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0933 SHOOTFLYING HILL RD
q 3�� �� �0�--�f ; .t���:tT�. u . � . .} . _ . � .1... x. — ._ � ., • _ .� �. � .. ._ .� p C, c ., p .. � �.' 1 -. _ _ �. - ,. .. - - � * �t�,�,y Town of Barnstable Permit Building Department Services Erpires6ma�seer issue date sAxxsrestE. : Brian Florence,CBO Building Commissioner ArFD MAr�' 200 Main Street,Hyannis,MA 02601 ' www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMT APPLICATION - RESIDENTIAL ONLY III D Not Valid without Red X-Press Imprint Map/parcel Number ( �-v Property Address ��� a l7/d�7� �/� / iYo [Residential Value of Work$_ X,/.750 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 4 ;11/�t J Contractor's Name �► 5 Telephone Number SA° ?C:Ay /dj,� Home Improvement Contractor License#(if applicable) 0,PM,% Email: Construction Supervisor's License#(if applicable) /o S'%2A orkman's Compensation Insurance Check one: ® (t ❑ I am a sole proprietor 1� ❑ I am the Homeowner have Worker's Compensation Insurance AUG 2 5 2017 Insurance Company Name ✓t-I✓� M� Cam � . T I J����� ARI S ABLE Workman's Comp.Policy# � G✓8�J -� Copy of Insurance Compliance— Certificate must accompany each permit. Permit Request(check box) l� ne-roof(hurricane nailed)(stopping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stopping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: •Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is, required. SIGNATURE: Q:IWPFILESTORM%building permit forms\EXPRESS.doc 08/16/17 �O ,.�/] The Comm.mornrrea *gfMasYarJruxd& DVa rfrnent of r strid Accidews . . 600 Washington&hwet Boston,CIA 02M unnunurssgOvIdia Workers' Campensaftan.Iuswauce Affid viL SuRder-dCianfractanMectucians/Phmihers AppUcant Infwmm ion �f Please Prim Leg ify �3II1B�$�attt7ah 'tbn;rS�_ M.�1t /�J�►''C . Adliresr 6 l CifyfSfiaxet Plao �' Are 174n employer?Checkthe appropriate bum ' Type of project(rued}: L. oyer < * 4_ I am a general contractor and I ❑ 1 empl yeesp(full a Nor part-ime)-* ❑Iiave luredt ie su'r-coal 6. New coustruction 2.0 Iam a sale proprietor orpartner- listed asthe attached sheet.. 7. ❑Rmodehng These sob-c=trac.tors have drip and ltat�e as employees. 0❑Demolitioa kv rynv forte is anytg: ernp layees andhave wodwrs' 9. El S.uifding acidities INo vv domrs! comp.insurance colop-mertran $ rued] 5- ❑ We area corporafionand ifs 10-❑Electrical repairs or adds ions 3-❑ I am homeovmer doing all work officers have exercised their 1L❑Plumbiagrepai s or additiora. M.Y {7�� per MGL Self':L`p Y�dr10ELS'i�I�_ "�"�on 17`.❑Ito dfLep31L'S . inm ance required j y c.152,§1(4k andwe have no employees_[NO woane&. 13.0 Other cow.mmranc;e required_] r�ayapg�i�d�atched3baa�lma>xaLafi7lv�thesectioabeTnm�nsdng�he-sa�orkess'comp�satinupoTicgi�v�sao� , Ho�evmaetswhe ssb=ft dais sffidav!=&citing d ey am&=.v zUwa t mi0=bim mtodecontma=amst.snft�tanem�da�t indieaaa;mob-' fCoatme�bs3�st c�ecX*h b=must attadmd maddiff—A shad siwuzagthz=ne of the sub-cam =.=d statmbeflm arnotrbnse eoritiesbm em,fl yeas.Iftheavbrtoat xdamh ce employees,they�rrtpmr�de#i»trarkrss'tamp.palm mmabrvL I am am empiapr dint;is pruurrdig,workers'caugrencrat`tant inutrancefor my empfvy yes. Maw is Atrpoiicy rud je8 sAs innf-ormathm hmaraacee Company Name: /`�gy m ✓f/�i / P ficy or^pelf-irns.I ia_ cveol l.J ti 63 3 FkpisationDate: Job RteAddt p�gad CiEyIS#atetrsg: �I1 0MPJ-, Attach a cop} arfthe workerse coanpensati n policy declaration page(showing the policy number and expiiation.ante). Failure to seomm coverage as required under Section 25A of MGL c-M can lead to the imposif' of criminal penaltes of a Ene up to$l,5aa OU andtar one-year imprisonmae�A as we:Il as civil penalties in the fame of a STOP WORD 01MERand s fne of up to$250-00 a dap agggainst the violater. Be adiised that a copy-of this statement nmy be farwarded to the Office of In-esfigatimoftheDlAfmifls mce coverage vdfrcatioa. ...Id'aherebyGw-qy-uxdcrrthepainsanndpawh&sof•gem}!tfl&Meircfarnza#ivrl•provu dJabowistrmandwrred Sit�atare• .�/l�" Bate: �T''"df''for 2 Phone t?,Ukitd tree asnTy. Do not write in tfds area,ter 8e cmnpkted 5g Gay amen li official ' City or Town: Perm tT.&ense: Bsving Authorit3r(drde one).: L Board of Health 1 Building Department S.fit—Town Clerk 4.Electrical Inspector S.Plmmibmg Inspector 6.Other Contact Person: phone#: — -- - --- 6 an ructioUs laformation. d last hj=sa���GGE<n�aal Laws chapter M rDgm=all employ=to provide worlzs'�=Md=fur their empIoYDM 3 Sys ,an avLV=is defined as.¢;cMYPeson in.tiie service of another ender any cordract of1>ae. express or implied,'oral or wln=-" An_ezrV&7y w is defined as"an ind v dmLt p��,asso®lion,corparation or other legal at1iy,or any two or more of the famgomg=gmged is a Joint ,antiincludmg tiie legal relaesenfafies of a deceased employer,or f6ie recdM or trustee of an fivffVid=L per,association or o{iimIegal may,=pl-0Ymg=3ploY=M- gowevr-r then owner of a dwelling homse I�avmg - - or the o of the- notmore than three aQartmenis and�ho resides•d�etP.m, dw eIIiag hnnse of snot =who euzploys persons to do ,rnneftnr ion or repa>z wow on such dweIImg hoase Abe deemedt o be an.eIploye�" e � or ur[r��theretn shaIlnolbecause ofsucliemploym or on ih gro � - old ffi e iSslQarice or � MCrI,cd�spter I�Z,§25C(�also SAS tj]at every sfafe hr IaC31TicPn�agency shah wrtiih -. renewal of a ficeme,or permitto opmzfe a business or to consiract bmldiags in the commorrvPealf3i for any apPlrrantwlio has not produced acceptable evidence of cdmplianm wrM the; zuraace.rnVerageregairred. Addiltio ,M(M rbaptn£152,§25CM states-Neither file nor my ofits political subdivisions shall an - e' ce. deuce of Iiancewitb.ih msurdn tetra ct for the Banco ofpublic evoric until acceptable eve comp - e�ink any P req==erfr of•fb r32ptPahavebeenpresentedto$ie cordr�.auffi.oiity:' AppIic-an-LS ., Please fill oirt file Worker''compensation affidavit compleinlY,by g the boxes that zpplY to your 511naiian and,if n �Y,�pjy s6-contxactor(s)name(s), addresses)andphonermmber(s)aIongwitlttbeir s)of insraance. LimitedI-iah y CoaiPames(LLq or Liited.LiabilityPmtat ishiFs(LU)•v9�-no e�loY�OtTier than the members or parfncis,are not rimed to cdny wotlo&compensation ins ran ce~ If an LLC or LLP does have employs,apolicyisrugmired. Beadvisedihat this affidayit maybe sabmixtedto the Deparfinentof Indnsfzial nffimation of insmFnoe coved Alsa be sure to sign and dafe 6e zMda vi t The affidavit should Acciderds mr co be•r• round to he city or town that the application for the pe=ft or Iicense is bang recjaestetl,no t the D epazfiment of e Ln3nsf ,al A_=dmtg- Shouldyon dye any questans regmdmg the law or ifyou are reed to Db inin a v,�ozirers' compensation poricL please call the Deparimm±at tine nnmbes listE below. seif-incised companies sb ouIci entry their s eif->nsaraa ce Hc,=se number ao.the appropriafe Ime. City or Town Offlicials f Please be sore that the affidavit is complete and pried legibly. The Department has provided a space at the bottom ofthe at�d3v]tfoT you to fill out intha event the Office oflnvestigafions has to Contact you regardingihe applicant_ Please be scneto fill mtiiepen�' censenrmberwhichwi]lbe used as arefr ncenomber.Inaddition.anagplicant t3gt must mbmiL multiple pem�cense appHtafi s m anp e=yew,need only sob it one affidavit indicaL cuu�t policy information(if neces�y)and under"Job Qs"the applicant should write:�aII locations in (�Y Or A copy of 1he-affidavit that has been officially sfnmped or marred.by the city or town maybe provided to the applicant as proofthat a valid affidavit is on file for fcdnre permits or licenses A new ai-5.dav±must be:filled out ra ch year.glIieae a home owner or citizen.is obtaiII ag a license or peamit not related to any business or comet a rcW Y&Of= - (ie;_adog license or permit to bum leaves eta.)said person is NOT re� �to complete this affidavit The Office of In 'nn wouldIlketo fl ankyouinadvance foryour cooperzdonand shouldyon.have any4�cM. please do not hesitate to give us a call. The 13epa rim e�f's address,telephone and fax number: Depaxbnmt c6f1 �� a 6o-nsMA 0i1II Revised424-07 - g�gfdm ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) �./ 04/25/2017 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 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 CONTACT Mark Sylvia Insurance Agency,LLC PHONE Heather.Pearce FAX 404 Main Street c' a :t 508 957-2125 A/C No: 508 957-2781 Centerville,MA 02632 ADDRIESS:mark marks Iviainsurance.com INSURERS AFFORDING COVERAGE NAIC f/ INSURERA:Farm Family Casualty Insurance INSURED INSURER B: Thomas Home Improvements LLC INSURER C PO Box 177 Centerville,MA 02632 INSURER D: 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 CONTRACT OR 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. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP lIMl79 LTR POLICY NUMBER MM/DD/Y MMIDD/YYYY A X COMMERCIAL GENERAL LIABILITY 2001X1416 5/01/2016 5/01/2017 "EACH OCCURRENCE $ 1,000,000 OCCUR 5/01/2017 5/01/2018 DAMAGER CLAIMS-MADE ED PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER-- GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- ❑ JECT L.00 PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: ' $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ [� D'ED CESS UAB CLAIMS-MADE AGGREGATE $ RETENTION$ $ A WORKERS COMPENSATION 2001 W8053 5/01/2016 5/01/2017 ' AND EMPLOYERS'LIABILITY Y/N - 5/01/2017 5/01/2018 ST TUTE .ER ANYPROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ 1,000,000' OFFICER/M EMBER EXCLUDED? ❑Y (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Carpentry 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 Troy Thomas ACCORDANCE WITH THE POLICY PROVISIONS. 499 Nottingham Drive Centerville,MA 02632 . AUTHORIZED REPRESENTATIVE a ©1988-2015 ACORD CORPORATION. All rights reserved ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD THOMAS HOME IMPROVEMENTS I.I.C. PROPOSES TO PERFORM THE FOLLOWING WORK: Location of proposed work: Ms. Caroline Reed 4 933 Shoot flying Hill Road Centerville, MA 02632 Date on which construction should begin: June/July 2017 The homeowner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that cannot be.avoided by the contractor shall not be considered as a violation of this contract. The contractor agrees that when such delays become known to the contractor,the contractor will advise the homeowner as soon as possible. The homeowner hereby acknowledges that in certain remodeling work,the demolition process may reveal defects in the existing structure which must be repaired,creating additional work which may need to be carried out in order to complete the work described in this contract. In such case the homeowner agrees that the duration of the work and the schedule date of completion may differ, and that such variation is not to be considered a violation of this contract. Cost for labor and materials under this contract: $14,250.00 30 yr.GAF/Elk Timberline HD Architectural shingle (Life Time Limited Warranty) In the event that while stripping the roof we find rot that needs to be replaced,the homeowner then has to agree and authorize any replacement or restoration. Then in addition to the above contract price,the homeowner agrees to compensate the contractor for any repairs or restoration at the hourly rate of$55.00 fora carpenter and$35.00 for a carpenter's laborer, plus the cost of materials. } -Roof to be stripped and cleaned of all old shingles and debris -Roof to be papered with weather watch leak barrier,Synthetic roof underlayment, and installed with Timberline architectural shingles using galvanized nails. (Storm nailed) -8" drip edge& new pipe collars to be installed -Cobra ridge vent to be installed on all ridges Timbertex premium ridge cap to be installed -A 10 yard dump trailer 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 BY LAW With the agreement of the contract$500.00 of estimate is due. Further payments under this contract are as follows: 1/2 of the estimate due at the start; and remainder due at completion of the job. • Y, 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 be subject to a finance charge of 1.5% per month. The contractor warranties the workmanship completed under this contract for a period of ten years 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 be at 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: Date: . Homeowner j� � � Contractor �_ Massachusetts Department of Public Safety Ij Board of Building Regulat ions and Standards n %Ire+,. l vicense: CSSL-099913 Construction Supervisor Spe4ialty Iy • �5 � �ft4i G TROY A THOMAS 499 NOTTINGHAM DRIVE r CENTERVILLE MA 02632� ',y Expiration: 'Commissioner 04/13/2018 ��e (paavn�aora�aecaL o/bIff"Iaack"Ja Offre of Consumer Affairs&Business Regulation License or registration valid for individual use only :a HOME IMPROVEMENT CONTRACTOR before the expiration date., found return toc't Registration 1g22 Type; j' Office of Consumer Affairs and Business Regulation d Expiration 6/9/2618, LLC 10 Pa&OIAZa._Suite 500 = Boston,MA 02116 : TROY THOMAS HOME IMPROVEMENTS, LLC TROY THOMAS i 499 NOTTINGHAM DR; —r CENTERVILLE, MA 02632 -- ` Undersecretary Not valid w' ut signature 1 . Assessor's map and lot number J 1..........t........... ..)(:..... Q FTHETo I, � swuvnn93d Sewage Permit number .'....frt�lM. y...�l.A .�(�t Q 81 a 0 g Z BABB9TABLE, i Housenumber ........................................................................ a TOWN OF BARNSTABL BUILDING IsNSPECTOR APPLICATION FOR PERMIT TO ............ ... �.... �.. -�` ......... ... TYPE OF CONSTRUCTION 4fe-1.4�v� 0 D �/�!4 ME 91 ....................../.. ..yv.........19 *-*-..,, TO-THE, INSPECTOR OF BUILDINGS: The undersigned hereby appin s fora permi according to the following information: `f Location ........................................� ...�. .�.. .f .(...f�' �- /4.. ......................... .... ... �... r... Proposed Use �''1�; mil. a�. .................................................................................................. C ZoningDistrict C ............................................Fire District .............................................................................. Name of Owner ...... ..........Address Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ................. ................................................Address. ................ Foundation ...C Number of Rooms �" tj ..................................I........... ................................................. Exterior ...... ............................ Roofing .. �5�1t .(. .. �.111 .lS ....................................... .... Floors ......................................................................................Interior ..........................................::........................................ ., Heating ..................................................................................Plumbing Fireplace ..................................................................................Approximate Cost .... .Q! ............................................... Definitive Plan Approved by Planning Board ---------------____-----------19--------. Area .......................................... Diagram of Lot and Building with Dimensions Fee E v----- SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to.conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ti Name ....................... ... ... ....�.�........ .. = ................. r-- � { , | r / � ^ ' ^ ' . | / . ' i . . ' \ / , ( ' � . ' . ! PERMIT REFUSED ` lA ^ ---- . } ` ____ Y ' ____ | , .................................................. � ------------ lQ . � �� �� mm� ' _ . -.------------.-------.--.-.- ----._-----...-------.-...--�.- | ' ' 0- 7 Assessor's map and lot number �9� .:......�, G...., 02 PROF THE Sewage Permit number !n.�....:r/7,, 1.,�1- ../, �9.i, r� 4- SAWSTABLE, i House f+"umber � �MAea 90po�1639 ♦� 'EO MPY a` TOWN OF BARNSTABLE a4 V BUILDING INSPECTOR APPLICATION FOR PERMIT TO +'�/ /,'....>`� .:..y -�Q ......... fi/L /7 ��ra r��, y4�= .,..... ........� r �..... TYPE OF CONSTRUCTION ............. ........ . :...../...9..`............................... lZ. ........19.'`r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora permit according;to the/following information: / Location ........... :5 t©! .... 5 ... . . ..... . t ! I�/....... � {......................................` 1, 1 11�-� ........................t .. . Proposed Use .. �� /........................... .. ........., ;� � _� ... ................ ........................ r � r Zoning District (rr................................................Fire District U Name of Owner ............. ....x ...... ........ .Address Nameof Builder ....................................................................Address .................................................................................... .Name of Architect ........... ....Address Number of Rooms ..................................................................Foundation .... Exterior .......:....?...hl Gil.: �?..................�.................................Roofing .....:.`lc r�i1.a 1f ,j,c� /!t��r/��;5 .................... Floors ..........................................................Interior .................................................................................... } Fieating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost .... :?; ,1i(: .`............................................. Definitive Plan Approved by Planning Board ________________________________19________, Area ... .......................... Diagram of Lot and Building with .Dimensions Fee ... �.�� !.. ............................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 4 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ::�.X .......(,t ';,.:......!.. ..................... Reed, John 91-36 7-7 No ..... Permit'for ........................ .................................... .. ......Location ..... R- .............C! lAqr.Y.LUe............................ ... ......... Owner .........J9bn.. Reed............................. Type of Construction ...—11—Wood-Fi-ame......... ...................................... .................. .................... Plot ............................ Lot ................................ Permit Granted ..... ....fTt.?.........20.........1979 Date of Inspection ....................................19 Date Completed ......................................19 P RM, REFUSED .......... . . ............... 1. .... 19 �, (� ............................ .............. .. . ...... ............................ ........................ ...................................................... .................... .......................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ..............................I................................................