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HomeMy WebLinkAbout0067 SOUTH PRECINCT ROAD .. :. ,,, :. .. � � .<. _ ., Y. .. -. �. > .. .. � "" r ,. S .' 4 - .: 1 ... ... v ., _,.. .. .. `� .. e _ r .. L �.,. r - � - .. g - ' g' .. .. .. ��. P .. — F � � � _ _ e ' � � _ .. .. i - - oFtMME T Town of Barnstable *Permit# C� . Expires 6 months from issue date OO Regulatory Services Fee p -STABLE, v� ASS- Richard V.Scali,Interim Director oa 1 Building Division � 1�DLG Tom Perry,CBO,Building Commissioner O`v V p`�t 1V O 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number .r S Property Address Sy UTt-I p R G i a�G'i 20 A t esidential Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name c ��J. r' Z1 v u t S ur ti._T Telephone Number 2 Q -f-4- Home Improvement Contractor License#(if applicable) I Ci3-71 Ll Email: 6 'R-C e Ca ZPLC o, Ce-rtt-) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner have Worker's Compensation Insurance Insurance Company Name l S Ca K Q Workman's Comp.Policy# (A1G > 02y Copy of Insurance Compliance Certificate must accompany each permit. Permit Reques heck box) e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to �-J�—p of ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) . ❑ Re-side ❑ Replacement Windows/doors/sliders.U=Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. ` Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. Ce SIGNATURE: /- TAKEVIN_MBuilding ChangesTXPRESS PERNIMEXPRESS.doc Revised 061313 i • � /2iLGZE2� Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 , Boston, Massachusetts 02116 Home Improvement,Contractor Registration Registration: 103714 r x Type:. Supplement Card j PAUL J. CAZEAULT & SONS, INC. _ Expiration: 7/9/2016 " -' �± `: RUSSELL CAZEAULT 1031 MAIN ST OSTERVILLE, MA 02658 Update Address and return card.Mark reason for change. sCA 1 0 20M-05/11 E] Address Renewal Employment ❑ Lost Card V�e rOa�7z77zart[aeal��a�C1��i99Ccc�[cJe�fJ ., Office of Consumer Affairs&Business Regulation •J License or registration valid for individul use only SOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: . Office of Consumer Affairs and Business Regulation Registration:.j 03714` TYpe� 10 Park Plaza-Suite 5170 Expiration ,7/9/2016"' Supplement Card Boston,MA 02116 PAUL J.CAZEAULT&,SONS ING. 1 `r RUSSELL CAZEAULT 1031 MAIN ST 0STERVILLE,MA 02658 Undersecretary Not valid witho nature Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor E License: CS-108157 l RUSSELL CAZEAULT ' • 2071 MAIN STREET Brewster MA 02631 431 Expiration Commissioner 11/23/2018 The Commonwealth of Massachusetts Department of Industrial Accidents' - Office of Investigations - 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ( Please Print Legibly Name(Business/Organization/Individual) Address:10 31 M >4 hL 0S yi City/State/Zip: /'/I,q-S_ US S' Phone � // 7 7 Are you an employer?Check the appropriate box: Type of project(required):. 1.Kam a employer with /C) 4. ❑'I am a general contractor and I * have hired the sub-contractors 6. ❑New construction employees(full and/or part-time). 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' Building additio n [No workers'comp.insurance comp. msurance.t 9. ❑ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑4 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no. / employees. [No workers' 13.[ Other �� /Ace comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether,or not those entities have employees. If the sub-contractors have employees,they must provide their workers`comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: e-% Expiration Date: �� z C) Job Site Address: (S-7 'a/)-E C AD City/State/Zip: CL-)_j 11206V I LLC- MA ®7.6 3 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as.well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification: I do hereby ce x4fy under the pains and penalties of erjury that the information provided above is true and correct Si-nature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: DATE(MM/DD/YYYY) ACC)R" CERTIFICATE OF LIABILITY INSURANCE 8/7/2014 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), HE REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If.the certificate holder.ls an ADDITIONAL INSURED,t' e pollcy(les).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 DOWLING &O'NEIL INSURANCE AGENCY INC NAME:CONTACT 973 IYANNOUGH RD PHONE FAX PO BOX 1990 c o Ext: AC No): HYANNIS, MA 02601 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE - NAIC 4 INSURERA: LM Insurance Corporation 33600 INSURED - INSURER B: PAUL J CAZEAULT&SONS ROOFING INC 1031 MAIN STREET INSURER C: OSTERVILLE MA 02655 INSURER D: INSURER E: INSURER.F: COVERAGES CERTIFICATE NUMBER: 21146':42 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELCW 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. 1�TR TYPE OF INSURANCE INSD ADDL WVDSUBRI POLICY NUMBER MM/DDY/YEYY1' MMIDDY� LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE 1-1 DAMAGEDAMAGE TO RENTED -- _— PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑P CT LOC - - PRODUCTS"-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY - - COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED" SCHEDULED - BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED - PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION WC5-31 S-386670-013 8/10/2013 8/10/2014 TPER/ STATUTE EORH . - AND EMPLOYERS'LIABILITY Y/N WC5-31,S-386E70-024 8/10/2014 8/10/2015 V ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1000000 - - - OFFICER/MEMBER EXCLUDED? ❑N N/A - - (Mandatory in NH) - E.L.DISEASE-EA EMPLOYE $ 1000000 If yes,describe under.-- DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. This certificate Cancels and supersedes all previously issued certificates,only as they relate to workers'compensation coverage 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. AUTHORIZED REPRESENTATIVE ✓ (� LM Insurance Corporation ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CERT NO.: 21146142 CLIENT CODE: 1614182 Lucy Garfield 8/7/2014 2:44:49 PM (EDT) Page 1 of 1 Property Owner Must Complete & Sign This Form If Using a Roofer / Builder. I (print) !t N �Z: / / , as Owner / Agent of the subject property hereby authorizes Paul J. Cazeault & Sons Roofing Inc. to act on my behalf, in all matters relative to work authorized by this building. permit application for: Address of Job oZ �"3.Z Signature of Owner Mailing Address of Owner �-f All C 17 Telephone # 70 - Q f 9 Date / T Please return this form to Paul J. Cazeault Roofing along with your signed contract. It is needed for us to obtain the building permit required by your town to complete your roofing project fax#508-420-4555 office@cazeault.com Assessor's map and lot number l!{ ••1........•• Sewage Permit number '`���...z .......................... THE y�FTO� E#67 TOWN OF BARNSTABLE � s i 33A"ST"LE. i "6 q BUILDING INSPECTOR r; O ON Or _ APPLICATIONFOR PERMIT TO .... ���` 1........................................................................................................ TYPEOF CONSTRUCTION ......off n!1 F ............................................................................................................... i 9Z� The undersigned hereby applies for a permit{according to the( followings information: Location . .?......��.....�..^... ........-'..!.. ..........!`A..........` ..k�'t.�•. tJ.. I�.............�..�Z:� ................................... Proposed Use ........ . ' �` z ..!:. ...................... ...............................................................................,......................... .... ...... ..... tt Zoning District Fire District s I,, t u r IF - �l�1. . ..rJa. . ......'."".......................[.�....... ^. ................................... Name of Owner ...�a. .!!! F� P A � .........Address '� p � . .Name of Builder � k,rt. .! Ur,1n� Otif.......................Address � � 4+� A F t��d tit r .... .......� ...... �K ............ ti ... ... ........... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ...............��............................................Foundation ....�A...........P.P.Je.t.....:.................................... Exterior ..t�.(.?!( LF�.............�.!..Q. .i .!� ....................Roofing ! D� . .................................................... ..... .... Floors '��' 'n e. ............Interior �^ G �' ............ ......................................................... r. .. ................................................. .... . ... .... ..... rCL U )A�ah Cn{� S / n !t fS q._ Heating ..�........................................................ .......::...............Plumbing . , . ' ' ... ......,...:.,..., ......................................... � Fireplace � 0 � d Cost ...�. 0 .......................... m ...u! 0 „ Aroximate ... Definitive Plan Approved by Planning Board -----------_-------------------19--------. Area ......ek c).`-.....`� �........ Diagram of Lot and Building with Dimensions Fee ..... - .!...... ............ SUBJECT TO APPROVAL OF BOARD OF HEALTH c: P7 f I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ................... ............................................. Reidy, . ) � ------ 48-145 *, No ..... PeArnhfor ........ ' single family - . 67 Cencer�il Owner Janet ',p= of Construction ......... f r'ame ............................................./ R | Permit—~ Granted- i ^ Date of o* Inspection uo/e Completed ' r_ ^ � | PERMIT REFUSED � ' -- _- -.. . 19 ` � .. . --..�J��.����1�r�-.--..--- . � | -'~-''---'~~---^----'-^^'-----'- ' ^ .,...-....--_.~^-..-.......-..-.........~. ' � � \ --.------.-^---.-----..-...--.-.' ' Approved ................................................ lA � -------.-.-----.....,---.-.---- , ' -------'-------------^^^^^'-- � AsseFssor's map and lot number ... .... .. r .......................... Sewage Permit.number ... .Ll......C�0 .. ypQ ?HE?p f/se#67 SEPTIC SY�" TOWN OF BARD I Lt 5 AND �y Z BARNSTABLE, i ;WNTAL CODE t� "6 9 a' U I L D I H G}" I H S P E C`1'� �RIEGULATI® S r �o bar ,_. APPLICATION FOR PERMIT TO +v c,.G ......... .......................................................................? f 1 TYPE OF CONSTRUCTION ... C.................... ........................ w_ .................................J... �....,9.l TO THE INSPECTOR OF BUILDINGS: The undersigned�h(ereby applies for a permit according to the fall, information: Location ...J.Q..v1 `!1.... .1`. ..�.�N(.1;. .... �!..,.......:\. �! F;r V,I�IG�...........��..�Z7 ................................... ProposedUse ............1,.4=.5.k4y-ocr—k�.................................................................................................................................. Zoning District .............................................................Fire District �,N. ��.V��.� ..-...Q.�1.� nVl�/� ........... .. . ................. Name of Owner .. !!(. ......!.l.ir.l..Cl.`f...........................Address 1 Name of Builder .......................Address . �..�M.!4.�1. !A.. .�S. .IJ'.t..G.:F....... ....... �l��r�(I Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ...............�............................................Foundation ....U.............V Q...........j.................................... Exierior A.I..ca te...........`..�� d.!n�`.. ....................Roofing ... .°1. .....I......................................................... Floors ....C1= n.p..�.f...........................................................Interior Y1� ..!^. ................................................ � L S,� .. Heating 9...C. ..... �t ..!^).. ..I......c A................„..Plumbing ...�...c ..... .... . ... .1`.( .D. ,. ........... Fireplace ...... . O......1 W 0 � ..5..,..0 .......................Approximate Cost...... tS�.a...............................� Definitive Plan Approved by Planning Board -----------_-------------------19_______. Area ..... S ..... `O Diagram of Lot and Building with Dimensions Fee � !..` "' SUBJECT TO APPROVAL OF BOARD OF HEALTH ear l I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..... . . ... .... ....................... Reidy� Janet, Permit for ..............1 1/2 st'?r —_p4b .....229 ................. .Y sin'gle famil-V dwelling .............................................................................. Location ......67..S.Outh...Prec.inct..Road.......... .... .. ........ ........ ........ ......... -Centerville .......................................................... .................... Janet Rei�,Y , Owner ............................. ................................. Type of Construction ........ f rame .................................. .................................................................................. 4 Plot ............................ Lot ............#27............. Pe.rmit Granted ........March...19...............19 81 ........... ... Date of Inspection ....................................19- Date C eted ............!!�. Z........ P1 PERMIT REFUSED .......................................... ................. 19 . ................. ....... ........................................... V .................. .... .................................................... ;V ............... ........................................... ....................... ............................................ Approyed ........... ................................ 19 ...................;;O�.... .. /4.6 .. ... ................ ... . ........ ..... ....... ........ ....... rj G� O A 0 o Lo-Y ng 4� ems_ 24 - W HE w � � 2 s�� PLoT PLAN SCALE 1 „_40' BE/&vG Lo7- �s �Ec0ler)Er� /N �EG/sreY OP DEEDS �8�4QivSTABLE CO.� 9 C. 4 FRANK G o WHITINGcEk 7-1FY 7-;(-IA7- 7 VE � Afo. 29869 C �� 4 �, ST2U!TU2E S!-!OW^.l /-/EOEON •9 atsi��' WAS L O CA TE D On/ THE GRO UND �� S v� Div �.s,s�.eG.,/• /�� i�8/ �, 6i�8i E'EG LAND SU217E y0� DATE BAYS/DE SUR VE-y CORK dg WILLOW ST YA/2t4OUTNPO271 1-14- (F'p.QM6.2LY C20WE�-�-t. T4yG0.� Cb��0.2HTiOti/> ` b J � � „a•""' TOWN OF+BARNSTABLE Permit No.-`'` } 7 t - - Building Inspector lwa.n '+ Cash ---------- 0o'�OYPY Y' OCCUPANCY PERMIT Bona :shZal "No building nor structure shall be erected, and no land, building or structure 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 Janet Reid-4 Address l.ot: 627) 67 Cough Precinct; Roa. - Centerville Wiring Inspector `' Inspection date Plumbing Inspector"6,',,. _ xf Inspection date Gas Inspector �, J„ Inspection date r A j Engineering Department I 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. .. ..�.. ......._........................ 19__..._... ..............�......----------- Building�Inspector _..__.........._.»_._