Loading...
HomeMy WebLinkAbout1650 OLD STAGE ROAD 1C�5D Old -IV,, i UPC 12543 Now «rl* HASTINGS. MN CAPE COD I N S U L A T I O N T(,A�N Of- BARNSTABLE IIYIA PUYY 1YAYI1111 IPA AT MAIA 1PIPYNORP &Am JPR1Yf IN1P""H "I"NOf 1-g00-696-6611 DIVISION t'c►wn of Barnstable Regulatory Services Building Divisi.on 200 Main St Hyannis, MA 02601 rr; Date: /,.A 3/20 Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Iq,, lation, Inc. performed &. completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building per.rnit application. All work has been inspected by a certified Building Perfortnanee institute (BP.I) inspector. All wort: preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village .41,A J WA40 /d sV VW s/lam 4.4W 6✓<s�- (c�.c,rJ� IFISLIlation Installed: .Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) ( ) ( ) ( ) ( ) Slopes ( ) ( ) ( ) ( ) ( ) Moors Mills ( ) ( ) ( ) ( ) ( ) Af. Sincerely �G171 Fla .ry L Cas. y Jr, President C' e Cod .h. ulation, Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel d A�pplicalion It Health Division Date Issued �Nl� Conservation Division Application Fee fir- Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 1k Village ES'r" 6 "S7rA-ems Owner ` AIV Wes' Address Telephone Permit Request �tt, O�ij ID W w6 4111 �WI Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay 1 CD Project Valuation !�6" Construction Type �� 1 -� « Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting decurTVtation. Dwelling Type: Single Family ­d/ Two Family ❑ Multi-Family (# units) =� Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway Yes ❑ No 0� r' 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 340 If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION lu /W JA!AWWLDER OR HOMEOWNER) l Name L� Telephone Number Address License # auf w6f44 ' �` Home Improvement Contractor# Worker's Compensation # W440J52510 I ALL CONSTRUCTION DEBRIS RESULTING ROM THIS P OJ CT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ra ADDRESS VILLAGE OWNER DATE OF INSPECTION: - K ,:FOUIVDATIQN ` FRAME INSULATION c, r :E r - '� FIREPLACE ELECTRICAL: ROUGH FINAL S - K PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING- ` Y DATE CLOSED OUT '+ ASSOCIATION.PLAN NO. rv• Massachusetts -Depaftr4wnt of P blic Safety .'�13`bard of Building Regulations and Standards • Construction Supenisor License: CS-100988 HENRY E CASSIDY'` 8 SHED ROW WEST YARMOiPP11 2 Expiration Commissioner 11/11/2015 r. Ile Office of Consumer Affairs and Business Regulation ,. 10 Park Plaza - Suite 5170 k Boston, Massachusetts 02116 Home Improvement Coiq�ragtor Registration Registration: 153567 =' Type: Private Corporation ' '"''------ Expiration: 12/15/2014 Tr# 233831 CAPE COD INSULATION, INC -`t :--'i`•` HENRY CASSIDY 18 REARDON CIRCLET: ----- �.._.- SO. YARMOUTH MA 02664 --------- ;�. - --- - ,.. pdate Address and return card.Mark reason for change. '�---'scn, c; zorn-ostl I Address Renewal Employment Lost Card � �1 /GL (()L�It•IIz(1�tt1t000GI/L 0Ib�ll"dj 6clwjettj Office of Consumer Affairs X Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: gistration: 1'53567 Type: Office of Consumer Affairs and Business Regulation W."'P tion: 12IT5/2014 Private Corporation 10 Park Plaza-Suite 5170 ^';"" ::;`;_,; Boston,MA 02116 CAPE COD INSULATION;1(*1 HENRY CASSIDY 18 REARDON CIRCLE SOf YARMOUTH, MA 02664 Undersecretary Atvwitho t Wsifnatkre ' I Workers' Compensation Insurance Affidavit: Builders/Contractors/Electrici ins/Plumbers Applicant Information Please Print Le►ibl Name (13usiness/Organization/Individual): ,Address: � �i(/(,gyp I/l �V,G I ti City/State/Zip:_�b t n Phone #: 'rqA " -715' ('21 Ore ou an employer? Check the appropriate box:am_2Gj 4. ❑ 1 a general contractor and I Type of project(required): I. I am a employer with employees (full and/or part-tirne).* have hired the sub-contractors 6. ❑ New construction 2.❑ 1 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 ❑ 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 I LEI 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 [ ty Ia-L�— comp. insurance required.] 'Any applicant that checks box#I must also fill out the section below_ showing their workers'compensation policy information. t Ilumeuwners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit It new affidavit indicating such. tContracturs thin check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have I employees. If the sub-contractors have employees, they must provide their workers'corn p.policy number. I um an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site infiumutiar. Insurance; Company Name: lr � U�ev lMAuvkCA Policy ii or Self-ins. Lic. #: Expiration Date: f/ �� t Job Site Address: City/State/Zip: Attach a copy of the workers' cornpensatiod 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 tine 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 tine ofup 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 cer tfy it the pains and penalties ofperjury that the information rovided above is tr e and correel. p — Si nature: Date: Phone la: 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 S. Plumbing Inspector 6.Other Contact Person: Phone#: h + I • lr P - CAPECOD-27 KLIGETT •��C,oR® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/1312014 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 CONTACT Rogers&Gray Insurance Agency, Inc. PHONE Barbara DeLawrence 434 Rte 134 Arc Na- t: AAiXc No: (877)816-2156 South Dennis,MA 02660 AI DRlEss:bdelawrence@rogersgray.com INSURERS AFFORDING COVERAGE NAIC p ---- INSURER A:Peerless Insurance Company INS RED INSURER e:COMMERCE INSURANCE COMPANY Cape Cod Insulation Inc INSURER C:Evanston Insurance Company 18 Reardon Circle INSURERD:ATLANTIC CHARTER INSURANCE GROUP South Yarmouth,MA 02664 I INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: TNI IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD IND CATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS C-f TIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, E,'LUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY-HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADOL�BR L7R� TYPE OF INSURANCEiN%n WVD POLICY NUMBER MMIDDPLIC�YY MM/DDn YY1 LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR CBP8263063 04/01/2014 04/01/2015 UA AGESOE occurrence)E $ 100,000 I — — — MED EXP(Any one person) $ 5,00 --- PERSONAL&ADV INJURY $ 1,000,000 IEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 X POLICY�l PRO- ❑ � JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER $ A TOMOBILE LIABILITY COMBINED SINGLE LIMIT B Ea accident $ 1,000,000 ANY AUTO 14MMBCKVMK 04/01/2014 04/01/2015 BODILY INJURY(Per person) $ ALL OWNED X H _ AUTOS AUTSCEDULED OS BODILY INJURY(Per accident) $ NONHIRED AUTOS X NED AUTOS PROPERTY DAMAGE i AUTOS Per accident $ $ UMBRELLA LIAB X OCCUR GG _ CUR EACH OCCURRENCE 1,000,000 !C EXCESS LIAB CLAIMS-MADE XONJ453514 04/01/2014 04/01/2015 — I{ AGGREGATE $ I DED f X I RETENTION$ 10,000 Aggregate $ 1,000,000 W RKERS COMPENSATION _ A D EMPLOYERS'LIABILITY STATUTE ERH _ D -AN PROPRIETOR/PARTNER/EXECUTIVE Y/N WCA00525904 06/3012014 06/30/2015 E.L.EACH ACCIDENT $ 1,000,000 �,OTICERIMEMBER EXCLUDED? ❑ N/AMndatory in NH)and E.L.DISEASE-EA EMPLOYE $ 1,000 0O If yes,describe under , DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 I i l)ESC.RIIITION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) VOr erg Compensation includes Officers or Proprietors. .ddi io al Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. ':ERTIFICATE HOLDER CANCELLATION OCT-26-2014 12 :03 PM DR. ALAN J WARD 773 271 4439 P.02 OWNER AUTHORIZATION FORM i I, (Owner'sRome) owner of the property located at I65-0 GId 514P xAA (Property Address) LPo1�Pr Gl �l Z (Property Address) hereby authorize ► G��� D V D � (subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform worts on my property. A h - / owner's nature v z Date Nt�SEP-22-2014 09 :03 AM DR. ALAN J WARD 773 271 4439 F. 01 M nn > > Y11111MIR ntlooinn l09 ,m elf�y ui�my .unnuirnuunrr ltNl Mehl liftmi. I lyMWftrNtA 1Vf'N -• ' www.towq.baro eta blsz a.u0 Office: 508462-4038 Fax: 508-790-6230 ni: $35.00 6 1 SIND REGISTRATION RESIDENTW,ONLY 300 square feet or lets f� S .11) STA6er ROAD WE51: 3.,40-S ~A.1 Z Low*of shod(oddroes) Wisp a•..r '"'C3 Q 2 WAND _ 773 a 7 1-- Y 4 3`9] •zo -o Ploptrty uwucr'a name Tolephone number Sins of Mad Map/Puod N M -2)Lj 3ignnitue Dace _.._._ Hyetmle Maiq Street'Wveeftenr Matorto District? Uld King's Highway Historto District Commifstort JurlsdictloN If over 120 square feet,you must Isle with Old Rlog's Highway Conservation Comnisalon(signature Is required) Sign ofthours for ConservaAou 8:00.9:30&3:30.1:30 t--LRASB NOTE: IF YOU ARE VnTM THE JURISDICTION OF ANY OF TIM ABOVE COMMISSIONS,THERE MAY BE A RVMW PROCESS AND APPLICATION M. PLEASE SET TER APPROPRIATE-COIVD4 MION FOR DETAXIS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q•tbmlo-6hedree �� vi ItRV;040014 i0141 i f Map Page 1 of 2 Town of Barnstable Geographic Information System New Sear Parcel Custom Map Abutters Mapslze ENE Zoom Out„",,,'tin viewer JPG s2 1D4s a ale Dq 152000 m 10 A 152005 - - V 00 151DW1A10 152010 e 1075 0 1550 13N 1840 0 04D I 11 Map: 152 Parcel: 010 Location: 1650 OLD STAGE ROAD Owner: WARD,ALAN I Locatlo n.Information 131007 Map✓3 Parcel 152010 01514 Location 1650 OLD STAGE ROAD ® Acreage 4.61 acres 1510021t00 11545 Current Owner 151047=0 Mailing Address WARD,ALAN 3 8D PARK TOWER-EDGEWATE 5415 N SHERIDAN RD#4 _ 1 51003 70 0 CHICAGO,IL 60640 1075 151007 W10 01e10 Appraised Value(FY 2014) 151002T00 Extra Features $9,600 0 11045 CC t" 152013N0 15100710D Out B 01040 uildings $0 G7 G7 kb ram II0r0 Land $150,300 Buildings $71,000 .Total Appraised $230,900 Set Scale 1"=gg Aeri lPhotos � I MAP DISCLAIMBR Assessed Value FY 2014 Extra Features $9,600 Cop/OgM 2005-2010 Tam of Barnstable,MA All rights mearvod.Send questions or comments to 018 Out Buildings $0 BarnstableMA v1.2.5122(Production) Land $150,300 Buildings $71,000 Total Assessed $230,900 Construction Detail Style Cottage Model Residential Grade Average Minus Stories 1 Story ' Exterior Wall Wood Shingle Roof Structure Gable/Hip Roof Cover Asph/F GIs/Cmp Interior Wall Drywall Interior Floor Carpet Heat Fuel Gas Heat Type .Hot Air AC Type None Number of 2 Bedrooms Bedrooms - Number of 1 Full Bathrooms - - Total Rooms 4Rooms Living Area 993 - Replacement Cost $109,202 Year Built 1930 Depredation 35 - Building Sketches http://maps.t.ownofbamstable.us/arcims/appgeoapp/map.aspx?propertyID=15201 Umappa... 9/22/2014 Assessor's map and lot number .......................................... TIC SYstem fi BE INSTALLED IN COMPLIANCk Sewa a Permit number /�� 1.�.. ui ..... < `g ... 2 �fil 'tI ARTICLE It STATE P111TARY CO THE A . TOM TOWN OF B AR N S`' �A.`t y�F t0AND . i 86SH9TLBM i ""` 1 DUILDING INSPECTOR 9�p t639. \00 CFO V a' � I �J, y /J ` � n �Q APPLICATION FOR PERMIT TO /7.�� /......�/.� ....:.......✓7. r 7 . .............. . .............. ................................. TYPE OF CONSTRUCTION ...................... �,J........ . .?.:t......................................................... ......................!..... .............19........ / TO THE INSPECTOR OFBUILDINGS: . The undersigned hereby applili��es--fjjo�� permit according to thefl,owing information: l , Location `� �T — CS ``���� ....v`�............0..?..(...c'� ©� rr R�. ......... ..... ............,, ....... ........ A.. ........ ........................... ........... .�.. W I ProposedUse ................�..........G., . .. ..���............................................................................................................ Zoning District .....................................Fire District ....................................��� cif..3.•-� ....................... ... ....................................... cc �. t�i 17)� C/"41. ` 14u 6 f�v��cK wry Nameof Owner ...............i.................................. ....Address .... ................ ........ ... Name of Builder .......... ` 'b C-L . JVCAddress .40....................5 ...... ......... .................. Nameof Architect ......................................�fA...�.............Address ..........................................................,......................... Numberof Rooms ..........................�.�...............................Foundation ..........��( ............................................. Exterior .........W.OQJ....... /T.I�V .�� .............Roofing Sac' . �... ( ..................... Floors ..........................,.,s................:........................................Interior .................................................................................... Heating ............... ...............................Plumbing ...................................... y. Fireplace .............. -...................................................Approximate Cost .................... !�+ O... ................ . ........................... Definitive Plan Approved by Planning Board -----------_------_-----------19_______. Area Ala e£ ........ ....... Diagram of Lot and Building with Dimensions Fee /�� .............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I I p I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable-a regarding 'the above construction. h � �. Name ..... .. . .......... ...............�....................... _ Ward* Rebecca ' - l / No .l7549.. Permit _.rapa1rf�re ---.......---_ ' \ ........... .. ~ ----------.. | A. - | ` � Location ']k...Old..8 .Rmad....^.................. ! West Barnstable .......................... ��������___________ | . , Owner --- =��� �ard ' ~ � --'~..~~~�-------- � Type of Construction .......frame........................ ---------.--------------�--~ Plot --------_� �t ___________ ^ Permit Granted --Ja1R!4;qy'3__.__]o75 � Date of Inspection .................................... Dote Completed -----.. ---l9 1 ' / | )` � PERMIT REFUSED ^ ) \ | lV| -----------~--------'' ` ' < ^ � '-------------------------- -.._------_~_______________.. -� / --------------------------. . | ' � . ---------------.-----.---��'.. i l \ Approved _--------------. lg � � ' � ----------------------.---. . ......................................... * � ] � ` Assessor's map and lot number .......................................... 7LED IN COMPLIAW—t Sewage Permit number ...1 ,4� 4. .. . ' Z ` WITH .ARTICLE 11 STA ePNI'TARY CO:� � THE TOWN ilk. A h Y BAflHSTAME, o APPLICATION FOR PERMIT TO ........... � .......... Y ........`..J....-,.(.�./.L....fl�....`.C..................... . / . fC TYPEOF CONSTRUCTION ............................... ..................,......., �r 7S TO THE INSPECTOR OF BUILDINGS: . n The undersigned hereby applies fo4 permit according to the flowing information: Location ......... .. .. ........ .... .. ..................................... ....... ProposedUse ...................................... ..................................................................................................................:................. ZoningDistrict ....................... ..........................................Fire .Distract ........................................... ...... ......: Name of Owner ............... .....�:L:.............L't' 117_, Address �.7................. . . ��7.AL r�vL� .... ............ .J. ........ ..................... l"jFA o-G . ..A. i c , �c.� � ............. r.�� 1-4-13/C Nameof Builder ...........................................A. ............... .... .......... ......... ....... ... ..... Nameof Architect ................................... ...............Address .................................................................................... Number ......................Rooms / /C r.. ...............................Foundation .......................... .................::..........................:.... Exterior .C. '.:1 f .(..1.t%�........�5.............Roofing .� f j ��.� ..�.... ................... .......... ........... Floors .......................................................................:..............Interior ............................:......................................... ' ..........! !:...�4--.......................... Heating Plumbing ....................................(,�»:.�................ ............. J " Fireplace ....Approximate Cost ' �'. . ..... . . .. . . Definitive Plan Approved by Planning Board _______________ 19__:__-_. Area A .................................. Diagram of Lot and Building with Dimensions. Fee ..........r:..@': SUBJECT TO APPROVAL OF BOARD OF HEALTH f�. O rr I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ......."�...... ,mac'% �` .. ... ..................... Ward, Rebecca ✓ A=152-10 ' �rmit #lY549 Repair fires - mage V r� , Old Stage Road West Barnstable January 3, 1975 ems- � , �