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HomeMy WebLinkAbout0558 LUMBERT MILL ROAD �.,. r-. �� a � o � ° o o �� o ��� o 0 S 11] a 1 ii, j i � .,. � } o �� ��� 4 , _ � r � o e i o i I I 1 i { ' . r _Town of Barnstable Building A■ Post This Card So That it is Visible From the Street ,Approved Plans-M' be Retained on Job and this.Card"Must be Kept" Posted Until Final Inspection Has,6een Made � Y . _ � Permit Where a;Cert�ficate of Occupancy is Required,such Building shall Not be Occupied until Final Inspection has been made.,?w s . u..- _ Permit No. B-19-4065 Applicant Name: SOUTHERN NEW ENGLAND WINDOWS LLC Approvals Date Issued: 12/04/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 06/04/2020 Foundation: Location: 558 LUMBERT MILL ROAD,CENTERVILLE Map/Lot: 146-024 Zoning District: RC Sheathing: Owner on Record: GALANTE,JOHN P& ELENA Contractor Named SOUTHERN NEW ENGLAND Framing: 1 WINDOWS LLC Address: 45 1ST AVENUE APT 412 - ; ' 2 'Contractor CHARLESTOWN, M License: 173245A 02129 Chimney: Description: Window replacement(1) Est. Project Cost: $6,500.00 _ t Permit Fee: $35.00 Insulation: Project Review Req: Final: " Fee Paid: $35.00 i Date. 12/4/2019- Plumbing/Gas Rough Plumbing:, e I Final Plumbing: BuildingOfficial This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six'months-after issuance. Rough 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.' t - > - 14 Final Gas: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 streetor.road and shall be maintained open for public inspection for the entire duration of the ' work until the completion of the same. t' Electrical The Certificate of Occupancy will not be issued until all applicable signatures:by the Building acid Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work Rough: 1.Foundation or Footing L � - 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: S.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health 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. 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 fir," IKE M5 t. Application number............... ................................. Date Issued.............I. ..............................RARINMBM MAS& 039. DEC 04 24 14 Building Inspectors Initials........1�0................... Map/Parcel....... ................................ TOWN OF BARNSTABLE �3J� (� � EXPEDITED PERMIT APPLICATION: ROOF/SIDEI;G/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 55, -g L-0e7w6e-e-f- Mi(I (M. NUMBER STREET VILLAGE Owner's Name: E Ax, Phone Number Email Address: I!Iala4 &ae--yeA 4v re c C nl" -7S Cell Phone Number I- Project cost Check one Residential vl Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building pertnitin accordance with 780 CMR Owner Signature: Sep Ar&ck,\� Od,,A" Date: TYPE OF WORK Siding [�Windows (no header change)# L _J_E Insulation/Weatherization L-1 Doors (no header change)# Commercial Doors require an inspector's review Ell Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# 17 3 2_q S- (attach copy) Construction Supervisor's License# yq S-7 0:7 (attach copy) Email of Contractor C �(O/- 2- 2- 9 -TS,,,)ee435,e 6tvw; I. cb(n Phone number ALL PROPERTIES THAT HAVE STRUCTURES16VER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. vti APPLICATION NUMBER *For Tents Only* Date Tent(s)will be erected 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 X X 7 X Additional tent dimensions can be attached on a separate piece of paper. Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location (s) of each tent 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. 1 p /� *WOOD/C®AL/PELLE'T STOVES " Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOME®V�NER'S LICENSE EXEMPTION Homeowner's 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. Signature Date PLIcANT9 S SIGNATURE Signature Date " All permit applications are subject to a building official's approval prior to issuance. Renewal . Agreement Document and Payment Terms byAndemn. dba:Renewal B Andersen of Southern New England_ Y gl John Galante Legal Name:Southern New England Windows,LLC 558 Lumbert Mill Rd RI#36079,MA#173245,CT#0634555, Lead Firm#1237 Centerville,MA 02632 WINDOW NE IACEMENr 10 Reservoir Rd I Smithfield,RI 02917 H:(781)608-5151 Phone:401-349-1384 1 Fax:401-633-6602 1 sales®renewalsne.com C:(703)585-2148 Buyer(,)Name: John Galante Contract Date: 11/16/19 Buyer(s)Street Address: 558 Lumbert Mill Rd, Centerville, MA 02632 Primary Telephone Number: (781)608-5151 Secondary Telephone Number: (703)585-2148 Primary Email: jgalante@ae-ventures.com Secondary Email: Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorporated herein by reference(collectively,this"Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Total Job Amount: $6,500 By signing this Agreement,you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. Deposit Received: $3,250 Balance Due: $3,250 Estimated Start: Estimated Completion: Amount Financed: $6,500 7-9 weeks 7-9 weeks Method of Payment: Financing We schedule installations based on the date of the signed contract and secondarily on the date in which we complete the technical measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date and time at a later date. Rain and extreme weather are the most common causes for delay. Notes: 50% deposit by bank balance on completion by bank Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s)and Contractor.Buyer(s)hereby acknowledges that Buyer(s) 1)has read this Agreement,understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. I NOTICE TO BUYER: Do not sign this contract if blank.You are entitled to a copy of the contract at the time you sign. YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 11/20/2019 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. legal Name:Southern New England Windows,LLC dba:Ren By de of Southern New England Buyer(s) Signature of Sales Person Signature Signature Paul Sandrey John Galante Print Name of Sales Person Print Name Print Name UPDATED: 11/16/19 Page 2 / 10 Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card SOUTHERN NEW ENGLAND WINDOWS LLC Registration: 173245 10 RESERVOIR ROAD Expiration: 09/18/2020 SMITHFIELD,RI 02917 -' SCA 1 0 20M-05/17 Update Address and Return Card. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Supplement Card before the expiration date. If found return to: Reaistratiiia Expiration Office of Consumer Affairs and Business Regulation 09/18/2020 1000 Washington Street-Suite 710 SOUTHERN NEW ENGLAND WINDOWS,LLC Boston,MA 0211 je _ � 9 BRIAN DENNISON 10 RESERVOIR ROAD "`3 SMITHFIELD,RI 02917 Undersecretary tiv� �� VHithout signature Y Commonwealth of Mass chusett� Division of Professional Licensure Board of Building Regulations and Standards �,onstrt ct n Supervisor CS-095707 L-,P i res : 09/08/2020 1 I BRIAN D DEIAISO(V 8 BLACKWELL DRIVE CHARLTON MA 01607 Co9'Y rrfissioner Cj Me Cotntlaonwealik"of Massachusetts v Department of ladus&W Accldenu 1 Congress Stree4 Suite 100 Boston,M4 02114 9017 www.mass.gov1dia Workers' Compensation Insurance Affidavit:Builders/Contractors/ElectriciansMiLmbem TO BE 1:CI.ED WITIf THE PEILirEfrrLolG AUTHORM. Aualiesnt Information Please Print Legibly Name(Business/Qrpnization/Individual): ��q�''f'�e or rye �g� �j�d/re r��J Jl�r) (`— Address: o City/State/Zip:-SM 1_f e Q R! 0Zg l f� = 7 Phone#: �/O/—Z7,�— Are you an employe'Check the appropriate box: Type of project(required): t. t am a employer with 204� mployees(frill and/or part-time).' r49. . New construction am a sole proprietor or pannccmWp and have no employees working for me in ] : ®Remodeling any capacity.[No workers'comp.insurance required o I[]I am a homeowner doing all work myself[No workers'comp.insurance required]* []Demolition 4.�I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all Contractors either have workers'compensation insurance or are sole 11. Electrical repairs or additions proprietors with no employees. 01 am a general contractor and I have hired the sub-contractors listed on the attached sheet 12.(]Plumbin;repairs or additions These sub-contractors have employees and have workers'comp_insurance.: 13.011oof repairs 6.[3 We an a corporation and its officers have exercised their right of a cemptioa per MGL e. 14.(Other W ` 152.§1(4).and we have no employees.[No workers'comp.insurance required] 'Airy 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 contactors must submit a new affidavit indicat ng 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. Ifthe sub-cohrOractnrs have ernplayees,they must provide their workers'comp.policy number. [am an employer that is praiddina workers'compensation insurance for my employees Below is the policy and job site anformafion. /� �,rQ, InsllranceCompanyName:--:f"t(EY�iP�1�r _n�jl,�VaMI-0_ (-O - 0r V�tfl.. b. a e Policy#or Self-ins.Lic.#:WC ,31, Z-ge Expiration Date: /' —2.0 2.® Job Site Address:_ Attach a copy of the workers'compensation policy declaration page(showing the Policy number and ea irstion date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fuze 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. =atilre: ccnder the p ' penalties of pedhuy that the information provided above is titre and correct Date: —/ Phone#: Official use only. Do not write in this area,to be completed by city or town gffuiaL City or Town: Permit/License Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CitytTown Clerk 4. Electrical Inspector 3..Plumbing Inspector 6.Other Contact Person: Phone#: �AC CERTIFICATE OF LIABILITY INSURANCE 7T5(MM1ODNyyy) 12/28/2018 1 1 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 I BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED I 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). PRODUCER O AC CoBiz Insurance, Inc.-CO NAME: PH 1401 Lawrence St., Ste. 1200 ccN o Ex • 303-988-0445 FAX No:303-988-0804 Denver CO 80202 E-MAIL ADDRESS: COMail@cobifinsurance.com INSURE S AFFORDING COVERAGE NAIC g INSURER A:Acadia Insurance Company 31325 INSURED ESLERCO-01 Southern New England Windows, LLC. INSURER B:Firemens Insurance Company of WA,D.C. 21784 ' dba Renewal by Andersen of Southern New England INSURER c:Homeland Insurance Company of New York 34452 IQ Reservior Rd INSURER D: Smithfield RI 02917 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:787175890 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 CONTRACT OR 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 ADDL SUER . POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CPA31SB728 1/1/2019 1/1/2020 EACH OCCURRENCE $1,D00,000 CLAIMS-MADE a OCCUR DAMAGE PREMISES Ea occurrence $300,000 MED EXP(Any one person) S 10.0m PERSONAL&ADV INJURY b 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 X POLICY❑JECT LOC PRODUCTS-COMPIOP AGG $z,DDo,DDD OTHER: g A AUTOMOBILE LIABILITY CPA3158728 1/1/2019 1/1/2020 COMc1ide�51NGLE LIMIT S 1 0000o0 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X AUTOS NED PROPERTYDAMAGE $ AUTOS Per accident S A X UMBRELLA LIAR X OCCUR CPA3158728 1/1/2019 1/1/2020 EACH OCCURRENCE $15,000,0D0 EXCESS LIAB CLAIMS-MADE AGGREGATE $15,000.000 DED X RETENTION$It $ B WORKERS COMPENSATION WCA315872924 1/1/2019 1/1/2020 X PER OTH AND EMPLOYERS'LIABILITY Y/N STATUTE I I ER ANY PROPRIETOR/PARTNER/ERECU nVE71 E.L.EACH ACCIDENT $1.0120.000 OFFICER/MEMBER EXCLUDED? If yes,describe under N I A Mandatary in ander E.L.DISEASE-EA EMPLOYE S 1,000A00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1.00.000 C. Pollution Liability _ 79300733411000. 1/l/2019 1/1/2020 e S2,Oo0,oD Each Occurrence - 82,Dao,00o Claims-Made Policy Aggregatu Retroactive Date 06/202013 Deductible $25,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may he attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. FOR INFORMATIONAL PURPOSES"ONLY AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD J TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ..•Map Parcel �� Application �Ov��OC Health•Division Date Issued t 1 Conservation,Division '; Application Fee %l a Planning Dept. Permit Fee .�=?�C Date Definitive Plan Approved by Planning Board :. _ k, g1l�IrZ.T Historic- OKH Preservation/.Hyannis Project Street Address ' S 5 R -gym beri ill 1'L Village Ce r,/,11 e Owner D Cj(bNA, Corm e Address ,5 6 , C-CAAal 11��e Telephone SIB Permit Request IF)Al Cc, y l A S e•. i-o `t GCH'I c NJ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain _Groundwater Overlay Project Valuation M Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Famill+ytl)Q Two Family ❑ Multi-Family (# units) Age of Existing Structure l 9 �. Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other ' ' rare Basement Finished Area(sq.ft.) Basement Unfinished Area(sgft) C-D ,j - , Number of Baths: Full: existing new Half: existing f _new Number of Bedrooms: existing _new - Total Room Count (not including baths): existing - new First Floor Room Count`-.,, Heat Type and Fuel: 'd Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑ Yes NLNo Fireplaces: Existing New Existing wood/coal stover ❑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 A No If yes, site plan review# _ Current Use. . . - - — Proposed Use- -- - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name "TWA iakc Telephone Number ` 3q3 " Address , V License # G • YN'rf-ke Home Improvement Contractor# Worker's Compensation # 0 0-+ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO `O C(AO��I� SIGNATURE DATE i FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED .a MAP_/PARCEL NO. r - ADDRESS VILLAGE OWNER DATE OF INSPECTION: -FOUNDATION.'.A,;�-," , ' FRAME - s INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL i� t PLUMBING: ROUGH FINAL GAS: _ ROUGH - FINAL . .. .:-FINAL BUILDING ;. DATE CLOSED OUT 1 ASSOCIATION PLAN NO: ' Building Permit -Authorization - peog$A# As owner hereby give, my permission to CAPESAVEINC, 7-D Huntington Ave. South Y6rmouth,,02664 (508)398-0398 µ to take a I I necessary steps to o btoi n a bue. ildi ng permit to perform to work at my property located at+ Signed Date •®,� - v 41 ` - w • , .. . rw ', t , f - :�- of 1 .' " f The Coinnionwealth of Massachusetts Department of InditstrialAccidents ` r Office of Investigations , 600 Washington Street F Boston, 11M 02111 www.niass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/organization/individual):!Z__, o\,Y f- S n C Address: • fl Hwn-tinq+an Rvenwe ° z City/State/Zip: oo-}�+ YaslnoyA MR OU64 Phone#: 568- 3 0 - 039 g " Are you an employer?Check t � "ropriate box: 1.�] I am a employer with 4. I am a general contractor and I Type of project(required):❑ ' 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' • [No workers'comp,insurance . comp.insurance.* 9• ❑Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doingall 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 .T n S U�,'ti►�i on 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 thepolicy andjob site information. , , Insurance Company Name: _Teo�n o l o 76 S w.r an c.0 F i G n Policy#or Self-ins.Lie.#.: T w C 3 3 -4 Expiration Date:' Job Site Address: cc fo.. LU�mber� 1\ 11 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-ye'ar imprisonment,as well as civil penalties in the forni 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 Investieations of theDIA for insurance coverage verification. I do hereby certify under the'pains avid penalties of perjury that the infornrntion proilided above is true and correct P Sianature: _ `� 1 cJ•.. . Date: J Phoney: Official rise only. Do not write.in this area,to be completed by city or tolvn.official , City or Town: ' Permit/License 9 ' Issuing Authority(circle ooe): r , 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector�5. Plumbing Inspector t% 6. Other Contact-Person: Phone, . �� ® S15/10/2012 DATE(MMlDDMl1^l) A CERTIFICATE OF LIABILITY 'INSURANCE 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 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). CONTACT Risk Strategies.Company. PRODUCER NAME: FAX Risk Strategies Company v PHONE (781)986-4400 0..(781)963-4420 .. 15 Pacella Park Drive E-MAILADDRESS: Suite 240 INSURERS AFFORDING COVERAGE° NAIC>a Randolph MA 02368 INSURERA:Selective Insurance INSURED INSURERB:Safe 'Insurance Company 33618 Cape Saver Inc INSURER C.Technology Insurance Company 7 D Huntington Ave INSURER D: INSURER E South Yarmouth MA 02644 INSURERF: COVERAGES CERTIFICATE NUMBERCL125948081 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 CONTRACT OR 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. DDLSUBR POLICY EFF POLICY EXP INSR TYPE OF INSURANCE POLICY NUMBER MMIDD MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE' $ 1,000,000 - DAMAGE TO RENTED $ 100,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence 'CLAIMS-MADE X OCCU R PPS1994480 1. I 0/16/2011 0/16/2012 MED EXP(Any one person) $ 10,000 A 000 INJURY, $ 1,000, AL&ADV JU , 4 PERSON GENERAL AGGREGATE $ 2,000,000 KXE�'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO- LOC $COMBINED SINGLE LIMITAUTOMOBILE LIABILITY Ea accident 1 000 000 ANY AUTO BODILY INJURY(Per person) $B ALL OWNED SCHEDULED 6208200• 1/6/2011 1/6/2012 EPROPERTY (Pera-,,ant) $ AUTOS AUTOS AGE X HIRED AUTOS N AUTOSNON-O $orist BI s lit $ 100 00X UMBRELLA LIAB OCCUR NCE $ 2,000,000 A EXCESS LIAB CLAIMS-MADE 3' AGGREGATE $ 2,000,000 DED RETENTION PPS1994480 ,•. 0/16/2011 0/16/2012 $ w C WORKERS COMPENSATION WC STATU- ToRyLurrsi O Ft AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE ANY E L EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? N NIA �C.21318007 /9/2012 /9/2013(Mandatory in NH) E.L DISEASE-EA EMPLOYE $ 500 000 If yes,describe under ', `DESCRIPTION OF OPERATIONS belowT. I. E.L DISEASE-POLICY LIMIT $ 500 000 ♦ _ .. e. 1. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,tt more space is required) Issued as evidence of insurance. . Issued•as evidence. of insurance. Thielsch Engineering, Inc. is listed as additional insured as respects General Liabilitylas,'required by written-contract: 7 CERTIFICATE-HOLDER CANCELLATION msong@capeiightcompact.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE;- THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Cape Light Compact Attn: Margaret Song AUTHORIZED REPRESENTATIVE PO Box 427/SCH 3195 Main Street j Barnstable, MA 02630 r Michael Christian/BAM ��d ACORD 25(2010I05) . ©1988-2010 ACORD CORPORATION. All rights reserved. INS025r9n1r1(K1n1 Tho A( (,ipn namo and Innn aru mnic4tarnri mar4c of ACAR11 - , ' - . �la�sachu:ctts- Dcp i tnient of Public Safety 7 Board of Building Regulations and Stantlard� Construction Supervisor Specialty License h License: CS SL 102776 " Restricted to: IC C CLUSKY WILLIAM M , 37 NAUSET ROAD WEST YARMOUTH, MA 02673 Expiration: 6128/2013 Tr: 102776 - -Office of Consumer Affairs and usiness Regulation - 10 Park Plaza -`Suite 5170 ` Boston Massachusetts 02116 r ' Home Improvement Contractor Registration Registration: 171380 ' Type: Corporation 4 Expiration: 3/14/2014 Tr# 222184 CAPE SAVE INC. WILLIAM MCCLUSKEY 7-D HUNTINGTON AVENUE: SOUTH YARMOUTH, MA 02664 - - 4 ,•" �' Update'Address and return card.Mack reason for change. t +` Address [—I RenewalU,Employment El Lost Card PS-CA1 as 50M-04/64-G101216 �, ✓fie "�"�"101 �� `� "�!"� License or registration valid for individul use only Office of Consumer Affairs&B smess Regulation HOME IMPROVEMENT CONTRACTOR - 'before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration: 171380 Type: 10 Park Plaza-Suite 5170 b I Expiration: -3/14/2014 Corporation t f Boston,MA 02116 C SAVE INC.':_..•, WILLIAM McCLUSKEY , 7-D HUNTINGTON AVENUE.= SOUTH YARMOUTH,MA`62664 Undersecretary Not valid wit 6 signa l 3 Cape Save IncTOY1 F. E 7-D Huntington Avenue South Yarmouth, MAX216642 2 P11 I 1 6 Tel: 508-398-0398 Fax: 508-398-0399 9/24/12 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permits f Dear Mr. Perry, This affidavit is to certify that all work completed for 558 Lumbert Mill Road,Centerville has been inspected by a certified Building Performance Institute(BPI) Inspector. Ceiling: R-46 cellulose(340 sq ft)R-22 (remainder) Knee wall: R-6 rigid fiberglass Box sill: R-19 fiberglass All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 4% ` Parcel Lev V, Permit# Health Division /� CJ / �d� Date Issued Conservation Division P Z i l®3 Application Fee ' Uv Tax Collector. Permit Fee L`l bl l x Treasurer SYSTEM mUST EE Planning Dept. t w UED IN C:OMPLKNC- ` Thy TITLE 5 Date Definitive Plan Approved by Planning Board �`7�[7�71TAL CODE A��� Historic-OKH Preservation/Hyannis Protect Street Address Village C-4,/�e;:�11"/1 Owner/ y re Address ff--f 7' Telephone -__ sde Swo —®oly Permit Request Y~e 360 14 AO Square feet: 1 st floor: existing proposed 0 2nd floor: existing Gov f proposed Total new 6 Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes Cl No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family Cl Multi-Family(#units) Age of Existing Structure SiP c.r_f Historic House: ❑Yes MNo On Old King's Highway: Cl Yes J&No . Basement Type: 4 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new 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 BUILDER INFORMATION Name Telephone Number 1Uop — �'— Address /lv �f ��-��' G���.: License# �� ✓ �� � Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO /�rJ��s7�.� SIGNATURE �� �— DATES —3 r +` FOR OFFICIAL USE ONLY G PERMIT NO. l DATE ISSUED r MAP/PARCEL NO. ADDRESS Y VILLAGE OWNER 1' , DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL y GAS: - ROUGH FINAL ' 1 FINAL BUILDING DATE CLOSED OUT ° ASSOCIATION PLAN NO. The CoMmonwealth of Massachusetts - Department of Industrial Accidents Office 9110Yestfg'8tf0/IS 600 Washington Street " Boston,Mass. 02111 1 Workers' Com ensation Insurance davit i name: location. IrIf /�V// Dz�,3Z city phone# Jr ❑ I am a homeowner performing all work myself. ❑ I am a sole netor and have no one worku in ca achy I am an em lover raviding workers'compensation for mp employees working on this job. !�ompanvn m <i i{ii'<ti�iiiii:iiii:�:>.�i'::YtG:���iiiiiiiiiiiiiiii}:2`t•:Li+};'i:'{}i_:ij';:iiiiiiiiiii:>ii:?:}�i}t}:tiisii�i:�riiii:�i:•:�ii�:ti�i$i:'f.;:iii�i:^'�i�iiR�:�i:L�i:�i?'�ij;::i:i•iS�i?:•} +:t:�:?4i�•:�:vt�iii?:�?:'�:�:::'iiY'ii�?:'%}:r:�}:�iiiii;:i;::isi:`.�:?:;{{:�v+r:i:;:;.'';•r;:;{i?•:{i.}'i•.?{.i}} :i�:!ws'{::;:{:.v::;.y:.v::;::::�:•isf:'i+?fir{;,-}:r...;?.:�+':ti:;.'.�;?:>.�:;>?<:•,;'i`;F;isfii:!iiti$:Yy?:;>�?i>.�j:>:;{itiv};`•'::�: j::;:i���:{; :::is�{::;{:it,:;}.:;::ti::''�:;ii�:�i:�::;`•;�:;:yt;ij:ti�j}::•i:i+}:i>:L�j(>is4>;:;i:;?iti:?j:{;:},:i�:iiY:+,isYi•i{}Xv::isjY:ii;`}:±>•!{}:{i•}}:;}>.!}:{• .... ..:......:........ f trip lion?��.�iiip;i : :� 3!<:??:i ::isi:ifii :i;•` EiSi?:o::+<:?i:;::iii '?;; :>i;;?;`iir i?'`':'??%' i is?'•i �if33r: ibi ?i.'•:i'% ..{, :f.;::j; {':;;::'!?i};•i;$2�:L�'• :?��� J:' :+•i.,i::{::j:i{! ?�:?:::L'?'}:?':j;:;iii:.:j;::ii::::;.;,yi}is4::}:i :;iii:;.;i:'::;`J±;,}i:•:. {ri:?:�i;:;i: }C`vii::l:i{i:;:; 1f�isuran %/ FEW 'ell OM i� .,� :� am a sole proprietor,M al contracto or homeowner(circle one) and have hired the contractors listed below who have the followin workers' compensation olices.: g .................................................:.:.:.::.::::::::::::::::::::::::::.:::.:::::::..::::::..::::............::.:.......t.::::::.,.,.:.,,.::.t,.:., a '�.^-�.-`*<t':`�.{` � � '�� `"ti?R :t:y` :�'i'•,i�%`k:'i'`>S?%?`'i''�z<5 ?''� 'j� �'rt: <�`': ><s^.'^� �%t'� :'{�'�t'`#i�i '•�%< fo112D V' ::.c4...}.::::::.�::....:•: :::::::::.}:;v}}}}}:•::.v:::::::ti:'}}}:}::::•i}:i?•}:}}':.v.�::.v:::::.v:::::::.v:;:v:v::::....:........tv:::vn:v:w:: :•}:{iL}}}}:{•:•}}:. ..................i x::is{^:L:n••:mv::}:•ii:'.-:•:::4;•}:::.....:.. ..........................:..:......::........... v;?�:?:n., .,.;.:...-...{•}:{{'. .......:. .................v:::.;::nv v::::•.v;}::::v.:v:::::::::::::::::.:v::::::.}'.i:w::::::::•.•:.t•:::::::",tv.4}:tV.:ti:•}:v:•}:vi{i{?•}:v:•::::::':y{t'::.y �:•}v:•}::...;.........,:rc ............ ........... ....................v... .....v:,{.:{:.}:•}:i{ii::a}::.;::: .....:•::.••:-:.v :::::::::::?. }:..}.Ti}:{ti?J:�•:�tr::::::::;t}'r,:i;:;}:$•}}'1,: .....t .... .................. .:::::.v:::.w::v:::::.v:::::::nv.::'L}:?{{.:4}}}:::•}}:w:. ^rti'•:-.....:::}:. .....,.......: ................................:. .. .i................ .................................... .. ..............................n::r::.v:.v:::♦ ........n:n.:..v.:......::x}...-....rvwnw:::.,t}.,{:}•:: •.:v•.v•:}i: ...........v.::.:.......... ...r... .........:.. .: •....:.............. .... ..............:..:............ ::..::.........................:•:::::.............:::::,•:rtta::::{:•}:{•}:•}}:v:.: .... w:•.•:•.•:+•::::.v::.v.Y>i•;ry.}:{{r}^:v. �• •t�sa -i 4::2>:;i •iti'� :fSSk�'�:�ii :�i :�>+�:i:d i;;r: ;:.}•+,:•i}x{•}:{:;y;•}}..: .:..:::::::•::......;..... .... ,:}}::;-:�':;•;:a:-.r-:::::; .• •.{. ... .. ...,... :::3}:ik�:iii:};i+:�iii:%�:;::<;:%:ii:�iii::>.}:i::�:a r� �::2=i1r`:• ';yam:. `i.tv {•. 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Faibme to secure coverage as required mtder Section 35A of MGL 152 can lead to the imposition of criminal penalties of a fine up to si rim.00 and/or one years'bnprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of S100.00 a day against me. I understand that a copy of this statement may be fo ed to the OM a of Investigations of the DIA for coverage verification. 1 do hereby certify the pains pen of pedury that the information provided above is t cnd correct Signature Date Pont name ll d� Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑��g Department ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office ❑Health Department ^ contact person: Phone#; _ ❑Other i (revised 9195 PW Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", 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 section 25 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,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. .ti Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and ', supplying company names, address and phone numbers along with a certificate of insurance as all affidavits maybe «. submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and f;:. date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is of Industrial Accidents. Should you have any questions regarding the"law"or if you being requested,not the Department policy,please call the Department at the member listed below. are required to obtain.a workers' compensation City or Towns 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. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The D artrnent's address,telephone and fax number. ep The Commonwealth Of Massachusetts Department of Industrial Accidents Otflce of Imestlg Btlolls 600 Washington Street Boston Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 . r EVE Town of Barnstable Regulatory Services BARNSTABL& " Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: ril � � � Estimated Cost Pew Address of Work:���� �y� ✓�� Owner's Name: 45eolr Date of Application: Ta 3 I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑lob Under$1,000 []Building not owner-occupied ❑Owner pulling own permit " Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the o er: Jmloez,1114Af fJ Date Contractor Name Registration No. .g x OR Date Owner's Name Q:forms:homeaffidav t IME goy, Town of Barnstable P 1'O Regulatory Services ' M E MASS. Thomas F.Geller,Director ,V ess. �prED MAy�,� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize d to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) gnadwner Date Print Name n.TN1DT dC./1 nrKTCD DT:D'h ATCCTfIAT LO ATI O N O F Fw E RTY LINES MAY NOT B E ACCU RATE STANDARD LEGEN NOTE:not all symbols will appear on a map GOLF COURSE FAIRWAY EDGE OF DECIDUOUS TREES ..... EDGE OF BRUSH ' ORCHARD OR NURSERY EDGE OF CONIFEROUS TREES / I MARSH AREA l f EDGE OF WATER DIRT ROAD DRIVEWAY MAPI 147 Imo=PARKING LOT \ PAVED ROAD ;' ------ DRAINAGE DITCH PATH/TRAIL PARCEL LINE 70 MAP 326 PARCEL NUMBER \�\ #367 E HOUSE NUMBER 2 TOOT CONTOUR LINE - i 0 10 FOOT CONTOUR LINE Elevation based on NGVD29 4.9 SPOT ELEVATION \P\ I STONE WALL -X—X- FENCE 0 � I. RETAINING WALL \ 2,--4 - -l-t-I- RAIL ROAD TRACK STONE JETTY # 558" ' P SWIMMING POOL PORCH/DECK ❑ BUILDING/STRUCTURE DOCK/PIER HYDRANT ', rs e VALVE OO MANHOLE <ri 0 POST 0'F FLAG POLE T O W N O F B A R N S T A B L- E G E O G R A P H 1 C I N F O R M A T 1 0 N S Y S T E M S U N I T SIGN ® STORM DRAIN !t PRINTED SCALE:IN FEET *NOTE:This ma rs an enla ement of a **NOTE:The arcel lines are onl ra hrc re resentations DATA SOURCES: Planimetrics(man-made features were interpreted from 1995 aerialphotographs by The James P r9 P y g P P ) P UTILITY POLE ❑ TOWER 1°=100'scale map and may NOT meet of property boundaries They are not true locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD w e 0 is v 80 National Me Accuracy Standards at this do not represent actual relationships to physical objects Corporation. Planimetrics,topography,and vegetation were mapped to meet National Map Accuracy Standards enlarged sca e. on the ma at a scale of 1"=100'. Parcel lines were di itized from FY2004 Town of Barnstable Assessors tax maps. ¢ LIGHT POLE O ELECTRIC BOX s 1 INCH=30 FEET* P• g P UNRIC ST A1'RED LAND lIIi itfl®ete _10442t; DEW SOOIL• � PAQE: ATTORW,.--FRANK K. DUFFY, JR ESQUIRE PLIN DOOR; PALL EDT(B)- PLAN NOVM, air 01= PAUL J. BANIA RSGISrJrJt t'D LAND APPLICW,_GEOFFREY N. k DEBORAH C. CONVERSE Ri)PAA`TON BODY. PAGE: Dim. 98/27/97 BCAIJ6:-t'■52' C6R'ITl1CA!'!t 01 'iT11,6 130465 FLOOD HAZARD INFO"ATION PLAN NU{(8 . 37432-A SHEET nDOD YAP COWXXITY ND:16CD1L_ ZONE;C AMSSOIIS MAP PANEL• 0015C DAM: 0960185 NAP; BLOCL• PASCEI: MORTGAGE INSPECTION PLAN 668 LUMBBRT MILL ROAD, BARNSTABL•E', MA LUMBIRT POND ,%-'_ LOT a Pam � . LOT 7 LOT 9 �' CONCe[1E ' 73,34' eDYMD MOR!2AGE LENDER LUMBERT MILL ROAD USE ONLY THIS IS THE RESULT OF TAPE MEASUREMENT, NOT THE RE5ULT DES i .T OF AN IN57RUMENT SURVEY AND IS CERTIFIED TO THE TITLE ���jy(�1�U INSURANCE COMPANY AND ABOVE LISTED ATTORNEY AND LENDER. &&C�.�1�/ TE$ NC. 130 WEST STREET, WALPOLE. MA 02051 THERE ARE NO DEEDED EASEMENTS IN THE ABOVE REFERENCED TEL.:(800)287-8E00 FAX.:(508)668-4512 DEED OR ENCROACHMENTS WITH RESPECT TO BUILDINGS SITUATED ON THIS LOT EXCEPT AS SHOWN. THE LOCATION OF THE DWELLING SHOWN DOES NOT FALL WITHIN tN OF A SPECIAL FLOOD HAZARD ZONE. MARIO THE LOCATION OF THE DWELLING AS SHOWN HEREON EITHER OOMINIc YANOANICI N WAS IN COMPLIANCE WITH THE LOCAL ZONING BY—LAWS IN No. 18841 EFFECT WHEN CONSTRUCTED (WITH RESPECT TO STRUCTURAL GfSTtt�p SETBACK REQUIREMENTS ONLY), OR IS EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER MASS, G.L. TITLE VII, CHAPTER 40A, SECTION 7, GENERAL NOTES: (1) The declarations made above are on the basis of my knowledge. Information, and belief as the.result of a mortgage Inspection tape survey made to the normal standard of care of registered land surveyors; practicing in Massachusetts. (2) Oedoratlons are made to the above named client only as of this date. (3) This plan was not made for recording purposes, for use in preparing deed descriptions or for constructions, (4) Verifications of property line dimensions, building offsets, fences, Of lot conAquration may be accomplished only by an accurate Instrument survey. l Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Reg istrati o rn-. 1.18952 Expi affon 5[a/2005 .Type _Ur THOMAS P DAMELIO god&>REMODELING THOMAS DAMELIO 16 WHITE BIRCH WAY = gyp W. BARNSTABLE,MA 02668 Administrator i .. - ----- -- - - - ✓fieB�an�rrieal!/a /�aaoaclueaelt ji � I OARD OF BUILDIN�REGIILATIONS License: CONSTRUCTION SUPERVISOR Numbe(,;'G!k 047420 Birltlkda fl4107i=19467-2 1zptres} 0 /0OR25 Tr.no: 10673 j Resjr.%ed' THOMAS P DAMS Ip s 16 WHITE BIRCH VAY�� W BYARNSTABLE, YES Administrator ■ ■ mom mommmommomm�N _ ■ ■ ■ MEN MEMOM■■■■■■S■■■■■■ Nrr ■■■ ■M■■NEN■■■ M■NNEN■■■■■■■■■■■■■■MNr NONE■mom ■■ ■ ME M■NNEN■l■■■■■■■MENEM M VIM No No ■■■M MEN M O , M MENEMM ONE■■ ■NO■mom moommommom OM■MOO MEMO■ ■■■■■■■ NNWON ■■M MONK■ MEMO 11212mmommommom■■■ ■ , ON , NN■ MEN■M MOE■ f ■■■■■■■■■■■■■■■ ■ O■■ M■NEM SEEM „ M■■ ■ ■ No M■■ M■N■M MONO ■MO N - OMNN NN■ MEN■M OEM _ r■ MMMNN �■M■MN■N - I Mr MN■■■■■■■N0 , , rE■■■■■■N ■■M■■m ■■■ MN ■M M■NN■NN0 ■MEM■M■M■MMNNN■MM■N■M ■ M■ ■■■■■■■■ ■■■■■■■■■■M■■■■MMN■MN■Milo MM NO ■■■m■oO ■■■■i M■N■M�� ' - �NINOOM ■OM■ON■ ■■■■■■■OEM ®■■■■M�■ ®.o. ;NMO■■MOEN . ::o:r�•�. ��� fa��au.. rr..r.c.� ��5. 0 NONE MN®M No ■■MN mom■ MM■ iN■M■ MOON M N■M■■■■■■■■■■■■®■■■■■■■ ■■NNN ■ ■MOOJ -- ■■®■■■■ M■ ► M■NMN M � NMNN M■M NN ■■■M■NM■M■ IMMOMMEM mom ENO MEN No. ■■■■■■■■■■■■■■■■■ENE ■M No NOON■: N■■ M® NN r NONE NONE MEM■�NNo MNM , y ■MNN M M MMNNM ■M ■N NME ■ MMNM No _ r it i yr I i .aW ' r i � _I N■ -- - - - _ _�_ ___ r _ Assesso's Office(1st floor) Map Parcel 2 Permit# f 6 931 J Conservation Office(4th floor)(8:30-9:30/1:00-2:00) Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) Fees l� Engineering Dept. (3rd floor) House# ;� i tHE Planning Dept. (1st floor/School Admin:Bldg.) -- - : BARNSTABLE. DefinitivepPlard by Planning Board 19TOWN OF BARNSTABLEBuilding Permit pplication Project St Village !'fir �Jc� l P`h` -a)r-,1 i N P' .:. �� � , Owner '�� ( Address� S�M p_ „1A� • Telephone ' � .�/ Permit Request Lpainn OUC ri( 5 ft( 4 Roa cn�'QS �y►r rr /'E`��4 w c t h a s�h�(� '-First Floor square feet Second Floor square feet c v4stimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size { Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential' Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No. of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool , Attached Barn None Sheds Other - / Builder Information /Name D�`� l,- ro C2/ /Tele hone Number Z G `� /I P /Address Pr / License.# M&_-71005 /Y)L V 5 O,?�G q7_ /Home Improvement Contractor,# �V/Orker's Compensation# Zi NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE Z, DATE / Z-12 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY oil PERMIT NO. DATE ISSUED MAP/-PARCEL NO. ADDRESS T A M i VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME+ r • I r �" r r = INSULATION — • FIREPLACE. t ' ELECTRICAL: ROUGH r FINAL : + t `:; PLUMBING: ROUGH .~i ' FINAL s GAS: ROUGH FINAL FINAL BUILDING r �" 171E - f DATE CLOSED OUT. ASSOCIATION PLAN NO. ! i i ` i •b The Town of Barnstable _ M Department of Health Safety and Environmental Services Building Division 3 367 Main Street,Hyannis MA 02601 Ralph Crosses Office: 508-790.6227 Budding Communor Fa= 508 775-33" For office use only Permit no.. Date AFFIDAVIT HOME DWROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the-"=nst=uction,alterations,'renovation,repair' on,com rsion' improvement,.Rmrnal, demolition, or construction of an addition to any pre-catinS owner o=zpi cd building containing at least one but not more than four dwelling units or to sanctureswinch are adjacent to such residence or building be done by registered contractors,with certain aao Mons,along with other /Type of Work: � C�/Yl pCost00U ddress of Work: Z—a / rer.Name: _ Pau Date of Permit Application: 3 I hereby certify that: Registration is not required for the following rrason(s): Work excluded by law Job under SI,000 Building not owner-oowpied Owner pulling own permit Notice is hey given that: CONTRACTORS OWNERS PULLING OWN ��G � FOR APPLICAB HONE WORK DON �HAVE ACCESS O THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the Miner. AU. C 'J 6 / Date Contractor name Registration No. OR Assessor's offioe (1st floor): / oFTNEto Assessor's map and lot number ..... .... . ... .............. ..... Board of Health (3rd floor): �� l��jy►/I Q jam/ �Q o Sewage Permit number ...... .. Z NARNSTADLL NAM ..... ��� � �rl� ' i67q. r HoulseEngernumbeing Department (3rd floor): ....'................................ �f�� �� e�®�P ��aYa APPLICATIONS PROCESSED 8:30-9:30 A.M, and 1:00-2:00 P.M. onlytd��'� �BTL�5R'�� .; ,1,j,,j,WrUqL C®®e A P P ) Q V TOWN OF BARNST�A�B LArj®Aq � G INSPECTOR e A , ta'.s..Q.P... .. . C�............. � PPLICATION FOR PERMIT TO ........... ..... � 1 ....... .....���............................. _ Or �( � / TYPE OF CONSTRUCTION ......... .v�} t-Z`. -........ ......../.�..(jL .... .................................................. ..............A. .....'1.....19 v_ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....�!'.:.'�1�-`:................................ ...S......................... �..^.^.c.�..�.�.>'...........�:P�( .....�.(�...... .:......... Proposed .Use v �0 c.........................i....................................................................................................................................... l e(l Zoning District ...e -c..�.c=C .�......� r.`> 4 .... .. . .........................Fire District .......... ,- .✓' .............. ................... .. Nameof Owner ...C.I..........;3.4?.-ti.t.P-7...........................Address .................................................................................... Name of Builder . .............. .....Address Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..... ......6... ...................................Foundation f :.!!................................................ W r ' ,wA Exterior .............. ..../.� .........................................................Roofing .....................WfAlk............................................. Floors (ft? ,./�1'�1QQ\Ce-- .Interior �- .. Heating ...............W1 0 .......................................................Plumbing .................................................................................. . ......... ... Fireplace ..................................................................................Approximate Cost �V .. .. ................. ...................... Definitive Plan Approved by Planning Board --------------------------------19-------- . Area ....G.).6..... 6.................... Diagram of Lot and Building with Dimensions Fee ....... ..D................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH rrll o _ 1 �Lile��Ak 01 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 .. ....I .,. Construction Supervisor's License 1 ............................. ... C. B?NIA 31495 Ad To Garage No ................. Permit f6 ........ .......................... 1 V tv Accessory Ub DI Z ling 5� .............................. V........ ...................... Location ... 558 Lumbbrt Mill Road, Lot #8 A ................ ......... .......................... Centerville .................................I.Ra............ .......................... C.. Baniai.. ........ ...................... Owner ...... ................ am Type of,Construction. . .. ....................... ........................... ....... .......................... Plot ...... ..................... Lot' .............................. December ll , ' 87 Permit-Granted ........................................19 Date of'Inspection ......................I...........'.19 znl i` Date Completed ................................Y19 0 /ssessor's offioe (1st flood): Assessors map and lot number IV � Board of Health (3rd floor): ! Sewage Permit number +. Engineering Department (3rd,floor): ti oo Nb3o \0� House number :::--:.:.......... a Uri a. APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only r TOWN OF BARNSTABLE BU-IL=DIHG . INSPECTOR , APPLICATION FOR PERMIT TO 4..4.P... ../........ ................. ....... ................................................... �'��r-S r �( TYPE OF CONSTRUCTION ......... .:............--.......... Q..../�... r (f.... .................................................. ................. / .//.....19V- TO _T.HE INSPECTOR OF BUILDINGS: v The undersigned hereby applies for a permit according to the following information: Location ....( ":....�...-�O.�.�.`.:�............:57,5: � !� v.�!�r4s���..�..�.......... �( ( ..... ..�....... .......... ProposedUse .............. ................................. ......................................................... ............................ Zoning District .......................Fire District ........-.... .-. ✓ /. `' .............................................. f.. -•../.�`.c.... ........ . r' l Nameof Owner ..C..>............ ...t .....................................Address ...:.......................y t...................................................... Name/,of Builder .W.......... ....:5........................Address .................................................................................... NameofArchitect ................Y.................................................Address ..........................f.......................................................... Numberof Rooms ....4. ... .. ..........:.................................Foundation .........:. .."•••.............................................. Exterior ............. " - ............e�........................................Roofing .................... ..............................°...... r Floors ................. .Interior nd..................................... "— Heating ................. .......................................................Plumbing .................................................................................. r i Fireplace Approximate Cost ............................................................................. r DefinitivefPlan Approved by Planning Board ------------------------._-__-_19__- __._ Area ...�. ......®.................... Diagram of Lot and Building with Dimensions Fee ......1tea. ............................. SUBJECT TO APPROVAL OF BOARD OF. HEALTH t .2DY V ♦ _ r y Of J n 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. t Name .. ....!S.S 6 . 2....r---�... � .�� Construction Supervisor's Licen'se ............................. ..... C. Bl'l4I7,- A=146-024 No 31495 permit for ,Add to Garage Accessory to Dwelling ......................................................................... Location ,,, 558 Lumbert Mill Road ............................................. Centerville ..................................................................I............. Owner C. Bania ................................................................. Type of Construction .....Frame . ..................................... ............................................................................... i Plot ............................ Lot ................................ _ Permit Granted .........................................December 11 , 19 8 7 . Date of Inspection ....................................19 Date Completed ...................:..................19 _ y t TOWN OF,BARNSTABLE Permit No. ______-� 3 ' f Building Inspector IU.S.-Am ' Cash 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 Cinristire 11. rBei'iia ` Address T,ot, 4f3-, 558 Lumbext Mill : oa6, O.ss,serville Wiring Inspector �� .err,.,.1 Inspection date Plumbing Inspector _" Inspection date Gras Inspector �? Inspection date X 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 Inspeet'o' _ SEP Assessors map and:lot number l../...... .. . df......... FTHET i2/ STALLIED I I� CO �y Sewage Permit number ......(9.1:... .. 1..................... WITH TITLE w Er. t -B 5 �$RONP'IENTALL 400 !Q 9HB9TADLE, i House number 9.1$04......... .................... _ 9 s p �d'�lAJIm Pr l6AT!,-)M. OD M6 q. ♦� �E'OMPY{r\ 'J""JE TO APPROVAL % TOWN OF BAR.NSTX �? LE CONSERVATION COMMISSION BUILDING INSPECTOR APPLICATION FOR PERMIT TO ......... . . . .r..... .............................................................................. TYPE OF CONSTRUCTION ... ............ ............. ................A 1..1.4.................19-K. TO THE INSPECTOR OF BU(LDINGS.The undersigned undersigned hereby applies for a permit according to the following information: Location ......1,6-T....... ..................�1 im L 7_-r.....0).1.11.....P. (�aTer,-,), .l.P......................... Proposed Use ...........&W..ee .i.I ....'_°....��NlC'_._.�!??XI).1.t. .............................. ................................................... Zoning -District .......... 'Sb.C?l. va............................Fire District ....fir .r.®.a. ..I ......................................... i , Name of Owner ...��.-..�-1KA.ST.-MA'........ Address RA.�.....LI&OA).n.i. 11 Nameof Builder ......4t3t M. A. .............................................Address .................................................................................... Name of Architect ......S.0'., 1 . .........................................Address .................. Number of Rooms ...........................L.....................................Foundation ...... 11lJNi ... Exterior ......:Ln_.)S:?L {'. ��. ..............................Roofing ........lat. .. .. �. .......................... Floors ........LOCX�',d.......'-...f 1.1�.................................Interior ..........-sh-t id,.a.....................:.................. �_..Heating' ......RC�TT... 1 ..................: ......................Plumbing ............ ,� Fireplace .....:.....11C—a..... .....LA I.Ck ..................Approximate Cost ............. ......,...00 .................................. Definitive Plan Approved by Planning Board -----------_----_--------------19________. Area bo Diagram of Lot and Building with Dimensions Fee .� SUBJECT TO APPROVAL OF BOARD OF HEALTH A0 13 � o P 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 ..... ........ HFNIA, CHRISTINE M. f 23714 One Story ................. Permit for ..................................... t ........Single...F.ami.ly..Dw.e11ing............. Location Lot...#.8....".5.58...Lusnber;t--Mi.1..1• • t- el r , Ostervi1le........................a.:........ y BahiaOwner .....C.h.ri.stine...M....... . .... ......... ............. ` Type of'Construction ,.F.rame..... ,. ., t ... ..... ............................. ................. ` ? ............ Lot w Prot ................. .............. ,. r Permit Granted ,, December 21, .19 81 Date of Inspection ............. .....19 F Date Completed ......... :: :19 I . I I , r , t t 1 } , i 7.7 - - a _ _ I 0 , - _ r - f - I - - - 1 1 r _. Iry + 1 3t I 17 4 `r r I it I Jr 1 1 1 1 t Tt- I ". .-. _ Sul! _... � •. - '- - -(' _ I , , _ r , I i I I I ` - • t ' ' �' r µ l Ott �Sx , .".. + - t.., I -I' r f-t -r--- Ple R3334' I _ �'�. ---a- �� r '., ' �__ �-•-� ; -f-�--�-� 1';�" �? r pl.6TG i,� IST MAI FT , 1 GG RTtKY' A�` 'T;14a; F[>V4�T�?/� t rL 141-^4) :F *� i f 43t: 4 Rr=p! Auk T�1 ®� -Yw ; r I , ; { TO W t.P of �_.I I l 1 TN1� DLA�-1 OS ►-fC?T L'�ASEV va.f AXASS: .l�;�tJ,t✓�,E1.lZ" SU�VG�{ ¢ Tti�C: U��S�'t"°S Si�IGli1l.D � 11PRt.1'GA.1+J,T` ,CH R15'fIN�;:�� :��N'IA,, ..w r E3C u u o Z"o Da TCPM %4 LLB. ,.: Lt14 e5 All, t> Assessor's map and lot number y1iy. .. .. .. -hr��....... I z THE .Sewage Permit-number ...... .......................... EARIN TABLE, House number NAM ....................................................................... 1639- TOWN OF BARNSTABLE BUILDING - INSPECTOR APPLICATIONFOR PERMIT TO .......... ............................................................................................... TYPE OF CONSTRUCTION ...AA.A(- S'�.!Nl......(bmrz,,..,.AMxn..t. A ......d.t U ................. ................19...... ........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location R.X...... ". A►tX . ..................... ........................ .......... le........V........................ Proposed Use ........... ....................................................................................... ......... Zoning District ........... ............................Fire District .... ........................................ Name of Owner S..Jw.ls m-y........flD....PN4.f9fa .....Address .3 1?.A........4.op.omn.........".. Nameof Builder" ....... 17n�7­...........................................Address ........................ ........................................................... Nameof Architect ....... .............................................Address .................................................................................... N 11 Number of Rooms ......................... .....................................Foundation ....... ....................................................... Exterior .......LA ..... ..................................Roofing ......... .......................... Floors ........ ....... .................................Interior ............Sb-e, �`r.y(.nnk.......................................... Heating ......k_N—:F7:7...r'k.!1!.............................................:....Plumbing ....................................................................................... �.Mt).................................. Fireplace ..... ......&TJS,4�..................Approximate Cost ........... Definitive Pla,5Approved by Planning Board -----------------------------19--------- Area ... ............. ----%Diagram of Lot and Building with Dimensions Fee ..... SUBJECT TO APPROVAL OF BOARD OF HEALTH A 19 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 ..... ........ 64i tl. .......... BANIA, CHRISTINE M. .� 6— 2 No .... 3 714 ............. Permit for ..One Story.......... Single Family Dwell-ing............ ........................................................... ... Location Lo.t...#.8..... M1.1.1 Rd. Ostervill ........................................ ..................... . ..,Christine Owner ........................e I. Banla, ... ................... .................. Type of Construction ...... .................. f ........................................................... ................... IL Plot ............................ Lot .......... .................... Delember 1 81 . Permit Granted .......... ............De ........... . ......19 Date of Inspection ...... ... .............. ........19 Date Completed ..... .. ................... ........19 h 4) t o ` \ 1_ C 0 4 ii9. G9 ' J ✓IL o -r 71 4. L. ZG, GG S_ Vplov,d � _Lam._. ?a . . 13� OO ., 29,- 7,z_ O 0 o v 1Aj a F-- ` `) N i Lu f _ .ZL• � M V eas 994. La S 35 ' 2o , i / e„ _ �J A I 7-- "I CERTIFY THAT THE FOUNDA TION SHOWN ON THIS PLAN IS AS IT ACTUALLY EXISTS AND THAT PLOT PLAN OF LAND I T CONFORMS TO THE TOWN OF BARNS TABL E ZONING REGUL A TIONS L OCA TED IN +� BARNS TABLE NIA SS. DA TE.• NOV. ?5, 1985 PREPARED FOR q�� DA �" CH ,RLES �G DA VID NI CKUL A S ..C> SANICKI R. L . S. ��, 28085 0 DATE. NOV. J5. J995 SCALE' 1 "-50 FT. /STEM p FLOOD ZONE C suer CAPE 6 ISLANDS SURVEYING TEA TICKET — MASS..