HomeMy WebLinkAbout0075 PINEWOOD AVENUE i5 �� �✓ �r
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
i.
Map _ Parcel �. Application 402' 0Z
Health Division Date Issued �P Z
Conservation Division Application Fee
Planning Dept. Permit Fee
Date Definitive Plan Approved by Planning Board
Historic - OKH Preservation / Hyannis
Project Street Address rJ P n C W 0 0 d ire AILP,
Village V+d -An i s
Owner n'1& j I se. Ste W.ac*- Address 5&MC
Telephone 50? " 7 ' 5 . 50319 aa
Permit Request &4A �,` 7 ceWulo56 ` 6 -tVje
3g 0,10S8 A 1c- t 0,53 to -the l OLSC Mey4f
A� Su a I `6e, ai��`�DI ane, anJ 6sem en+ W; O&nodIt
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation 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 149 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: ❑ Gas 91 Oil ❑ Electric ❑ Other
Central Air: ❑Yes 14 No Fireplaces: Existing New Existing wood/coal stove:0 Yes ,❑ No
Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑{n'bw s Vie_
Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:
� s{pyy
W
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ n
i
Commercial ❑Yes V No If yes, site plan review #
Current Use Proposed Use
APPLICANT INFORMATION
'' ''II MCC106-1
(BUILDER OR HOMEOWNER)
Name V"Aliant Telephone Number 0 3 g
Address : r D 6 a cfi1'f Cy `W!F" - License # --�--C t 0 � � b
S �mt� Y rr nn
tll,(`M O Ul.'�"►1 , rn�o Home Improvement Contractor# q
Worker's Compensation # —t WC 3 0J 7- g D L
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO f/CXf-M C)I&J�
SIGNATURE ` DATE 5 - I Ll 0�
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
t;. MAP/PARCEL NO.
r -
ADDRESS VILLAGE
OWNER
i
i
DATE OF INSPECTION:
e
FOUNDATION
r:
FRAME
INSULATION
FIREPLACE s
ELECTRICAL: ROUGH FINAL.
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
r
4
zij0 West Main Street
'J OUSING Hyannis, MA 02601--3698
!j[A_S S I S TANCE ENERGY & 110ME REPAIR
T (508) 790-7106 F (508) 790:ORPORATION 2425
HOME OWNER WEATHERIZATION WORK PERMIT& FUEL RELEASE:
V rll f A nr
THE APPLICANT HOMEOWNER.
I .�herbby consent to and agree that weatherization work may be
n y the Weat on Program of Housing Assistance Corporation ( hereinafter referred as
"Agency") on property located at:
�Ye
Theweatherization work donewill be based on programmatic priorities and availability of funding and
it may include all or some of thefollowing measures`
Weather-stripping& caulking of windows and doors, insulation of attics, sideNalls& basements, attic
and other ventilation measures and possibly replacement of badly deteriorated windows. In
consideration of theweatherization work to bedone at my home I agreeto thefollowing
1. I give permission to the"Agency" its agents and employeesto travel onto or across said
property with such equipment and materials as may be necessary to perform weatherization
work on said property.
2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the
weatherized unit on an ongoing basisfor no morethan five(5) years after theweatherization
work is completed.
I have read the pr ..bons of is agreement as I nd freely,give rpy consent.
Home Owner: (ggnature)
Data
Agent: (signature)
Data
HAG approved Weatherization Company :
All Cape Ea:ergy, Caliber Building&Remodeling, Cape Cod Insulation, Cape Sate, Creswell Construction,
Frontier Energy Solutions, Lahr&Sons, Peter Smith, Resolution Energy, Rock Solid Construction
;r
ICAPEO SAVE
Is
weatherization
508-398-0398
August 22, 2010
To Whom It May Concern:
William J. McCiuskey is an employee of Cape Save. Ile is authorized to negotiate
contracts and building permits for our.company.
Michael McCluskey
Cape save—Owner
919-593-5939 cell
7C HuntingtomAvenue,Sout1t yarmouth,MA 02664
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
www massgov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
ly
Anolicant Information Please Priest Legg
Name(Business/organization/Individual): 14�t
Address: -4 c— (AUn1�Initc'[Dt3 � -
City/State/Zip: S • 1AAMQqni A aaRone#:
Are you an employer?Check the appropriate box: Tvpe of project.(required):
1.[K I am a employer with!_ 4• ❑ lam a general contractor and 1 G Q New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ 1 am a sole proprietor or partner-
ship listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. 0 Demolition
-working for me in any capacity. employees and have workers' 0. 0 Building addition
(No workers'coiiip.insurance comp.insurance.=
required.)
5. 0 We are a corporation and its 10.0 Electrical repairs or additions
.3.❑ I ant a homeowner doing all work officers have exercised their 1 I.C]Plumbing repairs or additions
right of exemption per MGL
myself.[No workers'comp. 12.0 Roof repairs�..`t �.
insurance required.]} c: 152,§1(4),and we have no 13.®Odic! do
employees.(No workers'
comp. insurance required.]
'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation,polity information.
t Homeowners who submit this affidavit indicating they age doing all work and then hire outside contractors must submit a new affidavit indicating such.
tr-mtractors that check this box must attached art additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. if the sub-contreetors.have employees,they must provide their workers'comp.policy number.
lam an employer deat is providing workers'compensation.insurance for my employees. Beloit rs the policy and fob site
information. _`�`
Insurance Company Name: -=.n ran o m n
Policy#or Self-ins.Lic.:#: Expiration Date:
c
Job Site Address: 5 INC W o o A f�re, City/State/zip: 4 r.r,A
Attach a copy of the workers'compensation poficy declaration.page(showing the policy numb and expiration date).
Failure to secure coverage as required under Section 25A.of MGL e. 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$25.0.00 a day against.the violator. Be advised that a copy of this statement maybe forwarded to the Office-of
_ Investigations of the DIA for insurance coverage verification.
I do hereby cerafy under the pains d allies erjury that the information provided above is true and correct
�
Signature: YWJr Date:S —
Phone# q�S-
0jr1cial use only. Do not►trite in Jlris area,to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board or Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
AC40CERTIFICATE F LIABILITY INSURANCE DATE(MM/DD/YYYY)
O 10/20/2011
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 NAMEACT Shannon Sperrazza
Risk Strategies Company PHONE (781)986-4400 FAX o.(781)963-4420
15 Pacella Park Drive A-pmpAgELSS:ssperrazza@risk-strategies.com
Suite 240 INSURERS AFFORDING COVERAGE NAIC#
Randolph MA 02368 INSURERA:Selective Insurance
INSURED INSURER B:Safety Insurance Company 3618
Michael McCluskey, DBA: Cape Save INSURER C:Technology Insurance Company
7 C Huntington Ave INSURER D:
INSURER E:
South Yarmouth MA 02644 INSURER F:
COVERAGES CERTIFICATE NUMBER:CL11102041451 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 ADDLSUBR TYPE OF INSURANCE POLICY NUMBER POLICY
EFF MMLDDY� LIMITS
LTR
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE To RENT -
X COMMERCIAL GENERAL LIABILITY PREMISES Ea occuence $ 100,000
A CLAIMS-MADE ❑X OCCUR PPS1994480 0/16/2011 10/16/2012 MED EXP(Any one person) $ 10,000
PERSONAL&ADV INJURY S 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,0001
X POLICY F1 PRO- LOC $
AUTOMOBILE LIABILITY Ea accident SINGLE LIMIT $ 1 000 000
B ANY AUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED 6208200 1/6/2011 1/6/2012 BODILY INJURY(Per accident) $
AUTOS AUTOS
NON-OWNED PROPERTY DAMAGE $
X HIRED AUTOS X AUTOS Per accident
X Underinsured motorist BI split $100000 300000
X UMBRELLA UAB N OCCUR CPPS1994480 0/16/2011 0/16/2012 EACH OCCURRENCE $ 1,000,000
EXCESS UAB CLAIMS-MADE AGGREGATE $ 1,000,000
DIED RETENTION$ $
C WORKERS COMPENSATION Executive excluded X WC ST MIT7 I 'ER
AND EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
from coverage E.L.EACH ACCIDENT $ 500,000
OFFICER/MEMBER EXCLUDED? � NIAJ C3297972. 0/21/2011 0/21/2012
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required)
Issued as evidence of insurance. National Grid Corporate Services LLC d/b/a National Grid, d/b/a Boston
Gas Company, d/b/a Essex Gas Company, Action Inc., and Housing Assistance Corporation are listed as
additional insureds as respects General Liability as required by written contract.
CERTIFICATE HOLDER CANCELLATION
(508)7 90-2425 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Housing Assistance Corp ACCORDANCE WITH THE POLICY PROVISIONS.
484 Main Street
Hyannis, MA 02601-3698 AUTHORIZED REPRESENTATIVE
Michael Christian/SMSJti
ACORD 25(2010/05) 01.988-2010 ACORD CORPORATION. All rights reserved.
INS025r7ninnsini The er_npin name and Innn era reniefamei m2rka of Annon
i
0 ce of Consumer A air and Business Regulation
W 10 Park-Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improverient;Contractor Registration
Registration: 164432 .
Type: Supplement Card
CAPE SAVE - Expiration: 10/6/2013
WILLIAM McCLUSKEY
8201 S. HOURD CT -
CHAPEL HILL, NC 27516
Update Address and return card.Mark reason for change.
)PS-CAI 0 50re-04/04-GIo1216 L7 Address r-1 Renewal j:] Employment Lost Card
` Office of Consumer Affairs&Business Regulation License or registration valid for individul use only
a t.
�i0ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
' m N Office of Consumer Affairs and Business Regulation
'V"-9 Registration;;,164432 Type
C_ 10 Park Plaza-Suite 5170
7
Expiration:--'1:0ft13 Supplement Card Boston,MA 02116
CAPE SAVE -
WILLIAM MCCLUSKEI'= --=-
7C HUNTING AVE
S.YARMOU fH,MA 02654= Undersecretary Not valid without ' nature
'� 0iassschusctts- DePartmcnt of Public Safety
Board of Building
Regulations and Standard-.
Construction.Supervisor Specialty License
License: CS SL 102776
Restricted to: IC
IXN
WILLIAM'MC CLUSKYy
37 NAUSET ROAD
WEST YARMOUTH, MA 02673
Expiration: 6/28/2013
���mmiwi�mcr
Tr#: 102776
Cape Save Inc.
7-1) Huntington Avenue
South Yarmouth,MA 02664 -
Tel: 508-398-0398 Fag: 508-398-0399
6/9/12
Town of Barnstable
Thomas Perry CBO �—
Building Commissioner
200 Main St. Hyannis,MA 02601
RE: Building Permits °
Dear Mr. Perry,
This affidavit is to certify that all work completed for�175 PinewoodTRoad,Hyannis has been
inspected by a certified Building Performance Institute(BPI)Inspector.
Ceiling: R-19 cellulose
Floor: R-19 fiberglass w poly ground cover
All work performed meets or exceeds Federal and State Requirements.
Sincerely,
William McCluske
. Y
� �
A sessor; .'map� and.,lot.'number ..o� .". ........:.A... SEPTIC SYSTEM MUST E$STA
1
N LLED IN COMPLIANCE
l ,
Sewage Perinir.number ..& .... 7 WITH TITLE 5
ENVIRONMENTAL
E AL CODE AN1=.:
yoFTHEro�♦ TOWN`` OFBARNSTrIvB LATIONS
S BARISTSBL&,
"b DUILDING INSPECTOR
Gp�O OR a
+ APPLICATION FOR PERMIT TO }G�dCf llL.... ?c!S i 4da-Q®;� ,,, 4!LtiftQ
TYPE OF CONSTRUCTION .....:..... ....l !n.f............................................... ................... ' .......
.............�.? ... ... .qx!�ln....19.
TO THE INSPECTOR OF�BUILDINGS:
The undersigned hereby a,,//p��plies for a permit according to the following information:
Location ............................X/.tX..�J���......�.f��t.��....��✓2/5..................................................................................
ProposedUse .......... -.. !' ..... ........................................................................ ... ...................
Zoning District ... .........1.. .................................................Fire District ..........,/7y l,.C�....................... ..............
a
Name of Owner ...... '1!c. ... .... .....Address ........... .
` /gyp m �
Name of BuilderC...!4?��y� !.P'.#r�/�1�..................Address ..,.....1.7.L...kZ.01....®�!L.......lax X,17.. 0...f...
Name of Architect .....................vv!5: '/.`:I ..............................Address ......................................
Number of Rooms ..........................z....................................Foundation ... 0 � .............
Exterior ..............W.."A....!�:(AtajAf� .....................Roofing AsPky.-A.17.
........................_.............Interior .................. .. x
Floors ...... ...............c...........�.... ....... ...... . a,
Iv
Heating :.......................... :� ................... ... .....Plumbing ........................... .........................................
Fireplace ..................................................................................Approximate Cost ............. "d'8.................,..................
Definitive Plan Approved by Planning Board _______________________________19________. Area .... .:[..... ....................
�a Diagram of Lot and Building with Dimensions Fee o
C,,A.....�.........................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
t
15T 140
`IS@,
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N
1-hereby agree to conform to all the Rues nd Regul Lions of the Town of Barnstable regarding.the above
construction.
Name ...... JV/.............................................
SCUDDEI:, FREDERICK �{
.4ry y
:i ail 1
r
N2 9.1.9... Permit for. ..AUDIMION............
...r."Sl cr,1a:-Family...Dw�ellin,
Location ..P.;.11eW.oad.. .....R ste.
.................uyawlis............................................ i
4, Owner ...Fr-edel:ick...Scudde-r................... 4 +'
Type of Construction ...E.ramie..........................
+\ ................. ...................... �...........................•...• r r- • - - . t ' A - '^ - '
Plot .................... .... Lot ................................ x
s March 18, 81
Permit Granted ....................19
Date of Inspection —J 9
Date Completed S .s .............s..jW:190
J PERMIT REFUSED
............................................................... 19 -
,:..„...��.... .�:'............................................................
.........ow. . ...... ............................................... ..
Cl. �. ��... ...................�.............. .... `
�4a.w.. .. ...................................................
19 Approved�.f%.:.................................... :.Cr
Le.r'. .......!.........................................................
-.
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t
- s
.7� I ' LT /i f /� •r�r .� /
Assessor.'s map and lot number ...._. ................................ f - k l
T- -
Sewage Permit number &AZr L�'G✓ ��
.......... ...I......... >......................:fir
yOFTNET��y TOWN OF BARNSTABLE
1i BARNSTAIILE, i
"6
MP p,. BUILDING INSPECTOR
'�lE•0 Y
APPLICATION FOR PERMIT TO .................... .... '•'. .;;i�r. ,lS{'t�2 n t�.A.....a,-� !!.....................
•?s�r" i'G"f
TYPE OF CONSTRUCTION .............VV a n t,.. "` ,.c;.! ..........................................................,.. ...........`j.....
............................5:. .....19X/.
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
1p
Location AlAi',.JI4ntr G aEj �f
...................................................................... ... . ......................................................... ...................................
11-
Proposed Use ........................... ..°:2..... �. 2t. .....-..................................................................................I.........................
1-
Zoning District .............. .. .................................................Fire District ..................�1......ry/C
pp t
n �.11'►c� . c c.�ffCJ� 'ca -
Name of Owner ..........:........................................:..................Address ....................................................................................
Name of Builder(,.... ' ...................Address ........l t...
....r..n....t.......I.r............!..F.(...�..f.....f.�.....✓................. .......
Name of Architect <............................................Address
Number of Rooms °? Foundation ..f� c AS t-a c f % �L ,
................................................................. ..................................................IV...............
i
Exterior !AjArn� �� d f n c.��,i.....................Roofing 1 z_Pl�-t � �
.............................................. ........................................................ ...........
c 4Cvv�C-.C'-
C'....................................Interior Oa-V\ W/4 I?/ Mel: �r ! l
Floors .................................................. ....................................................................................
c-- IV .10
—Heating Plumbing
Fireplace .......:................................Approximate Cost fQ "
~ �
Or
t
Definitive Plan Approved by Planning Board -------------------_-----------19________. Area .... .......0
.............................
Diagram of Lot and Building with Dimensions Fee ?...... ............................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
i2t
J*� JL.r _
r
;y= ,
i
f.V\ or Oc 4 l;,el?
C�
tt
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction. /
Name .......... ....'':..... . '�...,��':..........................................
y �
SCUDDER, FREDERICK -76
is
No :.22,9.19. Permit for ......
. ......k...Si... Fami�.Y...J).w.ellirig........
:...
location"....1newQAGd1.... .f.:......
................Hya??Aj.5............................................
Owner FrederQk..SD.udder.....................
Type of Construction .....F.ramp........................
t i
........................ . ...................................................
.r
............................Plot Lot ................................
` March 18, 81
Permit Granted 19
1
Date of Inspection ....................................19 I
Date Completed .............19
E PERMIT REFUSED '
f ......................... ................. 19
S ................................ .........................................
/..�........................................................................
t ..1r...L/ . .L........�. .� ..V.. .....................
Approved ................................................ 19
................................ ...........................................
...............................................................................