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HomeMy WebLinkAbout800 BEARSE'S WAY (47) r r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma Parcel �"'� � `p ce AoFicafiion Health Division Date Issued Conservation Division Application Fee COD Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation /Hyannis Project Street AddressBe Village VuA*-k S Owner r\ C-jly Ict,l\ Address �Ct�"��� Telephone� a 5 L'l� _ 0 �-�o G Permit Reques T t Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay e,Project°Valuation= e0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) CONJO Age of Existing Structure Historic House: ❑Yes Ao On Old King's Highway: ❑Yes Z 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 rrevv 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 A Yes ❑ No If yes, site plan review# Current_Use Proposed-Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name L\,t- &- T4-�D,rcnon yooev, Telephone Number J MSS Address License# os ,:�q Lo 1 ram.—tO76AC- i"AC Home Improvement Contractor# Worker's Compensation # 1 9591 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO d b r-Ae, SIGNATURE '' DATE 5, 1 ;. FOR OFFICIAL USE ONLY rr APPLICATION# 3 DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION .FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL f FINAL BUILDING t E_ DATE CLOSED OUT ASSOCIATION PLAN NO. Aj= Lonzmajzwe4aa vfMassadiusdts DepartjnMj Office offnvadgatiom ' •6D0 A�ashington Street _ Bostan,MA 02ZII wwN.massgov1Wa ' Workers' Compensation f as¢rnn.ce Affidavit:gaflders/Contractors/EIeciliciaus/Piumbers Appficant Information Please Print LeEibbv Name pasiwss/ ,�,t,�,,,�,a „p l..a� t'-/►1f i� city/state/zip: �.�r .�� ®. f��(Q� Phone.#: SCa . . 7. Fryo an employer'? Check the appropriate box: a employer with -4. Q I am a general coufractor and I 'Type of Project(regUiTed):: loyees(fun an /or part time).* have hired the sub=coact= b. ❑ ew const ucticm a•sole proprietor or partner- listed on the•attached sheet 7. ' Remodeling and have no employees These sub•-rouractors have8 QDemolitioning for me is My capacity, ea�loyeess.and have worb�rs' worlonp, comp. ius r�„r•-r. comp.i m-Mume't' 9. ❑I�g addition requa ld-] 5. Q We area corporation and ifs 10.Q Eleectr ical repairs or ad�ions a homeowner doing iII-wor c officers have exercised thee• 11.Q Phrmbing repa>zsor additions l£[No wor3=, comp. right df exemption per MCrHI, 12 Roof=r required.]t c. 152, §1(4), and we have no Q repay emP�eS. [Nb workers' 13.Q Other comp.insurance reccered.] *Airy applicant that checks box 91 mast also M out fhe s=tion below showing theff 'eampeusation policy informa$� t Hamrow 'who submit$ris aindavit m6ccaating fey am doing 0 work and then him outside cantcecto¢s most suh�t a new #Conteactrna that check this box must attached an additional sheet showing aiindavitmdicatmg such. emppyees. ff far sub-cont actom have es $ must ° the r,= of fhb sub cuut<ac�s and state wbether ornot those entities have 1 �P�1'e they providt their worlmts c ofi number. �•P cY I am an employer that is providing workers'compensation insurance for my employees infor Belafy is the policy and job site mation. Iasmance Company Name: C.a Policy# Self=ins.Lic. � •Expiration Date: Jr � h� Job Site Address: W60 GSty/SistzlziP: ns e r Aftach a copy of the workers' compensation policy declarafion page'(sh(7vPiug the policy number and expiraon date}. Faffi re.to secure coverage as required under Secdm 25A of MCiI,c. 152 can Ieacl to fire imposition of penalties ofa am Tip to$1,500.D0 and/or one-year impmommer,as vmll as civil Penalties in the form of a STOP WORK ORDER and a f 'If up to$250.0D a day against the violator. Be advised that a c of this statement may be avesti lions of the DIA for insurance covers a vetcation °P3` y . forwarded to the Office of do hereby certify an th pains-an s of paddy that tAe information provided ab a is true acid correct i `i e: Date: bane# SN - i CJffcccal use only. Do oat write in ifzis area to be completed by city or•town ggldaL City or Town: PermitUcense# -IssuingABthority(circle one): -1.Board of Health 2.Building Department'3.Cityf Town Clerk 4.Electrical Inspector 5.Plumbin:Inspeator 6. Qiher CorEtact Person: t THE , Town of Barnstable Regulatory Services EARNSMABLEy� MA ' SS $ Thomas F.Geiler,Director 1639. ♦0 ' a " 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 Property Owner Must Complete and Sign This Section If Using A Builder J h , as Owner of the subject property hereby authorize to.act on my behalf, in all matters relative to work authorized by this building permit (Adc4ess of Job) *Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until ll final inspections are performed and accepted. CL► ' Vt �cry, 10VA Signature of Owner Signature of Applicant CL-1. ITV \el lJ•' \\a VA Print Name Print Name Q-o-VA oVI --- t Da e QYORMS'OWNERPERMISSIONPOOLS American Properties Team, Inc. June 27, 2012 Town of Barnstable To Whom It May Concern: This is to notify you that Scott Lohr, dba Lohr Home Improvement, is authorized to do work in Unit 5WF owned by John and Faith Conlon, at Cape Crossroads Condominium, 800 Bearses Way, Hyannis, MA 02601. Sincerely, American Properties Team, Inc., as agent for Cape Crossroads Condominium Peg Thompson Property Manager p '500 WEST CUMMINGS PARK•SUITE 6050• WOBURN •MA •01801.781-932-9229 •FAX 781-9354289 Massachusetts Department of Public Safety 190• Board of Building Regulations and Standards Construction SLIhA�'iaur License: CS-053961 SCOTT A LOUR 23 GRAND OAK t 02644 ' FORESTDA E MA } Expiration 06/09/2013 Commissioner I ............ � Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 172172 Type: DBA Expiration: 5/31/2014 Tr# 225858 LOHR HOME IMPROVEMENT SCOTT LOHR 23 GRAND OAK RD FOREST DALE, MA 02644 Update Address and return card.Mark reason for change. SCA 1 20M-05m Address Renewal Employment Lost Card ... . ....VT/c U owt9n,owriect.111,c�CJ%��7J6rcc�llJc/fi `. . Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration:' 172.172 Type: Office of Consumer Affairs and Business Regulation xpiration 5/31/201.4 DBA ti 10 Park Plaza-Suite 5170 ' Boston,MA 02116 LOHR HOME IMPROVEMENT„' '. - SCOTT LOHR 23 GRAND OAK RD Gi't FOREST DALE, MA 02644 Undercecretary Not valid without signature '~ CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) I%- a 06/2612012 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: Arthur D Calfee Insu ancie Agency,Inc. PHONE 508 540 2601 FAX o, 457-1715 VW1MLCalfeellSlUarlCe.00rY1MAIL ADDRESS, inf Ifeeinsurdnoecoin M6 mad Street INSURERS AFFORDING COVERAGE NAIC# Falmouth MA OZ40 INSURER A: NOMand IrSU anCe INSURED Acadia lrSuance INSURER B LOhr F'U I Inivioverna t INSURER C: 23 Grand Oak Rd INSURER D: ( r INSURER E: " FOrestdale MA 026 tt� 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. INSR TYPE OF INSURANCE ADDL SUB POLICY NUMBER MM DD/POLICY EFF MMID POLICY EXYYP LT LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X COMMERCIAL GENERAL LIABILITY - DAMAGE TO RENTED $Exclulded CLAIMS-MADE [X1 OCCUR y V614M 0901/2012 (60112M3 MED EXP(Any oneperson) $EXCILKW PERSONAL&ADV INJURY $EXduded GENERAL AGGREGATE $UK= GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ZWOM X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Fa amident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS $ . UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION - $ WORKERS COMPENSATION X WC STATUFl - OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIV�Y/N E.L.EACH ACCIDENT $�,ow B OFFICER/MEMBER EXCLUDED? E] N/A' V',-20- WOUM12 O5IO5IM (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $5MOM If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $W�WO DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,d more space is required) CERTIFICATE HOLDER CANCELLATION TOM CF BARNSrAE E SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BULDING DEFT. ACCORDANCE WITH THE POLICY PROVISIONS. 200 MAIN ST t-tYANNS,MA 02601 AUTHORIZED REPRESENTATIVE w ^ <EPND ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD f (),,�[/�'�r} �{, i ri��t• ^G/,�,� 1 I �! ! {, f � ( �. • � I2'4('l � � p - +)p/�N C*po LS18t116 K7 i 1 1 I . f 'MA 02562 a 7 NOW 1 « I �� .. ��� i e � � r ` �� ^^ � `1/� �, ��5^� _ � ' . . � 1y�C, � � a � � . i� 7 _.,� ^i :` ��--'�^