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HomeMy WebLinkAbout0039 RAYMOND STREET 413 - h , G Application number-;:.zal .... . ... tillFee........................... ' ............. r ¢ _ i g F SuiId•n Inspectors Initials... ............... i J ul l-' 2 4 20�0 •�!9Date Issued....21 . Map/Parce-71 ..'k............... z..... . . .... � �...1... TOWN'OF BARNSTABLE t t r EXPEDITED,PERMIT APPLICATION: r 4 ROOF/SIDiNC-M".NDOWS/DOORS/TENTS;STOVES,'XxTE ATHEP.IZATIONT .- '.`'PROPERTYJNFORMATION Address of Project: NUMBER , STRE T�hone-�umberVILLAGE Oc�ner's Name: � w Email Address: Cell Phone Number a9 t Project cost$ �t � Check one Residential Commercial . ". . -- ,OWNER'S.OWNER'S AUTHORIZATION As owner•of the above property I'herebv authorize to make application for a building permit in accordance with 790 CMR Owner Signature: _ Date: TYPE OF WORK -. t . /..i ". ,; . +4 � ,ey.'a.' • + fad i. -.w.. � ! .. , ., '�. '� SidingfWindo«s(no header change)# Insulation/VG+eatherization ,. ,. .. oors no header change)# Commercial Doors require an inspector's review.,, oof,(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOWS INFORMATIO v ., .. Contractors name .T % t a �� uoi:le Improvement Contractors Registration(if applicable)'# `, (attach copy) Construction Supervisor's License # Q ;—t S (attach copy) u Email of Contractor d,-fQ hone number ALL PROPERTIES TH T HAVE STRU OVER 7S YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPRO VAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) 4 �. Dimensions of each tent X •X X Additional'tent dimensions can be attached on a separate piece'of paper. Purpose of Event Check one:this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4.30pm.Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. J Fuel Type Testing Lab Offsets from combustibles: front back left side right side j HOMEOWNER'S LICENSE EXEMPTION Homeowners Name: Telephone Number Cell or Work munber 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'S SIGNATURE Signature Date All permit applicahions are subject to a ba�ilyding official's approval prior to issuance, • Mr ' f POSSIBLE EXTRA CARPENTRY: Any rotted or otherwise deteriorated trim boards, plywood sheathing,missing metal flashing,side walling or any other carpentry needing replacement will be done and charged for as an Extra: materials plus labor at the rate of $60.00 per hour. 0 PAYMENT SCHEDULE: A deposit of one half is due at the signing of this roof proposal and the final payment for the balance is due immediately upon completion. WORK SCHEDULE: All roof work is normally scheduled for completion within 30 days of acceptance and receipt of deposit providing the materials are available. C Please Make Checks Payable to: HxTech Roofing Solutions HyTech ROOf ng SOluhOnR- . ties-the-,Shingles and Labor for 20 years. CERTAINTEED Warranties the shingles and lafivr 1001/6 for a Erst 10 Years and the Shingles your 1 IFETUvM—the shingles bec zt ies defective. CERTAINTEED Warrants the YShingles'up to a CA'TE3RY.III HITRRICANE-130 MPS WIND WARRtN F1' - CERTA�Il�`1^EEH Warrants the$lungl�s to Ile Algae-Resistants: - - H TeGh_Roofi -------- ng Solutions -Carries Workman's Compensation`and Public I�iabilify Insurance on the above work _.`Handles all permitting and planning involved with the above proposed work Za cerh�ed�arectly by Cez�tax�tee� _and processes all Vvarrant�pap�rwoi�C in�.t�vec TOTAL INVESTMENT: (Enter TTottal Amount Including All Selected Options) DATE OF ACCEPTANCE: ACCEPTED BY: SUBNUTrED BY: am ou o Pa ck Cli rd—Alex Yaskavets MA CSL license 105951 ` MA HIC license 184383 X ... Office of Consumer Affairs and Business Regulation One Ashburton Place-Suite 1301 Boston, Massa�iusetts 02108 'Horrle improve _� or R�istration. .. Tye LLC HYTECH ROOFING SOLUTIONS LLC. "MaUMMU 184383 12 BALDWIN RD 602ftr 0110VAM DENNIS,MA 02638 scA l o2OM4M7 1.1pdateAddresswO Return Card. C�/� Memosuc�a�//j c��7/lauocr�asella . Offeae of cmasumerAffaft&Business Regulation HOME IMPROVEMB f CONTRACTOR Registration valid for uufividual use only TYPE:LLC 6ekwe the wTkahon date. if found return to: Omh ation Office of Consume Afrairs and Ibmtess Regtdal m 10 Park Raza-Suite SM HYTECIi ROOFONGSOLUTIONS I.M. Bin,MA 02116 00, PATHICK CLIFFORD rl 12 BALDWIN RD DHHMS,MA 02M UndwsecreWy Not valid wffltout signahm Cortmtonweaith of Massachusetts Division of Professionat Licensure Board of Buiidinq Requlations and Standilrds ConstructigJIS'3pilvisor Specialty CSSL-105951 Qxpires:06/02/2020 PATRiCK CL&FORD - 12 MLMM ROAD DENIM MA 0263_B Commissioner ti./""' I ' The Commonwealth of Massachusetts Department of IndustrialAccidents I Congress Street,Suite 100 Boston,MA 02114-2017 wwn:mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. ApOicant Information Please Print Leeibly Name(Business/O rga nization/Individual): �Q ^ �Q Address: I oC 1 n U City/State/Zip: S'4 59 Phone#: P�Q� �-� 4(T-j Are you an employer?Check the appropriate box: Type of project(required): I.❑I am a employer with employees(full and/or part-time).* 7. New construction 2❑I am a sole proprietor or partnership and have no employees working forme in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10❑Budding addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions p prietors with no employees. 12.❑Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet ese sub-contractors have employees and have workers'comp.insurance.$ 13. ,N repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.EJOther 152,§1(4),and we have no employees.[No workers'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. $Contractors 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: a" Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Cu^,-eryi l U.., Attach a copy of the workers'co a sation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.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 and of perjury that the information provided above is true and correct Si ture: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town of ciai, 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 # k h 4 v CERTIFICATE OF LIABILITY INSURANCE DATE03/19/1D9 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT'S 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 have ADDITIONAL INSURED provisions or 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 endorsement(s). PRODUCER _} LAJN NAME; PAUL SCHLEGEL Phoenix Ins LLC al 1 o ER T81d363024 FAX 8WYMANSTREET No 781-436-5754 STOUGHTON,MA 02072 ADDRESS: CERTIFICATE@_PhoenixlnsuranceLLC.com INSURERS AFFORDING COVERAGE NAIC# i INSURER A: A.I.M.Mutual Insurance Company INSURED INSURERB: TELAMONINSURANCE LEWIS SM CONSTRUCTION INC INsuRERc: 34 MARKET ST BROCKTON,MA 02301 INSURER D: , INSURER E: a I 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 MAYBE 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. INSR LTR TYPE OF INSURANCE POLICY NUMBER (MMI MM/DD LIMITS JAUTOMOBILELIABILITY COMMERCIAL GENERAL LIABILITYEACH OCCURRENCE $ 1,000.000 CLAIMSMADE �OCCUR PREMISES Ea occurrence $ 100,000 MED EXP An one erson $ 5,000 TBD043325 PERSONAL&ADVINJURY $ 1,000.000 'LAGGREGATELIMITAPPLIESPER: GENERALAGGREGATE $ 2,000.000 POLICY❑JECT LOC PRODUCTS-COMPIOPAGG $ 2,000.000 OTHER: } $ Ea BINEerDitSINGLE LIMIT $ _ ANY AUTO I BODILY INJURY(Per person) $ OWNED. SCHEDULED BODILY INJURY Per accident $ AUTOS ONLY AUTOS ,E ( ) HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY - - Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION - PER- QTH- AND EMPLOYERS'LIABILITY YIN• STATUTE I ER ANY PROPRIETORIPARTNER(EXECUTNE E.L.EACH ACCIDENT $ 1,000.000 B OFFICERIMEMBER EXCLUDED? w�A VWC10060236932019A 03/12/19 03/12/20 (Mandatory in NH) { E.L.DISEASE-EA EMPLOYEE $ 1,000.000 dyes,describe under DESCRIPTION OF OPERATIONS below - - E.L.DISEASE-POLICY LIMIT $ 1,000.000 I ' DESCRIPTION OF OPERATIONS I LOCATONS I VEHICLES(ACORD 101,Additional Remarks Schedule;may be attached if more space is required) FOR OPERATIONS COVERED ON INSURED'S POLICIES. f HYTECH ROOFING SOLUTIONS IS LISTED AS AN ADDITIONAL INSURED. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN HYTECH ROOFING SOLUTIONS ACCORDANCE WITH THE POLICY PROVISIONS. 12 BALDWIN RD DENNIS MA 02638 AUTHORIZED REPRESENTATIVE HYTECH ROOFING SOLUTIONS OLIVIA ELLIS ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD Assessor's office(ist Floor): r //'' r, �f Assessor's map and lot number AAp ."�`t 6 �T a� 00 I INS LVq � � f$d ����� Q�oSTWCTo`` \ Board of Health(3rd floor): WITH TITLE 6 Sewage Permit number _P Engineering Department(3rd floor): y> —� ENVIRAO,AN'pM� ENTALpCODEp AND = DAHd9TSDLL TS/YgO� �wl�L9Si®�®N�Aa7 rus House number: '- °o Faso• Definitive Plan Approved by:Planning Board . APPLICATIONS PROCESSED 8:30-9:30 A.M.land 1:00-2:00 P.M.only z TOWN OF BARNSTABLE ; p : BUILDING. INSPECTOR APPLICATION FOR PERMIT TO a TYPE OF CONSTRUCTION 0Q Yffn, e— { l i Ma�G� o 19 � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 3_l Raua4-ovLJ 5•4-1-ee4, Cec+�ryf ,lCe CWt5-f 14ya c[`s__ 02yr } Proposed Use Dec (— Zoning District Fire District C 0 M Name ofOwner�� IN I`k1U�� Address3� Rayvy�oncQ S�� Ct?r.I V`v[ I& Name of Builder lP,nb C64 XG0 ffo Address37 Qtot 5- 'VQC E Name of Architect t at. Address V� a Number of Rooms yy,, a, Foundation r Exterior PO`2,SSV rp— -re +&J U/-OO l Roofing a Floors Interior Heating Plumbing Fireplace Approximate Cost 41 000,00 Area Diagram of Lot and Building with Dimensions Fee �� + R0.y�dl, S� C Paper n I 36 �{vvs� Ft0I a)(10 (a) 00 dye P - � 44 x q (8) PX4 Decf� �'5 � $" fit' oG �ee�F 6lcrl� ou- soko `fv�E, Deck "lq X V'l as keeled Rai 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 &J Xvt T Construction Supervisor's License h HOUGHTON, T.DAVID No 34243 permit For Add Deck Single Family Dwelling Location 39 Raymond Street Centerville Owner T. David Houghton Type of Construction FRame Plot Lot Permit Granted March 29 , 19 91 Date of Inspection 19 Date Corgeted 19 .:4 CS ...t «ia � a, Assessors map and lot number 246=21r„(Lots`;.40 hl ouch 45, inclusive) �osTNEropy Sewage Permit number ............ ........�ltL(/h... .... ... . .. : d`' °� BJHH9TADLE, r" r :., �A ...a 'oo tb a House number . e� r` T.O``WN O F: BAf1 , STABLE{. r e; �teb. ' BUILDING INSPECTOR APPLICATION FOR PERMIT TO ... QNSTRUCT:. ......... .................... ....... ........................................ TYPE 6 CONSTRUCTION NAK.5lYaale...Family...Dveli-in1 ........................... Januar 1 r ...........Y...... ...................... .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for_a permit according to the following information: Location fit!y!p©nd..Street, Wept„TIX Int s:: 4?'t . :...: :...............:............ _Proposed use n le f ilx..dwell.? :................................... ..................................:.. t _ Zoning District ...........RB.............:........:............ ...............Fire District Cente.X.'.viele.-Osterville.................... _ T. David Houghton Pamela K. Hou ht Name of Owner ..... . ......g..t.=...................,..Address Name of Builder :........:QWnq.I"................................:...........Address ..................................................................................... Name of Architect ..........? .s.AR....................:....:.....................Address .......................... Number of Rooms ........1.0.:.......:................................... ......Foundation ..C.On1CT.Cte..................... Exterior .....WQOd .............................................................Roofing ASphalt...sh.-Ingle............................................. Floors .........QA .............. ...............................Interior ..Sheetr oak .::................................:. ... Heating GQ a-Rii.... .... ......... ........ ..........:....Plumbing ......... .Go Q ` :.: f..� :.11 ��:. ...... L P Fireplace br..i.Ck..... ...........:...................................'...............Approximate. Cost, .. jOy.O0O..0a....................................: Definitive Plan Approved by Planning Board nya_r____------------------19______--. Area Z,.,*00D...,sq....ft.......... Diagram of Lot and Building with Dimensions Fee. ..I/.©..... SUBJECT TO APPROVAL OF BOARD OF HEALTH. d� 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 .. . ...... ....... ' Construction.Supervisor's License .... t HQ GHTON, DAVID & PAMELA A- 27821 Two Story No Permit for . ........... s T4 Single Family Dwelling ............................................................................... ° r Location .. . ,3.9 Raymond Street L � { J _ c West T t _; _.a , �,. Owner ...•.David :& Pamela Houghton - ' • 5 T s }' Type of Construction ..Frame..... ................ ., C: ...... , ........................................................ Plot1' 1� ... ........ Lo .........� .....{. ......... P .z � i.Y !!l.•���/LLLf..._Ai •t' Y` F .-. rc. L.' F`� ' • s Q .— April', 30 , 19 85 Permit Granted Date of Inspection ..1-9 { Date Completed .. ... ;19j— 9 S I ' TOWN OF BARNSTABLE Permit No. Building Inspector e.u°r.n Cash OCCUPANCY PERMIT Bond Issued to David '& Pamela Houghtort Address 39 Raymond Street Wci t ly al_ spw Wiring Inspector `� ^�, j!/i r! Inspection date / Plumbing Inspector � Inspection date Gas Inspector r;/ Inspection date Engineering Department 0001", I 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. -cam Building Inspector 3y . Z e RICMARD A. ti 13AXTEFi No.24048 / I �1STv9A®4' 1 cE,eT%��Eo oar oXAAI .L6G.47-/diC/ i�/y.�IiYit//5�,��" .. .Hf./f�.ems/ ��.c:C_�'✓ �,_.5'� .!G'�st.''+�..�',,�' .»�:...-i' SCALG— AA 15,4,07- c',rr�'•E t..��'s5/r', ' �.0.4 it! .2E�'E.2�it/C� �- f�a� OATS:�` _ - - t,.,,( � �,t s•`�. .BA XT.E,2E I' NYE/NS7-,eUivlE�t/T 0.�,4s-FTS Syalt/y s/-/ovL� ,c%T 8� • �'l.4SS. T � _ 3. � t t, x too �— - 3cz1 z. Alo IA15 Femot, Tov-jo G a tk .� Top T. y � � i3ii, tit , r F u �NtQ?Ll CUT ...� Is1 jam,, 9e. �`���` 1 ��itllf�d � P"►'.'�..r W�t..� ���' ��,,,�' ° ;i� 9' � �4a. i! � ,`� ° '�` ► - �'-�= SDK - - Zc.. �x C.. ��M/'y� �/y •/� S jam.` K /1n. e WE PL/4 .83 40