Loading...
HomeMy WebLinkAbout0110 PATRIOT WAY /AGE �az�-�►�� � J a' Town of Barnstable -�- PostThis Ca � ,. n 9 rd So That rt is';V�sible`from the Street-ApproVW, ans Must be Retained on Job and this Card Must be,Kept Posted Until Final Inspection Has Been Made "f -MAS& m Where a Certificate of OccupancY`is Required,such Building shall Not be Occupied until"Fir ma,Inspection has been made �e�n�l� Permit No. B-20-834 Applicant Name: Robert Rostocka Approvals Date Issued: 03/17/2020 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 09/17/2020 Foundation: Location: 110 PATRIOT WAY,CENTERVILLE Map/Lot 192-135 Zoning District: RC Sheathing: Owner on Record: DOHERTY,MICHAEL C ' Contractor.,Name::' ROBERT A ROSTOCKA framing: 1 Address: 600 EAST SECOND ST x� Contractor;;License 113252 2 SOUTH BOSTON, MA 02127 "`� Est..Project Cost: $4,833.00 Chimney: Description: Insulation ; Permit Fee: $85.00 Insulation: Project Review Req: ,- Fee Paid: $85.00 T . Date. 3/17/2020 Final: .. Plumbing/Gas n <' Rough Plumbing: _ Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after'issuance. All work authorized by this permit shall conform to the approved application'a`nd the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be incompliance with the local zoning by laws and codes. This permit shall be displayed in a location clearly,visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. ! Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fite fOfficials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Y' Service: 1.Foundation or Footing _ �u 2.Sheathing Inspection _ Rough: �, 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: "Per s cting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). r Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 0.016 WgS'°1. �oFT rti Town of Barnstable *permit# Expires 6 monttr roni issue date O Regulatory Services Fee,.. o � BARN srABLE. ES v�ar EMiob A3C9y' a�� tl Ls F. Geiler,Dire ctor COO FEB 0 3 2010 ' Building Division, TOWN OF SAR� CBO, Building Commissioner am Street,Hyannis,MA 02601 www.town.bamstable.ma.us _ -Fax:508=790=6230- - -- EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 1/e.<'L) ` / Property Address //4 %fro ��.T � (-� esidential Value of Work���% Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address w1k Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) /ys'25'% Construction Supervisor's License#(if applicable) J�J<orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I the Homeowner have Worker's Compensation Insurance Workman's Comp.Policy# '>�0 Copy of Insurance Compliance:Certificate must accompany each permit. Permit Request(check box) e-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side: #of doors Replacement Windows/doors/sliders. U-Value (maximum.44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note:. Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License &Construction Supervisors License is required. SIGNATURE:. Q:\WPFILES\FORMS\building permi f.r s\EXPRESS.doc Revised 090809 The Commonwealth oflVlassachusetts Department of Industrial Aceidehis Office of Investigations h i+ t500 Washington Street 4 �`1 Boston, MA 02111 Z wrvm mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): �7 F ` J�oo �r-5� z1"e� ✓Fe Address: ,a, 16v City/State/Zip: & ' is j Phone #: 00 /d?s"" Are employer? Check the appropriate box: Type of project(required): 4. 1. am a employer with O I am a general contractor and I _ 6: New construction employees (full and/or part-time).* have hired the sub-contractors ❑ 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g• ❑ Demolition Workingfor me in an capacity. employees and have workers' Y P Y• 9. ❑ Building addition [No workers' comp. insurance' comp.insurance.$ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions officers have exercised their l .❑Plumbing repairs or additions 3,❑.I am a homeowner doing all work myself. [No workers' comp. right of exemption per MGL 12. of 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. 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 the policy and job site information: Insurance Company Name: �. Policy#or Self-ins, Lic.#: "7-R/ � y Expiration Date; i c30/d Job Site Address: Z/0 C WG City/State/Zip: . -+��� Attach a copy of the workers' compensatio 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 maybe forwarded_to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and enalties of perjury that the information provider!above is trice and correct. Signature: Date: 16; ' a 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 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: f r Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuarit­to-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`detined as "an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing e aged in a joint enterprise, and including the legal re resentatives of a deceased employer, or the receiver or trustee o an individual, partnership, association or other le al entity, employing employees. However the owner of a dwelling h use having not more than three apartments and ho resides therein, or the occupant of the dwelling house of anoth who employs persons to do maintenance, c nstruction or repair work on such dwelling house or on the grounds or buildr appurtenant thereto shall not because o such employment be deemed to be an employer." MGL chapter 152, §25C(6)also ates that"every state or local li nsing agency shall withhold the issuance or renewal of a license or permit to erate a business or to cons uct buildings in the commonwealth for any applicant who has not produced'acc table evidence of comp ance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7 tates"Neither the co onwealth nor any of its political subdivisions shall enter:into any contract for the performance f public work unti acceptable evidence of compliance with;the insurance requirements of this chapter have been prese ed to the contra ting authority." Applicants Please fill out the workers' compensation affidavit c pl tely, by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(e nd phone number(s)along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limi Liability Partnerships(LLP) with no employees other than the members or partners, are not required to carry workers' co ensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that thisffrdavr may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. lso be s e to sign and date the affidavit. The affidavit should be returned to the city or town that the application f r the penny or license is being requested,not the Department of Industrial Accidents. Should you have any questio s regarding t e law or if you are required to obtain a workers' compensation policy,please call the Department a the number lis d below. Self-insured companies should enter their self-insurance license number on the appropriate me. City or Town Officials 1 Please be sure that the affidavit is complete an printed legibly. The De rtment has provided a space at the bottom of the affidavit for you to fill out in the event e Office of Investigations h s to contact you regarding the applicant. Please be sure to fill in the permit/license nu ber which will be used as a.re erence.number. In addition, an applicant that must submit multiple permit/license app 'cations in any given year, need my submit one affidavit indicating current policy information(if necessary)and under Job Site Address" the applicant sh uld write"all locations in (city or town)."A copy of the affidavit that has beerllrll officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is oA file for fixture permits or licenses. A ew affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to a y business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to comp to this affidavit. The Office of Investigations would like t thank you in advance for your cooperation an should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and;f�,Jca number: � The Commonwealth of Massachusetts t 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.gov/dia I1z 09 From:MARK SYLUTA INS 5084209227 To: 15087906230 pATC(MMfuunr) D,W CERTIFICATE OF LIABILITY INSURANCE 00t03)2009 a THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Serial# 103846 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MARK SYLVIA INSURANCQ AGENCY HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 77. MAINSIREET ALTER THE COVERAGE Ar-FOROFD BY THE POLICIES ELOW- OSTERVILLE,MA 02656 NAIOS TEL: 809-428 d440 FAX: 609•420.9227 INSURERS AFFORDING COVERAGE✓ ` .: • INSURCR A FARM.FAMILY CAS.tJA1-TY INSURANCE CO INFJUREiI) . DOYL�8 TMOMAS CONSTRUCTION INC. INSURER B: P '166 INSURER C. Q BOX i INSURER D: CENTERVILLE, MA 0253E • IN9URfiR r. , COVERAGEs I Tt E POLICIES OW;INSURANCE LISTED BELOW HAVE!tjEBN ISSUED TO TW1:INSURED NAMED Af]OVP.FOR THE POLICY PCRI CERTIFICATE MAY DE SLUE DDING OR �cNY REe]lItRGMENi—TERM-OR-CONDI-T-ION QF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH Tests tv1AY PERTAIN;THE INSURANCE'APFORDEO-OY TH.E.P_QLIC�9 DESCRT9E0 HEREIN-1S-SUBJEC—T TO-AI,L—T-HE TI-RM5,_BXCLU810NG AND CONDITIONS OF SUCH -- - POLICIES,AOGIRLFDATq LIMITS SHOWN MAY HAVE?BEEN R13DUCED BY PAID-CLAIMS-- PO 1 F' Y P I_GY X T N. LIMITe 1.000.000 Iw ••• .TYPq Of INSURANCE' POLICY NUM013pt. EACH OCCURRIaNCL� S AC L+10 1Lr1 �n1 56 - SOs,o0O00 :at3N8RAI.6.AdILITYLRAL LIABILITY 2AO1X0465 07/21r2009 0721/201 0 COMMTRCIALOLN MEDRAP An ona mrgan C IMO MADM XOCCURPRloNA.h AOV INJURY 0 2 QbQ 000 GI NCRAL AOORfiOATR --- PROD4,IGTG•COMPlop AGG ? 2,000200 . OEN'L AGc;RnbATa LIMIT APPLIES PER X. POLICY P�91QF LOC COM131NGD SINGLE LIMIT q AUTOM0014E LIABILITY (ta 000idanQ ANY Al'1T0 ALL OWNFQ AUTO (Par Pa ton) g (Par aoroon). OCHCOULEP ALITOO HIROD:AUTOS ��DaL oidont�RY 5 NPN=OWNI D-Av TOG P(piOPE'RTY DAMAGE g (Pare..donq AUYO ONI.Y-pA ACCIDENT S ...,... aiA' Aar LIABILITY PA ACC $ OTHER N ANY AU't)0 AUTO OI LY .ACitl S DACN o.CDURRCNC! t EXCC66NMBRELLA LIABILITY AOG1RGpATE 6 OCGuii CLAIMS MADE L DQDUCTIDL® C IRITTENTION S X 0 d•' 2001W6380 07/01/2009 07/0112010 500 000 woRlcgli'scoMPelreArioNAND RMPLOYBR&'LIABIWTY fL GACIi ACCIDENT �. A�AGp.f A.('MPLQYE ANY PRQP III TORIPARTNCRr cCCV1iVE - _.,.- ---._.. _ _ :_ _„_ _ _ OPFICCRIMEMIMIR VC1,UDGD� Y�S OI.OICIIA(9R.POL.IGY 1-IMIT 6 500 000 II Yyvgi do6orlba unded 15P-'IA .PROVIEIO -below OTHL"R..... G` Dt aORIPTION OP OPCRATION61LOOATI0N5NCHICLUSIaKCLUOIONS ADDIIO BY CNDORS13MCNTISPUCIAL PROV16100 —1 p CARPENTRY L «, t-H� W4RKEaS COMPENSATION POLICY ODES NOT PROVIDE COVERAGE FOR TROY A THOMAS, SHAWN DOYLE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THfj ADOVD OnCRIDOO POI.ICIDI]OG CANCELLC'P p9FOR[?THH IXPIRATION OATI:THG COP,TI•le tSSUIN©.INSURER WILL UNPCAVOR TO MAIL DAYS WRI1l'EN TOWN OF BARNSTABLF, O NOTICE'Q 'H0 CRTIFI&ATE HOVXR NAMCD TO THE'LEFT.B1.11'FAILURF TO DO 00 SHALL BUILDING DEPARTMENT ATTN RALLY- ItdPC° •N 0ILIG1ATION OR LIAOILI' P ANY IND UPON TI IC IN9UIiGR,ITS AGfiN'fG GR HYANNIS, MA 02601 RFP Orr. T �' FAjQ 508-790-8230 JSD AUT RIZ e V O A RD CORPORATION 1826 AGQRD 28(2001108 -Roof to be stripped and cleaned of all old shingles and debris . -Roof to be papered with weather watch leak barrier and#30 felt paper, and installed with Timberline architectural shingles using galvanized nails. (Storm nailed) -All new 8 inch drip edge and pipe flanges to be installed -Cobra ridge vent to be installed on all ridges =Timberetex premium ridge cap to__be installed________-____-____ -20 yard container will be needed on site;and will be removed at completion of the job -Contractor will be responsible for all building permits needed at the property NOTICE REQUIRED BYLAW With the agreement of the contract$500.00 of estimate is due. Further payments under this contracture as follows: 1/2 of the"estimate due at the start; and remainder due at completion of the job. Balance of all materials and labor shall be payable in full upon completion of work described in this contract. Payment as agreed upon shall be made when due. Any payments which are delayed-shall-he subject to a finance chargeof-1.5 per month.---- - ----- - T - _ The contractor warranties the work completed under this contract for a period of ten year from the date of completion. During the stated warranty period the contractor shall be responsible for the service of the repair or adjustment, but the contractor shall not be responsible for the normal maintenance, repair due to abuse, misuse,and or normal wear and tear,which shall be the responsibility of the homeowner. All warranties for the materials supplied by the contractor shall be passed directly to the homeowner. The homeowner may be required to register or mail in such warranty card or evidence of ownership in order to activate such warranties. Homeowner failure shall not create any responsibility for the contractor under the warranty provisions;the choice of repair of replacement shall beat the --- ------discretion-of-the-contractor..-----=--=---=--- ---- ----------- ----- —=---—- -- --- The homeowner acknowledges that the form,content,and notices contained in this contract are intended to comply with the applicable portions of the Mass.General Law Chapter 142A, and regulations promulgated there under. In the event of any instance of non-compliance,only such portion shall be invalid and the remainder of this contract shall be in full force effect. In addition,any such portion not in compliance shall be read and interpreted so as to have its intended meaning to the maximum extent allowed under such law and regulation. Signed as a.sealed instrument on-this date: " Dater Homeowner MIACte/( ct. )6111V Contractor c� \ Board of Building IZcgulatro and Standards License or registration valid for individul use only {,W05 INI HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: Board of Building Regulations and Standards <l=1 Registration: 145954 g g Expiration: 3/15/2011 Tr# 282668 One Ashburton Place Rm 1301 Type: Private Corporation Boston,Ma:02108 DOYLE+THOMAS CONST INC TROY THOMAS 499 NOTTINGHAM DRY _ CENTERVILLE,MA 02632 Administrator Not valid wit lout signature Massachusetts Department (it'Public,Sat•ct% Board of Building Regulations and Standards: Construction Supervisor Specialty License License: CS-SL 999t3 Restricted to: RF,WS TROY THOMAS 499 NOTTINGHAM DRIVE CENTERVI,LLE, MA 02632 k4ti Expiration: 4/13/2012 ( , itimi i ncr Tr#: 99913 7 Sib a/SO% = 495 6P17 iood C-4Z, rA14K --� Tv ra4 n4 lG y FGau_, 3o GPD I�SE iotx> l� t PST `_ ,r"Na r Rlt(,*iARta i r- r 7*vP FA 4 , i LGa�r Ton" ?oP= 98 svatsor[ 4rPPE 4 rLae Et 9S /are G,o4 �Te rkt.25 �S4P77e- 9. /NO' [A-/eras �/ f tG 941so T,au r 97• .p 2.vJiu CQ 44 L EAG Al 14,,vet' cc= 94.r P�r Sr6ND LUl Ti� SA►a r3 t 0CATI O V-1 ,a© � a/t IA)4T�iQ. CMRTIP-[ 'rt-4A-r Ti-1�-.- FOvu-04T►©t4 500vuQ Pt_A.t..1 Rr_-F"EV-akic uEQCcs►..: COAAPL.VS Wl-r�-t T A i ,aura S�•raAGIG VC-QJ(rzGMia"T, OF T►-t N '-ow►.: c>P '$AV- 41STAB,- ��Au ooir_ lq�i �'ac�E I'rl . aEGtsrc.cz�n �".awo svev�.�{otzs 1 r-> IW OT L.-545�---V v�-4 A W �J 'Ttft c'.F�•,LT�, 5�{crc.��D AF�PLtG1J.hlT �1'r, C+r.rt�r�Mt EJt.:: tr_aZ l_i W -27 Assessor. map and'lot number`�-.—:.,...........�a:.:.... ' L/� CPTIC evc� r vvC vTEM M(!ST g� 1"STALLE� 7 I;� COMPLIANCe VV1T Sewage 'Permit number .............................. ........................... ' E 11 H A�T1�` 4, . �: , . ,_ SANITA..RY E STATE { , �, r TOWN OF B A R N.S T X' ' AND TO Ar. B,U1-LDIN'G ' 'INSPECTOR 0o iG"'Rain winnut, 39. e , APPLICATION FOR PERMIT TO ` ✓...!/ ��?�.� .......................................... TYPE OF CONSTRUCTION .......... .......... .......... .................................................... i- g ...... .. ....... .............192.7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: c Location ....... t� �`�! 1f�... .�6-. ..... ..... .............. ProposedUse ..... !?� �eR....... .Ate r../,/..... e........:.................. ...................................................... Zoning District ....... . .... .......:... �.4rZn ......................Fire District..... ?.... •r` °........./.�.j......�....�.....y.. �........... Name of Owner Address .......... Name of BuilderR ...Address ........... te!f.k� ..:.......:.............................. Nameof Architect ............... r -`.............................Address .................................................................•..................... Number of Rooms .7 ..........................Foundation ...trP.`r..A,2tws r-X:I/.. .............. Exterior .. ...".. ./.-f-`.. ��li LG ...:.Roofing ...... 41//..........'............................................ Floors .....01..- ............................................................Interior ......... .......................... Heating ..Q� 511 ......G.V..c x-110(.......We..............................Plumbing .....Ave.........�`. ................................................ da�v Fireplace ...... ................................................................Approximate-Cost ....C>:")....................................................... Definitive Plan Approved by Planning Board ____ ____ _______19----y Area ...n.((;?.... ............ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 (0 to I hereby agree to conform to all the Rules and Regulations of the Town of.Barrlstable regarding the above construction. . Name f1�.. ../�f/ iG��: ..P.��J.�................... R. Arthur Williams, Inc, # 19422 one story Nei................. Permit for .................................... k'�,Z—"single family dwelling ............................................................I.................... Location-.......patriots ............. ................ .... ................. Centerville.......... Owner .........R.....Arthur.xi.l.lia...ms.,.JRc,,.. K", A j� , .. . .... ... .... .. . . ...... .... Type of Construction ......... ..................... ............................................................ #9A Plot ............................. Lot ................................ July 22 77 Permit Granted ........... .. . ..................19 I Date of Inspectio'n .......... Date Completed ... .... 19 PERMIT REFUSED ................................................................�.'i 9 ............................................................................... ........................................................... ................... .7 > ................................................................... ...... LApproved ..........................................:...... .19 V .................... ............................................................................... 00 1..1Op