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HomeMy WebLinkAbout1204 OLD POST ROAD i2,o5° a-�a,< Q— A i vd Town of Barnstable EI► r 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-17-627 Date Recieved: 3/8/2017. Job Location: 1204 OLD POST ROAD(CT&MM),COTUIT Permit For: Building-Insulation-Residential Contractor's Name: MICHAEL T MCMAHON State Lic. No:, CS-068111 . Address: PLYMOUTH, MA 02360 Applicant Phone: (781) 831-1234 (Home)Owner's Name: NORTHEAST CAPITAL GROUP Phone: (781)831-12341 , (Home)Owner's Address: 76 WINN ST, WOBURN,MA 01801 Work Description: Weatherization,air sealing,weather stripping and blown cellulose tm rn Total Value Of Work To Be Performed: $4,400.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have,coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Mike McMahon 3/8/2017 _ . (781)831-1234' Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $4,400.00 Date Paid Amount Paid Check#or CC# Pay Type _ _.. Total Permit Fee: $85.00 3isi2o17 1 $85.00 3000t XXXX xx,rl Credit Card .. 7015 ........ .......: ... ...... Total Permit Fee Paid: $85.00 ` TOWN OF BARNSTABLE BUILDINGPERMIT APPLICATION, Map Parcel S�P�f e _ Permit# Health Division - Date I ued Conservation Division / ' Fee Tax Collector Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board r Historic-OKH Preservation/Hyannis t Project Street Address Po J� :Village i1 i 7' � Owner ,tiPRru �a-oil ' NO►d4a�s PLC Address =:�� �a�P,ro�' �. Telephone Permit Request '1 2 xi d-d k%Ur,,a ,NetJ A-e*7` t#(S S y5775Z� c /(its , ketoll_A h-db.r ��f S [A-,.- SG q O//sNC / I�i1� yam// /fib ' fF Square feet: 1st floor: existing proposed 'E '2nd floor: existing ® proposed O Total new Estimated Project Cost o Q'Od Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: es ❑No If yes;attach supporting documentation. Dwelling Type: Single Family ' Two Family ❑ Multi-Family(#units) Age of Existing Structure Xi-- Histo2therl�� House, Yes 91q0 On Old King's Highway: ❑Yes '5<0 Basement Type: ❑Full ❑Crawl ❑Walkout Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Q Number.of Bedrooms: existing_ new Total Room Count(not including baths) existing `7 ' new C3 First Floor Room Count Heat Type and Fu Gas ❑Oil ❑ Electric ❑Other' Central Air: Yes ❑No Fireplaces: Existing _ New Existing wood/coal stove: ❑Yes ffl o Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage: xisting ❑new size Shed:❑existing ❑new size Other: r Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name k 'Dw-tEa` Telephone Number g�7�0 7,1? Address 6s' 7::�u u c Peepp License# C Q*�"(IIA 3a Home Improvement Contractor# } Worker's Compensation# 0 C. 5- '(a Q O S3 ALL CONSTRUCTION DE IS RESULTING FROM THIS PROJECT WILL BETAKEN TO .. Coy # .,- L f SIGNATURE DATE • N 4 • ' - FOR OFFICIAL USE ONLY PI~,RMIT NO. ,, .• r F' - DATE ISSUED ova, MAP/PARCEL NO. ADDRESS 41 VILLAGE ? OWNER , DATE OF INSPECTIO Y ' FOUNDATION , i F FRAME + - j INSULATION - FIREPLACE ELECTRICAL: ROUGH FINAL w r rY PLUMBING: ROUGH FINAL GAS: .ROUGH FINAL •FINAL BUILDING " DATE CLOSED OUT { f ASSOCIATION PLAN NO. ESTIMATED PROJECT COST WORKSHEET Value LIVING SPACE 066 square feet X $55/sq. foot GARAGE (UNFWISHED square feet X $25/s4. foot= ) PORCH square feet X $20/sq. foot= q DECK square feet X $15/sq. foot= OTHER square feet X $??/sq. foot= 'Total Estimated Project Cost a Coo • ®�° g990915b < .. DAT:::::::::::::. „`::: .::::'i <'. :;: E MM/DD/YY._:::. :i A CORD . .R►> '�1.. TM`»:;:!;::;5:>::!::::::::::::::::Siiiiii:fi:i:C::: i;>:i;:i:iiii:X.....;:: G>:::: i::::::i:%%::i:;:;;»r.^:<4?:>:»»>;;:;>;:>::::._.::::::::::.:::::::::::::::::::::::::::::::.,.:::::::::::::::::::. 02 1 6 2000 PRODUCER (508)775-5830 FAX (508)775-6688 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE organ-James Insurance Agency, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 44 Barnstable R d. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO Box 250 COMPANIES AFFORDING COVERAGE _._............._....._...._............... _...__.__.............................._....._..._..._......................._._.._....... Hyannis, MA 02601 COMPANY Commerce Insurance Co. Attn: Ext: A _........... ..................... ........................................................;. INSURED _..............._._._.._........... _.............._._................ ...._. F. Michael Dwyer dba COMPANY Legion Insurance Co B FMDwyer Co. ........................_.............__._..........__.............. ......__......_.........._._._..............._........._....._ 772 Main Street COMPANY C Osterville, MA 02655 .........................._..._..............__._.............._..._.........._........_....._............._............._._...... COMPANY D :::::::::::::::::::::.::..:................................................................:............ .. ....................................:.:.::.::.. THIS IS TO:»: '>:;:; C ERTI E LISTED FY THAT THE POLICIES OF INSURANC E S ED BELOW HAVE BEEN IS SUED TO THE IN SURED 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. ,_.................__...................................... .._...._......_......_.........._.._......_._.._..............................._..._......_ ............... .._..._..............._......._....._....__................__....._............. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR; DATE(MM/DDIYY) y DATE(MM/DD/YY) ! LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ 1,0 0 0,0 0 0 X : COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OPAGG $ -,000,000 .............. ..... PE A s'`>s"'::- iVP2907 09/10/1999 09/10/2000 PERSONAL $ 500,000 $ OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE: 500,000 FIRE DAMAGE ...._.................._... EDAMA 50,000 ........................ ..................................... MED EXP(Any one person) $ 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS _..... __ .......... i......:: BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ........................... ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT: $ ....................................I................... ................................ AGGREGATE'. $ EXCESS LIABILITY EACH OCCURRENCE $ ..... UMBRELLA FORM .. ............................. ..... .. AGGREGATE $ !.......................... ........ _:...... OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND X :TORY LIMITS ER >` EMPLOYERS'LIABILITY """ "" "' B :THEPROPRIETOIL (^105-0929053 09/20/1999 09/20/2000 ...........100 000 EL EACH ACCIDENT $ PARTNERS/EXECUTIVE INCL EL DISEASE-POLICY LIMIT $ 500,000 OFFICERS ARE: X EXCL EL DISEASE-EA EMPLOYEE: $ 100,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS arpentry - 1 and 2-family homes in MA :CERTIFI A:: ::: »>:....:>::>:>:i>::>:>; :......::>:......>:;:;:;::>::::::>:s:>::>::<:>::>:>::>::<:>.::::<:>::>::>:: :.: :' »>::»:::<>.:::::>;;:>;»>::>::>::>::>:<:::>::>::>:«:::«:::::«««<:<:::;:::::<:;:;:.;;:;:;;:.;;;;;::.;:;;;<:.;;:. TE:hIU�.�ER:::::::::.:.....................................................:..:.:::::::.. ::.£A.N. .........................:......::::::::::::.:::::::::::::::::::::::::::::::.::.::.........................:..:.DEL .AT[t Id::::.::::::::::::::::. ......................:::::::::.:::::::::::::::::::::..::::::::::::::::::::::.:.......... ........................... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Town of Barnstable 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, A t t n: Building Inspector BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 367 Main St OF ANY KIND UPON TH50MPANY,ITS AGENTS OR REPRESENTATIVES. Hyannis MA 02601 AUTHORIZED REPRE N IVE Frank Horgan c.:...... ..................................................................... ::.:<::<;>: R€'(?RATEO�I::'19811 ✓.�e -Varrv��uueallL a�✓�aavac�rcGe�Ca 47� r HOME IMPROVEMENT CONTRACTOR o Registration 126122 Type - INDIVIDUAL Expiration 04/22/00 FRANK M. DWYER G� �o 94 PHINNEY'S LANE ADMINISTRATOR TERVILLE MA 02632 . � ✓fie U�o�y��rrroncctea.� o�,��zJvacfit�;te� MOWN- i DEPRTHENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Number, Expires, Restricted Ta: 00 RANI( H DWYER 2;941 PHINNEYS LN CENTERVILLE, MA 02632 , OSHA U.S. Department of Labor Occupational Safety and Health Administration i Francis Dwyer has successfully completed a to-hour Occupational Safety and Health Training Course in Construction Safety & Health i.R UR fs� (Trainer) °F IME T P The Town of Barnstable anaxsrnai.E. • MASS. Department of Health Safety and Environmental Services >Eo 39. a Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW - SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the`reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: Re m ode—( Estimated Cost �d C10 Address of Work: /0?6 Old POST W, ,1"el It,t Owner's Name: f=M J7(&2- Date of Application: a I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 []Building not owner-occupied .. []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY - I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name t q:forms:Affidav The Commonwealth of Massachusetts aj- Department o Industrial Accidents, alfrca offayestfgatioQs -_ " 600 Washington Street Boston,Mass 02111 Workers' Com easation Insurance davit name location- 2 G�l city C , 1)l S l 6l-e y� �i�. phone# 0 G ❑ I am a homeowner performing all work myself. ❑ I am a sole=oPfietor and have no one worlds in anv==tv ❑ I am an employer providing workers' compensation for my employees working on-this job..... .. .....:::.:: .,._:,:,::..:::;;,:;:;-::.>;;,;>.,,,. < `SSj _i'tt>f<t> ii�ia[ ��ii�� � ?i adre <::. :...... :.:....::::.:::•::::::::::: ::..::•. ...... . ::..::.::::: •.. city ;:. msurnnceca. ::..;:.:;.;::<:.:....:...:...,......::;.:.:: oltcv FEW ❑ I am a sole proprietor general contractor,. r homeowner(circle one)and have hired the co=actors listed below who have the following workers' compensation polices: ::.:.:.. :::,. ::. m:>:;::::> >:.::.;..;:.:.:.: :. :.::.::.:. ::::.;:: ::.:..::. .::.: :.:. .::.. :.:;>;:;;,>:..:::.:..:::::........::.::.:..... company name• . . ...w .. --.-. �1 ::..: ..::::::::::::::::::. ............ ...j >�.k.•:::::.• :. ..:_:•:.;.:::.�:.:::::::..:::.::.:,,:-:::.:;;::::.;.:,...,::.:::.:...... .....:.,:,:...:::::.........::::.;....:.:.::::.:::::...... ........ ......._ ................ ....... .... ...................v...................r. •:::: .. ............... r.... .... ............ ......•:;..•;..;...........:::.�:............. ...... - };}jiii:•}:':::�i�:�iti:ii:{�i:tiA!:-:{•i:•::^yi::•?i?:�:j�:l:.;..; .......� :::.�: :::: v::•.�: .: :: •::::::::::n�::::::.�:::. :w:::::.........:•v:w:::.:�:::::::.v:::::... ..v:•:::.,.. .... ..... .. ........... .. .........::..:: :.v:•:::•:::: :::•:.::..................::::::: . ....... .... .. ....... .::.:�:: .. •:i'i: `S:: F.ii' :::::::.::i4:;isi.+ii::iiitiv:{:iii:>:ii ?::ti•: i::ii:i:: city ` . ........:.... ' . .. oh ............ ::::.............::....:...:. ............... .::.,................................ . <..............::::::.. :.. H:.,....,.:..... manrance co:... �: .............. .�... ..+��' .:::: -- a;>::::>:: ::.:.::,... ..:.:.:. n Done h FaOnre to secure coverage as regnired under Section 25A of MGL 152 can lead to the imposition of crhnioal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the 01nce of Investigations of the DIA for coverage verification. 1 do hereby certi a pairs and penalties of pedury that the information provided above is int.and corned k i�ature Dat� oz�3�o� _ 7^(d �ln '7•Z oincial use only. do not write in this area to be completed by dry or town otncial city or town: permit/license# ❑BW&ng Department ❑Licm mg Board ❑check if immediate response is required a ❑Selectmen's Oinee _ ❑Health Department contact person: phone M. 00thr. (mued 9195 PIA) , Assessor's map and lot number ..........................:........:.....: Sewage Permit number ... ..' ... ....................... ' �0*THE.T TOWN OF 'BARNSTABLE SS i SAflB9TALLE, i 09•a.0� BUILDING INSPECTOR APPLICATION FOR PERMIT TO .....�Z�ZA..O....... .4� �e........................................................................... TYPEOF CONSTRUCTION .............1 R©A................................................................................:....................... ........................!..`...y... 19. .X. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location OLD P-bi7- �� TU tT ....P:.......! a......................................................................................................................... ProposedUse ...... .Ec..t........................... .............................................................................................I......................... Zoning District .....................J`.:l...:...............................:.......Fire District ..... F. ... n..............' ..... .® .V AT............... Name of Owner ....Address ...QL.Q.... .......C .rU.?. . ............ Name of Builder ��..� .�-c.............................:Address `S�Me ........................... .................................................................................... Name of Architect `S� !LE ........Address ......................... ........................... S.�M. ......................................... Number of Rooms ....................'-.........-...........................Foundation ©.1 .4........ caS. ..................................... Exierior ....................................................................................Roofing .................................................................................... Floors ...... .........................................Interior ................................— - Heating � � �........................................ .........................................Plumbing ............................................................................... Fireplace ........................................Approximate Cost .�d'n� `). ............ Definitive Plan Approved by Planning Board ________________________________19________ . Area ...... .... . ........ t � Diagram of Lot and Building with Dimensions G IFSS Pei 0 L Fee ...............`3 ................. SUBJECT TO APPROVAL OF BOARD-_LTH _1e_A - � I /ON I jhreb)y agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...94.JR......... . ....� '` ........ .............. .. Amesbury, Robert R. SC) 11> rt Date of Inspection Date C PERMIT REFUSED Approved .......................--------. 1 ' ( � ^ . ---------------..--,.--.----. � ----------------------^.—..— �L �~-