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Home My WebLink About0263 STARBOARD LANE �✓ � , S��6c�LA isi �- _ - - - Town of Barnstable *Permit Regulatory . > ® li ee 6 months from issue date _ " �+ aAmRrABm ' R MAss. Richard V.Scali,Director '^:'R. � 1639. A, • Building ' sion MAR ?Oil Paul Roma,BuildingPC�• A ` er 200.Main Street,Hyannis,MA 260 R'VS TAD LE 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 5 3 b Property Address (P "�� esidential Value of Work$ / 0 QUV.(1 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Pe U ,, J /� ", W �/ Contractor's Name rg I JyV Telephone Number �s3`1 Y /� Home Improvement Contractor License#(if applicable') Email: 121A= Construction Supervisor's License#(if applicable) VWorkman's Compensation Insurance Check one: tK l am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name 11/1 �l ILA Workman's Comp.Policy# �� .(�� 0 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) 1P e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to "(AJLCL ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note: Property Owner must ign Property Owner Letter of Permission. A copy of the Ho provement Contractors License&Construction Supervisors License is equired. SIGNATURE: C:\Users\decollik\AppData\Local\Microsoft\WindowsUNetCache\Content.Outlook\L7U69LF2\EXPRESS(2).doc 01/25/17 = snxxsTneu. MASS 039. Town of Barnstable ,0� Regulatory Services Richard V.Scali,Director Building Division Paul Roma 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 I, (�� ,as Owner of the subject property hereby authorize Low," 6to act on my behalf, in all matters relative to work authorized by this building permit application for: sIOL Wd " a&' (Address of Job) 16- i�- Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption.Form on the reverse side. C:\Users\decollikWppData\Local\Microsoft\Windows\INetCache\Content.0utlook\L7U69LF2\EXPRESS(2).doc 01/25/17 r The Coniniourvealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street _ - Boston,MA 02111 svrvluniass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/PIectt-lcians(Plumbers Applicant Information c Please Print 1,embl Name(Business/0%mization/Individual): Address: 3)• Gi 0 City/State/Zip: . W Ld,, Phone# `S-39- 2-- Akapu an employer?Check the appropriate box: T of project(required): am a employer with 4- ❑ I am a general contractor and I Type e 7 o �P Y : have hired the sub-contractors 6- New construction Iayees(full and/or part-time). 2. I a sole proprietor or partner- listed on the attached sheet 7- Remodeling and have no employees These sub-contractors have g_ ❑Demolition iv for me in an capacity- employees and have wormers' °fig Y � tY- I 9_ ❑Building addition [No workers'comp.insu mare comp.insurance 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 11.❑Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12. of repairs insurance required.]i c. 152,§1(4),and we have no employees.[No workers' 13_ Other comp.insurance required.] ;Any apphcat t that decks box 91 must also fill out the section below showing then waikeis'compensation policy information. Homeowners who submit this affidavit indicating they are doing all wad and then hire outside contractors must submit a new affidavit indicatio such tContrumrs tbat check this bwc must attached as additional sheet showing the nee of die sub-contrz=rs and state whether or not those entities have employees. If the sub-contractors hire employees,tbey must provide their workers'comp.policy number- lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. y Insurance Company Name: f, I Policy#or Self-ins-Lic_4: I Expiration Date: V Job Site Address: 10 ou �ety!'Stp I i te✓�: 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 farm 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 IA for insurance coverage verification. I do Hereby ce order the poi s and penalties of perj that the info ration prodded abotne is true and correct Si tune: -Date: Phone#: Official nse only. Do not write in this area,to be completed by city or tmvn official. City or Town: PermiVUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 4 David Sawyer Construction 318 Meiggs Backus Road Sandwich,MA 02563 508-539-1992 Proposal Submitted To Work Address Tom Casey 263 Starboard Lane Osterville,MA 02655 617-797.4010 TcaseyCa.standish.com 17 Sheffield West Winchester,MA 01890 -------------------------------------------------------------------------------------------------------------------- Worked to be Performed: *Strip Roof------------Replace with CertainTeed AR Architect Landmark Shingles Color-weatheredwood *Nail Plywood as needed *Clean Gutters as needed *Install: White Aluminum Drip Edge Ice&Water barrier on all edges of roof,valley's,chimney's and cheeks of main house Underlayment Paper System Hurricane nail shingles Ridge Vent Pipe Flange *Remove all rake boards—replace with azek trim. *Remove corner boards as needed-replace with azek trim *Strip 2 left sidewall gable walls,I second floor back wall and 2 cheeks-Replace with R&R white cedar clear sidewall shingles and install step flashing. *Clean and paint all trim with white duration paint. *Clean yard and take all debris to landfill. Total Labor&Investment$17 800 00 seventeen thousand eight hundred dollars Deposit to begin job$8,000 and balance due$9,800 at completion of work. All materials guaranteed to be as specific,and work to be performed as stated above in a workmanlike manner. Please remove and/or secure any fragile household items. Not responsible for broken or damage to household items. Five year Labor Warranty/PjVs Manuf ures warranty. Contract may be withdrawn if not accepted within 30 days. P se see b k or addit' al erm Respectfully Submitted, Date Acceptance of Proposal The above prices,specifications and conditions are satisfactory and hereby accepted. You are authorized to do the work. Payment is due as stated above. Owner signature: �__` Date 3 ��' _ Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston;Massachusetts 02116 Home Improvement Coop*tor Registration -= - y Registration: 134313 Type: DBA Expiration: -•10/24/2017 Tr1f 270759 DAVID SAWYER CONSTRUCTION DAVID SAWYER -318 MEIGGS BACKUS RD. SANDWICH,,MA 02563 sys h j:r Update Address and return card.Mark reason for change. -- ' El Address Renewal Employment Lost Card SCA 1 Q 20M-Mi I 1 Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CSSL-098859 Construction Supervisor Specialty ' DAVID R SAWYER 318 MEIG13S BACKUSROAD��, SANDWICH MA 62b63 - , 'j/fi �rtrz�— Expiration: /Commissio er 01/27/2019 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE AGENT NO 3020 OFFICE NO 3020 MARK SYLVIA INSURANCE AGENCY LLC 404 MAIN ST CENTERVILLE MA 02632-2916 FARM FAMILY CASUALTY INSURANCE COMPANY 508-428-0440 NCCI COMPANY NO. 16721 POLICY NO 200IW6406 INSURED AND`MAILING ADDRESS: "RENEWAL OF NO. 2001W6406 EFFECTIVE 3/05/17 DAVID SAWYER DBA SAWYER CONSTRUCTION 318 MEIGGS BACKUS RD SANDWICH, MA 02563-3131 I THE INSURED IS INDIVIDUAL Workplaces covered by this policy: ST WP NO. ADDRESS OF WORKPLACE RTG.BUR NO. INTRASTATE NO. MA 01 318 MEIGGS BACKUS RD 210677 SANDWICH MA ' - ::>I,''•. :[ :Li 'C:.L' ` "2 `? > ' ` ?'`%l?2 ` ? ? 5 s ' ':��? ` 5 "`' `s `` ` 1 2?`�`�'': '<';t r '2 j r'' ' ' The policy period is.from 3/05/17 to .3/05/18 12:01 A.M. Standard Time at the insured's mailing address. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the state listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury By Accident Bodily Injury By Disease Bodily Injury By Disease $ 100,000 each accident $ 500,000 policy limit $ 100,000 each employee I C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: All states except the states designated in item 3.A. of the information page and ND, OH, WA, and WY D. This policy includes these endorsements and schedules: WC 00.00 OOC WC 00 00 018 WC 00 03 15 WC 00 04 14 WC 00 04 22B WC 20 03 01 WC 20 03 02A WC 20 03 03D WC 20 04 05 WC 20 06 01A Copyright 1997 National Council INSURED COPY PROCESSED 01/13/17 on Compensation Insurance WC 00 00 01 B Issuing Office - Pb Box 656 • ALBANY, NEW YORK 12201-0656 / / n�ACi 1 Assessor's' map and lot number .I�J.E7/ E?..:.� :.... T SEPTIC SYSTE&e M E 3 Sewage Permit number Qr IS...�x�..�:.en..,- ,✓.?� ,ti-tia,.P o� INSTALLED IN COM • 0?63 STAR�ahRd 1.4u'� D��Rv<`�F rjq WITH TITLIE 5 ALE, House number ..........................................0.......................-',.... 90 rb a ENVIRONMENTAL CO TOWNS QF BARNSTAIN1 uLATI®NS BUILD110 INSPECTOR APPLICATION FOR PERMIT TO . TYPE OF CONSTRUCTION ..........� ......:.......................... .................. . .......................... ................................... : ............. ...2 .................., ./.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: a'6 3 _ 0sT�R v/ c. r1�s5. Location '............. .................................................................... ...............................�............. ................................... .......... .... R ProposedUse .. ......... ...t...........................�.............. ........................................................I......................... ZoningDistrict ........................................................................Fire District .............................................................................. Nameof Owner .>. �.� ..............Address..... .. ........... ............................. .................................................................................... ?0045 8Y I-OxiF7,71 Nameof Builder ...T,.M. R' L�Z'1£��.....Address..................................... .................................................................................... Nameof Architect ..................................................................Address .................................................................................... /,V 0;?&&Jg0 CpN`cREltr Numberof Rooms ..................................................................Foundation .............................................................................. Exierior ....................................................................................Roofing .................................................................................... Floors ....................................................Interior .............................. Heating .................................................................................:Plumbing .................................................................................. // ddD, oD Fireplace ..................................................................................Approximate Cost ..........J.................................................. Definitive Plan Approved by Planning Board ---------------_---------------19________. Area ..x...1.4.................. Diagram of Lot and Building with Dimensions Z67 /S 2,vv 4ca6 Fee ......./.D � SUBJECT TO APPROVAL OF BOARD OF HEALTH 66` p Pe p� ,+ 3� �a 5 EP El0 63 STiPRD/�P,n 1--,V1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. S*,. Name .. .. !!!✓!...... .... ... ....... ...................... ��' LEONARD, LOUIS 23138 PRIVATE No ................. Permit for ............................ ....... ...........Swi.mmi.ng ....... ....... .. ... ...................... ........... PRI VATE JT�E .................. ....... Location ....2.6.3...Starboard...Lan.................................... Osterville ................................................... ....... .................. Owner ...Louis Leonard 7. ............................................................. Type of C6 I nstruction ...Vinal ....................................... ................................................................................. ,Plot ............................ Lot ................................ y 26 , Permit Granted .........Ma ................19 81 Date of, Inspection ....................................19 Date Completed ................. 19 PERMIT REFUSED ..................................... 19 ............................................... 0, ................................................ ILI . ......... i................................................. .............. ............ .................................. Approved........I...... .................................. 19 ............................................................................... Asse°ssor 's map and lot number .l.L�'J:...� ...:�..A (/ 0`T E N Sewage Permit number ..04 c...:-• �63 ✓`TA&ARd LA1'F DJ,�RV1b-i- Mj� t B9HH9TSDLE, i 5 House .number .......................................... .........................:..... vo . rasa O 16}9, 0 a Mix TOWN OF BARN.STABLE BUILDIN-G INS:PE-CT�OR APPLICATION FOR PERMIT TO ........e't'l,4 TYPE OF CONSTRUCTION ... ............................ S- '(j....�........ ..................: ........................................ / ... ......................19:.?...... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information:. 3 O.. �R T y�GLE Location . .. . ..................a........ ...:5................................... Proposed Use .............................:........ ...............✓................^....................................................................................... "!%• ZoningDistrict .........................................................................Fire District ..................:...................,....................................... / ��✓� L OU(5 L EO Af AR b Nameof Owner ........................ .........................................Address .................................................................................... rA00/� 5 0V L• UZ/F T Tl Name of Builder ...'7"M. T y ...•.L UZ.t��f •.Address.............. Nameof Architect ..................................................................Address .................................................................................... lAt 9R6un/b C,oNc R—i£ Pooh. Numberof Rooms ..................................................................Foundation .............................................................................. Exterior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior ......................,............................................................. Heating ..................................................................................Plumbing ..........................................................:. Fireplace pp // 004, 00 .:...............................................................................A roximate Cost ..........).......................................................... Definitive Plan Approved by Planning Board -------------------_-----------19_______. Area �� x...�.p Diagram of Lot and Building with Dimensions 1-67 IS , 40?E6 Fee ...... ............ ......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 66 lb - 1 ,} �/po e ------------- gEpl(L i1 � DR�I�� war. I J �laus� 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. kName ..... !W .... .............................. . LEO0&BD, LODIS � . 23l38 PRIVATE No —..,--—.. Permit ------------ ` Swimming Pool --------.^-----------------. � ' Location ...2S3...Star.boar.d.. ____. Ooterville - ----.--------------------- ' . ` . Owner .....Loui��..I^��gazd. . ` � � . Type ofConstruction ..... �gl� ^ ' - ................... ' ` ^ ' ` . ` G 31 Perm it '_.�^�� —�----]V . ' Date of Inspection ............. ......................lg . . D"'= C" "p==" . . ~ ^ ^ ^ ' ' PERMIT REFUSED . . -----_--.. lV � , ' ' --------.— ---------------. ^_________../.____,__._._____.___ ' -- —.. ----------.. ' . ...................... ' , . ' � Approv'e6 ................................................ lg � | -----------~—`^'-----'—'~--''' ' | / -------.----.---------.—.--~. - &�� '