HomeMy WebLinkAbout0172 SKUNKNET ROAD 10,
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ALTERNATIVE
WEATHERIZATION
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Date: 02` O� NSTgS��
Town of Barnstable
200 Main St.
Hyannis,MA 02601
Re:Permit#k---1 Village:
The insulation/weatherization work at
has been completed in accordance with 780CMR.
Regards,
Timothy Cabral,
President
CSL-105454
58 DICKINSON STREET FALL RIVER,MA 02721 (508) 567-4240 ALTERNATIVEWEATHERIZATION@GMAIL.COM
CO i°I31 iy
Town of Barnstable *Permit# 46 —
,,y�' � Fvpires 6 months from issue date
1PE§jgulatory Services Fee
t
Thomas F.Geiler,Director
OCT 2 2014 -Building Division
®V V
T ,p' C BARNSTd ,CBO, Building Commissioner
1 N ®r 200 Main Street,Hyannis,MA 02601
www.town.bamstable.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 171 007 r
Property Address 172 Skunknet Rd
®Residential Value of Work$ 2000.00. Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address Susan Ready
172 Skunknet Rd Centerville MA 02632
Contractor's Name Richard Tupper Telephone Number (5 0 8) 7 7 8-0111
Home Improvement Contractor License#(if applicable) 178434 Email: aimat,,pperco com
Construction Supervisor's License#(if applicable) CS-0 6 9 0 5 8
iRWorkman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
�I have Worker's Compensation Insurance
Insurance Company Name AE I C
Workman's Comp.Policy# WCC 5005593012012
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
® Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to 546 Higgins Crowell Rd
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
W Yarmouth MA 02673
❑ 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
quired.
SIGNATURE:
C:\Users\decollik\AppDa'�' \Microsoft\Windows\Temporary Internet Files\Content.Outlook\8R76BDVA\EXPRESS.doc
Revised 061313
25 TU PPE R
CONSTRUCTION CO.u c
79B Mid-Tech Drive West Yarmouth,MA 02673
Phone 508-778-0111 Fax 508-778-5010
Registration#121845 License#069058
Date:
Attn: Building Department
I hereby authorize Tupper Construction Co., LLC to pull the permits necessary to complete
the project described on the attached permit application form.
Thank you,
Owners'
Signatures ( ' ��2J
pd L�Uc � 1
Print Owners Names: S �►,� (J
Street Address:1 -7�
So
PRODUCERCER (50 CERTIFICATE OF LIABILITY INSURANCE DATED ,
8)997-6061 - FAX (SO8)g90-2731 IO/03/20I4
cy, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Southeastern Insurance Agen
439 State Rd. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
SP.O. HOLDER.THIS E DOES
FOTHEPEXTEND
Box 79398 ALTER THE COVERAGE AFFORDED B O IC BELOW.
N. Dartmouth, NA 02747
INSURED Tupper Construction Co LLC INSURERS AFFORDING COVERAGE
INSURERA: Arbella Protection Insurance NAIC#
S46A Higgins Crowell Road INSURERB: AEIC
West Yarmouth, MA 02673 INSURER C:
INSURER D:
COVERAGES INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLIC
RACTOR Y PERIOD INDICATE
PERTAIN,THE INSURANCE AFFORDED BY THE POLICHEREIN
D.NOTHSTANDI
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONT OTHER H RESPECT TtM
CT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY IES DESCRIBED HEREI DOCUMENT WITN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH G
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TNPE OF INSURANCE
GENERAL LIABILITY. POLICY NUMBER ��
8S00008743 11/01/2013 11 Ol 2014 EACH OCCURRENCE Ln�rts
X COMMERCIAL GENERAL.LIABILITY / /
CLAIMS MADE OCCUR § 1 000 0
A PREMISES ocwr►ence $ 100,00
MED EXP(Any one person) $ 5.00
PERSONAL&ADV INJURY $ 11000,000
GEN'L AGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE
$ 2000
POLICY RO- s ,
JECTP LOC PRODUCTS-Comp/pp AGG $ 2,000,0
AUTOMOBILE IJAII S6662400002 12/Ol/2013 12/01/2014
ANY AUTO (OCBI ate)INGLE LIMIT $
AL.L OWNED AUTOS � 1,000 00
A X SCHEDULED AUTOS BODILY
X HIRED AUTOS T ) §
X NON-OWNED AUTOS BODILY
ILLYY1INJURY
e $
GARAGE LIABILITY PROPERTY DAMAGE(Per eceldenl) $
AM!AUTO AUTO ONLY-EA ACCIDENT § INC
OTHER THAN EAACC $
EXCESS/UMBRELLA LIABILITY AUTO ONLY:
4600058368 11/01/2013 11/01/2014 EACH OCCURRENCE Acc $
A
X OCCUR �CLAIMS MADE § 11000,00 DEDUCTIBLE AGGREGATE $ 11000,000
RETENTION § I
WORIMRS COMpENSArON $
AND FMPLOYEWLABBILM YIN WCCS00SS93012007 10/03/2014 10/03/201S X $
ANY PROPCER/M E BER/EXCLUDED? RICHARD TOPPER IS TORY LIMITS X
B OFFICER/MEMBER EXCLUDED? ER
(MantlatOrYdese in NH) LUDEQ FOR WC COVERAGE EL EACH ACCIDENT
If a desaibe under
SPECIAL PROVISIONS below EL DISEASE-EA EMPI.O $ 1.00010
OTHEt E.LDISEASE-POUCYUMIT §
1010 00
DESCRIPT'Opl OF OL'ERATipryg/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/. SPEGTAL PROVISIONS
CERTIFICA TE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLEp BEFORE THE EXt+IRATION LUTE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL
DAYS WRITTEN 4
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT;BUT FAILURE O 00 50 SHALL
TOPPER' CONSTROCTION CO LLC IMPOSE NO OBLIGATION OR LIABILITY OF ANY BOND UPON THE INSURER ITS A ti
S46A HIGGINS CROWELL ROAD GENrsoR
NEST YARMOUTH, MA 02673RESeIurATIVEs
. Alli}tOR¢Ep�RESENTATNE
ACORD 26(2009/01j Lora Lowe
19
served.
The ACORD name and logo are registered marks o ACORD RD CORPORATION. AO rights re
Ltt18 3(4�1 T °$ FDC dLa l i l"rut tl�� ?V1ass�c3i:ass his-f��p mPrt T. s oy
i07`HatfTbOg A00 SUAe Ito. 86arai ot.8di'dirig t��C3Tf4Y5S`and Sta��ard
f`+iii.iriacTiiin Suira ii.i�srr
a.f�iZs bU�i. Licente:CS-069066
RdCH(ARD S TUPPER ;,
' 79 A Mlb-
WEST YARcY1t3t1T$1 CIA ign
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�..lfllF !f-f.+J1F7iI(IPlA�l!!�f 13��'�[ff,�.rllCJltldf';t�1 � '�
Lieense or registration Vr�1+d Yor inaividt►1 use nnly
Q3Tfiee-'isf Cnnsamear�ifairs R Sasmess Regaalahon. b a
'SP1#PR4VEiViE�6T:GflN#RAC�t1R before the expi date. If found':returTg to
�— egiatration Gffice ofc ff rs;aied$us cress 32egn&ation
T
178434 20.Pa aza-Sa a 51-70
Excpirataon 4/1612016 LF C
A 021 ...
?UPPER CQNS.'F�tUCTtOt�i CC LL_'G_
itH-AkD TUPPER
W.YARMQC3TH;tVt�Q2673 Lfosdessecretary i�lo , � ttfi¢t�tstgnatese
8a hflFFER€:tfxRfTkoVE-
a
Pe6*fie6pingi eopleBuitaaSaferWorl.
�'fiIiFRNAii�Npk . '
'Ct�C011gGP _
UMBER
Richard Tupper
Tupperf Astrt�ctio
BuildlrigSafety professional
'741801201
Me tier#;8158 13 xp l;
a
-
The Commonwealth::of Massachusetts
Department.ofIndustrial:Accdents.
Office`of Investigations
:600.Washington Street;
Boston, l A 02M
www massgov%da
Workers' Compensation Insurance Affidavit::Builders/Contractors/Electricians/Plumbers
Apulicant Information Please Print Legibly
Name(Business/organization/individual); Tupper _Construction Co ,; LLC
Address: 546A Higgins Crowell,Rd
City/State/Zip;: West Yarmouth, MA 0 2`6 7 3 Phone:#:
Are you an employer?Check the:;appropriate box:. Type.of project(required):
I..❑X L am a:em to er with, 4. ❑ I,am a:general.cotttractor and I
P y 6 ❑New construction:.
employees(fW.l andlor part-time): have hired the sub-contractors
2.0 I.am a sole proprietoror partner listed;:on the:attached sheet.. 7. ❑..Remodeling
ship and have no:employees These sub-.contractors'have:. 8. ❑Demolition
workin for in an ca ac workers' comp insurance:.
g Y p ty 9. ❑B, -.w.mg addition
[Na workers'comp.insurance 5 ❑: We are a corporation.and its
required,] officers have exercised their 10.❑Electrical rep or'additions
3111' am a homeowner doing all"work, riot of exemption,per MGL. . 11.❑ Plumbing repairs:or;additions
myself:[No workers"comp. a 152; §1(4);;;and we have no 12:❑ftoof:repairs.:
•insurance required-1.1 employees. [No workers-'
13.1 Other WQafh -ri a ton
comp:.insurance required;)
*Any applicant that checks'box'#1 must also fill out the section;below.showing;their workers."compensation.policy information.
Homeowners who submit this affidavit kadhg.ihey are doing alI work and then hireoutside,contractors must submit a new'af & it'indicati. such
:Contractors that check ibis box must attached an additions]sheet showing the'name of:tlie sub-cont`actors and their workers'comp.policy information:
I am an employer that is providing°workers'compensation insurance for:my°employees. Below is the policy and job site:
informadoa.
Insurance Company-Name:::.AEIC
Policy`#or Self tns.tic.#; .WCC 5005593012012,. Expiration:Date: 1043/1�5
Job Site Address 172 Skunknet Rd.. Ctty/Stge/Zip: C nt _rville
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:MGI c.152.can.lead.to the imposition:of:criminad penalties of a
fine:up to$1,500.00 And/or'one year Imprisonment,as well as civil penalties in the fofm of a STOP WORK ORDER and.a fine:
of.up...to-$250.06 a day against the:violator. Be.advised that a copy of this statement may be forwarded to the.Office of
Investigations of the:NA,for insurance.coverage verification:
I do hereby!certify under tit q ' .and penalties of peq?ury that the information provided:above is:true and correct
Si afore; Date: .10/23/14
Phone#. (508) 778 l
O coil use only: Do.no#write in this area,:to_be:completed:by c4.yr town.q,�`iciaL
City or Town:. .... .. P.ermitlLicense#r.
Issuing Authority(circle one):
L:Board ofHealth 2 Building.Department 3.OWTOW0 Clerk: 4.Electrical Inspector 5.Plumbing Inspector
6. other
Contact Person;; . . Phone
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
gap 7/ Parcel 00 7 TO `N (] L,ARNSTABLEPermit# D
Health Division 7 �— 9��s � ate Issued 3_ 2 q_-6_Z _
�. //� D� -2002 MAR 19 AM 10: 40Ddl
Conservation Division i _ Fee d
Tax Collector �--` 3 oo� _
Treasurer �; DIVISION
Planning Dept.
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address 7 SK", f Qe
Village (P f��vr ear�/i�i e_ A4 C)�L-3-D-
Owner I � Ypy Address 17'd, S>1fJAv1z'rvL+12�
Telephone
Permit Request AD`> c)^j i-o D? t S-ti 'u ec tz 171
Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new
Valuation I �(� Zoning District Flood Plain Groundwater Overlay
Construction Type
Lot Size 0 Ac-ve-s Grandfathered: ❑Yes 0 No If yes, attach supporting documentation.
Dwelling Type: Single Family)5, Two Family ❑ Multi-Family(#units)
Age of Existing Structure f ta,'S, Historic House: ❑Yes > o On Old King's Highway: ❑Yes XNo
Basement Type: Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: a 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: Nd Gas ❑Oil ❑ Electric ❑Other
Central Air: ❑Yes $�No Fireplaces: Existing New Existing wood/coal stove: ❑Yes -)�kNo
Detached garage:0 existing ❑new size Pool: 0 existing ❑new size Barn: ❑existing ❑new size
Attached garage: 0 existing ❑new size Shed: existing ❑new size Other:
Zoning Board of Appeals Authorization Cl Appeal# Recorded❑
Commercial ❑Yes Ao If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name f _ �� �" Telephone Number
Address 0LJ.Aje-/ License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
s
FOR OFFICIAL USE ONLY
� h .
PERMIT NO. ,
4 DATE ISSUED
MAP/PARCEL NO.
ADDRESS' VILLAGE _
OWNER.
? DATE OF INSPECTION:�
FOUNDATION
'f t
f '
FRAME
r INSULATIONS
FIREPLACE
� a
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL `
FINAL BUILDING , r
t
DATE CLOSED OUT
o
ASSOCIATION;PLAN NO.
t
t RESIDENTIAL:
SHEDS -POOLS-.DECKS-OPEN PORCHES- GAZEBOS
DETACHED GARAGES
i
FEE VALUE WORKSHEET
ACCESSORY STRUCTURES >120 sq.ft.(Sheds,detached garages,gazebos,etc.)
>120 sf-500 sf $35.00 $
>500 sf-750 sf 50.00 $ -
>750 sf- 1000 sf 75.00 $
>1000 sf- 1500 sf 100.00 $"
>1500 sf—USE NEW BUILDING PERMIT APPLICATION
DECKS x$30.00= $
(Number)
PORCHES x$30.00= $
(Number)
IN GROUND SWIMMING POOL $60.00 $
ABOVE GROUND SWIMMING POOL $25.00 $
RELOCATION/MOVING $150.00 $
(Plus above fee if applicable)
PERMIT FEE $
Q:forms:dkcost
eff:082301
I
Tlie Commonwealth of Massachusetts
De artment o Industrial Accidents
-, , :� : omcrorr�ras�atfo�
-- = 600 Washington Street
. Boston,Mass 02111
.Workers' Compensation Imarance AWIdavh
i
1`ekD V
location
Div CJ✓�J �I ehone>4 S'off ' 7 3 _S
;EJ4am a homeowner peering all wade mysedE
❑ 1 am a sole prop etor and have.no oat:wcddnz is aav MN
. worktts' ob.
tm this'
❑ I am as employer provrcimg ,for
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❑ I am a sole pVneto4 general can=ctor,or hommmw(c oxe aad have:hind tha c=tm ctmrs Hsted below who
ham
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Of
The Town of BARNSTABU, Barnstable
9 MASS.Gp� 9. Regulatory Services s6gq pie
tE0 MAy •
Thomas F. Geiler, Director .
Building Division
Peter F. DiMatteo, Building Commissioner
200 Main.Street,Hyannis NIA 02601 .
ce: 508=862-4038 Pax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION: C L)A) AJ t7t'
number street
rvillage I
"HOMEOWNER
name home phone#� work phone#
CURRENI'M.AUJNGAD DRESS: 7 o[ Sic�Jl� Y lilt' cTa
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or
less and to allow homeowners to engage an.individual for hire who does not possess a license,provided that
the owner acts as supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on.which there is,or is
intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or
farm structures. A person who constructs more than one home.in a two-year period shall not be considered
a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the
Building Official,that he/she shall be responsible for all such work performed under the building permit
(Section 109.1..1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and
other applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building
Department minimum inspection procedures and requirements and that he/she will comply with said .
proce�qd�s and requirements.
Signature of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply
with the State'Building Code Section'127.0 Construction Control..
HOMEOWNER'S EXEMPTION
The Code states.that: "Any homeowner performing work for which a building permit is required shall be exempt from the
provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a
person(s)for hire to do such work,that such�Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming-the responsibilities of a supervisor(see
Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in
serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the
unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part.of the permit .application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a
form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community.
Q:FORMS:EXEMPTN
The Town of Barnstable
Regulatory Services
Thomas F. Geiler, Director
Building Division
Peter F. DiMatteo, Building Commissioner
200 Main Street,Hyannis MA 02601
Office: 508-862-4038 Fax: 508-790-6230
Permit no.
Datey�
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 adj agent to
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements. A
Type of Work: &>c> 0'J ��-6 Kt� � K Estimated Cost
Address of Work: 7 Cc:o+e_'j ii1f_ �
Owner's Name:* w". VeAo Y
Date of Application: `
I hereby certify that:
Registration is not required for the following reason(s):
[]Work excluded bylaw
❑Job 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 owner:
Date Contractor Name Registration No.
OR
owner
glorms:Affidav
:rev-122001
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LOT 16 O
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LOT 18
JOB # '96-251
CERTIFIED PLO T PLAN
LOCATION SKUNKN.ET. ROAD CENTERVILLE, MA
SCALE : 1" = 30' DATE : APRIL 11, 1997 PREPARED FOR:
REFERENCE LOT 17 PB 224 PG 127
CHAMPION BUILDERS INC.
I HEREBY CERTIFY THAT THE STRUCTURE
SHOWN ON THIS PLAN IS.LOCATED ON THE
GROUND AS SHOWN HEREON.off `1N Of MaS�
+ &M-506 az-oee`o1 AR+NE c�F
a aA
down cape engineering, inc. ` No• 8 0
p�+
CIVIL ENGINEERS --`\-, 11�-- ---- � OJyC) lA ------
LAND SURVEYORS — AL
939 main aL yormouth, ma 02675 DATE REG. RVEYOR
� ��►
. ILI
The Town of Barnstable
9 � Department of Health Safety and Environmental Services
En " Building Division
367 Main Street,Hyannis MA 02601
Office: 508-8624038 Ralph Grossen
Fax: 508-790-6230 Building Commissioner
SHED REGISTRATION
j a icv A.))C-AJe71
Location of shed(address)
Property owner's name Telephone number
17/- c)07
Size of Shed Map/Parcel#
Signature Date
Hyannis Main Street Waterfront Historic District?
Old King's Highway Historic District Commission jurisdiction? �1 /
Conservation Commission(signature required) O<��/ C
THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN
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"1 TF 52.0' ��
S8,�
LOT 17
0
17,134 sq.ftt 0
M 0.39 Acres
1>> 67'
LOT 18
JOB # 96-251
CER TIFIED PL O T PLAN
LOCATION : SKUNKNET ROAD CENTERVILLE,. MA
SCALE : 1" = 30' DATE APRIL 11, 1997 PREPARED FOR:
REFERENCE LOT 17 PB 224 PC 127
CHAMPION BUILDERS INC.
I HEREBY CERTIFY THAT THE STRUCTURE
SHOWN ON THIS PLAN IS LOCATED ON THE .
GROUND AS SHOWN HEREON. OF MAJ�y�y
�SW 36i-moo /►RNE
1 s OJA
14.
down cape engineering, inc. `p No. e o
CIVIL ENGINEERS , l 1��-- --- F C!—
LAND SURVEYORS — A U ------
DATE REG. RVEYOR
939 main st yormouth, ma 02675
-� TOWN :OF BARNSTABLE
II CERTIFI ATE OF OCCUPANCY
PARCEL ID 171 007 GE013ASE ID 9857 t
ADDRESS 172 SKUNKNET ROAD ` PHONE (508)888-6640
Centerville `� ZIP
LOT 17 BLOCK LOT SIZE
DBA DEVELOPMENT DISTRICT CO
( PERMIT, 24020 DESCRIPTION CERTIFICATE OF OCCUPANCY t•3Lr�G'. �2A ,
PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY , , 1
CONTRACTORS: DACEY, MATT Department of Health, Safety
ARCHITECTS:
and Environmental Services `
TOTAL FEES: THE
BOND $.00 , I
CONSTRUCTION COSTS $77,880.00
101 SINGLE FAM HOME DETACHED . 1 PRIVATE P:-44 Era
* 1ARN3rABM •
MASS.
OWNER CHAMPION BLDRS, INC,
ADDRESS 300 OAK STREET, 0155 FDIN1�►
6
BUILD ,( D VIS 1 s
PEMBROKE, MA BY
II DATE ISSUED 06/26/1997 EXPIRATION DATE
s c�� ! .r- • 4 . .'ti T4+ OF ABLE"
BUILDING
1
WN
BUILDING PERMIT
PARCEL ID 171 007 GEOBASE ID 9857
ADDRESS 172 SKUNKNET ROAD- PHONE (508)888-6648
Centerville ZIP -
LOT 17 BLOCK LOT SIZE
DBA DEVELOPMENT DISTRICT CO
PERMIT 18799 DESCRIPTION SINGLE FAMILY DWELLING (SEryW.PMT.#96-584)
PERMIT TYPE BUILD TITLE NEW RESIDENTIAL BLDG PMT
CONTRACTORS: DACEY, MATT Department of Health, Safety
ARCHITECTS: and Environmental Services
TOTAL FEES: $241.4
BOND $.00
CONSTRUCTION COSTS $77;880.00
1,01. SINGLE FAM HOME. DETACHED 1 r PRIVATE P
* HARNBTABM +
MAS&
OWNER CHAMP I ON -BLDRS,, I NC, 1639. A�
ADDRESS 300 OAK STREET, ,#1.55
BUILDIN • DIVIS,I,O.N r--
PEMBROK.E, MA BY. • ' �!-'C
.._ DATE ISSUED �10/24/1996 EXPIRATION DATE
I
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN-
CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR
ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS
PERMIT DOES NOT RELEASE THE APPLICANT FROM'THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF FOUR CALL INSPECTIONS REQUIRED
FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE f
1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR
2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU ELECTRICAL,PLUMBING AND MECH-
ANICAL TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE INSTALLATIONS.
3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. a, .
4.FINAL INSPECTION BEFORE OCCUPANCY.
® THIS CARD SO IT IS VISIBLE
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECIOCCAL INEffiEqTIONIAPPROVALS
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WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATE. V'6 His
THEINSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGE,. OR BY
VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE ORWRITTEN'N, T•IFICA- =I
TION. NOTED ABOVE. TION.
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y��FtHE Tq,_ The Town of Barnstable
BARNSTABLE.� Department of Health Safety and Environmental Services
MASS.
'�Fo;�•�'0 Building Division
--
.•- ""'367'Main Street,Hyannis,MA 02601
Office: 508-790=6227 Ralph Crossen
r I�} a13
Fax: 508-790-6230 5 , ,r,; -- �---- - Building Commissioner
t.„ N.V� Inspection Correction Notice
Type of Inspections
Location � ,s , �Permit Number
Owner Ct vl� Builder .
0 notice to remain on jobsite, one notice on file in Building Department.
e following items need"correcting: f
Please call: 508-790-6227 for re-inspection.
Inspected by
Date
�,,......e.sr�—+,,.v-..•?Y�...r�., �,,,Y* .a, .�+ �....i-• z r,wr�..,-,•`"-':r .. v ..-. " - 'i,.,,,...w" ..+ti.. ,. . r,,,��Kv,�..:,.....-,,.w,,,�
tNE The Town of Barnstable
o�
�9A Aq.q LE.
MASS $ Department of Health Safety and Environmental Services
0
t639' �0
plf039. Building Division
367 Main Street,Hyannis, MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
Inspection Correction Notice
Y
Type of Ins ection � °L
P
Location �l�UL�, Permit Number ej
Owner . �& i vJ Builder t 4AN th!�d
One notice to remain on jobsite, one notice on file in Building Department.
e following items need correcting:
Y ``
v LVq-T15- � ':;4
j
Please call: ,508-790-6227 for re-inspection.
Inspected by
J �
Date
0
To
Date Time
VN ILE OU WE OUT
M
of
Phone
Area Code Number Extension
TELEPHONED PLEASE CALL
CALLED TO SEE YOU WILL CALL AGAIN
WANTS TO SEE YOU URGENT
RETURNED YOUR CA L
Message
Operator
AMPAD 23-021-200 SETS
�JZ] EFFICIENCY® 23-421-400 SETS CARBONLESS
3 , � � �
�.,._`�,�rw�a�� I�
',
Engineering Dept. (3rd floor) Map 1 - ( Parcel 007 F4 Permit#
House# (��. JS� Date Issued
Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) `6 `-5-3 PY Pee 4-3
Conservation Office (4th floor)(8:30-9:30/1:00-2:00) _T
Planning Dept. (1st floor/School Admin. Bldg.) SEPTIC S ' we UST BE
oProject
n Approved by Planning Board 19 _
EN";TALLE LIAE�CE
s�. •ODE AND
TOWN OF BARNSTABLE TOWN R
Building-,Permit Application
Address LoT 1-i _t 1-7 Z R-o AQ
Village C GNTL2VNLX_::E
Owner _CtAA-,iy\Ptc?t,3 1;uNL_DE6LS , IN(_. Address o,p�k_ST,, Ps= X..c frA
Telephone _S'oB S 8 5 (o6 4-S
Permit Request -To Goi,_ST2v CT A S)Nj6�£, V-A MtL_4 D vJet_u�,Lr
First Floor BI(D square feet Second Floor Lo o o square feet
Construction Type t=fLAW\F
Estimated Project Cost $ -Z`1 �,I o
/Zoning District 2 L Flood Plain NO Water Protection
Lot Size 1-? t 3¢+/ LE,E, Grandfathered ❑Yes ❑No
Dwelling Type: Single Family Two Family ❑ Multi-Family(#units)
Age of Existing Structure NIA Historic House ❑Yes ❑No On Old King's Highway ❑Yes ul o
Basement Type: (Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 81(o
Number of Baths: Full: Existing New ( Half: Existing New
4
No.of Bedrooms: Existing New 3
Total Room Count(not including baths): Existing New (a First Floor Room Count 3
Heat Type and Fuel: ZGGas ❑Oil ❑Electric ❑Other
Central Air ❑Yes lb 1vo Fireplaces: Existing New ( Existing wood/coal stove ❑Yes EYNo
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) JA- x 2�-� (V:yTU 2£� ❑Barn(size)
❑None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
Builder Information
Name MA:'TEt'Ev S, DNC-C\-/ Telephone Number Sob 6s(b (cCaA-B
Address cjA-AMP)0i-J 9u►LA1E2S1 tt-SC„ License# CS 04-(00'L0
-;O® OA e- 5-S°P0E—N , Sy u G *1 S!� Home Improvement Contractor# �O 1920
FafV.,820V.0 t WrA 0-2, S Worker's Compensation# C 4-Vo 01 2-77 9
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 13o u QNE
iS-PUS741... F Ctx_k—1
SIGNATURE DATE AVGvST
BUILDING PERMIT DENIED FO THE FOLLOWING REASON(S)
FOR OFFICIAL USE ONLY }
PERMIT NO.
DATE ISSUED
MAP/PARCEL NO. _
y
ADDRESS VILLAGE
OWNER ;
DATE OF INSPECTION: "
FOUNDATION
FRAME J ' o-99
i
INSULATION
FIREPLACE. S/<2,/ -7 �
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING%
DATE CLOSED OUT
ASSOCIATION PLAN NO.'
LOT 16
171.04,
j
o
o
o
CONC.
r FOUND.. 7f
L TF = 52.0'
S8•�
{
LOT 17 0
0
17,134 sq.ft±
^� 0.39 Acres
171.67'
LOT 18
` JOB # 96-251
CER TIFIED PL 0 T PLA N
-?-z
LOCATION : SKUNKNET ROAD CENTERVILLE, MA
SCALE : 1" = 30' DATE APRIL 11, 1997 PREPARED FOR:
REFERENCE LOT 17 PB 224 PG 127
CHAMPION BUILDERS INC.
I HEREBY CERTIFY THAT THE STRUCTURE
SHOWN ON THIS PLAN IS LOCATED ON THE
GROUND AS SHOWN HEREON. Of �gs�cy
oR 608-362-4641 o� AFtNE GJF
fox sos 362-9660 H•
OJA
done cape engineeruLg, inc. ``Q4_ No•
8 0
CIVIL ENGINEERS �'� ` � L ` ` �_— _ —_—_ F 'AfCI—R
LAND SURVEYORS AL lA
t9 main sL yormouth, ma 02675 DATE REG. RVEYOR
°F SHE l�
The Town of Barnstable
• snxxsrnat.�,
NAM
1659. Department of Health Safety and Environmental Services
A,Eo ,�A Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
October 24, 1996
Re: 142, 152, 162& 172 Skunknet Road,Centerville,MA
Map/parcel numbers 171/004,005,006&007
TO WHOM IT MAY CONCERN:
This letter will verify that,in accordance with our meeting on October 22, 1996,You have agreed to do the
following as a condition of all building permits being released after foundation permits:
1. Upgrade the section of Skunknet Road in front of your lots 16 feet wide with six inch dense
graded stone and two inches of 3/4 inch crushed stone on top.
2. In addition, if the water main is not in front of your lots, it has to be extended.
Sincerely,
Ralph M. Crossen
Building Commissioner
RMC/km
LOT Ili- $ ku.N K;N CTROAD. 1
It
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DEPARTMENT OF PUBLIC SAFETY
License; ,,.CONSTRUCTION SUPERVISOR
Nutber; Expires
9AIT;HEY J OACEY
P0 80X,'1SS8
8 Z1ARDS BAY, MA 02532
COMMISSIONER
F
M IRICTIONS: IG f
00 - None
IA - Masonry only
I - 1 8 2 Farily Hones :
The Commonwealth of Massachusetts
Department of Industrial Accidents
oxce 011O VS9921/OOS
< 600 Washington Street
Boston,Mass. 02111
Workers'Compensation Insurance AfCda/it
,.
� -�
.a
name: C Ran e 3>1 e V A6&,--S
location: C)Q (Z)� `
I!`ea(3 r,E—, ` r �� �D�� phone#
I am a homeowner performing all work myself.
❑ I am a sole proprietor and have no one working in any capacity
❑ I am an employer providing workers' compensation for my employees working on this job.
company;name.
address:
ci phone No
insurance co, C10N>q INS02AW-C GO policy# C4-i(oOI7J
0 I am a sole proprietor,general contractor,or homeowner(circle one)and have Fired the contractors listed below who have
the following workers' compensation polices:
company name:
address•
city phone#:
insurance co. policy#
company name:
address
city: phone#:
insurance co policy#
1[alttdch additions(a6e �:> .'" '—'ram"
et if neeeisir� ,. r •__ : � :�.; _ f�''
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or
one years'imprisonment as well as civil penalties in the fo-m ors STOP WORK ORDER and a fine�:5100.00 a day against me. I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verificadon.
1 do hereby certlj at an penalties of perjury that the information provided above is true and correct
Signature Date kuL-,V ST' 21 I Volk(o
Print name H 14 T. I) ----Rhone#- (D 1-1 Bq-�, 9 Do
official use only do not write in this area to be completed by city or town official
city or town: permit/license# nBuilding Department
[3Licensing Board
check if immediate response is required QSelectmen's Office -
OHealth Department
contact person: phone#; rjOther
(revised 3/95 PIA)
t. OCT 10 '96 02:59PM 5087756029 P.2
The Town
BARMABM
of Barnstable
xPdAn Department of Health Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601
Office; 508-790-6227 P
Fax: 503-790-623,0 Rat h Crossett
5
Building Commissioner
J
S
October 17, 1996 -
} John W.Kenney,Attorney At Law
12 Center Place
1550 Route 28
Centerville,MA 02632
•
Re; Lots 14, 15,16& 17 Skunknet Road,Centerville
Map/parcels 171/004,005,006,007
T (142,152,162&172 Skunknet Road,Centerville)
,
Dear Attorney Kenney;
Thank you for your clarification of the beneficiaries on lots 14- 17 on Skunlmet Road in Centerville. "
Based on this information,I believe the lots are buildable from a zoning standpoint,
Sincerely,
Ralph M. Crossen
13uilding Commissioner
RMCAcm
lu, vi
SEPTIC PROFILE TEST HOLE LOGS
T.O.F. AT EL. (WT TO SCAW
ACCESS COVER TO Wff)4N fr OF FIN. GRADE
ACCESS COVER (WATERTIGHT) TO ENGINEER:—
WITHIN Ir OF FIN. GRADE
MROMUM .75' OF COVER OVER PRECAST 2% SLOPE REOLARED OVER SYSTEM
WITNESS: eo. 6,oa-a-
RUN PIPE LEWL
2' DOLMLE
I J
i �< DATE:
/—FOR FIRST 2' WASHED PEASTONE ___ _. �__�%�. ��_ -----_. -- j �
PROPOSED I OMFXES TO BE 3/Ir TO 5/fr
CALLON S07M \-�tl - z--2,
-1, -1 / .I . - I iom.-7
71 1 /1 PERC. RATE
5
A v 0 00 0
C& --q, 0,09
R 0 'IPA
0, CLASS SOILS P#
IFAX 4 15,9'.-LONG &Y 15"WME
- sp -I I --
ta
CRUSHED STONE OR MECHANICAL
(15-221 [21)COMPACTION OT
DEPTH OF FLOW TO 1-112' DOUBLE WASHED STONE
(--LA SLOPE) TEE SIZES: SLOPE) SLOPE) P Cr Cr
INLET DEPTH - 110
LOCATION MAP 1* Z,
OUTLET DEPTH
FOUNDATION— 10 SEPTIC TANK D. BOX - LEACHING ASSESSORS MAP PARCEL------
FACILITY 5.0 41 FLOOD ZONE
e4--
BUILDING ZONE:
Cj M j SETBACKS: FRONT
SIDE -
C 1, 4-
REAR -
P, PLAN REFERENCE:
r
I-It
rl
I A
-SEPTIC DESIGN_: (GARBAGE DISPOS.ER IS
AS 2.
1 . DATUM IS 4el�-I
,j DESIGN FLOW: BEDROOMS (-JL4�� GPD) GPD
I
W, A GPD DESIGN FLOW USE 2. MUNICIPAL WATER IS
SEPTIC TANK: GPD GALLONS 3. MINIMUM PIPE PITCH TO BE 11T PER FOOT.
80 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO-H '0
- t.)SF A 1!5 i2�,? GALLON SEPTIC TANK
LEACHI 5. PIPE JOINTS TO BE MADE WATERTIGHT.
6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS.
0 1 u U -.3.
77- ENVIRONMENTAL CODE TITLE V.
130 TTOM: 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE
-J GPD USED FOR LOT LINE STAKING.
TOTAL.: S.F. GPD
w 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-e PVC.
7 A
9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT
INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED
6 FROM BOARD OF HEALTH.
A<
LEGEND
100.0 PROPOSED SPOT ELEVATION
10OX0 EXISTING SPOT ELEVATION
PROPOSED CONTOUR
EXISTING CONTOUR SITE AND SEWAGE PLAN OF
BOARD OF HFALTH IN THE TOWN OF:
APPROVED DATE
PREPARED FOR: e5l.
0 F*0
SCALE: 12- DATE: 'q
down cape engineering, inc.
CIVIL ENGINEERS
LAND SURVEYORS
PHONE 508-362-4541
FAX 508-362-9880
030 MeliTl St. yetrmoutli, ma o2s76
JOB# P. ilk DATE
I.... . ..... IIlip;--$ IG 0 ILA 17, II00, M 01 16 ILI) '21 MT(- for lA ell t............ IIAW M 00, F7
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