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HomeMy WebLinkAbout0060 LUMBERT MILL ROAD �op .cc.nnb o ° a ov • g p y TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 6 2 Parcel_ 10`f Application # 17 Health Division Date Issued LIZY Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project S et Address Village Owner G® eWt,/ IK" 41 Address Telephone -174`' Permit Request � b � Il AIKY Square feet:,1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Aonstruction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family -3/ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old KinI ighway� Yes ❑ No ":77; t ;,T.-I :. Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq*) Number of Baths: Full: existing new Half: existing ne\Wr: ?1 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 wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) �l Name U Telephone Number v Z Address License # Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULT G FROM THIS PROJ TWILL BE TAKEN TO A&V" r%k, Aux SIGNATURE DATE1-1/ d7 I FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE e OWNER � r DATE OF INSPECTION: FOUNDATION - FRAME F r INSULATION FIREPLACE f ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DBE?CLOSED OUT ASSCCATION PLAN NO. I . n e Massachusetts Department.of Public Safety ..:boardp of Building Regulations and Standards Construction SuperNIS01, License: CS-100.988.. ter:i i ti r�r - HENRY E CASSID ' 8 SHED ROW WEST YARMOUTTHq-'J3 Expiration Commissioner 11/11/2015 mom 7 x = Office of Consumer Affairs,and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 ' Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2016 Tr# 259188 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE SO. YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. sCA 1 d9 20M•05nt Address Renewal Employment Lost Card ° V/2e W0��9Lr72o42CueCrLt�[i�C�/��CrJJac�udeC�J - C-\ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 153567 Type: office of Consumer Affairs and Business Regulation xpiration ::.1,2115/2..01.6 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSULATION HENRY CASSIDY 18 REARDON CIRCLE".. SO.YARMOUTH, MA 02664 Undersecretar - y N valid wi ut sign e N The Commonwealth of Massachusetts Department of Industrial Accidents W Office of Investigations W a 1 Congress Street, Suite 100 Boston,MA 02114-2017' www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Or z'zation/Individual): L!i 0 V L,Address: 0 V QtA, City/State/Zip:IA U-6y M1 N Phone#; Are you an employer? Check h 4.e appropriate box: general contractor and I Type of project(required): 1.�'I am a employer with 'Z ❑ I am a g * have hired the sub-contractors 6. ❑ New construction employees (full and/or part-time). ., 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' [No workers_' comp, insurance comp. insurance. # � 9. Building addition required.] -5. 0 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`afdavit 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,j.ic. 02 460 0 Expiration Date, . Job Site Address: � City/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 insurance coverage verification. I do hereby certify n r pains and penalties of perjury that the information provided abov is tru and correct. Si nature: Date: 1-cp Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit)License # Isuing Authority(circle one): s 1.Board of Health 2, Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: y CAPECOD-27 KLIGETT CERTIFICATE OF LIABILITY INSURANCEDATE /YY 6/13/2014 THIS CERTIFICATE 1S 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), RODUCER CONTACT ogers&Gray Insurance Agency,Inc. 'PHONE Barbara DeLawrence I4 Rte 134 /c o AIX No (877) 816-2156 , uuth Dennis:MA 02660 A DRIESS: bdelawrence@rogersgray.com INSURERS AFFORDING COVERAGE NAIC N INSURER A:Peerless Insurance Company suR�D INSURERB:COMMERCE INSURANCE COMPANY Cape Cod Insulation Inc t INSURER C;Evanston Insurance Company 18 Reardon Circle South Yarmouth,MA 02664 INSURERD:ATLANTIC CHARTER INSURANCE GROUP . INSURER E + INSURER F; 0 ERAGES CERTIFICATE NUMBER: REVISION NUMBER: T IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD IN ACATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH.THIS C RTIFICATE 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. R TYPE OF INSURANCE A POLICY NUMBER MM/LDD�F Y MMIDD E YY LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE I OCCUR CBP8263063 EACH OCCURRENCE $, 1,000,000 I 04/0112014 04/01/2015 PREMISES Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 If' PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY❑ PRO- GENERAL AGGREGATE $ 2,000,00 X JECT aLOC OTHER: PRODUCTS-COMP/OP AGG $ 2,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acc OWNED ident $ .1,000,000 ANY AUTO 14MMBCKVMK 04/01/2014 04/01/2015 BODILYINJURY(Perperson) $ ALL OW X SCHEDULED ". AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED AUTOS PROPERTY DAMAGE $ Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE XONJ463514 04/01/2014 04/01/2015 AGGREGATE $ DED X I RETENTION 10r000 Aggregate $ 1,000,000 ORKERSCOMPENSATION PER OTH• ND EMPLOYERS'LIABILITY STATUTE ER NY PROPRIETOR/PARTNER/EXECUTIVE YIN WCA00525904 06/30/2014 06/30/2015 FFICER/MEMBER EXCLUDED? a NIA E.L.EACH ACCIDENT $ 110001000 Mandatory In NH) f Mandatory describe under E.L.DISEASE-EA EMPLOYEE $ 1,000,000 ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 SCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) rkers Compensation Includes Officers or Proprietors, iitional Insured status is provided under the General.Liability and Auto Liability when required by written contract or agreement with the..Certificate Holder, iR IFICATE HOLDER CANCELLATION ' k 1 �toe�or� b PAMMAnxs mass save ow";.p Snvnmr fNarOn ortvrtiY aNfcloncv PERMIT AUTHORIZATION FORM , owner of the property located at: (Owner's Name, prin d) (Property StreetAddress) City/Town) 3- hereby authorize the Mass Save Home Energy Services Program..assigned Participating Contractor listed below to act on my behalf and obtain a buildingi permit to perform insulation and/or weatherization work on my property. Mfiir's,Signature Date FOR CSG OFFICE USE ONLY' Conservation Services Group has assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: CAPE co 6 Participating Contractor ate Rev.12132011 1 r , :CAPE COD INSULATION - 'r IIYYArT4 >tAMIISY INSU"GAM SUYFYN04 •• IARY uVRf YS INYu+ASIQN CSIIINVi •• - ' 1-800-696-6611 l,own of Ba-rastable .A Regulatory Services Building Division 200 Main St Hyannis, MA 02601 Date: Dear Building Inspector Please accept this Affidavit as documentation'that.Cape Cod Ins, lation, Inc. performed & completed the insulation and weatherization work at the property listed below: Cape Cod Insulation did this in accordance to the specifications listed on the building perglit application. All \work has been inspected by a certified Building Performaalee Institute (13P•1) inspector, All work preformed meets or exceeds Federal & State Requirements. ProPerty Owner Property.Address ::; Vil la e Sus . 1746M Ce4o�itv,uo, Insulation Installed: .Fiberglass °Cellulose. R-Value . Restricted Ui-Lestricted, Ceilings. Slopes floors Walls Sitice�•ely ' . •r. - . ... - • / �. `' .. .try t • if T ` . t 's. "He ry L.Cas. y Jr, President (_' e Cod :I ulation, Inc, r y\th4l a. V ` � l r ' G,aZTlFtap PL6-r T"A`r Tides pt:,.,�,tl R���2E►.3CE: AWt> SSE- AC14 WGQU'6ZSAA&ITS OP T ►i Z©u�ka 0;:* " A rk" ?L AO .. loq P6, S � 't 4-t t C�t_A�•.t i 5 t.1 t�T t��.�iEv Ut.� Aay1 U'�TEfLV►t,�,l.� © iltt�45'�• tt4St(2uME=-t,4T �,vs�v Y TUt; pFCS�t`� gtk�e�w APP'�.tCAt.1T t�kST" iBE USCca To Lo-r l.,.l wia,5 <"' V •,, ~` t � SEPTIC SYSTEM MUST BE ssees*s map and lot''number. ......................... O� ,/l - INSTALLED IN COMPLIANCE �- 7 WITH ARTICLE AND II STATE Sewage ,Permit number ................................. :......'........:.'..•.... ....... RE sAivIrARY CODE TOWN cuLATIo c y. TOWN OF 'BARNSTAB LE THE r0� is Z 9AHHSTADLE ULL I ': INSPECTOR tv �p i6}q. �g0 x 4 APPLICATION.FOR.PERMIT TO .. /�/! '� ::•:•• ......................... TYPEOF CONSTRUCTION ....................' .....................::............................................:........................................... `-w:�.... .....:........1,9.. � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 1 Location ........... . yJz C? !l.:....... . ..... ....... ...(..4r.G ......... ......... .... ....... ........... ............................... .Proposed Use ..................................... ................................................................................ Zoning District ....... ..... ....................Fire District ..................................................................... r Name of Owner .. ... . ..... dress ..... ............ .. � •. • �a Name of Builder ... ... • •••••• Name of Architect ..% . . . ....C%444 ...Address ....... .. ..... .... ( o Number of Rooms ..................... 4J�� c-o Foundation 1/. `.`�. .............................. .......... ............................. . . Exlerior .... . . ...... ................................Roofing ......... . ..2. .�1.�....,,:...!..i .. ............ Floors �'1-��' ..............Interior ...... .. :. .................... Heating %/.. �?�........ .. . ...... %Lu .........._....Plumbing ..� .Y... C,,�a- -...1 � Fireplace . ll,( ........................................................Approximate Cost ..:. j...... ................ hh � Definitive Plan Approved by_Planning Board ____________________;___=___---19-------- . Area Diagram of Lot and Building with Dimensions Fee 7,5................... . SUBJECT TO APPROVAL OF BOARD OF HEALTH OOK I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .(.'�/'� FY4. s, ...... Spilewski, Mr. & Mrs. Frank t T µ 20208 one story Permit for ;- t k ,'' : ..single family duelling ............. ......................................... r ' .w 60 Lumbert Mill Road 4"`"" F Location ................................................................ 4 L ^ Centerville Owner .......Mr.. & Mrs. Frank Spilewski r Type of Construction •frame - Y . .... t J ........... .................................................... ... ,. .. Plot ....................... Lot ..........#12............... Permit Granted May 15 19 78 Date of Inspection ...... .�. Date Completed V..i f..........19 r ' �7 .............. s t �.� 19 PERMIT REFUSED - ...................... ..................................... 19 ................. .. .�.......................................... r .... A4 ...... //�=........ '.. . • .......................... ... ...................../. ...) ,. T . a . r Approved ...........................................:.... 19 ............/.��................................................................... i l..0 ........................................................... 1� .�"� - ''.` .: - .�-��'�,.r"^- - R,•�:•.„i•'— .. .Y -2.,.f`y, +st„w�+.+►T �r �rw7.-.«,l �,- ,4 w. �..a4•..:n...,. � r wet+.: :aria:..-+�+..�'-.y,�..�•,.: LJO Assessor's map and lot number ........ ? r Sewage Permit number ....................:..................................... TOWN OF BARNSTABLE �O*1HE t0 Z BAWST"LE, i BUILDING INSPECTOR pNPYp' k. APPLICATION FOR PERMITjo .......... ......:............ ...... .............................................................................. rTYPE OF CONSTRUCTION .................! ..i!..... ................................................................................................ t� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: / 6; ) Location ........... .. ........ ... ..... ...... �........... . ... . ........................................................ ProposedUse ... -............................................................................................................................... L�!K: .........................Fire District .............. Zoning District .... .. : ................................................................ Name of Owner . .:.Address ..CL) . ... .. ,. .. .. . ...(.k4.. Name of Builder ..�.. ................Address ��� . . .. Name of Architect ... .. . .. ..G � ^.................Address �la...�....... ...A.- Number of Rooms .. ...� .-..c�.../SJ. ............Foundation ..!(�uY� Exterior ... .... ...... Roofing ..... A ............. Floors .Interior ... ... .....'...Plumbing ..........: ... .... Heating . � .. .. .. .... ............................. .... . ........... .............. r, Fireplace .. ........................................................Approximate Cost /..� ............................................. Definitive Plan Approved by Planning Board ----------------------_---------19________. Area ....�...I{...�I. .................. Diagram of Lot and Building with Dimensions Fee ' .......................... SUBJECT TO APPROVAL OF BOARD OF, HEALTH � � G 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ) �' .. '................... Spilewski, Mr. & Mrs. Frank A=168-104 2020s one story No ................. Permit for ..................... .............. single family dwelling ................................................................ ......... .... - 60 Lumbert Mill Rod Location ................................................... ... ........ - Centerville ............................................................................... Mr. & Mrs., Frank Spilewski Owner .................................................................. f _ Type of Construction ...... rame,.. . ........................................................ .........:............. Plot #12 Lot ......................... y 15 78 Permit Granted ........................................19 I Date of Inspection ....................................19 Date Completed ...... .........................19 PERMIT REFUSED ............................................... ........... 19 ............. ...... ../. .. ............ .. .. .. ...... ......... ...................... ..... ./..... .{. . • ....................... Approved ................................................ 19 ............................................................................... I ............................................................................... t . TOWN OF BARNSTABLE 20208 a Permit No. I »n m Building Inspector cash $428.d0 17q NYL w eyo. KAI�'` OCCUPANCY PERMIT Bond No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed,'or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Mr: & Mrs; Frank Spilews i Address lot #12 60 Lumbert Mill Road, Centerville Wiring Inspector -- ' Inspection date ` Plumbing Inspector li Inspection date Chas Inspector v t Inspection date Engineering Departmentf Inspection date 9� t i��✓lO�i'/ r av THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE -.00CUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. 7 19_.77 ..................._..... _ ...._..._, � . . ....................Ouilding...Inspector J