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HomeMy WebLinkAbout0005 CANTERBURY CIRCLE r Town of Barnstable *Permit Expires 6 months om issue �s Regulatory Services Fee Richard V.Scah,Director Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town batnstable.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 Prope . Address Residential Value of work$ 7c?GLc> Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address JqI CA�4 EL S e411— &UAIY&ff, Z// c Contractor's Name (�Wt✓`Y� (� Telephone Number �� �� Y 6 h Home Improvement Contractor License#(if applicable) 7 Email: l�cc�y►eooiG t G'•�o Ur0 Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance m Check one: ❑ I am a sole proprietor APR 15-•2016 2 I am the Homeowner have Worker's Com ensation Insurance TO w� F Insurance Company an Name , �A�NSTAg�E Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit.; Permit Requ (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 ❑ 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. ***Note: Property Owner must sign Property Owner.Letter of Permission. `A copy of the Home Improveme Contractors License&Construction Supervisors License is uired. SIGNAT Q:\WHILES\FORMS\building permit fonns\EXPRESS.doc Revised 040215 i KELLY ROOFING PH. 508 509 4640 8 Rhine Road MA C.S.L.#099167 Yarmouthport MA H.I.C.R-.# 128957 MA 02675 April 06'2016 Proposal submitted to the owners of 5 Canterbury Circle Hyannis,MA. We propose to supply all materials and labor required to remove and replace the existing asphalt roof at the address above Protect all walls, Windows, shrubs, plants etc. during roof strip. All debris to be removed to town transfer. 8"White Aluminum Drip Edge to be installed on all eaves. Ice and Water damage protection membrane to be installed on first three feet of all eaves in all valley areas and around any protrusions. Remainder of roof deck to be covered with#15 felt paper.Install limited lifetime warranty Architect style Shingles,color to be specified, G0 l+0 All shingles to be storm nailed (6). Replace vent pipe boots with new. Repair/Replace all(lashings as necessary including chimney. Install Shingle Vent II ridge vent with hand nailed caps. Complete Clean up off all areas including all gutters after project complete At a total cost of$7900 Proposal Submitted by:Oliver Kelly- - Proposal accepted by: Date.Y//�./ A-15/(al 3 41 39�0,00 P� 4 The Commonwealth of Massachusetts 4 Department of Industrial Accidents 1.Congress Street, Suite 100 Boston,MA 02114-2017 ,�•�''� www mass.gov/dia 117atkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information ,' Please Print Legibly Name (Business/Organization/Individual): Vt-Flu u11 k*ki r kt�c. Address: City/State/Zip: q P &-6 Phone #- S_jG Are you an employer?Check the appropriate box: Type Of project(required): 1.RfI am a employer with _employees(full and/or part-time).* 7. Fj New construction 2. I am a sole proprietor or partnership and have no employees working for mein $• Remodeling any capacity.[No workers'comp.insurance required.] , 3. I am a homeowner doing all work elf. t 9. ❑Demolition ❑ g myself[No workers'comp.insurance required.] 4. I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition , ensure that all contractors either have workers'compensation insurance or are sole 11. Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet 13.[?Roof repairs These sub-contractors have employees and have workers'comp.insurance.t t 6.❑We are a corporation and its officers have exercised their right of exemption per MGL a 14.❑Other 152,§1(4),and we have no employees.[No workers'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 th is providing workers'compensation insurance for my employees. Below is the policy and job site information. , Insurance Company :ie: Policy#or Self-ins.Lic.#: U 8)'`2_E qQ V-2.)'1 t Expiration Date: !S•. Job Site Address: C � �-7 „ CCL� City/State/Zip: p �®l [LKW6 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains.and DeAUdes of perjury that the information provided above is true and correct Si ature: Date: ` Phone#: 0S 5qcf 4OH 0 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#: DATE(MM/DD/YYYY) I . ACC> ® CERTIFICATE OF LIABILITY INSURANCE 02/24/2016 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 NAME: Linda Sullivan DOWLING&O'NEIL INSURANCE AGENCY In, 508 775-1620 FAICC No: E-MAIL ADDRESS: Isuilivan@doins.com 973 IYANNOUGH RD. INSURER 5 AFFORDING COVERAGE NAIC tt HYANNIS MA 02601 INSURER A: ACE AMERICAN INSURANCE CO 22667 INSURED INSURER B: KELLY ROOFING INC INSURERC: INSURER D: 8 RHINE ROAD INSURERE: YARMOUTHPORT MA 02675 INSURER F: COVERAGES CERTIFICATE NUMBER: 32810 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 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTRTYPE OF INSURANCE ADDL SUER POLICY NUMBER LICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILnY EACH OCCURRENCE $ E TO RENTED CLAIMS-MADE OCCUR PREMfSES Ea occurrence $ MED F-XP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑PRO ❑LOC JECT PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $4 _ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ $ WORKERSCOMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 500,000 A OFFICER/MEMBEREXCLUDED? I WA WA WA 6S621.182E90137115 05/06/2015 05/06/2016 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.govllwdhnrorkers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of Bourne - Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 24 Perry Avenue AUTHORIZED REPRESENTATIVE Buzzards Bay MA 02532 DanielCro�s r�eY,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Massachusetts Department of Public: Safety 4 Board of Building Regulations and Standards ` License: CSSL-099167 Construction Supervisor Specialty . OLIVER M KELLY 8 RHINE ROAD YARMOUfH PORT M ' r--jZM CA— Expiration: Commissioner 09/284017 Office of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston;Massachusetts 02116 Home Improvement Co$tl-actor Registration Registration: 128957 _ Type: Individual Expiration: 6/14/2017 Trit 266936, Oliver Kelly Oliver Kelly 8 Rhine Rd _ Yarmouthport, MA 02675 = Update Address and return card.Mark reason for change. 0 2OM-05111 [j- Address F Renewal C Employment ❑ Lost Card Jac C�t•»r�srirrrca�/�a�^'l�n:;ryr.�ir�ehS; _` _ Office of ConsumerAffairs&Business Regulation License or registration valid for individul use only kJ1OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to-' registration: _:128957 type, Office of Consumer Affairs and Business Regulation Expiration:=_514120T; Individual 10 Park Plan-Suite 5170 Boston,MA 02116 ar Kelly ar Kelly line Rd. nouthport,MA 02675 iJ derseeretary Not valid without signature ,says 1� �'/� Assessors map and lot number ......................t.................... r ?BE Se age Permit number ../%�?. .... ....��..........,:'.,..:,... !/ Z BMSTJIBLE, i Mouse. number ..................:........................................I.......... 900 M639 e �0 NPY \ zr TOWN OF BARNSTABLE ' ' BUILUING INSPECTOR �► c �- , - APPLICATION FOR PERMIT TO ......:..I'.�......���U a �r� � TYPEOF CONSTRUCTION ..................................................................................................................................... hy.+ . .......... ` ..................................19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...........T-:C:�"......U I ?C� � �r?� � �tiC ��IV / �/� �/ Ile ...............�........�,,...... ............. .............................�.........r.........:....... � Mi// % ProposedUse ..............*�C . ........^..�0......:................. .........................................................................�. .. ................ .. ZoningDistrict .........CC...................................p......:...........{. ........Fire District ......f...:.........................................................: Name of Owner ...... ..................................... ....Address ..:. ..1......: ''. 1............ Name of Builder ......... ..Address ......1.C.�bt. ,..I� .r.r . ... t�i....k � .. 0 E Nameof Architect ...................................................................Address .................................................................................... Number of Rooms ......:............. .............................................Foundation �Bt.................. ................................................. tt Gt. i Exterior ........... .�......` ........=�.1........... .............................Roofing .............. ,5 he 6 r , Floors .'. :.`:. .........................................Interior �,..'C? . ,f.;;aC. Heating ............. .'c,C£'�...................................Plumbing ...........(... ........................... ......................... kh� Fireplace .................... .... .............................................Approximate Cost ..........f'.5� ..................,. Definitive Plan Approved by Planning Board ________________________________19________. Area ....... ................ Diagram of eland Building with Dimensions Fee // v SUBJECT TO APPROVAL OF BOARD OF HEALTH f { J f d OCCUPANCPERMITS REQUIRED FOR NEW DWELLINGS a. I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above con%Vion. ll��,� Name i ?: ............ upervisor`s,�Ligcrense .� .. .......................Construction S ....... z LAURE TA, SALVATORE A=249-112 No . ..... Permit for .. 26450 ADD..TO..DWELLING rt ........... ...... ..... ................... Single� Family Dwelling ............................................................................... Locotion C�tebury Circle ................................... ........... ..................... .......................................................T111 K Owner ...Salvatore Lauretta ................................................... Type of Construction ......Fri ......................... M _ ....................... ............................ Plot ............................ Lot':.4................ ........ Permit'Granted ....... y..l7l.....................19 84 Date of Inspection .'..................................1'9 Date Completed 40 � � h _ Assessors map :and lot number ... .. FTHE T " - w Sewage Permit,:number 7. r SAWSTADLE, i House number ........ .................. ....... .. ... • : G i 639.ASIL e�0 TOWN _ F BARNSTABLE } BUILDING INSPE T R CO APPLICATION FOR PERMIT TO 4, .6 .J. .!S. ` y`'" .TYPE OF CONSTRUCTION .....Yb�.�C)L. - ..... -t . :.: :..................:19 /.. ; . TO THE INSPECTOR OF BUILDINGS: -The undersigned'hereby applies for a permit according to, the following information:t Location .......... ...... V... ......� 1�.! :I.��? t.. y L���t' ..........619J� . .. � ......... �} . Pro osed Use ... ..... 6►:. . ' ... .: .............................. ... .....:............. Y/9 AA&S... Zoning District ............................................ ...Fire District ::...f... . . �•.. Name of Owner ... .. .�.�� �:. v� `..Address .. ....1_z "!I'C/L Y��"� lit ....,.....� `S Name' of Builder .. �, 4! 1 �'"' . "Y1. Address ....1, .�"1 .k; �� I .!� �•v►v►,S. .. ... r. .... Nameof Architect .......................r...........:.............::................Address ..........:..:.:......................................:. Number of Rooms ................... .. ....::. ........Foundation . :.....:: ?.`y �� ............................ y �1 �. �`-1 rk r Exterior •r..:.......`'........ .. ....`���...........�....................,........Roofing ..............� .. ... .�...........^................................ Floors ........Interior .......:s...�' .......... ...... ....................................... kaQ Heating �� .... Plumbing �.. � ..................... . . a 9 .......... ....... ....... .. Fireplace. ....................!.� .. .................. ...............Approximate Cost ........r. . ................ ...... . . . ..... Definitive Plan Approved by Planning Board __________________:_--_________19________. r ;Area .......���................. Diagram-of Lot and Building with Dimensions Fee // .. SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 ` ' 15 N ' t, tom"I , ` - Y. 4 •�� i CCUP rCYPERMITS REQUIRED FOR•NEW DWELLINGS herebygeo conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction.• r '� t? = Name + ...� /'!LZ !! l. .il... ...... .. Construction Supervisor's License .............:.......5.... ....... LAURE,ITA, SALVATORE No 2450^. Permit for .ADD TO Dwelling , r ................................... + , , Single Family Dwelling _ �• •. Location, Canterbury Circle _ ............. yaY?i?is.......................... ................... Owner~ Salvatore Lauretta _ L ' 1, Ir Type_of. Construction .Frame................ _ (:...i.... . .. ............. ... ....... ' Plot Lot ....... ...' ........ c Permit Granted may; 17'..1 + ..................19 84 Date of Inspection ".......... ........ ! .19 Date Completed, " AI A....'. .....19d � }�� .�{... r� � � � • ' — `ter �" .� ,�,• a r; � � ` - 'u"' 2 9- ,/ TN E• n TOWN OF BARNSTABLE i BARNSTABLE, i 9� o p9. y BUILDING INSPECTOR ��- APPLICATION FOR PERMIT TO .................... . .. .. ..... ...................:.......................................... TYPE OF CONSTRUCTION ..................-T. . ..�. ..... % ...............................: . ...7: ly.........19.` e TO THE INSPECTOR OF BUILDINGS: The undersigned her y applies for a pe it according to the following information: Location ................ ..... ... .............. .......... .... k°'i�... .".. . .........'�-y; ............l.a.T��� /���� 0 Proposed Use ........ ...................... ........................................................................I......................... ZoningDistrict ........................................................................Fire District .......... .................................................................. Name of Owner A 2 . . Ij Address ..... . .................. ` j� Nameof Builder .. 9 &W.4Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ...........:.. X....................................Foundation .....67.. .. ..:�� �................................. Exierior .... �. fin -` �` ¢ ..c�- ?. .......Roofing ....... Floors � .............................:...Interior .........../ice � ��............................ Heating � .�1r� �1 �� .....Plumbing !...... . :........................... ... Fireplace .......................0-1- 1e2• ........................................Approximate Cost ............. ......................�f Definitive Plan Approved by Planning Board -----------____----_-_________19 Diagram of Lot and Building with Dimensions 1 SUBJECT TO APPROVAL OF BOARD OF HEALTH IM ) t7 <77 Ld zrXI Q Ln rj F U) U W I hereby agree to conform to all the Rules and Regulations of the own of Barnstable regarding the above construction. . r Name .. .:. .. X....... . l. '� • Cedar koresRealty Trust ... Permit for ......one story single family dwelling ............................................................................... j Canterbury Circle ' Location" ................................................................ ' Hyannis ............................................................................... Owner .........Cedar Acres Realty Trust .......................... ......................... Type of Construction frame....................... ................... . ................................................................................... Plot ............................ Lot .............."(.............. Permit Granted .....August..4............I.....19 72 Date of Inspection ........... ........ .............19 Date Completed ..,.. ...... ......19 PERMIT REFUSED ............... ................ 19 ....................:.......................................................... ................................................................................ i Approved ................................................ 19 ............................................................................... ...............................................................................