Loading...
HomeMy WebLinkAbout0066 OUTPOST LANE 4-4 G U Town of Barnstable.. L�G �� o Expires rrt7 m Rebidatory Services Fee %65 Thomas F.Geller,Diriecton APB I Building Division 'Tom Perry,CEO, Building Commissioner T® f� 3 200 Main Street Hyannis,MA 02601 www.tovm-bamstab1e.ma.us 08-862-403S Fax:508-790-623 0 EXPRESS PERNHT APPLICATION - RESIDEN` J AT, 0NLY lvot Valid wuhout RedX-Press bs print Map/parcelNumber Property Address /7 krtl�3!/l(i ❑Residential Vahre ofWork S 1 Minimum fee of S35.00 for work underS6000.00 I Owner's Name&Address r 7ra, Q' ` OA70,f V6 Contractor's Name17Lf iC �1t15 ��UiC f7�f)�; l� Telephone Number — d,�q 9,� Home Improve Co Lic ense cense r(ifapplicable) I 63 - - � IRTM-1-1: •.• � rCo �c v, Cry .r�G��l Construction Supervisor's License m(ifapplicable) Workmaes CompensationInstuance Check one: ❑ I ama sole proprietor . Wamthe Homeowner have Worker's Rnipensation.Insurance Insurance Company Name , S J + ._ �nsuravi6e, Workman's Conp.Polk # Copy oflnsurance Compliance Certificate must accompany each permit. Perna Regytst(check box) x • „� � �/'� Re-roof(hurricane nailed)(stripping old shales) All construction debris w-Mbe taken to Re-roof(hurricane nailed)(rot stripgia Going over_. existin layers o#roo#} LVJ Re-side ❑ Rephcement Windows/doors/sliders:.U-Value (maxiir=.35)#ofwindows #ofdoors: ❑ Smoke/Carbon Monoxide detectors 4 floorplans marked with red S and inspections required.- Separate Electrical&Fire Permits requiieed a'Wltre required:Issuance ofthis peseta does not exempt compliance with odrer town deparrmeLTtgtlatnas,ie.Historic,Conserve inn etc ***Note: Property Owner mrrstsignProperty Ovmer Letterof Permission. - A copy of t e Home improvement Contractors License&Construction Supersisors L'icense is required. , SIGNATURE- C�Users\decolblc'AppData'LocatMi=owftmV indoors\TemporaryTrstunetFtles\C=.em0ubok\M76BDVAI )TRESS.doc Revised 061313 ° FRASCON-01 PAAS ' ��'O�®^ - •, . -,. _•._ DATE(MMIDDIYWY) �- CERTIFICATE OF LIABILITY INSURANCE 9,19t2013 THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION'ONLY AND CONFERSNO 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 tINSURER(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 CONTACT - - • {508}676-0309 NAh1E: Ashle Paiva Viveiros Insurance Agency,Inc. • PHONE 375 Airport Road Arc No Exr: 508-676-0309 127 ,Arc,No>: 508-324-9147 Fall River,MA02720 aeDRESS:APaiva@Viveirosinsurence.com _ • - INSURER(S)AFFORDING COVERAGE NAIC 9 INSURER A:Granite State'Insurance CO INSURED Fraser Construction LLC - - INSURERS: - PO Box 1845 - INSURERC: • - ' Cotuit,MA02635 A INSURER6: INSURER E • - INSURER - 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. NSR LTR TYPE OF INSURANCE I R WVD - POLICYNUMOER MlDD MMIDD EXP LIMITS GENERAL LIABILITY . EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY - PREMISES EaEctarT- $ CLAIMSMADE a OCCUR MEDEXP(Any one person) $ PERSONAL&ADV IN„JPY - $ GENERAL AGGREGATE $ RETNAGGREGATELNIT APPLIES PER PRODUCTS-COPAP/0P.4GG $ OLICY I PRO- LOC OSILELIABILnV M I SIN LWIEa accident)NYALITO ., BODLYINJURY(Perperson) $LLOWNED SCHEDLLEDUTOSAUTOS?- - - SODLYINJURY(Peraccident) $ NON-OWNED RED AUTOS AU` . A $ Per accident UMBRELLALIAB OCCUR - EACHOCCLIRRENCE. $ EXCESS LiAB CLAIMS-MADE A - - AGGREGATE $ DED RETENTION $ , WORKERS COMPENSATION $4 - WORY LIMITS TH CSTATU. OTH AND EMPLOYERS'LIABILnY - - T A ER OFFICEWMEMBERREXC UDED CPROPRIETORIPAR UTIVE`Y . NIA W0009930601 ,- 9126/2013 9/26/2014 ' E.L.EACH ACCIDENT $ 500,00.0 (yes.deoryleund) - :E.L.DISEASE-EA EMPLOYEE $ 500.000 Iryes.descobeunder - DESCRIPTION OF OPERATIONS below _ E.L.DISEASE-POLICY LIMIT $ 500,000 ' F DESCRIPTION OF OPERATIONS ILOCAMONSIVEHICLES(AftachACORD161,AddRionelRemarks8chedule•ifmo re spacelsrequired) CERTIFICATE HOLDER CANCELLATION _ z . SHOULD ANY OF THE ABOVE DESCRIBEb POLICIES BE CANCELLED BEFORE Town of Barnstable Building Division`•` THE..EXPIRATION DATE •THERREOF. NOTICE_ WILL BE DELIVERED IN ' 204 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. • � Hyannis,MAOZ6O1- AUTHORIZEDREPRESENTATIVE , O 1988-2010 ACORD CORPORATION- All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD _ Tee Cornr�lo.2�N�alth of l�assachzrsetts �rT Depa�tme3�i of lndiarrial Accidents, 4 Office Of 17"west.gano s µ ;7 600 t,�a�v, gLoli Street e }��'�'� 7 C=o\ y�o° Bostol2, SVLtl OL11.T r _ ww w.r,2ass ;ov%dia M workWs compe-asadoll.Insurance Affidavit:BnilderslContracto:s/Electrieians/Pivanbexs . Applicant Tnfoi-lmtation E Pease Print Legibly Lazne(Business/Organi.zation/IndividuaI): � t'T f ,i} L' Address: City/State/zip: �C ©� 35 .Are you an employer?Check the appropriate box- Type TJpe of project(required): 1. L"J .J am a employer with D 4.❑ I_am a general contractor and I have E,. New co� c i employees(full and/or part-time).* hired the sub-c ^ � .non P' 1 ox tractors listed on ?. Rcmodeima a2• 0 the` 4ed•sheet�- O I am sole proprietor or partnership Thes 'sub-contractors have $ Q Demolition; and have no employees working for employees,and have workers'comp. 9.` Building addition mein any capacity.[No'yrorkers' msurance. comp insurance required.] 5.E]'We are a corpozmzion and its 10.Q Electrical repairs or additions officers have exercised their right of I l Plumbing repairs or additions 3 Q I am a homeowner doing all work exemption per MGI c.152§(4),and 12. Ztoof tiers myself Nt o workers'.comp, _-Q r .. . . p we have no einplayres,j?io warkers'' � I3. Other ' insurance required]i comp.insurance rMgnired.] 0 , 4 *Any applicant that checks-oox r1 rnrst slso Ell out me secdon belo:v showing their woikea'.comperrtiorpolicy itionratiot. t Homeonners who submit:his affidavit indicating they ar>do;ng alb work and then hie ouL6L-conttactars runt subr to new a 5davir indicating sroh *Contractors dla2 check this box must attach au addi=oral sheet snowing the name of tie sub contrarte.a and state whether or not thou entities hal a�vpioye ;f the sub conxz tors havenployees they mast provide taste workers'comp.policy number. I am an employer that is providing workers,compensation insurance for my employees.Selory is the policy and job Site irzfonrurt7an_ G ���/; I J' r� lnsuranca Compaay Name,, .1 W Policy Y or SeL*"*"-ins.Lic.. 0 DD%% JDta V I / f Expiration D'te: Job Site Address: r City/5tatelltp: ; Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Fai!ute to secure coverago as required larder Section 25A,of MGL c.152 can lead to the imposition of crrminal one-year impdsom, =Tt as we11 as civil peoaltiec in the form of a STOP WORK ORDER sod a fine of up w al penalties of a fine up to$1,5oo.00 ands, that a copy of this statement m2y be forwarded to the Office of Investigations of tic DIA for insurance coverage verificaty ag�t'Cat violaror.Be advised .16 hereby certify the 7 en¢liies of perjury t3rat the information sided above is true and correct " Signature: Date: phone#: 02 Official aia,only,Do not write in this area,to be completed by city or•,town offrciai City or Town: PernaitUcense n Issuing Authority(circle one): € 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Ir lectrical Zaspectcr 5.Plumbing inspector , 6.Other Contact person: Phone??: Massachusetts -Department of fiuhlic.Safety ' EE' 80ard of Building Regruatigris and Standards . f Crtnstructinn Superrisor - . License CS-097668 � DEAN C FRASRR�` ' 104 TWIAN VIEW EASTFALMaTJ Expiration Commissioner 0 610 7/2 0 1 5 avr:r�r,�%�zcur�r O ce o ConsumerAffairs and Business Regulation I O.Patk Plaza- Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration:- 112536 `TVpe: DBA• . FRASER CONSTRUCTION CO. 'itiO°- 3/23/201b arm"z37oss - DEAN FRASER P.O. BOX 1845 COTUIT, MA 02635 IJpdateAddress and return card_Mark reason for change, sr,:A Address ❑ 1tenewai Em to _,.. � P.Yment Lost Card Ofliicc of Consamer Affairs&Easiaccs 1Loguiation , License or registratioa valid for indrwidul use only OMS IMPROVEMENT CONTp CTaR before the cxpiratioo date If found return to: a" N Re9lstration: 1 i25 Type: Office of Consumer Affairs and Business Regulation. ��=`..:•Expiration: 323/2015. DSA 10$ark plats-Suite 5170 FRASER CONSTRUCTION Co. ' Boston,NTA 02116, ? DEAN FRASER � � �' 104 TV411NN VIEW LANE r / E FALMOUTH,MA 02536 ���"` �! Uadersccrctary Not valid without signature , - k f' 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$75.00 per hour, plus 20% mark-up materials. FRASER CONSTRUCTION Warranties the labor for LIFETIME of roof. FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 15 years. CERTAINTEED Warranties the shingles and labor 100% through the Sure Start Warranty duration. E Warranties h shingles ALGAE resistant f r hduration f the CERTAINTE D arrant es the s g es to be Cao the o Sure Start Warranty depending on the shingle that was purchased. Any deviation or alteration from 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: C Homeow r Fraser Construction, LLC 5 SEPTIC SYSTEM BE r� 'NSTALLED IN COMPLIANCE WITH ARTICLE II STATE ( SANITARY CODE AND TOWN TOWN OF A R1`.-'S T A9F NI Ii�E S' ".__. . ..__ S • r i 33AR33TODLE, i �,/► NAM 9 - UUILD1 G INSPECTOR O �1 p MAI a' F 4n•� a f.r ,. t APPLICATION FOR PERMIT TO .......................:?'' . ....................................... ......................... TYPE OF CONSTRUCTION ....... ................ ................................... ............................................................ ................A.oe:�... ,. .....19..73 y TO THE INSPECTOR OF BUILDINGS: 1 The undersigned hereby applies for a permit according to the following information: Location .... 0..L.. ..P-...6. .r!1'......... :!J f��0 S.l.... .RN ..................�N% {. E.....f/f L.G........... ................................... ProposedUse .....;•/;)•• JI(7C/!/t?C................................................................................................................................ Zoning District ........ ...................................................Fire District ........................... Name of Owner f ...✓.t.�!30W(VJ:..•-L MAddress ✓6 QV f �Y a9� � �:I F�!!I ...... .......... Nameof Builder ........... 38.-A.E..........................................Address .................................................................................... Name of Architect 1�.1 WA—fO.....P1.C7.QrAf�S)-t1............Address .......- ! .................................................... Number of Rooms .......... ..Z...............................................Foundation ?.11�2E: .... .a•/VC: � .............:....... • Exterior .... > `CEI� Sf�lNd ...Roofing ....... Floors . ! .� — Interior ...................... ....... Heating .....!1:�.YV e © 1.�— ...........................Plumbing .........�i 0 �........................................... Fireplace .......:. .......................:................................................Approximate Cost-..f I.p®.v..........................oe Definitive Plan Approved by Planning Board <--A— -J 9-fi_-___-19 Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH /00 zs' z f I 1 I � I r r 1 l 1 f ® Q { —P © 15 / I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .......... .(t..d. .... Daniel A. Brown Jr.. Inc. No .... Permit for ....... single ;�amJ4 Ing... .......................... ... .. Large Location ........ ......... .......................... ..... ...5k............................ Owner ............. Type of Construction ..................rrmft............. ..................... .........................................................Plot ............................ Lot ....................ft...... ?) 7, AUVst 3 Permit Granted ........ ...... 9 v7 T_ Date of Inspection ....I ... . ...................19 Date Completed .... .............. 0 ................ . PERMIT -REFUSED ,ft. ..... ... 9.... . .. ...../ TI 7 ........................................ ................................................................................. .............. ....................................................... ........................................................................ el Apotoved ............................................ 19 ............ ......................................................... ................11.1 .................................................