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HomeMy WebLinkAbout0047 CROSBY CIRCLE Lit q>51 h ,I n x0f Two ilk yl M kj; "4FIYW�1,­A'101� iY, Tam— rX:, XM. 1"j" 341i� f�I, A llll,015t 'f;R YW in MAJ 9F QgNtushl,I WIM—W t"! I I I i�itl! 'I _3_ '",M,ANSAW 0,� oil )l, '11PI"i MR' DAM "INT All MRW '�X �jp li SAW It's x?W Worm raw"T Net AIN— 4 '51M ka Ilk IRV ,%Ivi T,ug ,211 " vj gi "TT sumvp "Pup Wtv,% Xit ��tiv ),AlY jM U Igjtj�;V�w giv, f sp ffilsc�blvf LIT f �? �i -�j p 11.1i"v3P v� RHIN 14y, ft RNPOR Ell! 3C I MUMMMIN u gg NOW �M`, '01 wq MOM: r,�,, WA only, A it RIM !qgf WIND, If 'ek�i 0i ull, 11rB QIc p g wi OUR ;V a 1� "ill, j RUN' KOMI f WOE RIM Mai -,'A. 1, 1"t, 4 IVA MOM @12, 11 P -5 Nil ifivyj,��y 1 0 7%, �111$ li "Ah %�Pp; ;-0,',p 14,'" lip ,qx,5 ARW 1! t 14 jj fff��$ RNPIgg vf �yjt Tit( V, I 7i 44,3. MUMMA y t'g tj�jo`�, 41 f;,u-ZA M -1.1.T, TAHJA 11 .6; im W'S ij� �il% , ST j0 Al PIZ 'p 4 I !q I Al f4 A 'p Q,MN 11 vion lu y" *Pk!!!Zbvi�"INNilou') lily All —0, "n i w_,,_ ,__ 110P ;11 wMinyogg -1 AVi 111�13UCIIJ3, ,t"A 'PA4 -W i"1,4P ,mpg 4 P111 A,q SO Rill �Ip Rho, v"WN 1' xg WHO 1�i� 6#�jj;�P.111 i�, , x g �"t,j:'IyW��,--,�e�-,�� ' W, Nk IRA 110 W-frowls Ink Alm, —n"Jw. iiiii�whj� ',It,��j,iL��A,�k�j, 1"R �,A �', "",i; V, mg YAJW gglIgUSS�l A T WUNAK1 P4 , NU4,1'�kp l V.. 03 fill 4 -4iQ 1 1, ,,� tA 1W 1,Nil��.Iim 11 MTV dUPA WIN �,p 4� Nt Un & .gig, T 1h 41 10+ OWN "I'M SA phi mom M , , ) MOV05mvp k4 ij AWE vMT AMR jims V b " ...................... TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map. Parcel Application # Health Division `° 'Date Issued1 + 13 Conservation Division Application Fee Planning Dept. Y . Permit Fee Date Definitive Plan Approved by Planning Board O� 5li'+ld3 Historic - OKH _ Preservation / Hyannis Project Street Address 47 C�OS{�y OR-Cl2 Village Ca-ti 4-e r- v i e OwneraA-45r- DIOWr0 S-OSOn Address /K 9U54/ew©0d ed Telephone Permit Request R•P.f t1,Df 0Covd A.1 a.J;p-A „ ,�Ae5 Q-5, ez_ D JQ(k1s s�r /. . 9-ebI4'W /b//Y c.01L1117 w-f Square feet: 1 st floor: existing2exproposed 2tVZ 2nd floor: existing A�pproposed Total new .Zoning District P n_f Flood Plain Groundwater Overlay Project Valuation 000. Construction Type Lot Size �,�� Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family � Two Family ❑ Multi-Family (# units) ;:,.. ZE Age of Existing Structure /9?6 Historic House: ❑Yes �Mo On Old King's"Hghway 0 Yes--'�lo Basement Type: Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) 09, Number of Baths: Full: existing new Half: existing ne)W Number of Bedrooms: existin _new Total Room Count (not including baths): existing new First Floor Room Count 7 Heat Type and Fuel: ❑ Gas Koil ❑ Electric ❑ Other Central Air: ❑Yes (XNo Fireplaces: Existing New Existing wood/coal stove: ❑Yeslo 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 111'40 g V f Cf l l K_ Telephone Number $� Address I2� 6�lls'klr e �!c-� License # �� W 10:16le � �j��� Home Improvement Contractor# »� 7 Worker's Compensation # `'y���p®� ALL CONSTRUCTION DEBRIS RESULTI G FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE ' O 20� FOR OFFICIAL USE ONLY k APPLICATION# DATE ISSUED MAP/PARCEL NO. k - ADDRESS VILLAGE OWNER L rA, , DATE OF INSPECTION: i . FOUNDATION . F f: c FRAME t f INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING R f' t' DATE CLOSED OUT ASSOCIATION PLAN NO. 1 y The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations i 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organ tion/Individual): yle/1 // /n I Address: L2S in City/State/Zip::. "wa � Se, �'I//-Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.�I am a employer with -3 4. ❑ I am a general contractor and I ❑ employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition. working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers'comp. insurance comp. insurance.$ required.] 5.. ❑ We are a corporation and its 10.❑ 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.❑ 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, kContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state 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 the policy and job site information. //��,�,�, f f Insurance Company Name: Z_OP� Ic S/�Cek Policy#or Self-ins.Lic.#: 4��12ZA Z Expiration Date: /e/ mac/ ��ee22 1I Job Site Address: City/State/Zip: rt%4 1�/ "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 vio tor. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA f?r/,misura,96e coverage verification. I do hereby.,certify under a pa' and penalties of perjury that the information provided above 7,"Pr, is a and correct x _ -Si mature: - Date: O� a . Phone#: :IR � 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 S.Plumbing Inspector 6. Other Contact Person: k. -Phone#: t; Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. . Pursuant'to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer.is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing-employees. However the : owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on.such dwelling house' or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be'an employer."- MGL chapter.152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states'Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if. necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no-employees other than the members or partners,are not required to cant'workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial . Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please.call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact-you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current, policy information(if necessary)and under"Job Site Address"the applicant should write"all.locations in (city.or. ' town)."A copy of the-affidavit that has.been officially stamped or marked by the city or town may be provided to the . - applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to.bum leaves etc.)said person is NOT required to complete this affidavit The Office of.Investigations would like to thank you in advance for your cooperation and should you have any questions; please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 4-24-07 www.mass.gov/dia .. :1:• .4 CERTIFICATE OF LIABILITY INSURANCE F 'DATE(MMIDDNYYY) 03/28/2013 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). PRODUCER NAME: I JAMES R HINDMAN Schlegel & Schlegel Insurance Brokers Inc PHONE A` ' (A/C.No,Ext: 1508-771-8381 .(,mac, ADDRESS: ON.NET SS: Ne)508-771-0663 34 MAIN STREET 'w- SCHLEGELINSURANCE@VERIZ ADDRE - y ` PRODUCER CUSTOMER ID H: - West Yarmouth, MA 02673 a INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERANGM INSURANCE " 14788 Viktar Tuleika Dba Tuleika Building Company " wsURERBGRANITE STATE 125 Berkshire Trail INSURER C: INSURER D: West Barnstable, MA 02668 ` INSURER E: 1 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF JNSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE -FOR THE POLICY PERIOD INDICATED- NOTWITHSTANDING ANY REQUIREMENT, TERM' OR CONDITION "-0F 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. i , INSR - - LTR TYPE OF INSURANCE ,INSR WVD - POLICY NUMBER POLICY EFF POLICY EXP - (MM/DDIYYYY) (MMIDD/YYYY) a LIMITS , A GENERAL LIABILITY - MP16593Q• �. 4, 09/30/2012 09/30/2013 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY ,- - PREMISES(Ea occurrence) s500,000 CLAIMS-MADE OCCUR • - MED EXP(Any one person), $10,000 N PERSONAL B ADV INJURY' ". $"1,000,000 _ • GENERAL AGGREGATE S2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: y r- PRODUCTS-COMP/OP AGG s2,000,000 `+ PRO- - POLICY JECT LOC r A. .... - .- •," _ * S.. I - - AUTOMOBILE LIABILITY - s '• M COMBINED SINGLE LIMIT $ ANY AUTO • " .v (Ea accident) - " • �" BODILY INJURY(Per person) $• - ALL OWNED AUTOS - , - - BODILY INJURY(Per accident) $ ' SCHEDULED AUTOS i - . PROPERTY DAMAGE $ .. HIRED AUTOS (Per accident) NON-OWNED AUTOS * g - r s UMBRELLA LIAB OCCUR HEACH OCCURRENCE g S .. EXCESS LIAB CLAIMS-MADE r • AGGREGATE - S DEDUCTIBLE • - - +. S. RETENTION S ' S. -_.a. WORKERS COMPENSATION - W STA - H- AND EMPLOYERS`LIABILITY X TORY LIMITS f ER B ANY PROPRIETORIPARTNERIEXECUTIVE YIN 4512PO3-1-11 07/14/201207/14/2013 E.L.EACH ACCIDENT ; 5 100,000 _ OFFICER/MEMBER EXCLUDED? �. N/A • - "' ,�. _ - (Mandatory in NH)If ; �, • _ E.L.DISEASE-EA EMPLOYEE $ 100,000 Dyes.describe under - • E.L.DISEASE•POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) P. " VICTAR TULEIRA HAS ELECTED COVERAGE ON HIS WORKERS COMPENSATION POLICY CERTIFICATE HOLDER CANCELLATION TOWN OF FALMOUTH J BUILDING DEPT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE ` DELIVERED IN 59 TOWN HALL SQUARE . ACCORDANCE WITH THE POLICY PROVISIONS. " FALMOUTH, MA 02540 k AUTHORIZED REPRESENTATIVE - i• y 4 , 01IN&2009 AC CORPORATION. All rights reserved MICHELE CUDILO, P.Es ' —' Y Consulting Structural Engineer 123 Cottonwood Lane-Centerville, Massachusetts 02632=1979:•(508)771=7601 Fax(508)77,1-7163- r mcudilo@comcast:net , •David M.Curtis • DATE: August6,2012 16 Rustlewood Rd. Milton,MA,02186 , t` RE: STRUCTURAL REPORT 1 n Existing Residence 47 CROSBY LANE,CENTERV.ILLE,MA K _ Dear Mr. Curtis; ; t At your prior request,l went to the above captioned project on August 3,2012,for,the purpose of,addressing,:the' structural integrity of the above:[tesidential structure,in particular.as related to observed foundation cracks. ' The purpose of this report.is to list.the structural issues'of concern.with regard to the observed.conditions. Other issues are not covered herein. ;Hidden conditions remain itie'responsibility of original parties.'. s 1.0 Back round; The site is located'on a relatively flat lot in a residential.inland neighborhood. If is understood`from Assessors' Database inforrriaiion that the liuiiding was constructed around.I953'as a one story wood framed res dence,over a - ~ full unfinished basement,;with`,attactied`Garage There is,a rear attached'bump-out structure,a Sunroom. Site plan and building construction plans were noravaifable'at the time of our review. We observed the existing 36' avg.x 54'main full.foundatia :footprint ,axone-story gable roofed build ttg with woad frame construction on eancrete block fullfoundation wtith'eenter beam on expandab'le'steel columns and { center stair down to unfinished basemene ` 2.0,Foundation There are,two foundation,repair.drawings,;shown.SK-1 and SK 2 following this report. Where observed,the concrete block foundation' s showing cracks,horizontally and'vertically 'This'is due to thexfoundafion backfill soil ' being more than'4'differential;and'the wall'being unre.infocced. F s The Foundation requires re with a pier construct d with properly reinforced cores as shown an.SK-2. . Estimates for this'solution may be Ubtained'from;ltcensed.contractors. The repair'shows that the,f6phdation maybe x buttressed as showri'on S.K 2 with re-pointing between.buttresses in.order to span the Eva11 in'two directions, vertically and horizontally. The piers matt'be omitted at the Sunroom where there is less barkfill. t . Of further note as that the eA�sting centerbeam is supported on adjustable columns;'which are not'permitted by.Bade: The.solutton is,ta'replace:each with a3.5�'diameter concrete filled steel tally column. - i Continued - a STRUCTURAL MODIFICATIONS.to Existing Residence 47CROSBYLANE,CENTE.RV,I.L.LE,:MA Page 2 3.0 Conclusions and'Recommen'dations The above information provides you with the minimum requirements for maintenance of the structural.integrity of the above captioned residential structure;namely'reinforcement of the existing foundation,and replacement of the 3.= adjustable columns with laliy'.columns: Consult with a licensed contractor,,such,'as one you may find-in.the Blue Book of Building and Construction, is" , recommended to perform the scope of work#o.add the foundation components. I trust the'contents of this report meet your needs at this time. Should you have any questions,please call. a Aln dre ; Michele Cudilo,P.E. Jr+oF kq n012-121, MICHELE tic CUML v°O No 34774 f STRUCTURAL FGlS E. � t `FJ4NAl s 1 Date: V , i A'Z Drawing p� GrG l:(L1/11,lr he HA Scole:. AS NOTED Rev.- 0 File Nome: GUI. 5•., Project No.:245 2 a V, 7t �1aU�oR S,ors Cp tlio r ,7 f MICNELE SG I b TOWN OF BARNSTA LE 2013 APB 17 RIM LI: 1 C. I VJI S 10 N . pNWEALf�! 44 IVA e VA ke NgMkx t. , C _ C�s MICHELE UDILO, P TOWN OF BARNSTAB E Sl tMN d ' S n _ OfticeV%ort's�i?' ' fift�i 6ti4S�ft� HOME IMPROVEMENT CONTRACTOR S Registration: 161544 + Type: Expiration r10 27/2012`. DBA x k B. — NSTRUCTION t VIKTAR TULEIKA , . :. 1125 BERKSHIRE 'A y W.BARSTABLE,MA 02668 a� rF Undersecretary ° t�'litssucitusetts- Department of Public SafetN Lp Board of Building Regulations}ancfStxndards . • Construction Supervisor License Lrcense:'CS " 91854 EVIKTAR V TULEIKA "'� 125 BERKSHIRE TRL. W BARNSTABLE MA 02668 Expiration: 2120/2013 + <'ouunissioner Tr#: 13464 4 R • - - , 7 °" I L Office of Consumer Affairs and Business Regulation r` 10 Park Plaza -'Suite 5170 Boston, Massachusetts 02116 r � Home Im rovement Co ractor Registration - P _ Registration: 173709 Expiration: ''11 1/2014 Tr#^233302 TULEIKA BUILDING COMPANY LLC VIKTAR TULEIKA ;. 125 BERKSHIRE TRAIL ' W. BARNSTABLE, MA 02668 -,Update Address and return card.Mark 'reason for charge. SCA 1 Co 20M-05/11 ~ � [:].Address 0.Renewaf [] Employment 0 Lost Card' i a , e ! ��?�lliis.:�ir•�rrs�//i _ ". License or re istration valid for individul use only Office of Consumer Affairs & Business Regulation 1" g �HOME IMPROVEMENT CONTRACTOR. t .. before the expiration date. If found return to: egistration: . 173709 Type Office of Consumer Affairs and Business Regulation. • . 10 Park Plaza.-Suite 5170 • xpiration: 11/1/2014 � LLC �. t: Boston,MA 02116 j TULEIKA BUILDING,COMPANY..LLC. f ViKTAR TULEIKA 125 BERKSHIRE TRAIL R, W. BARNSTABLE, MA 02668�" Undersecretary Not valid thout signature DIME Tow6 of Barnstable. y .4. Re i lator t Senriccs " Thomas F.Cciler,Director Building Dhisi6n, Tom Perry,Building Commissioner ... . .... . ...... ................ ........ . "........ ...... ,..210.Main vc'L.r�..4�t 41,-%mnis;'NLA,02601... _.. .................... ..*.... .. ... .' .................. _._ www•.tow•n.barostable.ma.os F Office: 508.8624038 Fiiac: 508.790-t`►230; . . I'ro em'l�r�rner Must l� -tv Complete and Sign TWs Section 1 If Using A Builder as Owncr of the subject propczty hereby wAodze- y 6 kIN TV t�A iS�A 1ON�i KA act on my behalf,` in all matters re-lative to-work 2,u"tizcd by this building pecmitY . ' ' r• X_I6q G Mm j Address of job), _ Pool fences and alarms are the responsibility of the applicant' Pools are not to be filled or utilized'before fence is installed'and final . inspections arc performed and accepted. Signature Df Ovner S' o ppGcant E l's ►t Name. nint Name . Ditc - Q:FGRW:0WNUPMtM=00xPwLS b12012 ��r"... �w�.. ��r..y� y�� r'�R ���..., n..w w.. ►•:..��'.'• �i►rw.�w ��aiw .'+.�w.. � �w� _ -.r.�� ':`r�T _ 1421 EIKA BUILDINGCOMPANY ,LL C _ le TULEIKA' _ 125 BERKSHIRE TPL: - • W. BARNSTABLE;MA 02668 « n a w 7 53-7107 214 3 . DATE° d f ,F IE R OF /} r ci ta•� - - DOLLARS, • cam cm CL ►0 SOX 10 3 'r '�� '� e - - , - .. - .. 11600 L'As 2 V.. •l . 2 LA 3 7 L0,78":" 89 - E10 i S I S. Lu! k r`7MI�� -= 1 .. "-'�'..�INIO -«"«:. ''h:ya..�''' •=- '�-. �M.�C • 4•�.�.-•5-=`I�R04.:OR' -" ' A Details Page 1 of 1 Licensee Details Demographic Information Full Name: VIKTAR V TULEIKA Gender: Owner Name: License Address Information Address: Address 2: City: West Barnstable State: MA Zipcode: 02668 Country: United States License Information License No: CS-091854 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 3/18/2013 Issue Date: Expiration Date: 2/20/2015 License Status: Active Today's Date: 5/14/2013 Secondary License: Doing Business As: Status Change: 18 Prerequisite Information No Prerequisite Information Discipline No Discipline Information Documentum http://elicense.chs.state.ma.us/Verification/Details.aspx?Agency_id=1&license_id=280929& 5/14/2013 Maloney Kathy From: Schlegel Frank To: Maloney Kathy Subject: map 188 pcl 063 Date: Tuesday, December 09, 1997 4:24PM Map 188 Pcl 063 requested that I change town records for the above parcel from#45 Crosby Circle to#47 Crosby Circle, Centerville. This is acceptable to Engineering. There is a permit out there for#45 and should be changed to#47. Any questions,just call. THANX Page 1 TOWN OF BARNSTABLE BUILDING PERMIT PARCEL ID 188 063 GEOBASE ID 10894 i ADDRESS 45 CROSBY CIRCLE PHONE CENTERVILLE ZIP - LOT 14 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT' CO PERMIT 27519 DESCRIPTION WIDEN 2 "DOORWAYS/REMOVE NONBEARING WALLS PERMIT TYPE BREMOD TITLE RESIDENTIAL ALT/CONY CONTRACTORS: ROBERT D. GREER Department of Health, Safety ARCHITECTS: and Environmental Services i TOTAL FEES: $25.00 BOND $.00 CONSTRUCTION COSTS $600.00 434 RESID ADD/ALT/CONY 1 PRIVATE PS9*4) * BARN3TABLE ; I MASS. i639. { I. ILDI/N:G�VISIO� BY DATE ISSUED 12/04/1997 EXPIRATION DATE i BUILDING PERMIT PARCEL° I1) 188 063 GEOBASE ID 1.0894 ADDRESS 45 CROSBY CIRCLE PHONE CENTERVILLE ZIP t LOT 14 BLOCK LOT SIZE DBA DEVELOPMENT DISTRIcrt CO PERMIT 27519 DESCRIPTION WIDEN 2 DOORWAYS/R-EMOVE NONB BARING WALLS PERMIT TYPE BRE140D 'TITLE RESIDENTIAL AI,,T/CO.NV CONTRACTORS: ROKERT -A. GREER Department of Health, Safety ARCHITECTS and Environmental Services TOTAL Friss: BBOND y wt�s :XON COSTS i ! t"E $.0 AA�].1 E Yr 77,� y�,Y yin Yp e�•� ���;py�� 1 7��y 7[f t� 7� .. ` 34 1J! Adx4Tf+a.rVty,Y . +Y�.41;'k,L� �.6. ,1G #�.'� * BAItN3TABLE, + MASS. - } BUILDIINrG DIVISIO ' BY .✓' , DATK ISSUED 12/04/1997 EXPIRATION DATE � I THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE PERMITS ARE.1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION E. REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECFi- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION.BEFORE OCCUPANCY. un BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS ' 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL I WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVEDTHE STRUCTION WORK IS NOT STARTED WITHIN.SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION, - I BUILDING PERMIT ilngineeq*ng Dept.(3rd floor) Map i Paicel - _ Perinit#' 7 57 n F House# Date Issued r 9- Board of HealthOrd floor)(8:15 -9:30/1?00-4:30) %f2 Fee 4�10c d 19 �`/ TOWN OF BARNSTABLE� '`A° �� y Building Permit Applications ` Project Street Address C 5 Village G ��`#'Y(' 11- i 1 ,� ' Owner fA ;CL--1 •C, at er i Address __2 t%�-Q_ S tu-'r-odowt � Telephone I U -3,- 3 1�6, Permit Request W i d e on cA a o i- Pac a�e S © (o a LC f o y vvv 3 a Y-c< 4A,o&tt 3�-�� "ty, � � Re yt,�oL--•e_ X G( C, 115: 0A k, fChp1`t .First Floor /So U square feet Second Floor square feet -Construction Type U C_43 a , Estimated Project Cost $ 6 U C3, C CJ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family f]>'l Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes &I-No On Old King's Highway ❑Yes �O Basement Type: Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing 2— New Half: Existing- New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing( New First Floor Room Count Heat Type and Fuel: ❑Gas L4-Oil ❑Electric ❑Other Central Air ❑Yes L�,No Fireplaces: Existing _ New Existing wood/coal stove ❑Yes '&90' Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) &/Attached(size) f 4 4.Vl ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded Commercial ❑Yes d'No If yes, site plan review# Current Use In r-5. Proposed Use Builder Information Name Telephone Number I k Address 4A Q p r Pam.e,t -f J•eN r A License# o a(�3 o !7 Vl4 cc r Sec-A.5 Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO !�cde SIGNATURE DATE BUILDING PERMIT DENIED FOR TH OLLOW NG REASON(S) F. FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED: w - MAP/PARCEL NO` 0. j ADDRESS z VILLAGE OWNER DATE OR INSPECTION FOUNDATION FRAME 1 INSULATION - FIREPLACE 44 r 1 i ELECTRICAL: ROUGH r FINAL � r - r PLUMBING: ROUGH - FINAL GAS:, >R GH FINAL , _ In g( ti r I FINAL BUILDINdeo ol. .A. i DATE CLOSED OUT,. r ASSOCIATION PLAN NO.� THILIV a Town of �arntnble Department of Health Safety and Environmental Services Building Division 367 Main Stint,Hyannis MA 02601 Ralph crasser. Office: 508-790-6227 Building Come; Fax: 508-7 90-6230 For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing more than owner occupied building containing �least ce Or building t be donee by (our registered con tact rs units or structures which are adjacent to such g certain exceptions,along with other requirements Type of Work: Lv,c ce.,ti cc�d �•�j�+s Est.Cost "G Address of Work: Owner's Name Date of Permit Application:_ I hereby certify that: Registration is not required for the following renson(s): Work excluded by law VV" Job under S1,000. Building not owner-occupied owner palling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABR RAM ORA HOME RAN'I'Y FUND UNDER MGLOvMM[ENT WORK DO o I4ZA� ACCESS TO THE ARBITRATION SIGNED UNDER PENALTIES OF PERJURY I hereby apply fora permit as the agent of the Owner. tion No Date Cnatrac:or Nance Registra . The CfJJlllllotlN'crtltll Of.11assachuscttti Dc partnlcnt of lurlustrial.9ccirlults t Office o//nvestigat/nns 600 N aihinrton Street Briton. A1atvx 02111 Workers' Compensation Insurance Affidavit �PPlic•tntinformation• _._...._..._.__..___1'leasePRlNTIe;L�I�,_._...._...... .. ,, name: I�t3�t4�'" t G ✓ �f1 C C_f' C / e location: � f� LJ- CMI �s, nhone# I am a homeowner performing all work myself. &-am a sole proprietor and have no one working_ in any capacity .. _. '.•.�..•- O -_i9fe V,.Is �T•n�Mr�"/.7'lr�r T .,1.►�:'„��A� .�...rwr_� 1'. [] I a i an emplover providing workers' compensation for my employees working on this job. comtiany mimes address: cih•: (thonc#: insurnncc co. policy# I am a sole proprietor. general contractor or homeowner(circle one) and have hired the contractors listed below who have the following workers compensation polices: company nnrne- phone At: insurnncc co nnliev# �1. ._..__.-.... .._ ._.�_—....._. _I_�_...iYu.._ .wy.�:11r'.�.._Jr'- _`•-.. _ - .. _ ..: ....-�,-..,- _.�w�a:Y�Y�-•.. .L__.� company-name: address: sin: phnne#: insurnncc co. # .Attach additional sheet if necessary. =•. -^- +. --��"' T�•'fT •le;'^ -'•^'"~•` "'„- :�_�...�..:..r.�.::%::i.i_:ti :.�� _. �. -.,,. � ,r�s�us+w, yir•�.r:�ie•.w�r..:,x. Failure to secure coverage as required under Section 35A of 111GL 152 can lead to the imposition of criminal penalties of a line up to S1,500.00 andiur unc scars. imprisonment as cell as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. 1 understand that a cope of this statcutent mac be fonc:trdcd to the Ofricc of Investigations of the D1A for coverage verification. I do hereh-certify tinder the pains mid penalties of perjure•that the information provided above is true andj correct. Si_nature �(/ �. Date I /3/27 Print name y b e 1'{ 0 G C Phone# �'— Z S �� :.''oflicinl use unly do not write in this area to be completed by city or town official cite or town: permit/liccnse# rIBuilding Department C3Licensin-Board l] check if immediate response is required C3Seleetmen's Office 1 allealth Department contact person: phone#: MOther y, information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for the: it ter-under any employees. As quoted from the "law". an u�r lore is defined as every person in the service of •uu I . p 1 P contract of hire, express or implied, oral or written. An crmhlorer is defined as an individual, partnership, association, corporation or other legal entity•, or1anv two or more the foregoing enuaged in a joint enterprise. and including the legal representatives of a deceased emplover. or the receiver or trustee of an individual , partnership. association or other legal entity, employing; employees. However the owner of a dwellina, house haying not more than three apartments and who resides therein. or the occupant of the dwellim, house of another who employs persons to do maintenance , construction or repair work on such dwelling_ hog or on the ,rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter h.- been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the "law' or if you are required to obtain a workers' compensation policy. please call the Department at the number listed below. City or rowns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Plea be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned t. the Department by mail or FAX unless other arrangements have been made. Tile Office of Investigations would like to thank you in advance for you cooperation and should you have any question please do not hesitate to give us a call. r.-y..,._e-+.._... ...._..�.-v:..... ..�ww.w.-r-r..:e.r�. .v..-s.+.Tr........._�..rr...w..��+s..- The Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax 9: (617) 727-7749 phone 4: (617) 727-4900 ext. 406, 409 or 375 Yc ssembled Unassembled — + :hed HEIGHi': ;twd HEIGHT; :lied HEI(;HT; -- �hed FBEiGHT: INLAY' SPECIAL NOTES — —� i ne Depot adepts no responsibtfity fior r of measurements supplied by pu:i:ris:,,er, waved the specifiicati(ins on this twrm awl =feet. 1 CIO& LA-CAJ l i k f , v a •J NOME IMPROVEMENT CONTRACTOR Registration 118945 Type — INDIVIDUAL Expiration 05/09/99 } 6 ROBERT D. GREER _ 140 PEACH TREE RD L ►�o?, &rMTONS MILLS MA 02632 ( ROB i J I 4 y� ://�v (�rait+n�<ia;u�.��/� r/. /(ir.SJlt�u.N✓�.f .a\ CEPARI`ME6T Of PUBLIC SAW CORSIRDCTIOB SUPERVISOR LICERSE t lutber: Expires: Birtbslate: } } CS 826M9 03/24/19S8 03124/1954 j Restricted To: 0fl l + R039RT D GM f 10 PLACE TREE RD E YARSiOBS °AII:LS, N9 62648 s I � i