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HomeMy WebLinkAbout1030 PHINNEY'S LANE fo3o �hi4n�r �CA�✓c f -- — - - -- - - � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION T �N O LEARNSTABLE Map 2�� Parcel- "r,�� Application # Health Division " `i `"`' t� A"11 9: 4 1 Date Issued Conservation Division Application Fee Planning Dept. -•R =�E - - ..=.. .e Permit Fee 0 a r'iT Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address ,/dD ;% Village 14�4�pqgx:s Owner e✓d'�'/� / 7Z e Address ,�igGn Telephone Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation _, d Construction Type 4�Dzlo 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 WNo On Old King's Highway: ❑Yes ANo 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 Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name l/'fo 6 /.h/wA.9 Telephone Number `0 tY' Address ey,40& 4A License#�D ZZ WO 01,01 ii 7-4 Home Improvement Contractor# /.��7 G 7 Email Worker's Compensation #e�C e"oa 5'-3,�3n® ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO dU SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. f ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME A INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. .. ........ .:... . t HOME OWNER WEATHERIZATION WORK PERMIT: PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER. r I gr �m hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation on the property located at: � JC.� .--��4•�v'Gt.=t-• _,V- (.-``•r''L"�'l�(>i is};fa-, ?-•--,-. The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather stripping; air sealing; attic&basement insulation; exterior wall insulation;ventilation measures In consideration of the weatherization work to be done at my home I agree to the following: 1. I give permission to Housing Assistance Corporation the property with such equipment and materials as may be necessary to perform weatherization. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. I have read the provisions of this agreement and give my consent. Home Owner(signature): a—V Home Owner email: Date: t. i T� Agent:(signature) i Date: �(n Weatherization Contractors: n Adam T Inc Cape Save All Cape Energy Frontier Energy Solutions Alternative Weatherization Lohr Home Improvement Building-Science Construction Tupper Construction Cape Cod Insulation i. Massachusetts Department of Public Safety i; Board of Building Regulations and Standards License: CS-100988 Construction Supervisor 0 HENRY E CASSIDY 8 SHED ROW WEST YARMOUTH M 2', Expiration: Commissioner 11/11/2017 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2016 Tr# 259188 CAPE COD INSULATION, INC HENRY CASSIDY -- 18 REARDON CIRCLE SO, YARMOUTH, MA 02664 Update Address and return card, Mark reason for change. SCA 1 :; 20M-05/11 Address Renewal Employment Lost Card P51le�onr�raa�aeoerr.�G/a�C�/�ltWoac�uaeCtt -\ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only UVOME IMPROVEMENT'CONTRACTOR before the expiration date, If found return to: egistration: '1,53567 Type: Office of Consumer Affairs and Business Regulation xpiration; :.:;1;2/:15G20.1.6 Private Corporation 10 Park Plaza-Suite 5170 y, Boston,MA 02116• CAPE COD INSULATI'QN;INCH .: HENRY CASSIDY 18 REARDON CIRCLE .'..'' �- SO. YARMOUTH, MA 02664 Undersecretar y N valid wi ut sign e f The Commonwealth of Massachusetts f o Department Industrial Accidents P r Office of Investigations 600 Washington Street Boston, MA 02111 i.. www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): !,/r ?11 n/x Address: l� � City/State/Zip: �, �, ": a i � a D �d Phone Are you an employer? Check th appropriate box: Type of project (required): l. _I am a employer with l 4• ❑ 1 am a general contractor and I yp p I ( q )" * have hired the sub-contractors 6, ❑ New construction T employees(full and/or part-time). 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7, ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity, employees and have workers' comp, insurance,$ 9. ❑ Building addition [No workers comp, insurance P• - required.) 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 1 I,[] Plumbing repairs or additions myself, [No workers' comp, right of exemption per MGL 12,❑ Roof repairs insurance required,] t c.-152, §1(4), and we have no .employees. [No workers' 13.� Other P comp, insurance required.] *Any applicant that checks box 91 must also fill out the section below showing their workers'compensation policy information, t Homeowners who submit this affif'dvit 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 state whether or not those entities Have employees. If the subcontractors 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: , , 1� �W5ky�f Policy # or Self-ins. Lic, #: Cre"00 Expiration Date: / 9� � Job Site Address:1d.34 /�,W,11 ieyT 4-el d�'�i¢s�/fr City/State/Zip:�iJ 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 insurarO coverage verification, I do hereby certify d the pai an penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: 8 2 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 Contact Person: Phone#: CAPECOD-27 TQUIRK ACORO° CERTIFICATE OF LIABILITY INSURANCE OAT a/27/z27/2DlYYYYI— o1 s 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 poiicy(les)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: Rogers&Gray Insurance Agency,Inc. PHONE FAX 434 Rte 134 (A/C.No.Extl: A/c No: (877)816-2156 South Dennis,MA 02660 AiL a DRESS:mail@rogersgray.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Peerless Insurance Company INSURED INSURER B:Safety Insurance Company 39454 Cape Cod Insulation,Inc.. INSURER C:Endurance American Specialty Ins.Co. 18 Reardon Circle INSURER D:Atlantic Charter Insurance Group South Yarmouth,MA 02664 INSURER E: 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 AUDI.SU5R1 POLICY EFF -POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FTI OCCUR CBP8263063 04/01/2016 04/01/2017 PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY D PRO- LOC JECT PRODUCTS-COMP/OPAGG S 2,000,000 OTHER: $ AUTOMOBILE LIABILITY r nCOMBINED (Ea accident)EDSINGLE LIMIT $ 1,000,000 B ANY AUTO 6232707 COM 01 04/01/2016 04/01/2017 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ $ X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 2,000,000 C EXCESS LIAB CLAIMS-MADE R/O EXCI0006635000 04/01/2016 04/01/2017 AGGREGATE $ DED I X I RETENTION$ 10,000 Aggregate $ 2,000,000 WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE I I ER D ANY PROPRIETOR/PARTNER/EXECUTIVE WCE00431901 06/30/2016 06/30/2016 E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? ❑ N I A (Mandatory in NH) If E.L.DISEASE•EA EMPLOYE $ 1,000,000 yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Workers Compensation includes Officers or Proprietors, Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Bill Swanson Builder THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 50 Camelot Lane ACCORDANCE WITH THE POLICY PROVISIONS, Brewster,MA 02631 AUTHORIZED�-REPRESENTATIVE/ ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD v ) Assessor's �offioe i�t floor): � ,��^ f G 5a 'L, e THE G� O� oS f " t Assessor's r"�ap d lot number . ...... ...... r ��[ ,rni+e � �F wa. vQy� o Board of Health (3rd floor): ��' �3� d Sewage Permit number ...�: �...�5..4.:. .............. ��� �N C�>�%JR t,_, t 'BaaasTenLt. Engineering Department (3rd floor): a�f� TPTLE 5 �o clue � �g�p ee�� 6 9 .................................... �'. ,.l :Jid.IWV®b'H ®®� f{ O 39 House number ................................... 1 O NO d� APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only (J CYLb N REGULATIONS TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......&. ......................... '`�Ll.................................................... ................................ TYPE OF CONSTRUCTION .........1 :�" `ti�� 2��l.................................................... ................... ....19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........... ............................. ...............:..................................................................................................................... ProposedUse ......,/' dt ............................................................................................................... ZoningDistrict .........................................................................Fire District .............................................................................. � f Name of Owner .:!�....�...< /`f'°. �%s." .................Address ... ..... �'.�� h� Name of Builder - "'... .... 1` . ✓f.�` . ..............Address �?'�,e✓. �1 �... ... � '' C'�(s0` 'Name of Architect ..........LW.../�...................................Address .................................................................................... Number of Rooms ................Foundation .(���'�'�5✓/..........`!./,.`?�!'�..,..,.,.......,..,,..... Ex1er for .....��..�..�.....°�./....... .....'�t�12...................... ....... 1 Floors ........ .��..��,!..........................................................Interior ..........�...�,�"s.,.`4'..:-,-...� . .. ..........................:........ � Heating ... .. ... ...............................................Plumbing ........ �✓ Fireplace ......... �. „ ........:...............................Approximate Cost ............0.0001. vac... ..................... Definitive Plan Approved by Planning Board ------------------------_-------19________ . Area nn o Diagram of Lot and Building with Dimensions Fee V ........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS ? 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. .. . 'L Construction Supervisor's License ��� >.. r�. ......... GREG01RE, ROBERM No 3'1.4 3 9.... Permit for ......ENCROS.E...B.RE.E-/�'EWAY ..... ....... ....... .. .... .. .. .... . Single Family Dwelling .. ................................................................ Location ...1.0.3.0....Ph.i.nn.e.y.'..s...Lane................ .. .... .. .. .. .. ....... Hyannis ....................- .....................................:.................... Owner ..R.ob.e.rt....Gr.ego.ir.e........................... .... .. .... ......... .. .... .. Frame- Type of Construction .......................................... .......... ............................................... ...... Plot ............................ Lot ................................ November 24 , 87 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed .......................... ..........14 Assessor's offioe �Qst floor): p <TNE r Assessor's�.ra l�nd lot number o o� Board of-Health (3rd floor): ( — 39� Sewage Permit number Z a�o�s..:.. ... ........ i Baaa9TeDLL.MAS S Engineering Department (3rd floorj: ! I 'oo 39• Housenumber ...............................................................i........ APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00.2:00 P.M. -only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION"FOR PERMIT TO0�151�`� P eZe`JQ TYPEOF CONSTRUCTIONµ .........W1 6L-077.................................................................... ........................ Y . :....19..... - TO THE INSPECTOR OF BUILDINGS: f G The undersigned hereby applies for a permit according to the following information: Locationa��0 ►n �—�` . r.............................................................................. ProposedUse . ... ....`,!` . .L > ...................................................................................................:.......... y Zoning District ..:..........................................Fire District................. .... . Name of Owner . ..?.b " t/ : ���'.' .a............ Address ... ...... .... ... . ' Name of Builder :. ... ........,....•...... .. ............Address .'.. .../�P.� Z/% /��, , ,(�ij(/f/ ✓ Name of Architect ^/ Address. ` J f . . .� :r...�...1.........................................Foundation`s. .:.". . ... . . . �./�/`.........:�i Number of Rooms ... ........................................ f7'D y �! ;r Exie for SL.. ..'....` ......LY�� ......................Roa ng<..:....�i........� .... Floors :...../. •. �`�! �......................... Interior ......_.w. J, l �-!� ................................. Heating .... !....�...�M'..s fi'�I�.........:..... ...............:.... .........Plumbing ........�.. ... t o........................... Fireplace .........�X,t&-e. .........................................Approximate Cost ........... ,,,/ _t.��d,... ..................... Definitive Plan Approved by Planning Board _______________________________19-------- . Area t -e—o m, Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH r x - � Y OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name' Construction Supervisor's, License 0f, ?..f/.7. ......... J f _ GREGOIRE, ROBERT A=252-052 Sa No 31439 permit for ....ENCLOSE„BREEZEWAY Single. Family Dwell:ing........ 1$'............. . . -Totion 1030 Phinney,'s„Lane........... .......... Hyannis Owner ..Robert...Gregoire...................:.... - Type of Construction ....raM.e........................ ............................................................................... Plot ............................ Lot ................................ Novemver 24 , 19 8 7 Permit Granted ..............I......................... Date of Inspection ....................................19 Date Completed ...........................:..........19 oF�► ra,,, Town of Barnstable *Permit# 5 Expires 6 months from issue date Regulatory Services Fee BAMSMBLE, v� Mass. Thomas F.Geiler,Director i63q. ♦0 Building Division Peter F.DiMatteo, Building Commissioner 367 Main Street, Hyannis,MA 02601w X-PRESS PERMIT Office: 508-862-4038 Fax: 508-790-6230 JUL 2 .7 2001 EXPRESS PERMIT APPLICATION Not Valid without Red X-Press Imprint TOWN OF BARNSTABLE Map/parcel Number Property Address L' []'Residential OR ❑Commercial Value of Wo Owner's Name&Address 1' 1 Nf:-L 44 CRC-- (7-, 0 1 F G lt. fr )5-: 1� v ► L t. r / Contractor's Name'�D l-fA— n tic. t L i2 � Telephone Number ���` 3 6 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑'Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ®-am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Permit Request(check box) E-Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) ❑ Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature Q:Forms:ex pmtrg:rev-070601