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HomeMy WebLinkAbout0044 SOUNDVIEW ROAD .r h o o 0 o . °FIHEr°� Town Of Barnstable *Permit#�D/J� Expires 6 months fro s ate Regulatory Services Fee ) Y Y * BgRNSTABLE, # v� 039. Thomas F.Geiler,Director �f0 MP't A Building Division {/Z 13 Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY le- 22� y 2- Not Valid without Red X-Press Imprint Map/parcel NumberI Property Address -ft �svu.nd View Kw- f �, Ce4i iery Residential Value of Work 4 5- 1 000 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Ayk &AMCoa-t- (P 6n ri M ccw-j P&Lb&a Contractor's Name_ (4Pf tV1 d_°L11fi t P i S7.S - I&Jmcl 8gnelephone Number 5D8, -f 7 7 `OB7 7 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) C3_ 68 1 2—)13 p� [AWorkman's Compensation Insurance ESS PERMIT Check one: ❑ I am a sole proprietor JAN 2 2 2013 ❑ I am the Homeowner [� I have Worker's Compensation Insurance Insurance Company Name h(bQ l la TOWN OF BARNSTABLE Workman's Comp.Policy# 0054375 1- 11 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) gRe-side/Tnm #of doors 19 Replacemen indows oors/sliders.U-Value d (maximum.35)#of windows ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: X�C_c C:\Users\decollik\AppData\Loca icrosoft\Windows\ porary Internet Files\Content.Outlook\QRE6ZUBN\EXPRESS.doe Revised 053012 6 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations UT 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/Organization/Individual): COawlde �/� /Y/✓Y��c�I L L Address: J5-3 CoMYY1�f�� 05'eZ71- City/State/Zip: INash IP7� 1��9Phone#: �5 � `t 7 7 -7 Are ou an employer?Check the appropriate box: Type of project(required): 1.Are am a employer with 2 2 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet._ ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11:❑Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees. [No workers' comp.insurance required.] 13.❑Other *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 contractors 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 their workers'comp.policy information. I am an employer that is providing worker's'compensation insurance for my employees Below Is the policy and job site information. Insurance Company Name: 1 l �CL Policy#or Self-ins.Lic.#: C 3 Expiration Date: It'J�D'/ Job Site Address:_ t 1 66MC/ V f k) d rAle City/State/Zip: ( ,M 1U Vl Re M602b3 2— 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 for insurance coverage verification. I do hereby certyy under the pains and penalties of perjury that the Information provided above is true and correct Signature: Date: Phone#: 7 7 -7 Official use only. Do not write in this area,to be completed by city or town official, 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 IL Contact Person: Phone#: i License or registration valid for individul use only Office of Consumer Affairs&Business Regulation before the expiration date, 1f,found return to: OME IMPROVEMENT CONTRACTOR Type, Office of Consumer Affairs and Business Regulation lug, egistration: 143358 10 Park Plaza-Suite 5170 xplration: ..7/612:014 Ltd Liability Corpc: Boston,MA 02116 CAPEWIDE ENTERP0# i L; <r ;. RICHARD CAPEN �_ 4507 R RTE 28 g 6`" '�e�- nature COTUIT,MA 02635 Undersecretary Not valid withou g 1 Mass huse"s -Department of Public Safety 60ard of fluiiding Regulations and Standards Unrestricted-Buildings of any use group which (on%truction Supcn kor contain Iess than 35,000 cubic fed(991M )of License:CS40273 enclosed space. 10t 1M+ 1?�N 1212 w COW,. Failure to possess a current edition of the Massachusetts Expiration State Building Code is cage for revocation of this license. Comfnissioner 11/27/2013 For DIPS Ucensins Information visit: www.Mass.Gor/DPS Client#::51439 CAPEENT ACORD. CERTIFICATE OF LIABILITY INSURANCE Doaia i2olzm) THIS CERTIFICATE IS I3SUEO AS A MATTER OF INFORMATION:ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOTAFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND'OR;ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF-INSURANCE DOES NOTCONSTITUTE A CONTRACT:BETWEEN.THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR,PRODUCER,AND THE CERTIFICATE:HOLDER. IMPORTANT If the certificate holder 1s an,ADDITIONAL INSURED,the policy(ies)must,be endorsed.If SUBROGATION IS WAIVED,subjectto the terms and conditions of the policy,certain.policies may.requlre an endorsement.A statementon this certificate does not confer rights to the. certificate hoider;in Ileu of such endorsemengs). PRODUCER. ME; Linda Taddia Rogers:S Gray Iris. Kingston. PHO He E,tt:508.746-3,311 63 Smiths Lane; E MAIL roge No:877-8164.166 Kingston,•MA 02364-3700 ADDRESS::itaddla@rsgray com 508 74G-OQSS _ _ INSURERS AFFORb1k%CdVERAQE NAIC 0 INSURERA:Arbella Protection CO 17000 INSURED _.. CapeWide Enterprises LLC INSURER a: INSURER 6: J.PMacomber&:Sons: - I PO Box:783 NSURER D i. Centerville,MA .02632 INSURER E:. .. _.... INBURF.R:F:- COVERAGES. . .. CERTIFiCAT9:NUMBER: REVISION NUMBERr 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'GONDITION:.OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO'WHICH THIS. CERTIFICATE MAYBE ISSUED OR MAY ED HER EXCLUS 0 S ANO CONDIT ONS OF SUCH FPO ICIES.HLIM TS RTAIN, TE .S OINN MAY HAVEBBE1EN REDUCED 8Y PA D10E.AFFORDED. Y THE POLICIES: 8CI AIMS EIN IS SUBJECT TO ALL THE TERMS,: 1NSR ADDG SUB POLICYEFF :POUC EXP LTR TYPE OF INSURANCE POLICY NUMBER: MID MMIDD LIMITS: A GENEOALuA81llTY CPP8500050813. 4/3 012 0 1 2 OW301201 EACHoccuRRENCE a1 000000 X COMMERCIAL GENERAL LMUTY PREM 9E5 ENTEO I a ocarrence 3250 000 CLAIMS-MADE AI OCCUR MED EXP(Any oneperson). $:5'000 :PERSONAL&ADV:INJURY st000 OOO' :GENERAL AGGREGATE t2,000,000 GENC AGGREGATE':LIMB APPUES PER: PRODUCTS•COMP/OP AGG s21000,000 POLICY JF—lJECT .: LOC. $ A ,AuroraoBllJe LIABILITY, 58944400004 D 4/20/2.012 04.12.0/2 13 COMBINED SINGLE LIMIT 1;000;000 a .ANY AWO: BODILY INJURY(Per person) : 3 ALL OWNED SCHEDULED AUTOS X AUTOS. BODILY.INJURY(Per acddant) $: NON-OWNED PROPERTY DAMAGE X;HIRED AUTO$I X AUTOS Per accident $' E A X UMBRELLA Use OCCUR 4600050814 4/30/2012 04130/1 2.013 EACH 06CURRENCE $5 000 000 _. .. H:CLAIMS-MADE AGGREGATE: s5000 000 DED.: X .RETENTION 1.0000. E A WORKERS COMPENSATIon - 0054370411 4/14/2012 04/74/201 wC STATu, oTH AND EMPL OYEJtB:UABIIJTY YIN IlIY LIY[S .,._ .,....._ ANY PROPRIETOWPARTNERIEXECUTIVE E.L.EACH ACCIDENT SSOO OOO SARN MEMBER EXCLUDED. rN N7 A (MarMatory.ln NH). NO EXCLUSIONS EL.DISEASE•EA EMPLOYEE$50O O00 if yes,describe under.._ _ _ . . DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICYLIMIT $500000 DESCRIPTION OF OPERATIONS I LOCATION3.I VEHICLES(Attach ACORD 101,Additlonal Rernaft Schedule,It mom space Is required) I 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. AUTHORUED REPRESENTATIVE ®198 -2010 ACORD CORPORATION.All rights:reserved. ACORD25`(2010105): 1 Of 1 The:ACORD name and logo are registered marks of ACORD #S80369IM80368 CJF r �ofTr+e'o�ti Town of Barnstable, Y Regulatory-Services BARNSTABLE, Thomas F.Geiler,Director, E639. D `r'Building Divas;<on Tom Perry, Building Commissioner 200 Main Street,,Hyannis,MA 02601 www.town.barnstabie.ma.us Office: 508-862-4038 _ , ; Fax: 508-7.90-6230 Property bier Dust . Complete and-Sign This Section If Using ABuildder ; I fg ��-- eTT( K)" ` z=_ as Owner of the'sub'ect property' , herebyauthorize C.A?8 W i.DE N_>7 (Z-k S .to act on mybehalf, in all matters relative to.Work authorized bythis building permit application for: ` (Address of Job) Signature of Owner . Date Print Name Q:FORNS:O WNERPEpMISSION , Assessor's map and lot number ..�... .., .-,. .:.. THE ' �oF Toy Sewage Permit number �7 House number �_ .! /L/ y Mae& • ^� Apo,1639 `009 'Ep mo a TOWN OF BARNSTABLE BUILDING INSPECTOR ,(1 t/ APPLICATION FOR PERMIT TO 0/L S T lu .T 1 , I� P �... S roR'i .. ..................... .... ,. ................ fed �?..../=r . ? TYPE OF CONSTRUCTION ................. :........... �/Z Y/................19....9..3 TO THE INSPECTOR•OF BUILDINGS:, The undersigned hereby applies for a permit according to the following. information: Location ........../.7 .......SQ.u.tv.P..V(FI !.....�! p.� t'".p....... ar.... � j41z!15i (,11q 7.., �!/ s .c................. {� ,p i ProposedUse .......:..1.. .11.Gl?y.................................... ................... ....................... ........................I............................ Zoning District ...............1 �..........................:.....................Fire District ............. .. ..�/ /!!...5 Name of Owner Ho.&H....T..w.645.H..................Address .J E7Ut �.V.t!j ...... Name of Builder 176.M-.,5...l..L.'......Ci.O.Y.4/1;`..........Address 31..o. ......g y.... ........... Name of Architect--—fi/ ).&E..............................................Address ............... Number of Rooms .....Q&e...............................................Foundation ...0 40.GK................ ... ... ... ...Exterior ... /. e.......4 -! , .................................Roofng ..... 5.PN19c. ` �.7 Floors ... ...... . .. Interior ...... . ........ .......... .9../..�..D........t:�: .1pp... �.. Dr �oiP Heating .d., ..�r........................................................Plumbing ....:.... � ... .................................................... ' Fireplace ....:.... .l;'.Y..Q...............................................................Approximate Cost .::. 0.a.d.:.o(7..........:...:..... :r...... • rr Definitive Plan Approved by Planning. Board -----------_------_-----------19_______. Area ........ a.................... Diagram of Lot and Building with Dimensions Fee ......, 1..,2, SUBJECT TO APPROVAL OF BOARD OF HEALTH RCH R IL 1 \ r �c � ` r t i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS F I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. n Name .................................. ........................ Construction Supervisor's License .0.0..9 gR A=227-52 WALSH, HUGH T. No Permit for.ADD TO DIZLLING" .................................... ............... Location ...x=... le w...Road....... ...................W el Owner ...Uuglz...T.....Wa.jsh............................ Type of Construction ...F.r.ayfte.......................... ............................................................................... Plot ............................ Lot ................................ Permit Granted ..........5.e.p.t....15..........19 83 Date of Inspection .....................................19 Date Completed .......................................19 } Assessor's map and lot number ...... .. .': .. ... - oFTNETa� " Sewage Permit number ......: .: .-.. : .✓.................. e�Q ♦� ` SYSTEM �:,.=L.l���I;f� B ARNST LE,7C� �� '� T MUST M a ..... ... .. .................House number 639.I1STA LED ;INt i ` R'n j: TOWN OF BARN Tt BLEB PJD il.t� y RU�ILDING INSPECTOR 6 A&$TRU GT" DRCI� �....S1. APPLICATION FOR PERMIT TO ......... ........... ............................... ............ TYPE OF CONSTRUCTION . Wd©P.... f!:, "� TO-THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora permit according to the following information: D.��r.1� o ' ..- ..................Location .......... T....... Y& �� ProposedUse .........e6.R.al .................................................................................... .. .. .... q. Zoning District ...............t' ...........................:..................Fire District ............. .. .�/� � :.. ........ Name of Owner 1741 /.T.....T .�L-,� .::.. .Address ! 5 UN0 U.� .:.....!\ �:.:. ft' Ny�/IMf®a f7'7J �?pp .. ...... ...,. ...... .... Q /' M Name of Builder .V/.•/��5..: .`......C.0y�E...........Address 3f..1!/.l:� Ry..: F�....!� tIPG..LL..... .SS Name of Architect ....1OtiE............::...............................Address ...........:................ .......................... .............................. Numberof Rooms ....0&F...............................................Foundation ...04.�.e ......................................................... Exterior ...W...ff/.. ...... �.1'. !�..7.................................Roofing ..... 'T................................................... pL !!/d O Floors Q�`..... ....... ...... :.............Interior ...... ..� .....fir............... Heating ..... Q.N.�� ...........................................:...........Plumbing .........(!V� .. ..... Fireplace ...........jfk.o. ......................................................................Approximate Cost �,'d O. o� ........... ................................. ------:19--------. Area /........................ Definitive Plan Approved .by Planning Board _________________________ Z�o� Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH f MOW 4R J t OrL, OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I 'hereby.ogree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name :...... .. ....................... d Construction'Supervisor's License ....... WALSH, HUGH T. - 25542 ADD TO DWELLINCf - No .............. rrtjtrrfor, ................................... a t .............. t - t Location .. .:. S.0undvie-W...Road........... Owner ..Hush...Tr....-IeT"alsh..:........................... Type of Construction ....Frame......................... ......:................................................................... .. Ity Plot ! ......................... Lot ................................ `. Permit Granted ....Sept.r...15.c:.j.A :.19 83 r w : Date of Inspection .............................:......19 `S Date Completed �.-/1...... '-19 ;. •�- 'A d. .._.-. s t •�,r F T «ten+ t ") w �. • - _ - " r .• 1. J'r I F F