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HomeMy WebLinkAbout1319 MAIN STREET (COTUIT) _ a Ilk, ev Or i� 3 '7ti d+O'• th 1 •r,4 -O _ c4w . 4 , 6' a a , a a" r �✓ [ , 4, � ©0 " Al' I Town of Barnstable 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-16-3380 Date Recieved: 11/15/2016 Job Location: 1319 MAIN STREET(COTUIT),COTUIT Permit For: Building-Insulation Contractor's Name: BRUIN CORPORATION OF ATTLEBORO State Lic. No: 104439 Address: 479 Mount Hope Street, N. Attleboro, MA Applicant Phone: (508) 695-8222 02760 (Home)Owner's Name: COURTINES,ALFRED L Phone: (508)428-8943 (Home)Owner's Address: PO BOX 542, COTUIT,MA 02635 = ti Work Description: insulation and air sealing c Total Value Of Work To Be Performed: $1,900.00. Structure Size: 0.00 0.00 0.00 - -Width• = Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he.files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code;ordinance or statute,regardless of what might be shown or omitted on the submitted plans and'' specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Brian Olsen 11/15/2016 (508)695-8222 Applicant Date. Telephone No. , Estimated Construction Costs/Permit Fees Total Project Cost: $1,900.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 11/15/2016 $85.00 XXXX-XXXX XXXX-1 Credit Card 3637 Total Permit Fee Paid: $85.00 . .. .. 7 1 ' THE Town.of Barnstable *Permit/ •;e rpm Expires 6 mo r ue Regulatory Services Fee , * saxxsrnar.E, MASS.� z63 9. $ Richard V.Scali,Director A ,� rFDMPtA ffK� G������ 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 C� Not Valid without Red X-Press Imprint Map/parcel Number 01 koj_ Property Address 1315 K G I tl s t rec-4 C off,U& LIP W 6 3!,— [Residential Value of Work$ �,1Oom o°O Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address o f free' l.or�ines 1,?/9 lial/1 ,Street Cotuli HP 6o2635- Contractor's Name M t{e g J a n po►t-A Telephone Number Home Improvement Contractor License#(if applicable) j/y 0 f 3 Email: Con truction Supervisor's License#(if applicable) e S OQ IF orkman's Compensation Insurance Check one: ❑. I am a sole proprietor JW 10 2014 I am the Homeowner Q I have Worker's Compensation Insurance Insurance Company Name TrXrj/le s TOWN OF13ARNSTABLE Workman's Comp.Policy# t Cd 0 R P I!0 9'-G3 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) �1�, []�Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to SgncLA71?1nFelc x4/i�� ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement 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 Owner must sign Property Owner Letter of Permission. A copy of the a Improvement Contractors License&Construction Supervisors License is req ired. SIGNATURE: Q:\WPFILES\FORMS\building p t fo s )PRESS.doc Revised 061313 Construction Supervisor Home Improvement License Number#008267 Contractor Registration#114813 OSHA Approved Member of the Better Business Bureau Home Phone#508 420-5131 CELL PHONE#508 280-0802 ESTIMATE JAMES DANFORTH P.O.BOX 973 COTUIT, MA. 02635 Alfred Cortines 1319 Main Street Cotuit, MA. 02635 June 9, 2014, Work to be completed on the entire house roofs, as follows. House and shrubs will be covered with tarps while work is in progress. Remove the existing roofing shingles from the main house roof, the octagon roof will be reshingle over the existing shingles. Renail any loose roof sheathing. Check all step flashings on house cheeks. Install .032 aluminum drip edge around parameter of the house. Install grip rite ice and water shield on the bottom edge 3ft. up onto the roof, , in valleys and around went pipe flashings, also up behind lead of chimney. Fix and replace any broken or cracked lead Install a Rhino synthetic, roofing underlayment over the remaining roof sheathing, from the top'of the ice and water shield to the roof ridge. Install a 30-year Architectural type roofing shingle, using CertainTeed Landmark Woodscapes, which are algae resistant shingles. Shingle weight is 240lbs. per square. The standard wind warranty is 110M.P.H. I will use CertainTeed starter shingles along the roof eaves and rakes, I will also use CertainTeed shadow ridge for the roof caps, over the cobra ridge vent. I will also cut a slot on Each side of the roof for air flow though the ridge vent . This process will increase the wind warranty to 130M.P.H. Clean out gutters and clean yard with magnet and the end of the job. Removal of all rubbish. Material and labor$6,000.00 This price includes the building permit. There is a limited lifetime manufactures warranty on the shingles. I will provide a seven year warranty against any roof leaks. Payment schedule as fellows 1/3 down at the start of the job, 1/3 when half complete, balance due upon completed. All materials are guaranteed to be as specified.All work to be completed in a workmanlike manner according to standards practice.Any alteration or deviation from above specifi 'ons involving extra cost will become an ex charge above the estimate. Our workers are fully covere km n's Compensation Insurance. DATE OF ACCEPTANCE CUSTOMER SIGNATURE NTRACTOR SIGNATURE Hie Commount kt of Uassathus Departtnmt o•f bdksft cal Accidents QKwe o,f I s a ions 600 K"hington street Boston,MA 02LII wnhuanamgmldia Workers' Compensation Insarance Affidavit:Builders/Conti-actors/FlectricianslPlumbers Apphc.nt Inftsrmation Llease Print Legib IV Name Organizafion(fndivic�si): Address: / �! City/St:abelZip: Phone Are u an employer? eck the appropriate boa: Type of o'ect r nire _ 3'Re �- ] {'� �- 4. I am$ contractor and I I. I am a employer with_� ❑ 6_ ❑New.oomsEnsc#oa employees{full and/or Part ime}* have hired the sub-contimiors. 2_El I am a sore proprietor or partner- listed on the attached sheet +- ❑Rtmt,odeling , ship and have no employees emplThesoyees eescontractors have g_ ❑Demolitioa working for tape in any capacity_ �Pp and have workers' 9_ ❑Building addition [No workers' camp.insurancecoIDp_insurance-, quired_] 5.:❑ We am a corporation and its I0..0 Electrical repairs or additions re 3.❑ I cF a hom8o u ner doing all work officers hnm exercised their 11_E Tumbing repairs or additions oQyself.[No workers'comp- right of exeatptitaa per MCL I2. Roof repairs insurance required.]1 e_1.52, §1(4},and we have no . employees-[Na workers' 13.0 Other comp_insurance required.]; *Any appii�at that checks boag1 umst skso HU out the section bel w showing theirwcAecs''ooaapeasadoupoiieg»fore+ #Homeowners who submit this affidavit m&citing d Ley Rm doing an wa lk Lud them hire outride contiactoxs=5#submit a mwwl affidavit mdirQ�c snch 10mtractors that check this box must attached au additional sheet show-mg the na ne of the sub-comft3cbo-r5 and stets whether or=those entities have employees_ If the sub-contmctuts have employees,they Tatst provide their workers'comp.policy number. lam art emgloyw that isprm id6tg workers'conWruw ion imrurance for eery employee Below is thepoiicy and job situ infotmadom Insurance Company Name: Policy 4or Self-ins- Job Lie ` ExpirationDate: Site Address. CitylState/Zip: Attach a copy of the workers'compensation policy-declaration page(showing the policy number and expiration date). Failure to secure coverage as regruredunder Section 25A of MUL c 152 can lead to the imposition ofrriminal penalties of a fine up to$1,500.00 and/or one-year ifrIpfiWIlMent,as well as civil penalties in the form of a STOP WORK ORDER and a fiw ofup.to$250.00 a.day against the violator_ Be advised that a copy of this statem mt maybe forwarded to the Office of Investigations of tie DIA fDr insnrat ce coverage verffitation_ Ido hereby c fy rr Eh pains trdpenaTties ofpedwy that the informahon prat2ded above is hue and correct Sienature: Date Phone#: Ojai use onty. Do not sprite in this area,to be completed by ciiiy or town officiaL City or Town: Perrnit/License# Issuing Authority(idrele one): 1.Board of Health BnRditag Department .CifylFowrr Clerk 4.Electrical Inspector .Plumbing inspector 6.Other Con-tact Person: Phone#- 6 Information and Instructions , Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant-to this statute,an ernployee is defined as"...every person in the service of another wider 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 alay applicant who has not produced acceptable evidence of compliance with the insurance.coverage requ.ired." 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 v,Ziz'i 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-contractors)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. 'I'lae 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 you regarding the applicant Please be sure to fill in the penmitllicease number which will be used as a reference number. In add tion,an applicant that must submit multiple penmit/Ecense applications in any given year,need only submit one a fidavit 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 lice 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: nc,Commonwealth of Massachusetts Depa-dment cif Industrial Accidents (}truce of favestigatio-M 600 Washington Street Boston,MA 02111 Tel#617-727-4900 w 406 or I-& -MAS 'E Revised 4-24-07 Fax# 617-727-7749 Vi .mass.go-ddia is Office of ConsuinerAffairs&Business Regulation License or registration valid for individul use only 11 ? -� {OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 3 registration 114813 Type: Office of Consumer Affairs and Business Regulation 7 Expiration 10/27/2015 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 A VIES D DANFORTH REMOD ` ' A.MES DANFORTH, !` 1)5 OLD POST RD .(:(ITUIT, MA,02635 �`" -- Undersecretary t vPW4®r w . � ... - A, R M 33 9 Massachusetts -Departmeatt of l�u6Ijc,.Safety K' 3. tl if (Board of Building Regulatirxns�and Standards e j 4 rA CQ','si?ftrt9C:t1S1� `+'1tif1r License: CS-008267 � 6 JAMES D.DANFORTH ,• r � t PO BOX 973 l , COTUIT MA 02dl35 Expiration ner 05/20/2016 ;Commissioner - ` I t • a. a @ + } Aim TRAVELE /?S WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY TYPE AR INFORMATION PAGE WC 00 00 01 A) POLICY NUMBER: (6HUB-4861 P48-8-1 3) RENEWAL OF (GKUB-.4861P48-8'12) INSURER: THE TRAVELERS INDEMNITY COMPANY OF AMERICA " NCCI CO CODE: 13439 INSURED` PRODUCER: f DANFORTH, PAUL PETERS AGENCY INC DAMES DANFORr-�-REMODELING 680 FALMOUTH ROAD PO BOX 873 MASHPEE MA 02649 COTUI T MA 02 3_ E, Insured is N INDIVIDUAL Other work o�tt es and identification numbers are shown In the schedule(s) attached. 2 The policy l,E it d is from, 09-2y-13 to 09-29-1 4 12:01 A.M. at the insured's'malling address. 3. A. WORKi: l3 COMPENSATION INSURANCE: Part One of the policy applies to the Workers Compel+;r,t on Law of the states}Ilsted:here: MA B. EMPLCYE FiS LIABILITY INSURANCE Part"two of the policy applies to work in each state listed in _ item 3.P. "I ie limits,of our liability under Part Two are: �— E c it 1 Injury by Accident: ,$ 100000 Each Accident E c 1c it/ Injury by [)!se se: $ 500000 policy Limit a Eoali/ Injury by Disease: $ 100000 Each Employee C. OTHER d"4)kTES INSURANCE: Part Three of the-policyappl es to the states, if any,-listed''here; Ln ® COVERA3 REPLACED BY ENDORSEMENT •WC 20 03 06A D. This pol„c d i�tctudes these entlorsements acid schedules: ' SEE L! S i.1IG OF ENDORSEMENTS EXTENSION 'OF INFO PAGE 4. The premiui i f{ar this policy will be determined-by our Manuals of Rules, Classifications,.Rates and Rating Plans. All rEqu r;d'information is su' fect to verification and change by audit to be made ANNUALLY. DATE OF ISSUE: 3 3-13 13' EdC ST ASSIGN: MA OFFICL. 3 ZLANDO IPIDUS .AFF y 61 PRODUCEF ,itJL PETERS AGENCY INC 28L8R