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HomeMy WebLinkAbout0193 SEVENTH AVENUE (HYANNIS) ,�`�� �� i �. , � ao 77�>oy6(c�, . Town of Barnstable *Permit# Expires 6 months from issue date Regulatory Services Fee ja7. BAMMAJUX nswss Thomas F.Geiler,Director X-PRESS PERMIT Building DIv><s>ton Tom Perry,CBO, Building Commissioner { .200 Main Street,Hyannis,MA 02601 J U N 18 2013 www.town.barnstable m i us j i 0ffice: 508-862-4038 Fax:.508-790=6230 EXPRESS PERMIT APPLICATION - RESIDI�MRNSTABLE Not Valid without Red X-Press Imprint Map/pareel Number' Property Address �`�3 7J / T ifCL�lyl(S 6�� • Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address)e Sb nNl et- 1'W-Y1 e r 4 5 �c1ry Ric fi >J��d i�tzrn nn� O' -44 g y Contractor's Name -tA 0 V l r Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: R(I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ SmokelCarbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. "Where required: Issuance of this permit does not.exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors.License is required. SIGNATURE: .__.... ............m�._n��__ UA­%V1.DD RQQ Ann - - The Crra�m n iveait of assachuse.ft Depwft+ent oflndust7ia1 Act identr t-- Offl"ofl rove tigations 600 Washington Street Boston,H4#2111 _ V f"era LgVV1dia Workers' CUM13ensatian,Insurance davit±B erslCnn#r.ctnrsrE ecErici3nslPlz�mbers Applicant Information Paso P�7nt I.e�ib Name ,4o"y r)N���17-i 16 CityfSta p: D 74d C phony Tire you an employer?O&etk the appropriate box - T of ra'ect r 4. I am.a contractor and i � P l (required): 1.❑ I am a employer with ❑ t 6- ❑New conshnction employees(full ancVor paxt-bme)-* have hir-ed the sub-contractors I$Z I am a sole prnpsietrri or partner- listed an the aftached sheet 7. ❑Remodeling 1 sub-contractors have ship and have no employees 8. ❑I}emafiti�ou w in.fl for me in a employees and he workers' any�P�fY- at 9. ❑Building addition INO L�toriCErs'comp.isssxa„rg camp_fiMM MV 1 required] 5. ❑ We are a corporation and its I D.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised Heir 11_0 Plumbing repairs or additions myself.[No workers'comp. right of exemptilm per 14fGL 121-1 Rnof repairs ins „ e required]r c.152,§1(4,and we have no employees_[No workers' 13.❑Other comp.insurance required.] *AS'appli=that checks box#1 must also fill oat the section bgowshossiug theirwode&amTe arian policy isf4matian- I Homeownem wbo submit fhis sffi@ayst iM&cating they am&wg 2a wat smd flea hire antside coaacmrs mast submit anew affidavit m caving such fContmaors that cber8 this box must xttached an additional sheet duowing the-of the sob-comxxboa and state wbeiher or not moose entities ham emptoyees. If the s l,runt mrs Lwe employees,dieymnstpmvide their timrkeW romp.policy number. I mn art empiLj er that ispnn dding workers'cotrrpertsah'vn itrssrr tmce,for uzy eurplo} Bda v is dre policy ant jolt sit* informa6em . Insurance Company Name: - Policy 4 cr.Self ins.Lie.-9: Expiration Date: Job Site Ad&-ess: GitytStat yzip: iittach a copy of the workers' compensation policy dedtaratian page(sbawing the policy number and aspiration date). Failure to secure coverage as required under Section 25A of MGL c. 157 can lead to the imposition of criminal penalties of a tine up to$1,500 4Q aadfor one-year imprisonment,as wen as civil penalties in$re form of a STOP WORK ORDER and a fine of up to$250-00 a day against the violator. Be advised that a copy of this stgement may be orwarded to the Office of Immstigations of the DIA for insmance cmmmage yeri cation .' I do hereby cerf&under thepai ns and.pegabYes ofjpeduty drat the infanraaf°rarn ptvi ided aba"is&us and correct Si Date: r` Phone#- Z-7 ©foul use only: Do not write in this area,to be completed by city or tome o icia1 , UPT or Town: FermitUcense# �smint Authority(d de one): _ 1..Boar4 of$eahh I.Building Department 3.CA crown awk L electrical Inspector 3.Plumbing Inspector A.Gther.. _ of TM!:l°y, - . - • ... : . P� ti * �xxsrns[s. '�"� 1639. T of Btable 9� ��� own arns - ' .. . plEp MA1 A Regulatory Services Thomas F. Geiler,Director. Building Division Thomas Perry, CBO I 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, Q��' �1d17Q�a Soh ;as Owner of the subject-property hereby authorize / 1 Le', g}`f-'�.t,f/ _ s�aJ to act on my behalf, in.all matters relative to work authorized by this building permit application for: Jai 7,1 , wlDr (Address of Job) �YL / Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on,the reverse side. : Q:IWPFILES\FORMS\building permit forms\EXPRESS.doc ' J °FzHIE r° Town of Barnstable Regulatory Services STD'- Thomas F. Geiler,Director 1659. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.m.a.us Office:. 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one .home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such-work performed under the building permit. (Section 109.1.1) , The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, rules and regulations. 'The undersigned "homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspeption procedures and.requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 15,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. " HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors),provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. . In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. _..... _..._. _. _ _ _ __ •. _.. _ _ To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,.that.the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and .adopt such a form/certification for use in your community. n.rrmnn am rllnllCL..:7.7:_.--e..-.:�F....�1IIVDD CCC Anr .. .. _ Office of Consumer Affairs and Business Regulation: `l 0.Park Plaza_ Suite 5170 Boston,Massachusetts:02116 A�� Home Improvement Contractor Registration ='Y -^- Registration: 136590 i w �� Type: Individual � ►��,�. a _ gam.t ;u; Expiration:. 8/5/2014 Tr# 230730 TIMOTHY O'HARA I TIMOTHY O'HARA 37 WORCESTER LN_. ice• ,. HYANNIS, MA 02601 � '' k { pdate Address and return card.'Mark reason for change. Q Address, Q.Renewal 0 Employment. 0 Lost Card SCA 1 0 20M-05/11 V/ee�pamvriaovuoe�o�C�ia�¢c�tcQeCla Office of Consumer Affairs&Business Regulation License.or registration.valid for,individul use only I ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: istration: t 136590 Type: Office of Consumer Affairs and Business Regulation 10 Park Plaza piration 8/5/2014 Individual -Suite.517Q. r; Bosto i.MA 02116 TIMOTHY O'HARA Wes' TIMOTHY O'HARA 37WORECSTER HYANNIS,MA 02601 . � Undersecretary NoY.v withauYsignature 3 c r �Massachustus- Department of Public S feh • Board of Building Regulations and Standard, Construction Supervisor License ° > -License: CS 76694 '(`lM07Hlf OHARA ri 37 WORCESTER L-N HYANNIS, MA.02601dit .t Expiration: 10/21/2( 9 ('uYi�3lissiuncr Tr#: 5730' Town of Barnstable *Permit# all Expires 6 months from issue date Regulatory Services Fee -- ■nartsres[A NAM 1"9. Thomas F.Geiler,Director P S SPERMIT cR IT Building Division n Tom Perry,CBO, Building Commissioner 1 U N 2, 7 2011, 200 Main Street,Hyannis,MA 02601 TOWN OF BARNSTABLE 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 c�)7 S y Pro Zntial Address Value of Work Minim m fee of$35.00 for ork nder$6000.0 Owner's Name&Address 0 S� �s 4111 Contractor's Name Telep one Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) [ �orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner []I have Worker's Compensation Insuran Insurance Company Name V et Workman's Comp.Policy# G{ 6IT_1�?) e� b Copy of Insurance Compann a Certificate must accompany eachermit. Permit Requ�RZ(hurricane k box) nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) �y/t ❑ Re-side %� �t• /"[�� #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows *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. copy of the Home rov ent Contractors License&Construction Supervisors License is required. SIGNATURE: C:\Users\decollik\AppDa U ocal\Microsoft\Windows\Temporary Internet Files\Content.OutlookWDV87AAZ\EXPRESS.doc Revised 072110 77te Commonwealth of Massachusetts Department of Inditstrial Accidents Office of Investigations 600 Washington Street VJ_ Boston,MA 02111 mvw.ntass gov/din Workers' Compensatio 'uTance da .Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bly Name(Business/Organizatiou4ndividml)' ✓ C Address: City/State/Zip: Plfo e Are you an employ ?Check the appropfaatAbox: Type of project(required): L❑ I am a employer with G4. general contractor and I employees(full and/or part-time).s ired 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 subcontractors have S. Demolition workingfor me in an capacity- employees and have workers' y h' [No workers'comp.;insurance comp.instuance.l 9. Building addition required-1 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LEJ Plumbing repairs or additions 1£ o workers' right of exemption per MGL myself[N °°mP• 12.❑Roof insurance required.]T c.152,§1(4),and we have no employees.[No workers' 13_ (/ comp.insurance required] 'Amy applicant that checks box#1 must also fill our the section below shoving their wotiten'compensation policy information T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors submit a new affidavit indicating such =Conm=mm that check this box must attached an additional sheet shorting the name of the sub-contractors and stare whether or not those entities have employees. U the subcontractors bare employees,they must provide their workers'comp.policy number. I am an employer that is pro,idhig w kers'compen ation insaar ace for y emp see& Bel tv is the poliryrnd job site inforinatiott. -41 Insurance Company Name: _ap , Policy#or Self-ins.Lie. Job Site Address: CitylSta1f //GL ' Attach a copy of t e workers'compensation policy declaration page(showing the poh 'n er and esp* on date. Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposi n of criminal penalties o a foe up to S1,500.00 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 th�p DIA for insurance coverage •erification. I do hereby a fy under the s nd ena„ s of pe 'airy that the information prodded aboue' true and correct Si t re Date: tlleollt� l Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: PermitlLicense 9 Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City-frown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 a%W- V.L 'CERTIFICATE• OF LMILITY INSURA I TM hICE �n mum FIMSF1 PS-3aee ® zi &-c"ta lamle�a� 1�ey z>ac o�Y � S�fltits �Ie�Itl>aae>t+r q � w V 70 w i 6 iMrlapr O Lr9r Fil fl�r.VirY " V TO rou IN Ji r�grsrrr��FIW*R OONORtON Of ANY POUCY F tlf 0, Ai ID K?M11 COC t YOIIT AIA I 1p YiNOM TM CNMPWA TI MAY U DSSLW CA YAY Poo w,. MAY 1 811�JiCP TO Alt 11 � .DMLUftNB At* � OP mxm . TM�Qa3s .rb �E8• ���MAW 14fb d�Ot /�010 1/0t @Yl 'i:�. ,OOO 1 aC,CUR i IW O* PEN 166 Mm 91 AMAyrP� :. as S liu�rr ' ��etaAvroa I •. � ,�.. ..,_..ate � .. ;�• ''!. ,,,., �� �,•. .. .. Fe �je '• ,i IMIVAtlP' •, j ,i. .. .. `� ,,� .' •/ +� O�p7'�MM � 1 AM OtAM114 AA40tt �. .. •• i ' IkA Cosa 0� 9�ltt4oil e i��OVfNJ2 160A gum . Mloals o�ioaltir�'Atli ai awaall�•tttpmn�m• 7ti tII�IIIAtttlla ilttti�ilF•im itut n l tlIALL l 1➢p"Mm MAI=*,sw OPT,a, ,,-�,,----- . It suits'306 . . �. swiaet�o�t�Istui � �lltelRta�etrrrO�Ainr �aui�c, da+or101 I �A.O®RS 1lIOfP� 011 1, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1-06/01/2011 vaoouceR (978) 745-5905 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ALLAN INSURANCE AGENCY INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 63 1/2 Jefferson Avenue 2nd 8 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. BOX 511 SALEM MA 01970-0511 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:Nautilus Ins CO. Roofer's Edge & Siding, Inc. INSURERS:Safety InSuranoe 9 Clover Terrace INSURER c:Travelers INSURER D: Natick MA 01760- FINSURSRS: COVERAGES 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 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'! POLICY EFFECTIVE POLICY EXPIRA ON LTR N R TYPE OF INSURANCE POLICY NUMBER DATE MIA/D DATE MMIOWY UYl.4.. A GENERAL LIABILITY MC701836 09/12/2010 09/12/2011 EACHOCCURRENCE $ 1,000,-Do X COMMERCIAL GENERAL LIABILITY E TO RENTED CLANS MACE ®OCCUR / / / / MED EXP(PREM)SESnny o ! 105,000 PERSONAL&ADVINJURY $ 11000,000 GENERAL AGGREGATE S 2,0 0 0,OD 0 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMP/OP A G S 2,000,000 POLICY JE 1 LOC B AUTOMOBILE LIABILITY 62.04299 12/22/2010 12/22/2011 COMBINED SINGLELIMIT WAY AUTO Me aoeidw) . $X -ALL OWNED AUTOS, 7 • , BODILY INJURY , 250 X SCHEOULEDAUT99 . .. : . .... .... (Per person) S ,.0.00. HIRED AUTOS / / / / BODILY INJURY $ 500,000 NON-0WMVED AUTOS (Par a ) PROPERTY DAMAGE $ 100,000 (Per ecciderd) GARAGE UAINUTY AUTO ONLY-EA ACCIDENT S ANY AUTO / / / / OTHER THAN EA ACC S AUTO ONLY: AGG $ EXCESS/UlABRELLA LIABILITY / / / / H OCCURRENCE- OCCUR C�CLAIMS MADE AGGREGATE $ S DEDUCTIBLE RETENTION 8 S C. .WORK6R&COMPENSATIQNi�ND''L1IPLOYERS'UASWTY 7PJ9860326463A10 04/02/2011 04/02/2012 T X ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACC16ENT S 100,000 OFFICERIMEMBEREXCLUDEU7 E.L.DISEASE-EA EMPLOYEE S 100,000 N Yes,describe under SPECIAL PR VISIONS below E.L.DISEASE-POLICY LIMIT S 500,000 OTHER DESCRIPTION OF OPERATIONSn.OQATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTrom AL PROVISIONS CERTIFICATE HOLDER CANCELLATION ( } ( } SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Roofer's Ed!;e & Siding Inc EXPIRATION DATE THEREOF, THE ISSUING INSURER HALL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT 9 Clover Terrace FAILURE TO DO$O SMALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES. AUTHORIMn REPRESENTATIVE Natick MA 01760 ff Jr/ - ACORD 25(2001/08) PORATION 1988 INS025(oWonoe Page I d2 �' Nfassuchusett..-. De.pactment of Public Sutetv Board of Building r, Rc�rulations and Standards _ . Construction Supervisor License -.License CS Rest'ricted_to: 1'GF #FKEVIN P BLAKEMAN "�9 CLOVER TER �NATICKj�MA-0176,0 . a Expiration: 10/12/2011 ( isti onunione`f R tf : ... Tr#: 4823:: 4 pyILlI2007.[IJBCu[IL ✓VGOdd [.lsOfi'u0. Office Qf Consumer Affairs Business_Regulation. OMEIMPROVEMENT.CONTRACTOR. ation524 Re gist 1'1' .. �; Expira n _ 011 9 75�o Tr# 28 1 Types PrI�aWECorporation ROOFERS EDG &SIDING �iC KEVIN BLAKEMAN j 9 CLOVER TERRACE' ,^`• 60oyNyye r NATICK;MA 017 Undersecretary � !I License or registration valid for individul use only before the expiration date. 1f found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 s, ' Boston,MA 02116 s I Not valid without signature Restricted to: 1 G 00- Unrestricted 1G-1 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Refer to: WWW.Mass.Gov/DPS Windows Roofer 's Edge & Siding, Inc. Carpentry Painting www.roofersedgeinc.com 2 Summer Street Doors Suite 306 Gutters Natick,MA 01760 Leaf Guards Office: 508-6504995 [Cell: 774y286-1240 Residential Contracting Agreement 1Vlember Read this agreement and make sure you understand it before signing it. This agreement has legal force and effect and binds those who sign it. Massachusetts Home Improvement:Contractors Registration# 157411 Licensed General Contractor#46783 Notice: All home improvement contractors and subcontractors engaged in home improvement contracting,unless specifically exempt from registration by provisions of Chapter 142a of the general laws,must be registered with the Commonwealth of Massachusetts.Inquiries about registration and status should be made to the Director,Home Improvement Contract Registration,One Ashburton Place,Room 1301,Boston,MA 02108 This agreement is made on r/49,r//between ROOFER'S EDGE&SIDING,INC. (DATE) (CONTRACTOR) of 2 SUMMER STREET SUITE 306 NATICK,MA 01760 (ADDRESS) hereinafter called"Contractor"and 'S'r APOS. of .193 J (O Y— (ADDRESS) (PHONE NUM �� .hereafter called"Owner". DETAILED DESCRUMON OF WORK TO BE PERFORMED&DETAILED DESCRIPTION OF MATERIALS TO BE USED Contractor agrees to perfxm in a good and workmanlike manner all work detailed below and materials to be used in performing described work consist of the following. Strip existing shingles from roof of home. Agin !&'o /�� S�/{� L Dispose of debris into dumpster,provided by contractor. Nail down loose boards as needed. Check for.dardaged wood on roof of home. . Replace u4t o,3 filtieets of:.Ialywood or 1:06 f.of linear boards inncluded in contract. e .., .. ..._.._ Mitalt ridge'vent to Home. 92 El— Install new pipe vent flanges. /��— �U� 3� Install 8 inch cetto all edges of roof. I r 6a','/t/t t'.ydtai� 32ZC1 � AP I" o 6 ft f rubber ice and water shield to front and rear of home. Apply 3 ft.of and water shield around chimps ,valleys and skylights if apply, Install new step flashing around chimney. _ Apply 4 5 lbs.felt underlayment over roof boards of home. —' Apply_ ear warranty architectural shingles by or GAF b owners choice./ Clean yard of debris. Magnetic clean up of nails. Tax and insurance included. � II. PRICE Contractor agrees to do all work described in Section I for the totel price of$ III PAJ� �7004,-r Payment w IP ill V (33'/)%( �}upr signing Contract. %($ )upon completion of ($_ )upon completion of 'A! o monthly service ch d to all accounts 30 daysWy7u,rn4AJ%te. �✓ Notice: No agreement for home improvement contracting work shall require a down payment(advance deposit)of more than one-third of the total contract price or the total amount of all deposits or payments which the Contractor must make,in advance,to order and/or otherwise to obtain delivery iv a of special order materials and ry p equipment,whichever amount is greater. N CAMML`N/`GtL41TlUT Awn rn%innT - • •. ,.� ava.,u,�■ ,+.1ai a vivara,r aav��yr vrvacn Contractor will not begin the work or order the materials before the third a follytirin #is Agreement,unless spycNled here In writing;Contractor will begin the work on or about (date).Barring ,> p 'delays caused by eircuwnstances beyond Contractor's control,the work will bKompleta by _ (date). The Owner hereby acknowledges and agreea that the scheduling dates are approximate and sr foldable by the Contractor shall not be considered as violations of this Agreement. Workers Compensation and Public Liability coverage on all work OWNER: DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES j Owners stare Date S' ed � ✓ � Ge702 Contracto 's Signature Date Signed Owner's Signature Date Signed ti , TOWN OF BARNSTABLE BUILDING PERMIT,APPLICATION —Map Parcel Permit# Q Health Division Date Issued 8I17 q Conservation Division Fee5•d d Tax Collector ' 0 Treasurer (4 Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis f-b. Project Street Address (9 3 'l A Q Village Owner :S'NCA1, SO4 44£9— ° Address A:-, ka'), Telephone Q Permit Request Square feet: 1 st floor:existing proposed 2nd floor: existing proposed Total new Estimated Project Cost 3oc.-,0 Zoning District Flood Plain Groundwater Overlay Construction Type 2joyl: Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family lid' Two Family ❑ Multi-Family(#units) Age of Existing Structure 'S_l `4DA-g.. Historic House: ❑Yes CENo On Old King's Highway: 0 Yes O'No Basement Type: ❑ Full ❑Crawl tdWalkout . ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) '-Number of Baths: Full:existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: 5/Gas ❑Oil ❑Electric • ❑Other Central Air: 0 Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:O existing ❑new size Pool:❑existing ❑new size Barn:0 existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other:. Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name 0.,i.,C4 6 C-of Telephone Number & 75 Ict 4 Address 50-5 P4 w License l !0 n '? W �k eyozi-ek/ Home Improvement Contractor# /Z$S S Worker's Compensation# 0 C Y —O Z e,273 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE _ 4q, 16 f r ' FOR OFFICIAL USE ONLY '• - i PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS;-' VILLAGE OWNER DATE OF INSPECTION. ., FOUNDATION FRAME INSULATION » FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL FINAL BUILDING _ DATE CLOSED OUT ASSOCIATION PLAN NO. r r ' Board of. Building Regulations and standard- One Ashburton Boston lace - Room 1301 021 Home Improvement Contractors Re ' ration Registration: 121,957 Expiration: 6/14/01 Type- Individual Oliver Kelly Oliver Kelly 503 Main St . Unit 8 Yarmouth MA 02673 I s.t. - '� • ' Department of Industrial Accidents . . OfffccOff"85MOMORS _ _�( 600 Washington Street - c,I; Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: location: city phone# . ❑ I am a homeowner performing all work myself. ty MOO❑ /%%%///G%%%/a sole% %%%/%%%/// %rietor and%%%%�///////%�////%%///%no one 1///%%///%/anv%//%%%%///////%///%%%%%/%%%%/%/////////%%%%///%%/////%/%%/%/%%%%%%%/�%/%%O%�/////%O/////�//l am an employer providing workers'compensation for my employees working on this job. ... ..... ....................... ..... comaanv name:: sdd t ess. ;.:.: ::::>:.:::.:;:;:: city-:.. : _ bhone#. ::.. . msuranc : ...:.::..: ..... :.,.. olicv# / =ama et ,ge er o ra or r homeowner(circle one)and have hired the contractors listed below who ' the followin workers ensation ohct:s .. ..:.;:::.;::.:::.;:: .: .;.::...;..:.::.:. .... ::.::;.;;:.:.:.;:..:...:...::.;::.;:::::::. :.:.. cotiaany name:.. . fit; ; `>">?; i >:':.. .:: . . . .....: .:...,..:.,:..,.%-..-.-.%..,.:,..:-.".-.'-.'-.-.-.-..'..-'-.-.-.=...�......: >:::>s>s:.<: .. ... :. ::...::....:::::.: : ..... :>::....—�.::: .::::.:::.:.I--:::ii: ... ::.:. :. .......... '::av::•ti:::::::::: ::::::: .................. .................................................................................................. .. :..::: ::::...............................................................::. :::.• ::.� ;�;•:c•::: :.:::.o:. ...... >::>- : I'Dbone :>< :> ........`.%.:...:....... ::.;>:;:;:>:: ci. :::...:..::: :............................. ............... :.: ...:;;;.::.. ::::.:::: . ::::::.:.: :;:::.::.: «x`:> . :::. ....::::.;:. ::..::.... .:;::.:.:. insurance co. :... :. n .. :...... :::.::... .. .:..... o>+icv# •: ° ... ..:.. ' ... . ////O//I%//. cumaanvname::... ::::>.....::::......:::<:::<:»:: _. ::.... ,.. ................. . :::::.::::::::::.::;:::.::::;::::.::::::::::::::.::::::::::.:::::::::::,. .::::::::::::.:.::::.:..........:...................................................::..:...:.................................... I. ;.:.: ::;>: .. ::: address. :. .... :::;::::;:;::.;:>:::::;::::>:: hole#s:.::::.:>::::::.:;:>:;:::::::;:;: ::;:: :;<:::::::::::»«:>'.>::<,'..::::'<;:: :: <>:< «:>: city- - p :.;:..:..,;..:,.. ::::::::::::..:::::::.::.::::.:::.::::::".::.:::::.::.......................:......:._.:.::::::::.:::._:::::.:.:::::::::::.::::::.:...:..................:....:.:.. % .. -...........:%:::....:.::.:::.:::::::.:::::::::::.::::::::::.::,.::...r.::::::::.::::::::.:::::.::..:.:::::::. insurance co:.: .. ... ;.....:;:..,.. . ::.:. __ pricy# . .. . ........ ....:.......... .. __.. ....._..... Fafimte to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. . 1 do hereby cerV the pains and penalties of perjury that the information provided above is b�and correct - Signature Date !o, Uo -775 4 491 e5 Print name LA yEI V— � t— Phone# 7 official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Sdectnen's Office • _ Health Department contact person: phone#; ❑Other 0cmed 9/95 PJl) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law",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 section 25 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,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 in the workers' compensatiodiffidavit completely,by checking the box that applies to your situatian and supplying company names, address and phone numbers along with a certificate of irmuance as all affidavits may be submitted to the Departm=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 any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns 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 pernut/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you 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 Invesligadens 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 0 ° The Town of Barnstable Department of Health Safety and Environmental Services P Building Division } 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. n. Date�1 AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: r y (�MS (SL Estimated Cost e � 4L n Address of Work: Owner's Name: :SACJA g- Date of Application: 0% % Cl I hereby certify that: Registration is not required for the following reason(s): Work excluded by law C]Job Under S 1,000 Building not owner-occupied [30wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. �J L��L �Z�CScI J Date Contractor N e Registration No. OR Date Owner's Name g1orms:Affidav ARDTTO, SWEENEY, STUSSE, ROBERTSON&DUPUY, P.C. ATTORNEYS AT LAW PAUL R.TARDIF 25 MID TECH DRIVE,SUITE C WESTYARMOUTH,MA 02673 TEL.(508)775-3433 FAX(508)790d778 Also Admitted in Maine BUILDING DEPARTMENT TOWN OF BARNSTABLE Correction Notice Job Located at .... .3..... q 2 :...... �� I have this day inspected this structure and these premises and have found the following violations.(D......(:aaP ........�........&....... w-S ...Q3r ..... f......!; . .:......= . ........ a . :.....�............................. ....................................... Q........f �. ..:�.......r s�.�........�. .. ........................ .Y......................` ��.............. ................................5 -— .................................................................................................................. .................................................................................................................. .................................................................................................................. When corrections have been made, call for in- spection. Date ................................. .................................................................. Inspector for Building Dept. DO NOT REMOVE THIS SIGN Assessor's Office 1st floor Ma i1l,,ts .-loot"' 4� Permit# —Conservation Office Oth floor) �� Date Issued 4--Board of Health Ord floor � A6�1.10--'>� �tl f� r BE Engineering Dept. Ord floor) House# '�� °4 to _ • ^ "1 Planning Dept: (1st floor/School Admin.Bldg.): [EN!ll ' gM Definitive Plari Approved by Planning Board 19 (Applications processed 8:30-9:30 a.m. & 1:00-2:00 p.m.) } TOWN OF BARNSTABLE. Building Permit Application Pro•ect"Street Address ' 9,� 7 Ave., Village Gl i S 06 Y -k Fire District Owner U In Y�P, Address p-QS Telephone S W)6 0 Permit Rcauest: RC ell Cv deck Zoning District Flood Plain Water Protection *Lot Size Grandfathered • Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Existing Information Dwelling Type: Single Family V Two family Multi-family Age of structure Basement bw Historic House Finished Old King s Highway Unfinished Number of Baths 3 No. of Bedrooms Total Room Count not including baths First Floor Heat Type and Fuel �C�,S Central Air - Fireplaces Garage: Detached Other Detached Structures: Pool Attached uvtdcv- Barn / None Sheds t/ Other Builder Information Name DA V 1 9v 6ev'� eY��' Telephone number 7 S 5-,)i/ Address 0 (t S 1')dY-e,- License# a I �QG�SSG Ma S 5 Home Improvement Contractor# - / f� P �- Worker's Compensation # ::/2 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO A d ya p3Ce Project Cost ` Fee 57C`c'/ SIGNATURE DATE -_' I / — v`. BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T FOR OFFICE USE ONLY 7 .41 - 4 *17 ADDRESS l / .�:�P.s�JL/L C� v .LAGE OWNER DATE OF INSPECTION: FOUNDATION ` FRAME , A INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ';. ROUGH FINAL d FINAL BUILDING: -9 J r. DATE CLOSED OUT:E ASSOCIATE PLAN NO. , L fl The ToWTI Of 13,qT-T1StfJJ1C 1 � : ..:. •' I m rr"rrtttCrtt:tl -~;��►^f' .; ittii.�iri� i�i� i�ii�n 367 Main Strew Hyannis MA 02601 Office: 508 790-6227 Ralph Fax 508 775 3344 Building Commissioner For office use only Permit no. Date lam` AFFIDAVIT HOME IMPROVEMENTCONTRACTORiAW SUPPLEMENT TO PERMIT APPLICATION MGL c.I42A requires that the"rteoorsuuctioa,alterations,remation.rcpalr,modernization.ommmion, . improvement, removal, demolition,or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which ere adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. T3PC of work: F/I'.!��!LY��Ct'.VOZ-Tl l Est.Cost Address of Work:' l - Ave, Owner Name: y�c�� SO ("vt•G� Date of Permit Application: ell I hereby certify that Rcgisuation is not required for the folloAing rc2son(s): Work excluded br law Job undo S I,OW Building not owncr-occupied Owner pulling own permit Notice is hereby givcn that: OtVNERS PULLING THEIR OWN PER!,',TT OR DEALTNG'�T 1-H UA'REGISTERJ D COIN-TRACTORS FOR APPLICABLE HOME IWROV r'•f-:1.> NVOFJ: DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAMS OP.GUARAJKTY FLT'D L^,'DER 1`iGL c. 142A SIGN£D UNDER PENALTIES OF PERJURY I hcrcb\.2pp1v for 2 permit as the 22cm c`t':c Date Contr2ow,name Registration No. OR Date Owncr's name '6:� _ 77 e .ti x to ,Puck, j SI,�X dkck{:nj 6 �ec14�v�5 2.x8 To is O, C- 4riple- 2x/o Gar( Af �J `Gtr► C'r" �� � , Oh qU edges t Ska:`r S 4 Y 2)4 2- \"q I is�"cvLW • arau�d StA.��'S 3 �� •o l d ' 1 �J yX/0 Lar�ty' j s-�i LQll�r P�Sfs S f,6 order dec.K, 1 74 nk 25F, r=F..,s,,,.,;x' :. •{ .is.,e'er'a >.. rt , 2Y;, - ,r w!G wJ( 1- _ �• .`{ �+ ;h�rr.e..�`at �..-.•t'd;,a'�'t ,.,��y,y`F. 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