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Home My WebLink About0041 MIZZENTOP LANE ' T ryl i �-C�iYI, .1.2_Y1Qi I. I JAM no WAY AN Avon 40 On ITS Al I WAS - k v t .t'. IQ own pn t �a r >r Town of BarnstableBuilding « Post This Card So That It,is�Vlsible from the St eet Approved Plans Must be:Retained on Joband this,,Card�Must:be,K,epi � � e « e� Ar;cc « Posted Unt1lFinal lns ec ltit on Has;6'een Made ' j� , a �s Where aCert�ficate of.Occu,pancy:s�Requtred,such Buil,"dmg�shall Not�be�0ecupied`until a Ftnal£Inspect�on has�been°made�� ei l� � &-- ...� :. •;� :.:�.� ,.�5,2�.., a,,.,. ;:,�„ .,. :. ., a#E '.:. �...,� '*� <,. ,_, y^'. ., .,�: .. � ,�.>.�,..„... �F£:. ,d� ;sue, � ::oC. Permit No. B-18-3413 Applicant Name: THOMAS A LONG Approvals. Date Issued: 11/01/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration bate'- 05/01/2019 Foundations Location: 41 MIZZENTOP LANE,CENTE_RVILLE Map/Lot: 227 066 Zoning District: RB Sheathing: Contractor Name .THOMAS A LONG Framing: 1 Owner on Record: LOMBARDI,KRISTIN L g Address: 110 FIRST AVE#502 Contractor Llcen e142393 2 -F CHARLESTOWN, MA 02129 3 x Est Protect Cost: $ 1,700.00 Chimney: � y Description: window replacement(1) Pernit Fee: $35.00 r Insulation: Project.Review Req: €. K € Fee Paid $35.00 Date 11/1/2018 Final: Plumbing/Gas Rough Plumbing: 77 Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within siz months after Issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the'approved construction documents for whic11Th this permit has been granted. _. All construction,alterations and changes of use of any building and structures s all be in compliance with the local zong',by�lawsarid codes.rn 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. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Budding and F re Officials ar6�provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: �z ��' 1.Foundation or Footing 5 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 _ Application num er,.. .....S11.. Fee. ��................................................. QCL15.-2B18 Build ing.inspectors Initials.. .... :a.. I Date Issued... M a p/Parcel.............:................ ...................... ••�•• TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ,: , • ' ; ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION c, PROPERTY INFORMATION Address of Project: 41 " Mt Z?-6k3i` P \-AVAr � ec� ai_i.� • ` ��4 �� NUMBER STREET =Y ' -VMLAGE . Owner's Name: 1;�a � -.�r.l, 1=�r. �� Phone Number Q'� -�{l h-'1 b 3 F t . Email Address: mo-r%%AS Lon e-ctoL ( anr) Cell Phone Number a-1 3 - zi I $--503 ft Project cost$ 1V7 00 ,oD , , Check one Residential _✓ Commercial st - - • - OWNER'S AUTHORIZATION". As owner of the-above.property I hereby authorize am A5 Las to make application for a building nesmit in accordance with 780 CMR .,_, ,...._ Owner Signature- i. --Date: TYPE-OF WORK a tt§iding T 0 Windows (no header change)# 1 Insulation/Weatherization -- 0 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 P,,&va -a q;6 i y4 .LA��aLL . `."' ,l .?`.Is f- .2:` r r ,. 4 s�,•�.,� • , ... j .. y..,�� L;':r''�'.-.•� is " �s-�i.'.If.t�" !' ' CONTRACTOR'S INFORMATION-.--~~�, * ` • •^�_�: Contractor's name- 1^ +J - ...: �.. lc.Y} �.r�.'w«.. .._. . >... ....,...„._ ......_. . t-.xf'-'i,..,_ r,: tea, E'"'+•.Z�`�}s.�;r�} .._.._�`' _ +r - -- Home Improvement Contractors Registration(if applicable)# V-��L 93 (attach copy) Construction Supervisor's License# � 0 (attach copy),`' M Email of Contractor Phone'number '47 =�a --u Os- ALL PROPERTIES THAT HA Vt STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY.IS IN A U/CTADU•'II ICTDw "r V^II RAI ICY f10TA 1111 MICTA DV` ADDDAI/A/ DCCADC A DCOAAM PA R1 DC ICCI ICII APPLICATION NUMBER *For Tents Only* _ Date Tent(s) will be erected'! k, 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 r , 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 - - - -- -- -r-= 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-GasYes : 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 I.D. - Fuel Type Testing Lab Offsets from combustibles: front back left side'' right side HOMEOWNER'S LICENSE EXEMPTION r -Homeowner's Name: - Telephone Number ?' P Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction F 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 p Date APPLICANT'S SIGNATURE C Signature - Date 16 .6-T_a 1� All permit applications a subject to a building official's approval prior to issuances AWL . The Commonwealth of Massachusetts ..' Department of Industrial Accidents . Office of Investigations 000,Washington Street, Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians&lumbersY Applicant Information _ . , L, Please Print Legibly Name(Business/Organization/Individual): 7%4amAS Address: I Lci V,6oT 4 TtF3f ' bo - ..r K, . : j+ [� ' - `►,' 3 '. 'ice _�Fr., i City/State/Zip: � i l t, ',�1fl./a►- ' Oa&3 a':Phone#: -_l7el'' 3�--�U'�l C� Are you an employer?Check.the appropriate box: Ir. .Type of project(required): 1.❑ I am a employer with -, .4. I am a general contractor and I - *, hae hired the sub-contractors. 6. ❑N v ew construction mployees(full and/or part-time)., [ , 2. I am a sole proprietor or partner- listed on the attached sheet. [7.,.f R' &odeling ship and have n o employees These sub-contractors have_ P_ _ _ 8._ Demolition working for me In any capacity. F 'employees and have workers' ;.. r ❑ in�r*an_ce.t 9. Building addition .° [No workers coin comp.insurance p' 10.0,Electrical repairs or additions required] . •,, , 5..E,We are a corporation and its, , , -�.. 3.❑ I am a homeowner doing all work ., ;;-officers have exercised their+ ;� 11.F�.Plumbing repairs or additions' myself. [No workers'comp. -right of exemption per MGL' 12:0 Roof repairs = insurance required.]t '_ r . c. 152, §1(4),and we have no :+ employees. [No workers' ; 13.�Other comp.insurance required.] *Any applicant that checks box#i 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. 1 am an employer that is providing workers'compensation insurance for my employees. Below is-the policy and job site information. -. ,. f •a.I , Insurance Company.Name: Policy#or Self-ins.Lic_#: Expiration Date: tic.� 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 ceM* nder'llepailflndptnalfies of perjury that the information provided above is true and correct Smnature: f �+ ° Date l L l Phone#: 7�4' ��—�� h_ )'I Official use only. Do not write in this area,to be completed by city or town official City or Town: PermittLicense# 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#: 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 deice employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing loyees. However the owner of&.dwelling house having not more than three apartments and who resides therein, the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair ork on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employ /ena deemed to be an employer." MGL chapter i52, 5C(6)also states that"every state or local licensing agency sithhold the issuance or renewal of a licens o ermit too erate a business or to construct buildin s inommonwealth for anP g Y applicant who has p duced acceptable evidence of compliance with the inqee coverage required." Additionally,MGL cha r 2, §25C( )states"Neither the commonwealth nor aa4y of its political subdivisions shall enter into any contract fo ormance of public work until ac ptable evid ce of compliance with the insurance requirements of this chapter av een presented to the contractin a ority" Applicants Please fill out the workers'compens on i it completely,by c c ' e boxes that apply to your situation and,if necessary,supply sub-contractors)n (s), ddr (es)and phone n ber(s along with their certificate(s)of . insurance. Limited Liability Companies LC or L' 'ted Liability ershi (LLP)with no employees other than the members or partners,are not required to w kerrs' . ens a' n' am . If an LLC or LLP does have employees,a policy is required. Be advised th t affida ' ma be sub ed t the Department of Industrial Accidents for confirmation of insurance coverag so be su to sign and ate a affidavit. The affidavit should be returned to the city or town that the application r e permi license is be' g r quested,not the Department of Industrial Accidents. Should you have any questions eg din the 1 or if you e r uired to obtain a workers' compensation policy,please call the Department at the a listed b w. Self-' d 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 le 1 e De autment h s rovi a ace at the bottom P P g P P space of the affidavit for you to fill out in the event the Office of ve 'ga'ons has to con t you arding the applicant. Please be sure to fill in the permit/license number which ill be ed a reference n er. addition,an applicant that must submit multiple permit/license applications in y given ar,need only submit ne davit indicating current policy information(if necessary)and under"Job Site A dress"the a h ant should write" 11 lions in (city or ` town)."A copy of the affidavit that has been officially ped or m e by the city or town be provided to the applicant as proof that a valid affidavit is on file for fu a permits or li . A new affidavit be filled out each year.Where a homeowner or-citizen is obtaining a li nse or permit not 1 ed to any business or ommercial venture (i.e.a dog license or permit to bum leaves etc.)said rson is NOT requir t complete this affida t. The Office of Investigations would like to thank yo in advance for your coo lion and should you ave any questions, please do not hesitate to give us a call. - The Department's address,telephone and fax n er: The Co onwealth of Massa chuse - IIe ent of Industrial Accidents Office of Investigations ' 600 Washington Street _ Boston,MA 02111 - T .#617-727-4900 ext 4.06 or 1-877 MASSAFE Fax#617-727-7749 Revised 4-24-07 www.mass.gov/dia J a r �T�� i�nnzairrceo�l�ajmi��c �selGs - t Commonwealth of Massachusetts Division of Professional Licensure Office of Consumer Affairs&Business Regulation IF Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR TYPE:Individual Constr.qcti6r0§bpe,rvisor 4 Reaistration: E 'o �g23g3 05/02/2020 CS-086040 }L�cpiies: 08129/2019 THOMAS A LONEiY r THOMAS A LONG xr�j 166 KNOTTY PINE LANES 'THOMAS A.LONG.�� tf CENTERVILLE MA# 166 KNOTTY PINE CENTERVILLE,MA 02632 Undersecretary. Commissioner Cz "— Construction Supervisor Unrestricted-Buildings of any use group which contain less than 36,000 cubic feet(991 cubic meters)of enclosed Registration valid for individual use only 1 space. before the expiration date. If found return to: x Office of Consumer Affairs and Business Regulation One Ashburton Place-Suite 1301 Boston,MA 02108 f Failure to possess a current edition of the Massachusetts Not valid without gflBtUf@ State Building Code is cause for revocation of this license. For information about this license Call(617)727-3200 or visit www.mass.gov/dpi i AC40RIDO® CERTIFICATE OF LIABILITY INSURANCE F°ATE'MM,D°"YYY' 10/15/2018 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 have ADDITIONAL INSURED provisions or 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 CONTACT Ashley Clark NAME: Leonard Insurance Agency,Inc PHONE (508)428-6921 FAX (508)420-5406 C o t: A/C No): 683 Main Street E-MAIL Ashley@leonardagency.com ADDRESS: Suite B INSURER(S)AFFORDING COVERAGE NAIC# Osterville MA 02655 INSURERA: Main StreetAmerica Ins.Co. 29939 INSURED INSURER B: Thomas Long INSURER C: dba Jake's Construction INSURER D: 166 KNOTTY PINE LN INSURERE: CENTERVILLE MA 02632-2304 INSURERF: COVERAGES CERTIFICATE NUMBER: Master 2018-19 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR 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. INSR A - -.POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 500,000 CLAIMS-MADE �OCCUR DAMAGE TO RENTED 500,000 PREMISES Ea occurrence $ ` MEDEXP Anyoneperson) $ 10,000 A MPB35176 02/06/2018 02/06/2019 PERSONAL BADVINJURY $ 500,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 X POLICY ❑PRO- ' JECT LOC PRODUCTS-COMP/OPAGG $ 1,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO - - BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED - PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAR OCCUR - - - EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$'. $ WORKERS COMPENSATION PER OTH- - AND EMPLOYERS'LIABILITY Y/N _ - STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE--EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101;Additional Remarks Schedule,may be attached if more space is requiredp. - Project: Marius Lombardi 41 Mizzentop Ln Centerville,MA 02632 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street AUTHORIZED REPRESENTATIVE Hyannis MA 02601 W"ii? � @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD • Town of Barnstable � � �✓I9l- l � Build-in �- �Post�This C'°rdfSo�That rt is°�1/is�bleFrom°the Street ;°A roved�Plans'Must be Retai ed�on Job andthis Catd M,ust�be;Ke �, s�nrrsreuus,. • l',`.3.t'� ... "�,. x p fi �....''`�.�> �� .: �:- � Pp'.,'..1 N '..,z + '� k � � '� .�� a 3 � MAE& Posted Until Final Inspection Has Been Made 5� �� ,4 r i � "' Permit llll• �R Whe,�.e a Gertifi.eate of®ccupancy;sRequred;,#such Buildmg�shall Notxbe Occup�edu,nt�l a Final Inspection has beenmade �„ , 1 �i t Permit No., B-18-2958 Applicant Name: Mike McMahon Approvals Date Issued: 09/11/2018 Current Use: - Structure Permit Type: Building-Insulation-Residential Expiration Date: 03/11/2019 Foundation: Location: 41 MIZZENTOP LANE,CENTERVILLE Map/Lot: 227 066 Zoning District: RB Sheathing: Owner on Record: LOMBARDI KRISTIN L J Contractor Name ,MICHAEL T MCMAHON Framing: 1 Address: 110 FIRST AVE#502 Contractor icense CS 068111 2 All CHARLESTOWN, MA 02129 w 1 1Z � Est Project Cost: $8,275.00 Chimney : � T Description: Weatherization,weather stripping,air sealing'and blown cellulose. Permit Fee: $92.20 I Insulation: Fee Paid° $92.20 Project Review Req: 9/11/2018 Final: Date 41 �} Plumbing/Gas -� � Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzec(by this permit is commenced within six months after.issuance. Rough Gas: =� = " All work authorized by this permit shall conform to the approved applicationjand,the�approved construction documents'for which�this permit has been granted. :. . All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning=by l _ aws,:and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for publicinspection for the entire duration of the work until the completion of the same. Electrical op The Certificate of Occupancy will not be issued until all applicable signatures by th Bu ding an14, d'Fire Offi cials are provided on th ss permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing xFF r` 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 C