HomeMy WebLinkAbout0230 PARK AVENUE .: _ a . ,
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Town of Barnstable *Permit#o?Oo�o
Expires 6 months from issue date
Regulatory Services Fee
Thomas F.Geiler,Director -
-P Building Division �k y115-16
�i� m Perry,CBO, Building Commissioner
APR Y 4 2008 200 Main Street,Hyannis,MA 02601
TO��� www.town.barnstable.ma.us
Office: 508- �Ph E ti ( rfl PLI ATI Fax: 508-790-6230
EXPRESS P 2IVIIT AP C Old - RESIDENTIAL ONLY
Not Valid without.Red X-Press Imprint
Map/parcel Number a Q
Property Address .23 D P cL,-e. C rn �--
U�esidential Value of Work / /i Jam` U Minimum fee of$25.00 for work under$6000.00 .
Owner's Name&Address C 4� � U
Contractor's Name F/} G2,aL-L, �Q yt/), U!�„ Telephone Number ,50
Home Improvement Contractor License#(if applicable) 6 3(P
Construction Supervisor's License#(if applicable) C CJ 69
loworkman's Compensation Insurance
Che6i one:
❑ I am a sole proprietor
❑ I am the Homeowner
ZI have Worker's Compensation Insurance
Insurance Company Name T k2_
Workman's Comp.Policy# O 5 5 O L- 35 ,5
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
[&Re-roof(stripping old shingles).All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows/doors/sliders. U-Value (maximum.44)
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e,Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License is required.
SIGNATURE:.
Q:Forms.expmtrg
Revise061306
1
r
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street r
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): ��}��� �o/y,T CL-t-Cfi d A-)
Address: _PQ
City/State/Zip: nz 3_. Phone #: �Z 0 Y� � �o�c)-
Are you an employer?Check the appropriate box:
Type of project(required):
1.X`I am a employer with__7� 4. ❑ I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. El New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have g, ❑ Demolition
working for me in any capacity. employees and have workers'
9. ❑ Building addition
[No workers' comp. insurance comp. insurance.$
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.,�Roof repairs
insurance required.] t c. 152, §1(4), and we have no
employees. [No workers' 13.0 Other
comp. insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
: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. l
Insurance Company Name: !'! y ��-
Policy#or Self-ins.Lic.#: D g,S L S S50 Expiration Date:
Job Site Address: C 3J0 � � n 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 certi er the sins and lties of perjury that the information provided
/above its true
and correct
Si ature: Date: % `1 o .
Phone#: Jc-O Z C;) /oZ
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#:
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PponucEa YFIIS CERYIFIC:�YE IS ISSUED AS A NIIATTER OF INFORNflAYIOW ."
WISE & QUINN INS AGCY ORILY ARID CORIFERS RIO RIGIiTS UPORk• THE CERTIFICAYE
449 PLEASANT ST HOLDER. Y1i15 CERTIFICAYE DOES RIOT Al19EWD EXTERID OR
ALTER YHE COVERAGE AFFORDED®Y TaIE POLICIES®ELODU.
BROCKTON MA 02301 COMPANY COMPANIES AFFORDING COVERAGE
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INSURED A HARTFORD UNDERWRITERS INSURANCE COMPANY
COMPANY
FRASER CONSTRUCTION LLC
PO BOX 1845
COTUIT MA 02635 COMPANY
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COMPANY
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POLICIES ...........................ED NAMED A
HAVE BEEN ISSUED
THE
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOOR OTHER RDO DOCUMENT W►THERESPECT TO WHI HE THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TER
Co MS, '
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE POLICY NUNIBER POLICY EFFECTIVE POLICY EXPIRATION
GENERAL LIABILITY
DATE(MMAIDDIVV) DATE(MIMIDDIVY) LIMITS
COMMERCIAL GENERAL LIABILITY GENERAL AGGREGATE $
CLAIMS MADE 0 OCCUR, PRODUCTS-COMP/OP AGG. $
OWNER'S&CONTRACTOR'S PROT. PERSONAL 4,ADV.INJURY f $
EACH OCCURRENCE $
FIRE DAMAGE(Any one fire) $
AUTOMOBILE LIABILITY MED.EXPENSE(Any one person) $
ANY AUTO COMBINED SINGLE
ALL OWNED AUTOS
LIMIT $
SCHEDULED AUTOS BODILY INJURY
HIRED AUTOS (Per Person) $
NON-OWNED AUTOS BODILY INJURY
(Per Accident) $
GARAGE LIABILITY PROPERTY DAMAGE $
ANY AUTO AUTO ONLY-EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH ACCIDENT $"
EXCESS UABIUTV AGGREGATE $
UMBRELLA FORM EACH OCCURRENCE $
OTHER THAN UMBRELLA FORM AGGREGATE $
A WORKER'S COMPENSATION AND
EMPLOYER'S UABIUTV (GS60UB—0850L 35—5-07 STATUTORY LIMITS
09-26-07 09-26-08 E PROPRIETOR/ •" ••�•••.......
PARFNER8/EXECUTIVE INCL EACH ACCIDENT $
OFFICERS ARE: X EXCL DISEASE—POLICY LIMIT $
OTHER DISEASE—EACH EMPLOYEE $ 500 000
j
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS
i
THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICAT
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE.CANCELUED BEFORE THE
EXPIRATIOPo DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
ERASER ENTERPRISES LLC 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TOTHE
PO BOX 1845 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHAH IMPOSE NO OBLIGATION on
. COTU I T MA 02635 LIABILITY OF ANY KIND UPOPo THE COMPANY,ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTA
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Possible Extra -After the shingles are removed from the roof, we will lift one sheet of
ro plywood to make sure that the insulation is not up against the plywood sheathing
preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be
installed by; removing the plywood sheathing, installing the panels, turning the
plywood over and then re-installing the plywood. If needed, this would be charged for
as an extra at the rate of$4.00 per panel including Materials & Labor. There are 6
Panels per sheet of plywood.
Possible Extra -Any rotted or otherwise deteriorated trim boards, plywood sheathing,
lead flashing, or other carpentry needing replacement will be done and charged for as
an extra at the rate of$50.00 per hour, plus materials, plus 20% overhead mark-up
on total extras.
FRASER CONSTRUCTION Warranties the labor for 12 years
FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years.
CERTAINTEED Warranties the shingles and labor 106% through the Sure Start
Warranty duration.
CERTAINTEED Warranties the shingles to be ALGAE resistant for the duration of the
Sure Start Warranty depending on the shingle that was purchased.
Any deviation or alteration from above specification will be executed upon written
orders and will become an extra charge over and above the estimate. All agreements
contingent upon strikes, accidents or delays are beyond our control. Owner should
carry fire, tornado and other necessary insurance upon the above work. We, if not
accepted within thirty days may withdraw this proposal.
FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public
Liability Insurance on the above work, certificate available upon request.
DATE OF ACCEPTANCE:
Homeowner Fraser CO
ruction, LLC
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.JOB 86-255
CERTIFIED PLOT PLAN
4oCATION: LOT 2 PARK AV CENT . PREPARED FOR:
SCALE: 1 " =40 ' DATE: 9/24/86
REFERENCE:
PB 870 PG 7 GABLE CONST .
I HEREBY CERTIFY THAT THE BUILDINGS
SHOWN ON THIS PLAN IS LOCATED ON THE. tH OF
GROUND AS SHOWN HEREON. *�
BUILDINGS CONFORM TO SETBACK REQUIREMENTS AtiPIEyG
OF THE TOWN WHEN CONSTRUCTED. H.
OJAIA
`$ N26348 �
down cape engineering ��fs��fcISTER�S%
CIVIL ENGINEERS <
LAND SURVEYORS
ROUTE 6A YARMOUTH MA DATE PEG. LAND SUPVEYOP
� 4
ssessor's ma + and 'lot number . ? . .�`...��✓ `� FYNEr
1SYS MuST
lewage Permit number ..J............ �f n O(Z� 'G LLED IN e Y� o
�� �
... d
INSTAs �..
B 9T11DLE, i
IIOUSe number .Z?. .............................................. $ TITLE r y ,�M6 a
TOWN OF ,BARNSTABLE
BUILDING INSPECTOR
Construct new dwelling 12,APPLICATION FOR PERMIT TO .................................................................................... ...............'...................
TYPE OF CONSTRUCTION 1 Family dwelling (wood frame)
4 December 10 19 84.
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
• A
Location Lot 2 Park Avenue, Centerville
Proposed Use ..... Family dwellin. g
.....I...... . . .......r1 ........... .............................................................................................................. .... ....
i ,�^�
Zoning District � /.............................................Fire District 'y
Dr. Peter (Joan) Rufleth
Nameof Owner ......................................................................Address ....................................................................................
Gable Construction C.o In ' 515 Main St Harwich ort MA
Nameof Builder .........................................................'.�.......�Address .................................-..:........e.............. ........:...........
Designer
Don Ta artName of Aggbkck ............................ .................................Address ...515 Main St.-.�...Harwi.c
XA?��.,....i�.......................... ............. ..
Number of Rooms Ten (10) Foundation Poured concrete 8" thick
............................ ....................................................................
Exierior White cedar...sh,in les.........................Roofing .....Asphal,t...........Arch: 80
............. ...........................................
Floors ........wood...............:...................................................Interior ......�z ...... ...sheetrock
. ...........................................................
Copper and brass water pipes and
Heating fired hot water plumbing .fit... ngs,,,w/,,,PVC waste & vent,..pipes
Fireplace ..................!...............................................................Approximate Cost ............ ............... .............
Definitive Plan Approved by Planning Board ________________________________19________ . Area .......f 9.--4 ...................
Diagram of Lot and Building with Dimensions Fee a
BScll .........!.......o o............
SUBJECT TO APPROVAL OF BOARD OF HEALTH S h ho•� g6 '
y
tt�, i �eTu r V � a,. l c(e,r
$T
r AA/ ti5
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 GG...
016314
Construction Supervisor's License ....................................
'
\
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AUFLETH, DR. PETER (JOAN)
29969 l Story � .
�No �-----. Per m� for ..-..?............................
,
' o�leDwelling .. �.
Lot #2 & ', 230 Park Lqca. �ve�ue ' /
"°. ------------.--------..
— �--.�--Ceote��ille.---.------- . .
`' Ovne, —Dr�Peter �����! Dufletb
-- ----' ---------..
.
x . '
'
Type of Construction on -------.---. ..........
------':.........................................................
Plot ............................ Lot ----------''
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^
' Se 26 86 `
Permit, Granted ---.������..--'�--l9
- ��_�� "~«�� —
' Date of |n ---.— . lv
�
Date Complete `
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GABLE CONSTRUCTION COMPANY
COMPASS REAL ESTATE
March 23 , 1987
I'f Joseph Daluze
Barnstable Building Inspector
397 Main Street
Hyannis MA 02601
RE: RuFleth Job
Lot 2 , Park Ave
Centerville, MA
Dear Joe:
As per our recent conversation please find enclosed a copy of the
RuFleth site plan showing exact location of water service. The
water service skirts around the proposed reserve septic field and
ties into the house.
Sincerely,
Timothy F. Wade
Vice-President
General Manager
xc: Peter RuFleth, owner
Mark Iverson, - supervisor
ENCLOSURE
SOUTHPORT BUILDING, 940 MAIN STREET, SOUTH HARWICH, MA 02661 617-432-5379
Your Real Estate and Building Professionals
TOWN OK RARNSTABLE, MASSACHUSETTS ' RM T
A-207 164
• DATE (�::t.''il�) :!: U 19 8 6 PERMIT 2aW
APPLICANT Gable hilt? ADDRESS r r ` ., .
1;E.Fb6�+-��}(r� AF+--('E3� (NO.) '1571i T t� CbN7R' IL E
PERMIT TO ( L ) STORY _ NUMBER OF
DWELLING UNITS
PI K
AT (LOCATION) I ZONING
.. i DISTRICT_
BETWEEN AND
(CROSS STREET) (CROSS STREET)
SUBDIVISION LOT
LOT BLOCK SIZE
BUILDING IS TO BE FT. WIDE BY FT. LONG 9Y FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
REMARKS: Snary,(rP f185-14
i;able. Condtr. Go.
(140 -L1in Str,.,q, sox 68
AREA OR VOLUME E S T I 'j �'{ �-�JJ ]•1 - PERMIT
PIAll'E CI$ST y' Sf)all�)(i.00 FEE � cl �c
(Ca BIC SO ARE FEET) ,rmh ir�ti -
OWNER __ Tlr- P.aY.�T^
ADDRESS BUILDING DEPT.
BY
THIS PERMIT CONVEYS NO'RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY
PERMANENTLY. ENCROACHMENTS ON PUBLIC 'PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE .
P_ROVED_B.Y_TH,E_JUR.LSDICTION. STREET ,OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PU.BLIC SEWERS MAY BE OBTAIN
r FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUAN-C'E--OF THIS F'ERtd1T'G'GES-1•i'O'FRE•�EicB-E--TH{--!.•P-PL-IC-A-NT—FL79M-T-NE-GOtya.,�c-
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR
ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND
I. FOUNDATIONS OR FOOTINGS. ' MADE. WHERE A CERTIFICATE OF OCCUPANCY 'IS RE- MECHANICAL INSTALLATIONS.
2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
MEMBERS(READY TO LATH). FINAL INSPECTION HAS-BEEN MADE.
.r_ 3. FINAL INSPECTION BEFORE
OCCUPANCY.
POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
1 7"
i
2 z ��t f� viwl�ty-✓c 2 ,
3 HEATING INSPEC IN APP OVALS REFRIGERATION INSPECTION APPROVAL
NEE 1NG
Q --=z -- - D ARD OF HEALTH
WORK SHALL NOT PROCEED UNTIL THE PERMIT WILL BECOME NULL AND VOID IF .CONSTRUCTION INSPECTIONS INDICATED ON TH!5
INSPECTOR HAS APPROVED THE VARIOUS WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY TELEF
STAGES OF CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. OR WRITTEN NOTIFICATION.
b
�ofTHE�O` TOWN OF BARNSTABLE Permit No. ................
° BUILDING DEPARTMENT
TOWN OFFICE BUILDING Cash
�,6}
on-lb HYANNIS,MASS.02601 Bond ................
I
CERTIFICATE OF USE AND OCCUPANCY
Issued to
Address
USE GROUP FIRE GRADING OCCUPANCY LOAD
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 MASSACHUSETTS STATE
BUILDING CODE.
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CIVIL ENGINEERS OR:
LAND SURVEYORS
8ZSZSI:St. REG.!_ARID SUP.bSY^R --
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tl/3 �Z WITNESS BEDROOM HOUSE
TEST DATE DESIGN
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PERC RATE MIN/IN.
FLOW RATE 4-4W(GAL./DAY) L 1 oae� 1 J t,oWN�RDug6j ) �i J ,ko`'� aZ�`' ': 03 i4
Ft c SEPTIC TANK 44-0 (tS)= � �`L !/A`� 'C i �14,
c csD. ME Y REQ'D SEPTIC TANK SIZE t oon _ - / / x
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LEACH FACILITY
c>?c ezr!+:�igrI, SIDE WALL
BOTTOM G/D. { ST /
kiln" 2t".S �1�.. lo�j TOTAL Coon _ (vCm
USE: r s aC LEAmCHING -T ICt-p ��..9 q 12
t '� \l'S r� 30` e �e� l.. 7S ZCJt �• Later 4 G. e-o.5 c�e, (. ' ` to• (�
WATER ENCOUNTERED i
2-
NOTES:" (UNLESS OTHERWISE NOTED) , of
usGS c�ua o y��� ss9 gyp Of y Z. �E laCn ,��.
1.DATUM(MSL)—TAKEN FROM. C ` U
2.MUNICIPAL WATER_--.-__-----------------------------AVAILABLE ARNE ARNE H. yG G.�. H �,
3.PIPE PITCH:4a"PER FOOT t-�, .2, H. O�ALA W 1 /� ` CJ — —q�/
4.DESIGN LOADING FOR ALL PRE-CAST UNITS:AASHO- -44 o OJALA CL �'C
5.MIN.GROUNDCOVER OVER ALL SEWAGE FACILITIES: (1) FT. #26348 ca CIVIL H I�SCh
6.PIPE JOINTS SHALL BE MADE WATER TIGHT NO. 3079
.7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. O SITE PLAN
STATE ENVIRONMENTAL CODE TITLE 5 �fCI E Q ASTER �C�
�. USG SCtIEDUuE 4l� rtPE �Jtloc� DPJvcwAY AREAS. qN� URJ�y 'rS t LOCUS: ` QT Z - ?,�•- �yG
9• It CEt2Tlr-tcgT%0ilS AL_ F.Equta£o -tHL EtIC N£�r� Mv$T' REG.PROFESSIONAL ENGINEER cT-m-�.(LV\l.t
PX tZ4 tAtt14L` -tU S7.ti.k4 1t�S P£cZ COI.lST2uLZ�bla. c U 11 `V' 1)�27 w9 ®pf� //��. REF'
down Cope Gf o fle r1fil PREPARED FOR: -�CJFtIJ �-t. , V��� ! H
CIVIL ENGINEERS
r BOARD OF HEALTH ' LANDSURVEYORS ————— ------
928 U81A$L REG.LAND SURVEYOR. t 40 It/q
F�P.TZI.ISTA��L E _
CONTOURS (EXISTING)---- SCALE C
(PROPOSED)-0-0-0-0— APPROVED DATE MA- Yi VA �.,�{ t O ��/, II 27 �c} DATE