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Home My WebLink About0025 WILLIMANTIC DRIVE 'k.F�/ ixM.>w.�_..f."�- .e Yuu�•,�-a..nr,..:+.++a+..w.r.�nnu.+raas�n.wn0.�::w�iY x_ - Town of Barnstable Building enK. i.e. Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept tesq �� Posted Until Final Inspection Has Been Made. Permit ►aa+' Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-20-1206 Applicant Name: Kirsten McCracken Approvals Date Issued: 05/18/2020 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 11/18/2020 Foundation: Location: 25 WILLIMANTIC DRIVE, MARSTONS MILLS Map/Lot: 103-050 Zoning District: RF Sheathing: Owner on Record: MCCRACKEN,RICHARD P&KIRSTEN B Contractor Name: Framing: 1 Address: 25 WILLIMANTIC DRIVE Contractor License: 2 MARSTONS MILLS, MA 02648 Est. Projec t Cost: $8,000.00 Chimney: Description: Remove deck Permit Fee: $90.80 Replace side door entranceway Fee Paid:f $90.80 Insulation: Replace siding,windows and some trim Final: Date: 5/18/2020 Project Review Req: 3- 10 sono tubes required on 13-1/2 foot edge. Reference: Prescriptive Residential Wood Deck Construction Guide based � ��-� Plumbing/Gas on the 2015 International Residential Code for the deck Rough Plumbing: construction. Building Official M Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced withiih.six months afterkissuance. All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. Rough 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 street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: ng 3.All Fireplaces must be inspected at the throat level before firest flue lini is`inst'aITd 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health 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 MGL c.142A). Building plans are to be available on site Fire Department � All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: ir - i ��"• ..�^" lid � , lb . Y t� cam—/. � V"� + ,• _ 8' SF ill y}(�� Y ft°,ft;2 3Air', , y %e oCA�'10�+ IT Ap cr.aTir- Tti4Ar 't14'C-- t-1E�Er�t� 6coAP1_YS WIT" TWG �jID`El l►�� , A-wL-> >AC►G V C-Q E W'T O P T � S�'rC� �.1tjZENt S - VT RC:C-.1S'rZA"cz.0 14A •lL) 6Uzwai 4>i?.4- le, Q.0-'r ,. BA'iev 0" 4w � tlS'TC��/1�..1.G cs �ca1s. ?sl 0 ,. `,` t» OI&L i> `�'t ra�y,i C,c' t l i��11: IL t":'c" 1. ,�•,.E� � � � 'tf Town of Barnstable *Permit#, 610 �4N, Expires 6 mondLtfrom is uadafe "7 Regulatory Services Fee • BAMsrABLE, Thomas F.Geiler,Director M6 ,,•� Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 UAW www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number \Q3 QSO . M I Property Address (ID`j Residential Value of Work � �'{� Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address a)oad Contractor's Name —A2,.) c elephone Number Sa ya 6 Home Improvement Contractor License#(if applicable) MWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor XmPR SS PERMIT ❑ I am the Homeowner RI have Worker' Compensation Insurance ' \ FEB- — 5 2009 Insurance Company Name V` C OF ggRNSTA6LE Workman's Comp.Policy#� ►JC V��j�> Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) XRe-roof(stripping old shingles) All construction debris will betaken t 4 n"fl bC—& ❑Re-roof(not stripping. Going over existing layers of roof) R. Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.44) i *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.HistoricConservat o g etc. c=1 ***Note: y'` Property Owner must sign Property Owner Letter of Permission. /copy f the Home Improvement Contractors License is required. c n co SIGNATURE: �r. Oy a, r- �! 1-rt Q:Forms:buildingpermits/express Revised 123107 I 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). _ Address: _City/State/Zi ' `� Phone.#: ` -y QSa Are you an employer? Check the appropriate box: Type of project(required): 1. I 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' 9. ❑Building addition [No workers' comp. insurance comp. insurance.t 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 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12NA-19 Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 131-1 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: , C,�,, x � �c Policy#or Self-ins. Lic. #: fm cnS 6 Expiration Date: 0 Job Site Addresss � City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy nuVnber 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 tip 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 d y against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of th D r insurance coverage verification. I-do-hereby-c-er-ti- / n r-t ains-and penalties-of perjury-that-the-infor-mation-provided-aboue-is-tr-ue-and-corr-ect. Si ature: Date: Phone#: Official use only. Do not write in this area,do 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 S.Plumbing Inspector 6. Other Contact Person: Phone#: Client#:47298 CAPIHOM ACORD,- CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) PRODUCER 12/30/08 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rogers&Gray Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 434 Route 134 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P.O.Box 1601 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. South Dennis,MA 02660-1601 INSURERS AFFORDING COVERAGE INSURED NAIC# Capizzi Home Improvement,Inc. INSURER A: NGM Insurance Company Capizzi Enterprises,Inc. INSURERS: American Home Assurance 1645 Newtown Road INSURER C: Cotuit, MA 02635 INSURER D: INSURER E: COVERAGES 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 AN POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. D CONDITIONS OF SUCH s LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE MM/DD DATE MM/DD LIMITS A GENERAL LIABILITY MPB1075H 06/08/08 06/08/09 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY. DAM_EBIAGE TSESO RENTED $5O OOO CLAIMS MADE F x1 OCCUR MED EXP(Any one person) $rj 000 PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JE O- LOC PRODUCTS-COMP/OP AGG s2,000,000 A AUTOMOBILE LIABILITY M1 M28044 06/08/08 06/08/09 ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $500,000 ALL OWNED AUTOS X SCHEDULED AUTOS BODILY INJURY (Per person) $ X HIRED AUTOS X NON-OWNED INJURY WNED AUTOS (Per accident) $ X Drive Other Car PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCESS/UMBRELLA LIABILITY CUB1076H 06/08/08 06/08/09 EACH OCCURRENCE s5,000,000 X OCCUR CLAIMS MADE AGGREGATE $5 000 000 DEDUCTIBLE $ X RETENTION $1 OOOO B WORKERS COMPENSATION AND WC6957000 12/25/08 12/25/09 TDII'ICEAS7EPOLICY - OTH- EMPLOYERS'LIABILITY LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE ENT $500 000 OFFICER/MEMBER EXCLUDED If yes,describe under EMPLOYEE $500,000 SPECIAL PROVISIONS below - LICY LIMIT $500 000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Carpentry CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION* Town Of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL I n DAYS WRITTEN 200 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Hyannis,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08)1 of 2 #S40650/M40647 KW 0 ACORD CORPORATION 1988 �-\- 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: rf\ Board of Building Regulations and Standards Registratjpp; 100740 One Ashburton Place Rm 1301 A51 -"fi 23/2010 -:,'7l Boston,Ma.02108 `element Card CAPIZZI HOME tARY GUSTAF30ty �_ 1645 Newton Rd. `•: <::% Cotuit, MA 02635 1' —'-- Administrator No valid itho nature _ Nhjss,tcbusetts- Dep.artnicrtt of Pulalic Sill* t. -- — — Bo;:rtl of Baililiwg Repl;itions ;md Standards Construction Supervisor license License: cS 74640 Reatri.cted:to: QQ Y. GARY:GUSTAFSON" :. >, 8 SHORT:I .AY M SANDWICh ,.MA 02563 Expiration: 11/29/2010 i uf74Fn i.�atnf:r;' "1r 7755 .. Page 7 of 7 CAPIZZI HOME IMPROVEMENT INC. SPECIFICATIONS AND ESTIMATES STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT I, OWN THE PROPERTY LOCATED AT IN , MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER: '� y OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit, MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: Assessor's office (1st floor): pF7�ET0 Assessor's map and lot number ....6.31!�J0.J.'k'.... Sewd of Health (3rd floor): �� ^$g�' INSTALLED IN COMPUANC t BAB39TADLE, S Sewage Permit number ...... ...�....... �.................. •Engineering Department (3rd floor): 05 a-?1T�'I TITLE 5 'oo rb 9. 0� 'riouse number ......................................................................... Etf�EO; .=a !�? 'AL CODE AND Definitive Plan Approved by Planning Board ________________________________19-----TOWA REGULATIONS APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING .INSPECTOR APPLICATION' FOR PERMIT TO ......&4a...........j0l.�.G.IS......C�� .n..Degi TYPE OF CONSTRUCTION .......1/✓✓D.m.�......C�f >S.! .!' ....��C.c� . . ......................................................... �12...... ....................I 9.7.T TO THE INSPECTOR OF BUILDINGS: ' The undersigned hereby Japplies for a permit according to the following information: Location . /t M G.A ,,C Pr Proposed Use ...�.Sf1yl.�....l.:Cc.rrR.CIf......{ 1 .�`lf.Hf............................................................................................................ Zoning District ..Fire District / ( `/ Name of Owner ....C..C......!6.C2.C.11.O.............................Address .. 5_Afne..... .........................................:.. Name of Builder ..f".t .4s.'2.+ .t.S..... ....G.a.11J..1f .............Address /.C7..T..:. r.f?✓.c,��.... .�.... rM6tl �.r�:rYl... ��73 ,Name of.Architect ..................................................................Address .................................................................................... Number of Rooms .........,.....................:..................................Foundation ...... 6n/ /2 94.0�� Exterior .... ............................................................Roofing Floors ............lda.00......................................................Interior Heating ........... ......................................................................Plumbing ......................................................... Fireplace .............--:-................................................:............Approximate Cost`(...1.570..<?.:e..o:s?Jf..................... ...... Area ...... ... ....�j...!fr.. .......... Diagram of Lot and Building with Dimensions Fee ...................... N bo e A k < (✓, II ma•�� c Or OCCUPANCY PERMITS REQUIRED FOR NEW.DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Construction Supervisor's License .66A-770.......... BOTELHO, ED No Permit for ..ADD..DECK ..................... Sing- ............... ........ Location ....2.5....Willimantic.....Drive........ Marstons mills ................................................ Ed Botelho Owner ............... Type of Construction ........FXAMe...................... ............................................................................... Plot ............................ Lot ........ ....................... Permit Granted ........Ju.n.e...1.0...............19 88 Date of Inspection ............. .................19 Date Completed ..................I .......19 c. 73 M n r:;, .. .s-�. �. .�. r.rp �.-� ,.. ._ -.•:'f:,?tiv �.>��.':�.`ti�`-.�i��aTJ.R:'�'b-=u'��8:.� �•Y4si��J+'.-�,�,"w.VaO"-+:adiiYlics(� ,brla-� fir. :c3:.'�_...U,_,.. �•- Assessor's office (1st floor): �TNET Assessor's map and lot'number ..../�.3 �` .�: �o Board of Health (3rd floor): + ( WQ o Sewage Permit number ...... ......................r� ..................... t IA"S LBLE. 2 Engineering Department (3rd floor): 1.-dS os oo ;'6 9• 0 Housenumber ........................................................................ o No 6. Definitive Plan Approved by Planning Board ________________________________19________ . APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN 'OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ..............:..............................................................................�............................... TYPE OF CONSTRUCTION �/'�oo ��ess�r'c (✓cca7 �d ....................... ................................................. � 7. !?..f .^........................19........ �- TO THE INSPECTOR OF BUILDINGS: + The undersigned hereby applies for a permit according to the following information: tj Dr Location ..............................................--:-..................:.....G r.5....f?....�....................:x:. ..........,:......°:........................ O ��h�/e Gina d/y1f✓c��r-y _ Proposed Use ..........,..........�.................. .................. , - ......................................... Zoning District Q r�/A /•f ......!..`.... ..........................:............................Fire District .../ !C/�.5�b✓15..........i//S . .................................... Name of Owner ....... .e/.k0..............................Address ..S nr.....4'... �?ti. ............................................ Name of Builder .. Y..`:.....{.......�e..... o/�r.(1r.............Address �4?.$....�� ........`........'�mav� 11 ............h...:............. Nameof Architect ..................................................................Address ..................................................................................... Number of Rooms .........Foundation ......'�6�......................................................... ............... Exterior ....................................................................................Roofing i ......................................................... .. ......................... �D o�Floors ......................................................Interior........ .................................................................................... Heating ............... ...............................I..................................Plumbing Fireplace ..................................................Approximate Cost'........... ......................................... .. ...... Area ... ... f.' `... Diagram of Lot and Building with- Dimensions ' Fee3 74� _.�.�.., 1 F�u✓S`` o 1� d ' •V0 i (J, �� H1 a n.i� O , OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and':.Regulations of the Town of Barnstable regarding the above construction. Name .' .�..��.`..:`� f ��......................... Construction Supervisor's License . l5.a..�.7� BOTELHO, ED . A=103-050 No ... Permit for ...Deck ........................ Single Family ........... Location .?,5..Yi.1.ji.m.an.t.ic...Drive........... .. .. .... .. .... .. .. .... . ..................Mj!K-KAtpn.s...M111s........................ Ed Botelho Owner .................................................................. Type of Construction .......................Frame....... ........... ............................................................................... Plot ............................ Lot ................................. Permit Granted .....June 1.0., 88 ............... .. ................19 Date of Inspection ....................................19 Date Completed. ......................................19 Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 10/31/14 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St.Hyannis,MA 02601 RE: Building Permits Dear Mr. Perry, This affidavit is to certify that all work completed for 25 Willimantic Drive has been inspected by a certified Building Performance Institute(BPI) Inspector. Ceiling: R-19 cellulose Knee Walls: R-7 Thermax All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 103 Parcel 6 5 Application # ` O b W(O U Health Division Date Issued Conservation Division Application Fee I Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board �L Historic - OKH _ Preservation/ Hyannis CRC Project Street Address ot, JC IN MOLA I C ri Y 1 Village Cq aSsb A 5 Owner 'P—d m a r a n:'e l h o Address gay M E Telephone 5 0 B 4 a 8 1051 Permit Request 9 G8 l.orS l� iv I n+ w14 S I Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 0 Construction Type I 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 0 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 0 Appeal # Recorded ❑—. , _ .Commercial ❑Yes XNo If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) wI � I� rn PC CII�Name BTelephone Number 65 Q c9 R Da Address License # n 11 �OL�M ►. J h, �(T� Home Improvement Contractor# Worker's Compensation # -W 9308f) ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE `I FOR OFFICIAL USE ONLY �. APPLICATION# 3r DATE.-ISSUED R MAP/PARCEL NO. ADDRESS ' VILLAGE T OWNER ` DATE OF INSPECTION: :�FFO.UNDATIQNta�i�t:u;.• ;�i-,-�;��s;l:,,:c::,.r . __ FRAME -, INSULATIONq i!`i_'y�-- FIREPLACE ELECTRICAL:.- ROUGH FINAL C PLUMBING: ROUGH FINAL r GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT i ASSOCIATION PLAN NO. It . Housing � Assistance kinor Corporation Cape Cod HOME OWNER WEATHERIZATION WORK PERMIT&FUEL RELEASE: PLEASE FILL OUT AND SIGN THIS FORM IF YOU ARE . THE APPLICANT HOME OWNER. I r go hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation ( herein after referred as "Agency" ) on •the property located at: "v The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather-stripping & caulking of windows and doors, insulation of attics, sidewalls & basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows. In consideration of the weatherization work to be done at my home I agree to the following: 1. I give permission to the "Agency" its agents and employees to travel onto or across said property with such equipment and materials as may be necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. T have 'read the provisions of this agreement as listed and freely give my consent. ome Owner: (Signature) � � Date: Agent: (signature) Date: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations t__ . . I Congress Street, Suite 100 A .,;:= Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Cape Save Inc. Address: 7D Huntington Ave City/State/Zip: South Yarmouth, MA 02664 Phone#: 508-398-0398 Are you an employer?Check the appropriate box: Type of project(required): i.�✓ I am a with employer 4. I am a general contractor and I p have hired the sub-contractors 6. New construction employees(full and/or part-time).' listed on the attached sheet. 7. Remodeling 2.❑ I am a sole proprietor or partner.- ship and have no employees These sub-contractors have 8. [].Demolition workingfor me in an capacity. employees and have workers' y P' n'- 9. ❑ Building addition [No workers' comp.insurance comp. insurance.* - required.) 5. F1 We are a corporation and its 10.[3 Electrical repairs or additions 3.❑ 1 am.a homeowner doing all work officers have exercised their I LEI Plumbing repairs or additions myself. [No workers'comp. right of exemption.per MGL 12.0 Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.0✓ Other Insulation comp.insurance required.) 'Any applicant that checks box#] must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this atlidavit indicating they are doing all work and then hire outside contractors must submit a ne%v 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: Wesco Insurance Company Policy#or Self-ins.Lic.#: WWC3085633 Expiration-Date: 04/09/2015 Job Site Address: l/`5 w()I 1 NADLA l� b (\i Ve- 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 S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of 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 D1A for insurance coverage verification. 1 do hereb certi tinder fire pains and enalties ofperim6 that the information provided above is ue and correct. Signature: Date U Phone#: 509-399-0399 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 1.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: .4co CERTIFICATE OF LIABILITY INSURANCE DATEIMMMD"""' 4/14/2014 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 poiicy(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 endorsements. PRODUCER CONTACT NAME: Colleen Crowley Risk Strategies Company PHONE E., (781)986-4400 Lafg._NO AlC No:(781)963-4420 15 Patella Park Drive L ADDRESS. Suite 240 INSURERS AFFORDING COVERAGE NAIL i Randolph MA 02368 INSURERA:Selective Ins. of America INSURED iNsuRma..Safety Insurance Company 3618 Cape Save, Inc INSURERC Wesco Insurance Company 7 D Huntington Ave INSURER D: INSURER E: South Yarmouth MA 02664 INSUR6RF: COVERAGES CERTIFICATE NUMBER:CL1441475243 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, IL R- TYPE OF INSURANCE .POLICY NUMBER MMIDDY EFF POLICY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COM141ERCLAL GENERAL LIABILITY PREMISES Ea occu rents $ 160,000 A CLAIMS-MADE f X1 OCCUR S1994480 0/16/2013 0/16/2014 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,00d GENERAL AGGREGATE $ 2,000,000 GENT-AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $ 2,000,000 JECT POLICY" X PRO X LOC I $ AUTOMOBILE LIABILITY Ea accident SINGLECOMBINED LIMIT 1,000,000 B ANYAUTO BODILY INJURY(Per person) $ ALL X SCHEDULED208200 1/6/2013 1/6/2AUTOS019 BODILY INJURY(Peraaidant) $ NOWOMED X 'HIREDAU70S X AUTOS Pe�acadeNEE X ..UMBRELLA LIN X .. .... OCCUR. EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIM�ADE" AGGREGATE $ 1,000,000 DEO RETENTION$. all S1994480 0/16/2013 0/16/2014 " C WORKERS COMPENSATION fficers Included For X VtCSTATU- OTH AND EMPLOYERS'LIABILITY YIN MI ANY PROPRIETOR/PARTNER/EXECUTIVE overage E.L EACH ACCIDENT $ 500,000 OFFICERIMEMBFR.EXCLUDED? NIA (Mandatory in NH) 085633 /9/2014 /9/2015 E.L.DISEASE-EA EMPLOYE $ 500,000 If yyes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 560,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES"(Attach ACORD TOT,Additional Remarks Schedule,it more space Is required) Issued as evidence of insurance. Issued as evidence of insurance. Thielsch Engineering, Inc. is listed as additional insured as respects General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION msong@capelightcompact.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cape bight Compact ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Margaret Song PO BOX 427/SCH AUTHORIZED REPRESENTATIVE 3195 Main Street Barnstable;. Mh 02630 Mchael Christian/CLC ACORD 25(2010105) O 1998-2010 ACORD CORPORATION. All rights reserved. INS025(201005)Al The ACORD name and logo are registered marks of ACORD Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 -Home Improvement Contractor Registration - Registration: 171380 Type: Corporation Expiration: 3/14/2016 Tr!# 249649 CAPE SAVE INC. _ WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 ?� Update Address and return card.Mark reason for change. SCA 7 0 20M-05/11 Address Renewal R Employment Lost Card (92,11 ((097t711a7t[//Bl(�C�0� ��JJCLL'�L(JB S 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: 171380 Type: Office of Consumer Affairs and Business Regulation Expiration: 3/14/2016 Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE SAVE INC. WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE 4 - � SOUTH YARMOUTH,MA 02664 Underseeretary Not vali rthout signature 1111M Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supen-isor Specialty License: CSSL-102776 �� WILLIAM J MC 4%US 37 NAUSET ROAD " # West Yarmouth 111A 011" m';) Expiration Commissioner 06/28/2015 TOWN OF BARNSTABLE BAR-W Ordinance or Regulation WARNING NOTICE Name of Offender/Manager Address of Offender MV/MB Reg. # Village/State/Zip Business Name am/pm; on 20 Business Address Signature of Enforcing Officer Village/State/Zip Location of Offense Enforcing Dept/Division Offense Facts This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD/REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^ � DATA TOWN OF BARNSTABLE BAR_w Ng 3232 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager Mlark Sk, _ 1,�Ap Address of Offender�j Wi% 11 1% ar3'1 C(c�+) Village/State/zip_�11_1W��® Business Name Business Address tT� 1 1ar C�2 per Village/State/Zip 1�Y1� Sin.S ! J 1 J`rl S y ��U '�'l7i'1 U�J Location of Offensea5 ;ion Offense V' 3 / A(l) v Fact l AfifUi AT-) A" n. (4swill�serve_ only as a warnin At this t e o legal ac i n has been takenIt is th goal of Town agencies to achieve voluntary compliance � of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. TOWN OF BARNSTABLE BAR—W N9 3232 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager fflark Si 1t%/,�q4--) Address of Offender j �0�``� �(��. 1 MV/MB Reg.# Village/State/zip � � ItYIJ - (.� Business Name �v am/pm.,- on 20 Business Address 96 W1111irna 4ic" Sign ture .of forcing Officer Village/State/Zip Location of Offense,25 If t'!n.an C. ��_ �� j /,L// Enforcing 43, t/Division Offense Fact �n 6 \ 4. QC� bf� CW,&A AIJA WV((� 6VA is will serve only as a warnin At this t e o legal ac i n has been taken. It is the goal of Town agencies to achieve voluntary compliance � of Town Ordinances, Rules and Regulations. - Education 'efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. 1 V TT11 Vl L4 J.LV b+V lV,iru a v § 240-46. Home occupat on.D [Added 8-17-1995 by Order No.95-1951 ( A. Intent. It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single-family dwellings,subject to the provisions of this section, provided that the activity shall not be discernible from outside the dwelling;there shall be no increase in noise or odor;no visible alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. B.After registration with the Building Commissioner,a customary home occupation shall be permitted as of right subject to the following conditions: (1)The activity is carried on by the permanent resident of a single-family residential dwelling unit, located within that dwelling unit. (2)The activity is a type customarily carried on within a dwelling unit. (3) Such use is clearly incidental to and subordinate to the use of the premises for residential l purposes. (4) Such use occupies no more than 400 square feet of space. (5)There are no external alterations to the dwelling which are not customary in residential (" buildings,and there is no outside evidence of such use. (6)The use is not objectionable or detrimental to the neighborhood and its residential character. (7) No traffic will be generated in excess of normal residential volumes. (8) The use does not involve the production of offensive noise,vibration,smoke, dust or other particulate matter,odors,electrical disturbance, heat,glare,humidity or other objectionable effects. (9)There is no storage or use of toxic or hazardous materials,or flammable or explosive materials, in excess of normal household quantities. (1o) Any need for parking generated by such use shall be met on the same lot containing the customary home occupation,and not within the required front yard. (11)There is no exterior storage or display of materials or equipment. (12)There are no commercial vehicles related to the customary.home occupation,other than one van or one pickup truck not to exceed one-ton capacity,and one trailer not to exceed 20 feet in length and not to exceed four tires, parked on the same lot containing the customary home occupation. �,(13) No sign-shall-be displayed"indicating the-customary home occupation: (14) if the customary home occupation is listed or advertised as a business,the street address shall not be included. http://ecode360.com/printBA2043?guid=6558130&children=true 7/16/2013 Town of Barnstable Regulatory Services Thomas F.Geiiler,Director TOWN 0E BARNSTABLE t Building Division t BAMMME F Mess. g Tom Perry,Building Commissioner 2013 OCT 2 5 API 11: 4 3 16 200 Main Street, Hyannis,MA 02601 j www.town.barnstablema.us Office: 508-862-4038 DIVISION Fax: 50 - 90-6230 Approved: Fee: 3�' Per>mit#: HOME OCCUPATION REGISTRATION Date: Name: ///l%////YG� _�f�/�r(/Gri`` Phone#: '7 `1' - 2-41 Address: �� L i`N/jG✓t�/eG �y , Village;/�'/i-iiY S' vex ./"L.'G C S Name of Business: Type of Business: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to die provisions of Section 4-1.4 of die Zoning ordinance,proNrided that the actnaty shill not be discernible from outside the dwelling: there shall be no increase in noise or odor,no usual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration Azth the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. e No traffic will be generated in excess of normal residential volumes. • The use does not involve die production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to I exceed 4 tires,parked on the same lot container the Customary Home Occupation. No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,die street address shall not be included. • No person shall be employed in die Customary Home Occupation who is not a permanent resident of the dwelling unit. 1,the undersigned,have read and agree die above restrictions for my home occupation I am registering. Applicant:` Date: G — $_— } Homeoc.doc Rev.01/3/08 I r YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: �- / ( Fill in please: APPLICANT'S YOUR NAME/S: /17 +' C Ci ✓. BUSINESS YOUR HOME ADDRESS: VP7 r 8- TELEPHONE # Home Telephone Number NAME OF CORPORATION: NAME OF NEW BUSINESS �Lp-� �✓�C TYPE OF BUSINESS IS.THIS A HOME OCCUPATION? ES NO ADDRESS OF BUSINESS 0i r4J ✓Yl��► ��` MAP/PARCEL NUMBER /D 3 S (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. MUST COMPLY WITH HOME OCCUPATION 1. BUILDING COMMISSIONER'S FICE RULES AND REGULATIONS. FAILURE TO This individual has b i rmed of permit requirements that pertain to this type of busine�Mpl_Y MAY RESULT IN FINES. uthorized Si ture** COMMENTS: O C, d Gd�. G� O 2. BOARD OF HEALTH This individual has b n in o/1�-4 Athe permit requirements that pertain to this type of business. MUST ,OMPLY WITH ALL �' V" " ' r ' HtiZARDOIJS MATERIA Authorized Signature** COMMENTS: C PATION O 3. CONSUMER AFFAIRS ICEjN5t1VJG AUTHORITY) C I_YMAYRESULT I ESThis individual ha e d of the licensing requirements that pertain to this type of business. Authorized Si9dature** COMMENTS: The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601. 0ffice: 508-790-6227 Fax: 508-790-6230 Home Occupation Registration 1,7 Date: __// / rr/ Name:_25i a'�1 Zrl Z� lXd Phone#: Address: � .��1�/�T c ��' Village: 617 A, NameofBusiness: Tr��l�s Type of Business: T1S1/4<' Map/Lot: /D 3—f Sd INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings, subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;-and no increase in air or groundwater pollution. After registration with the Building Inspector, a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings, and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. The use does not involve the production of offensive noise,vibration,smoke, dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation, and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity, and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: C_ /�'�i�L�� '�/�G%? Date: Homeoc.doc