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HomeMy WebLinkAbout0055 PILGRIM LANE �b ,6 3G 76 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Applicatio # DC Health Division Date Issued 3J S Conservation Division Application Fee Planning Dept. Permit Fee �� n 0 6 Date Definitive Plan Approved by Planning Board :Historic - OKH _ Preservation/ Hyannis Project Street Address JY1 p�/g� z-,Q"e Village H S aaZ6d� Owner ���� ��� �S��`f Address d S lc lf/'%°-M Gop f, y0„r%S Telephone /•����01, (Permit-Request_ kZO►^;ayrr/ _a y C/ llea-1/' 0 L—k'7 u'ti o.�/-TY7Cu/99�01 1✓a /cl)'4M ..,.r:.fa_T. Square feet: 1 st floor: existing 7-5proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay �Projeet Valuation C 00 Construction Type �.J Lot Size �;S 3 f I Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ® Two Family ❑ Multi-Family(# units) Age of Existing Structure C�1 Sd Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full W 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: 0� existing _new °? Total Room Count (not including baths): existing _new First Floor Room Count-, Heat Type and Fuel: R G-aS ❑Oil ❑ Electric ❑ Other J e 7s w" Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/cdal stove; :❑Yew ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ ex sting O: ew Tze_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: +Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ 1 Commercial ❑Yes 51"No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name /G a<c ox Telephone Number Address /0.0. J3Ok V 00 License# CT"CW- 3I � M,4 Home Improvement Contractor# 100 61 Email Le_,JOWAD ,.p s/ -SP cC i nlitOWorker's Compensation # 6 2 Y/NFMO ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Y4nno�t- 4 Dtx4g SIGNATUR DATE - S FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCELNO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Main Level Oq 51411 r 0 o N M � M 6' I N 1 6' 6'411 Kitchen 6' Shed °O �o 131311 MM 20' 3" T, Main Level. FREDRICK_ASDOT-RECON 3/17/2015 Page: I The Cammmtwealth o,f Massackusetits DL-j rtrnerit of Indus& a1 Accidm f Office of Investigations = 600 Washington,Street t Boston,MA 02111 »w ntmamgvv1dia Workers'.Campensation Lasurauce Affidavit: Builders/Contractors/ElectriciansrPlumbers Applicant Information Please hint Lem y Name qoogqb&v Xgc 08,4 s71e.1-i"Ove Adddress: 0 4W tad-56'3 City/StatEr Phone,�--AOf ker 1, 1 ,3 A u nemployer?Ch_eck the appropriate box: . Type of Pr ]e (required): 'e�: 1. ama employer with lo 4. I am a, contractor and I 6. ❑New eortstruction employees(full andtorpart-time).* have hired the sub-camtaacum 2.❑ I am a sole proprietor or parbner listed on the attached sheet. 7. Nelternodeling ship and have no employees These sub-contrac#ors have g_ Demolition woding fx mein any capacity. employees and have woders' 9. ❑Building addition [No`vod mrs'comp.insurance comp.insuranne.2 5. ❑ We are a corporation and its 10:❑Electrical repairs or adtiiticrns d-� 3.❑ I am a homeoumer doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No worhns'comp. right of exemption per MGL 12.❑Roof repairs insurance required.];. c.152,§1(4),and we have no employees.(No workers' 13.0 Other comp.insurance required.] •Any aq�plicaaC @gat chedm boa f1 aaams8 also fal out the sectionbeliowshowing their workers'compensa6an policy infotitiaaa. �F3aaneom.who submit this affidamit indicating thq are doing all wo*and then hike oots&cant moors mast submit anew affidavit mdicatiug stub. IConumtors that cheek.this boat most attached au additional sheet showing the acme of the sub-camttactots and:state whether ornot those entities bare employees. If the sub-canha ms have employees,they n=pwvide t9 w worken',comp.policy number. Inman empiayer that is prm+kft workers'congm sation insurance f or arty engalayees. Below is the policy and jab site informadom Insurance Company Name: �^•GC�<'f Z�P� � �dt�4�4C� �i�. Policy#or Self-ins.Uc.#: 6 Z Z I t AF 4106 270 6 ExpirationDate: tz/W 16' Job Site Address: 55 P L � City/State/Zip: `ff aoit A �1r16D l 5 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 andlbr one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine of up to$250.00 a day against the isolator. Be.advised that a copy of this statement may be fm-%wded to the Office of Investigations of the DIA for insurmcae coverage verification- Idoherebycenl& n e pains andpenahUes ofperjuty that the infor matian pm ided abmw is bue and.correct SIMMtUre e 1A AHate: 3 / /.i Phone 0, &id use only. Do not unite in this area,to be completed by city or town o ficiaL City or Town.: PermitUcense# Issuing Authority(circle one): 1.Board of Health-2.lading Department 3.City/Town Clerk d.Electrical Inspector 5.Plumbing Inspector 6.Other i Contact Person: Phone#: 6 f f Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO 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 I, �/'e(J/' G!c �S°�(� , as Owner of the subject property hereby authorize �i Sa��er Sow c.�`/,sS to act on my behalf, in all matters relative to work authorized by this building perniit application for: (Address of Job) ✓ / Ls— S&A�e of Owner Date • a� S Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:IWPFILESTORMS\building permit forms\EXPRESS.doc Revised 061313 f U ;UG ;DCJ PM 1JALi?_ 4/004 Fax Server .4�oee�® CERTIFICATE OF LIABILITY INSURANCE 0DATE 1-09.2015 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)• PRooucER CONTACT OCEANSIDE INS GROUP NAME: PHONE FAX 52 WEST MAIN ST (A/C.No Ezt: No HYANNIS,MA 02601 EMAIL INSU R E R(S)A FFORDING COVE RAG E NAICk INSURER A:AMERICAN ZURICH INSURANCE COMPANY INSURED INSURER B: BENABBY INC DBA DISASTER SPECIALISTS INSURER C: P O BOX 480 - INSURER D: SANDWICH,MA 02563 INSURER E INSURER F;. V AT U REVISIONNUMBER: 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 08 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 ADO SUB POLICY EFF POLICY EXP LTR INSR WVD POLICYNUMBER (MM/DD/VYYY /DDIYYYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE RENTED CLAIMS-MADE❑ SI OCCUR -PREMISES m ocer ce $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO. ECT LOC PRODUCTS-COMP/OP AGGhI - n AUTOMOBILE LIABILITY ANY AUTO a accident SINGLE LIMIT ALL OWNED SCHEDULED - BODILY INJURY(Per person) AUTOS AUTOS NON•OWNED BODILY INJURY(Peraccdel HIRED AUTOS gUT05 �IOPERTYI AMAGE UMQRELLA LIAB OCCUREACH OCCURRENCE EXCESS LIAB CLAIMS-MADEDEp RETENTION$ AGGREGATE WORKERS COMPENSATION AND EMPLOYERS'LIABILITY WC,STATU- OTHANYPROPRIETOR/PARTN ERNE XECUTIV�Y�y/N�, X TORY LIMITS ER OFFICERMIEMBER EXCLUDE07 LJ N/A 6ZZUB O1.01-2015 01-01.2016 E.L.EACH ACCIDENT $1,000,000 (Mandatory in NH) II yes,describe under 4102P700 E.L.DISEASE.•EA EMPLOYEE $1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICYLIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Altach ACORD 101,Additional Remarks Schedule,it more space is required) ERTIFI A E HOLDER A ELL ATION 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 b -11 ACORD 25(2010105) The ACORD name and logo are registered ACORpCORPORATION.All rights reserved. � Sri s k+1 * t of Public Safety• I j Massachusetts-Oepa men d 5tan`d*ds-. . =•Board of gulding Regulations an Construction Supet'isor } License:CS-055731 NNOX '. + RICNA[iD J LE , 4 po sox aso , - 1 Sandwich MA 02563 1f{ ^. Expirat'son 111o712016 Commissioner e; �'*l n r 71 w41 I N�f Ye*� .f of tiy�4� , b{ { • f. Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement CQntractor Registration Registration: 108642 Type: Private Corporation Expiration: 812012016 Tr# 256343 BENABBY INC/ DISASTERSPECIALI; T RICHARD LENNOX - Box 480 Sandwich, MA 02563 — - Update Address and return card.Mark reason for change. scat tt, 20M-051fl Address 0 Renewal ❑ Employment Lost Card (92en»anzanraeall� Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistratlon: • 108642 Type: Office of Consumer Affairs and Business Regulation . Private Corporation 10 Park Plaza-Suite 5170 qjExpiratIon-,;.--7:8/2d/k16 Boston,MA 02116 BENABBY INC/DISASTER SPECIALIST RICHARD LENNOX ; 9 Jan-Sebastian Way Sandwich,MA 42563 Undersecretary of valid without signat e F i i } u II 1 i k MAS"SACILTtSETTS` OLIC�tIVENSE..R'S 9T EHO qil NI1tSBER F f09.25 2014 ONE.,- .z r �sDaM �xr u_ 9s�:.•M rwcfi 40 ^ DM 2 RICHARD J JR a 20 STOWE RD * 1 SANDWICH MA 02563.2501 s RU09 26 30f4t v07 152009 1 t I Aco CERTIFICATE OF LIABILITY INSURANCE D/28/IDDIY �r � I ���N C 528/2014 THIS CERTIFICATE 18 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 NAM ;CT Christian Barber, CIC' The Oceanside Insurance Group PHONE (508)775-0500 A!C No•(508)790-7955 MAIL ADD R 52 West Main Street INSURERS AFFORDING COVERAGE NAIL U Hyannis MA 02601 INSURER A-Nautilus INSURED INSURER B AArbella Protection Insurance Benabby, Inc. , DBA: Disaster Specialists INsuR cOurich-American Assigned Risk P. 0. Box 480 INSURERD: 9 Jan Sebastian Way INSURERE: Sandwich MA 02563 INSU E F: COVERAGES CERTIFICATE NUMBER:CL1452803290 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, INSLTR R TYPE OF INSURANCE POLICY NUMBER MP LDIC Y M POLICY DI EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES fEaoc l re Ce $ 100,000 A CLAIMS-MADE FX OCCUR X ECP200533012 6/1/2014 /1/2015 MED EXP(Any oneperson) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 X POLICY PIFCT RO- LOC $ AUTOMOBILE LIABILITY COMBINED I a IN LLIMIT1 000 000 B ANY AUTO X BODILY INJURY(Per p erson) $ ALLWNEDXULD 102001156901 1/1/2014 /1/2015 O AUT-0 X BODILY INJURY(Per accident) $ N PROPERTY AMAGEHIRED AUTOS AUTOS Persocl erd $ PIP-Baslo $ $ 000 X UMBRELLA IJAB OCCUR EACH OCCURRENCE $ 1,0001000 A EXCESS LIAO ][ CLAIMS-MADE AGGREGATE $ 1,000,000 QED I I RETENTION$ X �FX80001006 6/1/2014 /1/2015 $ C WORKERS COMPENSATION WC 6TATU- Wit-, AND EMPLOYERS'LIABILITY Y 1 N Q` ANY PROPRIETORIPARTNERIEXECUTIVE .L.EACH ACCIDENT $ 1 000 000 OFMCERIMEMBER EXCLUDED? N iA (Mandatory in NH) 6ZZUB4102P70-019 /1/2014 /1/2025 E.L.DISEASE-EA EMPLOYE $ 1,0D0,000 If yae,describe under oleo OF OPERATIONS IW. E.L.DISEASE-POLICY LIMIT $ 1,000,000 CPL X ECP200533912 6/1/2014 6/1/2015 1,000,000 A Baileas ECP200533812 6/1/2014 /1/2015 250.000 DESCRIPTION OF OPERATIONS i LOCATIONS r VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Workers Comp cert to follow directly from insurance carrier. 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. AUTHORIZED REPRESENTATIVE C Murray CIC/MC MW tD ' ACORD 25(2010105) ©1988.2010 ACORD CORPORATION. All rights reserved. INS025 onlnnm,n1 Tha Annul name anti Innn aro mnietarart ma&a of Ar.npn May 08, 2012 To whom it may concern, = live at 55 Pilgrim Lane, Hyannis, by the Airport rotary for over 23 years. There has never been a light over the cars behind the car dealership, until this pasta year. The light is so bright, that it shines through the windows .at night and is very Annoying. . The light does not need to shine toward the houses .on the opposite side of the street, they could put a dimmer or point the light over there cars, as not to shine in the houses across the Street. Thank you, Linda j. Beasse \ Howard A. 8earse U' f C�THE f° TOWN OF BARNSTABLE Z DAfl39TAHL MAM 6 q. MASSACHUSETTS � j Solid Fuel Stove Permit { ' G� I LG , DATE OF APPLICATION ................................ �1--?................:....... F PERMIT ........................I.................. ........... �7lfln� �l.. R...............�t12 tNAME Installer fs './ <✓!��t.t?....A.t .�cn12s�NAME (owner) ... ..... ......: /J-�e s (Installer) , • ADDRESS ../�J.�� 1"(...kk..�M........A C........................... ADDRESS ������.�.!<`�.....�..�.►' e.............................................. J.. STOVE TYPE ................. f ............................................. CHIMNEY: NEW ........................ EXISTING .... - Manufacturer .5..........5`7 0-e.....Oa..........:................... CHIMNEY: Masonry ........ .. ....................................................... Mass. Approval .....:�.L......../ .......................... CHIMNEY: Metal ................................................................................................... This is to certify that the above installer has permission to install a solid--fuel burning appliance at the listed address in accordance with an application on file with the ................................................................................................... Fire Department, and subject to the provisions of the Commonwealth of Massachusetts, State Building Code and regulations made under:the authority thereof. IssuedBy: �_ �.......... � Date..... ,�1�:•rs............................................ i / .............. ......... Permit to install expires 60 days after issue date Stove ........ -�i fin' Stove Clearance ....N S�e '^� Floor �/lil,/ -SD.�. ........................................................................................................ :................................................................................................................................... Smoke Pipe I'.'S�f ......................... ....................................................................................................................................................................I............................................... ........ SmokePipe Clearance ................. ................................................................................................................................................................................................................ Chimney /ZI5�,cJ`" .................................................... ... ..................................................................................................... SmokeDetector ................... ............................................................................................................:............................................................:..........................................................,... The undersigned hereby certifies that the installation of solid fuel burning stove and equipment made under au- thority of permit dated :.................................................... has been made in accordance with provisions of the Commonwealth of Massachusetts State Building Code now currently in effect and pertaining thereto ......................................................................... Installer INSTALLATION APPROVED `�?` ` 3 •�G � /' �/' � /. ........................................................... By.................... ................................................................... Title: .................V.......................... date WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT