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HomeMy WebLinkAbout0066 SHELL LANE Coco S �,Q� ( �c��,z r I Town of Barnstable Building t •zBAWM _` r? '•>,' q, ,-°,' xi' .z. '..� a'.nt ,x ": "'"n'. +.,-: :° -:.s ,�•> s-.:r` '` " . '2 r., :zi. '`` PostThis GardFSoThat it isVk�s�ble From the Street ;A roved PlansxMust.be Retained on ob::and#his Card.Myst be Ke t• , ; Aet.B, J 1 • 16 P,ostedUntil Final Inspection Has Been3Made� �`4 �;fi ,, ._3R� �'r, �z,3x�, " €: ;�F.`.` :'�;, �:r'':.n ,\�` ..� .- a''' "s'.: ''^ ..�._.. ..:': ` k_.: :•_;..�r azw'". z°;`� :. ' .. . 'here a Certificate of Ocru an �s Re cared uch"Bu ldm 'shall Not be Occu ied:until,a Final Ins ection.has been made , ,, Permit .� , ,�• � �. .. � ., p, .,..,4a.•- �' _.. ,..>g-: fi,,. _ s,.�,. ..e p> .:w ,. K. . .. .. �� p ..,.. ��: .__ca t.. ...., € Permit NO. B-18-2119 Applicant Name: MORITZ CONTRACTOR INC. Approvals Date Issued: 07/02/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 01/02/2019 Foundation: Location: 66 SHELL LANE,COTUIT Map/Lot 019-092 Zoning District: RF Sheathing: Owner on Record: DAVIES,ALAN'R i z�n s Contractor' Name EDWARD C MORITZ Framing: 1 Address: 50 SHELL LN g Contractor License CS 029456 2 COTUIT, MA 02635 Est Project Cost: $4 650.00 Chimney: Description: RE-ROOF TO BE STRIPPED Permit Fee: $35.00 Insulation: Project Review Req: Fee Paid: $35.00 Date � 7/2/2018 Final: g �t �crn. Plumbing/Gas Rough Plumbing: • Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work author¢ed'by this permit is commenced within six months after-issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents'for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures-shall be in compliance with the local zoning by laws and codes. This permit shall be displayed in a location clearly visible from access streetior road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical y Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are prov-ded on this permit. Minimum of Five Call Inspections Required.for All Construction Work: ' Rough: 1.Foundation or Footing �, �?_. ,�ti , ... >_ ._ ... ., ...�_, 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: '."Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MG c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 9..Application number. '��.. ..�..1. .. • Date Issued....... �.�:.�.. . • 163s Building Inspectors Initials..... ................ UL 2 NIB Map/Parcel.......l .l. ....... ..� �...... Iry Ong r0\Nk � TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 6i�o �� �i4 c, -V NUMBER STREET VILLAGE Owner's Name: 4e- �>,,-V/ Phone Number ..Email Address: Cell Phone Number Project cost $ ��o Check one Residential Dc Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK 0- Siding F-1 Windows (no header change) # F-1 Insulation/Weatherization 0 Doors (no header change) # Commercial Doors require an inspector's review Z Roof(not applying more than I layer of shingles) To Construction Debris will be going to 0�ya S S,gvu,�-� CONTRACTOR'S INFORMATION 0 Contractor's name M aq r L ea-v Ae Home Improvement Contractors Registration Cif applicable').# cr 7 7 dt- (attach copy) Construction Supervisor's License# e 5= 4aj'? (attach copy) Email of Contractor 9Ceae >i 'r7,0 Ae� Cc*v— Phone number 679'S77 OLr7 ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS/N A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE 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 pleaseattach floor-.,plan with exits marked) Dimensions of each,Tent X X ;X Additional tent dimension's can be attached on a separate piece of paper.. . 1 pt: fit, 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. Fuel Type Testing Lab Offsets from combustibles:'front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number 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 '7 2 Alt permit applications are subject 2uilding official's approval prior to issuance. MORITZ CONTRACTOR INC 23 ATWATER DR. FALMOUTH, MA. 02536 #` ph. 6.N. 508-540-8253 ecmoritz@ao[.com G�q Mr.Al Davies ] 66 Shell Ln. Cotuit, Ma. 6-13-18 Enclosed please find a proposal for roof replacement General Use tarps to protect the house and grounds Remove all existing roofing material from the house (except side porch) Remove all debris to a qualified disposal site Instal 30 year rated architectural style asphalt roofing shingles- match those existing on side porch- if they are `Certainteed" brand, use of starters all around and cap shingles will establish a Certainteed Warranty 3' of ice and water membrane- 18" in the valleys 8" white aluminum drip edge on all eaves.and 5' up the rakes New ridge vent material New aluminum vent stack flanges 6 nails per shingle- storm nailing Cost: $34K00 price includes all necessary labor, materials, permit and fees Payment schedule: 60% O down and 40% O at finish Homeowner: 1 P3 /O Contractor -S r � c� z (0 The Commonwealth,of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):Mopes &r462 }zo X—' Address: fr V City/State/Zip: fA-v 44 ��Phone 4: Are you an employer?Check the appropriate box: Type of project(required): I am a employer with 1, 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑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 8. ❑Demolition workingfor me in an capacity. employees and have workers' Y P t3'• � 9. ❑Building addition [No workers' comp.insurance comp.insurance. required.] - 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.Woof 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. $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 the policy and job site information. Insurance Company Name: Policy#or Self-ins,Lic.#: W GS 3 IS 3 3,2, bZ4- Expiration Date: �,�' - !'-11 Job Site Address: & S����- L� City/State/Zip: G i i & Attach a copy of the workers'compensation 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 may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Si nature: Date: Phone 6!�� 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#: Information and Instructions f Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to 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 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." .J. ,fi, ► 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 mi the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." 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 with 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. The 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 permit/license number which will be used as a reference number. 4n addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit 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 like 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: i The Commonwealth of Massachusetts', 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 . QOIN!/V IWAt A/!f�C!.-Z7f!„dtccl[[1sa/,'. Offiee of Consumer Affairs&Business Regulation V "' HOME IMPROVEMENT CONTRACTOR Registration ` Ylm& '107729 T ' Expiration 8/5%2018 Private Corporatio i MORITZ CONTRACTOWINC Edward'Moritz a. 15 Hoover Rd Walpole;MA 02081 Undersec- retary License or registration valid for individual use only 77 before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 Not valid Irithout signature Commonwealth of Massachusetts , } Division of Professional,Licensure `i Board of Building Regulations and Standards Consirfil�n' uperviso r CS-029456 empires 09/11/2049 �. f f 71, � EDWARD C MORITZ- k 15 HOOVER RD k ' WALPOLE MA�02081 Commissioner t `4 ,a►co CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 04/06/2018 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 endorsement(s). PRODUCER CONTAC NAME; Susan McCall EASTERN INSURANCE GROUP LLC PHONE , (508)923-2205 a No): E-MAILD ADDRESS: smccall@easteminsurance.com 233 WEST CENTRAL ST INSURE S AFFORDING COVERAGE NAICn NATICK MA 01760 INSURERA: LM INS CORP 33600 INSURED INSURER B: MORITZ CONTRACTORS INC INSURERC: INSURER D: 15 HOOVER RD INSURERE: WALPOLE MA 02081 INSURER F: COVERAGES CERTIFICATE NUMBER: 255184 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 BR POLICY EFF POLICY EXP LIMITS LTR POLICYNUMBER MM/DD MM/DD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ AMAGE CLAIMS-MADE OCCUR PREM SET EaEoccmence $ MED EXP(Any one person) $ WA PERSONAL&ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ECO- LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTYDAMAGE $ NON-OWNED ED Per accident HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS LIABILITY ANYPROPRIETOR/PARTNER/EXECUTWE YIN E.L.EACH ACCIDENT $ 100,000 A OFFICERIMEMBEREXCLUDED? WA NIA NIA WC531S332366028 05/01/2018 05/01/2019 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-wmpensationrinvestigations/. 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. Falmouth Building Dept 59 Town Hall Sq AUTHORED REPRESENTATIVE Falmouth MA 02540 �"'Q Op Daniel M.C y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD