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HomeMy WebLinkAbout0217 MEGAN ROAD �t I '`l I�1 e ��°G O r t Town of Barnstable Final Inspection Affidavit Date: '- I�_ • Thomas Perry, CBO ' Building Division 200 Main Street Hyannis,.MA 02601 RE: Insulation Permits Dear Mr. Perry, This affidavit is`to certify that all work completed at: Street: Village: T has been ins ected by a certified Building Performance Institute (BPI) Inspector. All work performed meets or exceeds federal and state requirements. Permit application number: ' Issue date: i Sincerely, . C> c Francis-Sheehan President , . Frontier Energy Solutions, Inc. 502 Harwich Road b '� Brewster, MA 02631 Office: 774-237-0410 Email: fssfrontierenergy@gmail.com TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map I Parcel �W'Z Application # 116 i Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee: 7 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street:Address Village E- 4ANNIS M A Owner IV ES WEE 5 01 Address ZM ME_&PTW It!> Telephone Permit Request 11Gl CRC.IA)voS� 7D OPEN P1T 1 C Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain_ Groundwater Overlay Project Valuation 1XID 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) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Roorn 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 0 Appeal # Recorded ❑ =« Commercial ❑Yes ❑ No If yes, site plan review# ( 5 Current Use _ _ Proposed Use a ND rn APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name _COND R MCI NMW Telephone Number Address 31 (0 9-7C5 ISO , SV Me C License # SA - I C�} Mf't OZS Home Improvement Contractor# t b D S SN Worker's Compensation # (&D I Z-i5 4/D 1 U 12 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 3 FOR OFFICIAL USE ONLY 1 = APPLICATION# .DATE ISSUED, yard r� F t ' 1 4MAP/PARCEL NO.."7-" ADDRESS, VILLAGE 1 - f OWNER ' 1 i DATE OF INSPECTION: _r,,'fOUNDATION+mot; t FRAME k ' 'J INSULATIONILAI i � r ' 4 r v FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL I € GAS:-+ur ROUGH 1,"n2,- ry- , FINAL- c :FINAL BUILDING'_; DATE CLOSED OUT ,.' . . ASSOCIATION PLAN NO. r - The Commonwealth of Massachusetts Print Form Department of Industrial Accidents Office of Investigations � I Congress Street,Suite 100, g '1 Boston,MA 02114-2017 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibiv Name(Business/Organization/Individual): FRONTIER ENERGY SOLUTIONS Address:376 ROUTE 130, SUITE C City/State/Zip:SANDWICH, MA 02563 Phone#:339-832-2823 Are you an employer?Check the appropriate box: Type of project(required): 1. ✓❑ I am a employer with 8 4. ❑ I am a general contractor and l 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. 7. ❑Remodeling ship and have no employees These sub-contractors have $. []Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp..insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per.M.GL 12.❑Roof repairs insurance`required:]t c. 152,§1(4),and we have no 13. ✓❑Other employees. [No workers comp:insurance required.] *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. tContractors that check this box must attached-an'additional sheet showing the name of the sub-contractors and state whether or not those entities have 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. Insurance Company Name:AIM MUTUAL INSURANCE Policy#or Self-ins.Lic.#:6012954012012 Expiration Date:7/25/2012 Job Site Address: 217 MEGAN RD City/State/Zip: HYANNIS 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 23A of MGL c. 152 can lead to the.imposition of criminal penalties of a fine up to$1,500.00and/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 hereb certi. under the ,ins and enaldes o er'u that the information provided above is true and correct Si ture• bate• . 1.2/2/11 Phone.M.. _ . Official use-only. Do not;write in this area,to be completed by city or town off ciaL City or Town: . Permit/License# Issuing Authority(circle one): 11 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: t. $ • DATE(NOWDDIYYY) / CERTIFICATE OF LIABILITY INSURANCE V 10/18/2011 THIS CERTIFICATE IS ISSUED AS AIV�BLY I�ND NFEOX TTZOA ALTSRATHSCollizisi COVSRAGSOAFFORDEDUBYNTHES POLICIESCBELOWLTKIS CERTIF. THIS ICATE OF� - DOSS NOT AFFIRMATIVELY OR NEGATIVELY AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ZNSURBNCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE.ISSUING INSURER(S), . CERTIFICATE HOLDER. subject olio ies) must be endorsed. If SUHROGATZON IS WAIVED, require anendorsement.-A statement on this certificate does not IMPORTANT: If the aertifioate holder is an ADDITIONAL INSURED, the p Y( to the terms and conditions of the policy, certain.policies may 4u confer rights to the certificate holder in lieu of such endorcemeunTt(s)• PRODUCER x ` FAI . Insurance Agency PHONE (ABC. Fb(: Rogers 6 Gray (ABC. N.. B:L): E-FAIL Inc ApORELL: - ' PO BOX 1601 MA PRODUCER FF ``It 02660 CDBTOMLR IDN• - NAIL 1N60ReD(81 wowlNc covaRAGc E South Dennis I 33758 Ixsuma A: A.I.M. Mutual Insurance Co nr.�JFSI• Frontier Energy Solutions LLC INSURER e: ' - - 39 Siasconset Drive INSURER C: MA 02562 INSURER D: Sagamore Beach, INSURER E: INSURER F: - REVISION NUMBER: COVERAGES CERTIFICATE NUMBER: INSURE PECT TO LISTED BELOW HAVE BEEN WHICH FOR THE POLICY PERIOD INDICATED. OF-ANY CONTRACT OR OTHER DOCUbn" HIT"RE SPECT TO THIS CERTIFICATE MAY BE ISSUED OR MAX THIS IS TO CERTIFY THAT THE POLICIES OF INS ISSUED TO THE O IONS AND CONDITIONS OF SUCH PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRI POLICIES. LD.dITS SHOWN NOTWITHSTANDING ANY REQUIR04ENT' TERM OR CONDITION BED HEREIN IS SUBJECT TO ALL THE TERMS, MAY HAVE BEEN REDUCED BY PAID CLAIMS• POLICY EFF POLICY EXP LIMITS POLICY NUMBER Pn/.I Y Gdd/O0/rrrrl - eu� TYPE OF INSURANCE EACH OCCURANCE E GENERAL LIABILITY DAMAGE TO RENTED y PR HISES(Z-oeeuYt-- ❑::JAAEF:'IAL GEIJ'eF:lLL.LIALI LI T'i $ MED EZP (MY one�pereonl ❑❑•IIrIhL.HALE ❑=•:''LO'. - PEIL40NAL G AOV INJURY S - GENERAL AGGREGATE 8 GRIP L FI•II'IGATE LIMIT APPLIE--EIL: PRODUCTS-COMP/OP AGO $ S ❑FC•Llri ❑PF+:J ErT❑li:: - COIeINED SIN[E.L LIMIT $ Gee eOcidenc) AUTOMOBILE LIABILITY - - 8 ' - BODILY INJURY (Pee p—en) - MALL-:MJEC•AUTOS - BODILY INJURY(Pet a IAent) S . ❑E_HELULEL AUT-'S _ PROPERTY DAMAGE $ (Pee...Went) ❑XiF'.EC'NJTi3 - F . 6AGli OCCURRENCE ❑UMPAIELLA LLAt ❑ ':'-�'�!IR' AOGREGATE, - 8 11EX•:ES0 LIAR- ❑ •'LAMAS MAE-E - $ �GELI>:TitiLE 3 � C]F'•ETEIJTICRJ lOLY 4DtITY LL WORIZRS COMPENSATION - 1,000/000 AND EMPLOYEES LIABILITY EACH ACCIDENT 6 THE FkJF'F;1 ETJk/F'AF:TNEFS/ . Ei:ECl1TIVE �iFFI�ERS ARE - g.t. DISEASE-POLICY LIMIT 6 - 1,000,000 F A ?_:cl 6012954012011 07/25/2011 07/25/2012 lIl':1 ® B.L. DISEASE-BA g0'LOYEL $ 110001000 COMMENTS/DESCRIPTION of OPERATIONS 0R LOCATIONS:' - ALL MEMBERS ARE EXCLUDED FROM THE WORKERS'COMPENSATION POLICY. ) CANCELLATION E ICATE HOLDER POLlcxes BE CANCELLED BEFORE THE VATION SERVICES GROUP SHOULD ANY OF TE ABOVE DESCRD3ID©GJIRATION DATE THEREOF, NOTICEWILL BE DELIN ACCORDANCE HITH THE POLICY PROVISIONS.HINGTON STREETAUTHORIZED REPRZSENTATIVEG�ROUGH, MA 01581 s il- �> A. ^' s a + a x 4 o Z z � a Az0 Ui u� Q u CO 1 UD tl' * �t W o0 7 0 : o z g C LrYl tL' Z; c a c = N Q .w i.�. w a o V) w to ., w V W = w V p Co Z' i� w LU wwT O. ` w Z ¢ 0 4 Y � 0a ;z z � a u. N License or registration valid for individul use only ; before the expiration date. If found return to: r Ofiice of Consumer Affairs and Business Regulation z " 10 Park Plaza-Suite 5170 I. Boston,MA 02116 alid without signatu m OWNER AUTHORIZATION FORM -2w 1 Zy Z (Owner's Name) owner of the property located at '24 roperty Address) (Property Address) hereby authorized i=^ (Subcontractor, 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 Signature Town of Barnstable Regulatory Services of Thomas F.Geiler,Director Building Division - -4 - 3AWM421 v� .1 .1� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: (D(C HOME OCCUPATION REGISTRATION Date: I 1(96 �a Name: W2;)6�4 tA) -1'1 1,4-J`-i'!!lSOn 6 , (k)e S� Phone#:M8-Iq&-®3l I Address: ,91-�- 02!!n h 'Rd man� A, ymage:l�am-'%+n u Name of Business: A+ W L=Q wn U-re- + Mi2:)r4r --n a JC f— Type of Business: L.Q Lo r) Care- Map/Lot: VafC C INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: L•— The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. ,,e' Such use occupies no more than 400 square feet of space. There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. Ao No traffic will be generated in excess of normal residential volumes. The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. 1.l Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. There is no exterior storage or display of materials or equipment. ;�•' There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pickup truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. r� No sign shall be displayed indicating the Customary Home Occupation. u If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersign ve read and afire with the above restrictions for my home occupation I am registering. r Applicant: Date: j a Homeoc.doc Rev.5130103 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost $30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. - it does not give yail to operate.) Business Certificates are available at the Town Clerk's Office, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) a WA .. DATE: 1��6�6� N Fill in lease: 1 APPLICANT'S YOUR NAME: BUSINES�jq YOV HOME ADDRESS: r- Apt/ TELEPHONE # Home Telephone Number lbg-776 0 NAME OF NEW BUSINESS Lltml C.+-re i;/ pNANGe- TYPE OF BUSINESS IV IV,- IS THIS A HOME OCCUPATION?-,---- YES NO: Have you been given approval from the building division? YES NO ADDRESS OF BUSINESS `Z e �4 /U/v MAP/PARCEL N:UM.B:ERa o` l When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St.-(corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. tl/rBUILDING COMMISSIONER'S OFFIC This individual has informed of y permit requirements that pertain to this type of business. -OLLOW HOME rp Authorized Si ature** ()Cc.upA.TION RULES COMMENTS: J 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature" COMMENTS: CONSUMER AFFAIRS (LIC UTHORI Y) This individual has be e f e lice ng irements that pertain to this type of business. orized Signature COMMENTS: Al. Asse vor's mop* and lot number ,.. T BE TIC ISVSTEM INSTALLED IN COMPLIA14CE Sewage Permit number .. ...r�?�./..,.../.:... ....... .............,.... PTI 'L.E li STATE WITH A SAKITARY CODE. ANQ TM. C*THETO = TORN . . OF BARN �� -' BA1139TSDLE, < 9' M6 9 . BVILDIN:G . INSPECTOR s APPLICATION FOR PERMIT TO ....5..G/ .................................... .......................... t` TYPE OF CONSTRUCTION ... ...d ... ................ ..�/��.....,. .......................................................................... ...........................................19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....A............................ . Ale .................... Proposed Use ��.��� �12�L/ �. .................... .................................. ... .r r ...... yam...... 4c?�.,....................�' ... r Zoning District Fire District ,4 � `r Name of Owner ............ ......................�...........1�..........Address .. . ..... ......... �, Nameof Builder ......`.............................................................Address .................................................................................... a f� Nameof Architect ..................................................................Address ......................................................................... ......... Number of Rooms ............................................Foundation Exterior f .... ..............Roofing ... G i g .. .r Floors ..- ` ....................Interior l.?........ . .. Heating ..... � ..............................Plumbing .......... .................................................................... Fireplace ............../...............................................................Approximate Cost .....2:�.`f �............................../�i...... Definitive Plan Approved by Planning Board ___.___19 __ _ - -----Z-— �. Area. ......... ...... ......,..... Diagram of Lot and Building with Dimension Fee .......... ............... SUBJECT TO APPROVAL OF BOARD OF HEALTH i (awe­� I hereby agree to conform to all the Rules and Regulations of the Town o arnstab a regarding the above construction. ` Name ... ....... ...... Dacey, William 17156 one story N ................. Permit for .................................... single family dwelling ....................... an Me.............Road'........................................... Location ..............g.................................................. L #^1 ....................... ......................................... ,r' 01, William Dacey Owner .................................................................. 1004 Type frame of Construction .......................................... .............................................................................. Plot ............................. Lot .........#22 ,^ ....................... Permit Granted ............Jujxp-..19...f'-.'...;-`i 9 74 'Date of lnspec'tion ....................................19 Date Completed 9 PERMIT REFUSED ................................................................. 19 fY ......................................................................... .................................................. ........................................................................... A.............. ........................................................... hi 'Approved' .... 19 ............................................................................... ............................................................................ ® ® 7 zve. r • �Z . _ . C E R T I FIE PL.® T P..t:. A _ L.o c AT I o N: SCALE: '30� DATE S12 -Z k R E F E R E N C E 95 SyoN o✓ ; . ...... DATE I HEREBY C. E R T I F Y T HAT . T.,H. E 8lJ I L DI N G R LAND SURVE Q5f S H O W N O N T H 1 5 P L A N t S L O C AT`E`D. O N THE GROUND AS SHOWN . HEREON; AND THAT tT Oo �S C 0 N FORM TO THE ���iHt7F qss\ E ZONING 8Y - LAW5 OF THE TOwN OR H E N C O'N S..T.-.R U .G T..E D..`,` U� JOSEPH M. ~ 8 MONAHAN,JR. N' I M ; , BARN-ST-A-BLE= SURVE;Y _ CO-N-SUt�.TANTS, INC . � �� rsYE C)*,- WEST YA,RM,OUTH``MASS IVI) SUMfl