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HomeMy WebLinkAbout0040 NATHAN ROAD � �/ � _ _ __ � _ .� � - � �, � �� r F �I e I Town of Barnstable Building din Post This Card So:That it��s Vis�ble;3From&the Street Approved�;Plans Must be:Retained on Job and�this Cartl Must be Kept � Mom. Posted UntiltFinal Inspection HasfBeen Made��� � �"_� � � � � r �� -�- x '* ' ° Whe`re a Certificate�of Occupancy�s Required,such�Bultlmg shall Not be Occupied until a Final lnspection has been made pet ... �., .,..,,.;x �.z;�a�„ ._w .»..,.�.s w: , ,..,.._.�,., �": :a .,,,.. w •.. „emu _n.., ,.',�.. R..�.�>.,�,. � , ... Permit NO. B-18-3034 Applicant Name: WADE M KEENE Approvals ., ; .: •. Structure Date Issued: 10/02/2018 rCurrent Use: S ure Permit Type: Building-Deck Expiration Date: 04/02/2019 Foundation:�g�S6ass�Op ttdlp Location: 40 NATHAN ROAD,CENTERVILLE Map/Lot 230-033 . Zoning District: RD-1 Sheathing: Owner on Record: HAASE, BONNIE A TR + Contractor Name 4,WADE M KEENE Framing: 1 Address: 40 NATHAN RD onr. -058549 2 License CS Ctracto CENTERVILLE, MA 02632 � � Est Protect Cost: $4,000.00 Chimney: Description: build a 12 by 12 deck on back of house Permit Fee: $ 110.00 j Insulation:- Project Review Req: r Fee Paid $ 110.00 10/2/2018 Final: Plumbing/Gas Rough Plumbing: Building Official > Final Plumbing: This permit shall be deemed abandoned and invalid unless the work author¢ed by this permit is commenced within six months aft&1ssuance• Rough Gas: All work authorized by this permit shall conform to the approved application and the-approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and str,`uctures shall,6e in compliance with the local zoning by laws and codes. Final Gas: This permitshall be displayed in alocation clearly visible from access streetiorroad end shall be maintained open for:public inspection for the entire duration of the work until the completion of the same. s - . Electrical The Certificate of Occupancy will not be issued until all applicable signatures:by the Building and Fire Officials'are provided on this permit. - Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing - Rough: 2.Sheathing Inspection M "" 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT p Application I�bc �..a . ...................... ...........,.... ...... 4 r_ + r t # HARNMA13M q 110 z6SEL20 R� Permit Fee........... ..........'........Other Fee.................:...... �. SEP �1t B N�T�bi_� Total Fee Paid.....................- ............................. ............... TOWN OF TOWN OF BARNSTABLE Penrt Approval b........ . ..................:on....�°�?-1/. :..._ BUILDING PERMIT s ....30.......Pa=........... .. .:............ APPLICATION Section I—Owner's Information and Project Location Project Address Village Owners Name �.Y 1 C%,Ac., 00 ot Z` wy\z Owners Legal Address city e �M,. h �� state Zip owners Cell# ? 76 57 5 L Frmail Section 2—Use of Stractare Use Grroup ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling Section 3-Type of Permit ❑ New Constraction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild Deck Apartment . ❑ Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify Section 4 -Work Description T act T ndxte& /2018 _a Application Number. .................................................. Section 5—Detail Cost of Proposed Construction _ Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist WFCM Checklist ❑ Design Section 6—Project Specifics ❑ W"ning ❑ Oil Tank Storage ❑ Smoke Detectors Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland,coastal bank? Yes ❑ No ❑ Section 8—Zoning Information 1 1 Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Lastmaatna 2/9rz019 Application Number........................................... Section 9—.Construction Supervisor. Name AJ' Ke-ckLA Telephone Number 2?6� 3� 6 0 Address EO 1�Z L q City l� State Zip License NumbeC —0��,icense Type Expiration Date 2:_ Z Contractors Email Cell# I understand my responsibilities under the rules and regulations for Licensed Conshnction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. signature Date Section.10-Home Improvement Contractor , Name .R �/(.� Telephone Number • a 0 Address a City tate Registration NumberIMJ5,1 Expiration Date 0 I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and docummeniation required by 780 the Town�Bams�tabk. ttach a copy of your H.LC... Signature Date of -► Z^/ Section 11—Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature_ IN Date 2-, l Print Name W c4 --e_, Telephone Number y2®� 7 E-mail permit to: leyt�k CCAA- -%eck.e,N®v,5*(�q)e14 o® P co VV\ l Section 12—Department Sign-Offs Health Department © Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department, Conservation-1 ' - ❑ 4 r For commercial work,please take your plans directly to the fire department for approval Section 13—Owner's Authorization L A1,1 r, e S-'l 8 as Owmer of the-subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: mil,0 h� v _ •�c� �.�a4 iA' t M �— fi (Address of job) `}^�J K'`.✓2 s R i r � � ��� � V Signature of er "' r' } dale ...,,y '.. 1 ✓.r 5 1 /716 Prm N e t ♦ 1 Last undated:2/92018 Barnstable Bldg.Dept. Approved bY'#-��-�--3 .3 , Permit#: 1-- It �na�- i try 0 �1� U,Xi6 -d Z N C: O v O cc � . T `1 g" no 7 3 fk- Ha lVq �- "Vx COOL The Commonwealth of Massachusetts Department of IndustrialAccidents 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/Organizat on/Individual): O-AA-e, ����n A Address: 00,5 Bel log 1A—O Z� (o �� City/State/Zip: 'Sa 13�° P one#: O _7 Are you an employer?Check the appropriate box: Type of project(required): 1.X I am a employer with L 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 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 t 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' 133Z tffi 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. tContractors 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 thepolicy and job site information. Insurance Company Name: �—fExpDate: Policy#or Self-ins.Lic.#: g� �tJ�°��{�-f6_�.�j>-�,�- C iration � Job Site Address: L-0 -V y"A&u, J?. _lCity/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 coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Sianature 0n", Date: G j l~Il9 Phone#: �3 Official use only.,Do not write in this area,to be completed by city or town officiaL Cityor 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#: 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 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. 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 ybu'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 permittlicense 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 bum 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 Revised 4-24-07 Fax#617-727-7749 www.mm.gov/dia Commonwealth of Massachusetts ® Division of Professional Licensure Board of Building Regulations and Standards Constrg4� �Nbpervisor CS-058549 es: 04/23/2020 j WADE M KEENE , P.O.BOX 1095=� x SAGAMORE BEACH>IVIA 02562?> I Commissioner ` �-._.__.�.....• ✓2e �o��2rnorz�cea�2 a�✓iil�¢JJ¢c2uJcl�l - - Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR I T P�Em.4lndividual Rif aistratldfi-' Expiration 111 �95°� ,,P09/07/201 s WADE M KE-. i WADE KEENE.,� j a ' 19VICKERSON'AVE " SAGAMORE BEAGH;'(tAA' 02562 Undersecretary a I Construction Supervisor Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call(617)727-3200 or visit www.mass.gov/dpl FE Registration valid for individual use only 4 before the expiration date. If found return to: i Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 I �_. Boston,MA 02116 I � Not Valid without signature I � Y Parcel Detail Page 1 of 3 e X Y _ Logged In As: Parcel Detail � Thursday,September 13 2018 Parcel Lookup Parcellnfo Parcel ID F30-033 � � „Y W.•.__ _.•_._. . ._" _ -Developer Lot Location 40 NATHAN ROAD 77j Pri Frontage 188 �. mnl Sec Road „NM1 Sec Frontage Village Centerville Fire District C-O-Ni Town sewer exists at this address NO � � Road Index Asbuilt Septic Scan: ; $ 230033_1 Interactive Map ) e. ' 230033_2 {` Owner Info owner HAASE, BONNIE A TR owner %GRISSINO, NANCY S. ,�.•,» —I Owner streets 40 NATHAN RD streetz city CENTERVILLE state AMA zip�02632 country Land Info ..... ....__... ......._.. .. __ ......... _. ..._...... _ ......_....__ ..... _............. ......... ...................................................... .......... _....... ................................... .......... Acres r,0.23 use FSSingle Fam MDL- 11 zoning RD-1 Nghbd 0106 Topography Level I Road Paved Utilities Public Water,Gas,Sep tic f Location Construction Info Building 1 of 1 Year 1982 Root.Gable/Hi Ext Built Struct Wood Shin le - - p .I Wall g �. .. Living 1346 Roof Asph/F GIs/Cmp Type 3None Area Cover yp . Style Colonial Wall D�all Rooms 3 Bedrooms Model Residential Fioo� Hardwood R oms 2�FUIj Half a- Grade Average Tee Hot Water Rooms<'5 Rooms YP F#-" Total Stories 1.8 Feat Fund- MPOUred ConC. ation Gross 2568 � Area Permit History Issue Date jPurpose Permit# Amount insp Date Comments Visit History _ Date Who Purpose 1/22/2010 12:00:00 AM ' Paul Talbot Cyclical Inspection http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=16325 9/13/2018 ll ho J \l/ *7 k XI \ \0- . V Lip' 'V • � 125 WAD"�N � 4d. O� 'C �c ASS.�M E D FPoT ECr i o�i Ur,.l DE[Z. AQ77cL1✓a2 , c�lA p i�L� -1�, ,cu- E, �tN Of M � CERTIFIED PLOT PLAN 0 a F°�eTf eke I N 4No sun��y �. �� STA B L F � M A ss SCALE, I DATE , L i2 02 LDREDGE ENGINEERING CO.IN CLIENT I CERTIFY THAT THE FbJNDA'nCN 'REGISTERED REGISTERED SHOWN ON THIS PLAN IS LOCATED CIVIL I LAND JOB NO. 810A ON THE GROUND AS INDIO'ATED AND ENGINEER SURVEYOR DR.BY! _ •1� _ CONFORMS. TO THE ZONING LAWS OF �R►�'�`r,4-8�>_.� M ;S S, 712 MAIN ST. � CH.'BY �_ HYANNIS, MASS. SHEET E_y� ._ _ ..__. _ OF DATE E . L...AND.._.. SUR__._._VEYOR ti Town of Barnstable *Permit# �0 Expires 6 months from issue date Regulatory Services Fee , �� Thomas F.Geiler,Director ��25�07 Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PEItNUT APPLICATION - RESIDENTL&L ONLY Not Valid without Red X-Press Imprint Map/parcel Number il`✓U b Property Address P � EROIResidential Value of Work .SC�C�� u0 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name ��t�i't �2 SS0 Telephone Number Home Improvement Contractor License#(if applicable) 10 A 3(o r Construction Supervisor's License#(if applicable) 6orkman'sCompensationInsurance X-PRESS PERM' Check one: ❑ I am a sole proprietor MAY 2 4 2007 I am the Homeowner [<rhave Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name Workman is comp.Policy# 4)C)-- 3/ 3�Co fije.. ®3� Copy of is Compliance Certificate must be on Permit Request(check box) 2Re-roof(stripping old shingles) All construction debris will be taken to J S�fn�DkJ tf_� ❑Re-roof(not stripping. Going over existing layers of roof) ' ❑ Re-side ❑.Replacement Windows/doors/sliders. U-Value (maximum.44) *VJheresequired; Issuance of this.permit does not f, gompliancci with'other town department regulations,i.e.Historic;Conservation,etc. ***Note: Property -weer must sign Property Owner Fetter of Permission. A copy of the Home Improvement Contractors License is required. t1Z AI N C4JZ7 SIGNATURE: j11 ® �A• 4 '� a W Q:Forms:expmtrg � ' Revise061306 "" ' { CORP.; CERTIFICATE OF LIABILITY INSURANCE OP IDPIM j DATE/MM9 Y •.; THIS CERTIFICATE IS-ISSUED AS A MATTER OF INFORMATION Rider tJ L--II' �cvta fists ' ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR DO sos; ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Cataumet MA 02539 - --_- Prone: 508-564-7200 Fax: 508-564-7272 j INSURERS AFFORDING COVERAGE ; NpIC II:SL'REq q : PERSSON ROOFING & SIDING, INC. usugEPc LIBERTY tUTUAI I BoiJrO7E MA 02532 ----.__..._---_----- 1 TttE"ri4::'FS O`PSUP4NLE,^'ED BLLLIt'�'H/1NE BiEN AiSJFL-- I•E N5l-E \- :+� _P i F ,�� J' _G N - '•.N,i — 4I:1 REOU'FEA,'c NT,TEPM OR CONDIT'DN OF ANY CONTRACT CI.OT-rt P OOCtIMEN 1'n T..1"Sil THIT MAY GE LSSUED 01 MAY PERT&IM THE INSURANCE AFFORpEO BY THE POLICIES DESLRI2FD HEREIN,.WIDJEC-T _ POLICIES AGGi:EGAT`.I;.,,'S SM)Y✓N MAY:7A•T_SEEN REDUOF.D EY FAIC'CI gTTS LTR NIBAD TYPE OF INSURANCE POLICY NJIA°EA PCLZy E.cECTIVE POLICY EXPIRATION ._ .. ..._...._.._ ._. DATE INMJOC'YY) DATE IMMJDDTYYJ LIMITS GENERAL LIAEILiTY I � I EACH OCCURRENC(� g C_OMNERCMI.GENERAL LIABILITY DAMAGE ____—..._-.-1-...__.___._—_.�DAMn� ro I � � PREMISES;Ea[xcwenr,¢l I f ...._..... ._ q PERSONAL S ADV INJURY _.._.-._......-. GENccAALAG � GRCCPTE OEM,AGGREGATE LIMIT APFLIER PER PRO• .__ I I PP.ODUCTSCOMPJOP ARG �I y I -.1 POLICY JECT I AUTOMOBILE LIABILITY COMeIMED SINGLE LOP,-. KIE'll'NJ 5CHEDVLEO AUTOS i ;ar rhncr:' 1 YIRED AUTGD N:,N-7hN-rD A'JT:JS INJURY PROPER- AP Y DAr .r i A wee;: GARAfE LIABILITY -_-• - --' - I JTO ONLY.EA ACCIDEN]' i WY AUTC I -MLR TNAN -EA ACC AUTO ONLY � I S I EKCESSNNBRELLA LWBILIN. AGG " `l EACH OCCURRENCE _ OOf.U.. 1 CLAIMS MADE ._—..__._..._._..__...— _.-_. . r,.._--_._..... 'GGPEGATE S -- ' I WORKERS COMPENSATION AN O I EMPLCYERS'LIABIL;T1' X TOR7 LEMRS L_ 1_ER WC2 31S 326613 035 - A:/PRGPk:ETDPA44'NE4)<.X,CCU�IVE 08%02/06 08/02./07 L OFF:CFP L EAf,Hl,CCIDEN7 S 1Qe r60Q i '4E'.'SER EXCLI:=EDP 11 y_•s�ec;J;ez ur-0c: I j E.L DISEASE.EA F,MVLO'iEE �SFEC;n;,PROVLS'VNS crb..gR,?VLSVNS ecb. i ___ iOTHEA I �" - --•j-�— ELC15[ASE-POLICyLMIT .--. f 5�C/9G0 .._.... .. - i : I iBCP;PTION OF DPERAr10N8 I LOG 4TIONS I VEHICLES(EXCLUSION$ADDEC BY;,NODRSElt �`E'JT%S>EL'AI.i'RGVISIGNS �- ERTIFICATE HOLDER CANCELLATION BHCJLD ANY O6 Tr:[4BOVE DESCAIBED PO.ICIEE BE CANCELLED BEFORE THE EXPIRATION _~ . Fie„FTHCPP,!,F tMP.SCI,iNf.:NSIIRFP'MI;FN1?FAv(,gT'.MA•I, - DAYC Wq,i-FN NC'OE'O T''E CERTIFICATE NOLZER NAMED TO-THE LEFT,BUT FAILURE TO DO SO SHALL 3O IMPOSE NO OBLIGAT,ON OR LMEILITY'OF ANY KiNO UPON THE WSURER.ITS AGENTS OR gEPRESE'TA7rv'ES - - AUTHORIZED R'FPESENTA -ORD 25(2001/08) CNARiEs C. RI7ER n ACORD CORPORATIQIV 1998 I Persson Roofing and Siding Inc. 22 Colony Ave. Bourne,MA 02532 Phone: (508)759-8959 Fax: (508) 743-9303 PROPOSAL SUBMITTED TO: PHONE: DATE: -B144- cos spa_- as y y�a9/o7 STREET: JOB NAME: ARCHITECT: 58ax d 5�� CITY,STATE AND ZIP CODE: JOB LOCATION: DATE OF PLANS: 9RN s�9�3 C E M rfi aa�3o 'Ve-rmw ;?b _. . We hereby submit specifications for: Strip off old roof shingles from entire roof and remove to the dump. Inspect roof deck. Install 30 lb. felt paper underlayment on entire roof deck. New aluminum drip edge will be installed on all eaves. Install ice and water shield over drip edge and in all valleys. Install new flanges on all plumbing vents, and new flashing where needed. Install new Tamko 30 year architectural roof shingles on entire roof. Color will be E43 i/f F o ni F- CEZ92 s!9RHY ALA. s/D>rvC, w/7H Ridge vents will be installed on all ridges. w-9sd io cl-69a-J Job site will be left clean. iffE- 6uRFHcF— -rw/C€ /r- ✓vac s5R 01-'1 Job will start on or before Q/ aoo r7 Completion date J'WJ E a007 Mass Home Improvement Contractor's License # 102365 YOU HAVE 3 BUSINESS DAYS TO CANCEL THIS CONTRACT. We Propose hereby to furnish material and labor—complete in accordance,with above . specifications, for the sum of: (4,,a 17 S 00) Ft u F-- i 140 v5 8:v6 i w o I-Jwu ogC-2) ,ESrVe iry r-I vE- DOL&k S, Payment to be made as follows: `70,), 00 ZDwtii a9L6fU C€ CAJ MP&r--71-t0AJ Any work preformed beyond the scope of this contract will be billed separately Authorized Signature:as extra work. This includes conditions which could not be foreseen by the contractor.In the event the custdmei does not keep the payment terms,work shall cease,an customer agrees to pay any legal fees incurred to collect payment.work progress is subject to.weather conditions. Note:This proposal may be withdrawn if not accepted within 30 days. Acceptance of Praposal—the above prices, specification,and conditions are satisfactory and are Signature: hereby accepted. Payment will be mad as outlined. Date of Acceptance: 7,L � Signature: z l` y f ___—___--- - p �reovzeuea�C�z � c•�oetta Board of Building Regulations and Standards before the expiration dateLicense Or registration . If found d for `return to' HOME IMPROVEMENT CONTRACTOR Board of Building Regulations and Standards Registration: .102365 One Ashburton Place Rm 1301 Expiration 7/1/2008 Boston,Ma.02108 Type:::Private Corporation > PERSSON ROOFING AND SLbING INC. Kent Persson i Not valid without signature 22 COLONY AVE. . BOURNE,MA 02532 Deputy Administrator The Commonwealth ofMassachusetts Department oflndustrial Accidents Office of Investigations d 600 Washington Street Boston,M-4 02111' wndw.mass.gov/dia ' Workers-* Compensation Insurance Affidavit: Builders/CoiAtractors/Electricians/Plumbers Applicant Information .Please Print Le6ibly Name(Business/Organization/Indi-y•idual): . �R 55 6 A-) . [Lyr-lN'-C -r S!>{iL'�, lrtdL •Ad(iress: .10- COLONY City/State/Zip: toU&&1*— Phone.#F: Are you an.employer? Check the appropriate bom :Type of pioject(required):, 1.Lei Z a employer with 4. [] I am a general contraotor and I .employees(full and/or part-time).* • have hired the stub-contractors b. 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 mein any capacity. employees and have workers' ' comp,insurance. � 9• ❑Building addition [No workers comp,insurance p required.] 5. We are a corporation and its 10.[J Electrical rep airs or additions officers have exercised their '3.❑ I am a homeowner doing ill-work . 11.❑Plumbing repairs or additions , myself.[No workers' comp. r1ght of exemption per MGL 12,❑Roof repairs insurance required.]t C. 152, §1(4), and we have no employees, CNo to ees 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 anew affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the Sub-contractors and stzte whether ornot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.polity number, r am an employer that isproviding workers'compensation insurance for my employees. Below is.the policy and job site' information. Insurance Company Name: Z16M?1. 446- let1 .- Policy#or Self-ins.Lic.#: a<C 2 3 (S 3 d-Ce G 17 03 (. Expiration Date: F/Z-Lo'7 Job Site Address: AJ.PtTilf1ft,U �� City/State/Zip: #Y1d:,&"I Attach a copy of the workers' compensation policy declaration page'(show'sng the policy number and expiration date). Faiiure.to secure coverage as required under Section 25 A of MGL c. 152 canlead to the imposition of criminal penalties of a fne 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$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the-Office of Investigations of the MA for insurance coverage verification. !do hereby certify under the pains•and penalties of perjury that the in provided above is true and correct. signature: `� Date: 6 — Phone .�Q 7S J S9' FIB30ard aniy. Do not write in this area, to.be completed by,ciry. or town official n ' .Perrnit/T_•icense r ho:ity(eircle one): i Realth 2.Building Department 3, City/To-irm Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone-#: I 7UN-19-2021 15:12 PAPNSTAELE HO!JS rJG 15387789312 P.E11 Barnstable Fat I$i;S)77ti-93;2 76*' [_eased Housing Dept. ('108) 771 .... ,r �, ona► Housing. Authority 146 South Street•Hyannis. A4u,s.O26o')I ZONING VERIFICATION TO, Gloria Ure!nas FROM: Robert Hooper, Leased Housing Coordinator IRE: Legal Rental Unit 'verification Date: Address: Y ._. -- Village: C e-,�kr✓ �_! e� Emit Type: ���s�� r-a i/1 Bedroom Size: Map & Parcel No.: 03-3 The owner of the above listed property is entering into a contract with us for the rental of the property as listed above. Please verify by signing below that the unit Is legal and meets all zoning requirements for a rental in the town of Barnstable. If it does not, please list reason Isere: --------------- ---------------- Thank ou) for your assistance in this m nature _ Tint name 41, - � 9 - mil ®aid VIA FAX: 790-6230 MRVP Section a Rev. 9198 Esuat Housin , Dpporl.mity Agenc.v TOTAL_ P.31 �•""' TOWN OF BARNSTABLE Permit No. _- --------_-- .,�y •" Building Inspector �ma Cash -------------------- ♦• YY� O�0 YPY•\� OCCUPANCY PERMIT Bond ---- _----- _ _ No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor ' first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." • Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date o/ Gas Inspector Inspection date Engineering Department 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. � n\ IV Building Inspector f 1p ' ' t i or g o aX O 12 s W I`DTN F�o7><cr-i o..j U D R- AQTic-i tN OF CERTIFIED PLOT PLAN Wo $ tor44 0A11-44W Znko CeaTeelI�LC �Q�srEa�o� IN 4No su��y $A Q Q 'S TA B L NA A SS SCALE: 1 5' DATE : LDRE,DGE ENGINEERING /N I CERTIf:Y THARLAT THE ti�-now CLIENT_ ., _ SHOWN ON THIS PLAN IS- LOCATED E4ISTERED RE819TEREO CIVIL LAND- JOS N0, '8 : ON THE GROUND AS INDICATED AND.. L CONFORMS. TO THE ZONING LAWS ENGINEER SURVEYOR DR.S + � OF. R,�S7-,q �= cND M SS. 712 MAIA ST . ' CH.BY= HYANNIS, MASS. _. SHEET,L,.OR DATE, E LAND SURVEY _ OR. essor's map and lot 'number ......:.................................... ` c%THE ro Sewage _Permit number` ..................................... .... SEPTIC 5'Y STEIN IMUST 't B House number .....1..�.n?'. ................................................. ;. INSTALLED IN �® �,ro-0 6AM LE, ; -;. s MI LIA M639• ♦� l WITH TITLE 5 a MAY a. TOWN OF B.MtA COaEr � 5 .ATIO 3S ' BUILDING INSPECTOR - - APPLICATION FOR PERMIT TO CO � .. `...�n 1,�...... ..... ...............:.. TYPE OF CONSTRUCTION ................. ��� ta��—.................................. .................................... tr. .. ... ........ a.................19.�.r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for`a permit according to the following information: Location .......`-.a ........�!'k......N.o:k� .U`n........�`Oa c.... ....�! '.'.. Q, .y\.\Z....... ................................... ProposedUse ....... j ...�� ....................................................................................................................... Zoning District ...... e.S.`..S�t � G�\ ...Fire District ��\�— 05�................................... Name of Owner ,P?.i��:� arv� � CC ...Address .�'...:. �5?1nmq.kd................................. Name of Builder' �......c.. s � G...r\.. � ......................... Name of Architect ...................................Address ................................ f Number of Rooms .............1...............................:.................Foundation ........... C:O!�CA9�J-' Exterior .CA.&O0L 1 -F . .......................Roofing _ n p Floors ....... . .... ...... ?....... "..........................Interior ..........:..... .... Heating ...�.�P ..........Q,.a..S.........................................:..Plumbing :......... . ......... ........................... Fireplace ................IDA-................. ......................................Approximate Cost ............. f-� OC�C�.............. ................ Definitive Plan Approved by Planning-Board -----------_______-----------19___-___.' Area Diagram of Lot and Building with '.Dimensions Fee �l' SUBJECT TO APPROVAL OF BOARD OF HEALTH.. �Lk -3 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 construction. Name ..... .R .....fit....... . . . .....'C.................... K; ERR, WILLIAM 24074 fo�-.11112�'--S tory No ................. Permit ................................... Single Family Dwelling . ............................................................................. .6cation Lot #44 40 -Nathan - Rd ........... ........................ ...... ..... Centerville ............................................................. O�Mner' ....Wi.l.li.am...Ket.r............................... .... .. ....I..... .. .... .. Type of Construction ...Frame....................................... ................................................................................... Plot ............................ Lot' ............. May. 2 4,, 82 .............Permit Granted ........ .......19 Date of,Inspection ....................................19 Date Cpmplefed ...... 9