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HomeMy WebLinkAbout0135 WEST MAIN STREET (5) aao - �Do - i t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel y2- W I Application # Qu�q 6 IZ��J Health Division Date Issued Conservation Division Application Fee ,` Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project St ree Address 13�' lbesr / WMi Sr % 9 Village l5 eI, m Owner iQ 1-,Q E`� ����1 / Address 3 l� /'!i�/V Telephone 3Tg-- 77/-- ©f?3 A_)P/� NA oa6 71 J Permit Request IIIT /IC7l� L l Al "10 boo Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio AolS 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 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 ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing woo al stoves❑YeA ❑ No p....q ^� C> R 1 r i Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn. C �5xisting �ewglize I M.....4 .. C) Attached.garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: '...,. co r Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ .9 Commercial ❑Yes ❑ No If yes, site plan review# '' v, v► Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) p Name 52)L efN OW t 914iUA W IP44 o b Telephone Number Address 20 License # G>9s707 Home Improvement Contractor# �73Q45"_ Email Worker's Compensation #A 1 e_-qa7'1k3f&, ALL CONSTRUCTION DEBRIS RESULTIN FROM THIS PROJECT WILL BE TAKEN TO r; . N SIGNATURE DATE -3 t26114 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED ` MAP/PARCEL NO. ADDRESS VILLAGE OWNER i r DATE OF INSPECTION: M FOUNDATION FRAME INSULATION k : FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL L� GAS: ROUGH FINAL , r FINAL BUILDING DATE�CLOSED:OUT ASSOO 10N PLAN NO. L Zi , 1 Men" 0. 77 cr :aea■i � j� d . 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I 'Ml+�R1I m notk .br.scr� + I Aiinal r�Irli uivCh�m Now sa d�r,i l i1a , We !H7 @ �r p`� I®o44.0mi-A 1+ mW� �!we 1. �r �dO1�9nC �t7;1RI 4ZQ 3, i cR1RW1■'R5lRi. -- �i7ir141i. .-__,i_wr s' ' c _ ice.i",vt�Y' 'VYhlps �y►i+"' ID9"��114�i/ liil��'�M3�y%i IPlrl� , Southern New England Windows d.b.a Renewal by Andersen of SNE -Massachusetts -Department.of Public.-Saiety Board of Building Regulations.and Standards Con-truction Supeh-isor` 'License:,CS-095707 BRIAN D IDENMSdN. % 7 LAMBS POND+CIRC Chariton MAO.15U1 :x { Expiration Commissioner .09/08/2014 i�rn �J Office o Consumer A airs Business egu ation 10 Park Plaza-Suite 5170 Boston,Massachusetts 02116 Home Improv=6 Contractot Registration E _ r Registration: 173245 Type: Supplement Card t t _ Wraftn: 9/1912014 LL� SOUTHERN NEW ENGLAND WINDOWS , DENNISON BRIAN V 1137 PARK EAST DRIVE � .i WOONSOCKET,RI 02895 � ,v:` � i f: §d L ` 'Update Address and return card Mark reason for change. .SCA r o 20uavrr ❑Address Q Renewal ❑Employment ❑lost Card W..'x1piranoin: of Co co er ARfin d•.B 'oen Reg tattoo License or registration valid forindividal an only IMPROVEMENT CONTRACTOR hefore the esplretlon date.if found return to: btro0on 1732<5 Office of Consumer Affairs and Basin Regulation Type: l0 Psrlt Ptarsi-Suite 5170 =grygn014 Supplenenl:;aW Boston,MA.02116 SOUTNERNNEW ENOIAND WIN�WS LLC. RENEWALBY ANDERSONI - _ 1137 PARK EAST DRIVE WOONSOCKET,RI 02NS Undersecretary Not valid without signature - Tire Commonwealth of Massachusetts Department of hidustrial Accidents Office of Invadgadons 600 Washington Street Boston,MA 02111 www ma'ssgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A licant Information Please Print Leeiblv Name(Business/OrMization/Individual): LLC Address:_ a {0 l oAl p , City/State/Zip:_L/Il/LD /t/ , ro 041.6' Phone#: YDf ,? S- T VDO Are you an employer?Check the appropriate box: ro'ect r uir 1.1 I am a employer with A a 4. ❑ 1 am a general contractor and.I .�of p I ( � �' employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I 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' n [No workers'comp.insurance comp,insuranceJ 9 ❑Buildi g addition required.] S. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑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.t 3. ther azj comp.insurance required.] Any applicant that checks box#i must also fill out the section below showing their workers'compensation policy rmation t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contactors must submit a new affidavit indicating suc& tContnsctors that check this box must attached an additional sheet showing the name of the rub-conftcu rs and stale whether or not those entities have employees. If the sub-contractors 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 thepolicy and job site information. Insurance Company Name:-A vj- f Policy#or Self-ins.Lic.#:A'111, 102 7S/ JS 3&Z Expiration Date: a Job Site Address: 3 �A.lIJ�T/'( �(.� �l City/StateMp: Attach a copy of the workers'compensation policy declaration page(showing the policy num rand 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 STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investilzations of the DIA for insurance coverage verification I do/hereby ce under the pains and penalties of perjury that tine information provided abov is and correct c Signature: D Phone it: L/t7 o2 oZ 9 n Official use only. Do not write in this area,to be completed by city or town gfficial City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.-Plambing Inspector 6.Other Contact Person: Phone#• Client#:30124 SOUTNEW ACORD. CERTIFICATE Of LIABILITY INSURANCE DATE(MMMONYYY) B10612013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDM.TH18 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATWELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the policy()es)most 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 i c.ONT Anita Little Willis of New Jersey,Inc. �y W.$56 914.466E 856A14-1881 1015 Briggs Road,PO Box 5005 E MAIL ADDRESS, an(ta.11ttle@willis.com PO Box 5005 i INSUREAFFORDING COVERAGE NM d Mount Laurel,NJ 08054 INSURER A.Selective Insurance Co of the S 39926 INSURED Southern New England Windows LLC INSURER B,Argonaut Insurance Co. 19801 INSURER c.Beacon Mutual Ins.Co. 2401T D/B/A Renewal by Andersen 26 Albion Road INSURER D Lincoln,RI 02865 INSURER 8 INSURER P, 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 PAIDCLAIMS. NOR TYPE OF INSURANCE gl UBRj POLICY NUMBER MppMIDD Ml M ! SITS A GENERAL LIABILITY S202945900 081.1012013 0811012014 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY °PREMISES $rano® $100 000 CLAIMS-MADE I Aj'OCCUR MED EXP mm raon $10 000 PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE s3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: f PRODUCTS-C.Otu1P/OPAGG 53,00000E POLICY PRO LOC I S A AUTOMOBILE LIABILITY S202945900 8�10/2013 08/10/201 COMBINdEDSINGLELIMiT 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED 1 BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X �OSWNED PP eOPER dent) DAMAGE $ ------ A X UMBRELLA LIAR OCCUR S202945900 8/.10/2013 081101201 EACH OCCURRENCE S5 QQd ODO EXCESS LIAR -`OLAIMS MADE AGGREGATE $5 O0Q 00Q-- DED I RETENTION$ $ C WORDS COMPENSATION 00Q0Q68028-RI $f2112013 06/2i/201 X N1°STATu ° AND EMPLOYERS'LfABiLRY YIN 1 f •RY LIMITSgR B ANY PgOpPR1ETORIPARTNERIEXECUT1VE AIC927818352394 ;1/2013 08/21/201 E.L.EACH ACCIDENT $1 000 000 OFFICR/MEMBEREXCLUOEDI N!A! i I (Mandatory In NH) i i E.L.DISEASE-EA EMPLOYEE $1 000 000 If yae describe abler ! DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1 00Q 000 i DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES(Attach ACORD let,Additional Remarim Schedule,if more space Is requhed) CERTIFICATE HOLDER CANCELLATION Southern NE LLC SHOULD ANY OF THE ABOVE pESCRMED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE 'THEREOF. NOTICE WILL BE DELIVERED IN 26 Albion Road ACCORDANCE WITH THE libucY PROVIsioNS. Lincoln,RI 02865 AUTHORIZED REPRESENTATIVE I 01988-2010 ACORO CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S215109/M215058 AXL Yy... -. �� •_.. �� _i. _ �. - ✓tom R s • f j : — . r �+" • r , o ^ eFn'.. � 4 /� _ e ,urn : Y..�^f f k, ..i:.wW"'.w.Yi �..r.J �k..'wl•..��'.,Ny,,.w•r �1 .': FA y y .,. `� � � �... mow.w.i' may►:"^' f a • i` " � w.+✓"Fl:�wrt �� ^:,.:,r i.✓,. ..:. . fit 1 � � $.. e� w y ." r r:ws F..�.'�..."-�+-_, w'1 _. .s�l�l'^.� ,<.�+IT:• �--. .. ram...-..:�• .: .�, .�_...r .v..w .....^+�+�,y .. ' .M.«T• -*°,ate,.+..._,...+wrr+` .,..r... ' a t �x ti �1 sr fit.. , Y Y . HAS, IINGS Meadow BaarA of Trustees 135 West Main,Stirect HVanin is, Massachusetts 02,60-2 (S h)420taiDOQ Mar h 10,,ZL-1t4 Railph i alifFL1sd 1,35 Writ Ma In St,rY C,'' U1011 2.0 JI-yaFl,n1s,MA 02601 ��,ull IlCsl l�l�, Thq � � aRk� l4riY �uur���;� �� � glltlhtCi lit OfV-0 r�cW �rrc f tdu$tt K s rt �, I��i�t9r►��! ic:�cGivvIr�arrti;ruinoiY�!lY� raS:�ti�ri�tiY 191 reels 30Y[t r€ ��Jsilfb� + r 1s ±I�tiUs�I� Iie.Q�rrgd'q�niYatuY�msc,I.' Q1�Be: a'Ater teviewing,the d reauestedl„the:E611. wind was p!roatd'ed:-, WORK IgSA MiRiLETED,, Repl tcorl (lilt of p,d-OO;r 1.. eDpy of the DING P PIER f T fH!l !FV}OTi been,race ivied. ',. A cop[V of`the, .'I�.>E Ft-,r'SION :i,.Ere rYse MAS beeat re ued. o A c0py�of the c-'erl;ifiicA loo-wraokc-6 �irid!,��r woA m$il'i' rorm!pa�Yn+��i;lltneeria�rtC��Ii��SmliV�� r�Vi��`i[![]!�'d� Co MI��Gql ft�m � l�ydliN , D t� Ip -O cett��at; L _ r l: The WentISC260A Of tta6 caepa tter perf�rarng thee,WorkMU-St sae.ve.rifil d !�y the gRgundt manager at the � time,of I'nsuhl �;;. AI I materl 9s to hie takgn off the Ar-0,00 and not placed I'ni di�rnpst;�as on t.ae heyon STATUS: APPROVIED Shc UN-1 thet Work Cormpok od nrio/g 1tt may 10-stalled not coni r1%to MIT.subm1,glOaa,ahe hoafdl 0. ruM¢rek tiMt1111 ne �i'r F'TrIOwr��laCOfro(Von to,COMPIV wIth t�It A1, lilr Van hA a ot+y questioges pIj3 se,On-Mad 0A.4 Tali esah ait 508.175,9 JO!ltisN PUP a¢ ,4 20 qOO+t'7, 6dia-fly 4 ar"D mbar d Pa,s-W rl;t: ttaxkir s hAF.Mml`ow .nd'ominilu m, TOWN OF BARNSTABLE Permit No. 9-250 I SUM= Building Inspector � rua Cash _--------- OCCUPANCY PERMIT Bond ____N/A_____ 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 James J. Taylor Address, Centerville r� I�it #9 135 test Main. Street., HXarmis Wiring Inspector / ` Inspection date ,,.,1.. Plumbing Inspector 0110 .(� � Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL- NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. t tFi( 19'1 ��� .P r Building Inspector _� _