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0939 OAK STREET (CENT./W.BARN)
� � ��� .�� o I Qa 2J yZ UPC 12543 IVO.o. 53LOR HASTINGS, MN •\ . I �I i -�_ __ _ :� _.�. _ .. i Cr MOO* So 0.A... © O U) U) %O -n O 1 0 April 1,2013 =� � —e Town Of Barnstable C Thomas Peary, CBO rn 200 Main Street Hyannis,MA 02601 RE: 939 Oak Street Dear Mr.Perry, This Affidavit is to certify that all work completed at 939 Oak Street has been inspected by a certified BPI Inspector. R42 Cellulose was added to the attic. All Work Performed Meets or exceeds Federal and State Requirements. Sincerely, Roland L Angevin Insulate 2 Save,Inc O f President p CSL 103861 Q` I-RC 166311 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �Q �d L�� Map Parcel Application # Health Division Date Issued Conservation Division Application Fee v Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address q3q Oa Y_ 5-�- Village LO f-e Owner NoAc Address UcttC- �+ Telephone 'SU�`�C)cl Permit Request C d )QIQQ_A(T1PXY+ I 510 1Q_� _bQN-of) i Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay ® a C> Project Valuationt Construction Typej7)J0J_0_4cTJ1 �+ Lot Size Grandfathered: ❑Yes ❑ No If yes, attache support' documentation. Dwelling Type: Single Family -0' Two Family ❑ Multi-Family (# units) 10 :Z- E Age of Existing Structure Historic House: ❑Yes ❑ No On Old Kin 's Highw:y: ©-kes o'No Basement Type: ❑ Full ❑ Crawl .❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) rn 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 i APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name A lord /,a_nq-Pyl o Telephone Number 5� "JZn 7 Cp7C;C� i Address Q10 ( -nW -5�- License # /00S& Pu. Home Improvement Contractor# i u tv3 Worker's Compensation # I / 3I ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOP)i FCC ( anfe Dun�'SI x t1/6 r--otme _5j - u pjuv.r n/(k SIGNATURE 0'"� DATE _L r ia I FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED I� MAP/PARCEL NO. ail + VILLAGE ADDRESS . OWNER / 3-� DATE OF INSPECTION: FOUNDATION i� I` FRAME INSULATION FIREPLACE p? ELECTRICAL: ROUGH FINAL p PLUMBING: ROUGH FINAL GAS: ROUGH FINAL T FINAL BUILDING fit j DATE CLOSED OUT " '` ..�.• y r;, ...r.. . t r+ = CO i ASSOCIATION PLAN NO. t The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations - e 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeEibly Name(Business/Organization/Individual): '' � Q- Address: City/State/Zip: �� Phone #: � D�- 7d(-D Are you an employer?Check the appropriate box: Type of project(required): 1.21 am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers' comp. insurance comp. insurance.1 required.] 5. ❑ We are a corporation and its ME] Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑ 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 13.aOther— , AQ )�d employees. [No workers' comp. insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. !Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:(;�( L Q Yt(4 1 `c' CD ���C`, Policy#or Self-ins.Lic.#: TN Lo C I 1 S I Expiration Date: to I a Job Site Address: �� 1L — City/State/Zipwl 6aM561301C 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 provider!`above is true and correct. Signature: Date: Phone#: *5.0-1^UD-7n1.0 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#: I 0 GATE (MWDOrr" A U CERTIFICATE OF LIABILITY INSURANCE 12/11/2012 THIS CERTIFICATE IS ISSUED AS A !NATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMAT VELY 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,AI4D 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 endomement(s). PRODUCER NAYE: __ _ --.- ANTHONY F. CORDEIRO INS. P.GCY. , INC. (A/C. e.,):_(.508) 677-0407 Fwc Ax NAI.(soe) 67T-o4o9 E-MAIL- 171 Pleasant Street ADDRESS: -- PRODUCER - — CUSTOMER Fall River,_ MA 02721=._. —. INS URE_pjAFFORDINGCOVERAGE �... NAICM --- INSURED INSURER A_:PAtlantic Casualty Ins.. Insulate 2 Save Inc. INSURER B :Torus Specialty Ins. Co. _....__...._-.- 410 Grove St INSURER C :Great American Ins. — INSURER o :Guard Insurance Group__ INSURER E Fall River NIA 02720- 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. _ '—" '-- POLICY EFF POLICY UP �DDL...$-Q6R' .—. —7' LiMtr9 LTR TYPE OF INSURANCE INSR'yyyp POLICY NUMBER (MWDOIVWY) (MMloorrrvr) GENERAL IJAmuTY Y Y M 08100017d U6/12/2012 06/12/2013 ;EACH OCCURRENCE $ 1,000,000 A DAat�.GE R NT D� 1A0,00.0 X COMMERCIAL GENERAL LIABILITY I PREMISES,(E_e_occunerrce'�Ij$ _ CLAIMS-MADE X OCCUR MED EXP(Arty one person) 1$ _ 5,000 _ 000,000 / / / / PERSONAL 8 ADV INJURY $ 1� GENERAL AGGREGATE S 2,000,000 i / / / / PRODUCTS-COMPIOP AGG $ _2,000,000 GE_N•L AGGREGATE LIMIT APPLIES PER: X POLICY LOC / / / COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $ -.- ANY AUTO BODILY INJURY(Per person) ALL ONMED AUTOS I i / / / / BODILY INJURY(Per acdCent) $ SCHEDULED AUTOS PROPERTY DAMAGE $ (Per accident) -HIRED AUTOS NON-OVNJED AUTOS - X UMBRELLA LIAR _X OCCUR Y Y 178264D12OAL1 i 6/12/2012 06/12/2013 EACH OCCURRENCE $ 2,DDO,000 B ExeEss uAB CLAIMS-MADE AGGREGATE ---.. $ _2,000,000 DEDUCTIBLE $ RETENTION $ 10,000 I 2/10/2012 12/10/2013 X WC STATU- OTH- D WORKERS COMPENSATION IINWC311431 , _-ZORYAND EMPLOYERS' LIABILITYYIN iE.L.EACH ACCIDENT 500-1.000 ANY PROPRILTOWPARTNER/EXECUTNE TT���� N!A OFFICERIMEh8ER EXCLUDED? CI ..'L-- DISEASE-EA E_MPLOYEO$_. (Mandatory in NH) E.LDISEAE-POUCYLIM Stlyes.deaibeunder 500,000 DESCRIPTION OF OPERATIONS below p6/12/2012 06/12/2013 Shop i I Milt 75,35 C Equipment Floater n4P3759976 / / / / VaNde Storage Limit 0 76,250 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Anach ACORD-101. Addiaond Rrmarts SchsdYM, if mon ap.- is rWu6e4) Proof of Insurance. Residential Insulation Contractor. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED`.BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL HE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Barnstable 200 Main St AUTHORIZED REPRESENTATIVE - - - Hyannis Ma 02601- ACORD 25(2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. AdOR (225(2 The ACORD name and logo are registered marks of ACORD i Office of Consumer Affairs and Ifusiness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Cotractor Registration Registration: 166311 Type: DBA ;�.�ice'?;•. r.�•�---- {�-i.� Expiration: 5/11/2014 Tr# 222532 INSULATE 2 SAVE ROLAND LANGEVIN _= 410 GROVE STREET �: -=' = --- — ---- FALL RIVER; MA 02720 Update Address and return card.Mark reason for change. -- [] Address Renewal Employment [].Lost Card DPS-CA1 0 50M-W04G101216 ............. Of p__ g fice-fo&,0i-. airs 8 u`siness on License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: ,�,66311 Type: Office of Consumer Affairs and Business Regulation Expiration: 5t.-'t�/Z014 DBA 10 Park Plaza-Suite 5170 _r- Boston,MA 02116 TE 2 SAVE : ROLAND LANGE�AW3�-;� 536 EASTERN AVE:-,,-' FALL RIVER,MA 02723 == Undersecretary `~ Not valid without signature a._•.. Massachusetts- Department of Public Safet% Board of Building Resulations and Standard. Construction Supervisor License License: CS 103861 Restricted to: 00 ROLAND LANGEVIN 536 EASTERN AVE. FALL RIVER,WA 02723 x Expiration: 8/24=3 ( unmii..iuner Try: 103861 OWNER AUTHORIZATION FORM c < < 1, --- , (Owner's Name) owner of the property located at , (Property Address) ca (Property Address) hereby authorize -T (Su contractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. X. Owner's tignature Date I EC. I RISE ENGINEERING Federal o5A405629 Rl Contractor Registration No 8`186 'I MA Contractor Registration No 12020979 A division of Thiclsclt Engineering CT Contractor Registration No 620120 1341 Elmwood Avenue,Cranston,RI 02910 CONTRACT (401)784-3700 FAX(401)784-3710 Page 1 i PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE I ENGINEERING AND THE CUSTOMER FOR WORK AS CLC-RC S DESCRIBED BELOW ENGINEERING ......... PHONE DATE Clients CUSTOMER Christopher D Maki (508)509-5995 12/07/2012 137068 "-' BILLING STREET SERVICE STREET 939 Oak Street 939 Oak Street SERVICE CITY,STATE,UP BILLING CITY,STATE,ZIP West Barnstable,MA 02668 West Barnstable,MA 02668 JOB DESCRIPTION rhealthful abor and materials to seal areas of your home against wasteful,excess air leakage. This work will be d in concert with the use of special tools and diagnostic tests to assure that your home will be left with a level of air exchange and indoor air quality. Materials to be used to seal your home can include caulks, eatherstripping and other products. Primary areas for sealing include air leakage to attics,basements, attached garages and other unheated areas(windows are not generally addressed.) (8)man hours. $61 C.00 Provide labor and materials to install R-13 faced fiberglass to(100)square feet of kneewall. Then install I"rigid board insulation. Seal all seams with FSK tape. S343.OU Provide labor and materials to install a 12'.' layer of R-42 Class I Cellulose added to(42)square feet of open attic space. $6132 Provide labor and materials to make(3) temporary access to an attic area. The opening will be closed with. materials similar to those existing. Finish sanding and painting is not included" $222.57 Provide labor and materials to install(440)square feet of R-19 faced fiberglass insulation to the basement ceiling among randomly spaced joists. $822.80 Provide labor and materials to install(320)square feet of R-19 faced fiberglass insulation to the crawlspace ceiling. $566.40 C' C E- 1 ; DH 2012 I.F RISE ENGINEERING Federal 405629 RI Contractor Registration No 8186 A division of"I'hielsch 1?ngineerin� MA Contractor Registration No 120979 CT Contractor Registration No 620120 1341 Elmwood Avenue,Crunstun,Rt 02910 (401)784-3700 FAX(401)784-3710 CONTRACT Page 2 RISEPROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE CLC-RCS ENGINEERING AND THE CUSTOMER FOR WORK AS DESCRIBED BELOW ENGINEERING CUSTOMER PHONE DATE Cliont# Christopher D Maki (508)509-5995 12/07/2012 137068 SERVICE STREET BILLING STREET 939 Oak Street 939 Oak Street SERVICE CITY.STATE.ZIP BILLING CITY.STATE.ZIP West Barnstable. MA 02668 West Barnstable,MA 02668 JOB DESCRIPTION Provide labor and materials to install (320)square feet of 6 nil polyethylene over open ground in designated crawlspace/earthen basement areas. $246.40 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently,for eligible measures,the Cape Light Compact offers 75%incentive, not to exceed S4,000 per calendar year. -S I.698.30 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently, for eligible measures,the Cape Light Compact offers 100%incentive. -$616.0t1 JDJ i F10 P F 1 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Five Hundred Sixty-Six& 19/100 Dollars $566.19 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 30 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES.RIGHTS OF RECISION.SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES THaR¢ED SIGNATURE-.,RISE ENGIN ING // —CUSTOMER/ACCE, ANCE NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACE ? ACCEPTANCE OF CONTRACT•THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE C� SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO 00 THE WORK "� DAYS. AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE f• qvo � "Rcation to ®1b Ringo hway Regional 3�isstDric Aliotritt tOr1YClttittPP_`��l �f � In the Town tt Barnble 5 2004 E �'.;'TABLE CERTIFICATE OF APPROPRIATENESS PpES10N Application is hereby made,with four complete sets, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings, or photographs accompanying this application for. CHECK CATEGORIES THAT APPLY: 1. Exterior building construction: ❑ New ❑ Addition Alteration ' G — i20 0 Indicate type of building: ❑ House ❑ Garage ❑ ommercial L. Other Q` 2. Exterior Painting: ❑ Lww vw3"w a��icrr 3. Signs or Billboards: [INew Sign ❑ Existing Sign ❑ Repainting Existing Sign 4. Structure: [IFence El Wall El Flagpole ❑ Other TYPE OR* PRINT LEGIBLY: DATE .S•�y ADDRESS OF PROPOSED WORK !J?9 ®a-LG ��- 1A/ ASSESSOR'S MAP NO. 2�� w Te—, OWNER �S 5 S�wviy.c. �,�r ASSESSOR'S LOT NO. DS'� HOME ADDRESS .5 ATM>r TELEPHONE NO. FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any public street or way. (Attach additional sheet if necessary.) AGENT OR CONTRACTOR �L - L �i/�1J�7� i° �}�'�z,�es ZZeTELEPHONE NO. � AkZ -D fv ADDRESS P®. FadX /? GGvI' 'mr`�i DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, includi g materials to be used. Please include locations of proposed signs. � 4���1� ��� �� ������ �s�avhhdr. � Signed �' Owne-Contractor-Agent For Committee Use Only ,r^ >V, f "" This Certificate is herebA Date 02 5 Approve Denied Zmittee Members' Signatures: I,, r n Town of Barnstable -- Old King's Highway Historic District Committee SPEC SHEET V OUNDATION AUGA 0 5 2004 ' LTOWpf g H/ST!)p C ,I RNR TA21 SIDING TYPE GVk fit- C ov7 1w0i COLOR GYWI ►- CHIMNEY TYPE /' !i ROOF 'MATERIAL A O�V 12Ybh (-COLOR ✓�-F.�,f�_ &A z PITCH 61/001� Ui iU / COLOR �fi.� r - SIZE Z�'X�✓�,� ZZ 1r37 S y � -3� �f WINDOWS TRIM COLOR DOORS COLORS SHUTTERS - COLORS GUTTERS COLORS . I DECKS MATERIALS GARAGE DOORS COLORS ' SKYLIGHTS SIZE COLORS i SIGNS COLORS FENCE COLOR NOTES: Fill out completely, including measurements and materials/colors to be used. Four copies of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plane, when applicable. soFrCHT 0 �1Q U)cr! JI8ig , Z � V w � .3 � LL 11 � dT • s cn o , 7 Town of Barnstable 3 ° Regulatory Services ate. ' Thomas F.Geiier,Director p` Building Division Tom Perry, Building Commissioner 200 Main Street, Hyanais,MA 02601 Office: 5084624038, Fax: 508 790-6230 Property Owner Must Complete and Sign This Section If Using A Builder ' 56 Elf .V I �as Owner of the subject property hereby autiiozize to act on my behalf, is aIl matters relative to work authorized by this building permit application for. (Address of job) V igtlaAnef er '~ Dam S Za c 2 . '►MA�t,C�� Print Name I Q•.FORMS:OW NERPERMBSION Results Page 1 of 1 Home Improvement Contractor Look Up Enter Search terms separated by spaces. Search terms can be Town/City, Name, or License number �iSelect Search type: AND r OR ';Search.:,- Search Results Reg. No. Applicant Street City State Zip Name Title Expiration 28 ENTERPRISES, HIDDEN MARSTONS GILMORE, 134443 LLC. VALLEY MILLS MA 02648 KEITH OWNER 10/29/2005 RD. Total of 1 Records matched. 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