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HomeMy WebLinkAbout0028 HOLLY HILL ROAD o d :i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION C'" ` YA 2-�(n q. Map Parcel `��d19 Application Health Division ® i� �. Date Issued Conservation Division Q ®), Application Fee ��nn so Planning Dept. NQ��' �/I/ Permit Feel oW srgeC� Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village Owner Address W Telephone Permit Request /Usi�L 4 .�i /� Z .f`e-al C ell S P124 X �•DFI� /�Sv/� eC� � C���i s��L� /��f/s, .fir/ 12714 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation L d Construction Type s v !4 pt1 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name /�� G''� j/,�Sl��i9/1"62 ic/ Telephone Number !Z % Address �/ k/ge'w,�g J4o& License # Home Improvement Contractor# Email f�l cl� P��G' A����//�S�,��o�/r CWorker's Compensation # �Jl���dGj z ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL �B-E�TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY J, APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION' FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ' � AAA .. _ •, .. The Commonwealth of Massach usetts Department of Industrial Accidents a $ I Congress Street,Suite 100 Boston, MA 02114-2017 www.mass,gov/dia 1lrorkers' Compensation Insurance Affldavlt: Builders/Contractors/Electrlclans/Plumbers, TO BE FILED WITH THE PERMITTI0 AUTHORITY, Applicant Information �'� Please Print Leeibly Name (Business/OrganizaeorAndlvldual); Cape Cod Insulation Address; 18 Reardon Circle City/State/Zip; South Yarmouth,MA 02664 phone#; 508-775-1214 Are you an employer?Check the appropriate box: Type of project(required); I,©I am a employer with 48 ' employees(full and/or part•time),r 7. ❑ New construction 2-ElI am a sole proprietoror partnership and have no employees working for me in $, Remodeling any capacity.(No workers'oomp,insurance required,) 371 am a homeowner doing all work myself,.[No workers'comp.insurance required:]t 9. ❑ Demolition 4,[]1 am a homeowner and will be hiring contractors to conduct all work on my property, 1 will 10 ❑ Building addition ensure that all contractors either have workers'compensation Insurance or are sole 11,❑ ElectrJcal repairs or additions proprietors with no employees, 5,Q 1 am a general contractor and I have hired the subcontractors listed on the attached sheet, 12. Plumbing repairs or additions 7 hese sub-contractors have employees and have workers'comp,insurance= 13,Q Roof repairs 67 we aro a corporation and its officers have exercised their right of exemption per MOL o. 14. ✓[]�Other Weatherization 152,110),and we have no employees, (No workers'comp,insuranos required.) 'Any applicant that cheeks box#l must also fill out the section below showing their workers'compensation policy information t Homeowners who submit thisaBdavit indicating they an 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 bf the sub-oontraotors and state whether or not those entities have employees, if the sub-contractors have employees,they must provide their workers'comp,policy number;. 1 am an employer that is providing workers'compensation Insurance for my employees. Below is the policy and Job site information. Insurance Company Name; Atlantic Charter Policy#or Self-ins.Llc, #; WCE00431902 ' Expiration-Date- 06/30/2018 Job Site Address;J)f 1,V -Ay y, //eCity/State/Zip;_ , e�2 z 40 Z Attach a copy of the workers eornpensatlon policy declaration page(showing the policy number and expiration date), Failure to secure coverage as required under MGM o, 152, §25A is a criminal violation punishable by a fine up to $1,500.00 and/or one-year lmprisonment, 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 verificadon, 1 do hereby cWn ,:and penaltiesorf�perJury that the ir{formation provided above is true and correct. it e' H ;�~� :t iMF WMw WwW Y IRMu1.W/ Phone#: 5 Offlelal use only, Do not write in this area, to be completed by city or town OIJICIal City or To 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#: ' J CAPECOD-27 KDOYLE CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 06/30/2017 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 pollcy(les)must have ADDITIONALJNSURED 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 Ileu of such endorsements . PRODUCER C ACT Rogers&Gray Insurance Agency,Inc. PHONE 434 Rte 134 Alc,No Ext: AC,No:(877)816-2156 South Dennis,MA 02660 maliCaprpRers9ray.corn INSURERS AFFORDING COVERAGE NAIC# INSURER A:Peerl ass Insurance Company 24198 INSURED INSURER 13:SafetY Insurance Company 39464 Cape Cod Insulation,Inc. INSURER C•Endurance American Specialty Insurance Company 41718 18 Reardon Circle INSURERD:Atlantic Charter lnsurance Com an 44326 South Yarmouth,MA 02664 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 INSO POLICY NUMBER LIMITS A X COMMERCIAL GENERAL LIABILITY + 1,000 OOO CLAIMS-MADE a OCCUR a 4 EACH OCCURRENCE CBP8263063 04/61/2017 04/01/201$ ES DAMAGE TO RENTED 100,000 MED EXP(Any oneperson) 5,000 PERSONAL&ADV INJURY 1,000,000 EN'L AGGREGATE LIMIT APPLIES PER:POLICY❑PpeJ LOC GENERAL AGGREGATE 2+000+000 X OTHER: PRODUCTS-COMP/OP AGG 2,000,000 A $ B AUTOMOBILE LIABILITY a: COMBINED SINGLE LIMIT 1,000,000 $ OWNED 6232707 COM 02 04/01/2017 04/01/2018 BODILY INJURY Per person) $ SCHEDULED NLY X AUTOS pN pV�Ep BODILY INJURY Per accident $ $DWORLPENSATION NLY X AUTOS ONLY P OP.E tl nt AMAGEUMBRELALIAB X OCCUR EACH OCCURRENCE 2,000,000 LIAR CLAIMS-MADE EXClOO66636002 04/01/2017 04/01/2018 2,000,000 AGGREGATE KERSCOMPENSATION X PEMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN RIO WCE00431902 06/30/2017 06/3012018 FICER/MEMKgER EXCLUDE( � NIA E.L.EACH ACCIDENT 1,000,000 andatory In NH) 1;000,000 If yes,describe under E.L.DISEASE-EA EMPLOYEE DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Workers Compensation Includes Officers or Proprietors. Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. 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. AUTHORIZED REPRESENTATIVE + 7 ACORD 25(2016/031 • .i Commonwealth of Massachusetts Division of Professional Licensure Board of Building.Re ulations and Standards Con s�r�Ctlr�I bp�rvisor CS.100988 t� ff'i, Tres; 11/11/20.1.9 C HENRY E CAS�SIDY 8 SHED, i cr • s WEST YARMOilTM�02673 ?s� Commissioner CL Office of Consumer Affairs and Business Regulation 10 Park Plaza Suite 5170 Boston, Ma&'tbrrusetts 02116 Home Im prove meh"i'0©.6tractor Registration Type; Corporation Ca e ��) " IJ' Registration; 153567 p Cod Insulation, Inc ;; � �..: tl� 18 ReardonpClrcle 1 .1 r` '_. W Expiration; 12/14/2018 r :{? 1 G So, Yarmouth MA 02664 {C+4d 20M•05/11 --.•l�' Update Address and return card, Mark reason for change, _ ._.._._._....._..._.._..........._.._....._.(�..Adr,;;:�s:�;+...1 _!i•�nr..1;: �:_n G,r^la�.m'vrt �j / •r � �\ �® (DO?J7?JLO'!2lU6Cl.GC�oy�C�/��rcaar�c%cwe� Office of Consumer Affalrs&Business Regulation . HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only Type; Corporation before the expiration date, If foun urn to; Office of Consumer AHalrs and sl ss Regulation fin �- 10 PAMA 5170 12/14/2018 1s; Bo Cape Cod InsulatiW Y Henry Cassidy c 18 Reardon Circl$' t ,Q So.Yarmouth,MAQE4��3'' C� ~^a Undersecretary pout SI atu Town of Barnstable Regulatory Services nntuysrA Richard V.Scab,Director MASS. 9° Building Division p 1639.: Paul Roma Building Commissioner 200 Main Street,Hyannis,MA 02601 www-town.barnstable.ma.us - Office: 508-862-4038 Fag: 508-790-6230 { Property Owner Must Complete and Sign,This Section L CONSTANCE G INGHAM , as Owner of the subject property hereby authorize OAS — to act on my behalf, in all matters relative to work authorized by this building permit application for: I 28 Holly Hill Road Centerville,MA 02632 !' (Address of Job) j Signature of Owner Date M..5 >C co 'T'fi-N Gam.. Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form. C:1UsersldecoUW AppDatalLocaf Microsoft\Windows\IN@tCache\Content.Outlook1L.7U69LF21EXPRESS(2),doc 01/25/17 } C �1-2lV �VIEr Town of Barnstable"=Pe Exglres 6 mcr 7s bwm firsAte R.e uhtory Services Fee TedWASS. , Thomas F Geiler,Director QED MAC16 �� Building l}"ion Tom Peary,CBO, Bufldim;Commissioner . e 200 Mafia Street,Hymmis:MA o2601 ww-wsownbamstable.ma i Ofce: 508-862-4038 ! .Af,�� 5 81��90 EXPRESS PERIIT APPLICATiUhT - RESIDE�V x.O1V'IY�Oj Noz VaEd mAozuRedX--Press rmpj u Map/parceiNumberI�f' � II Property Address is s Value of Work S 1bTiazimn m fee of S3S.00 for�vork underS6000.00 Owner's Name&Address l ZD IN11'1�F- CSL� Conrractar's Name "Ci .+� 'o5f(Ah` t� 4 Telephone Number �� / (�•�' 0��� I'iome Improv=ez t ContmctorLicense#(fappbcable) l a 3 W ET all 13 6 f gcicir C Q L[Cfl G'r�I�VP�� •4�(' r Con=uction Supervisor'sL e T(ifapplicable) r Woom=z s CompemationInmrnce Cbeck one: Q I area sole proprietor RlilbaveWork-ers wpeosafionh=ra=e Q CO WorkmmWs Coma.Policy? W Copy oflasuMee Compliance Certificate iutust accompany each permit. Permit R (cheek box} Re-roof(huiacane nest ed)(strippiag gold sbio_les) AIIconstmctiondebiis wMbe rakento /g � V Y`.• ❑Re-roof(hUX3dCane nailed)(not strippitz. Goii9 over exis h El Re-side a yetis aftoo$} Cl Rsplacerneru'Wiudows/doors/sliders.U-Vibe (m,,,;ax a.35)#ofwindows #ofdoots_ ❑ Smoke/CarbonMonoxide detectors 4 floorpkm marked with red S and inspections required. Separate Electrical&h"ue Permits require rt4�sete zceMhk I—oftbis perz*does act except cozx3p7maee mitk other town d�urntregn}ecnns,fie$fist-it,Clow ft vatma,ezc. k'e*Note: Property Owner muststnFrowrtyOwner Letter ofPermissfon. copy of t ee Horne Improvement Contractors License&Construction Sttperrisors License is required. SIGN�iTURE: r t:r C�1i7sersldac o3�AppDam�I,otaRl2iaosofdV i�dnu-s�T'emporary Iatcaet Fal:slCxumtOorTook18276BDVAtF`XP�gES S.doe Revised 061313 . The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations =' 600 Washington Street r. J it= Boston,MA 02111 ' www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bI Name(Business/Organ' ation/Individual): Address: f,�i' ox IV�'d� City/State/Zip: r`� � Phone#: AVlam u an employer?Check the appropriate box: Type of project(required): 1. a employer with 10 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 g, ❑ Demolition working for me in any capacity. employees and have workers' [No workers'comp.insurance comp.insurance.+ 9. ❑Building addition required.] 5. ❑ We are a corporation and its 10.❑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.❑ Roof 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. 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. , j.p Co Insurance Company Name: { u'-w( J L �( I c��,tl,�C� m Policy#or Self-ins.Lic.#: ULe V 0 g3ao© I Expiration Date: �t{1 Job Site Address: � � ����T�'r /�'/J City/State/Zip: �� V Ar, 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Si afore: 1 Date: l Phone#: '07 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector- 5.Plumbing Inspector 6.Other Contact Person: Phone#• FRASCON-01 PAAS CERTIFICATE OF LIABILITY INSURANCE9129/2 '14 0 Da0r4 9129I2 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER (508)676-0309 NAOME CT Ashley Paiva Vive375Airp Insurance Agency,Inc. AICNo Ext-508-689-2713 FAX 508324-4553 375 Airport Road Fall River,MA 02720 ADDRESS:APaiva_@Yiveirosinsurance.com INSURER($)AFFORDING COVERAGE NAIC# INSURERA:Granite State Insurance Co INSURED Fraser Construction LLC INSURERB: PO Box 1845 INSURERC: COtult,MA 02635 INSURERD: INSURERE: 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, NOTVVIITHSTANDING 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. ILTR TYPE OF INSURANCE INSR 4WD POLICYNUMBER MMIDD I MMtt70 P LIMITS GENERALLIASILITY i EACH OCCURRENCE S COMMERCIAL GENERAL LIABILITY rre I PREMISES Ea bcarce S _ CLNIS-MADE 7OCCUR MEDEXP(Aiy one person) S PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'LAGGRc'GATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGO $ POLICY 7 PRO- J LOC $ AUTOMOBILE LIABILITY INGLE U(rllT Ea ac6dent} $ ANYAUTO BODILYINJURY(Perpsrsar) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per ac:idenQ S HREDAUTOS AAUTOSWNEC (PERACCIDENT) S I S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMSdyIADE AGGREGATE $ DED I I RETENTION S $ WORKERS COMPENSATION 1 iSTATU- OTH- AND EMPLOYERS'LIABILITY Y1 N X TORY UM!TS ER A ANY OFFICEOPRE BE IPAR EREXUDEDO CUTNE N!A 0009930601 9126/2014 9126/2015 E_L EACH ACCIDENT $ 500,000 (Mandatory In NH) EL DISEASE-EA EMPLOYEE $ 500,000 RE describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POL'CY LMfT $ 500,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable Building Division THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601- AUTHORFLED REPRESENTATIVE � ^� ( O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1 • Massacliusatts .IJep+lrtment of Pubile Safety 130XIM of Building Regnlattons and Stanclarcia C41 list('llvil 11 Sopolvism. r License; C8-097668 I AN C XHASL+R IUQ TVMN VIEW x U I :� EASE'T�AL.Tuoni [ r_x raIfoil Cummiasioner 06/07/2015 t &=7 1 Xle up"Mno4w.'�" WcAwdd��� 1 _ Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 . Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 112536 Type: DBA Expiration: 3/23/2017 Tr# 263597 FRASER CONSTRUCTION CO. DEAN FRASER P.O. BOX 1845 COTUIT, MA 02635 Update Address and return card.Mark reason for change. sca 2oM-osi�� Address Renewal GI Employment E] Lost Card ��ie�om�7oaoaureal�o���caaac�aae/d'd _ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only, OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 112536 Type: Office of Consumer Affairs and Business Regulation Expiration:, 3/23/2017 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 FRASER CONSTRUCTION CO. DEAN FRASER 104 TWINN VIEW LANE E FALMOUTH,MA 02536 Undersecretary Not valid without signature a Fraser Construction, LLC 31 Bowdoin Rd.,Mashpee, MA 02649 Email: info(a fraserconstructioncapecod.com -_ www.fraserconstructioncapecod,com. FAX 1-508-428-0123/ PHONE 1-508-428-2292 HILL#1,12536 CS#97668 RE-ROOFING PAOP® AL Date 4 14 15 Name Mike Ingham Email michaelin"hamnW ail.com Phone 508 862-9190 Mailing Address 28,Holly Hill Rd.. Centerville, MA 02632 Job.Address 28nH611y,'Hill Rd. Centerville,, MA 02632 FRASER.CONSTRUCTION hereby proposes to perform the following services in a neat, professional manner.m accordance with the manufacturer's specifications and local building,code. CertainTeed;Shin le O` tions Good Better 'Best Shingles Landmark dmark Pro a. Landmark TL Algae Resistant , '10 years 15 years - 15 years Wind Warrant y 1.30;MP.Hy. ., ,130-MPH 130 MPH Weight/square 2401bs• -_ 260-270 lbs 305 lbs Shingle design Two-Piec&;'i Two-Piece Three-Piece Color Palate Standard" Max-Definition Max Definition Valleys Closed cut Closed cut Open copper Investment $17,475 '_ •. ,$1'8325 $25,695 * All above shingles quoted with-CertainTeed 50 year non prorated 4-Star warranty Shingle Selection:� Colo Initfa ! Payments accepted are: CASH- CHECK- MASTERCARD-VISA-AMERICAN EXPRESS *Any payments not immediately paid upon job completion will be charged 0.005%for every day after the given 5 day grace period upon day of job completion. } * Please note that roof prices reflect:removal=of(1) layer of existing roof unless otherwise indicated in contract: If additionaa layer or layers are removed additional charges will be assessed: " . Possible Extra-After the:shu gles,are•°removedkfrom 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-iris g�the plywood. ,If heeded;this would be charged for as an extra at the rate of$6:00 per' panel includi g Materials &-Labof. There are 6 Panels per sheet.of plywood. , • 't� Possible Extra-Any rotted or otherwise detenorated trim boards, plywood�sleathing, lead flashing; or other carpentry needing replacement will be:done and charged for as an extra at the rate of$7500 per hour, plus 20% mark-up,materials. FRASER.CONSTRUCTION guarantees the labor fo"LIFETIME of roof: ' 4 { FRASER'CONSTRUCTION guarantees the sfiingles against Blow-Offs for 15 years. Please note that all pricing is contingent upon current market pricing If contract is not accepted within',thirtty{days of date of proposal; change`in price may occur due to deviation in material"' - r j r A Any deviation or alteration from,above-specification will'be'executed upon written orders and will become ar extra charge over and Above,the'�estimate. All agreements contingent upon strikes, accidents'or delays are be'yo cl our control. Owner should carry necessary insurance upon,ihetabo_ve,:work: We;>if not accepted within thirty days may withdraw this proposal. hr � FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public Liability Insurance on the above wo k, certificate available upon request. DATE OF ACCEPTANCE: Homeowner :' ' t. Fraser Construction, LLC Y r . t. Engineerift r) ap /! Parcel %�� Perinit# ti _ House#- ` Dat Issued j' Z� —9 Is Board of Health(3rd floor)(8:15 -`9:30/1:00- Conservation Office(4th floor)(8:30- 9:30/1:00=2:006 r Planning Dept. (1st floor/School Admin. Bldg.) $T BE SEP e I C 3 Definitive Plan A ' • lanning Board j/bt'�i,ire f 19 IN$TALLE*J�_ DE IANC6 ell,our TOWN OF;BARNSTABLIVV-��`°)�° AND f• Building Permit Application WWI REGULATIONS Projec ress Village Owner Rit- .�i�-L- .� ✓� Address �vfs�cL� •Telephone Permit Request y f ,�i�G/�/G`�✓ ��J�/%/4'A/ ..First Floor /� r square feet Second Floor square feet .Construction Type_ �,1404 C Estimated Project Cost $ S 5� ZG 1710 Zoning District Flood Plain Water Protection Lot Size /QU2 Grandfathered ❑Yes ❑No ` Dwelling Type: Single Family El"' Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes �No On Old King's Highway ❑.Yes No Basement Type: �11 &Yll!'rawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: as ❑Oil ❑Electric ❑Other Central Air ❑Yes ANo Fireplaces: Existing _Z New Existing wood/coal.stove ❑Yes XNo rw Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) UAttached(size) y}C7de� ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name ,ia Z5 . efj��,c yiG Telephone Number ZZ �/�G// Address eV ?UdZ License# T— Home Improvement Contractor# 3_9 Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO l SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOL O ING REASON(S) r FOR OFFICIAL USE ONLY PERMIT NO. -- - DATE ISSUED MAP/PARCEL NO. i k5 ADDRESS VILLAGE+. Y OWNER ! DATE OF INSPECTION: FOUNDATION FRAME 2 � INSULATION FIREPLACE ELECTRICAL. .' ROUGH _ FINAL - PLUMBING: �ROyGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT: • , tL}w � t� ! i - c ASSOCIATION PLAID . . _ cu - mCZ s ; r MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2.0 Checked by/Date CITY: Hyannis STATE: Massachusetts HDD: 5973 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 5-29-1998 DATE OF PLANS : 5/29/98 ` TITLE: HOLLY HILL PROJECT INFORMATION: East Bay Builders , East Bay Builders Ingham Job Holly Hill. Road COMPANY INFORMATION: - Prepared by CAD Designs '508-833-2057 COMPLIANCE: PASSES Required UA = 65 Your Home = 65 Area or . Insul, Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------ CEILINGS . 196. 30 .0 0 .0 7 WALLS: Wood Frame, 16" O.C: 315 13 . 0 3. 0 22 GLAZING: Windows or Doors 57 0. 316 18 DOORS 40 0 . 320 13 FLOORS: Over Unconditioned, Space 168 30 .0 5 ----------------------------------------------.�-------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these' documents is consistent with the building plans, specifications; and other calculations submitted with the permit application. The proposed building has been assigned to meet the requirements of the Massachusetts Energy Code. The heating load for this building, -`and the cooling load if appropriate has ,been determined using the' applicable Standard 'Design Conditions found in the Code. The .HVAC equipment selected to heat or cool ' the building . shall be no greater than 125% of the design load -as "specified . in ' sections ,780CMR 1.310 and J4.4.: Buil der/,,DS§gner Date MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2 .0 3' HOLLY HILL DATE : 5-29-1998 Bldg. ; Dept. ; Use ; CEILINGS : [ ] 1. R-30 Comments/Location WALLS: [ ] 1. Wood Frame, 16" ,O.C. , R-13 + R-3 k Comments/Location WINDOWS AND GLASS DOORS: [ ] 1. U-value: 0. 31 For windows without labeled U-values, describe features : # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location t . DOORS : [ ] 1. U-value. 0 .32 ' Comments/Location t FLOORS : [ ] 1. Over Unconditioned Space, R-30 Comments/Location AIR LEAKAGE : [ y ) ; Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations , or installed inside an appropriate air-tight assembly with a 0. 5"• clearance from combustible materials. and 3" clearance ,from insulation. VAPOR RETARDER: [ ] Required on the warm-in-winter side of all-. non-vented framed ceilings, walls, and floors t • t MATERIALS IDENTIFICATION: [ ] Materials and equipment must be identified so that compliance can be determined: Manufacturer':manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must. be clearly marked on the building plans or specifications . DUCT INSULATION: [ l Ducts in unconditioned spaces must be insulated to �R-5 . Ducts outside the building must be; insulated to R-8.0. '' ; :DUCT CONSTRUCTION: [ ] All ducts must be sealed with mastic and fibrous backing tape. Pressure=sensitive tape may be used for fibrous ducts . The HVAC system must provide a means for balancing air and water systems . . ;. TEMPERATURE .CONTROLS [ ) Thermostats ^are required for each separate, HVAC system.' A manual, or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or- floor shall be provided. HVAC EQUIPMENT SIZING: r [ ] Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified " in sections 780CMR 1310 and J4.4. MISC REQUIREMENTS : [ ] Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems.' ----NOTES TO FIELD (Building Department Use Only) - k. 41if Ia 4c '-fit:t-It -IlrOlP I Isda -Ton L)"I.L -10 OAVF, b3l f 0-t 4 ;`S b 1;0i ar i al&b eA I mitt Zr c 1 5-n d-i bY.U: (71EI �410,Oe an -oa ,dbrt. q q.,l JC 08V r.R bsifl:'dn -to I MJ svolfi z.bTzt'l. Eazy-:wron dF Sf1!T� .°: The Town of Barnstable � 1079. Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commission: For office use only ` t Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization. conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: - Afr(c/ s 221'Tait 4'1X I`( Est. Cost 3S iGGtG,G�i Address of Work: ,2 ,.�/��L Owner's Name em',l Date of Permit Application: / �z I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under SI,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE H051E IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGZAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: /l a Da a Contractor Name Registration No. OR Date Owner's Name The Commonwealth of Massachusetts 1 Y1_ Department of Industrial Accidents Office affnYestig Offs 600 Washington Street , Boston,Mass. 02111 Workers"Compensation Insurance Affidavit name /��.ci �L 2 L f- Z�9C12 location city shone# ❑ I am a homeowner performing all work myself., elam a,sole proprietor and have no one working in any capacity ❑ I am an employer providing workers' compensation for my employees working on this job. com nnv name address• city phone#: insurance co. policv# Cl I am a sole proprietor general contractor, or homeowner(circle one) and have hired the contractors listed below who haves--- the following workers' compensauon polices: company name: address: dtv phone#: insurnnce co. G olicv# //// cam any name: address: city- phone#. Insurance co. Failure to secure.cover age as required under section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herebv certify under the pains and penalties of perjury that the information provided above is truo and correct Signature Date Print name �1i , i��i Irv/L G Phone# 7 official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑checkifimmediate response is required QSelectrnen's OMce (/Health Department .contact person: phone#; []Other_ (te+vea 9i95 PIA) Information and Instructions ' Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", 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. MGL chapter 152 section 25 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 any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,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 in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be -ubmitted 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. City or Towns 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. The affidavits maybe returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents 0mce of imlestlgadoas 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 i a MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2.0 Checked by/Date CITY: Hyannis STATE: Massachusetts HDD: 5973 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 5-27-1998 DATE OF PLANS: TITLE: COMPLIANCE: PASSES- Required UA = 63 Your Home = 59 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 168 38.0 0.0 5 WALLS: Wood Frame, 24" O.C. 320 19.0 3.0 17 GLAZING: Windows or Doors 40 0.400 16 DOORS 36 0.350 13 FLOORS: Over Unconditioned Space 168 19.0 8 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections 780CMR 1310 and J4.4. Builder/Designer ��k , j //� � �,(��,�Q Date i laScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2 .0 DATE: 5-27-1998 Bldg. Dept. Use CEILINGS: [ ] 1. R-38 Comments/Location WALLS: [ ] 1. Wood Frame, 24" O.C. , R-19 + R-3 Comments/Location WINDOWS AND GLASS DOORS: [ ] 1. U-value: 0.40 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: [ ] 1. U-value: 0.35 Comments/Location FLOORS: [ ] 1. Over Unconditioned Space, R-19 Comments/Location AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations or installed inside an appropriate air-tight assembly with a 0.5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: [ ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. DUCT INSULATION: [ ] Ducts in unconditioned spaces must be insulated to R-5. Ducts outside the building must be insulated to R-8.0. DUCT CONSTRUCTION: [ ] All ducts must be sealed with mastic and fibrous backing tape. Pressure-sensitive tape may be used for fibrous ducts. The HVAC system must provide a means for balancing air and water systems. I TEMPERATURE CONTROLS: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in sections 780CMR 1310 and J4 .4 . MISC REQUIREMENTS: [ ] Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems. ----NOTES TO FIELD (Building Department Use Only)------------------------- 1 i { F Fr—T— i \ i f`sx '` It S7 j I PROPOSED ADDITION L;=Fi' ELEVAION ADDITCN I EAST BAY BUILDERS I SCALE� 114 _T \ GAD DESIGNS - 833-2057 /� I - I I— I_ I. I a I— � L 1= . _ Jid L .. i YLJ #1 I-L-L LU =" H -J I I I— t_ E ti INGHAN - F :ONT ELEVATION ADDITION EST BAY 3 U I LIRE PIS SCALE 1/4"_1' DATA 1 5/10/g8 \ GAD DESvNS - 8333-2C57 PF'OPOSED ADDITION Hill } 9NGHAM - REAR ELF-VA ADDITION_ FAST BAY BU I L.DEia?S SCALE 1/4"=1' DAT= 5119198 GAD DESIGNS - 833-2057 t l' 4'7- - ' ANQE2EN FRENCHwoOD N OFFICE HINGED PATIO I - - - - -- 16'FWH�OroBPALR 5 l 1'6t -3'10- — 3'8 410-- I k \ I I 0 tv \ - o 0 ao CEILING FAN L-° C) —� �y. 4.T, LE + 244-0 2A4ry \ ffI I DINING - -DN i HATC-=ED Lid \k/ALLS ARE '12OP75EG I N �aDDITION I iv ; f IFri i I f I � i I I , --4'3 - —5'6 4'3 47-- — 715 i -� INGHA"I - PROPOSED ZM7= CLDITION i BAST BAY BUILDERS SCALE 1/4" = I _� CAD DES1 GN5 - 833-20.57 i r `11GRO LA-1 BEAM FOR RIDGE #235 ASPHALT 5HINOLF-5 2 X ro COLLAR TIES FOR OVER 1/2"COX PLYWOOD -`� VAULTED CEILING - R-30 INSULATION IN CEILING AND SLOPE CEILING �2 X 10 RAFTERS 10"O.G. 2 X 410" O.G.74" 2 X 10 FLOOR JOISTS 16"O.G. WHITE CEDAR SH NGLES OVER 117 GDX PLYWOOD R=9 INSULATION--� J /BILGO SIZE"G" BULKHEAD 2 X ro PRESSURE/ TREATED SILL <-- ,8"THICK X 70"HIGH POURED OVER SILL 5EAL. CONCRETE FOUNDATION k 3" POURED CONCRETE FLOOR 10"AIDE X 8" HIGH POURED CONCRETE FOOTINGS cc PROSPOSED ADDITION GROSS SECTION TBAY B U!�D L�S SCALE 1/4"=1' DATc 5/19/9E \ GAD DESIGNS - 833-2057 If I it I II i j Lo to N Mg I \ 16'X 6"CONT NUOS POURED \ i CONCRETE FOOTING \ \�\ ALINE=PRESENT FOUNDATION \ WA-L cV S'POURED CONCRETE < -FOUNDATION 76"HIGH 3,000 P.SJ CONCRETE \ i 61LC0 SIZE `� ► HATCHED WALLS ARE } i PROPOSED FOP, ADDITION N cC I N � I I i I I i 1 � I I I I T8 4'10 1'6 29' LIV r 43' I i /INGHAM - PROPOSED ADDITION FOUNDATION PIANO EAST BAY BUILDERS SCALE 1/4"= DATE 5/19/98 �• � � GAD CESIGNS - 833-2057 5 Y i 9. 1. ft a 11 r�4} r I J W? 7 z{ .4 �, }r - 5 yJ! 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