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HomeMy WebLinkAbout0062 PINE STREET � , �� __ � �a�� i � . I'�, i �� I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION q BARNSTABLE Ma ' I Parcel (��� AYA! pplication # �2413 Health Division .x Date Issued Conservation Division ., Application Fee Planning Dept. - Q. � Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation/ Hyannis Project Street Address Q 2 �l 1(l-� ► 1 Village Owner Ctk11 L C q I�1—I r i Cl ISCI D tth Address 5� / Telephone 0 _ S5f 6 9 5 ..Permit Request ll/li�l� t � ► 1nlS Square feet: 1 st floor: existing�i��6roposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation y u Construction Type Lot Size m 1 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units)—.-- Age of Existing Structure C 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: Unc Gas ❑ Oil ❑ Electric ❑ Other © � Y Central Air: ❑Yes U No Fireplaces: Existing New Existing wepN/coal stye: L-Yes ❑ No -- Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: existing ❑ ngjy size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: a Zoning Board of Appeals Authorization '❑ Appeal ## Recorded ❑ e in r� Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION l ^ (BUILDER OR HOMEOWNER) CName �� C,V1 � o Telephone Number �° ,C Address dJ�� CD m wo� p� License # Home Improvement Contractor# 1,1f,953 Worker's Compensation # t 12D�5 I Dt12— ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE I IDATE .k u FOR OFFICIAL USE ONLY Y wl APPLICATION# 1, DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER w; r DATE OF"INSPECTION: "FOUNDATION_ FRAME INSULATION E FIREPLACE k ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL s� GAS: ROUGH FINAL � r FINAL BUILDING DATE CLOSED OUT - i ASSOCIATION PLAN NO.: 1 4 N C1ie zoomzmwncaealf�"��P/�a��ac�itirvplll License or registration valid for individul use only Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: OME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation egistration: 143358 Type: 10 Park Plaza-Suite 5170 , xpiration: 716120'14 Ltd Liability Corpc: Boston,MA 02116 CAPEWIDE ENTERPFiI-55,L;L iZ RICHARD CAPEN 4507 R RTE 28 COTUIT, MA 02635 Undersecretary Not valid with ou s'gnature t f t�ias ch�jsetty -Dep�srtment of Public :Safety .. Board of Building Regulations arltl 7t=+"d lVd!; Unrestricted-Buildings of any use group which (im--truction Super•i.nr contain less than 35,000 cubic feet(991m')of License:CS-MZ73 enclosed s pace. I:�1C[tA.itl)"lB1 CAi�Ei1 r ....... 1 2W11IT14NU1 ^710 � Failure to possess a current edition of the Massachusetts Expiration State Building Code is cause for revocation of this license. Commissioner 11/27/2013 For DPS[icensina information visit: www.Mess.Gor/DPS { i Jun, 26. 2013 4:48PM Daniel C. Scioletti, Jr. , CPA (No, 5187 FP, _1/3 r Town of Barnstable. Regulatory SeJrvl.ces gti�ar�etJE, _ r Thomag F,Gei.ler,birector Building Mvisioii Torn Perry, )wilding Commissioner 200 Main Strut, Nyaffiis,MA 02601. YrTm-town-b arnstabitpa.ue Office: 508-862-4038 pax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder 7� Y (G PC (o Gl f7( as Owner of the subject properry Hereby authorize A xe wl k C n 4 //c--, cc c, to act on my behalf, in all matters relative to work autbotized byfhis 6i ding permit application for: . (Addxexs o job Signature of Owner Date Print Name QSOWNS:OWN7ER?ERMiSSION Assessing As-Built Cards Page 2 of 2 CAPEENT-01 DCOSTELLO DATE(MMIDDIYYYY) ;a►co�ro� CERTIFICATE OF LIABILITY INSURANCE 4/22/2013 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). CONTACT PRODUCER NAME: FAX Rogers&Gray Insurance Agency,Inc. PHONE AIC No AIC No Ext 434 Rte 134 E-MAIL South Dennis,MA"02660 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Arbella Indemnity Insurance INSURED - INSURER B Capewide Enterprises LLC INSURER c: J.P.Macomber&Sons INSURER D: PO Box 763 INSURER E: Centerville,MA 02632 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELO HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY-PERIOD W 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. POLICY EFF POLICY EXP LIMITS INSR TYPE OF INSURANCE INSR WV POLICY NUMBER MMIDD/YYYY MMIDDIYYYY - 1,000,000 GENERAL LIABILITY LTR EACH OCCURRENCE $ 8500050813 4130/2013 4/30/2014 PREMISES Ea occurrence $ 250,000 A X COMMERCIAL GENERAL LIABILITY 5,000 CLAIMS-MADE �OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OP AGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: P POLICY E LOC COMBINED SINGLE LIMIT 1,000,000 AUTOMOBILE LIABILITY Ea accident $ A ANY AUTO 58944400004 4/20/2013 412012014 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ PER ACCIDENT X HIREDAUTOS X AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE 4600050814 4/30/2013 4/30/2014 AGGREGATE - $ 5,000,000 _ DED I X I RETENTION$ 10,000 _ $ WORKERS COMPENSATION - - X TORY IMITS OER AND EMPLOYERS'LIABILITY 4/14/2013 4/14/2014 500,000 A ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N 9120510412 E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? F_N1 NIA 500,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ It yes;describe under E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,IT more space Is required) With regard to general liability,blanket additional insured and blanket waiver of subrogation apply if required by executed signed contract x t CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD http://www.town.barnstable.ma.us/assessing/HMdisplay.asp?mappar=120037&seq=1 4/19/2013 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Uf www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information D �o Please Print Legibly Name(Business/Organization/Individual): �de. C/ e LAC Address: 16 W M YYV__fCA City/State/Zip: M\1 PA cone#: 8�)7"7 Are you an employer?Check the a propriate box: Type of project(required): , 1. I am a employer with 2` 4. ❑ I am a general contractor and I 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 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I I&Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12,❑Roof repairs insurance required.]t employees. [No workers' 13.0 Other 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. ;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: c1`(/ Policy#or Self-ins.Lic.#: a ��U�� I Expiration Date: -i ' SDI I it Job Site Address: �e 2 City/State/Zip:[ q c&_� r'l S 02 LP-® t 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 insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the Information provided above Is true and correct. Signature: rv�L Date: L"t Ii 3 Phone#: /Y-7 — FNA 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 i Contact Person: Phone#: YZ C i i E i _ .......,_._.. ............ 6 f _1 Q� 000 } IN ,o Vo I V let a Z ; 000 r Li. i t 11 F � "✓ tl M � 000 JOSEPH D. DALuz TELEPHONE: 775-1120 liwhlink Comunissiontr EXT. 107 TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 November 24, 1987 Mr. and Mrs. Daniel Scioletti 62 Pine Street Hyannis, MA 02601 RE: 62 Pine Street, Hyannis Dear Mr. and Mrs. Scioletti Please be advised that the property located at,6-2—Pine Street, Hy_annis-,has a legal non-conforming status under the Town of Barnstable Zoning By-law. Peace, Jbs ph D. DaL z — ..,Building Commissioner JDD/gr n