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HomeMy WebLinkAbout0055 HARTFORD AVENUE =OMNI Sao�� Town of BarnstableBuilding .�. _ �. .. . Post This Card So That it is Visible;From the Street Approved,Plans Must be Retained on Job and this Card Must,be.Kept Posted•Until Final Inspection Has Been`Made ti#s mot." �. Permit Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection ha's-been made Permit No. B-18-2416 Applicant Name: Rebecca Collins Approvals ! Date Issued: 08/01/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 02/01/2019 Foundation: Location: 55 HARTFORD AVENUE,MARSTONS MILLS - Map/Lot: 103-066 Zoning District: RF Sheathing: i � Owner on Record: BARNSTABLE HOUSING AUTHORITY Contractor Name:` REBECCA L COLLINS Framing: 1 Address: 146 SOUTH STREET Contractor License: CS=072020 2 HYANNIS,MA 02601 Est. Project Cost: $30,350.00 Chimney: Description: SIDING,TRIM &WINDOW REPLACEMENT Permit Fee: $ 160.00 Insulation: Project Review Req: Fee Paid $ 160.00 i Dater 8/1/2018 Final: ; N`r Plumbing/Gas Rough Plumbing: y. Building Official r +, Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after`issuance. I f , Rough Gas: All work authorized by this permit shall conform to the approved application and theapproved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for4public inspection for the entire duration of the work until the completion of the same. ¢ Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable ,RECEIPT. "B1 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-18-2416 Date Recieved: 7/25/2018 Job Location: 55 HARTFORD AVENUE, MARSTONS MILLS I l t o Permit For. Building-Sid ing/Windows/Roof/Doors l Contractor's Name: REBECCA L COLLINS State Lic. No: CS-072020 Address: , FALL RIVER, MA 02722 Applicant Phone: (508) 678-5201 (Home)Owner's Name: BARNSTABLE HOUSING AUTHORITY Phone: (508)771-7222 (Home)Owner's Address: 146 SOUTH STREET, HYANNIS,MA 02601 Work Description: SIDING,TRIM& WINDOW REPLACEMENT J o p � w � � T N Total Value Of Work To Be Performed: $30,350.00 � cn Structure Size: 0.00 0.00 0.005 a 00 Width Depth Total A;�§a i-n I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Rebecca Collins 7/25/2018 (508)678-5201 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $30,350.00 Date Paid Amount Paid Check#or CCtt Pay Type Total Permit Fee: $160.00 7/25/2018 $160.00 XXXX-XXXX-XXXX- Credit Card 1239 _........................_....._......_....................._..........._...__...._.._.............................................._......._......__..................._....... ........-.__.--...............__..._._.._-._e. Total Permit Fee Paid: $160.00 THISISaNOT ATERMIT, t r P h' I Town of Barnstable *Permit# Ot.t Expires 6 months from rom issue date f . Regulatory Services Fee �,35 , — eAarlar/� .All Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstab le.ma.us Office: 508-8624038 Fax: 508-790-6230 EXPRESS PERAUT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 103 Property Address �S tt��T r-� t i Y 2 ah /SLn-s Mats m a Residential Value of Work 5W Minimum fee of iao for work under$6000.00 Owner's Name&Address 46 0 Contractor's Nam n'le_ 'lv-v\(Jr,�,y-e mE.rj Telephone Number 50s-- -7 -7.5- 1117 S Home Improvement Contractor License#(if applicable) 10 3 7 5 7 wa ���E R IT Construction Supervisor's License f#(if applicable) C5 Co Co`{ AUG r . A WO [<orkman's Compensation Insurance F �A{��5�-A��. Check one: TOWN ❑ I am a sole proprietor ❑ I am the Homeowner GJThave Worker's Compensation Insurance Insurance Company Name 0 Gt.C�.�-� Zv1al.•t SA-r S-3 C� (Y)P1 Workman's Comp.Policy* Copy of Insurance Compliance Certificate must accompany each permit. Permit Request'(check box) Re-roof(stripping old shingles) All construction debris will be taken toQ ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.44)#of windows *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 co of Improvement Contractors License& Construction Supervisors License is eq ' SIGNATURE: Q:\WPFII.ES\FORMS\building permit forins\EXPRFSS.& Revised 090809 l The Commonwealth of Massachusetts Department of Industrial Accidents ' Offlee of Investigations 600 Washington Street • Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A licant Information `' Please Print Legibly Naive(Business/Organization/Individual):S 1)r,J)Y- 2 tt' me__ — 4 fbV2 mey%� Address:- [99,..'Z' ^rn5 W4e_ P00A City/State/Zip: 4 i5 Da(00 Phone#: 6C4' 7 7.5 ' l-77 3 Are you an employer?Check the appropriate box: Type of project(required): I am a �,� . general contractor and I 1.IJ t am a employer with 4 � 6. ❑ 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. ❑ Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' 9 Building addition [No workers' comp.insurance comp.insurance.t required.) 5. We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LEI 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.p 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 indicadng they am doing all work and then hire outside contractors must submit a new affidavit indicating such. tContrsctors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontractors 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.MA UX, 70 I6 q 9 q 361 kb 16 Expiration Date: C l � Job Site Address: 5S. a4— 1-i d�• City/State/Zip: t�2Ge�G Attach a cop y:of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to seGuie coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,300.00 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 Investiptations of the DIA for insuranee-overaize verification. 1 do hereby eery u e ain nd penalties of perjury that the information provided above Is true and correct. Si nature Date: ,?, — Phone Of cla/use only. Do not write in this area,to be completed by city or town offlclal. City or Town: Permlt/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#: z r Town of Barnstable do . 4 Regulatory Services Y ' Thomas F.Geller,Director MA&& �Eo; ,16 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstabli.ma.us Office: 508-862-403 8 Fax: 508.790-6230 Property Owner Must Complete and Sign This Section If Using Builder as Owner of the subject property hereby authorize LAP—. to act on my behalf, in all matters relative to work authorized by this building permit application for: .(Address of Job) 5igna SING AUTHORITY Date 146 SOUTH STREET WANNIS,MA 026M Print'Nat= If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. f1•FCIRMR•f1WNF.RPF.RMI.CC1nN R�® CERTIFICATE OF LIABILITY INSURANCE OP ID DS DATE(MM/DD/YYYY) SPRIN-1 01 05 10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Bryden & Sullivan Ins Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 88 Falmouth Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hyannis MA 02601 Phone: 508-775-6060 Fax:508-790-1414 _ INSURERS AFFORDING COVERAGE I NAIC# INSURED INSURER A: A60oC1ated Industries of MA —I (----"-----'---- INSURER B. Srinkle Home Improvement Inc. INSURER C —� 139 Barnstable Rd I Hyannis MA 02601 NsuRER INSURER E COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE CMI UDONYYY I DATE MMID�Q LIMITS GENERAL UABILITY EACH OCCURRENCE j S -TTANIAU COMMERCIAL GENERAL LIABILITY I j I PREMISES(Ea occurence) S CLAIMS MADE OCCUR i j �ME�O EXP(Any one person) i$ j PERSONAL&ADV INJURY S _ GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG I S PRO- �� POLICY JECT I LOC I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ! (Ea accident) i ALL OWNED AUTOS 1 I I BODILY INJURY I SCHEDULED AUTOS t(Per person) S f i ! 1 HIRED AUTOS i BODILY INJURY S (Per accident) NON-OWNED AUTOS j I � i I PROPERTY DAMAGE j S i I f(Per accident) GARAGE UABIUTY AUTO ONLY-EA ACCIDENT S l ANY AUTO i i OTHER THAN EA ACC $ i AUTO ONLY: AGG S EXCESS I UMBRELLA LIABILITY j { EACH OCCURRENCE $ OCCUR CLAIMS MADE j AGGREGATE $ I i S DEDUCTIBLE RETENTION $ I$ WORKERS COMPENSATION TORY LIMITS ER AND EMPLOYERS'UABILITY — A ANY PROPRIETOR/PARTNER/EXECUTIVE[j AWC7004943012010 01/01/10 01/01/11 E.L.EACH ACCIDENT E 500000 _ OFFICER/MEMBER EXCLUDED? LJ (Mandatory In NH) + I E.L.DISEASE•EA EMPLOYE $SOOOOO If yes,describe under I I E.L.DISEASE-POLICY LIMIT Is 500000 SPECIAL PROVISIONS below I OTHER I I DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION sPRNKHO DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Sprinkle Home Improvement, Inc IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Fax #508-775-1350 REPRESENTATIVES. Margo Mack AUTHORIZED REPRESENTATIVE 199 Barnstable Rd. Kelley A.Sullivan annis MA 02601 ACORD 25(2009/01) ©1988.-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD L �j �O°"'�'zR'} "� " "`Reg 1' License or registration valid.for individul use only Office o onsumer ajrs siness egu a on ROMM HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration:412 757 Type: Office of Consumer Affairs and Business Regulation Expiration: Private Corporatic i - h 10 Park Plaza-Suite 5-00 - Boston,MA 02116 S KLE•HOM - =IY INC. s Brad Sprinkle 199 Barnstatile'Rd A Fi nis,'hi171.026$1 �G Un-derseeretary Not valid without sign lure M'irss.ichusetts - Dep:u-tmciit of Public $.rich' Restricted to: 00 Board of Buildim-, Regulations' it St:indar(ls 00_ Unrestricted Construction Supervisor License I 1G-1 2 Family Homes License: CS 6643 Restricted to: 00 • i ' BRAD.K -SPRINKLE ' Failure te.possess a current edition of the 190 LOTHROPS LANP--" ' j Massachusetts State Building Code W BARNSI613LE, MA 02668 I is cause for revocation of this license. r �. Refer to'. WWW.Mass.Gov/DPS Expiration: 10/812011 ('ommissiuucr 8 Tr#: 547 r •