The URL can be used to link to this page

Home My WebLink About0049 GOSNOLD STREET COs�oL� �'j 9 � �� Soy �6a — Town of Barnstable *Permit# 1 y°R Expires 6 months jr issue date OCT - 5 2o07 Regulatory Services Fee 7`QwN 01z BA E Thomas F.Geiler,Director RNSTABL Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.banistable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTUL ONLY Not Valid without Red X-Press Imprint Map/parcel NumberM 3d ty Of 3 Property Address ❑"R sidential Value of Work /24 f ID- ev Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Ro G6 y- 'a vr- e' a-r%0 (iJl��rvzltle Contractor's Name OfLT 6 JAIJr Jl1lG Telephone Number SD 776 O Wy Home Improvement Contractor License#(if applicable) 1X dP6 Construction Supervisor's License#(if applicable) [�orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner M!have Worker's Compensation Insurance Insurance Company Name LGtT �y Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roofl 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 f the Ho Improvement Contractors License is required. SIGNATURE: 0 SI G` i� Q:Fomis:expmtrg Revise061306 I The Commonwealth of Massachusetts Department oflndustrialAecidents Office of Investigations • 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers" Compensation Insurance_Affidavit: Builders/Contractors/Electricians/PIumbers Applicant Information Please Print_ Legibly Name (Business/Organization/Individual):. ~_ l4� G C42✓,)' Address: 07. dG�6e City/State/Zip::(��Tii�� Phone.#: 776 �9�y Are you an employer? Check the appropriate box: Type of project(required):. L 1. _I 1 am a employer with 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. t' • 9. El Building addition required.] 5. ❑ We area 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' camp. right of exemption per MGL 12,D Roof repairs insurance required.] t C. 152, §1(4),and we have no • employees, [No workers' A3.0 Other r P/,r/��. comp. insurance required] . r *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(rave employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below islhe policy and f ob site information. Insurance Company Name: Jtle Policy#or Self-ins,Lic.M Expiration Date: Job Site Address: d1lo / 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 6. 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification Ido hereby certify a thepains• ndpenalties ofperjury that the information provided above is true and correct: Signature: =!C Date: le Phone #: !F 7?� Official use only. Do not write in this area,tb be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2.Building Department 3. City/Town CIerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: �0t fHE � 'own of Barnstable. Regulatory Services i EARNSfABLE, asasa Thomas F. Geiler,Director �ATEn Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 "w.town.barnstab le.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to.work authorized by this building permit application for; (Address of Job) Signature of Owner Date Print Name r QYOR.MS:OwNERPERMIS SIGN f Isfa nd S iding a nd Ro ofing a division of RLTConstruction,Inc. Proposal to: October 2, 2007 David Trotto Re: 49 Gosnold St. Hyannis 164 Scudder Rd. Osterville, Ma. 02655 We are pleased to submit the following specifications and estimates for re-side, windows, trim replacement, etc. Remove existing cedar siding and (lashings. Install Tyvek housewrap and window flashing. Install Maibec Grade A R&R Bleached white cedar shingles and ribbon detail. Cut back and remove patio slab to notched area leaving partially to support wall_ Install Azek pvc trim replacing all rotten cornerboards and new lx8 water table on west side wrapping around to front south side.As well as new Azek airboardsand light blocks. Install a total of 9 Harvey classic 6 over 6 dbl hung replacements with half screens and 1 new construction casement window in kitchen. 483-2 R.O. 29 3/a x 56 3/a. Install 2 vinyl louvers replacing wooden louvers on gable ends. Remove and replace necessary amount of roof shingles to install flashing. Clean up and haul away all debris to landfill.. We hereby propose to furnish material and labor- complete in accordance with the above specifications for the sum of. $13,500.00 No deposit, Payment in full due upon completion. All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alterations or deviations from the above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents,or delays beyond our control. Owners to carry fire,wind damage and other necessary insurance. RLT Construction, Inca carries General=friability°and Worknm's•� Compensation Insurance. Certificates of Insurance provided upon request. ACCEPTANCE OF PROPOSAL: The above prices, specifications and conditions are satisfactory and hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Z76Date of Acceptance: �7 Signature_ 1711 + Start Date: Signature 31 Manni Circle - Centerville, Massachusetts 02632 Telephone 508.420.5243 and 508.833.5249 - Fax 508.420.1776 - Eniaifcaperoofer@caperoofer.com Jj RightFax H2-1 10/3/2007 5 : 12 : 09 PM PAGE 003/003 Fax Server ACORD. CERTIFICATE OF INSURANCE DATE(MMXDDlYY) 10-03-07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE EDWARD A GRAZUL INS AGCY HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO BOX 337 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE_ MARSTONS MILLS,MA 02649 s — COMPANY 28Y2K A HARTFORD GROUP - INSURED COMPANY - -"" B — R L T CONSTRUCTION INC COMPANY 31 MANNI CIRCLE C ' CENTERVILLE,MA 02632 COMPANY - D COVERAGES 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. CO POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER DATE(MMIDD%YY) DATE(MMIDDIYY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL PRODUCTS-COMP/OP AGG. $ CLAIMS MADE OCCUR. PERSONAL 68ADV.INJURY $ OWNER'S 88 CONTRACTOR'S PROT. EACH OCCURRENCE ' $ FIRE DAMAGE(Any one fire) $ MED.EXPENSE(Anyone person) $ AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY.INJURY(Per Person) $ SCHEDULE AUTOS BODILY INJURY(Per Accident) $ HIRED AUTOS PROPERTY DAMAGE $ NON-OWNED AUTOS GARAGE LIABILITY ANY AUTOS AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGREGATE $ EXCESS LIABILITY UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ WORKER'S COMPENSATION AND A EMPOLYER'S LIABILITY UB-1051CO45-06 12-24-06 12-24-07 STATUTORYLIMITS X THE PROPRIETOR/ EACH ACCIDENT $ 100,000 PARTNERS/EXECUTIVE X INCL DISEASE-POLICY LIMIT $ 500,000 OFFICERS ARE: EXCL DISEASE-EACH EMPLOYEE. $ 100,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIRESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE TOWN OF BARNSTABLE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE - ATTN:BUILDING DEPARTMENT NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR 200 MAIN STREET REPRESENTATIVES. HYANNIS,MA 02601 AUTHORIZED REPRESENTATIVE Raman'Ayer ACORD 25-5(3193) ✓�ie Coom�maaiuueal�i a�✓�aaaac/z.raetla Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registr ation Board of Building Regulations and Standards 134286 One Ashburton Place Rm 1301 Expi rat—[on 10/22/2009 Tr# 133426 Boston,Ma.02108 G. RLT CONST INC,DBA 1'SLAND SIDING&ROOFIN. RONNIE TAYLOR� 31 MANNI CIRCLE`t\ � CENTERVILLE,MA 02362" Administrator of valid without signature t,