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HomeMy WebLinkAbout0086 GROVE STREET oI � -aa� 1p Town of Barnstable Buildin a Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this,Card Must be Kept, y enititt3Yet�LE Posted Until Finel.InspectionT Has,Been Made... Permit ib3 1 l�1 11l Where a Certificate of Occupancy is Required,^such Building shall Not be Occupied',until a Final Inspection has been made Permit NO. B-19-804 Applicant Name: MICHAEL DELUGA DBA VILLAGE CRAFT BUILDING & Approvals REMODELING Structure Date Issued: 03/19/2019 Current Use: Foundation: Permit Type: Building-Addition/Alteration-Residential Expiration Date: 09/19/2019 _ __ Sheathing: Location: 86 GROVE STREET,COTUIT Map/Lot:` 019-027:: Zoning District: RF Framing: 1 Owner on Record: HEHER, PAUL M'& ELLEN M I Contractor Name: MICHAEL DELUGA DBA VILLAGE I CRAFT BUILDING & REMODELING 2 Address: P•O BOX 1971 t Contractor License: 105548 Chimney: COTUIT,`MA 02635 Description: Build a 12x16 sundeck on rear of house Est. Project Cost: $3,500.00 Insulation: t Permit Fee: $ 110.00 Final: Project Review Req: Y - - Fee Paid: $ 110.00 Date: 3/19/2019 Plumbing/Gas Rough Plumbing: Final Plumbing: Building Official Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Final Gas: All work authorized by this permit shall conform to the approved application;and 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-laws and codes. 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 Electrical work until the completion of the same. Service: • The Certificate ificate of Occupancy will not be issued until all applicable signatures by-the Buildingand Fire Officials are rovided.on.t his per mit. Rough: Minimum of Five Call Inspections Required for All Construction Work: - _ - s• 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection . 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: &Insulation 7.Final inspection before Occupancy Health Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT1 ��.� Ai ApplicationNumber.. _............... ..................... Ito . � XA88. Permit Fee.......................................Other Fee........................ Total Fee Paid.............:....... Permit Approval by.................................on.............:............ TOWN OF BARNSTABLE BUILDING PERNUT MV......:..o t ................... al........o..a..1................................ APPLICATION Section`1 — Owner's Information and Project Location Project Address s/ t/ Village Owners Name ��� Owners Legal Addre s {� b' State Zip �✓ 6Q' �gQ-9 �9 - Owners Cell# E-mail� U U Section 2—Use of Structare r= Q Use-Group ❑ Commercial Structure over 35,000: ubic feer z Commercial Structure under 35,00 cubic fed . ❑ Single/Two Family Dwelling Type f Permit Section 3— ,. _ TYP ❑ New Construction El Move/Relocate ❑ 'Accessory Structure El Change of use- ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System i ❑ Addition ❑ Retaining wall ❑ Solar El Renovation ❑ Pool ❑ Insulation Other-Specify i; Secti 4 -Work Description �. tip R' h� J T act=&fed:2/9/2019 Application Number.................................................... Section 5—Detail Cost of Proposed Construction Square Footage of Project 6 V az Age of Structure Dig Safe Number # Of Bedrooms Existing 3 Total#Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist []' Design Section 6—Project Specifics a ❑ Wiring Oil Tank Storage 0 Smoke Detectors , ❑ Plumbing Gas ❑-Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑` Public Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ _ Hyannis Historic District ❑ Old Dings Highway Debris Disposal Facility: I amusing a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation e Within or n adjace t to a wetland, coastal bank. Yes No Section 8—Zoning Information - 1 Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage : #of Dwelling Units(on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑,Yes ❑ .No Last imdated:2J92019 .= .'' — -• �` 1 �� �j vim" � act d y _ s ca m i u Co f f 3 r - is table Bldg' �.D� � - f .. Approved by, ��.cz Z,P o -r-� 3ccA 22 -f-mit#: I Qt—$ `� T ,1 vac'! i IT f Aer 7i9 u-T, ,� Qr Cf, (- 560 Ivr p 41.oh P j LOT Oa 140E yy Nse -;{86 s 510 o LOTS• 141A LOT �o 1418 RES. ZONE.•. "R.F'" 'This" MORTGAGE INSPECTION Plan is ; FLOOD ZONE- ank Use Onl TOWN. CO-T- T _- REGISTRY OWNER .PAU 4 s�._P.�T4&L_&AR!�A_S 1a�awl DEED REF.• �01 2 M___ ---_BUYER: ._RSWr Nam,:_ DATE: �Q, 93 PLAN -REF: tlQ �5_ - ---_ CUE I:'-`HEREB" CERTIFY TO �6LP�`_'=Q C4-_OPERA?1VE� `�— —�--- YANKEE SUR�IEY & FIRST AM.�RICAN 77TLE IN_S �(T'fHAT THE BUILDING �H OF SHOWN ON THIS PLAN IS LOCATED Old THE GROUND AS �� �+AtJL oy CONSULTANTS , o SHOWN -AND THAT ITS POSITION DOES _ CONFORM q, 40g (SUITE 1) } TO-.-THE ZONING LAW .SETBACK REQUIREMENTS OF THE S: MERrtHEW �► INDUSTRY ROAD: TOWN W. BA8ffST.Q$I ' ---AND THAT No.9098 _ `-1T DOEST LIE WYTHIN T�iE SPECIAL FLOOD IiAZARD MARSTONS MII,I,S, biA ,,0�$A8 ' AREA 4S c�OVtT? ON THE H.U.D. MAP DATED_? Cl�7% �`� TEL 428-�0055 o Far �+ 2�ODOl DO 1 D '� —'- `��Mq= aAID FAX 20-5553 PLAN NOT -MADE M, .'INSTRUMENT PA4TL A. My P — TO DE usm OR NCES arc. I,2735 DPG TnTAL P.01 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street - Boston,MA 02111 ' www.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers ApplicantInformation Please Print Le 'bl Name(Business/Organization/Individual): �/0 ^ Address: ,a „ 4)-7 ` City/sta-te/Zip: !/ Phone#: �vz v 7 . AVI on an employer?Check the appropriate box: Type of project(required): 1. am a with employer 4. I am a general contractor and I �* have hired the sub-contractors 6. ❑Now construction employees(full and/or part-time). 2.El 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 0 Building addition [No workers'comp.insurance comp.msurance. 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#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**ether 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 f urance for my employees. Below is the policy and job site information. Insurance Company Name: G G/ s Policy#or Self-ins.Lic.#:G�GG' �� �' � Expiration Date: 2 Job Site Address: Eve City/State/Zip: `t C 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 under t pains aad p of perjury that the information provided above ' true correct. Signafore: Date: Phone#: lJ �+ / 7 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#: 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-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of ili Companies or Limited Liability Partnerships(LLP)with no employees other than the insurance. Limited Liability mp (LLC) members or partners,are not required to cany 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§s"the applicant 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 burn 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 Mmachusetts " Department of Industrial Aoddents Office of Investigations 600 Wasbington Strut .Bostan,MA 02111 Tel ,4 617-727-4900 ext 406 or 1-877-MASS Fax#617-727-7749 Revised 4-24-07 `www.mass,gpv/dia. Commonwealth of Massachusetts . c�f Division of Professional Licensure Board of Building Regulations and Standards Constrgdtbrl�ipervisor CS-050234 E�pires: 07/09/2020 e MICHAEL DELUGA 668 SANTUITAD COTUIT MA 0A Commissioner r%/rriur�rr=taroctr/!t,o/r?ll{r arfr. Office of Consumer Affairs&Business Regulation Office IME IMPROVEMENT CONTRACTOR TYPE:individual Reaistre ion EXpLgLon 105548 07/16/2020 MICHAEL DELUGA DfB/A VILLAGE CRAFT BUILDING&REMODELING. MICHAEL DELUGA 568 SANTUIT RD. COTUIT,MA 02635 Undersecretary , } e Registration valid for individual use only before the expiration date. if found return to: Office of.Consumer Affairs and Business Regulation One Ashburton Place-Suite 1301 ' Boston,MA 02108 A", Not valid without signature a WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE Associated Employers Insurance Company 54 Third Avenue, Burlington, Massachusetts 01803-0970 (800) 876-2765 - NCCI NO 40959 POLICY NO. WCC-500-5006114-2018A PRIOR NO: I WCC-500-5006114-2017A ITEM ` 1. The Insured: Michael Deluga DBA: Village Craft Building& Remodeling Mailing address: 568 Santuit Road FEIN:**-"**2146 Cotuit, MA 02635. Legal Entity Type: Sole Proprietor Other workplaces not shown above: 2. The policy period is from 12/23/2018 to 12/23/2019 12:01 a.m. standard time at the insured's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers'Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident Bodily Injury by Disease $ 500,000 policy limit . Bodily Injury by Disease $ 100,000 each employee C. Other States Insurance: Coverage Replaced by Endorsement WC 20 03 06 B D. This Policy includes these Endorsements and Schedules: SEE SCHEDULE 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Classifications Premium Basis Rates Code Estimated Per$100 Estimated No. Total Annual Of Annual Remuneration Remuneration Premium INTRA 000355380 INTER SEE CLASS CODE SCHEDU E Minimum Premium $500 Total EstimatedAnnual Premium $3;474 EGO GOV Deposit Premium $899 CLASS 5645 - State Assessments/Surcharges $3,122.00. 3.83009/6'. $120 This policy,Including all endorsements,is hereby countersigned by 11/26/2018 Authorized Signature Date Service Office: Malcolm &Parsons Insurance Agency Inc 54 Third Avenue. P 0 Box 527' Burlington MA 01803 Stoughton, MA 02072 WC 00 00 01 A(7-11) Includes copyrighted material of the National Council on Compensation Insurance, used with its permission. Application Number.................:......................... Section 9—.Construction Supervisor Name Telephone Number .`6� y Address City U l : State Zip License Number O. License Type, G� Expiration Date z6 Z 6 Contractors Email {J / 1 Ce # c�6 � , , J r. b y I understand my responsibilities under the rules and r�g&ones for Licensed ckion Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understan the construction inspection proceduu es,specific inspections and documentation required by 780 d the To of le.Attach a copy.of your license. Signature V Date Section.10 —Home Improvement Contractor Name U Telephone Number 759 Address y ty State Zip Registration Number Expiration Date 2� b I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by ZV CMR an own of Barnstable.Attach a copy of your H.LC... Signature Date 1c7 Section,11 —Home Owners License Exemption Home Owners 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. Signatuure Date APPLICANT SIGNATURE Signature Date Print Name z ✓ g Telephone Number E-mail permit to: 1 t� ►�( ✓)` 1'�L ?,2i T e•.F.....i..as.i.•i M/•1A10 Section 12—Department Sign-Offs Health Department © Zoning Board(if required) El Historic District ❑ Site Plan Review(if required) ❑ Fire'Department ❑ '_ '�, Conservation ❑ T t. : For commercial work,please take your plans directly to the fire department for approvA Section 13=-Owner's Authorization as Owner of the-subject properly hereby authorize ) " L)n to act on my behalf, in all matters relative to work authoriz by this b ' din permit application for: e;re V`,(-, ,. (Address of job) Si ature of Ov,71er Print Name 4 • z Last undated:2/92018