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HomeMy WebLinkAbout0021 FOX RUN S W;*JO"M OW At ,fz- Itlit, k I II i Town of Barnstable Building ` ' .. t Post Th Card So'-That it s:VisibleFrom the Street-Approved`Plans Must be Retained on'Job and this'Card°Must=be'Kept; raaar�rnsre ,p Posted Until Final lnspection Has Been.Made. k 63 1`8' _ m Wh re:a Certificate of Occupancy is Requmed, uch�Building hall Not be;Occu'pied__until a�Final lnspectipn has beemrnade, Permit Permit No. B-19-4246 Applicant Name: ANDRE YARMALOVICH Approvals Date Issued: 12/24/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 06/24/2020 Foundation: Location: 21 FOX RUN,CENTERVILLE Map/Lot: 227 160 Zoning District: RC Sheathing: Owner on Record: CHIZEK, PAUL&GERTLER, LESLIE a Contractor Name ,ANDRE YARMALOVICH Framing: 1 Address: 21 FOX RUN Contractor License CS=111305 2 CENTERVILLE,•MA 02632 " _.. Est.�Pro je.ct Cost: $3,700.00 Chimney: Description: roof Permit Fe: $35.00 Insulation: i `r Fee Paid: $35.00 Project Review Req: / Date: ' 12/24/2019 Final Plumbing/Gas . Rough Plumbing: -- ; Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorizedy t s commence bhis permit id within sonsa ua ix mthftd'issnce. All work authorized by this permit shall conform to the approved application and the,,approved construction documents-for which this permit has been granted. Rough Gas All construction,alterations and changes of'use of any building and structures shall be in compliance with the local zoning by-laws and codes. F " ' Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. ic r . ., Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Buildingand�Fire Officials are peovided on this.permit. Service: Minimum of Five Call Inspections Required for All Construction WorkF 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage final: Where applicable,separate permits are required for.Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT ISSUED RECIPIENT 5 � i 40 Application number..... .�..`....... .....!.. . Fee ................................................. ........... = Building Inspectors Initials.........::. ... M ............ Date Issued.................�.�1...`.t �°` l..Map/Parcel....... .... .... ............... (a.............. TOWN. OF BARNSTABLE mL EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION-' .' PROPERTY INFORMATION Address of Project- � �t�l L- �r7 NUMBER STREET VILLAGE Owner's Name: �LA�a-�� % ��/� Phone.Number Email Address: Cell Phone Number Project cost$ 3 700 - Check one esiden ial Commercial• OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: - TYPE ®F WORK ❑ Siding ❑ Windows(no header change)# ❑ Insulation/Weatherization. ❑ -Doors(no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles). Construction Debris will be going to CONTRACTOR'S,INFORMATION Contractor's name (N � y__192:1 'g Home Improvement Contractors Registration(if applicable)#. 2 % , . (attach.copy) . Construction Supervisor's.License# �� l (attach copy) Email of Contractor`�d g tvtOW J✓C,4 �"d-r- - . Phone number ���2�� ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN v^i 1 ■Ai icr nnrA/AI LJICTADIr ADDDAI/A/ DCCnDC A DCDAAtr rAAI DC 1«I►Cn APPLICATION NUMBER *For 'Vents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread.Sheet of each-tent must be attached. Provide a site plan with.the.location(s)of each tent Fuel source being used LP tank 20 lbs. or>Yes No , if yes,a gas permit is required. Natural Gas Yes No , if yes,a gas.permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9.30 am or 3.30 pm-4:30pm. Commercial events may require Fire Department approval, *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction'' Supervisor-in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date �. APVPCANT9S SIGNATURE Signature Date L Z &V/ All permit appl anon re subject to 4 bull official's approval.prior,to issuance. The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600.Vashington Street.- Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information - Please Print Legibly Name (Business/Organization/Individual): Address: ���� I'>�L�- - City/State/Zip: kf Phone#: �ou Are yo n employer?Check the appropriate boxe Type of project(required): 1.EV am a with employer 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- :A'listed on the attached sheet.; ',7. .❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition employees and have workers working forme in any capacity. yt 9. ❑Building addition [No workers'comp.insurance comp.insurance: 10. Electrical repairs or additions required.] 5. ❑ We are a corporation and its. ❑ p- 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.[1Other 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. tContractors 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. Insurance Company Name: Policy#or Self-ins.Lic.#: w !Ja—,vxpration Date: . Job Site Address: _f F-V X e'l��i �, ! y/State/Zip: 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 insura ce coverage verification. I do hereby certify under the p and penalties of perjury that.the information provided above is true and.correct• .. SigLiature: Date: �Z Phone#: LZ 9, 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 Contact Person: Phone M 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-contractors)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 carry 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'Addre'ss"theapplicant 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 /(r Estimate - r x K " Date ;Estimate# DEL ISLANDSF H o mie Im provement 9/3/2019 1092 Bel Islands Home Improvement 204 Cinderella Terrace Na e i Address Marstons Mills, Ma ,02648 Paulchizek 21 Fox Run, Belislandsroofingandsiding.eom Centerville,Ma 508-280-1794 508-364-6909 Terms Project i, , .' a. �m _ Description a �� 1Qty. �v 4Rate �Total �, .r you^' .r�;.-ilu wow*' ��Vr,`a � ,-�CW t a � a .'�' 4'Na 4Sa e ka wa - Bel Islands Home Improvement-ROOFING PROPOSAL- 3,100.00 3,100.00 labor/materials( architect shingles)-back middle section of the house only BEL Islands Home Improvement hereby propose to perform the following services in a neat professional manner in accordance with manufacturers specifications and local building code Strip existing roof shingles(1 layer of shingles) and remove all debris.Any more layers of roofing needed to be stripped-it will be additional charge. and install: New Shingles:Certainteed Architectural Landmark shingles with lifetime warranty, 10 years Algae Resistant, 110 MPH Wind Warranty,240 Lbs weight/square-(Every shingle will be nailed by the code with 6 nails-storm nailing system) install: 8"Aluminum Drip Edge install Certainteed ice and water shield to eves,valleys,rakes,and skylights and low pitch areas ( 18"on rakes and skylights and 3 ft on eves and valleys to prevent ice dams) install Certainteed Swift Start-with self-adhering asphalt starter course on all eves and rake edges install Aluminum&Neoprene Soil Pipe Flashing Install Synthetic underlayment paper(Rhino) install Pre-cut Certainteed Hip&Ridge shingles and new ridge vent Total 'Pagel -Estimate Date`r "`' Estimate# ISLANDS Hose Improvement 9/3/2019 1092 Bel Islands Home Improvement 204 Cinderella Terrace Marne i,aaress P- Marstons Mills, Ma ,02648 Paul Chizek 21 Fox Run, Belislandsroofingandsiding.com Centerville,Ma 508-280-1794 508-364-6909 T Terms Project Description at wr Y- Total Extra charge to upgrade shingles to Landmark Pro is$450 POSSIBLE EXTRA: Any rotted plywood,trim boards,lead flashing or other carpentry needing replacement will be done and charged for as an extra at rate of$60.00 per hour,plus 15%mark up materials Bel Islands Home Improvement Guarantees the labor for Lifetime of roof and against Blow-offs for 15 Years. Bel Islands Home Improvement:Carries Worksman's Compensation and Public Liability Insurance on the above work, certificate available upon request Dumpster 400.00 400.00 permit 250.00 250.00 \ 7 V z3 Total $3,750.00 Page 2CC P� l I' onmpmn I •S nm SNO.L.gmvW Consteuction Supervisor 1 trlldQRU'3 be • i ' Unrestricted_Buildings of any use group which contain. WA i. y Ikss than 35,000 cubic feet(991 cubic meters)of enclosed .. space. l- 0 V/Wa i Failure to possess a current edition of the Massachusetts State Building Code is cause for,c4yocation of this license. -- ------ ` For information about'this license JauoissiwwoO Call(617)727-3200 or visit wWw•mass.gov/dpl �. ,._---------------- 1`C Vitt S71W SNOISHVW O 32t30N1�t+OZ t or iadivfdual use only rim to i s: and ... 1 O1VW2iVA ..�+..3210N1/ dot .., ; •� tfls t1�,9 eXi!! . ,:&uslnoss Regull i 1 �: oosumer Re 710 I CZOZ/LO/90 aaJliI L 100 W4 . Boston,MBA 02112. Jose N .: . J SUO t spJepuelS pue suolleinbab BulplIng to Oros aJn'sue3ol lguoissaloJd to uolsuyip sllasny3essem to 4lie8muouxuo3 pWt SI @ N�• i ,0 ' s r AcoR CERTIFICATE OF LIABILITY INSURANCE SATE INY eU.YVYN �-� THIS CERTiFICAT£ IS ISSUED AS A MATT[R Of INfORMATION ONLY A10.CONF£.IIS NO RIGHTS.UPON THE CER1I:f3CAT:E HOLDER-PINS CERTIFICATE DOES.NOT AffIRMAT1i+LLY OR XEGATIVELY AMEND,EIiTEND'OR ALTER THE COVERAGE AFFORDED.RY THE POLIGJES. BELo . THIS CERTIFICATE Of INSURANCE DOES NOT COPtSTITUT.E A CONTRACT.HE?WEEK THE ISSUING IfislinRISpl,AUTHORIZED REPRESENT ATIVE OR PRODUCER;AND THE CERTIFICATE HOLDER. IMPORTANT: 1106 crrliTitate I1618At is 8.41.ADDITIONAL INSURED,th"e.Poiitil'iesl musthelotWiTI NAL;%SUREO prorl9luuaafb8Indorsed. 11"SURROGATI4N IS"WAIVED.Subject to the.tetaiis:"end toridlijans-tq the purity,tertelN noliOea,Ileay require an eeatolSerntlot;A slatoweal on this certititate does of mratl light to"Ih: .LetSi;itafe hol:de:r ill lieu of t clo eridol atm.eN!'s,. Prfeuu!iA BRYDEN-a SVLLIVAN INS. CMO 88:FAUTH RD PN6ME _ tAe HYANNIS:MA 02601 .XL;..„. Ap;.dI55 _ th�f.UNf F.3i AiiJRvi9t I Sq#RaLf mAlti - . M Cotyorplisn - WOO lUr,uAFU .. BEL ISLANDS OOM.E IMPROVEMENT LLC 204_'ClNDERELLA TERRACE fbSUR.R C. MARSTONS MILLS MA 02648 AlsuR=M.s ' ..i. .COVERAGES CERTiftt.Aft IJM ER..&ffit1@32FI'EMt 1ON AII{Rl1idERt THIN:$TO CE00'THAT 1NE PC LIC IS Of IkSURAKI.LISTED, HAVE SEEN IMia TO 111E`hSORED NAMED AU09't' FOR.t{1E PGU8V flERloO POWCA1ED. 6101 t11f+STANDiNf.ANY m6ulitimil(T, COO 00,0h011iEN.01.ANr. CON 11iko OR.OYHfR 0clim(RT WITH AFtnet 1:0 tiwic14 1*IS. CE;91"illc$tE.Y.AY at'ISSUED OR mAY PtAlAgh. T-HE INSURANCE AFFOr,01U (!;Y THE POLICIES US 114 0 14EAE.IN A SuIIJECT TO ALL JHE URIAS. . . 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" l • ° TOWN OF BARNSTABLE permit No. -27549 Building Inspector Bunn J Cash ---------------------- — R Bond x OCCUPANCY PERMIT --------------------------- Issued to David Building Trust Address Lot 13, 2.1•-Fox Faun, Centerville � Wiring Inspector l A � � � Inspection date - Plumbing Inspector/ � ..., Y Inspection date t - i t Gas Inspector Inspection date xEngineering Department �/ �~ / ?r �y s Inspection date//,� - Board of Health kInspection date fO 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTTS STATE BUILDING CODE. ...................................................... 19......_ . v................. Building ..Inspector............. ..w__ m'�'�`T �•,ew TOWN OF BARNSTABLE BUILDING DEPARTMENT = s'esaar TOWN OFFICE BUILDING r�ra HYANNIS, MASS. 02601 c MEMO TO: Town Clerk FROM: Building Department AG° DATE: An Occupancy. Permit has been issued for the building authorized.by ' Building Permit #._...... ,.7 9' 9 . .. ............................................................... ........ issued to Y�(J <✓rc/fNx 1fr.....................�"' � xvvGi ° ` Please release the performance bond. Assessors,map and lot number ........... '.:. THE. �It,••�•A�•�• . ST �=C� -TIC � v�� JI � � Qof ropy Sewage Permit number ggr,� tqgg LIA ��ww��++ �.? 4r�.. 1, F LIA AHH9TODLE, i " - P r. House number• .......... .................... ........................ � ` , 9 0, 9 3 TOWN OF B,A' NSTABLE *� rids 'n' -Y BI UIL I =G 'I CT0R APPLICATION FOR PERMIT TO .... ....... . ..... `..... ....... ................... .P.... ......... ......................... TYPE OF CONSTRUCTION .t >,' _ .. ..A....`.. ......................... ...:.............19. . � TO THE INSPECTOR OF BUILDINGS: c The undersigned hereby applies for a permit according to the following information: Location ......h ...! ......';*X..... ........ . .............. . ............... .... .. Proposed Use .....�:�:` 4!.. ... i9�ai G�....:.�®. ..`....... .. ..... ....... w .:... .... ' ....... lZoning District .....,............ ..................... .... .. .:......... .:....Fire Distract ..... . ........ v . v�L sA/ Tlfc$'� Address �'O �o ......c��%i� .(p Name of Owner �!.`�.'...�....:...� � .PZ .................................. Name of Builder .Address .......... Name of Architect.................................... ... ..... ... Address :.. :. ... . ............. . Number of Rooms . .... :-Foundation Foundation ........ Exterior .................. :Q`' �... 'h% 9 4aS ......: .......Roofing ...............� .....................................�f) ` .......................... .......Interior tl r Gs��4 Floors .................�/!9ftYGt�®Da!. ................................ Y.. ..... .... g ............. }/ D iC ........... . o� /� B,�i Heating Plumbing fly �C.F t�5 5i�B ®O� Fireplace. <... ......................... .. . ..... ....... ...:....Approximate. Cost ........ ..../... p Definitive Plan Approved by Planning Board „_r ________ 19 Area oZ�. .. ?.......0 .. Diagram of Lot and Building with Dimensions ................ Fee SUBJECT TO APPROVAL OF BOARD O.F HEALTHG , - OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules'and Regulations of the Town of Barnstable regarding'the above construction. Name ... 4aG . . frf r.... .............. U oaa'6`S Construction Supervisor's .License :. ...._ .... DAVID BUILDING TRUST 2 7 5.4 q< One Story fNo .................... Permit-for..................................... �=�-Single Family Dwelling .......................................................................... Lot 13, 21 Fox Run Location .................................I.............................. Centerville .......................................:....................................... Owner ....6avid...Building Trust ......... ............... .................................. Type of Construction Fr .................................ame...... ............ ...................................................................... Plot ............................. Lot_..... ................................ : Permit Granted ......February 22,..........19 85 • Date of.Inspection* .................................:1.9 Date Completed ..... ..............19 4, 140 Assessor's map and lot number ..: 7' ?/v......... ... 6 i B E ropy Sewage Permit number Z 33AR39TADLE, i 9 NAG& House number ......... ... ....: ................................................. �e 0� �O 7 9• �0 aMAX, La QTOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION 'FOR PERMIT TO .....Si! �.... �''�'Lv 'ee's wc� ,.. .. ...... ............................................................... TYPE OF CONSTRUCTION t ti? .. '.....:. ..............19........ TO THE INSPECTOR OF BUILDINGS: The undersigned'hereby applies,for a permit accordinc to the following information: Location ..... ......... w..-...............�pn/.T.to.. .L .. '..............:...:................,........................................ ......... ........... .......... .. .. .. Proposed Use . ". .r' ......' i9��:<y... ��ai'ti,o .................................................. . ..... Zoning District a.::...... .....Fire District Name of Owner ... ) . Address ......�P�✓TF'w.L /yJ............. Name of Builder ................................................ ...................l.Address ........................................................................:........... r Nameof Architect ...................................:..... ................ ......Address .................................................................................... Number of Rooms .Foundation .... n � .���.....�©'��'� ........................................................:......... ............................................... Exterior O��/' ..`Silt vq!05 `. g .......ff ..................� 9 C.T `� '��. .........`.......... ............ ii .... .................. ..Roofin Floors `jAitf/Gc�OD /yt� 9 < < .... ........................................................................................Interior ..................................................:............................. Heating. ; 11/114 ?y OiCi .:/.. .��°' ... ....:...............:.....Plumbing Fireplace �'���� v 6.40 'k ........Approximate Cost ...�/a4iO4C .... Definitive Plan Approved by Planning Board -------------------_-----------19________. Area .....................::. Diagram of Lot and Building with Dimensions Fee ..... ..... ............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH s r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name rr.....................: . Construction Supervisor's License- ..O CPd DAVID BUILDING TRUST A--227-160 ZZ-7.-/6 0 ^ No _V548 ^ for .O[Q..�@WXY.----.. ............. . ................. Location ..................... . . ----.- ---------'^--. Owner -I)AVLd. .�rzo±------ ' Type of Construction ..Fzaoe----.-----. --------------------------. ' Plot ---'-----' Lot ................................ ' ' ' ! Permit Granted . 32^_---lg 85 ' Dote of Inspection ------------lV � Dote Completed ------------..lg � \/ � Y . ' . ' ` ^ ^ ' ' ` ' ` s D. 2r` k c 70 � It . M r �� _ ►� �, i RICHARD . to A: : No.24046 O L GISTS r'� e: ;,; C6�Z`I'IF�EU j�l_b`C" tit-.•��1 LOCIaTIOIJ cn� %Ab I CMZZTII=1f T}4A-r Ti-1r-- A R��EIZE►�IGE NEQEo�3 GorVLPI.�(S W►TN TtaE Slv�.�.11-1� ��'-- � ... A>\lt� St `r'$1�C�G KEQVitZEM�I.I�'S b[; TNT �-�/ � 3Zf,.� �G• 73 TdWU of •LoG ATE t> W I TI-1! ,4 ` UL- �=LoOD FLAW t•AWv SuevGYoz THIS VLAW 1$ LJOT E5AeE--'D OW AW OSTEZVlLLG o ASS, II.1S17LtJ EtJT SUcZVc%? ¢ Ti4E= oFG•,Sr--T'S 5i.10 uLr-> APPLI G/S."7"; i c' Kt,7 BC- u5I'rc> Ta DerGPMtuc LO:'V t_IWa5' Engineering Dept. (3rd,floor) Map moo?7 Parcel �G'D Permit# �p. House#« c_ /' Date4ssued q tt Board of Health(3rd floor)(8:15 -9:30/,1:00-4:30) 30-9:30/1:00 2:00) 1 Admin. Bldg.) 19 n����,ti�. .!? ABLE. l r 4 TOWN OYBARNSTABLE. i' Building Permit Application Projec treet Address Village C E r•a'C!L v'► 1\E - p t r Ap Owner k Cu_3 L 7, L-e Li G C.k i Z,c Address 2-1 Fa 2 V i1, C�n..ttC,r vi l ll ~ Telephone Permit Request A-00 ' -ouvy . 1"O r F:--:i ri i S�e�1 First Floor square feet Second Floor square feet Construction Type (:y ov a Estimated Project Cost $ 1-1 q,CPI, Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family 2-' Two Family ❑ Multi-Family(#units) Age of Existing Structure 1 1 Lj CS Historic House ❑Yes p No On Old King's Highway ❑Yes ❑No Basement Type: 8-full ❑Crawl Q Walkout ❑Other - Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing 2- New I Half: Existing New No. of Bedrooms: Existing _ �� New Total Room Count(not including baths): Existing ( New 7 First Floor Room Count 3 Heat Type and Fuel: ❑Gas a6il ❑Electric ❑Other Central Air ❑Yes E'&lo Fireplaces: Existing 1 New 0 Existing wood/coal stove ❑Yes No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) LO �Z%--1 ❑Barn(size) ❑None p Shed(size) - Q Other(size) Zoning Board of Appeals Authorization p Appeal# Recorded❑ Commercial ❑Yes IfNo If yes, site plan review# - Current Use S.^ot4 w.', 41 wt t t i nCi Proposed Use k(I n g Builder Information Name►0 m -rbo I d.6.A. 'Ut S-ASk- �PP-64L)s*rS Telephone Number 300-l.1 Address q aper\ SabassTt Loo,. License# OS IslCt�o Sc��l��c Yln�, • 0"Q;-3 Home Improvement Contractor# 10'9 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 SIGNATURE ��n� `�-- �� DATE �2z �C�-? B FOLLOWING REASON(S) • FOR OFFICIAL USE ONLY ~� _ "•�'•. _ P ' f 7 + , ` ' -_ .. , ` - � ''+fin. PERMIT NO. DATE ISSUED w - w , MAP/•PARCEL NO. ADDRESS ��. ;`, VILLAGE OWNER' �, ,: ,. , •£ ;� � s ;f ._ � � � • � z» ` DATE OF INSPECTION:, i •. , t - - ; _ ; FOUNDATION FRAME INSULATION , .. ', F , _ •• l _ c _ FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: a 'ROUGH FINAL _ cl GAS: �^ �► ROUGH FINAL FINAL BUILDi&G DATE CLOSED OUT. , ASSOCIATION PLANjN F F s F The Commonwealth of 1fassachuscnt Drpnritn nt'Of Industrial Accidents l \ ;': -- r `'' 600 N'ashitr,tuir Street Bostutr. Mass. 02111 Workers' Compensation Insurance Affidavit i li :irit iriforrnation• �� Please PRINT - i�lV �. name: _Oy,�O m w.S To go i t.1 de�e�.� •C�r a,s a,JTtW SCW_Ck f► S location:0l Sin r1 S-Qb4ST�Avg 1�•1,A. CM, hone# .20s) i?"81R— m3 1 am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity l • . :.-..,. <:L'•---•P-•.........__,.-..--."n......-� f.zr--....+r.=rn+.,•+'��...,..,.,...•-+was-a+.........�.,...�,. ....r-- '3'+'.,.........— ....,..----•----•..:. - - .,..........c..,�;..:,..—...�,..- ..�.csi... am an emplover providin: workers' compensation for my emplovees working on this job. cooma v name: �tS�rSrt C SP Q-�s�''L-i'STS a(Idress: q �IA-r� �.2�i4ST�A.11 L�?�•• . city: rJ�9��rJ y ic� nhnne#• So$) 8 ;R-8 �ll l-3 insurance co._ poliev# 1 am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: comnam' name: address: cih•: ohone#- insurance ro. Policv# 1 •1.::"-..,�=,..._. - �•�Y•....:..� __ -- -�r^":�::�.�.�' �T"S.!7ww_s .-TR..._ _ ...a•�u...�,.,..._..._ cmmvanv name: address: city Phone#- insurance co. noiicv# Attach additional sheet if peel sary _=, -��' Yam " :1,.�M•1 +"" 7 ' -=• - '';..'....rati�� ,- ..,�.fir= _�..,_.�. .�� ya'ur?.r��ir•e.�:::::•s. F.Iilurc It')secure coverage as required under Section 25A of n1GL 152 can lead to the imposition of criminal penalties of a tine up to 51.500.00 andior one y cars' imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of SI00.00 a day against me. I understand that a cope of this statement mai be forwarded to the OMcc of Investigations of the DIA for coverage verification. I do herebt•ccniftltttttler the pains and penallies of perfurr that the information provided above is true and correct. Signature �'�W � Ju y�7 Date g —_2Z(�_7 Print name' 7"t-k-D S P 1061 NJ Phone#SSDA?) 8 official use only do not write in this area to be completed by city or town official city or town: permit/license# r'tlluitding Department i 0Licensing Hoard rl check if immediate response is required 0Sclectmen's Office _ 011c21th Department contact person: phone#: r JOthcr riw Information and Instructions • fat� i3'� p4 i.,�.✓,;5.'.t `. ,; � .,•. ',.. _ Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers comp' far the: employees. As quoted from the "law". an el?Ohwee is defined as every person in the service of another-under an' contract of hire, express or implied. oral or wrineii An emp.1(trer is defined as mi individual, partnership;association, corporation or other legal entity, or any two or more 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 havinn 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, 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 ever•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 an,% applicant who leas not produced acceptable evidence of compliance with the insurance coverage required. Additionallv, 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 ll� been presented to the contracting authority. t �. �-.w..�.-_.. ..�... �:. .. .�--fit:�. ���. ,. ..p.... ••�.� .v ..;y��j•r•._;s.. la� .'..'• r!'!;.:. _ • 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. Pie-- 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. The 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. - - - •.. 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 #: (617) 727-7749 phone #: (617) 7274900 ext. 406, 409 or 375 M WE T The Town of Barnstable 059. �e� Department of Health Safety and Environmental Services ' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Eor 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 owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: ►'-L*%%o&LL Est.Cost Address of Work• 2 �o,e 2y� C��z�-+'v ►� Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: z - Date Contractor Name Registration No. OR Date Owner's Name } y 4 ' � ✓rie TDam�raaozurea�,f o��/UGa��ac�iccael�s tt i i DEPARTMENT OF PUBLIC SAFETY r: CONSTRUCTION SUPERVISOR LICENSE Number: Expires: Restricted 4o: 00 Giro, THOMAS P TOBIN 41 BRENTWOOD CIRCLE PLYHOUTH, NA 02360 .r � ��-��`;S.��c� ✓Ae TOa9 ^Jsi7/Gfw�eal�c�✓NOddOde<WeQd-^ � V'�i?I.•#'>�Ye NOMEPROVEMENi-_CONTRACTOR . M Registration :i. 8642 . f �k-, r, DB ' xEzpiAAration08/20/98 4 ; MNIM Aug " vo AISASTER-SPE'Cl ALIST .Thomas Pw W480 ! 6 9 Jan Sebastian Ya t•�� - 'ADMINISiAA MR' f{ SandwiCh MA 02563 . L i DISASTER SPECIALISTS 9 Jan Sebastian Way P.O. Box 480 Sandwich, MA 02563 800-675-3622 Fax: 508-888-2951 08/21/97 Client: Paul & Leslie Chizek Res. Ph: (508)775-7604 Address: 21 Fox Run Centerville, MA 02632 Estimator: Tom Tobin Bus. Ph: (508)888-1113 Ext: 13 Estimate: CHIZEK File Number: 35797 - CONSTRUCTION I f DISASTER SPECIALISTS Paul & Leslie Chizek 08/21/97 Page:2 CONSTRUCTION SERVICE Room: Basement Rec Room LxWxH: 2710" x 1410" ,x 716" Subroom 1: Offset LxWxH: 810" x 510" x 716" Subroom 2: Stairwell Closet LxWxH: 810" x 310" x 516" Subroom 3: Closet LxWxH: 316" x 216" x 716" 2" x 4" lumber - frame in dropped ceiling 308 LF Blueboard & plaster - texture finish - the ceiling 451 SF Stud wall - 2" x 4" x 7.6' - 16" oc - interior partitions 73 LF Batt insulation - 3.5" - exterior wall perimeter 240 SF Blueboard & plaster - the walls 945 SF Door opening trim ( jamb & casing) - slider door 1 EA Window trim - stain grade ( jamb & casing) - double window 19 LF Window trim - stain grade ( jamb & casing) - small window 10 LF Closet package (shelf, rod, jamb and casing) 3.5 LF Baseboard - 3 1/4" stain grade 70 LF Carpet pad 59 SY_ Carpet - (material and labor) - average grade 59 SY Room: Basement Kitchenette Cabinetry - upper (wall) units - material & labor 11 LF Cabinetry - lower (base) units - material & labor 11 LF Countertop - flat laid laminate 11.5 LF Room: Basement Bathroom LxWxH. 101 6" "x 8 0 x 71 6" 2" x 4" lumber - frame in dropped ceiling 70 LF Blueboard & plaster - texture finish - the ceiling 84 SF Stud wall - 2" x 4" x 7.6' - 16" oc - interior partitions 30 LF Blueboard & plaster - the walls 278 SF Medicine cabinet - material & labor 2 EA Vanity 3 LF Countertop - flat laid laminate 3 LF Baseboard - 3 1/4" stain grade 30 LF Floor preparation for sheet goods 84 SF Vinyl floor covering (sheet goods) 11 SY i DISASTER SPECIALISTS Paul & Leslie Chizek Pa 08 21 97 e:-3 / / 9 Continued - Basement Bathroom Room: Basement Office LxWxH: 1510" x 1210" x 716" Subroom 1: Closet LxWxH: 1016" x 510" x 716" 2" x 4" lumber - frame in dropped ceiling 215 LF Blueboard & plaster - texture finish - the ceiling 233 SF Stud wall - 2" x 4" x 7.6' - 16" oc - interior partitions 42 LF Batt insulation - 3.5" - exterior wall perimeter 200 SF Blueboard & plaster - the walls 638 SF Window trim - stain grade ( jamb & casing) - double window 57 LF Closet package (shelf, rod, jamb and casing) 16 LF Baseboard - 3 1/4" stain grade 79 LF Carpet pad 30 SY Carpet - (material and labor) - average grade 30 SY Room: Stairwell Up LxWxH: 910" x 313" x 716" Blueboard & plaster - part of the walls - unfinished area 92 SF Carpet pad 9 SY Carpet - (material and labor) - average grade 9 SY Step charge for carpet installation 11 EA Room: Basement Hall LxWxH: 719" x 410" x 716" 2" x 4" lumber - frame in dropped ceiling 65 LF Blueboard & plaster - texture finish - the ceiling 31 SF Blueboard & plaster - the walls - finished room side only 80 SF Baseboard - 3 1/4" stain grade - sheetrock wall only 7 LF Carpet pad 4 SY Carpet - (material and labor) - average grade 4 SY f DISASTER SPECIALISTS Paul & Leslie Chizek 08/21/97 Page:4 Room: Basement Utility LxWxH: 1310" x 910" x 8'0" Framing repair - frame in door opening 1 EA Room: GENERAL CATAGORY Dump & trucking fee - haul deris generated from construction 1 EA Grand Total , $17,909.53 Tom Tobin Estimator September 8, 1997 Tom Perry, Building Inspector Barnstable Building Department Town Hall South Street Hyannis , Ma 02601 RE: Chizek Property 21 Fox Run Centerville, Ma Dear Mr Perry: The renovation of the basement at the above referenced property is for the private use of our family only. Please feel free to contact either Leslie or myself with any questions at our home 775-7604 or my office 790-3375 . Sinc ly Paul and Leslie Chizek 08-21-1997 12:84P11 110nEY I14SURgNCE g5ENCY 1 508 945 9358 P.01 DISASSI CV 08/21/97 POLICY: 1660259X9544TZA PCKG * M E M 0 Town of Barnstable Building Inspectiors Office Attn: Louise Via FAX: 508-790-6230, Louise Re: Disaster"Speci'alists Enclosed is a certificate of insurance on the above-.referenced customer which you have requested. Please review this certificate. If you have auy questions, or if we can be of further assistance, please let us know.. MARK T. VOKEY INSURANCE AGENCY 508-945-9368 Craig S. Vokey 21.9-21-1997 12 t 05P[l I NSi RRNCF- RGENCY 1 503 345 9369 P.0-2 S � L49USDAT'E OAM/D /YYy AA ,.:. AC� � � 08121197 PRODUCER :r. THIS CERTIFICATE IS ISSIUED AS A MATTER OF INFORMATION ONLY AND Mark T. Cokay Insurance Agency CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE crazy S. vokey DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE, P.o. Box 1247 POLICIES BELOW. goat Chatham, MA COMPANIES AFFORDING COVERAGE 02669-1247 Craig S. vokay .... ..... 508-945-3535 COMPAA'Y LEI7ER TraveioL's Zndamnity/Antes C&S : .................................. _. .................................._.................. .. ..... .. ...... COMPAINY LE'iT6R INSURED Benabby, Inc, dba COMPANY C Disaster Specialists LETTER P.O. Box 460 sandwich, MA <,OAipANY 0256 3 LF ITT1t CONIPANY Fs L6ITER TI,IIS IS TO CERTIFY TILAT 7RE POUCIES OF IN.CIRANC&-,1STED BELOW HAVI.B . . . , • l>:N ISSURD TO THE INSURED NAMED Al30vE FOII TII&POIaCY PERIOD INDICATED,NOTWITHSTANDING ANY REQVIRrE NIP:NT,TERN:OR CON71)MON OF ANY CONTRACTOR OTHER DOCUMF4NT W%'I'II RESPECT TO WHICH THIS CERTIFICATE MAY BF ISSUED OR NIAY FLiRTAIN,THE INSURANCE AFFORM)BY THE POLICIES DESCRIBED HIM N IS SUBJECT TO ALL THE TERNS. EXCLUSIONS AND CONDMONS OF SUCH P01,ICIES.LIPIICS SHOWN'MAY HAVI?BRF-M REDUCED BY PAID CLAIMS. Cam..... :PGLICY EFFECTIVE,POLICY EXPIRATIOI LTR TYP80FINSI.OL4iVCS : pOL3C!°NUMPEIt DATS(MMIDD+YY) . DATE(MM/DDTY) : .LIMITS CANRRALLIABILITY GENERAL AGGREGATE 'S ,ti,.000,000 a R :COMMERCIAL GENERAL I..iAPZ.PI•Y I660259X9544,TI.S 03/21/97 03/31/98 'PROiJUCTS.C'OMP(OPACC. ;$ 2,000,000 ............ ._.........................._............. CLAIMS MADE; X OCCUR. PERSONALS ADV.INJURY a 1.000.000 OWNRR'S&CONTRACTOR'S PROT. :EACH OCCURRENCE $ 10000,000 . iFIRE DANIA613 WW an On) 3 50:000 .. : MLD,EXPENSE(Any vmmi i 3 5,000 AUTOMOBILS LIADUAI 1' COM8IYFD SINGLE ANY AUTO umrr 3 3 ........ .. ... ... `• ALL OWNED A`JT03 BODD..Y INJURY ......: SCH£OULEDAUTOS :(p:rpenml _.................................................. .. _...... : HIRM AUTOS BODILY INJURY 'NON-OWNED ALTOS {peTawldmn) $ GARAG13"LLITY PROPERTY DAMAGE S EXCESS LIABILITY FACH OCCURRYNCE ; ....... UMBRSLL4FORM :AGGREGATE :3 - OTHER THAN UMRRELLA i7ORhi A WORKER'$COMPENSATION Y9U8185YC73D:97 - 03/31/97 (te JO±./59 STA7SlTORY LiM1TS s . EACH ACCIDENT :3 : AND 100,000 DISBAST.-POL0.^Y LO,W $ 500,000 EMPLOYERS'LIABILITY ................................................... ............ DISF.A4F..-F,AVR RMPI,OWT 3100,000 UESCitIW1YONOP 0 F A IONS/LOCATIONSINEIIICLE$isrg(,iAL unis P.R T Property Restoration CI FTGAT _ILOI I)ER ;C 1C13YIgXT[Q N... . ........ ...........x . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BF.FOORE THE ExpimTION DATE THEREOF.THE ISSUING COMPANY WILL ENDEAVOR TO Town of Barnstable MAIf. 12 DAYS WM-M-..'I NU',IICE TO-IME I,r;RTII'ICATE IIOL DER N,'uMED TO THE building Inapector Attn: Louise LEFT,BUT FAILURE TO 1LAIL SUCH NOTICE SHALL IMPOSE NO 0OUGA71ON OR 367 Main Street UkOlUTY OF AN KND UPON THE COMPANY, ANENT$ORAX-P9wENTA11VEs. Hyannis MA 02601 :AUTIWRTLE D REPRESENTATIVE i,Czaiy S vckey , �rvc1. I5.s.ff9v► aco 1490 TDTAL P.S2 Mx ate, f1_c>Lcrs. . i w � � W,_.,�..- - :-- -._._.,. _ -- _ _ Q- --o•.S 1� kPr�a�4- �v�. p l.e..ms.sz._ C..��n S ._ ca ! - 2 1 FOX. 1r v+rl CQ.�ea2�d 11�2. r' -77 Y T ry _ i r r `,�...- .� -_...�...,' �i----- f• '.""�-i�:"I�.'F_ 15� 27� 6° SLIDER rnCD TO UTILITY ROOM 9 146 OFFICE - REC ROOM 124 _ a 2g 28 �',� 49 CLST 28 X6g -26 CLST j ,09 O a I . CLST 2y UNDER UNFINISHED AREA STWL UP STORAGE 6° 5 H 1N R a O 30 0 --- (U N FI NI SHED) 3oX66 Z;�c6 50 40 173 140 _.. 8" me wavo woo PAUL # LESLIE CHI?EK ,r , L R I C FOX RUN — 2 1 NT LE E . E V Tom Tobin BASEMENT PLAN Disaster Specialists S C A LE 1\4 =.1 Box 480,Sandwich, MA 02563 Tel:(508)888-1113•Fax:(508)888-2951 Mass.Area 1-800-675-3622 OF ✓✓/ €/ �A +2 Z �. 1-4 F CIVIL , iv r _ 22,0 XF 30 / c -41 r • y.�•,� �G , h., aUAT.•4 • 31 : G./C� 0.. 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