HomeMy WebLinkAbout0088 MOCO ROAD y
! MEAD
No. 53LOR
UPC 12543
smead.com • Made In USA
3
Town ®f Barnstable ��Z9 0 3 y 9_5
Expires 6 months from issue date
PeR Regulatory Services Fee 41, �
JUL r Thomas F.Geiler,Director
2 8 2009 Building Division l�
rOWN OF
BARNS Tom Perry,CBO, Building Commissioner rzM
TABLE 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 p p� 9S 0 n n -
Property Address O O Q cc) IZ S (AA L� CS04/�S'J r7'r'-�
21 Residential Value of Work /Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address ('t y �l Vv CUY1 l
Contractor's Name F- 6_� c6YL� b",,_ �ti Telephone Number-50
Home Improvement Contractor License#(if applicable) P S 3�P
Construction Supervisor's License#(if applicable) C o
Oworkman's Compensation Insurance 5 Ck
Ched one:
❑ I am a sole proprietor
❑ I am the Homeowner
[&I have Worker's Compensation Insurance
Insurance Company Name T Le. fFlt�t �CLO
Workman's Comp.Policy# _ l,t_..f� ' y 1 rn 5,5 b _b
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
3-Re-roof(stripping old shingles) All construction debris will be taken to C�J►��S�Q c�L
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows/doors/sliders. U-Value (maximum.44)
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License is required.
SIGNATURE:
Q:Forms:expmtrg
Revise061306
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
v-.
600 Washington Street
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information ^� /Please Print Legibly
Name (Business/Organization/Individual): I /�0-d�.�� ��y� L LC,
Address:
City/State/Zip: C�)b�l.L�E Phone #: 56 9—y a5 7 0�
Are you an employer?Check the appropriate box: Type of project(required):
l;,fJ am a employer with�� 4. ❑ I am a general contractor and I 6. ❑ New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers' 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.$
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.❑ Roof repairs
insurance required.] t c. 152, §1(4),and we have no
employees. [No workers' 13.0 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 state whether or not those entities have
employees. If the sub-contractors 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.#: U, nj — b 3 q I m 5,5 6 — U d 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 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 cep he d pe ies of perjury that the information provided above is true and correct
Signature: CC p Date:
Phone#: UQ�' ��0 0?02
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#:
. •� ���'� --y.����: _,-. I�i�b+4�1FCiFdY�l•L bQ•�
Sots 4AL 4 Le r
ovdaoft
spu�pa S R $�fft.jolow*
T
Board of Building Regulations and Standards
License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registration; 112536 Board of Building Regulations and Standards
E-PiratiUri:=3%23/2011 Tr# 281021 One Ashburton Place Rm 1301
Type: DBA- Boston,Ma.02108
FRASER CONSTRUCTION C.O.
DEAN FRASER
104 TWINN VIEW LANE
E FALMOUTH,MA 02536 Administrator <]LNot re
i
BoaToffuVilrinegVeagulaVoen'-s/a�n tan ar s
One Ashburton Place - Room 1301
Boston, Massachusetts 02108
Home Improvement-Contractor Registration
Registration: 112536
Type: DBA
Expiration: 3/23/2011 Tr# 281021
FRASER CONSTRUCTION CO.
DEAN FRASER ,
P.O. BOX 1845
COTUIT, MA 02635
Update Address and return card.Mark reason for change.
[] Address Renewal [:] Employment Lost Card
:A1 Co 40M-08108-DBSLIFORMCA108212008
i
1
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RightFax C2-2 10/1/2008 1 : 00:56 PM PAGE 2/002 Fax Server
:..r . r??•r:;:{{•::{•�: r:?•r ??•::; :`?:;.r ISSUEDATE
0
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
PRODUCER AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AMFM EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE POLICIES BELOW.
WISE&QUINN INSURANCE AGENCY COMIPANMES AFFORDING COVERAGE
449 PLEASANT ST
BROCKTON MA 02301 ""� A HARTFORD UNDERWRITERS INSURANCE CO
INSURED COMPANY B
FRASER CONSTRUCTION LLC LETTER
PO BOX 1845 COMP C
COTUIT MA 02635 �ARNY D
:1.;::1L• :.�:f....•::•:?.�N{•;?••{•}••:•:???:• ?fJ.•JJ:Sh:f.�1{Yf Sfj•1
THIS IS TO CERTDTY THAT THE POLICIES OFINSURANCB LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED.NOTVIRIIISTANDINO ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OT ER DOCUMENT WITH RESPECT TO WHICH TIOS
CERT gCATE MAY BB ISSUED OR MAY PERTAIN,THE INSURANCE AFFORD®BY TIE:POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCHD BY PAID CLAIMS
CO TYPE OF INSURANCE POLICYNUMBER POLICY POLICY LIMITS
LTR EFFECTIVE DATE EXPIRATION DATE
MM/DDNY) (MNMDNY)
GENERAL LIABILITY GENERAL AGGREGATE $
❑COMMERCIALOENERALLIAB Lrry PRODUCISCOMPIOPACIO. $
❑ CLAIMS MADE ❑ OCCUR PERSONAL&ADV.INJURY $ .
❑OWNERS A CONTRACTOR'S PROT. EACH OCCURRENCE $
❑ mRE DAMAGE(Any One Tim) $
MED.EXPENSE(Any one person $
AUTOMOBD.E LIABILITY COMBINED SINGLE LIMIT $
❑ ANY AUTO
❑ ALL OWNED AUTOS (Pa Fa n) $
(Per Ptrson)
❑ SCHEDULED AUTOS
❑ IEID AUT03 BODILY INJURY
HI $
(Per Acctdrna)
❑ NON-OWNED AUTOS
❑ GARAGE LIABILITY PROPERTY DAMAGE $
EXCESS LIABILITY
❑ UMBRELLA FORM EACH OCCURRENCE $
$
❑ OTHLiR 7IIAN UMBRELLA FORM AGGREGATE
STATUTORY LIMITS X
A WORKER'S CONTENSATION EACH ACCIDENT $500,000
AND UB- 09/26/08 09/26/09 DISEASE-POLICY LIMIT $500,000
0341M556-08
EMPLOYER'S LIABILITY DISEASE-EACH WeLOYBE $500,000
OTHER THB
PROPR srOR/PARTNFRsmECUIIVE
OFRCEAS ARE INCLUDED
DES WVHON OF OPERATIONS LWATI rnOM
THE IIW9 M D9 MA WORMM COMPJMT[ON POLICY AND ITS LJIPB•r®OnM STATIC MURANCE M=R91 Wfr AUTRORUM THR PAYMWr OF BEMs M bUR CLAENS
MADE BYTHE INSURE"MA EMPLOYM INSTATES OTHER THAN MA.NO AUTHORIZATION IS GrM TO PAY CLAIMS FOR BEPMFITS EV ANY STATR OTBER THAN MA IF THE
D 0AW HLEES,OR HAB BREED,DGWYM OUIBIDE OP MA.THIS POLICY DOSS NOT PROVIDE COVERAGE FOR ANY STATE OTHER THAN MA.
THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERPIFLCATE HOIABR AFVWnNG WORKERS COMP COVERAGE
1 �?lfiSLY:..l�•.S:{• LSV .S?•JY.{:S•J ••JY.ti f.�{W.•lfhV}yy :{•L. .{.. .. .•:1...•... S•S? ?:�?•:VL{•::.tiV Y.LLS:SL:LSY.•:S•ff.{L�
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FRASM ENIMUIERPROM UX SHOIDD ANY OF THE ABOVE DESCRIBED POLICIES DE rAarrva,un g THE
PO BOX 184E EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVORTO MAR.
C07 U1T MA 02635 ID DAYS wmTm NOTICE TO THE ammo ICATE ttoum NAIL To TIIB Lar,
BUPFABAIBETOMM.BUCHNOTICESHAM MOSBNOOBLRJATRJNOR
IJAHBILY OFANY EMM UPON TBE COMPANY rIS AGSM OR REFFMMUATnM§
A xBPID�vrnTTVH
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Fraser Construction, LLC
CONSTRUCTION P.O. Box 1845, Cotuit MA. 02635
' Email: fraser construction@verizon.net
aserroofing com FAX 1-508-428-012")
508-428-2292 HIC #112536 CS#97668
RE-ROOFIN PROPOSAL
Vp^TE: December 9, 2008 PHONE:
SAME: Carolyn Conley
C®NTACT: John Norman 508-566 9351 EMAIL: jtn1721@yerizon.net
;;j�L ADDRESS: P O Box 484 West B rnstable, MA 02668
j0B ADDRESS: 88 Moco Rd. Nest Barnstable, MA
&.BASER CONSTRUCTION hereby proposes to perform the following services in a neat
eLd professional like manner and in accordance with the manufacturer's
Specifications and local building code.
-Remove and Haul away all of the old roofmg material
-Re-nail all plywood sheathing as needed.
tsply and Install - CERTAINTEED LANDMARK /WOODSCAPE AR 30: 30 -Year.
Vyarranty, 5 year Sure Start Protection, CLASS A FIRE RATED, ALGAE Resistant,
Extra Heavy Weight, Self Sealing, Multi- Layered, Architectural Style, Fiberglass
Based Asphalt Shingle with.New England's Exclusive COPPER/CERAMIC Stones with
a Full 10 Year Warranty against ALGAE Containment. 5 year 110 mph wind-
resistance warranty with six nails in common bond area, Fraser construction
includes six nails in common bond area at NO additional cost. See actual warranty
for specific details and limitations.
Color: PRICE- $4,895 Initial
Price is for payment with check
Supply 8s Install - CertainTeed Winter - Guard: (ice & water shield)
Waterproof Underlayment System (3ft. on eves and
valleys, 18" on rakes, walls, and skylights)
gupply & Install - Roofer's Select Underlayment Paper (as recommended
by CertainTeed)
gmly AL Install - Hick's Ventilated Drip Edge or 8" Aluminum Drip Edge
gupply 8s Install- Aluminum & Neoprene Soil Pipe Flashing
gupply & Install-Air Vent Ridge Vent (as recommended by CertainTeed)
Clean & Remove - Debris from work area daily.
0
X4 Star Warranty Upgrade will be applied if proposal is signed and
returned within 10 days. (see enclosed brochure)
NO MONEY DOWN-NO Payment at the start or part way thru
*Any payments not made within 30 days of completion will be charged 1.5%for every 30 days the
payment is late.
Possible Extra-After the shingles are removed from the roof, we will lift one sheet of
plywood to make sure that the insulation is not up against the plywood sheathing
preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be
installed by; removing the plywood sheathing, installing the panels, turning the
plywood over and then re-installing the plywood. If needed, this would be charged for
as an extra at the rate of$6.00 per panel including Materials & Labor. There are 6
Panels per sheet of plywood.
Possible Extra-Any rotted or otherwise deteriorated trim boards, plywood sheathing,
lead flashing, or other carpentry needing replacement will be done and charged for as
an extra at the rate of$55.00 per hour, plus materials, plus 15% overhead mark-up
on total extras.
FRASER CONSTRUCTION Warranties the labor for 12 years
FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years.
CERTAINTEED Warranties the shingles and labor 100% through the Sure Start
Warranty duration. .
CERTAINTEED Warranties the shingles to be ALGAE resistant for the duration of the
Sure Start Warranty depending on the shingle that was purchased.
Any deviation or alteration from above specification will be executed upon written
orders and will become an extra charge over and above the estimate. All agreements
contingent upon strikes, accidents or delays are beyond our control. Owner should
carry fire, tornado and other necessary insurance upon the above work. We, if not
accepted within thirty days may withdraw this proposal.
FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public
Liability Insurance on the above work, certificate available upon request.
DATE OF ACCEPTANCE: �O /j6 /0
l� gy, C
Homeowner Fraser Co struction, LLC