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HomeMy WebLinkAbout0039 YORK TERRACE � t'� ��r�c�. � � i i ry � Town of Barnstable *Permit# 097 Expires 6 months from issue date nnnn�srwet�, x Regulatory Services Fee •�1 MA g Thomas F.Geiler,Director 16.79- �fo �a Building Division Tom Perry,CBO, Building Commissioner 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 Property Address_„? W�6 zy QMCc OW69VI Lim y� [TResidential Value of Work /-1xiy00 Minimum fee of$25.00 for work under$6000.00 Owner's Dame&Address .ftnAll"- t�te Contractor's Name IrYy l b mtTztl Telephone Number `•�2-0 5� Home Improvement Contractor License#(if applicable) fYJ /y k Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance r� 5 PERMIT Check one: i� P�ram a sole proprietor APR 17 2007 ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance TOWN OF SARNSTABLF, Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) B Re-roof(stripping old shingles) All construction debris will be taken to �lrl�/YST�1�l,C �u1/I►� ❑Re-roof(not stripping. Going over existing layers of roof) cr ❑ Re-side ❑ Replacement Windows. U-Value (maximum .44) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations;i:e:-Historic;Conservation,etc. ***Note: AH 0 ust sign Property Owner Letter of Permission. ry ent Contractors License is required. SIGNATURE: Q:Forms:expmtrg Revise071405 I i The Commonwealth of Massachusetts c d Department of Industrial Accidents t Office o Investigations .�.T .f g 600 Washington Street ` 4 Boston, MA02111 y �b� www.mass.gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Pluinbers Applicant Information \\^^ Please Print Legibly Name(Business/Organization/Individual): 1�✓�� � � Address: PO 60X (03Y City/State/Zip: W. -64"81"A&E, Phone #: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the'sub-contractors 2.R i am a sole proprietor or partner- listed on the attached sheet. $ �• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work - right of exemption per MGL I L❑Plumbing repairs or additions myself [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.] t employees. [No workers' 13.F Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and 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 information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-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 aga the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the D fo insurance v rage verification. I do hereby certify er he p s and enalties of perjury that the information provided above is true and correct; Sianature: Date: ' /7— 01 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#: a IKE Tp� ti > M Town of Barnstable Regulatory Services gEDe Thomas F. Geiler,Director Building Division Tom Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and.Sign This Section If Using A Builder as Owner of the subject property hereby authorize ✓/� to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner Date Print Name i Q:Fomis:expmtrg Revise071405 ¢� 1 J' D WwMAtt N Rmwdo ft&F'tttri k CaMernly PO Box 638 West Bwmtabk MA 02668 March 29,2007 Mrs.Susan Carey 12707 Iverary Circle Fort Myers, FL 33912 Re: Proposal for Home Remodeling—78 York Terrace,Osterville, MA 02655 New Asphalt Roof,Chimney Repair,SWewall 1.) Roof Remove and replace existing asphalt shingle roof with 30 year architecMW asphalt shingles in color selected by owner. Prior to installation of new roofing shingles the roof sheathing will be covered with 18"of ice and water shield and asphalt paper. Shingles will be nailed with the appropriate nailing as recommended by the manufacturer. Appropriate vent pipe flashing and drip edge wilt be installed. Vented ride will be installed Total Roof$10,330.00 2.) Sidewall Repair Remove and replace white cedar siding on 5 side-wall"cheeks". Total Sidewall$2,865.00 3.) Chimney Flashing Remove worn lead apron flashing around the existing chimney.Replace with new flashing. Total Chimney Repair$675.00 The above to be completed for the amount of$LWO.00 for all materials,labor and job site debris removal. Upon acceptance of this proposal payment is to be made as follows: 501.due to start the job(6,935.00), and the balance (6,935.00)due upon completion Please note:any rotted sheathing,trim etc.found by the carpenter will be brought to the attention of the homeowner. Repairs to such will be billed over and above the contracted rate on a time and materials basis at S55.00 per hoes plus matyri�ls upon approval of homeowner. Contractor is licensed and insured. Submined:by: Accepted by-- David L44sres Sum Carey /' w O O W m < < N. D m p p Z � D r Z. T W N = 0 (p e CD N•. l,G -Licen#e or registration valid for individul use only m before the expiration date. If found return to: `^�"•w Board.of Building RegulationsN and Standards � � m � d (TI Z c 3 One Ashburton Place R 30.1 b 0, °D = i °� w n o Y Bost*Ma. 2108 ° o =!� Z 1 O =a V. ....._.._.......— 9s - d y .no valid without signature � � :; •