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HomeMy WebLinkAbout0135 WEST MAIN STREET (13) �n�`�-�� - - - �� o - tr�a-4���� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel /0,) pp t✓ A lication qd0f 10 Y Health Division Date Issued Conservation Division Application Feei Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation/ Hyannis Project Street Address !Ak� ff)�I0 Si. MIJ AS 4Y Y)'IS (YA CL�420 1 Village Owner SW OUrN Address 5+ l to it J Telephone nos `?fin 91 ` a Permit Request q hDi1c5 (' tt' Q��r'lG1 , IQ l ��I©n LUPIN-Ft� iPC L�� @1Y � tt r15 a 5 Ck 1 l m-c,M &14 0 ' o '( v 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 X Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure C f 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 Y. Number of Bedrooms: existing —new Total Room Count (not including baths): existing 4 new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil U 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 K;.iwGZx-a' 1,appfr Telephone Number ©� �� 0 C r Address 19 im l iClr1 lr License# V� 0 0 o 6U Lbtn�� I rn 4-- 0 ab 3 Home Improvement Contractor# Email ad o l62, � W_W , u m Worker's Compensation # I���c�/��J-1��L ALL CONSTRUCTI DEBRI RESULTING FROM THIS PROJECT WILL BE TAKEN TO J_q0 � t I Id'loch UY .` I' SIGNATURE DATE ti ' FOR OFFICIAL USE ONLY APPLICATION# i DATE ISSUED MAP,/PARCEL NO. { ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL h GAS: ROUGH FINAL FINAL BUILDING DATE-CLOSED OUT ASSOCIATION_PLAN NO. -- The Commonwealtkwf Massachusetts; Department of Industrial Accidents Office of Investigations 600 Washington Street: Boston,MA 0211.1 www.massgov/da Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant.Information Please Print Legibly Name(Business/organization/individual) Tupper Construct ion Co.,: LLC Address: 546A Higgins Crowell, Rd City/State/Zip West Yarmouth, MA 0,2673 Phone.#: 50.8-778-0`111 Are you an employer?Check the;appropriate box:. Type of project(required) 1. X❑ 1 am a employer with. 4.. El. Lam a:general contractor and I 6. F144ew construction employees(full and/or part-time):* have hired the.sub-contractors; 2.0 I am a sole proprietor.or partner- listed on the attached sheet.t ❑Remodeling ship and have no employees These sub-contractors have 8. []Demolition workinme in any capacity: workers' comp.insurance. g for 9. Building addition .[No workers'comp..insurance S. Q We area corporation and its 10. .Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all.work right of exemption per MGL. 11.F 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.[ ,Other:Weatherization comp.insurance required:] Any applicant that checks box#1 must also fdl 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-c ontrdctots and their workers'comp,policy information, I am an employer that is providing workers'compensation_insurance for my employees. Belvw is the policy and job site information.. Insurance Company Name:' �I C L. Policy*or Self-ins.Lic.# WCC ;5 0 0 55 9 3 012 012 Expiration Date: 1013/15 7 _/1 y UI/l/ �' City/State/Zip:p Job Site Address: U ty/State/Zi :#VdAels _ Attach a copy of the w' rke9rSL9C0mpensationL policy declaration page(showing the policy nu bertand`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;$00.00 d/or'one-year imprisonment,as well as civil penalties inthe form of a STOP WORK ORDER and a fine, LL of up to$250.0 a da nst the:violator. Be advised that a copy of this statement may be forwarded to the Office of fnvestigatio e'D or insurance coverage verification. I do.her the pains and penalties pfpecj..wy that the in,formadon.provided'above is true and:correct Si a Date: Phone 508) 778-0111 Official use Duty. ➢o not wrde in this area,to be completed by city or town©}j`rcial City or Town:. PermitUeense Issuing Authority(circle one) 1.Board L of'Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector L5.Plumbing Inspector 6.Other Contact Person: Phone#;. f A COR _ ... CERTIFICATE C3F LI�E3tLf ��ISUt �CE i2iQ3 , ._ _T /2013 HIS CERTIFICATE.IS ISSUED AS A MATTER OF INFORMAL ION ONLY AND CONFERS NO"RIGHTS:UPON THE CERTIFICATE HOLDER.THIS ,D CERTIFICATEOES NOT,AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE:OF INSURANCE,DOES NOT CONSTITUTE A CONTRACT BET!NEEN THE'ISSUtNG iNSURER(S),AUTHORIZED' REPRESENTATIVE OR PRODUCER,.AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the poilcy(16s)must be endorsed: If SUBROGATION:IS WAIVED,subject to the terms and conditions of tho-,' Iicy cQrtairi;poficiesmay roqu re an en lomernent: A statement on this certificate does not tanter rig€its to the certificate holder In lieu of$uch eadorsement('s). ARDDUCER CONTACT, LDra Lowe NAME:' Southeastern Insurance Agency, Inc, a °N; . (508);997-605I aX N,;(508)990-2731" 439 State Rd. E MA L .. ADDRESS: P.O. Box 79149 PR OUCER CUSTOMER ID N. Qart1110Uth, MA 02747 INSURER(SIAFFOROINGCOVERAGE PIAIC9. ..•, _ .. INSURED INSURERS`:. Arbe73a Protection Insurance' Rapper Construct on Co LLG lNsuRERB AEIC INSURERC;i CNA Surety 27 Roberta Drive INSURERD: West Yarmouth, MA 02673, INSURER F .... - INSURER-F! . COVERAGES CERTIFICATE NUMBER: 2013/14/I REVISION NUMBERc` THIS IS TO CERTIFY THATTHE-POLICIES OF INSURANCE LISTED BELOW HAVE'.f3EEN ISSUED TOTHE INSURED NAMED'ABOVE FOR THE POLICY PERIOD INOiCAT ..NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT-f.6 WHICH.THIS CERTIFICATE MAYBE ISSUED OR MAY PEkTAIId,THE INSURANCE AFFORDED BY THE POLICIES:DESCRIBED HEREINISSUBJECT to-ALL THE TERMS, EXCLUSIONS AND CONDITIONS:OF SUCH POLICIES.LIMITS,SHOWN:MAY HAVE BEEN REDUCED BY:PAID CLAIMS. INSR. ADDL BR MPOODICYEFF MPOOU vffym LIMITS. CY.EXP LTR TYPE OF -INSURANCE( INSR.:WVD POUCYNUMBER- ..GENERAL:LIABILnY 85UOOD874 .11f01/2013'1110112014 EAOtt'OCCURRENCE _._..S 1,,000, X 1 COMMERCIAL;GENERAL LIABILITY DAMAGE TORp7 g 100,00 PREMISE Es ocru nca (CLAIMS-MADE OCCUR MED EXP,(Any one person) A ( PERSONAL&ADV INJURY -I_S 1:.1 QQO,UQ ... tt GENERAL AGGREGATE -S 2:,OQQ,0:0,- GENL AGGREGATE UMIT APPLtES PW.. y. PRODUCTS-�Rtpi�At ; 5 Z.,UQO�O. POLICY "..PRO- .. . �JECT LOC S AUTOMOBILE LIABILITY 5666240000 12M.112013 1=112014 COMBINED SINGLE LIMIT (Ea aamdent) 5 1_,000 _ , ANY AUTO sBODILY INJURY(Par person} S ALLOWPtEDAUTOS BODILY INJURY(Per eccldeitl S' A X SCHEDULEDAU OS PROPERTY DAMAGE X HIRED AUTOS (Per aaident) INC X NowOWNEDAUTOS S UMBRELLA UAB' )( .00CUR 460005836 1170112013 1110112014 EAfFi000URRENCE S 1,000,UO A UA9 CLAIPAS-MADE �: AGGREGATE S I,OOO':O0 DEDUCTIBLE RETENTION _as.. �.5 .. _.._ WORKERSCOMPENSATION WCC5Q05593072Q0 t.O10312013 10/0312014 X 'VCSTATU- X Dn+ AND EMPLOYERSLIABILITY YIN.: TORYLl I= ER: ANYP#20PRIET6R/PARTNERJEXECLMVE RICHARD TOPPER E.LEACHACCIOENr S 1,000,06 B OFFICEmemsER EXCLUDED? N t A (MandatmIn NH) : INCLUDED FOR.WC COIIERA _..I EL DISEASE-EA EMPLOYEES 1,OO(j r.om _. It yes desrnbe under, DESORiPTION OF OPERATIONS heJoiv EL DISEASE-POLICY UMM S 1,000 0010 1 ( OESCRIPTION OF OPERATIONS i LOCATIONS/VEHICLES(Attach ACORD 161,Additional Remarks Seheduk:,$:more apace isrequired) !r CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE'CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL .BE DELIVERED ACCURUANCE VW►TH THE POLICY PRQVIStONS: "For Information Purposes onlyst Tupper Construction Co LLC AUTHORIZED REPRESENTATIVE: 27 Roberta Drive W 'Yarmouth, MA. 02673, Lora. Lowe ©1988-2009 ACORD CORPORATION. AIL rights reserved: ACORD 25'(2003l09) The ACORD name and logo are registered marks of ACORD •.�--�`, t.�i1V€i f�i��-tl(adfl�lffaT+EL:f�,(lam 1�'�id 1� 1l41C : tassacirusetis-Oeparcarsrt aT. alica` xa fl(1'p Harn1&S Rya ,Seta i1tf: T t SQard it.Building Rngi.la aAs ana Etas-lards 8 ma,my t2m: C+snctrueti>n Su r'i.+r:r i8T7)2-4-1274 [�` Micar.,se'CS-069058 +�urer.Gt7i.colrs "r RI.CiARD.s TUPPER _ 79 t14ID TECH DR WE9T XAR+XOGTFi MA'..431ri'i3 Richard TUPW ^may $'t'*P• 45.E VA. % ..X-.'ZIP h. 4 4SEefiE4 SIQE FOR !6t?InONSAIDEA°ipAYiDN Cornrssy�ri�r 12t3*2014 7: s E :. [,a>rrrr[r:,rrtr/!1 {:. ZCr ut[crrJr 11 �,.Office:of Censusaer Affairs�Bas;gessRegr�#arioa� License.or registration valed for indsvedul use only OME;IMPROVEMENT CONTRACTOR before the ex pi €iaCe If found return to; registration: 1T8434 Typa Office of C ffz$irs and Business Regulation xpiratian A11612416: LlG 3Q Fa aza-Su'_ 517Q B I1 A 021 . "UPPER CONSTRUCTION CO.LLC RICHMD TUPPER 73 8 MID-'rECK:OR - W.`fARM+OtJTFI;:RRA fl2613~ tiniferseereiar}+ ttlo �ih ut signature BEAD HERE TO RWOViE FNIO. ptwpw''twpingpooleBnit43$afer'wo3iiERkAtIQNbi f'�IC31,ar. TWOT Tupper Constru06p, B44lding:8afety Professional Member#;81 58119 Exp:4/34f201 - - - r OWNER AUTHORIZATION FORAM (Owner's Name) owner of the.Property located at (Property Address) ) yY_ C7 ,f� A7 026oi (Property Address) hereby authorize (/ �' d�,SL&M—NJ (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 • . .23 .E Date V I I CONSTRUCTION C®_LLc 546 Higgins Crowell Rd West Yarmouth, MA 02673 Phone 508-778-0111 Fax 508-778-5010 Registration#178434 License#069058 Date: 9/16/14 Attn: Building Department I hereby authorize Tupper Construction Co., LLC to pull the permits necessary to complete the project described on the attached permit application form. Thank you, Owners' Signatures Print Owners' Names: - -Hastings Meadows Condo's Street Address: _ 135 West Main St, Unit 25 Hyannis, MA 02601 Hastings Meadow Condominiums 135 West Main Street Hyannis, MA 02607 Phone:508-775-9445 Date: Attn: Building Department I hereby authorize Tupper-Construction Co., LLC.to pult the permits necessary to complete the project-described on the attached per mft.application form. Thank you, Owners' Signatures Print Owners' Names: Street Address. TU PP CONSTRUCTI10 .' . f TABLE 546A Higgins Crowell Rd,WEST YARMOUTH,MA 02673 PHONE: 508-778-0111 FAX: 508-778-501:Q .4 , WVVVV.TUPPERCO.COM ,3 Cl fD I VJISION " Date: -� Town of Barnstable Thomas Perry CBO 200 Main Street Hyannis, Ma 02601 (508) 790-6230 fax Re: Insulation Permits Dear Mr. Perry This affidavit is to certify that all work completed for permit application # o 400 l Issued on jb f has been inspected by a certified Building Performance Institute (BPI) inspector. All work performed meets or exceeds Federal and State requirements: Sincerely, Permit #: + qo& U � ��- Richard Tupper Address: LL 4` n a, V1 License # CS-69058 of 151409°35a TupperCom 15087785010 p.2 Hastings Meadow Condominiums 135 West Main Street Hyannis, MA 02607 Phone: 508-775-9445 Date: Xv Attn: Building.Department C- I hereby authorize Tupper Construction Co., LLC.to pull the permits necessary to complete the project described on the attached per mit.application form. Thank you, Owners' Signatures Print Owners' Names: Street Address: J „��"”'• TOWN OF BARNSTABLE 22950 Permit No. --------- 1 NAUSTAU Building Inspector w Cash OCCUPANCY PERMIT Bond No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Jams J�, Taylor Address Centerville alit 25 135 Kest fair_ Street, li-yannis Wiring Inspector �) / �x inspection date �.. ...�. Plumbing InspectqzrXIel Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID,WAND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. Building�Inspector