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Home My WebLink About0790 PHINNEY'S LANE 5 avlou M"i 'a "r�,�t Moves "NO k"O -F_4y, OR MO— fir ��R Ig- -111.11.1il,."""�,��,��,,��",Oj��.-,"��".?�,,,.�?,, 1-1-1---1 K, ", I W .03f Igm -q— W V U, gw, 'All'' gov R, Al F4, ymm--d OWN, q— tn". vN 451t,"Rv�%,11;ellll �lkj7,111 77 AR MW_ p qf! Ali ry VAN 1 Ix"'i.1, .. I N_ < vallay, MST Pam-J-4- jW NENi� A Yg Yaw— TO N,_lll", g i4 t i-A NNE. NU SW N RAWT&MMY", 1, 01 Y�4 "if CA "UIPIM �k �j ,g , " It *,q-p M j vx Numv any 1 v- N Ann pneinm "s, Igo VMS M. NPI Q MUM we, -7-7 7,7,77", q V, MO -just W v RI ry OWN REFEN N MIN rg- ,4F�,' MIN! All, Ng 1021 `!,�,Z'4 Iq ZEA jkge Y'R Mitt 9 , , r Town of Barnstable *Permit# � � >► 1 4 � � Expires 6 onths from issue d 111E 'Regulatory Services Fe ' Richard V.Scali,Interim Director TOWN 0 °` 9"� 3 ABLE 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 ^^�� VC) Not Valid without Red X Press Imprint Map/parcel Numb�r�f� Property Address A9 N Ec io -e Residential Value of Work$ d oo 300•C5 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address �f r� Q Nrd A1,,J('Pq•P4eaT ,�Q } Contractor's Name kA A C`,.o� Cvc\AW) Telephone Number 11-1,00..ML9 V4% Home Improvement Contractor License#(if applicable)_ 1�DJ Email: E2� �i-►�/�G C6 d`� Construction Supervisor's License#(if applicable) (!,C-.-)- ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name .A E� Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit R;Re-roof t(check box) e-roof(hurricane nailed)(stripping old'shingles) All construction debris will be taken to4l�(hurricane nailed)(not stripping. Going over existing layeis of roof) e-sideeplacement Windows/doors/sliders.U-Value _(maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. •Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: . Property Owne must sign Property Owner Letter of Permission. A copy of the ome Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: TAEVIN Muilding Changes\EXP S PERMITAEXPRESS.doc " Revised 061113 eesusraaL& _ MASS.39. Town of Barnstable Regulatory Services Richard V.Scali,Interim Director Building Division Thomas Perry,CBO 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 as Owner of the subject 1 property hereby authorizee(l A4 1 � to act on my behalf,(� in all matters relative to work authorized by this building permit application for: ii rV I`P 7qC) �hIan3zVS Lti � Cer�� (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. TAKEVIN Muilding Changes\EXPRESS PERNPEXPRESS.doc Revised 061313 l 4Client#: 16665 2MEAGHERCO TE(MMTE IDDIYYYY) (MM ACOl�D- CERTIFICATE OF LIABILITY INSURANCE DA015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endomement(s). PRODUCER CONTACT NAME: Dowling 8 O'Neil IFAX ac°NE :508 7754620 Insurance Agency E-MNIL ac,Nc: 5087781218 ADDRESS: 973 lyannough Rd., PO Box 1990 INSURER(S)AFFORDING COVERAGE NAIL a Hyannis,MA 02601 INSURER A:National Grange Mutual Insuranc INSURED Meagher Construction Inc. INSURER B:Associated Employers Insurance Timothy Meagher INSURERC: 776 Main Street INSURER D: Osterville,MA 02655 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILNTSRR TYPE OF INSURANCE ADD SU POLICY EFF POLICY EXP INSR WVD POLICY NUMBER MMIOD MMIDD LIMITS _ A GENERAL LIABILITY MPT125OG 0/16/2014 1011612015 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY PRE TO RENTED PREMISES Ea oca,rrenca $500 OOO CLAIMS-MADE OCCUR MED EXP(Any one person) $1 O 000 PERSONAL 8 ADV INJURY $1 000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMB Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$___ $ B AND EMPs COMPENSATION WCC5050054422015A 6/23/2015 06123/201 X WC STATU OTH AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE Y/N E.L.EACH ACCIDENT $1 OO OOO OFFICERIMEMBER EXCLUDED? 7 N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100 000 ff yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $500,000 T. DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,ff more space is requheM Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed.to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S1533401M153339 CBD The Con:ntonweaNk of Massachusetts Departanait of Indusoial Accidents Office ofIm�estigations 600 Washington Street Boston,MA 02111 nwi mass g 1dia Workers' Compensation Insnrance Affidavit:Builders/Contractors/Electncians/Plumbers Applicant Information n Please Print 1*6bly Nate Musinesa101ganiZat mUdteiduall= Address:-1-1�p "C11Z f)�jegt City/State/Zip: \ Phone 4 -L Are you an employer?Check the appropriate box: Type of project I am a general contractor and I p ]ect(required): 1_[�I am a employer with�_ 4- ❑ g employees(full andlor part-ime).* have hired the sub-contmetors 6. E]New construction 2-❑ I am a sole proprietor or partner- listed on the attached sheet- 7- .❑Remodeling ship and have no employees These:sub-contractors have g- ❑Demolition working for me in any capacity- employees and have workers' [No workers'comp-insurance comp-insurance.1 g• ❑Building addition required-] 5. ❑ We are a corporation and its 10-0 Electrical repairs or additions 3.❑ I am a homeowner doing all woric officers have exercised their 11-❑Plumbing repairs or additions myself[No workers'comp- sight of exemption per MGL 12.❑Roof nepaits insurance required.] c.152,§1(4),atld we have no employees-'[No wodms' 13_0 Other comp-insuranoe resluiral *Any applicant that checks box,il must also fill out the section below shoving their workers'compeamdonpolicy inforination- Homeowners who submit this affidavit indicating they are doing an work and then hue outside contractors ma suhmit a new affidavit indicating Stich- =Contractots that check this box must attached an additional sheet showing the nsstie of the sub-csmnacmrs and state whethu or not those entities have employees. If the sub-contractors have emplogees,they mnstprovide their workers'comp pah yaumber- I.atn an einpZoyer A&is pmidWg wroAan'mngmuadott insurance for any amployeeL Below is thepotiey and job site inforniddOt6 Insurance Company-Name: Policy#or Self-ins-Lic- _%C 6 LV3l Aq )-Z b r y'M Expiration Date_ Job Site Addtexs_ :79 o &r.Jr,)f*S L N Citylstatelzip. f l,y eT a , HA 0(963 Attach a copy of the workers'compensation policy declaration page(shoeing 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 andlor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDERand 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 verifcatiorL I do hereby ce - FBI to pains and penalties of perjury that die information pmided above i hue and correc.t Signature- Date: Phone#: . - it - • ®G- Official use onty. Do not write in this area,to be completed by city or town officiat City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Budding Department 3.Cityflown Clerk 4.Electrical Inspector 5.Plumbing Inspector 5.Other . Contact Person: Phone#: 9 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-102260 NUCHAEL S MEA,GHER 97 EMERALD LANE Marstons Mills MA 0264p f Expiration Commissioner 11/05/.2016 r (921e(eomircz6,9c v C',�t, a C/G`aaarcc/craelll { Office of Consumer Affairs&Business Regulation # G(YOME-IMPROVEMENT CONTRACTOR E 1 Registration 162938 Type: Expiration: 4%27/2017 DBA ' MEAGHER BROTHERS CONSTRUCTION MICHAEL MEAGHER JRT' 97 EMERALD LN t MARSTONSMILL,MA 02648` Undersecretary " 1 1 Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991M )of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS License or registration valid for individut use only before the expiration date. Office of Consumer If found return to: Affairs and 10 Park Plaza_ Business Regulation Boston S e 5170 Boston, 6 Not v `d W1 hout signature ' i I