Loading...
HomeMy WebLinkAboutBLD-19-1454 ncte,c- 9/„/q, ONE & TWO FAMILY ONLY-BUILDING PERMIT Town of Yarmouth Building Department w r 1146 Route 28, South Yarmouth,MA 02664-449241 508-398-2231 ext. 1261 Fax 508-398-0836 L4:;\ & Massachusetts State Building Code,780 CMR Building Permit Application To Construct,Repair, Renovate Or Demolisy R E D a One-or Two-Family Dwelling This Section For Official Use Only SEP 04 2018 Building Permit Number:&7)—/Cl-07) its y Date A : r1 f`'\ S A S r- ty I—/T-/8 By ILDfDI�EP TAgF N Building Official(Print Name) .( Date SECTION 1:SITE INFORMATION , 1.1 Property Address: 1.2 Assessors Map&Parcel Numbers 7 Snua Harbor 91 195 Lia Is this an accepted street?yes X no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: R-40 residential .04 acres - Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 30' 30.4' 20' 57.6' 20' 10.3' 1.6 Water Supply:(M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public II Private LI Municipal_ Outside Flood Zone? Municipal❑ On site disposal system El Check if yes® , SECTION 2: PROPERTY OWNERSHIP' 2.1 Owner'of Record: Lee M Partvka North Haven, CT 06473 Name(Print) City,State,ZIP • 376 Mansfield Road 203-407-5180 No.and Street Telephone Email Address - SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction❑ Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) BI Addition 0 Demolition El Accessory Bldg.0 Number of Units_ Other 0 Specify: R E C E I V F D Brief Description of Proposed Work2: 1st and 2nd Floor Bath Remodel SEP 12 2018 1 ' •••:• - .-, ,••'SECTION At ESTIMATED CONSTRUCTIO$COSTS:.,3 Bin I fl nr Estimated Costs: Item Official i)s'e 0 y (Labor and Materials . -..•. -:';':,17",' 1.Building $ 50,960.00 `I::Building Permit Fee:$,SO Indicate how fee is determined:' 2.Electrical $ a Standard City/Towg Application Free +._' ;',,•'!.,,i ;�, 5,880.00 ❑Total Protect dose(Itgb)x mulhpher � x 3.Plumbing $13,110.00 2 Other Fees. $ 3 5 4.Mechanical (HVAC) $ 0.00 List;` . .- - • .,. •'_, ':.-'':, `r . . , :. 5.Mechanical (Fire ";; 'c tis-':a, 7 'rr' :' Suppression) $ 0.00 Total All Fees:$. .-.,';'-'7'•- - Cash Amount: 6.Total Project Cost: $69,950.00 CheckNo;' _Check Amount:'� LI Paid in Full: ill Outstanding Balance Due:_t1C • SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 015649 06/0912020 ' Robert K Steilo License Number Expiration Date • Name of CSL Holder List CSL Type(see below) U 310 Commerce Park, P.O. Box 776 No.and Street . Type Description , South Chatham,MA 02659 U Unrestricted(Buildings up to 35,000 cu.ft) Cityffown,State,ZIP R Restricted l&2 Family Dwelling M Masonry _ RC Roofing Covering _ • • WS Window and Siding SF Solid Fuel Burning Appliances 508-432-2218 mcaplice@stelloconstruction.com I Insulation Telephone Email address D Demolition • 5.2 Registered Home Improvement Contractor(HIC) • Enterprises, Inc. Robert K Stello 192090 06/07/2020 Stello Construction Enter p HIC Registration Number Expiration Date BIC Company Name or HBC Registrant Name 310 Commerce Park,P 0.Box 776 mcaallcefmstelloconstructlon Corn No.and Street Email address South Chatham,MA 02659 506-492-221$ City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.e.152.§25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit ; Signed Affidavit Attached? Yes Cl No ❑ SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN , OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize Stello Construction Enterprises, Inc. to pact on my behalf,in all matters relative to work authorized by this building permit application.4.4(1-4--.-- . • \�Hme(Electronic Signature) "g•�` ate SECTION 7b:OWNER'OR AUTHORIZED AGENT DECLARATION • By en ' g my name below,I hereby attest under the pains and penalties of perjury that all of the information con i in this ap li on' e and accurate to the best of my knowledge and understanding. 6 -r (� 8 r30 -lR Print er's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(IDC)Program),will nor have access to the arbitration program or guaranty fund under M.G.L.c,142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found atwwwsnass.eov/tips 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.)_ Habitable room count • Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system. Enclosed Open , 3. "Total Project Square Footage"may be substituted for"Total Project Cost" air TOWN OF YARMOUTH oBUILDING DEPARTMENT $ 1146 Route 28,South Yarmouth,MA 02664 508-398-2231 ext. 1261 Fax 508-398-0836 BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Chapter 40,Section 54 and 780 CMR,Chapter 1,Section 111.5, I hereby certify that the debris resulting from the proposed work/demolition to be conducted at 7 Snug Harbor Work Address Is to be disposed of at the following location: S &J Exco Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Chapter 111, Section 150A. (Ag —lb —if ignature of Application Date Permit No. The Commonwealth of Massachusetts Le.,..r.--_ Department of Industrial Accidents -_,their E' Office of Investigations ran=.a 600 Washington Street '–_'_.• — a Boston,MA 02111 .% ;;" www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information • Please Print Legibly Name (Business/Organization/Individual): Stella Construction Enterprises, Inc. Address: P.O. Box 776 City/State/Zip: South Chatham, MA 02659 Phone#: 508-432-2218 Are you an employer?Check the appropriate box: Type of project(required): 1.❑X I am a employer with 10 4. ® I am a general contractor and I 6. 0 New construction employees(full and/or part-time).' have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.: 7. N Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity, workers'comp.insurance. 9. 0 Building addition [No workers'comp.insurance 5. 0 We area corporation and its officers have exercised their 10.0 Electrical repairs or additions required.] o 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp.insurance required.] 'Any applicant that checks box NI 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 their workers'comp.policy information. l am an employer that is providing workers'compensation Insurance for my employees. Below is the policy and job site Information. Insurance Company Name: Zurich American Policy#or Self-ins.Lie.#: 6ZZUB-921X274.4-02 Expiration Date: 09/01/2019 Job Site Address: 7 Snug Harbor City/State/Zip: South Yarmouth,MA 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 ify nder th !S p{/f, s [/a' enalties of perjury that the Information providedaboveis true and correct. Sienature: ' ) _�� ?Y eX Date: \D 1 X Phone#: 508432-2218 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#: tif ei'mmo (!hail V10 eatuarA,nrf/J Office of Consumer Aria 6 Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Corporation Peofstration Fxnlratlon 192090 06/07/2020 STELLO CONSTRUCTION ENTERPRISES,INC ROBERT K.STELLO a2,. • 310 COMMERCE PARK N SOUTH CHATHAM,MA 02659 Undersecretary ' • 4®� Commonwealth of Massachusetts • Division of Professional Licensure Board of Building Regulations and Standards Constructidtt SOpervisor ' ' CS-015649 Expires: 06/09/2020 ROBERT K STELLO •1• • PO BOX 776 CJ f SOUTH CHATHAM MA 02659 . q✓� Commissioner L • • Acc•Rp CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDDIYYYY) 09/04/2018 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(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 CONTACT NAM!: Craig Vokey CRAIG S VOKEY DBA MARK T VOKEY INSURANCE PHONE Falk (508)845-3535 MFAX Mel, Maw creig©vokeylnsurance.com PO BOX 1247 INSURER(M)AFFORDINGCOVERAGE ANC II WEST CHATHAM MA 02669-1247 INSURER A: AMERICAN ZURICH INSURANCE COMPANY 40142 INSURED INSURER B: STELLO CONSTRUCTION ENTERPRISES INC INSURER C: INSURER D: PO BOX 778 INSURER E: SOUTH CHATHAM MA 02659 INSURER F: COVERAGES CERTIFICATE NUMBER: 310215 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. NOTIMTHSTANDING 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 auUL40S11 LTR TYPE OF INSURANCE iNRD VNO POLICY NUMBER IMIMODNYFWI IMMIODYIVYYYYI LIMITS COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE S CLAIMS-MADE ❑OCCUR PREMISES Euo mil S MED EXP(Any one person) S N/A PERSONALS ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE E POLICY PE1-1"' LOC PRODUCTS-COMP/OP AGG_ I I OTHER S AUTOMOBILE LIABILITY COMOIGLE LIMI accident] ( S ANY AUTO BODILY INJURY(Per person) I — ALL UTOUTO OWNED N/A BODILY INJURY(Par SONtM) S HIRED AUTOS AUTOS NON-OWNED PROPER rY DAMAGE _ j (Per aoGdeMl S UMBRELLA LIAB _ OCCUR EACH OCCURRENCE S EXCESS UAB CLAIMS-MADE N/A AGGREGATE S DEO RETENTIONSWO KERS �/ p7H. S ON AND EMPLOYERS'LIABCMPENSATILITY YIN ^ STATUTEANYER A OfF GERM MBEACLUpEEMEC�YE WA WA WAEL EACH ACCIDENT S 1,000,000 (Mandatory In NH) BZZU8921%274418 09/01/2018 09/01/2019 Mt YYea deealba untla E.L.DISEASE•EA EMPLOYEE f 1,000,000 DESGRIPTIONOFOPERATIONS below E.L.DISEASE•POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPER/MONS I LOCATIONS I VEHICLES IACORD 101,Additional Remarks SahsduS,may be MMeMd X mon seam Is mored) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 0,no authorization is given to pay claims for benefits to employees In states other than Massachusetts If the Insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was Issued(unless the expiration date on the above policy precedes the issue dale of this certificate of Insurance), The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool et www.mass.govawd/workers-compensation/Investigationst CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Yarmouth Building Department 1146 Main Street d AUTHORIZED REPRESENTATIVE South Yarmouth MA 02664 Daniel u M.Cr, y,CPCU,Vice President—Residual Market—WCRIBMA ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD • "---1 STELLC7 OP ID' NM ACORO- DATE(MMND/YVY1) Lars-- CERTIFICATE OF LIABILITY INSURANCE 09/05n016 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 pollcy(les)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 endorsement(s). PRODUCER 508-945-3535 CONTACT Mark T.Vokey Insurance Agency PHONE 28 Village Lndg,P.O.Box 1247 uC,No,Eat);508.945-3535 FAX so).508.945.9368 West Chatham,MA 02669.1247 MAM1Ea: DPE INSURERj!I AFFORDING COVE RAGE NAIC 0 INSURER A:Scottsdale INSURED Stello Construction Ent.,Inc. INSURER Sr Robert K.Stello,President P.O.Box 776 INSURER C: South Chatham,MA 02659 INSURER 0; INSURER E: INSURER P t 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. INTR TYPE OF INSURANCEminPoLN:Y NUMBER POLICY EFF ' POUCYEXP witIMM?ODfYYYYI IMWDO/TYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 3 1,000,000 CLAIMS-MADE O OCCUR NCS0001312 09/01/2018 09/01/2019 DAMAGE TO RENTED 100,000 "DAMAGE RENo rr f MED EXP(Ana one person) $ 5.000 PERSONAL SADV INJURY $ 1,000,000 GEHL AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE 2,000,000 POLICY O Ye U LOC PRODUCTS-COMP/OP AGO_.5 2.000,000 OTHER B AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT AESS ANY AUTO BODIL+nenn I .— OWNED — SCHEDULED BODILY INJURY(Per meant f AUTOS ONLY — AUTOS apply INJURY(Per emMentl 5 — AM ONLY — RAM ONLY Pw PE�R�IOAMAGE $ S UMBRELLA LIA9 OCCUR EACH OCCURRENCE j EXCESs UAB DED f DED RETENTION$ S WORKERS COMPENSATION I fTAT ITE I I FRTM AND EMPLOYERS'LIABILITY ANY ARTNEREXCLUDEE ECUfIVEril N/A EL EACH ACCIDENT $ Lmentletory In NH) E.L.DISEASE•EA EMPLOYEE $ rdescribe wider DESC RIPTION OF OPERATIONS below E L.DISEASE•POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Location: Lee Partyka-7 Snug Harbor Drive,South Yarmouth CERTIFICATE HOLDER CANCELLATION YARMOT2 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORETHE EXPIRATION DATE ACCORDANCE WITH THE OL THEREOF,Y PROISIONS NOTICE WILL BE DELIVERED IN Town of Yarmouth Building Imp 1146 Main Street South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE �� ACORD 25(2016/03) 01988.2015 ACORD CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD /sr F/mfi- /4E1C K4 7 54,)7 140.‘60 r &--- ' r L 19LCOItie.S ,k.1t.4. Sk,9wt 1 ki,FL LVVA4.1. cr. on c„- - NtaJ (:.ow.4fh- ,e�i" watt rCry St+. A0 < ,v ;+1 \Yt0s c P aes ±•.l w, QV./ -cVat'C.+ -grvsk ,Jt64; -':As‘ke5 S' TOWN OF YARMOUTH REVIEWED FOR BUILDING AND ZONING CODE COMPLI- ANCE. ERRORS OR OMISSIONS DO NOT RELIEVE THE APPLICANT FROM THE RESPONSIBILITY OF'AS BUILT' COMPLIANCE. 0 DATE: CY I I ID „77-4:. ,-, - BUILDING OFFICIAL 2-•A& (0p( 1,...41 FILE COPY 7( - PJ.e,,.• cosi 4r+- k5* c,..f :t e ton* L . iO \ : / JeW a " V , -itii IS, n k. 0-N -t-c a .vct± ! • I • f �1 . levo lotto woes -Ilse-L. S t•Lo,M'e r T E-a.k Work 0-r`tk 1 ( Sc14f- 0f b,-A-. botLroons R/ ar,a_ to,r hn-Ftnrwn. S('' IZC/ r•x 7G+ .' fN,t00fR'� p, Xep(0.oe skwctoAl. 1 g, 1 . . . . . • --FA-1.--i- L l } I I T • 0 2-e 1a.ce.- -04 w;+L Skog • CO & tRe.iwsvL4.4c 7' .J © 1Re(oface va44.i4aj a --n.v0vf a q {al}i ® Rettkt.•L u.c1-er Glvst-4 • P I Roo-C C7OEePlc44...c. ftiedte1n.6 ca&Aaf •_f gspktt- I al / 5ktvtiles • EI'.c( t - a • ?Ebtt+'A rr3 - ' IJo Wa rtk o ►Jo luo Zk •L• • X. • -Zoo4 v - . asphw(t • 51.-..5le5 • ),Nb FLoor2 93(e so-C+- I 312' ?apfl1� 5'I r jp (sr �o,,r & c /i 35 �Fa- 9/ / r--I Q ���la a e 1-:I le 0 N�IoIae: vartilli ,wt peg csi�,(�tt•cw P�votfi [�J L • 1 Ft: . GRRt�GE • Q e?tk.cc 51..•e& roc . '7' _ rr O (.?o WO 2k` - wa �`1 0 S�E� (if oZ�r ►:..,' -h-if tic . -,14: 51\1we-r PO lPoitir... 4j ji _.----\.)A.--,-, -� \-, . i . 1W�7 5 FAMtLv Rtn • - EMI NO ui0 2k 4 III . . • • Wanti • $tJ1J _ UvIi&RM Nal DIA(/VG C6'1 I .1 . to • RooM -' go WOZK SIM 1,10 WotK " U 1 1 l , . • tit 0 U.t*r RR y • • • • . • • z5 Tk}RP(kc tl / 1 . . . • . -7 SNUG ►-1R2i3oz DR. • to �� 3(o c&v rk Y4RMo.rN /5? P160 / 735 Sq "