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HomeMy WebLinkAbout0615 LUMBERT MILL ROAD F�I'S 1.�..r�bey--�- �1 � 1���Z�., �� _ .� ,, u j ._� : . .a � ; �. _ Q - � - - ., o � n � .. .� ,� _ q ,. �. /! a Q .„. _ ,� 0 .. .. �m� -� .. � e .. ,' m ' � � .,. � rQ Town of Barnstable Building ' Post This Card So That it is-1/isible From,the Street Approved Plans,Nlust be=Retained on Job and thisCardMust be Kept .>ro s t a 4 c' i x >"' ®. �+ b , Po'stecl Un"til final Inspection Has Been Made er 3 rg µ x .lTxy ®®,...'T R/r Where a Certificate3of Occupancy is Required,such Buil,dmg shall Not:be Occupied;untii a Final Inspection has been made 'ii mi .;. .,. Permit No. B-18-3421 Applicant Name: SCOTT PEACOCK BUILDING & REMODELING INC Approvals Date Issued 12/04/2018 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Dater 06/04/2019 Foundation: Residential Map/Lot 147-118 002 Zoning District: RC Sheathing: Location: 615 LUMBERT MILL ROAD,CENTERVILLE Contractor Name' : JAMES S PEACOCK Framing: 1 :Owner on Record: NUTILE,THOMAS A JR ContractorLicense: CS-094500 2 Address: Est Project Cost: $ 15,800.00 Chimney: k Permit Fee: $ 130.58 Description: REFIT 3 BATHS insulation: Fee Paid.` $ 130.58 Project:Review Req: NO STRUCTURAL WORK. EXISTING BATHS REMODEL: Date 12/4/2018 Final: y R a ;rax� .iPy - Plumbing/Gas Rough Plumbing: a Building Official �` ; Final Plumbing: x Rough.Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within sic months after.issuance. All work authorized by this permit shall conform to the approved application and theapproved.construction documents for which this permit has been granted. . Final Gas: All construction,alterations and changes of use of any building and structures,shall b"e in compliance with the local zoning byylaws>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 work until the completion of the same. 3 Electrical d f. `' Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Offival�are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work € ? Rough: 1.Foundation or Footing 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: 5.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. Final: Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). . Fire Department Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT p ... Application Number........... ............. .................... .» MAee. Pemut Fee................:......................Other Fee................,....... 14 TotalFee Paid...................................................................... BARNSTABLL �� � P val by.. .................. ..on...Ld.Y!l ....... TOWN OF �, i BUILDING PERMIT OCT 1 °� .... . ".................Parcel..........�.�. .. ...... APPLICATION TORN oFBARNSTAR T Section I —Owner's Information and Project.Location Project Address (o l 5 Lu m � M i �) l264J' Village L�yt.�r'V v Owners Name i l i-xMn S Owners Legal Address !)`7 D' Sir h hArnx) ogre-c;f— city, (_I) r I wVdv state FlUr i��a..) zip 0� .owners Cell# LQ t '7.'S 10-q 3 S 1 ),-mail ,r) 1R S" A- a� (rJ7'Yt Section 2—Use of Structure Use Group ❑ Commercial.Structure over 35,000 cubic feet ❑- `Commercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling Section 3—Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment Sprinkler System ❑ Addition [] Retaining wall ❑ Solar Renovation ❑ Pool ❑ Insulation Other—Specify Section 4-Work Description T act nndate&719=18 r __. Application Number.................................................... Section 5—Detail Cost of Proposed Construction Square Footage of Project Age of Structure. '< Dig Safe Number # Of Bedrooms Existing !Total#Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas -❑ Fire Suppression ❑ Heating System El masonry Chimney ❑Add/relocate bedroom — Water Supply ❑ Public El Private t - jJ- Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Ilighway Debris Disposal Facility: t1�- I am using a crane ❑ Yes ❑ No .Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland,coastal bank? Yes ❑ No ❑ Section S-Zoning Information 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=datrd 2J9201 S r • ) I 117�I . f 4 OE PT NOV 13 2018 -OW t�OF BAB�STABLE r T�L l Barnstable Bldg.Dept. tapproved Bl Permit#: `�'3 a Town of Barnstable ,l s Regulatory Services •: 1MM • MAM Richard V.scab,Director •' Building Division Tom Perry;Building Commissioner 200:Main Street,Hyannis,MA 02601 www.town.barnstable'ma.us Office: 508=862-4038 Fax: `508790-6230 Property Owner Must Completer and Sign This: Section: , If Using A Builder I Thomas A.`Nuble . as Owner,of'the subject property hereby authorize J:Scott Peacoc►c �to act on.my>behalf, n-A.matters.relative.to..work authorized by ibis building permit application for: 615 Lumbert Mill Road Centerville,MA 02632 (Address of Job). **Pool fences=and alarms:axe.the responsibility of`the applicant. Pools are not to be filled or utilized:. efore fence is installed and final inspections pare performed and accepted.. _ a Signa er. S tiziee of Applicant, Print Name Print Name: ;Date F AC�® DATE(MM/DD/YYYY) AC� CERTIFICATE OF LIABILITY INSURANCE F07/19/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER CONTACT NAME: Germani Insurance Agency PHONE (508)428-9194 n/c No): (508)428-3068 908 Main Street E-MAIL ADDRESS: certs@germaniinsurance.com INSURERS AFFORDING COVERAGE NAIC# Osterville MA 02655 INSURER A: SAFETY INS CO INSURED INSURER B: Granite State-AIU Holdings Scott Peacock Building&Remodeling,Inc. INSURER C: P.O.Box 171 1NsuRERD: INSURER E: Osterville MA 02655 INSURERF: COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTRPOLICY NUMBER MM D MM/DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence) $ MED EXP(Any oneperson) $ A BMA0022118 07/05/2018 07/05/2019 PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑JECT PRO ❑LOC PRODUCTS-COMP/OP AGG $ PRO OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB . CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION I PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 B OFFICER/MEMBEREXCLUDED? 0 N/A WC005-81-5464 06/22/2018 06/22/2019 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT '$ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be 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 Scott Peacock Building&Remodeling,Inc. ACCORDANCE WITH THE POLICY PROVISIONS. P.O.BOX 171 AUTHORIZED REPRESENTATIVE Osterville MA 02655 Fax: 508-428-7625 Email:scott_peacock@vedzon.net 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts i Division of Professional Licensure ' Board of Building Regulations and Standards Constrp ori'Supervisor CS=094500 EXpires:07/22/2020 JAMES S PEACOCK ' 1046 MAIN ST..UNIT 7 " P_O.BOX 171 OSTERdILLE MA_02655 ' Commissioner Vim" /ce�crcc7nomcactcll�n�?<'f�a:;aac�cc�e/�' Office of consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE::Corooration Registration.-: Expiration 151:853._..,--___07/06/2020 BUI SCOTT PEACOCK LDING;&REMODELING INC JAMES S.PEACOCK_ 1046 MAIN STREET"SUITE 7:: OSTERVILLE,MA 02655--- " Undersecretary t r. ate 1✓o,Ta moyapteakh of Massaehrtsdts Deparfineat of huhuf ial Accidents - O e ofimyesagations 640 Washuigtm Street r8ston,,MA 02111 wmv.7na-,mgo-v/dua Workt-rs' Compensatian Insurance Affidavit:SuaZders/Con"ctors/Uectricians[numbers Applicant Infarmationn, Please Print Legibly Nary(Bosroe2s/6rgani7atimffiidividml):JGC,)f- A t A-e-V cJC 3'�--t e i fir � L. Address: P, 0, box l --)I i G y( M Ct )1 0 6t, s LIi 1 - CiWStatx-Jzip�Dsfervi ) (F (GSS� Phoneme -7U00 Are you an employer?Check the appropriate box: Type of profit ct(required)_ 1_T4'I am a employer with 4- ❑I am a general contractor and L 6_ New con5f r. ioa employees{full and(orrt#i pa - me}* haves the�b C° c ❑ 2-❑ 1 am a sole proprietor orpartn'ev- listed on the attached sbeet 7- ❑Remodeling s and haze no employees - These mb-oontractors have 8_ or nap y employees and have workers' ❑Demolition : working forme in any capacit}r. $ g_ ❑Building addition [No worktis' comp_insurance comp-msurranr reTlired_] 5-❑ Vre area cotporationand its 10.0 Electrical repairs or additions 3_❑ 1 am a homeowner doing all work officers have exercised their 11_.Q Plumbing repairs or additions myself.[No workers'Comp- right of exemption.per MGL 12-0 Roof repairs iusunmce required_] r c-152,§1(4),and we halm no employees_[No workers' 13-0 Other comp.insurance required.1; -Arty ampUcwt that checks boar nl most also fill out the section belowshavrin5 ibrir tvoxls��compensstiaa pnlicq fieftr od j Snmeawners vrbo sabmit this afhdwir indicating they are doing aU UuA and then hire omsi&contactors nmsi submit a new affidavit ihdicatin sack. Contractors that check this box must attached an additional sheet show-mg the name of fte itAF--oo m and state whether cc=tbm5e onfities,have employees. If the sub-cconttmaots ham a emnlupees,they must piovidp their workers'comp.polity atmaber. .Tam art employer dzat is pro*&zg workers'conTertmrh'on irmwance for nth*ampioyetcs Below is fare ponce curd job site irtforrrtatiar� /J Insurance Company Name. �r Yl 1 C� J�,ff' Vq L.ran 0-'e l_--G, Policy 9 or Self ins_Lic :' ons — ro Expiration Date: a Date- job site Adams S Lv rr r+ JU1 i i 1 Ro city'stawzip_ C e i M o d l�3 �. Attach acopy of the workers'compensation policy declaration page-(shaming the policy number And expiration date). Failure to secare coverage as regairB under Section 25A of MGL c- 152 can lead to the imposition ofcriminal penalties of a fine up to$i_500.OU and/or one-year imprisonment as well as civil penalties in the foan of a STOP WORK;ORDER and a fine of up to$250-00 a day against the.violator- Be advised That a copy of his statement maybe forwarded to the Office of Investigations of the DIA for instuance coverage verifcation- I do herel!y rttfy under t irs anal penabiies ofperjury thatthe irafortrta#ian prm2ded abos,e is true sand correct SitutatotrE: Date_ Pbotu'g- y;t ______.._.__ �`icr:aI tiseiin€}-Iyartot-s�r�te irl-fFtis�rrerr�rx$s-co° or-torcn �------- -- City or Town-. PermitUcense# Ls-suing Author4(circle one):: 1.Board of Health 2.Building;Department 3.CitylTown(Qerk d.Electrical h3spec#or S.Plumbing Inspector 6.Other Contact Person. Phone 9: 6 I Application Number........................................... Section 9-.Construction Supervisor NameJSCD+4- PWCQ6-,,t..- Telephone Number 5_0$'- Y d1 Address P. o i3oy) t city 0_W ryo/I L state A - Zip oaf S. License Numb License Type' r —Expiration Date o1 t Contractors Email A ecte- kai Yr r)-Z0Y1.✓1 e-_" Cell# !D8 '3&L/- `l 3.5�3 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 equired.by 780 the Town of Barnstable.Attach a copy of your license. signature Date Section-10-Home Improvement Contractor Name S a YYl - a S a.bcye, Telephone Number Address City State Tip Registration Number i S 1 9>53 Expiration Date '� �go go I understand my responsibilities under the rules and regulations for Home Improvement Contactors in accordance with 780 CMR the Massachusetts State Building Code. I understand the constriction inspection procedures,specific inspections and documentati required by 780 CMR and the Town of Barnstable.Attach a copy of your HZC... Signature ,. _. Date Section 11-Home Owners License Exemption Home Owners Name: Telephone Number Cell or Wor Number I understand my responsibilities under the rules and regulations for Licensed oiistruct.Ou Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the-construction' action procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Dke APPLICANT. SIGNATURE R Signature Date 10 Print Name J . sC PGc%LCOCt_ Telephone Number 18 7�f E-mail permit to: 5LU++7 7ycc..LC�C= � r`t 7,0Yl, nP Section 12—Department Sign-Offs ' Health Department © Zoning Board Cif required) Historic District ❑ Site Plan Review Cif required) ❑ Fire Department ❑ � l Conservation ❑ For commercial work,please take your plans directly to the fire deparonent for approval- f 1 Section 13-Owner's Au horization hI , as ner of the-subject property hereby authorize to act on my behalL matters relative to work authorized by this building L flefftron,for: (Address of job) Signature of Owner date Print Name Last wdate&2/92018 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel lie QO Z Application #�� Health Division Date Issued 1 Y Jig- Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 615 L to 6TcT I'r i J Village cedofyll110 Owner 5 tkS a q �8 0_t I t0 Address l�fi�dei Telephone 5 0 $ 50 Old 61 Permit Request �4ar 3� t:�,� a Al2 ``-�j� �, (^C, �d �- a� 9 d k i L ,c ' t Iona ��(r?, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ 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' oal stove.., ❑des ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: isting 114 nev�t, size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: ad en Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ P- Commercial ❑Yes ';�No If yes, site plan review # Current Use - - - --Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) 1 A Name �c A �8 Telephone Number 569 398 03 �� Address ' 1 , License # ITY to I �y r' S E X:ATMAJA � `I Home Improvement Contractor# u� ( 3$ Email / Worker's Compensation # 414 30 U ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE Z DATE �� Q liq k FOR OFFICIAL USE ONLY #PLICATION# t DATE ISSUED k MAP/PARCEL NO. f ADDRESS VILLAGE 4 OWNER i DATE OF INSPECTION: Ii ok FOUNDATION FRAME 4 t. INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT 4" ASSOCIATION PLAN NO. _ c, - Building Permit Authorization I, Botello, Susan , as owner - hereby give my permission to Cape Save, Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Office: 508-398-0398 to take all necessary steps to obtain a building permit to perform work at my property located at 615 Lumbert Mill Road Centerville, MA 02632 Signed Date A i The Cotnmotovealth of Massachusetts I�ep,.artrtient of Industrial Accidents Office of Investigations . • 1 Co,ngress Street,Seiryte 1 QQ ' • y J. Boston,MA D2T 14-2017 { www:mass:gov/da Workers' Compensation.Insuraneg Affidavit:Builders/Contractors/Electricians/Plumbers, Avolicant Information Please Print.Legibly Name(Busincss/Qrganizationflndividual) Cape SaVe Inc - ' , 7D Huntington Ave ' Address,:.. City/State/Zip: South Yarmouth, MAIM Phone`#:. 508-398-0398 Are you an employer?Check the appropriate boz: Type of project(required); LEI 1 am a employer with �U. 4.,0 1.am a general contractor and 1 P - 6 New construction:. employees.(fuIl and%or part-ttme).t have hired the sub-contractors r 2•0 1 am a sole proprietor or partner- fisted on the attached sheet; . 71 . [,Remodeling;' ship and have no employees These sub-cantractot5 have: g []Demolition working,for me tn.an ca actt { y p y employees"and have workers' 9 0-l3utldirig addition "'` [No workers' comp,.insurance: comp:insurance.« 5_ We area corporation and its 10.[]:Electrical repairs or additions' re9uircd.J 0 officers have exercidse their 11. Plumbing re airs or additions 3, 1 am-a homeowner doing all work; 0. p myself.[No workers'comp; right.of�e#mption per MGL I2. Roof.repairs t c. 152, §1(4);,and we.have;no insurance required.] 13.®>:Other_ Insulation employees. [No Ns orkers' comp.insurance.required.] "Any applicant that checks,tiox#1 must also fill but the section belo++!slo+ving their�+orkes'compensation policy ildoriatatton. t Homenwneis who sukimit this af'lidavit uldicating,they are.d Mig all�?ork and then hire outside contractors"must submit a new affiday.,Q.dicating such.,. +Contractors that check this box must attached an addition&6 sleet shownfi the name of the+sub contmetors andstate whether or not chose entities hive employees. if the sub-contractors:have employees,they must provide their v♦orkets'comp;.policv number. l am an employer that is providing ivorliers'coreipensut on,in�uranee my employees. Below is thepolicy and job;site infurriuitiarr, . nsurance Company Name: WeSGo InsuranceC y ompa y "WWC308 633. ,. Expiraton'Date 04/09/2015 s Lxc. Folic #or Self-in, Job Site Address:.. . _ . • City/State/Zip:;. : ' Attach.a copy of the workers'compensation policy.declaration page;(showing the"poliey n.umber and expiration.:date) Failure to secure coverage.as required under Section 15A of MG c. 152 can lead to the Imposition of'criminal,penalt es of a tine up to' 1,500:00 and/ozone-year'imprisontnent as well as civil penalties in the forth of a'STOp WORK ORDER and a fine of up to$250.00.a day against the yiolator: Se adv ised.thava copy of this statement may be forwarded:to the Office of Investigations of the DIA,for insurance cgverage ueritication. J do hereb certi `;underthe ains,and enaJties o er' that the in orination provided above is true and"correct; . ,. Date �. Signature: Phone#; 50$-39$-03.98 O ciu1,iise only. Do not write iri tl:is area,:to be completed by city gr to►vrt.offieiia - City or Town: . l'ermit7License- .".. + Issuiug.Authority(circle.one) 1.Board of Health 2;Building Department:3.Cikyt`1'own Cterk 4.Electrical Inspector &Plumbing Inspector 6.Other Contact Person; _ Phone* A CERTIFICATE OF LIABILITY INSURANCE � ioizo M �... --- 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 pollcypes)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions ofthe policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsemen s. CC PRODUCER. NAME'. Colleen Crowley Risk Strategies Company PHONE . (781)986-4400 AC No:1764 963-4420 15 Pacella Park-IDrives acrow'1ey8risk-strateg es;.com Suite 240 ,. INSURERS AFFORDING COVERAGE _ NAIC Randolph MA., 02368 UN§URERA':Selective Ins. oF. America. ',I FJSUREb INSURERw-Allmerica Financial Alliance 10212 Cape Saxte., Inc INSURERC'WeSca IaSlaraaCe an 7 D Huntington Ve ItaURERD: INSURER E South, Yaalsouth MA _02664 IMURERF: COVERAGES.. %CERTIFICATE NUMBER:CL14111085532 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. I�SR TYPE OFMSURANCE POLICY NUMBER MMLICYEFF' POLICYE%P LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAVWGE TO PENT PREMISES E n e $ 100,O00 -MADE CUR one person)- 10,000A CLAIMS 0/16/2014 0/1 /2015 P PERSONAL&ADVdNJUl4Y $ 1,00.0 y 00O GENERAL AGGREGATE $ 2,006,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG .$ 2,0001000 POLICY X PRO- X: LOC $ AUTOMOBILE LIABILITY _ Me'accidents__. 1 .000 000 ANY AUTO BODILY VJURY.(Per-person) $ B ALL OWNED SCHEDULED MQLAA6796600 1/6/2014 1/6/2015 AUTOS X AUTOS BODILY,INJURY,(Poe accident) $ X DAMA HIRED AUTOS X AUTOS � Perecdd PRTn°' G $: X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ :L,O00,000 A EXCESS LIAR CLAIMS-MADE AGGREGATE $ 1,000,000 R DED ETENTION 811 1994480 0/16/2019 0/16/2015 $ C WORKERS COMPENSATION f£icers Included for X STATU OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEX CUTIVE YIN OV9rage. E.L.EACHACCIDENT $ 500 O00 OFFICER/MEMBER EXCLUDED? NlA 3085633 /9/2014 /9/2015 (Mandatory In NH) r E.L.DISEASE-EA EMPLOYE $ 500 00.0 Ifyea describe under t. - DESORIPTION OF'OPERATIONS below ' E.L DISWi.:-POLICY LIMIT $ 500' 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks`schedule,If 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. Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION msong@capelightecmpact.oxg SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cape Light Compact ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Margaret Song PO Box 427/SCKz AUTHORREDRERRESENrATIVE 3195 Main-'Street Barnstable, MA 02630 'chael Christian/CLC ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD ��• �G�'j'/•?r��Lf1/12tf�P(,�'•1,��12 O�. �-i/��C�`;1f,�G?�C�Y�iLI/,�P : ' Office of-Consumer Affairs and Business Regulation ` 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 171380 Type: Corporation y . Expiration: 3/14/2016 Tr# 249649 CAPE SAVE INC. WILLIAM McCLUSKEY ' 7-D HUNTINGTON AVENUE } �+' in SOUTH YARMOUTH, MA 02664 �� ---- --- — Update Address and return card.Mark reason for change. sCA 1 0 20M-0511 1 Address Renewal Ej Employment Ej Lost Card Q Xe 6 sn=riu ruuwtrlG�r lTr�ar�r�eG' — - Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 4`11380 Type: Office of Consumer Affairs and Business Regulation _ `Expiration ,3[14/2046 Corporation 10 Park Plaza-Suite 5170 i Boston,MA 02116 CAPE SAVE INC. 3 WILLIAM McCLUSKEYkle � T 7-1)HUNTINGTON AVENUES g �©� SOUTH YARMOUTH,MA 02664 Undersecretary Not vali rthout signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Superviw:r Specialh License: CSSL-102776 M W ILLIAM J MC C-.US 37 NAUSET ROAD West Yarmouth MA 02673 ,J,,G— Expiration' Commissioner 06/28/2015 . i f Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fag: 508-398-0399 12/30/14 Thomas Perry CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 ` ZE RE: Insulation Permits Dear Mr. Perry5. w c— rn This affidavit is to certify that all work completed for 615 Lumbert Mill Road,Centerville (201408204) has been inspected by a third party Certified Building Performance Institute (BPI) Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey oFTHEro• TOWN OF BARNSTABLE Perrnit No. .,28 ....... BUILDING DEPARTMENT D°81A'' Cash M TOWN OFFICE BUILDING Q o,QQ) °�nuv HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Paul Botello Address Lot #71, 614 Lumbert Mill Road Centerville, Massachusetts 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. 4 19..... ..... ...k. ... ............. f Building .Inspector a r Sam " TOWN OF BARNSTABLE, MASSACHUSETTS E R -� Am147-118 g 06 . WEATHf, C1�RpQ , Q2 4M W DATE November 18 85 RKxae. Q t. lV�VC! APPLICANT Owner 19---_..."rn`•PERMh�p'NO ,.. w ld�► f`� .. ADDRESS L 8L i' 1 :- (NO.) (STREET) r r(CONTR'S LICENSE) PERMIT.TO Build 'dwelling,.'. ( 1 i 1 STORY Single ,'f8DLi1y dWe`11in aK .-NUMBER OF �� a•, (TYPE OF IMPROVEMENT) NO. DWELLING UNITS (PROPOSED USE) t�r AT (LOCATION) Xot #71 615, Lumbert Mill Rosd r • ►��lY� ZONING KC R$ (N0.)t (STREET) DISTRICT Qa , - r Centerville BETWEEN r <' (i4{: b6 A �;(CROSS STREET) • AND „ ... t. - ' - (CROSS STREET) . U + 7 SUBDIVISION r` LOT LOT BLOCK SIZE - A BUILDING IS TO'BE FTW ( ' d s 4r �- FT, LONG BY FT. IN HEIGHT AND SHALL CONFORM IN-CO NSTR . , . UCTioi s.. .0 TYPE �. Pitfi \ USE GROUP_ I3 BASEMENT WALLS OR FOUNDATION A .t r REMARKS: r Sewaa e•"#85--1033 s (TYPE) fj AREA OR D8Vid 'N. � '.'VOLUME 1k54 sq ft'. ickulas) 80..00 ESTIMATED COST 35,000 PERMIT p. 88.00 (CUBIC/SQUARE FEET) FEE. W s T%'',n:OWNER~ P8>jl BOte110 - ri• r rt ' ADDRESS BUILDING DEPT, BY .4 � - e ;T:HIb PERMIT CONVEYS NO RIGHT TO - -� '•` ;� PERMANENTLY. ENCROAC4MENT5'- OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY`PART THE EOF,�EITHER�TEMPORARILY OR ON PUBLIC PROPERTY, NOT.SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY-THE JURISDICTION jC WORKS. S. ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE. ,��• y •*' FP'OM THE DEPARTMENT. i ;OF NY APPLICABLE SUBDIVISION THE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM-THE;CONDITIONS }( c OBTAINED fi MlNi CO OF THREE 'GALL r -" APPROVED PLANS MUST BE RETAINED ON JOB AI,v 'rH15 WHERE APPLICABLE SEPARATE ,tpIN$P'ECTIONS REQUIRED FOR Lq_KKYY CONSTRUCTION WORK: CARD'`KEPT POSTED UNTIL''FINAL INSPECTION HAS F�'LEN PERMITS ARE. REQUIRED FOR FOUNDATfi)Nfi'OR FOOTINGS. % `� M1l,DE, WHERE A CERTIFICATE OF .00CUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVER,MCi STRUCTURAL ELECTRICAL, PLUMBING AND MEMBERS(READY TO LATH). QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED•UIVTLL rO 9 FINAL INSPECTION•BE=ORE FINAL 1N&PECTION.HAS BEEN MADE, tr .00CUPAN�Y, - ' :_`•POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS c.� -'• c• �. PLUMBING INSPECTION APPROVALS " + dt ELECTRICAL"INSPECTION v1PPROVALSy . Ze `� 2 Ilk b - 3 ..,. 'HEATING INS PECTIN AOP_POVALS � REFRIGERATION INSPECTION APPROVALS; 'VVN OF BARNSTABLE�_ NGI !,E IhTG DIVISIOhT. 2 ( - —_`__- Z �11ALL_�,"NCT ?P.00EEO UNT G'• TF{E 'I / r N`Pec oR-'ON" PROVED -HE VARIOUS PERMIT WILL BECOME NULL AND VOID IF'CONSTRUCTIOti 1NSPE6T1ON`S INDICATED ON THIS CARD, °TASyES OF CONS l(CTiON.' WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. �` OR.WR WRITTEN NDTEFICATION'TELEPHON , 4_ arl fif� SUBJZ--T T0 essor's map;and lot number.. ��..:-..� ..}... �( BARNSTABLE I c^OMMIssia; l QyoF rot♦ Qc �` THE a 1. Sewage Permit number ..........:..U„ '...�.®�� ...... C .. SEPTIC SYSTEM ABLE, IY, House number .... �+ .........'�.� ........ ......... ... TIC r JIMITALLED IN CO T TITLE 5 s p >P o v W N O F B A R-N S r TAL e�CDE 1dA y a "``'t`im.,� ; sp of mt >4 Car ae TO"q f Al P I.DIHG INSPECTOR a APPLICATION FOR PERMIT TO ......... �........... .......... ..�...............�...................... TYPE OF CONSTRUCTION .....................O�wt�ti�. 1z?,J..S. ............ ....1....1..!!.!... . ............. ................... .....�........19..0 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....�f..0.....!..1.......LV.rn..�?--e d.�...e.:..`.:..!.�..:�C1:....... �........................ ProposedUse ........H.a V�� ..........................................................................................................I......................... �p ,j,,, � l J Zoning District .......................1...... .................................Fire District ......�= �d � vs`G/'I/, `"` AL ......... . .................................. Name of Owner jj .......U` J.!.....15!eA .... ........................Address .... ...:............................. Name of Builder .......... i �a:�.�....��?....�!1.,'.'......................Address ........���. .e:.�.�I�..A-.Q........................................ Name of Architect 0dS� ... .e. .,. .�.A' ... ,. .. . . ...�.... ..... ... Q .....Address ........ .��.. ......................... Number of Rooms .6 ............................................Foundation ...'.�? itieC! 16 �,¢Yl �re-k A-1&-) J .........//.. . ....................................... Exterior .......... .....................................................Roofing ...........a �C> .`...t........................................ Floors ...........................................Interior .........� >�...+� rPL° C��Ge ................... Heating Az,,?.Z-0Med.i. ......./5/ g .. ............................................ Fireplace .............�N..............................................................Approximate. Cost ...... �. .......................... . ...... I Definitive Plan Approved by Planning Board ________________________________19________. Area ..... ... .. . ....5.• .....:...... Oa Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH �{�1,0 �V !� C� �b V . 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. �e"7 Name ...... . .... . . . ......................... Construction Supervisor's License(922; .(QIS�.�.... it 1 � I BOTELLO, PAUL No 28683..... Permit fo 5.t.OX ` Single Family well,. ........ 4 " Location ..,...,,Lot.../'"�1��. ..6 n mbse t..Mi.11• Road .. C _ Owner Pau.l...B.olt to ........ . .. . . ............................ Type of Construction ...... f .................................. . ...... .............................. _ Plot ............................ Lot ................................ .. s Permit Granted Novem.ber 1:8, 19 85 .......... .... . Date of Inspection .....................................19 Date' Com leted r r i '0LWa'e � 0�5 t t?:� ✓1+ e. to i C v 6 e r H F J t _ r :y Assessor's map.and lot numb ./... ��,.--..I�:r''� .;., �(, oFTNeTv Sewage Permit number ............ ........ --� ...... C�.. . ............... £l Z BAR3STABLE, i Any House number • ... : . ...... 90o rb v m� 3 �0 a• TOWN OF BARNSTABLE --;. BUILDING INSPECTOR APPLICATION FOR PERMIT TO .................... ............................. / , �• fin �r TYPE OF CONSTRUCTION ............. .... , :� ......1 J.5.. .:............/ .D ....1....1. l F!::�.. ............ ................... ..... .........19.: TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to' the following information: Location .......... ......... ....... . ...... . ........ w ,.......:..................... Proposed Use .�1.... .. e_. .. Zoning District .......... c�[' t`I• / 1l3 1`t' ��a �7 .............................................................Fire District .........,..... t............ . .... Lj ' f 1 � �1 p Name of Owner . � '....................................Address Name of Builder .................�.... .'.c� �......``......................Address ....... �:��..;.... f'\I �. ................. Name of Architect ..................................................... ..i�:.........Address .........,�.. ... !. ....r............. .:.,................. Number of Rooms ................. .................. Foundation ...'c' `......FC�.. �6 Y1 C.r P P Ct l� Exterior .......... r........................................................Roofing ...........Q S .z�'?. ` ........................................ Floors ............. �� .�?:............................ Interior .........� .............` 1`a .,... ..... HeatingC?' � ... Plumbing . ............................................. ........... ...... ...........�::...:..... ...� Gad. ..,.. ........ ...... ...... g � Fireplace ., .�3........... ........Approximate. Cost U..0 ................ Definitive Plan Approved by Planning Board -----------------------_---------19________. Area .......................................... Dri.agram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH /k F r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS el.. 1/hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. a!7 ( Name .... '� Co Struction Supervisor's Licens . . �\ BOTELLO, PAUL A=147-1 8 - D©1, r No ..28683.... Permit for ...1....Story............... Single..Famil. . y...Dwellin. . . g r " .. .. . ...... . ...... . . .... y Location ,..,Lot 71, 615 Lumbert Mill Road Centerville . ..............................................................................: Owner ....... aul Botello ....................................................... Type of Construction .......Frame ................................... ................................................................................ Plot ............................ Lot ................................ I �+►, November 18, 85 Permit Granted ........................................19 Dq..te of Inspection ....................................19 Date- Completed .......................................19 / I �60 } uq n