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HomeMy WebLinkAbout0179 CEDRIC ROAD � 7q C�A�r�'� '��l v � q. .. � fl .. U � � i As•�'essb?"s map and lot number 1 r Sewage .Permit,"number ....................� ......'......... ............. F7NEr " � 0 � , TOWN OF BARNSTABLE EBHBSTADLE, • r- "6 9 DUI1DING � INSPECTOR O `D ppY a APPLICATION FOR PERMIT TO ...:!r !. •` kle : .... .f ...:......................................... �"f TYPE OF CONSTRUCTION ................. 1" t2.:.............. � .... '...................197... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit,according to the following information: Location Proposed Use ..... )" r �,. ....................... �!t!� ...4 •��•; (•.9• .................................:........................................ R Zoning District ......................................................... ..............Fire District ... �' F� ........©,;3••f I ..................................... Name of Owner ...t6 !`�fn1 t C7 p �.?N� Address � � 1`fi.k�1/ f�. t.� /! �!` l� ......... G1.............. :.. S ;.......... : . l Name of Builder .. i' !, .. .. t k Name 'of Architect ..................................................................Address._:.,_.,...................A............................................................ co Number of Rooms .Foundation r aA ...... .................................................... O S l a-{+ ................r r..............-.......................... 1 Exterior r - S` � i i��.. . .........Roofing ........: ?. r ..N ...f.......................................... J1 1 Floors C{ ,( •� ............................Interior �.t 1�._.... Heating...... .....! .�.j� ..... Plumbing ...... :....................................................................... ..CA ........ Fireplace ......... ............................... ................... ......Approximate Cost ...................................................... Definitive Plan Approved by Planning Board `'*_____-----------19---77. Area ...� �'?........................ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH M I hereby agree to conform "to all the Rules and Regulations of the Town of Barnstable regarding the4abovelconstruction. ;1Name,.! .............` ................... ........ 18164 - one story, single family d�elling Cedric Road Type of Construction ....../ f.ram.e.................. Date of Inspection ....................../............ 19 10 PERMIT REFUSED Approved ---------------.. lA ............................................................../................ ................... .l-----.--. ' rc 1t dais r t A: 14 qx! 41 202a' 4!'/ t.. ., ft„# ty c ws` S `v�•A E � a`t'�1 ty L } '•" � O o 3r. `• s �N`Q"\ rS'� �`? z + ,..�, p U � c::.kk•� '�'. :.. - fw S t -.� ..+.-* g ,>r` „i!>~ f �.-7F N. ^ D R�n C. h f9i o d»P YYYIIII � 9 'f• b 7t '#A ° } 44 s rr Al `V�, 5 V s . _r—+. _'.._�ti._�. ._. _� .t.�.r•«-- —�. +.r :- +wa—fir#t r k_ a jet 17 ti i s s 1 C3�/•�/;cy fS ,"fir I�ltCO�E�y CEPL"T/�Y 7-AVAV7" TL•/E tau/4.17/.V�►� 1 + l ! s d>E � 4 ` aw9dA/M ®.V >///S Fed,FB.V IS L O C ATE a O.V THE 4 'bee,6/D Fda -SAOOVVA41 A-010,-ZOA/ Ga,l/a T,e- 4?7' /7" CO.VFO,e M 71C, ZO.u/.t1� � .•-----. � � ?, ��� c�a{' 7-owAv o��.9 '�sr.�.a c ��N �F hl4s °g 4 ARN,E o OJAL.A' c�i� + #26348 / GA) -1,A�.CEMOUTi n/siT--- ,� r •. t� � + J assessor's .rT ap;and .lot ;n /. ........... .. ..... °; ® P ;, • f SE f C :SYST'i`A MrU:T B. % INSTALLED IN COMPLIANCE 1 x,lllg WITH ART "J.E 11 STATE r Sev e•Permit number ............. ...................... ..ti... . 1<t[TA`;Y s�fJ'SA CCDF � TOWN rMA TOWN . OF BARNA Wt-K BABB9TeDLE, ` : , R U ILL DING I H`S P ECT 0 R 1 .• rJ v APPLICATION,. FOR,PERMIT TO 4::.u. ..................... ..... TYPE OF CONSTRUCTION. .................. .. .. ...........I .... ................................. ............... I ...........................{ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit,according to the following information: �e � ...........�- ..... drat. ....... .................... ................................................................................. Location .................. KL ProposedUse ............................. .:... :4.. ......... .............:............................................................. Zoning District .........................Fire District / Name of Owner ...� .fiJ l .'... ..................Address .... . .}�� ... . j:`...... :....... .... '� o Name of Builder ......... ...........................................................Address ...................................................................................... 1• Nameof Architect ..................................................................Address ..................................................................................... Number of Rooms ...........Foundation Exlerior —w-".Th....... ...... .........Roofing ...... ................................................... Floors .�Q.. .....................................................Interior ...•�L.......�-4f .................................... �4 �U� o Heating ..................................................................Plumbing ................................................... Fireplace ............... k....................................................................Approximate Cost ..... ....... Definitive Plan Approved by Planning Board -----______�----------------19__— Area ...1-5T1Q......................... Diagram of Lot and Building with Dimensions�� Fee ...... :,...................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I��7 ,� ram• / I hereby agree to .conform to all the Rules and Regulations of the Town of Barnstable r arding the abov construction. Na ......... :..�..' .... . L Capewide Development it 18164 one story, N� .....!n= Permit,for-. ................................. single .family dwelling .................. ......................................................... 1.7ocati11 .......Cedric....Road .................................... .. . ........ ...... . i Centerville J ................................................................ Capewide Development� Owner ............................................. CP. frame.. Type of Construction .............................. ............ .........................................:...................... #38 --,Plot ................. Lot ................................. Febfuary 10 - 76 rPermit Granted .... ..... .......19 Date of Inspection k Date Completed ..........19 �� PERMIT REFUSED.—w ................................................................ 19 • ..........................................I...............n.................... ................... .. ..................................................... ............................................................................... • ,-J Approved ................................................ 19 'All ........................................................... ................ ........... .................................................. 7 A-1 4 l a��i2 CAPE E COD, _r ANSULATION � . El N R w., 1.- i NRBR GLASS -A-" SPRAYTGAM SUSVSNDBD r, BATTS 3UTTERS INSULATION CBIBINGS • ' - { 1-80, -696-6611 Y Town of ✓�Gsi'/1<S f�-��1� y R Regulatory Services 4 Building Division ' Address - Address'2 - . . _. Date: � Dear Building inspector' 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 thetspecifications 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 p 1 ''Property Address - "IV,lTlaf?e - . r ♦. Insulation Installed: Fiberglass" Cellulose _R-Value >; Restricted . . Unrestricted ,.... Ceilings Slopes wean Walls S cerel #.:: ' t � ` AI • ,: . ; He y A entCape C g F {TtL' 0 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma Parcel A licatio, p pp q Health Division Date Issued i Conservation Division _ Application Fee Planning Dept. Permit Fee vr Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street.Address r Village . a Owner ! Address Telephone t. ? o Permit -IR Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay ea 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) A Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Roor County 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 :3 new' size size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 3 rz) _ at en Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes C9'No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number' _ Q7 5" . Address ��`�� 2_(' License #__�-� IL'sr, NA Home Improvement Contractor# _'�1 7 ' Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO _ l SIGNATURE ' DATE d f a FOR OFFICIAL USE ONLY ' APPLICATION# DATE ISSUED MAP/PARCEL NO., ADDRESS VILLAGE r . -OWNER r 'r. { t • k. DATE OF INSPECTION: FOUNDATION, � '.• r FRAME i 'INSULATION._' FIREPLACE t ELECTRICAL: ROUGH FINAL F PLUMBING: ROUGH FINAL - GAS: n ROUGH FINAL FINAL BUILDING DATE CLOSED-OUT ' .: ASSOCIATION PLAN NO. i 10 Park Plaza- Suite 5170 `Boston,�Massachusetts 0211.E Home Improvement Contractor Registration Registration: +153567 "• Type: Private Corporation Expiration: 12/15/2012 Tr# 206433 CAPE COD INSULATION, INC , HENRY CASSIDY 455 YARMOUTH RD. w!\ • r .� t HYANNIS, MA 02601' �* . �; 's -- , r,. Update Address and return card.Mark reason for change. �r r. rLr D Address. ❑ Renewal ':Employment' Lost Card DPS—CA1 Cep 5OM-04/04-G101216 -� HOMegoru fairs Bus'ne ReguI tion- License or registration valid for irdividu! i e ^.!y "`'before the expiration date.-If found return to + Registration: 153567. Type: Office of Consumer Affairs and,Business Regulation Expiration: 1,2/15/2012 - . Private Corporation 10 Park Plaza=Suite 5170 _ Boston,MA 0211E r -OD INSULATION, INC _ s �= _ HENRY CASSIDY` ' y ' 455 YARMOUTH HYANNIS,MA 02601 c r " Undersecretary +° t ali d ith t si tune . { Mfissachus'etts- Deliartment of Public Safety t , _ Board of Buildin!a Reoulations`and Standards Construction Supervisor License +. License: CS 100988 HENRY EAS$IDY r.> � 8 SHED ROW F m WESTARMOUTH, MA'02673 +' Expiration: 11/1.1/2013 (`unmIussioner Tr#: 7620 Client#:4597 " } CCINSUL ACORD .M CERTIFICATE40F LIABILITY INSURANCE.. DATE(MM/DDIYYYY) ' - 2/02/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELYAMEND,'EXTEND OR ALTER THE COVERAGE'AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE-A CONTRACT BETWEEN THE ISSUING;INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER: IMPORTANT:it e certificate holder is an Awl I iuNAL Ifilbylity,the po lcy les must be en orse __UAIIUNISWAIVtU,subjectto the terms and conditions of the policy, certain policies may require an endorsement.A statement on this certificate does+not confer rights to the certificate holder in lieu of such endorsement(s). " PRODUCER - - Ma arG't Rogers$Gray Ins. -So. Dennis �' : �� NAME , rg . 9 r :„ y "k d PHONE .. FAX , x t 508?60-460? 816-2156'AC NoEx -434 Route 134 .H77 P.O.Box 1601 PRooucEloungma@rogersgray.com South Dennis,MA 02660-1601 ' t ` . CUSTOMER ID# i>+ t, INSURER(S)AFFORDING COVERAGE Ir NAIC# INSURED INSURER A:PeeriessInsurance ? r -. '18333 ... .. ._, Cape Cod Insulation Inc INSURER e:Ohio Casualty Insurance Company ',;R ,- 455 Yarmouth Road ° c 6 s , Hyannis,MA 02601 " INsuRERc:Atlantic Charter InsuranceH 1 s 'f ' ,ONSURERD:Commerce lnsuranceCompan,y; 34754' •,:,,INSURER E S w! - ts• K e„' 1NSURERE: COVERAGES CERTIFICATE NUMBER: w - a` =REVISION NUMBERi 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 CONTRACTOR 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. NSR AODL SUER' _ POLICY EFF" POLICY EXP A GENERAL LIABILITY CBP8263063 -`;04/01/2011:04/01/2012 EACH OCCURRENCE.. $1000,000 ' 1. m COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED ' X COMME, ,- „-'F T ,8, R 3 �' ar`,• 't` i..•:* " " PREMISES(Ea occurrence),'� $A10O 00.0 .. CLAIMS-MADE,,, X' OCCUR s < 4 -�- ,x - i 4 x >.T .. XP(Any o e person) $5,000 ^ .. _ 1;0 0,0 r � MED E n , 1 I PERSONAL&ADV INJURY ,-, $ 0 00 GENERAL'AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER I 3 M# w +,PRODUCTS-COMP/OP AGG $2,000,000 ) PRO x t •-sa �$° D AUTOMOBILE LIABILITY' ^_` .,? 1,1 MMBCKVMK ';;b 04/01/2011 `04/0112012 CoMBINED SINGLE LIMIT. # $ ; d Y .000 (Ea accident) ANY AUTO e 4 T c + BODILY s INJURY (Per•person) $ ' ALC OWNED AUTOS BODILY INJURY(Per accident) $ X SCHEDULED AUTOS + *x" f f 7. PROPERTY F"DAMAGE X .HIRED AUTOS , (Per accidenp; $. X NON-OWNED AUTOS ) ✓ ' e ) i' r § t 3#%t a A�: - t .$. ' $ B UMBRELLA LIAB X,' OCCUR,- • AUU01254514645i 04/01/2011.04/01/2012 EACH OCCURRENCE _ $1 000 000 —EXCESS LIAB ' r CLAIMS MADEa , " : ` .�, ., } ,� AGGREGATE; Y $1,000,000 i DEDUCTIBLE X RETENTION $' 10000 C WORKERS COMPENSATION WCA00525902:"i` - '06/30/2011 ` wC STATU- - + OTH AND EMPLOYERS'LIABILITY Y/N 06/3O/ZU12 X µC.TORY LIMITS' `' ,:ER " ANY PROPRIETOR/PARTNER/EXECUTIVE L OFFICER/MEMBER EXCLUDED? N NIA t E L^EACH ACCIDENT (Mandatory in NH) E L DISEASE-EA EMPLOYEE5QQ,000,, If yes,describe under E.L.DISEASE-POL16Y 6MIT' 71 J i r ^ ' DESCRIPTION OF.OPERATIONS/LOCATIONS/VEHICLES Attach ACORD 101,Additional Remarks Schedule,if rare Space is.w Workers Gomp Information`Included Officers'or Proprietors+ _ .a°' rrirred) ^ TM , . _� ' k�u v» CERTIFICATE HOLDER g _ ' r CANCELLATION ` ° ' SHOULD ANY OF THE ABOVE''DESCRIBEDpPOLICIES BE CANCELLED BEFORE THE 'EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN + ( # ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE +v 01988-2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S77368/M68179 MEY j The Commonwealth ofMassachusetts Department of Industrial Accidents Office of Investigations . '600 Washington Street Boston, MA 02111 www.mass`.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ' Applicant Information Please Print Legibly Name (Business/Organizatio 1� n/Individual): CA PP CA A}('l � i i-" J A,�. Address: A OVA City/State/Zip: - Phone #: j Are you an employer. Chtck the appropriate box:,- 1. employer to er I am a em with 4.. Q•I am a general contractor and I Type of project New construction(required): Z� ; employees(full and/or part-time).*� ' - have hired the sub-contractors '.� ❑ g 4 , 2.❑ I am a sole proprietor or partner- listed on the attacli'ed sheet. 7. Remod-e in ship and have no employees These sub=contractors have g• Q Demolition , working for me in any capacity. employees and have workers' ' [No workers' comp. insurance comp. insurance.$ 9:,❑ Building addition required.] " 5. ❑,We are a corporation and its• + 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all workr- officers have exercised their .I I.❑ Plumbing.repairs or additions myself. [No workers' comp: right of exemption per MGL' 12.❑ Roof repairs j e t C. 152; 1(4),and we,have no }` insurance required.] § ' employees. [No workers' �13.❑ Other'- employees. insurance required.] ,r *Any applicant that checks box#1 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 outside contactors must submit a new affidavit indicating'such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors'and state whether or not those entities have° v employees. If the sub-contractors have employees;they must provide their workers'comp.policy number..:' I am an employer that is providing workers',compensation insurance for my employees.- Below is the policy and job site' information. f Insurance Company Name:- �Rnt[(_ A,�fe...r 7► A1,101MV 1 p (0 . Policy#or Self-ins. Lic. #: CA oorav?,ry l Expiration Date: • 3f? Z. Job Site Address: ��� V� City/State/Zip s 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 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•foe insurance coverage-verification: t _ 1 do hereby certify it e pains "nd penalties'of perjury that the-information provided above is true and correct. I } Si nature:" Date: Phone#: Official use only. Do not write in this area',to be'completed by city or town officidl a` City or Town: Permit/License# .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#: 6" - a OWNER AUTHORIZATION FORM (Owner's_Name), - owner of the property located at . (Property Address) ' (Property Address) �. hereby authorize . � .�. _ • . S _a4N (Subuuntractor) ' z } 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'= ature Date - i #P MAR 5 2012