,..... Address ...............(..(........................i ........................................... � Name of Architect 1'� ...�j...l.. ...� .e�? dress V17 «< Number of Rooms .............L,�.................................................Foundation ... u ... ... Exierior ....`::. �'�`?4 :�%/.. .r� � f'R6 ng ....................... ....................................... Floors ..............I...L�'... Gv . ....................................Interior ............. 1.. . .' !..,�... Heating .................. .....e .....................:.....:...Plumbing U....4- .... �.-.. ... ..... ....... Fireplace .......................... .14 ....�. .�1.................................Approximate Cost ............... .� Gf.:............. ..... . Definitive Plan Approved by Planning Board --------------------------------19--------. Area ..............,� ...:�-- . t Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH l � t ,U I ' J(� y^ I hereby agree to conform to all the Rules and Regulations of the T wn of Barnstable regarding the above construction. Name -�•........... .. ................... .t L� " ` . S TRUST - { . ' .I�!t`..49^-'-7O2- './�..I��n� ' - �� ----- ....~`..�~-~~----.------- --8 I, T ��-ot................................... "==` --S-. -..-�- Type o[Cony�uc�on .]������----.---.-. ^ ' . ~ / ..............�:---..---.-,~-.,-.---.._--.. ^ ' l ' Plot '-��--.----. Lot -------�---. . ^ . Sept.Permit 8 A83tu6 . �� . ,� uqta ���@#� REFUSED . _ ` ^ � l9 ' ~' '-'~---~--~^^^^^'' ---~-~-'�--'-^^� ° .-'--..-.-_..,�...---..-...-..--_.-.-.. ...................................... ' .........-,~._-...--..-.~..-.-..-....,... ' ~. -------.-.-.-..-.-,.--~.,........,..- - --------------.-- lV Approved / - -------.-------..--..�-.~-.-.-,- . . . . . / . . - -- ........................ | ` ` ' � III S4 0005/ v N Oe° Z7' 3Z " ter 4 Fcv wPA r10n1 C -RT1F16,4 Lo r 49 FI 11 ,1"E-K'.5- LAivy- Crvi /vsr,�8 , MA. • Aug. Z9 �98 3 /"= 30' On the basis of my knowledge s, information and Sox 6 p/� ^/o rx4,--lOurq MA belief, x certify to„76e that as a result of a survey_ .t da: on : a ground on , •T find that: . The structure(s) are located o th® site as SN OF shown.Ivi Cargo/iar,�c w��6��/�e Town Za�nir�y /3=y-Laws " , '' The title", lines and lines, of ocoupation of the 4° w'µt^^" �yN site are as shown hereon. W^Rwtac ,..The site is pituated � k'�.00d, �4ne .�/vi7-� a No. 19771 c'.o=un ty G?�zd Asti cis URV Fn.,, 0 _ d �� 111 ` �' �� �• . TOWN OF BARNSTABLE 25506 Permit No. ---- _------------ Building Inspector • Cash 'r0 )9 _ _ __ OCCUPANCY PERMIT Bond _______ Issued to S L S Trust Address Lot 49, 702 Phinney' s Lane, Centerville Wiring Inspector /J': Inspection date Plumbing Inspector ;. ✓�"��Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ....................................................... 19 ...._._ .................................................................................................................. Building Inspector