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Town of BarrnstabRe *Permit# � 75
Expires 6 months from issue date
-PRESS PERFAIT Regulatory Services Fee t LA_/
Thomas F.Geiler,Director
J U N 1. 6 2009 Building Division
TOWN OF RARNSTA�L� Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTUE ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number c2Q n 6 _
Property Address 3 1 `lC)--t��cJti t `� � � �
esidential Value of Work Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address F tan -
�
s �1
ConaatorJsame Telephone Number
Home Improvement Contractor License#(if applicable) a� 3
Construction Supervisor's License#(if applicable) �J j
OWorkman's Compensation Insurance
Checl one:
❑ I am a sole proprietor
❑ I am the Homeowner
0I have Worker's Compensation Insurance
Insurance Company Name1lL '
cn
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box) (I
O-Re-roof(stripping old shingles) All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows/doors/sliders. U-Value (maximum.44)
*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 is required.
SIGNATURE:
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Department of Industrial Accidents
Office of Investigations
I' r
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): /l 0.�� ��[jy� �y��� , L LC
Address: 9CX,
City/State/Zip: 0oQ63S Phone#: 56 9 Y g s 9o'Z
Are you an employer?Check the appropriate box: Type of project(required):
l al am a employer with�D _ 4. ❑ I am,a general contractor and I
employees(full and/or part-time).
have hired the sub-contractors 6. ❑ New construction
2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. employees and have workers'
9. ❑ Building addition
[No workers' comp. insurance comp. insurance.
$
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions �I
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
Y [ P 12.❑ Roof repairs
insurance required.]t c. 152, §1(4),and we have no 13.❑ Other
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 the policy and job site
information.
Insurance Company Name: -J
Policy#or Self-ins. Lic.#: U 3 q J M 55 6 — U Expiration Date:
}�1a-�,Q, I d t c
Job Site Address: � City/State/Zip:
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 cep a nd pe Ides of perjury that the information provided above is true and correct
Signature: Date: f 6 r
Phone#: ud�' Yoe b ' o2
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
e
Contact Person: Phone#:
✓die�amneoozcuec��/ o��✓f/laaaac�ivav/�
Board of Building Regulations and Standards License or registration valid for individuI use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registration; 112536 Board of Building Regulations and Standards
E�piMt on2=3/23/2011 Tr# 281021 One Ashburton Place Rm 1301
Type: DBA Boston,Ma.02108 r
FRASER CONSTRUCTION C.O.
DEAN FRASER ) %'
104 TWINN VIEW LANE
E FALMOUTH,MA 02536 Administrator Not re
Boa7ro7rui1=negq(egula4eons an tan ar s
One Ashburton Place - Room 1301
Boston. Massachusetts 02108
Dome Improvement Contractor Registration
Registration: 112536
Type: DBA
Expiration: 3/23/2011 Tr# 281021
FRASER CONSTRUCTION CO.
DEAN FRASER
P.O. BOX- 1845
COTUIT, MA 02635
Update Address and return card.Mark reason for change.
Address Renewal Employment Lost Card
Al is 40M-08/08-DBSLIFORMCA108212008
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ItightFax N3-2 10/1/2008 1 :56: 31 PM PAGE 2/002 Fax Server
:::, :. ISSUE DATE
THI3 CERTIFICATE IS ISSUED AS A MATTER OF INFORD[ATI
1/08
PRODUCER ON ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS
CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE POLICIES BELOW.
WISE&QUINN INSURANCE AGENCY COMPANIES AFFORDING COVERAGE
449 PLEASANT ST
BROCKTON MA 02301 COl"PAN r A HARTFORD UNDERWRITERS INSURANCE CO
INSURED LETTER
B
FRASER CONSTRUCTION LLC CUTTER
PO BOX 1845 COMPANY C
LETTER
COTUIT MA 02635 cowANY D
LETTER
COMPANY
E
LETTER
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 REQURUBCDIT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THUS
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
CO TYPE OF INSURANCE POLICY NUII1[3ER POLICY POLICY LI1�Q1B LTR EE!•ECrIWDATE EXPIRATIONDATE
QVINVDD/Y-Y) MM/DD/YY
GENERAL LIABILITY GENERAL AGGREGATE $
❑COMMERCIAL GENERAL uABnxrY PRODUCTS-COMP/OP AGG. $
❑ CLAIMS MADE ❑ OCCUR. PERSONAL&ADV.INJURY $
❑OWNER'S&CONTRACTOR'S PROT. EACH OCCURRHNCE $
❑ FIRE DAMAGE(Any Ont Flrt) $
MED.EXPFNSE(Anyoncpason $ i
AUI OA4UBILE LJABILITY COMBINED SINGLE I RffT $
❑ ANY AUTO
❑ ALL OWNED AUTOS BODILY INJURY $
(PuPtrson)
❑ SCHEDULED AUTOS `
11 HIRED AUTOS BODILY INJURY $
(Pv Accident) .
❑ NON-OWNEDAUTOS
❑ GARAGE LIABILITY IABILITY PROPIt1tTY DAMAGE $
❑
EXCESS LIABILPI'Y
❑ UMBRELIAFORM EACHOCCURRENCE $
❑ OTHER THAN UMBRELLA FORM AGGREGATE $
STATUTORY LIMITS X
A WORKER'S C071�ENSATION EACH ACCIDENT $500,000
AND UB- 09/26/08 09/26/09 DISEASE POUCY LIMIT $500,000
0341M556-08
EAWLOl'ER'S LIABILII T DISEASE EACH EMPLOYEE $500,000
OTHER THE
PROPRIE MR/PARTNERS/EXECUTI VE
OFFICERS ARE INCLUDED.
DESCREMON OF OPERAMr-S/LOCATTOMS/VEMCLL?S(3pECL1L YMIS
TIM INSURED'S 5L1 WORKERS COMPENSATION POLICY Alm ITS IMUTED OTEM STATES INSURANCE ENDORSEMERNr AUTHORIZES THE PAYRIFNI'OF BEIVEPJ7-S CLAMIS
FOR IILADE BY THE INSURED'S NEA ENIPLOYEES IN SPAIES OTHER,THAN ALA.NO AUTHORIZATION IS GIVEN TO PAY CLA7111SFOR BENEFlI'S IN ANY SPATE OTHER THAN BR THE
INSURED HIRES.OR HAS H1RED.HM1:I.OYEES OUTSIDE OF NIA.THIS POLICY DOES NOT PROVIDE COVERAGE FOR ANY SPATE OTHER THAN 51A.
THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTMCATE HOLDER AFFECTING WO COMP COVERAGE
:..::
....................
TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DFSCRLBFDPOLICIFS BE CANCELLED BEFOREITHEPO BOX 40 EXPIRATION DATE T HEREOF.THE ISSUING COMPANY WILL ENDEAVOR TO HYANNIS MA 02601 10 DAYS WRITIF.N NoTICE TO THE CRRTTFICATE HOLDERN"IBD TO THEBUJ'FAILURE TO HEAL.SUCH NOTICE SHALL]ArI o9ENoOBLIGATIONOR
AEIGUEIANY KBVD UPON TM COMPANY.ITS AGENTS OR REPRESENTA
nvlBoa>�u BBPR6981YP�TIV6
> KAffZA C,4tS7Z- Z-09LER
Fraser Construction LLCCONSTRUCTIONROOFING & SIDING
P.O. Box 1845, Cotuit MA. 02635
SPECIALISTS Email: fraser construction cr verizon.net
ww.fraserroofing.com FAX 1-508-428-0123•
508-428-2292 wHICL#112536 CS#97668
RE-ROOFING PROPOSAL
,;,,L
DATE: r2QA8 PHONE: 203-257-1121 ` o
NAME: Frank Callahan 508-77-1-9748 Y
MAIL ADDRESS: Same
JOB ADDRESS: 133 Harbor Hill Rd. Centerville, MA 02632
160 S fire"i s 1-- 0 6
FRASER CONSTRUCTION hereby proposes to perform the following services in a neat
and professional like manner and in accordance with.the manufacturer's
specifications and local.building code.
-Remove and Haul away all of the old roofing material
-Re-nail all plywood sheathing as needed.
Supply and Install - CERTAINTEED LANDMARK /WOODSCAPE AR 30: 30 - Year
Warranty, 5 year Sure Start Protection, CLASS AFIRE RATED, ALGAE Resistant,
Extra Heavy Weight, Self Sealing, Multi- Layered, Architectural Style, Fiberglass
Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with
a Fall 10 Year Warranty against ALGAE Containment. 5 year 110 mph wind-
resistance warranty with six nails in common bond area, Fraser construction
includes six nails in common bond area at NO additional cost. See actual warranty
for specific details and limitations.
Color: PRICE-
Includes Buil id ng Permit Initial
Supply & Install- CertainTeed Winter - Guard: (ice 8s water shield)
Waterproof Underlayment System (3ft. on eves and
valleys, 18" on rakes, walls, and skylights)
Supply & Install- Roofer's Select Underlayment Paper (as recommended
by CertainTeed)
Supply & Install - Hick's Ventilated Drip Edge or 8" Aluminum Drip Edge
Supply & Install -Aluminum & Neoprene Soil Pipe Flashing
Supply & Install-,Air Vent Ridge Vent (as recommended by CertainTeed)
Clean & Remove - Debris from work area daily.
¢1 PLYWOOD REPLACEMENT: .Any plywood replacement will be billed at
$1.50 per sq ft Initial
SHEETROCK REPLACEMENT: Will be billed out at time& material. We bill
out at $55 per man hour and 15% markup on materials.
Initial
x4 Star Warranty Upgrade will be applied if proposal is signed and
returned within 10 days. (see enclosed brochure)
2% Discount if paid by check immediately upon completion
NO MONEY DOWN- NO Payment at the start or,part way thru
Payments accepted are:
CASH- CHECK- MASTERCARD =VISA-AMERICAN EXPRESS
*Any not made within 30 days of completion
payments y p ehon will be charged 1.5 /o for every 30 days the
payment is late.
Possible Extra-After the shingles are removed from the roof, we will lift one sheet of
plywood to make sure that the insulation is not up against the plywood sheathing
preventing ventilation from the eaves to the ridge. If it is, ventilation panels will.be
installed by; removing the plywood sheathing, installing the panels, turning the
plywood over and then re-installing the plywood. If needed, this would be charged for
as an extra at the rate of$6.00 per-panel including Materials 8v Labor. There are 6
Panels per sheet of plywood.
Possible Extra-Any rotted or otherwise deteriorated trim boards, plywood sheathing,
lead flashing, or other carpentry needing replacement will be done and charged for as
an extra at.the rate of$55.00 per hour, plus materials, plus 15%overhead mark-up
on total extras.
FRASER CONSTRUCTION Warranties the labor for 12 years
FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for.10 years.
CERTAINTEED Warranties the shingles and labor 100% through the Sure Start
Warranty duration.
CERTAINTEED Warranties the shingles to be ALGAE resistant for the duration of the
Sure Start Warranty depending on the shingle that was purchased.
Any deviation or alteration
J on fr
om rom above specification will be executed upon written
orders and will become an extra charge over and above the estimate. All agreements
contingent upon strikes, accidents or delays are beyond our control. Owner should
carry fire, tornado and other necessary insurance upon the above work. We, if not
accepted within thirty days may withdraw this proposal.
FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public
Liability Insurance on the above work, certificate available upon request.
DATE OF ACCEPTANCE:
Homeowner Fraser C sti cti n, LLC
TOWN OF BARNSTABLE
3Ak39T LF'4
D�Y- \e� BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ................ ............& .............
T PE OF CONSTRUCTION ......................... .... . . ... ... ............ ......................
.................. ......Z.1......
TO THE INSPECTOR OF BUILDINGS:
The undersigned her by applies for a permit according to the fallowing information: . . .
Location ............. ...........7� .....a .,. . .......zxzc
ProposedUse ............D....4... .... .... . ...................................................................................... .........
Zoning District .............. ................
. ....................................Fire District ... ..7 ............................................................
Name of Owner ...... ............�......(�f .....Address ......
Name of Builder ...... ...... ...Address ........... ................. ..............................
Nameof Architect ................ .:j ..-::...............................Address ..........— .................................................................
Y.K..?4.................................Foundation .........j�-�6.. ...........................
Number of Rooms ..................... 4fla-le.-
Exierior ........ ��. .Roofing .........1. . ... .......................................
Floors .....vt/.. ..... 4*a--. -71Z4--4040Y(e r i a r ........... .....................
..... d
i /
Heating ......../4-1/•....lev�,u.•. ....4��1514�lf Plumbing ......... . ... .....CU..
Fireplace .................... ...........................................Approximate Cost ...........
Definitive Plan Approved by Planning Board ----------- -----19 2_7
Diagram of Lot and Building with Dimensions
SUBJECT TO APPROVAL OF BOARD OF HEALTH
Ci
321
7.
5E
W
cl
CL z 0
0
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name . ..............
Theo Construction
15 one story
No ................. Permit for .................................... 4
single family dwelling t
...............................................................................
l`33 Location ........Harb.or..Hills..Road
...................
........ .... ........... ......... 1
...................................... ............ ..........C'e�
. t�
e
Owner Theo Construction
t
......................a. .........................
Type of Construction ..........f......rame..........................
Plot Lot #60 1.......................
February 16 73
Permit Granted ........................................19
Date of Inspection ...... ..... ...... ................19
Date Completed .... ... ...^. ..........19
PERMIT REFUSED
............ 19
i
...............................................................................
................................................... ........................
I
...............................................................................
Approved ................................................. 19
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