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HomeMy WebLinkAbout0018 LIAM LANE r .d n : es a. „ . r v t t a n , A , r a • .r ry r t n � � r u H a : J " , : a . . - i .. .. - �� � .. 4' .:Y .. .. .r. .... _ .. _ 4 a .. Y_-' - .. � - a ' �' ♦. a... - - S. .. .. .> - _ e ,. ... - � .. f i ,. • �. � �. r � y i.. A r t. . � '� .�� � • .. ., :. .. y_ ��.. '... ': -, � .. � .. v r s ,. r - s _ .. ., �. • � li r . i. � ., of rq� Town of Barnstable 'Permit# 1G(t53 E Tres 6 months rom issue�te Regulatory Services Fee a�x>vsTnsLe. ; — 9cb�3 Richard V.Scali,Interim Director • Ya 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 Not Valid without Red X-Press Imprint Map/parcel Number�17 / G L 0 Property'Address_ / ,-41-1 Lh [(Residential Value of Work y, D S] Minimum fee of S35.00 for work under$6000.00 Owner's Name&Address ePl;l�fv,'Ik 1'14 Dy G 3 y BR A,) Contractor's Name t tOS ISoi✓ Telephone Number 10/-JZr-f oft Home Improvement Contractor License#(if applicable)_732/_5" Email: Construction Supervisor's License#(if applicable) O FJ 7,0 7 AWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor do a I am the Homeowner I have Worker's Compensation Insurance EON Insurance Company Name NA l�5 . - JUN 2 g 2016 Workman's Comp.Policy# W�iQa B'Q�j-g �y y u ^r-1jA HN 'TgBLE Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All.construction debris will-be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side aReplacement Windows/doors/sliders.U-Value . SQ (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor,plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Wheie required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: QAWPFILESTORMSIbuilding permit formslEXPRESS.doe q Revised 061313 R ewal Agreement Ddcument a ndl Pai r � t Terms i AM d6a Renewal By LNGw btnp`mwl ind UF'dahmall Soo ften New EmW"j Wr4w,tLC 18 Liam i;,N R,l X3 7 i.. �173t 5�€T OWN , L-end'�iriiin '�1 ei,t li `i�ar,w 02637 AhIAIRIM? M Alb Ski Rdd I linrdp cil 1205 : . Cwtufma(s) CitminAeFjai) 9cfect rY��lElacai, fib Uaim Laift CentOrcr6110, (MASS 02d.3;2 i'f�f�a�}'.`Czlcplri�iii iBf alS i �50$ 2 -0074 wkillasy,C"le�iliraa�Nu nbe -- UwY,vW htF--6 +ppmiiifly'IAd McN.ira1111}��. 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L fiidi�iiter , , §,? cI i)i,�'lli agf~��me q,�L5f,7 Cl�li±t7wi � 4 gli r;rlw�'i sil l fae i$ d ilia -ffioe �Im ani 41 f�af�9�l�4 iii� by pepegowl islitc4kt bo{c AI ,-cWiv. a,-) W a, f3alaaiefati ;3�1' 5 ��ei,f�tat-i St ice , E ci9tlpkLfe 1 i5Cf5WftiA IaB1:Wi13C�7 42 1I� 10 +C tl ffai;! fi Lpfmi iit,. cl odil. rt'. : ''' ,i illat�flee a�lll tf are deai rfi rli lme LvrL I fLLtact tfm�9• v nrfollacyiy spat eke date In,which�w o mplete tha terlmkiil - . IwI msa lladom 6-te tutUat i Dip*sit $135 1L6 pro-Ading fit 6404ve u-Ly�i adfoilti 0 43]Tl d:aw 0 I6n 3 2705 lIkIr t1.I11W 5g.a.Isti r rl , PMui.,a t r 11r6A9 ,� i�'' Bplirs. 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If�9i++ i;u�ii cio a tied; .,�a Frilly:ngiifii�iriolw�¢I�v Ii�}�'a rift s CAL 1..'i i loin ' NOTICE TO OWNER.,W n6i Apt idli,cbmtL it iflllaBiI Ybu arU tndLl..1.wii itopy she chme-Le1341,t491i, Vovo"THE E I)G�YRRo MAC dll� ��,'�"l�l�,�t C lt�l��,�1 1'rQi l��lT ANY TI�� C+�<�T'�.�1T����1ALN M. �C+�C I'r.11T Of 0 2-0.1201 6 Oft THt THIRDBUSINESS DAI F-T!01PRE ONVE OF T ISS IMAN CT NK 14 J f IN CI�'.'iM C'.�si?fi .'sf�it3iLfr� " �i�fiaLtfgb.. James Cot Paul Udonin ll 1ilraf t N im, of s ik CdrAo.gi :"' .` Nil it'Maink" IV K, a Southern New EnglandWindows deb.a Renewal by Andersen of SNE I Massachus.-,fts-usPar-u-nent of Public Saiety I Boa.0 of Building Re_UlabOns and Standa.ds � MAR D IIB1 BN - j 7 LAPM PO-ND i Charlton V1.4 GM - fi i P� -a_5on + t ' I i ......... Office of Consumer Airs Mulsin'�"ess Regulation 14 Park Plaza-Suite 5170 Boston.Massachusetts 02116 Home Improvdment Contractor Registration Reg"jsLabon: 173245 Type: Supplement Card E=ira5an: 9/192016 SOUTHERN NEW ENGLAND WIXDOYVS LL __--- DENNISON BRIAN 26 ALBION RD - ------ LINCOLN,RI 02865 S-ipdate Addle m and mWrn card.A9art::rason for chnngr- Address t-Rmewal -1 Emplovmmt =Lan Card SCA-C 2DL Mit ihr�s,,,cn.c,:/G�cifa,+ad>uxt.. ffirr of Conseexr Attain h Hminn:RKnlaCoa License or tassttioa ea&d for iadiridnf nsc aatj E pypROVEtMENTCONTRACTOR befomthe emitraf=date.Iffound,rim tir e.. - aaffro of:o=8ater rain and Budam Regulab- egistraUOrr f7;245 Type 10 Parb Ph -$nne 5170 Expiration: V92076 SupplemmL= Bostan.:K_402116 SOUTHERN NEW ENGLAND WMIDOWS.LL6 RENEWAL BYANDERSON -�- DENNISON BRIAN - 2E ALBION RD LINCOLN.RI 0256-1 Ltaderseaeun tint valid t9 ehoat sigaatats 77ie conzwomwe-alth of Deparftmt of1ndmvftia1Acc&,_-1 s -office 0f1ffVW*afi0§2S y 1 Confess Seel,Sz&E 100 Borlon,MA 02114 2017 :. www mass e o'Offs Wo3 leers' Comp ens an"on Isarance da Briers/CornactorslMed elmls/Plambers A��li�� 'lease Print Ledbly Name (Business/Organization/IndividtW). SOUTHERN NEW ENGLAND WINDOWS . Address:25 Albion Rd City/Siate/Zip:Lincoln,RI 02865 Phone :401 22&9800 Are you an employer?Check the appropriate box: 'Type of project(retired): I_ I ari a employer with 20= 4- [I I am a general contractor and I employees Gull andlorparrt-time),I have hired the sub-contractor,; 6_ []-Nevi construction 2. r listed on the attached sheet 7- ❑Remodeling Q I am a sole proprietor or partner- ship and have no employees These sub-contractor have 8. []Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers"comp.insurance comp.insurance t required] 5_ Q We are a corporation and its 10.Q Electrical repairs or additions officers have exercised their I I. plumbing repairs or additions 3.Q I am a homeowner doing all work Q myself. NNo workers' comp. right of exemption per MGL 12.0 Roof remirs insurance required.]t c. 152,§1(4):and we have no 13. Other employees_[No workers' 1 comp. insurance requires] I'Any applicant thatcheft box;il mustalso fill out the section below showing their worka compensation policy information_ T Homeowners who submit this affidavit utdicating they are doing-all.tioik and then hire outside contractors must submita new aifdasrt i g sacb- �Cont actors that check this box mast attached an additional sheet showirm tine naive oFthe sub-conhactors and state whedw ornot those entities hm employees. If the sub-contractor have employe they must provide their workere coma.policy number. I=an employer Mat is providing workers'compensation ln=Tance for my employees Below€s the policy and job site information. Insurance Company Name:ARGONAUT INS. CO. Policy 4 or Self-ins-Lic.#:WC 928058352394 Expiration Date:8/21/2016 Job Site Address: •- . /F 1,417e City/Statelzip: ePn flyd-de . •h1 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-ef-IUL c. 152 can lead to the imposition of criminal penalties of a fine up to S 1,500.00 and/or one-year imprisonment,as w,it 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 foi insurance coverage verification. I do hereby certify under the ains and penalties of'perjury that the anfor)neon provided above is true and correct Date: Phone#- 4012289800 Off idal use only. Do not write is this area,to be eompleted by city or folyn offreiaL City or Town: ,PerrnitfLicense# Issuing Authority(circle one): ` 1.Board of Health 2.liuildmg Departmeat 3.Clty/f own Clerk 4 veetrtcal Hnspector g.rig 6.Other A SOUTNEVV-01 SHETiYSHT - DATE(MM1DD(YYYY} CERTIFICATE OF LIABIL,ITY INSURANCE ONF 8119/20i5 T}{I TIFICATE IS It ISSUED AS A MATTER R NEGATIVELY ONLY EXTEND OREALTER RS NO RIGHTS COVERAGE AFFORDED BY OL[�OLIR.CtES CERTIFICATE DOES NOT AFFIRMATIVELY I AUTHORIZED BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSLRER(Sj, REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. i { IMPORTANT: H ffie certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS �AIAIVED;subject to I 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). ( CONTACT VUliils Cerrf1cate Center j l PRODUCER NAME: I FAn (888)467-2378 I Willis of New Jersey,Inc. { E-ONE 877ti 945-7378 ': AID.No= y AIC No Ext.� p (c/o 26 Century Blvd ADDRESS,cer'ti icates@ ii8s-Com P.O.Box 305191 { ADDREss: Nac 1 Nashville,TN 37230-5191 i INSURER(S)AFFORDING COVERAGE INSURER A,Selective Insurance Company of Southeast 1399 76 INSURED INSURER 5,One5eac In insurance Company 1980i Southern New England Windows LLC ; INSURER c:Argonaut Insurance Company DIBIA Renewal by Andersen I INSURER D: I i 26 Albion Road INSURER E _' Lincoln,RI 02865 � ! INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT T THEDING POLICIES I EQOOF INSURANCE ENT TERM LISTED CONDITION OF ANY HAVE BEEN CONTRA T OR OTHER DOED—10 THE INSURED CUMENT EN WITH RESPECT TO WHICH THIS � i INDICATED. CERTIFICATE MAY BE ISSUE D CONDITIONED OR S 0 SUCH POLICIES.LIMITS SHOWN MAY KKlr--BEEN REDUCED BY PAID CLAIMS. ESCRIBED HEREIN IS SUBJECT TO AID THE TES, IEXCLUSIONS P POLICY E! POLICY EXF LIMIT'S INSR POLICY NUMBER MMfDDM'YYl: MM/DDM'YY i,000,000 ,TR( TYPE OF INSURANCE 1 INSD'M' EACH OCCURRENCE I S A 1 X COMMERCIAL GENERAL LIABILI Y i { AMA 1 S 100;000 ! j IS 2029459 i 08f10,1201510811012016; PREMISES Ea occurrence CLAIMS-MADE OCCUR s i0,000; MED EXP(Any onE pe ran) ? 1,000,0001 PERSONAL 2s ADV INJURY 1S I GENEPAL AGGREGATE is 3,000,0001 - I GE.N'LAGGREGATE, PRO MIT APPLIES PER: - i DUCTS-COMPIOP AGG ! 3>000,0001 i i POLICY JET LOG LOC s - 1 _ COMBWED SING'.LIMIT is 1,000,000I OTHER ` .� i IEE accident 1 AUTOMOBILE LIABILITY ` •o8ti ?2a:� opt!�I2a BODILY INJURY(Pe meson) IS 2029459 A rX 1 BODILYIWURY(Per acatlen q�; � 5 - ALL-OWNED..,...-1• i-SCHE--L,'LEn i AUTOS !�•AUTOS �. I. - `'.-. PROPERTY DAMAGE g I 1 NON-OWNED (Peraaident! !HIRED F AUTOS I � AUTOS r+IR...D ,.^ EACH OCCURRENCE S 5;000,000j i X 1 UMBRELLA LIAB I OCCUR 5 i 081i0/2Qi ;08?10I20'46 k A GGREGATE. is A 'EXCESS LIAB I 1 I �S 2029459 i .. I{ ! � i.S i i I CLAIMS-MADE' I 1 ' 1 ' ! I DED RETENTIONS 1 i i . LX p E {ER i WORKERS coMPENsAnor, I I1 0000,001b AND EMPLOYERS LIABILITY Y 1 N 1 0000068028 0812'11201 5 1108121120116�E.L EACH ACCIDENT S000,00B ANY PROPRIEMRfPARTNERIEXEC?NE (NIA 1 Y i L DISEASE-EA EMPLOYEE 5 OFFICER/MEMBER EXCLUDED? I I �. (Mandatory in NH) I I E L DISEASE-POLICY LIMIT I S 1,000,00 III Yes.describe under i ! DESCRIPTION OF OPERATIONS below , `WC928058352394 1 08121.120151 0812iI2016.jSee Attached- 1 C orkers Compensation I I I I 1 DESCRIPTION OF OPERATIONS!LOCATIONS•`VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached i`more space is required) 1 l 1 ( I CANCELLATION f CERTIFICATE HOLDER s SHOULD ANY OF THE ABOVE DESCRIBED E LLCBEC DELIVERED©IN THE EXPIRATION DATE THEREOF, I ACCORDANCE V11TH THE POLICY PROVISIONS_ I - - I AUTHORI7--D REPRESENTATIVE I ' Evidence of Insurance Cc 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and loge are registered marks of ACORD ACORD 25(201410i) ' . . / INSTALLED IN 03'P WITH TITLE 0 TOWN OF BARN SWADLE(AL BUILDING INSPECTOR FOR PERMIT TO ............................................ .0 APPLICATION , *�^~� . _ ------..K�'� �� l9. �� � ' —,---'—' —~'~^ ' TO THE INSPECTOR OF BUILDINGS: ' The undersigned hereby applies for o permit according to the following information: ----..—---- ��. '- Ott- Location �-.------«�~~---~--. ^� .'�' ----..^~^.. ---.c e� ' lrwa.. . Proposed Usa ----.---------..:�..y������---.---.��r���.—��—_-----------'--------. ' � Zo6ing District -----------.... .----Fioe District --------.».�.. ^—=--___. � ` � �� � �—�m Name ofOvvne, ---. ��L,--.�:� .A66nso .^�'---'���—..^.---.�*.:o«---��.���f��..�~ �� ��~*`�� � Nome of Builder' ----=--------------�A66rmx ---------------..—.--..~—.---. . . . Nome of Architect A66,ex ---------------------------.— ^^ �� ^.......................................FounJohoh ------------------.------._Nom6er of Rooms ------- Exterior .............& `� Roofing -------- ............... Floors ................... '. Interior --------�5..f 4------.. ' Heating --------'F- ...��—.0....................Plumbing ............................-Z......... ................... � 8 Fireplace ----------���������.. ....../--.Approximate Co� -----..�;. Definitive Plan Approved by Planning 800n6 lR���~._ Area --.�.�.74. �����—'�' - Diagram of Lot and Building with Dimensions Fee __ - v�_ 7�/\ x1 | ' SUB 83 T� APPROVAL OF BOARD Of HEALTH ��,^/"���7 | � ~ ' ` x�'� / m � ' . U � y �^ ? �� »° ` \ � � \ � . � |' , . . OCCUPANCY PERMITS REQUIRED. FOR NEW DWELLINGS | hereby agree to conform to all the Rubs and Regulations of the Town of Barnstab gardin.g t 4ebov:e construction.'' ^ Nome ..--..--l��. GREENBRIER CORP. 25162 Build 11-2 Story -No ................. Permit for .................................... Single Family Dwelling Lot 8, 18 Liam Lane Location .......................................;........................ Centerville ................................;.;............................................ Owner .....G.re.enbrier CoriD. .. .... ..... , ......................e;.,....................... Type of Conitruction ..F.ra.m.e........................... .. .... .. .. .......................................................................... Plot ............................ Lot ................................ Permit Granted ....j:qRP... ................:7J 9 83 Date of-Inspection ........................... Date Cot 71' ..............19 „e� ” ►e TOWN OF BARNSTABL•E Permit No. l •AUnA Building Inspector cash ---------------------------- WYl ,Gig. 04". OCCUPANCY PERMIT Bond - --- - _ ._- Issued to reenbr ier Address 4q 157 T=-,T T f' tem lle Wiring Inspector Inspection date Phimbing Inspector 1 Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ....................................................... 19......_._ ...............................................................................� Building Inspector S x y.i - � t: - .. ////'' • ' l'- fie. iH 4�•,_ ;I L b i Tt Y } � , LoT1`9 sr ov z M cA R. , 7 eb l cl �N� CERTIFIED PLOT PLAN IN su / .� SCALE` 40 ^ DATE�!5%atef4"_`1, ` C'LOI,�EDG� fIVG1Nw=�RHVG C®.lM ow I CERTIFY THAT. THE fv"Nr�A CLIFoNT :�-, ---�-- 'SHOWN ON THIS. PLAN IS: LOCATED EOISTERE® R 01STERED ��•e i/ - ON THE GROUND "A8_`INDICATED AND- LAWt } CIVIL JOB CIO. ,...........,, . : EN®WEER SURVEY®R tM.®Y� CONFORMS TO THE ZONiNA LAWS bmi • i OF F3A�i:ls L , AAASS: 712 M"A I N S T R E ETCH.RYA - , 5 'l0 83 j HYANh11S, MASS. SHEEP:1;1�R, .. ®ATE ®: `LAND SURVEYOR z k <�