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HomeMy WebLinkAbout0009 WEST STREET Q ( �� SL Project Name:--- 10 Address:-­ V U�� I�CQ111 Permit#• r �� Pe nut Date.-��----------------- M/P.---- --�---- LARGE ROLLED PLANS ARE IN: BOX: SLOT:----�_ Date entered in MAPS program on:_= By y a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �= '� ` Parcel � Application Health Division Date Issued IM16 Conservation Division M" BUILDING DEFT. Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board FEB 10 2076 qfe Historic - OKH _ Preservation/ HyaOnni ' OF BARNSTABLE L Project Street Address ®.f% �� C �L� 24- Village cc Ir Owner you 7 �� ��5Z`c , Address Telephone Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed � Total new / Zoning District 2 Flood Plain Groundwater Overlay 1`poa Project Valuation �- Construction Type STte Lot Size �� A 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) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new 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: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ 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 141-?�� S /� Proposed Use 4,4? S tea, APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name SZ� �oo1 l;_4 C0.104 Telephone Number r0�7/-0L� Address do I , h S" 7L License # S �Go�77 doh/A- I Home Improvement Contractor# Email I'Ll r/� /�Z'fZ/�yGaEz v �oa2j� Worker's Compensation # I X 6G/7,f�/ZO L� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO V,*Ap SIGNATUR DATE � � l� i FOR OFFICIAL USE ONLY j APPLICATION # DATE ISSUED , MAP/PARCEL NO. i ,4 r { ` ADDRESS VILLAGE i OWNER DATE OF INSPECTION: FOUNDATION FRAME s 4 INSULATION } FIREPLACE ELECTRICAL: ROUGH FINAL ! i s PLUMBING: ROUGH FINAL GAS: ROUGH FINAL 2 FINAL BUILDING DATE CLOSED OUT ' { ASSOCIATION PLAN NO. s I Initial Construction Control Document VTA To be submitted with the building permit application by a d Registered Design Professional for work per the 8th edition of the N Massachusetts State Building Code, 780 CMR, Section 107 Project Title: Cotuit Water System Improvements Date: March 2, 2016 Property Address: 9 West St.; Cotuit MA Project: Check one or both as applicable: New construction ❑ Existing Construction Project description: Construction of a new elevated water storage tank y 1 ad I Garrett F. Keegan MA Registration Number: 48005 Expiration date: 06/3:0/20e16 , am a registered design professional, and I have prepared or directly supervised the preparation of all design puns, 59 computations and specifications concerning: $F [ Architectural [ ] Structural [X] Mechanical [ ] Fire Protection [ ] Electrical [XJ Other Civil Site, Demolition and Instrumentation Plans for the above named project and that to the best of my knowledge, information, and belief such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, (780 CMR), and accepted engineering practices for the proposed project. I understand and agree that I(or my designee) shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to: 1. Review, for conformance to this code and the design concept, shop drawings, samples and other submittals by the contractor in accordance with the requirements of the construction documents. '2. Perform the duties for registered design professionals in 780 CMR Chapter 17, as applicable. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine if the work is being performed in a manner consistent with the approved construction documents and this code. Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107. When required by the building official, I shall submit field/progress reports (see item 3.)together with pertinent comments, in a form acceptable to the building official. Upon completion of the work,I shall submit to the building official a `Final Construction Control Document'. (� Digitally signed by Garrett Keegan �A OF Mq Enter in the space to the right a"wet"or DN:cn=Garrett Keegan,o=Green ��P� ss9c electronic and seal:signature Seal Environmental,Inc.,ou, g GARRETT F. ya email=gkeegan@gseenv.com, m � KEEGAN c=us -j. 0 CIVIL ti Date:2016.03.02 16:57:31 -05'00' No.48005 Phone number: (508) 888-6034, (978) 764-1643 cell Email: gkeegan@gseenv.com SS�ONAL EN Building Official Use Only Building Official Name: Permit No.: Date: Version 06 11 2013 § 76-16 FEES a • § 76-16 ARTICLE_ III Exception for Water Tower Construction Projects [Adopted 4-16-2009 by Order No. 2009-0861 § 76-16. Exemption from payment of fees. - Notwithstanding the provisions of any other ordinance of the Town regarding Schedules of Fees, water tower construction project(s) shall hereby be exempt from payment of such fees. 76:11 07-01-2011 02/10/2016 10:02 508-428-7517 COTUiT WATER DEPT- PAGE 01/01 >' , Feb. 10. 2016 8-,46AM "No 5620 . P. 1 Town of Barnstable r ' -Regulatory Services Richard V.Scully Director RdI ing Division Thomas Fewry,CSO jaurnding Commieslover n 200 Mum Sbr a Hyannis,MA 02601 wwmtowu l arnst Imuia.us ; Office: 508-862-4038 'Faye 508.790-030 Property Owner Must , Complete and Sign This Section If Using.A.Builder �,}ll`► �11(Y�(i` CC F 1) ,as Owner of the subject propesty he=by awlorize 1 S 2 o CC 1rrhf. •0a r10. to act on.mq behA 3m alb xelatKa�e to�dork authariz«1 bq this bm�ding petlmx a�placation£ox f . . �, :«� ., 4 �- (Address offob) Somas►=of Onvaex ]7aDc Orls asemezilw Print Name ,S"v�v Lek rt r- J�r f f,-,rerD . .. if property Owner is applft for permit;please;complete the Hemeowaur Llee&se.Txemption Form on the Q;1�9PFII�ES1PORbl516m7d'mgpermitEonmsl��tPRESS.dee S ; d _ _ •. Rc& d MIS Tie Commoyrivealth a,—Massadiusetts Deep artwerrt c�,frndaytria1Acciderrts l r• a m:�sti, atiaru. 600 Washikgton Skreet -__ BrxStfl}7�M4 02111 ttlrpxt.:ilass�gavIdia N17''arkers' Campens'af anIusur-anceAffidatiit Bmlder-s/C,untractursMectdcians/Phunbers iapliccant Infarmafian / Please Print Leaib Na=(Sncin�c� anQafa deal �� Z�r, Cdv��z C�u h1 Address_ X 02.60, LC1WW4 d(__ c±y/state] a A )A t ad 7,�1 Plane _5�0lr-e 77 "an an employer?Check the appropriate bo-= Type roject(required): I l air a employer v,tli ),C2 4 ❑I am a general confractor and I employees(full an-dlor part-time)-* hate hiredthe sub-contractors 6'1v construction 2.❑ I am a sale proprietor orparfner- listed on the attached sheet. 7_ ❑Remodeling ship and have no employees. These sub-contractors have '�PS_ ❑Demolition , working far me in any capacity employees and have wodcers' [No workers'camp.insurance comp_ nsuranc-f-al 9_ ❑Building addition required-] 3_ ❑ We are a corporation and its lb;_❑Electrical repairs or additions 3.❑ I am a homeoramer doing all work officers have exercised their I❑Plumbing repairs or additions myself[No workers'mnp_ right of exemption per MGL L_❑Ito ofrepairs 3nn=nce required-]1 c.152,§1(4)6 andwe have no employees.INa tvoricers' 13.❑Other comp_insurance required.] •Any spplicmtHtst cbectsbox rl mast also Moutthe sectioabeTaa shmdn-Z dieirwo*m:e compersatiaaporuyinformsuaa T Mmwwnem who submit dik d5d2vi-c i&k&tmg they ale doing e3Twe*ant tbeahire out ide[,,tIaCtDiSn=t submit anewamdavit iadicgfitg rnrx ZCan=wt+*t f=check f1ds bax must attached an additiaosl sheet sbowiag the nzn a of the sub-camractom and stare whether or na ftse eatitks hav employees.1f1hesuTt-caatmctoshzve emp1gts_-,9heymnstpmtdde their uorken,camp.Policy number_ I ant art euiplayYrr fltrrtis prm-�ir�yvorkers'cattr�ertsrrhart itiszirmnce fur�}*enrglp}�ees Beloty is the puticy�ruzd jo7a srte� • Inforrrcrcfiort. //// ` J Insurance Companyi ame: ��� �, /, e GLLo C Tohcy,or Self--ins.Lic-4: Expiratioa Date: Job Site Address: l i✓f S fGl/ T /"�" City/StaW2l p: Attach a COPY of the workers'compensationpolicy declaration page(showing the policy number and expiration dare). Failure to secure coverage as required under Section 25A of MGL c,15 can lead to the imposition of criminal penalties of a fine up to$1,500-OG andror one-yearimpriso as well as civil penalties is the form of a STOP WORK ORDER and a tine of up to WO-00 a day against the violator. Be advised that a copy of this statement racybe forwarded to the Office of Izvestigations of1he DIPS fear iwurance cav-erage l ifo hereby c & s Widpert a S:atttta infarmafimrpt mirleJd abm i� /-e and carrect SSimature= IXate: V' % l lQ Phone ir 0SW al use anly. Do itat avrke in dds area,to be wympleted by city artnnn affrci A City or Town: PermitUcense ff• Issning An6writy(Cade one): L Board of H•eilth 2.Building Department 3,City-frown Oerk 4.Electrical Inspector S.Plumbing Inspector b,Other Coa#act Person:- none rig: Taformation and lnstruefions Massachusetts Gebraal Laws chaps 152 req>ares an employers to provide wo=kras'compensation far their employees. pm this Statafn,an ev,:pkyee is defined as."_.evEay person.m$ie service of another under any contract ofhire, express or implied,oral or written-" An emplvym-is defined as lan individnal,partnemship,association,corporation or other legal entity,or any two or more of the foregoing engaged is a Joint ,and inch Zing the legal saprescatgives of a deceased employer,or the receiver or trastee;of an individual,partnership,association or other legal entity,employing employees- However the owner of a.dw6lRog house having not more than three apartments and who resides therein,or the occupant of the- dwdlling house of another who employs persons to do maintenance,constrartion or repair work on such dwelling house or on the grounds or bm mg app tTieretn ZnR not becanse of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that`every state or local Rcensing agency shall withhold the issuance or renewal of a Hcrose or pef-mit to operate a business or to construct buildhip in the commonwealth for any applice utwh.o has notproduced acceptable evident=of compfianm widx the insurance.coverage required_" Additionally,MGL cliapt fx 152, §25CM states'Neither the commaawmn nor any If" political subdivisions shall ent-r into any contract for the performance ofpnbIic wow uniII acceptable evidence of compliancewith the iusur nC6._ re of ements of this chapter have been presented to the contracting aidhodtyf A 4canis PP Please fill oirt the workers' compensation affidavit completely,by ch=k;ng the,boxes that apply to your sitnation and,if necessary,supply sul- ntractor(s)name(s), addresses)and phone numbers) along with their certificates)of insurance. Lfi itedLial?dty Companies(LLC)orL>mitedLabi7ityPart msbips.(LLP)withno employees other thanthe members or partners,are not required to cauy workers' comp ensation fisar nice If au LLC or LLP does have employees,apolicy is mquired. Be advised that this affidavit _h- maybe submd to the Department of Inda-strial Accidents for confnmaiion of insurance coverage_ Also Be sure to sign and datethe affidavit The affidavit should be rutrmmed to$e city or town that the application for the pemait or license is being regaestrA not the Department of „ , 1�_=d�. Sbouldyou have any questions regarding the lax or ifyou are regahe3 to obtain a workers' compensafionpolicy.,please call thD Deparbnent at fly--n=brr listed below Self-ins2nedcompanies shouldentertheir self-m Mr ce lice0se number on the appropriate line. City or Town O fa a s Please be sere that the affidavit is complete aadprinted legibly- The Departmeuthas provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be,sine to fill in the p en liVlicense mrnbes which w71 be used as a reference nnnaber. In addition,an applicant that must sabmt multiple permhMcrose applications in any given year,need only submit'one affidavit indicating cmreat policy infb=ation(if necessary)and under`lob Site Address"the applicant shoulld write"all locat cns in (may or- town)"A copy of the-affidavit:that has been officially stamped or maticed by the city or town may be provided to the . applicant as proofthat a valid affidavit is on file for foture permits or licenses. Anew affidavit must be filled 0i t each year.glhere a home owner or citizen is obtaining a license or permit not Mated f� to any business or commercial vene Cie. a dog license orpermit to bum leaves eta.)said person is NOT requhsd to complete this affidavit The Of of Inye;sdga d=would hke to thank you i a advance for your cooperation and should you have any questions, please do not hesitate to give m a call ter one and faxnumber_ The Department's address, eph - ' C:a�qZeajtjj of Massach�t#s ' Dtpa�ment of I lustdd AoDgent ()ffi=of 7av ti= _ J Soo-VasbhlaiQm Bost=n MA 0�11I Tf,-L 4 61T- -4 'Qxt4-06 or 1--VMAMUE Fax 9 617-727 7M R.eviscd 4-24-07 WW MpsggQgidia Client#:751203 BISZKCON3 ACOR®TM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 5/29/2015 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(ies)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 NAME: USI Insurance Services LLC C/L PHONE 855 874-0123 FAX 877 484-4772 AIC No Ext: AIC No 5700 Post Road E-MAIL P.O.BOX 1158 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# - East Greenwich,RI 02818 INSURER A:Employers Insurance Company of 21458 INSURED INSURER B:Crum&Forster Ins Co 42471 2 - 0 Dee Contracting Corp. INSURER C:AIM Mutual Insurance Company 33758 0 Development Street INSURER D:Westchester Surplus Lines Insur 10172 Fall River,MA 02721 NSURERE: Liberty Mutual Fire Insurance C 123635 INSURER F: COVERAGES CERTIFICATE NUMBER: 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. LTR TYPE OF INSURANCE ADDLSUBR NSR WVD POLICY NUMBER MM/DIDY/YEYYY MMIDDYNYYY LIMITS A GENERAL LIABILITY X X TBCZ11259952 6/01/2015 06/01/2016 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence 000,000 CLAIMS-MADE I X1 OCCUR - MED EXP(Any one person) $5 000 X PD Ded:2,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY X PRO LOC $ JECT E AUTOMOBILE LIABILITY X X AS2Z11259952 6/01/2015 06/01/201 6 COMBINED SINGLE LIMIT Ea accident 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X AUTOS SCHEDULED AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident X Drive Oth Car $ B X UMBRELLAL.IAB X OCCUR 5811029424 6/01/2015 06/01/2016 EACH OCCURRENCE $10 000 000 EXCESS LIAB CLAIMS-MADE AGGREGATE $10 000 000 DED I X RETENTION$O $ C WORKERS COMPENSATION VWCI0060175812014A 7/01/2014 07/01/201 WC X STATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y 1 N E.L.EACH ACCIDENT $1,000,000 OFFICERIMEMBER EXCLUDED? _ N N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000, If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 D Pollution CPL200265213 6/01/2015 06/01/2016 $1,000,000 Limit Liability $10,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION Sample 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 ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S15194146/M15193867 AXGZP L Massachusetts Department of Public Safety ; lugBoard of Building Regulations and Standards License: CS-080277 Construction Supervisor I MICHAEL BISZKO III 20 DEVELOPMENT STREET <; FALL RIVER MA 02721s Expiration: I Commissioner 11/26/2017 (. L �FINE Town of Barnstable BAMMAMST"�'� ` BARNSTABI,E r Regulatory Services Richard V. Scali,Director 1639-2014 �Ag Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.maxs Office: 508-862-4038 Fax: 508-7-90-6230 April 2, 2015 Mr. Christopher Wiseman, Superintendent Cotuit Water Department 4320 Falmouth Road Cotuit, MA 02635 RE: Site Plan Review 008-15' Cotuit Fire District Water Department 9 West Street, Cotuit, MA Map 021, Parcel 009 Proposal: Replacement of an existing 200,000 gallon elevated water storage tank with a 300,000 gallon pedisphere-style elevated water storage tank. New tank will provide adequate storage for population needs for the year 2020 and an increase in necessary fire flows. Dear Mr. Wiseman: Please be advised that the above proposal received site plan review approval at the formal site plan review meeting held on April 2, 2015 subject to the following: ❖ Approval is based upon, and must be substantially constructed in accordance with plan entitled "Cotuit Fire District/Water Department Water System Improvements—June 2015"consisting of 17 sheets, prepared for Cotuit Fire District,by Green Seal Environmental, Inc. Sagamore Beach, MA and dated March 16, 2015 "permit plans". ❖ A road opening permit must be obtained from DPW for work in the Town layout. ❖ Any onsite lighting proposed must demonstrate zero (0) light spillage onto abutting properties. ❖ Applicant must obtain all other applicable permits, licenses and approvals required. Upon completion of all work, a registered engineer or land surveyor shall submit a letter of certification,made upon knowledge and belief in accordance with professional standards that all work has been done in substantial compliance with the approved site plan (Zoning Section 240-105 (G). This document shall be submitted prior to the issuance of the final certificate of occupancy. A copy of the approved site plan will be retained on file. Sincerely, a Ellen M. Swiniarski Site Plan/Regulatory Review Coordinator CC: Tom Perry, Building Commissioner Cotuit Fl) Green Seal Environmental, Inc. § 76-16 FEES § 76-16 ARTICLE III Exception for Water Tower Construction Projects [Adopted 4-16-2009 by-Order No. 2009-0861' §76-16. Exemption from payment of fees. Notwithstanding the provisions of any other ordinance of the Town regarding Schedules of Fees, water tower construction project(s) shall hereby be exempt from payment of such fees. I 76:11 07-01-2011