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HomeMy WebLinkAbout0161 BISHOPS TERRACE I to( ��.s�'�,� ���-c'-e. i • c�b�io �t Town of Barnstable *Permit R""res 6 mantles from issue date Regulatory Services Fee : . �16 _ - `"" ® Richard V.Scali,Director JUL 31 201 1 Building Division �t ToUPI-Mrain erry,CBO,Building Commissioner MAIN ��� AHNS 1 Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-8624038 Fax:508-790-6230 EXPRESS ERAUT APPLICATION RESIDENTIAL ONLY SI Not Valid without Red X-Press Imprint Map/parcel Number t Property Address Re t jaK l Residential Value of Work$ ��� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Addresses M Contractor's Name- (2 G� 4 a" (l Telephone Number \)Q, Home Improvement Contractor li ense# if a licable t? 9 � �' q 1 9 ' P C pP ) Y Email: 1 nt1 � .{.4 .1 t/1�_C GF' � Construction Supervisor's License#(if applicable) C,Is Workman's Compensation Insurance Check one: ❑ I am a sole proprietor w ❑ I am the Homeo er I have Worker's C mpensation Insurance' V Insurance Company Name 5nc> (2:, a � �-� ACC,. `, Workman's Comp.Policy# LL-) 0(3 t r Copy of Insurance Compliance Certificate must accompany each permit. Permit Requ heck box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ' e-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc" - - r ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of a Home Improve ent C tractors License&Construction Supervisors License is required. . SIGNATURE: C:\Users\Decollik\AppDataU ocal\Microsofl indowsGemporaty Internet Files\Content.0utlook\2 10IDHR\EXPRESS.doc •, Revised 040215 Client#: 16665 2MEAGHERCO ACOR& CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/22/2017 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(ies)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 Dowling&O'Neil Dowling&O'Neil Insurance Agency alto"; El;508 775-1620 FAX,No): 5087781218 973 lyannough Rd, PO Box 1990 EMAIL Hyannis,MA 02601 ADDRESS: coi@doins.com INSURER(S)AFFORDING COVERAGE NAIC# 508 775-1620 INSURER A:NGM Insurance Company 14788 INSURED Meagher Construction Inc. INSURER B:Associated Employers Insurance Company 11104 INSURER C Timothy Meagher / INSURER D: 776 Main Street INSURER E Osterville,MA 02655 INSURER F: 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 CONTRACTOR 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. INSLTRR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS INSR WVD POLICY NUMBER MM/DD/YYYY MWDD/YYY A GENERAL LIABILITY MPT125OG, 10/16/2016 10/16/2017 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE T RENTED PREMISES Ea ."en.) $500,000 CLAIMS-MADE 51 OCCUR MED EXP(Any one person) $1 O 000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY I PRO- JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ ' HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ �EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$_ $ B WORKERS COMPENSATION WCC50050054422017A 6/23/2017 06/23/201 X WC sTATu- ER OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1 OO OOO OFFICER/MEMBER EXCLUDED? ] N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Town Of Barnstable r SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE' THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED .IN Building Dept. ACCORDANCE WITH THE POLICY PROVISIONS. . 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE u ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1_ The ACORD name and logo are registered marks of ACORD #S192660/M192659 CBD it , The Comm6nvvealth of Massachusse is Departnedn:t of industrial Accidents Office of Investigations 600 Washington Street " Boston,CIA 02111 ivmv.anas&gm,1dia Workers' Compensation Insurance Affidavit: Bmiders/Contractur ecfriciansJPlumTbers Apy 'cant Information Please Print Lezib . i Name(Bus-=a/0gAii-zationtlndsve"1): ci. K0 Ir Address: LD Ci JStateJZip: Phone#: F[11 mployes?Check the appropriate boa: Type of project(required): + mployer with �' _ 4 ❑ 1 a generafl conbaetor and Ib. ❑New constructionees(full and/or gact- * have hired the sub-ccmtractorsListed on the attacked sheet7, ❑Rd nodelhng ole proprietor or partner- These sub-contractors have skip and have no employees 'S, ❑Demolition woddng for me in any capacity. employees and have workers'. 9 ❑Building addition o workers'comp.insurance cep-insurance.z [No omp- 1t).❑Electrical repairs or additions required] 5_ ❑ We are a corporation and its 3.❑ 1 am a homeowner doing all work officershave exercised their 11_❑plumbing repairs or additions myself[No workers'comp- right:of exemption per MGL 12.❑Roof repairs insurance required.]s c. 152,§1(4),and we have no 13.Other employees.JNo Workers' comp-insurance required-j 'Any applicant that checks box#1 tnmst also all and the section below shownig ebe w0*ers'conrpeasatwn PGlxY inforxnati 1 Hcmeownss who submit d us offidatit in&zahng they are dams all_mh arrd then hire outside contractors MM sah=a new affidavit indicating SUL kontractors tint deck this box umst attacbed an additiond sheet showirg tlse name of the sab-demurs and Oft whether art of ftw etrtitk s base employees. if the sub-caammis base employees,d iey must PMV Ae their workers'comp.policy number. I am an employer that is proms 'ttg workers'cowgWsration ' ee for M eng90)rees. Below is ttte patio'and job site i►tformafio+t. �� ' Insurance Company Name:''.. •�� !' Q,, Policy#or Self ins.Lie.#:'V C?�xpit atom Fate: Jab Site Address: - MOL Cityi'State zip: Attach a copy of the workers'cornpensntion licy declaration page(showing the policy number and expiration datej�. 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 imprisommerlt,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the D for lace aft le &ation. I do hereby certify a the pains end attfes peditly thatthe irdfornwhon prm�i abore is true and correct Si tore: Date: II ' Phone ( I`t� `-t Official use only. Do not write in.this;area,to be completed by city or town official, _ City or Town: Per•mitUcense 9 Issuing Authority(circle one): 1.Board of Health 2.Budding Department 3.City frown Clerk 4.Electrical Inspector 5.Plumbing Inspector ti.Other Contact Person: Phone#: _ - 6 . 07/28/2017 09:25 5087753821 OLDE CAPE COD INS AG PAGE 01/01 Ju1.28.2017 09:08 AM Meagher Consruction Inc. 15084280529 PAGE, 1/ 1 '#A 'Town,of Barmtsible R%Taato,ry Services ' 7�uiugl1 �to� TomPam'A c bd(we r 200Baia3 *awk bJlA0260I . fo'VeFo'.f11'1YA.baTAtS�Sb�E.S�lt.�ie Off: 508-�G't,�p�8 . 5o8��9t?�623Q Property Ovvwx must Complete aad Sign This Sectaiou 7.1s' A Dt9da SS ,u Ow=of die subject P=Pnty- in all.Mau=rrjLdve to 03thO&A b7t6 bWj'dM* g pe=tr 4pj?1 a*jZ for , • b Q TT J b) -*"Poolfenca and ala=' -ae the respansibMYofthe appli Mt,FQQh arc.nnt� be .ar u�.befox�fence is iust�d and a�. , ' ' imp ,are pesfb=ed and ac�ept�, x Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-102260 `Construction Supervisor Construction Supervisor Restricted to: Unrestricted-Buildings of any use group which contain MICNAEL S MEAGHER JR _ ,,,, less than 35,600 cubic feet(991 cubic meters)of 97 EMERALD LANE,'aU enclosed space. MARSTONS MILLS MAA - A - Expiration: Commissioner 11/05/2018 Failure to possess a current edition of the Massachusetts. State Building Code is cause for revocation of this license. DPS Licensing information visit:WWW.MASS.GOV/DPS ,}� �a»�inonruecr��/����aercc/%uoel,Li \— Office of Consumer Affairs&Business Regulation _ HOME IMPROVEMENT CONTRACTOR ` -ON TYPE:Individual �istration Expiration ` 16293$_ 04/26/2019 �'t E � '; Registration valid for.individual use only MEAGHER CONSTf3UCT10N,ItyG: before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Pla .Suite 5170 MICNAEL MEAGHER JR` r�(}; Boston, 02116 776 MAIN STREET OSTERVILLE,MA 02655 Undersecretary , ,/ t valid without signature i Town` of Barnstable i rmit# Fjpb$ Regulatory.Services ee 6""" s "' KABL Thomas F.Geiler,Director way Building Division V`� Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY n Not VaW without Red X-Press Imprint Map/parcel Number Property Address [Residential Value of woj Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name Sprinkle Home Improvement Telephone Number 508 775-1778 Ext. 10 Home Improvement Contractor License#(if applicable 103757 ) Construction Supervisor's License#(if applicable) CS 6643 o RES IT )0Workman's Compensation Insurance Check one: NOV ` 9 2012 ❑ I am a sole proprietor ❑ 1 am the Homeowner ® I have Worker's Compensation Insurance TOWN OF BARiVSTABLE Insurance Company Name Associated Industries of MA / A.I.M Mutual Insurance Co. Workman's Comp.Policy# AWC 7004943012012 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris.will be taken to ❑Re-roof(hurricane nailed)'(not stripping. Going over existing layers of roof) ❑ Re-side #of doors V11'Replacement Windows/doors/sliders.U-Value_ . ; _(maximum.35)#of windows _ \*Where required: Issuance of this pennifdoes 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 metprovement Contractors License&Contraction Supervusors Itiicense is SIGNATURE: C:\UsersWecollik\AppData\Local\M=soft\Windows\Temporary Internet.Files\Content.Oudook\DDV87AAZ\EXPRESS.doc. Revised 072110 ' The CCo»amonweaU .of Massachusetts Department of Industrial Accidents r Office.of Investigations -�, LCongress Street Suite 100 .� Boston MA 02114-2017. iVWW.InQS&g'OY/dl0 Workers' Compensation:Insurance'Affidavits:Builders/Contractors/Electricians/Plumbers Aaplicant Information Please Print Leeibly Name(Business/Organization/individual):: Sprinide Home Improvement Address: 199 Barnstable Road City/State/Zi : Hyannis, MA 02601 Phone#: 508 775-1778 Ext.10 Are you an employer?Check the appropriate boa: Type of project(rttired)a. I. I am a_employer with . 10,12 4. 0 I am a general contractor and l ❑ 6..D.New construction employees(full and/or part-time).* have hind the sub-contractors , 1 2:.0 I am a sole proprietor or partner; listed on the attached sheet. 7: D Remodeling ship and have no employees These sub-contractors have S..D;Demolition workingfor in any.capacity.. ` employees and have workers' Y Pa h'• p _ 9. ,D Building addition [No workers' comp.-insurance comp.;insurance. required.] 5.E We are a corporation 10.0 Elecirical.repairs or, 3.❑ I am a homeowner doing all work officers have exercised their 1.1:0 Plumbing repairs or-additions. myself. [No workers'comp. right.of exemption per MGL 12: `Roof repairs: .insurance required.]+ :c. 152 §1(4),and we have no ._ employees.:[No workers' . 1.3. Otha�.t7�A { compAnsurance required.] •Any applicant that checks box 91 must also fill out the section below showing their workers'compensation policy:information. ry Homeowners who submit this affidavit indicating they are doing an 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.polity.number. I am an employer that Is providing workers'compensatlon insurance for my,employees Below is the po ft and fob site information. Insurance Company Name: -Assodated Industries.of MA./A.I.M Mutual Insurance Co. Policy#or Self--ins:Lie.#: 7004943012012 Expiration Date: 01/01/2013 lob-Site Address: UL I t`S�'►'n�5 1 ��rr G{.CSL City/State/Zip: n t S �} Attach a copy of the workers'compensation policy declaration page(showing the.policy num6er 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 WORKKORDER and a fine of up to$250.00 a day against the violator: Be advised that a copy of thi&statement may be forwarded to the Office-of Investigations of the DIA for insurance.coverage verification. ::ncertify and a enaltlm o er that the Information provided above is true and.correct Phone# 508 775-1778 EA 10. Offices use-only., Do not write In this area,7o be.completed by city or town of kal City.or Town: Permitrueewe# Issuing Authority(circle one): L Board of Health 2.Building.Department 1-..City/Town Clerk. 4:Electrical,Inspector S.Plumbing Inspector. 6.Other Contact Person: Phone#i III $ Town of Barnstable Regulatory Services Thomas F.Geller,Director Building Division Thomas Perry,CBO Building Commissioner 206 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 000LA 0. t't 11\� 64 as Owner of the subject property Sprinkle Horne Improvement hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) w 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\&wllik\AppDataU,ocal\Microsoft\Windows\Temporary Intemet Files\Content.Oudook\DDV87AAZ\EXPRESS.doc Revised 072110 Unrestricted-- Buildings of any use group which _ contain less than 35.000 cubic feet (991m`)of" 1 M \4assacnusetts - Department of Duoiic Saret•; enclosed space of of-3wioing Regulations:ana Standaras i�.,se CSA006643 BRAD K SPRINKLE. 190 LOTHROPS LANE Failure to possessazurrentedition''of:the Massachusetts W BARNSTABLE MA'U_6 State Building Code is cause for revocat ion,ofthis license ' For DPS orensmg information visit w--1 Mass Gov/DPS ... _ 10/08/201.3 Orrice r►f Consumer Affairs'&Busineas'Regulation• License or.registration valid for individul use only •, `,JNOME IMPROVEMENT.CONTRACTOR before.the expiration date. If found return to: =_p Registration: 103757 Type:- Office of Consumer Affairs and Business Regulation ; = Expiration:- 7/9/2014 Private Corporatior•. 10 Park•Plua-Suite 5.170 'Boston'MA 02116 SPRINKLE HOME IMPROVEMENT,,INC. Brad Sprinkle" 199 Barnstable Rd Hyannis, MA 02601 ,Undersecretary Not valid witho .'signature I l2/•20/2011 9 :.35 : 33 AM 8740 � '02/0.9- CERTIFICATE OF.LIABILITY:INSURANCE DATE 1`vzo 20�"11 " Tula cEATIrZCATX to ZOOM As A l m9R or ZRranumXOR O=LT Am.Coanas so RZORTO oval TRR C=RSZVZCMX ROZ,DRA. TRIs CRRTZrICATE � Doze war irrivxAvZVRL! OR.EMMUM lI,Y AMD,: =Mm Os Amm Tn.covm DE.JLM OED =Y'ru P=CZ=s.OCL01..T=Zs CERTZrZCATR or j Z=auau= DOES sm Coxamu E 1-CO=TltaCD'BET fm Zssma Z=sOYER(s)I AOTRORii® RSvmsSRTiT W an.rung=, AND THE ccmrxI=lE ROZDa. MRoRTARr: ZZ the aoctUlcato holdAr'i■ an ADDi:2Z*Mj6u ZRSYRRD, t o pollay(it.AY unst be.�osNtl..Z! soAROGI►TZOR.IB WAZVRD..nab3oct to to=@ ADd aonditimw of.WN poiiry, COCUSA P6110'q asp.=Oq"= an endertaseu. A .tAteont.oa.tbtr.wstitiost• do•• not confer rights to the cert1fleets boldAr in llota of *Mb Atlda!=Arnt(A), au•fa• con - Bzyden & SM11iv2a 1as Agemay ,11MISt. ..a Inc 88 ft3=uth Road ,e...f . Hyaanis, M& 02601 tlfrs.,u.. tssnirs/=t.tfffne.f cffnufe na a"°i° taafatd av]►:I.M. Mutual'Zn>aurantso Co' 337H Spriakle Ham UP rdVtamnat ZbC 199 BaZWtable Road - Hyaaais, 'M& 02601 MUM f1 tt+tetsa r. , COVL"B71G8S CES=FIC.M NO sm: RMSION 2tMMM:. as czatm%W Teas or ZMSUKWM BZitiO rots ism S iY.to Wasfvsm r XND=m. i9'17Tif 118PADDq ARr tiQOtaO! t4tf.do Cotmrfmd or A1T ODa mmy m aTOR Dorm rr.Mot mewwr to!ll'D=TRa.cm=rm=:Nm"mmum oa roar 111MM. Tali irlOAtam xT S7O wars 5 oOOtsID� Zi fV842M%Q_W&.4O tttAO. MMWZtatf Am 00toS1ZCm OT><V0 loZiCCtti..Ltmis as M may sate samt samotm sY!�CtAt1O. ldmter.m: �asst:Y m yy�s, TM a. - u.1=fwn=1 lrwwerl •taalax feetAtres • - QeaflOCtAt.fIM"LLfiS tlr , .. tasrrmR•.•es•a.•wP � 00aJ2111 wit Qa=" 11110 - fO.fOL a art Imlat f .Qq.ttr -QMNRf'.ohm _ -frR a- cnt=Itf a1.f' f ` iCYfLO•OtO" fa1pOCStKf - - ;� Dufr.ma 1 = .!D Oo7A1�1.LZZ1a.21Y +1�aoas o TBE.PROPRSb701t/PARiHERS/ '. omcv'Ivc O"ZC=3 ARE tttiR.e �: 500,000 V A — 0-excl '7004963012012' {.L. "ma a.ittr Lacer . •. 00,000 0 incl Ol/01'2612 :61/.01/2013' .:L: f:111=111-.a tfm.ar f 500.,000 tAf{Ort R= >W it muma 1f fo MCIJlfitl - - - - .woRRaRs' CcdZVL%WOx COVERAGE APPLIES TO MRSSAatascrrs r Loners CatTIFZCATLr.HOLDIIi- 'c"c1creI=10s _ DROOP'OP IHSDRANCE- ' ssdvtD APR or Ts Atali. la7.1dCZ:s:dR C71lCQJia ssroatae Taa' RailA!'SDR DA'1! TROiOr,-101RCR'tit<.L it:DQ.tfiRm n AOODlDIICR'sm Tn ' `awa��sfsaes=arnw ` 5289 l