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Home My WebLink About0545 LUMBERT MILL ROAD .: .. ,� � � /��i/l . , . . z� i a .. � .. ., a >. .. �� - � - - i7 .. _ _ V ., '' - ., a.. ., - �. - „ ,� .. .. .� .-� _ �`f � - � '- F .. ,� .. Dr6n4P� {m - OCT 9 2DD7 Town of Barnstable *f'crrnitfl ` ��1 LVI ires G moijilrs from issue dare 1tARN3rADtE � ;regulatory Services lieu MASS E r a .4a,D a L= �' 1 39. �e Thomas F.Gcilcr, Director Building Division Divi bk i�n�30/0-7 TOM Perry,C130, Building Commissioner 2.00 Main Street, Hyannis, MA 02601 www.town.barnstablc.ma.us Office: 5M-862-4038 F Lx: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL, ONLY Not Valid tpithout lied X-Press lmprin!. Map/parcel Number rl Property Address '-t II V m �r� �l i 11 /� �.Pi1`�-Pr l! 0a,to _�gResidcntial Value of Work Minimum fee of$25.00 for work wider$6000.00 Owner's Name&Address /l/ f (' S vm� r� lei 1� �(it1 ( �QYI rlyfr ��1� ��b3 � Contractor's Natne PC j Ld" 7- 2 (' .4—�• Telephone Number Y -7 Home Improvement Contractor License 1R(if applicable) 103 7 % Construe �Lion Supervisor's License fF(if applicable) Q A& 3 � tworkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner. �. I have Worker's Compensation Insurance - Insurance Company Name Workman's Comp.Policy Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All ponstruction debris will betaken to O ` ❑Rc-roof(not stripping. Going over existing layers of rooO ❑ Re-side ❑ Replacement Windows. U-Value {, (mi ximum.44). 'Where rc uired: issuance oPthis rmit does not exempt compliance with o 9 ther town department regulations ix'.historic;Conservation,eta ***Note: Property Owner must sign Property Owlier Letter of Permission. Honic Improvement Contractors License is required. SIGNATURE: (/4 Q:rorms:oxpmtrg U. Revisc071405 i s The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information - (� Please Print Lettibly Name(Business/Organization/Individual): Pa 1) �ll Z P[�1) �' '�`Q�n o--f n a T w C Address: Q 3\ `m(7,1 t'1 -- ` City/State/Zip:__Q S c65 Phone#: 90 S y ZS Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 1 Z 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New.construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' o workers'com comp.insurance.x 9 ❑Building addition [N comp. P• 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 I L Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL insurance required.]t c. 152,§1(4),and we have no 12.E55Roof repairs employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their worker'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-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: r P,.\f eAe r', —E IJ S Policy#or Self-ins.Lic.M f V e)0((DC,�j Q> �Q y /�0 Expiration Date: J�. O 6 Job Site Address: `i� �u rn bey--r- r �) `�� City/State/Zip:��d'�Ul 1 f{ 6A(03 Q--- 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 eerti under the pains and penald f perjury that the information provided above is true and correct Si ature: Date: Phone#: CO '3 1 OJ1icW 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 The Commonwealth of AYlassachusetts _NWIN __ V Department of Industrial Accidents i -^, ONCE 01/AVes##2Lf00s �� qg 600 Wasitinaton Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit _ l name: location: ciry phone 7 I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. company name: addre-"• cam• phone T: inen�wneY rn 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 name: address: - city- phone 4: insunnmcoi pommy# company name: - addres:r city- phone#• irs�itiaAtc tp policy# Failure to secure coverage as required under Section 25A of AIGL 152 can lead to the imposition of criminal penalties of a fine up to 51.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA.for coverage verification. 1 do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone 7 Cffsenly do not write in this area to be completed by city or town official permiUlicense# n Building DepartmentC]Licensing Boardmmediate response is required C]Sefectmen's OfficeHealth Department on• phone#; f—IOther (rmsed 3/95 P1A) 10/26/2007 06: 59 15082730200 PAQUETTE ASSOCIATES PAGE 01 Property Owner Must Complete & Sign This Form If Using a Roofer / Builder, n rp,,Ra�� V 1..D as Owner / Agent of the subject property hereby authorizes Paul J. Cazeault,&ems,Roofing inc. to act on my behalf, in all matters relative to work authorized by this building permit application for: Address of JobhA Signature of Owner -,(. Mailing Address of Owner relephone# B-- Z 097 , Date (Please return this form to Cazeault roofing along with your signed contract; it is needed for us to obtain the building permit required by your town, to complete your roofing project,thank you)fax#808 420-4555 r Page, 003• .103 RightFax H1-2 8/24/,2007 1 :21:48 PM PAGE 003/003 FaX server ACORD. CERTIFICATE OF INSURANCE PRODUCER DATE(MM100%YY) 08-24.07 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION DOWLING&O'NML INS AGC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 973 IYANNOUGH ROAD 2ND FL HOLDER. TH13 CERTIFICATE DOES NOT AMEND,EXTEND OR PO BOX ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. HYANMS, COMPANIES AFFORDING COVERAGE MA 02601 M 22LGR COMPANY A TRAVELERS DIRECT ASSIGNMENT INSURED COMPANY PAUL J CAZEAULT&SONS INC. B 1031 MAIN STREET COMPANY OSTER'VILLE,MA 02655 C COMPANY D , COVERAGE THIS IS TO CERTIFY THAT THE POLtC1E3 OF INSURANCE USTEID BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TH6 DGYERPERIOD INDICATED,NOT1MTFSTANDINO p ANY RECUO MGNT,TER1I OR CONDITION OP ANY CONTRACT OROTHER DOCUMENT WITH RESPECTTp WHICH THIS CERTIFICATE MAY POBE CY EO OR MAY PERTAN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL PAID CLAIMS. THE TER ,EXCLUSIONS MD CONDITIONS OF SUCH POLICIES, BEI/S SHOWN MAY HAVE BEEN REDUCED BY CO POLICYDFF PCluCYEXp GbNGRAL LIABILITYBILI'T LTR TYPE INSURANCE POLICY NUMBER DATE(MM►DbIYY) DATE(MMIDDIYY) LIMITS LIABILITY COMMERCIAL GENERAL LIABILITY GENERAL AGGREGATE $ CLAIMS MADE OCCUR, PRODUCTS.coMP/OP AGO, 3 OWNER'S a&CONTRACTOR'S PROT, PERSONAL&&ADV,INJURY 3 EACH OCCURRENCE 3 FIRE DAMAGE(Any one tire) 3 AVTOM01i1L6 LIABILITY MED.EXPENSE(Anyone person) S ANY AUTO ALL OWNED AUTOS COMINNED SINGLE LIMIT S SCHEDULEAUTOS BODILY INJURY(Por Pe man) g HIRED AUTOS BODILY INJURY(PorAccident) g NON-OWNED AUTOS PROPERTY DAMAGE g GARAGE LIABILITY ANY AUTOS AUTO ONLY-EA ACCIDENT g OTHER THAN AUTO ONLY: EACH ACCIDENT 3 EXCESS LIABILITY AGREGATE 3 UMBRELLA FORM EACH OCCURRENCE 8 OTHER THAN UMBRELLA FORM AGGREGATE g WORKER'S COMPENSATION AND A EMPOLYER'S LIABILITY UB-0095B64A-07 D8-1 U-07 08-10-08 STATUTORY LIMITS X THE PROPRIETOR! PARTNERS0MCUTIVE X 'INCL EACH ACCIDENT $ 100,000 OFFICERS ARE EXCL DISEASE-POLICY LIMIT $ 500,000 GiHER DISEASE.EACH EMPLOYEE S 100.000 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIRESTMICTIONSISPGCIAL ITEMS THIS REPLACES ANY PRIORCBRTIFICATE ISSUED TO TITS CE IgCAIE HOLDER AMCTING WORIMRS COMP COVERAOL CERTIFICATE HOLDER _- _ _ CANCELLATION -- '--" SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENOFAVOR TOMAIL to DAYS WRITTEN NOTICE TOTHE CERTIFICATE HOLDER NAMED TO THELWT.BuT PAL URH TO MAIL SUCH NOTICE SHALL IMPOSE NO 013LIGATrON OR LIABRITY OF ANY WNC UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Charles J Clark _ = ' Board of Building Regulati ns and Standards One Ashburton. Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 103714 Type: Private Corporation PAUL J. CAZEAULT & SONS, INC. Expiration: 7/9/2008 Paul Cazeault 1031 MAIN ST OSTERVILLE, MA 02658 Update Address and return card. 111:u I(reason for c6a11;;c. 's cntM•os/oe•Pcnaso L...I Address Renewal I j 'Employment COCOLust Card I....� Te '�amr�no�r o�✓ ac�tuaelCa Board of Building Regulations and Standards ' License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration(late. if found return to: Registration: 103714 Board of Building Regulations and Standards Expiration: .7/9/2008 One Ashburton Place Rnt 13('t Type: Private Corporation Boston, a.02108 CAUL J.CAZEAULT B.SONS,:INC. 'aul Cazeault 1031 MAIN ST JSTERVILLE, MA 02658 - _.....__ - _y Deputy Administrator �Notw,lid.withot( si nature' _ - Boar o ui ing egulat'on4an etan?a'rd"s4e&j One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Construction Supervisor License License CS: 26325 Restriction: 00 Birthdale: 10/20/1959 Expiration: 10/20/2009 Tr# 6311 PAUL J CAZEAULT 1031 MAIN ST OSTERVILLE, MA 02655 ------------- Update Address and return card.Mark reason for change. DPS•CAt 19 50M-07/07-PC8490 C � Address I- Renewal Lost Card ' _ ..i•j�� ^: ,, ;'.Bo d of Building egulation and Standards f"Y+~ Construction Supervisor License d License, CS 26325 Birthdate: 10/20/1959 r +, Expirations 10/20/2005 Tr# 6311 i�.. RestrlCGon .00, PAUL,J CAZEAULT:'`: 1031 MAIN ST OSTERVILLE,MA 02655 Commissioner -_ I TOWN OF BARNSTABLE Permit No. --------19950 _ Building Inspector Cash _-___ 9. 039. � rua OCCUPANCY PERMIT Bond _ N/A "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Harry Sher Address lot #11 545 Lumbert Mill Road Centerville Wiring Inspector Inspection date f Plumbing Easp c c Inspection date r Gas Inspector Inspection date ✓Engineering Depart t Inspection date THIS PERMIT WILL NOT BE VALID, THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. .........-, 19 Building Inv ector.. �„�•3� TOWN OF BARNSTABLE Permit No. ----------_--------- Building Inspector aaun.a Cash ------------------ 'v0 ,619. �0110 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 Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ...................................................... ...............................................................................»._.... .�._ Building Inspector Gi 17 ,��Y,�i x � S � •9M �S t J ty Ij• f SS,,d y� ;ji ' { �� ,� < t tl t r ty!� rm{'l':a, �a4•�t ' .� t / 1 (, ,"y � '.+ ?. ��' Y /` � �rJ r.�y't �� d 1 f - � ,'r. 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Yr t{ rk. tf tilt 1y r., XG?/GG �Z t af. , ►e 4r�/'?�'Fs qi,A;—VIP.E'Aoofb(,✓T'A4 MA5.. !r"O��'r+pq I 4ba ��33 77 AS 's map and lot number �, senc SYSTEM MU ST ~Y, r, INSTALLED IN COMPLIANCE = II STATE i �.: of Sewage,Permit number .. .............................. WITH ART, W n.; f -- - �, y CODE AND TO SANITARY ypiTHETO� TOWN OF BAR �L'N 11P BLE t �P ;- . Z 8988 STAH rs . 9 639 UUILUING INSPECTOR _., APPLICATION FOR' PERMIT;TO ...............................................::..L ... �x?`:.!..... ..... .. ......... -, F TfPE OF CONSTRUCTION ............... ......... .11-10 . . ................................. .. ...... ..........Z .................. .... .1'..........19. . "--TO THE-'INSPECTOR' OF`BUILDINGS: The undersigned/hereby applies fora;p4erit according to the f�olllllolowin/g/�informati n Location .... �`-t7 ......... �........ : r............ ......//< �Vr`� .Proposed Use ........... ....... . ... t...( ..... . 54........................................................ . ................... ZoningDistrict .......................................,�..... ...................(..J..``''.....Fire District ................................................. Name of Owner ;/!.. .�.. .. ..�.. ..`^^.5....`f `'S.Address ` �... .. , ..�... r✓ . t 7° Name of Builder ....... ........ .!4 "" -..............................Address ....................................... Name of Architect .. . .. ............. �.�...Address ...../ 19.WL y...5............ Number of Rooms ...................... ......................................Foundation .......... ..apt^. � �.4-�'1� .... ►`_'_ Exieriorvj.. `' /....`T!.!.-Q.. ... :. � Q !J'.Roofing ...............0....� 1 ez7 .... .................................. Floors ......... .. v . .....................6.0 ....................Interior ............ .. 1 c�C.................................. Heating ... .�`l: ....:........ �..�..............,.................Plumbing ........... ✓...�' ..... ......f..�J. S�.it? .......... Fireplace ........ 1 . ....................... . ...................Approximate Cost ..... �. 4 ...... Definitive Plan Approved by Planning Board ________________________________19_______. Area ... ....r v.................... Diagram of Lot and Building with Dimensions Fee �' S .. :..... ............... SUBJECT TO APPROVAL OF BOARD OF HEALTH . Il° I hereby agree to conform to all the Rules and Regulations of the Town of Barnstab) regardi the above construction. � 449 . Name ...a . ...................... .... ..... ..... ........ .. ,Tally Ho Farms Inc. ' s r 19950 - 1 1/1 ory Permit for :................................... • `- t` ngle family dwelling [ ...........................�..................................................... - 545. Lumbert Mill Road ` ` Location Centerville .................................................... $ _ ' Tally Ho Farms, Inc. Owner . ..i..... ... .................... .... - q { Type of Construction frame r ............ ............................................. .................. #11 I . . Plot ............................ Lot ................................ February 8 78 o Permit Granted 19 Date of Inspection .✓.. .�..:/. ...............19 a Date C plet .............................:`:19 -PERMIT REFUSED :........ ... ............ ... 19 ` ..... . .. ......................... 4 ........................................ - ............................ - [ Appro ed .... :...............'" ...... 19 - .. .. ..... . . ... y:../...... ..... ........... ........................... M, i Assessor's map and lot number .......................................... 1/ Sewage Permit number °`?"ET°�° TOWN OF BARNSTABLE o Z BARNSTABLE, i 1639.IN, BUILDING INSPECTOR,/ o�� Y a'e APPLICATION FOR PERMIT TO ...................................................fF"" Ir, 1 :. r ........ . . ..................... .........., TYPE OF CONSTRUCTION ............... !'? .........5 � .. .-....° ......... "...................... l� 2I 192.1 TO THE INSPECTOR OF BUILDINGS: The undersigned jherebyy applies for a permit according to the following information: ` Location ........-.z' '...................................................!J! t ? ....... ',!. .. :.. .......... .:............rye .1/r.?.. ProposedUse ........... < ) /.o..... !...! ...... c' ............................................................... ................ r: ` ' ZoningDistrict ........................................... ^........................Fire District ........................ ................... ......... Name of Owner /�`-!. .. .. !^^.r.... z✓'..Address .: ...... ..... . ....C Q �-vf i — Nameof Builder ........................+*^'.s... ..............................Address .................................................................................... Name of Architect h.. Address - 1 Number of Rooms ..................... ................ Foundation -........� .Yh �T<,cc� F` ExieriorXl q,.�; 1 ,.rr �.p ' , r..r' ' „l.vf c.. ...k. ...'... ....QA"r� .Roofing ............. : ra rflV."...................................... Floors .........r P�-�i.- ......... ......0 ......... .........Interior ............. k .. .. ....... .l:`.^.`. ...0:........................... ...... Heating f` 4� o 1 Plumbing �r/C. � Co ri e)�-qL.- ...................... ......... .......... ............................ ...................... Fireplace ............\�..n(..l �. . ....................... . ...................Approximate Cost ..... ..... .....)...I.............r....... . ..... Definitive Plan Approved by Planning Board -------------------_-----------19________. Area ................................... Diagram of Lot and Building with Dimensions Fee 'a` '1 SUBJECT TO APPROVAL OF BOARD OF HEALTH _ 1 - J � F 1 I hereby agree to conform to all the Rules and Regulations of the.own of Barnstable regarding the above construction. Name... ................................ -;................... SIIYZ3 XZM Tally Ho ems, Inc. A= - 146-27 �19960 1 1/2 story No ............... Permit for .................................. c tingle family dwelling ' ............................................................................... 545 Lumbert Mill Road rLocation ................................................................ Centerville Tally Ho Farms, Inc. + Owner ............................................... t frame Type of Construction .......................................... t ...................................................I........................... iPlot ............................ Lot . ......... 11.............. i Permit Granted F ruary 8 78 ` Date of Inspection .. r Date Completed .. t F ' PERMIT REFIDSED t ..................................... ..................... 19 i �.�. ..........t'.. . ....................... :%..J. .... ....Y..................... ...................... r � : �. �. . .................... 4 Approved ............................................... 19 r t f f