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HomeMy WebLinkAbout0050 OAKVIEW TERRACE �.50:�_�C���c:.Kv� �v �r�c�� t - - t �IMME -Town of Barnstable', ' *Permit# Ezptres 6 mont from issue date �T Regulatory Services Fee BMWSTABM MA9' $i639' Richard V.Scali, Director �� p�ED MA'I A Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY C;�—j Not Valid without Red X-Press Imprint Map/parcel Number 1 ` Property Address 0 6L I 1 C w ❑Residential Value of Work$ ( Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address �'ti L L ,�5 .9 2 Contractor's Name G� G u< (, L_ Telephone Number Home Improvement Contractor License#(if applicable) 3 Email: l (k Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ElI am a sole proprietor OCT 8 2014 ❑ I am the Homeowner U/I have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name l� -i 7i L Workman's Comp.Policy# 9(Lc��.- f 3 .7-7 Copy of Insurance Compliance Certificate musaccompany each permit. r` 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 ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#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 her must sign Property Owner Letter of Permission. A copy the Ho a Improvement Contractors License&Construction Supervisors License is qu ,SIGNATURE: ' Q:\WPFILES\FORMS\bui ng permit formS\EXPRESS.doc Revised 061313 ' r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 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): Address: r v 1 ' City/State/Zip: �1 �tr�( �"�- Phone#: ? l -2 -3 Are Xou an employer?Check t ppropriate bog: Type of project(required): 1.PI am a employer with 4. ❑ I am a general contractor-and I employees(full and/or part-time).* have hired the sub-contractors ' 6. ❑New construction 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.: 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.❑ 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.#: L�1/��-- 1�j 7?S� �lC`� O�L�iExpiration Date: Job Site Address: �7—� ��!/G View V 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 overage verification. I do hereby certify under the p a enalties perjury that the information provided ab ve ' true and correct Signature: -� 'Date. Phone#: 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 I Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector .6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the.service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have an questions regarding the law or if you are required to obtain a workers' Y Y g g Y q re compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly: The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www.mass.govfdia - DATE(MMIDDIYYYY) A` D CERTIFICATE OF LIABILITY INSURANCE 517/2014 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 FRANK L HORGAN INSURANCE AGENCY INC CONTACT 44 BARNSTABLE ROAD PHONE FAx PO BOX 250 E-M-M o Ext Alc No AIL HYANNIS, MA 02601 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A: LM Insurance Corporation 33600 INSURED INSURER B: CAPE& ISLANDS CONSTRUCTION COMPANY INC PO BOX 210 _ INSURER C: - CENTERVILLE MA 02632 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 20102526 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 TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP - LIMITS LTR POLICY NUMBER MMIDD/YYYY MMIODNYYY COMMERCIAL GENERAL LIABILITY •- EACH OCCURRENCE $ CLAIMS-MADE OCCUR _ DAMAGE TO PREM SES(Ea occurRENTErence)nce) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ MOTHER: 'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ POLICY❑PRO ❑.LOCJECT PRODUCTS-COMP/OPAGG $ $ AUTOMOBILE LIABILITY - - COMBINED SINGLE,LIMIT $ - Ea accident ANY AUTO - BODILY INJURY(Per person) $ ALL OWNED - SCHEDULED - BODILY INJURY'(Per accident) $ ' AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR - EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE - AGGREGATE $ DED RETENTION$ - - _ $ A WORKERS COMPENSATION - WC5-31S-377540-014 5/7/2014 5/7/2015 ,/ SPER TATUTE OERH AND EMPLOYERS'LIABILITY - ANY PROPRIETOR/PARTNER/EXECUTIVE YIN - E.L.EACH ACCIDENT $ 1 OOOOO OFFICER/MEMBER EXCLUDED? ❑N N/A - - (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 100000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)' ' Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers'compensation coverage CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED IN 2OO MAIN STREET 200 MAIN MA 02601 ACCORDANCE WITH THE POLICY PROVISIONS. u . AUTHORIZED REPRESENTATIVE ✓�- � ��� /� -." - LM Insurance Corporation ©1988-2014 ACORD CORPORATION. All rights reserved, ACORD 25(2014/01) The ACORD name and logo are registered`marks of ACORD CERT NO.: 20102526 Lucy Garfield 5/7/2014 7:38:38 AM (PDT) Page 1 of 1 - - Estimate Date Sep 3;2014 Cape & Islands Co ' structi®n Co PO Po Box 210 . .Centerville Ma. 02632 508.775.7663 Ship Via Ship Date emu , Paul Ligor 50 Oak View Terrace Hyannis Ma. 02601 508-778-6885 CERTAINTEED Certainteed Shingle Roof 14,400.00 Strip existing shingles from roof. Secure any loose sheathing. Install Hicks brand-vented aluminum drip edge. Install Wip brand Ice&Water Shield to all eves, rakes, valleys and all protrusions. Install Surround brand Synthetic Felt Underlayment. Install Certainteed Quick Start starter shingles to all rakes&eves. ' Install Certainteed LIFETIME architectural shingles.-FV0 Gs)c5t, -ci L �5 1-q . Storm nail all shingles. (State building code requires 4 nails, we use 6) Re-flash all vent pipes with new boots 4A���ge ve Remove and dispose of all job related waste. leave your property looking like.we were never there! Provide all manufactures warranties and LIFETIME warranty on our labor, if it ever fails due to our workmanship we fix it, forever! It's The Best In The Business: ` Please note our wind warranty is also the best And longest available ANYWHERE! ***Includes striping and re-siding left front inside cheek*** Total : SOl'ell t Page 1 4 , }� ew�,?a,Zaryoec�/C/z o�c/l�craaac/c�aeChlI j Massachusetts - Department of Public Safety \ Office of Consumer Affairs&Business Regulation ' Board of Building Regulations and Standards ME IMPROVEMENT CONTRACTOR r l Construction Superi isor _ egistration 166936 Type:, License: CS-074660 P xpiration: 4/9/2016 Private Corporation JOSHiJA X KOURf '. CAPE& ISLAND CONSTRUCTIONrCO INC. 4I PO BOX 210 .Y r V P CENTERVILLE MA 02632 . r :; JOSHUA KOURI a. 55 ELM AVE. 4, HYANNIS, MA 02601 Undersecretary ��'�-� � Expiration Commissioner 02/12/2015. 6 License or registration valid for individul use only before,the expiration date. If found return to: Office of.Consumer Affairs and Business Regulation 10 Pack Plaza-Suite 5170 j (' Boston,MA 02116 v id'w bout signature8 L Assessors map and lot number ....._.._............... T u THE o SewApe Permit number ...... !R—.35?.�.........:............... Z 339BH9TOBLE, i Hous number ........................................................................ ro rasa CaN 4, C i639. \00� V �f 0 MR TOWN OF BARNSTABLE BUILDING -, INSPECTOR 611,LjF2� APPLICATION FOR PERMIT TO .. : Z J !'':: " Y+?a 4rt/ '�'�```"`e '-4 S�C6 4> '�'f• TYPE OF CONSTRUCTION .......�LxfgZZ-O.IC6 'M. .....: tt ............................. ...................lU.: %Z.7....19... �� TO THE INSPECTOR OF BUILDINGS: { The undersigned hereby applies for a permit according to the following information: Location .. .... '3 � � Gr/ aEs ..;... 1�s# s # .........../� c3 ! f ear l) ...... �, .. ProposedUse .....: .f..................................................................................................................................... I Zoning District ................................................Fire District �'T ��f-� . .. .... ... Nameof Owner ......................................................................Address .........................,...................... / t 2/ r Name of Builder* ..t 4-- "" ` ............................Address f �' J 2 4AI, �� !' �;,+�,!S`'+y�" ........ ............................. .//........................ Name of Architect ..l f!9 ,S"� l� "V Address ... l,+U 7�! Z ......�r�.!".'�'s �...................... ................................ Number of Rooms .........4....................................................Foundation .... Q r�/C l ^ ..........................:........................................ Exierior ......-;rfr/ S � ... �?�1 ..: Roofing. S'1P/'1�A7, . .��'r��!�l g!�:,�.......................... ............................. ...... Floors .... " Interior .................................................................................... Heating ..............Plumbing ......:.......... ...............:.................................. ..........,......................................................... 7, Fireplace ....: ..........................................Approximate Cost j ------19•-------. Area :%�' 4........Definitive Plan Approved by Planning Board __________________________ ...,.... .......... Diagram of Lot and Building with Dimensions Fee ........ SUBJECT TO APPROVAL OF BOARD OF HEALTH =r '' X OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the-Town of Barnstable regarding the above i construction. Name\.: ,,.,yr ;, ! -'fi ,y�t• vG�i!......., .� ()o LIBOR, PAUL �'� ' 24511 One St ry No ...........,-e..�. Permit for .................................... --. ..... Single...FamilX Dwelling. ................... ... .... Location ... 0„_Oakview. ...Terrace. . ...................... .... ..... ....... .... Hyannis ........................ ..... Owner Paul Ligor .................................................................. Type of Construction Frame ................................................................................ Plot ............................ Lot ................................ November 2, 82 Permit Granted .......................................19 Date of Inspection ....................................19 Date Completed ......................................19 E V 1 ✓�. Z70 z3e �: 30 9.130 Assessor's map and lot 'number roo�� , .z-�.I...........:...... �.; ';:. A. D� 2.'D O Sewage Permit number ...... !R..... ..,............................. 3 0 d 'A i-- Z 33ARNSTAJILL i House number s'° 3 Maas 9� p�i63q.a`0� u -f f� TOWN OF BARNS M MUST BE rjM1rC0.PL,ANCE WITH TITLE 5 BUILDING ISPE ` � �r�T�LC�� � APPLICATION FOR PERMIT TO .. � � .... �. �'�.o.....�. TYPE OF CONSTRUCTION ...... ... � ®�/1!J TJJ ...... !3 ............................. ............... i ...................12���.. ..:I9-Bia TO THE INSPECTOR OF BUILDINGS: f The undersigned hereby applies fora permit according to the fol lowing'information: Location .. �... .. ... ... .... ..r.......... .. ProposedUse .....RA! .................................................................. .............................................................. .T�,.[✓.:..................................................Fire District .............:.. nT /( .-5................................ Zoning District ....... Na ...of O ner ! dL....... ....... ..................Address ..1.��"f ��.../—A/,.....Cf�e ,1.� Al ZFC �uL�lGQ2. �. _ � Name of Builder" . . . . ............................Address 1... ��"r``� ® � �... // 7 '�. /�. �� Name of Architect ..�� ��... /F�� 4 ,k....................Address R Number of Rooms ......... ......................................................Foundation i[/�P. 7` .............................................................................. ..v3;� .Exierior .SN .•• ) f44ff - /'V& .......................... S,' are.. .. ..Interior ............... 4� .......................................... ,Floors ..2-..'��........ ..J`.........®................... .. ���T..... ..�. 'Heating .. .. .. ................................................ y � , Fireplace .....a..../.!4..el ......................................................Approximate Cost ..... �1,a .............................. .....• ........ Definitive Plan Approved by Planning Board -------------------_-----------19________. Area -... ................... Diagram of Lot and Building with Dimensions / �� Fee ......... . ...................... SUBJECT TO APPROVAL OF BOARD OF HEALTH • OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the egarding the above construction. f Name .... ..... ....... ... .... -LIG-OR,-'-PAUL T.-"No�124511... Permit for ...O.n.e...S.to.ry........................ .. .... ..... ............ .....`j Sin ........ ... Location .....50 QAk,yiew Terrace ......................................... Hyannis ............................................................................... Owner ....Paul Ligq?�................................... ................... . Type of Construction .........)Frame.................... ................................................................................ Plot ............................ 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