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HomeMy WebLinkAbout0039 SALT MEADOW LANE �n llll UPC 12543 • Now �`zm;O NAR11N4$ ON �.....�^.�T._.....rr- _:a:..s_as.. .��...�,.,�rt.T � _ s...yr.�:..w�i•-_ t�_. _ 5�-_ _ _ .__ ,. ��„�! _ Cape Save Inc-TOWN 0r 210 NSTAr'4 r 7-D Huntington Avenue South Yarmouth, MAi026,6;' ?'I $: 1.; Tel: 508-398-0398 Fax: 508-398-0399 DIVTC7f� 8/27/12 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 39 Salt Meadow Lane,West Barnstable has been inspected by a certified Building Performance Institute(BPI)Inspector.• Ceiling: R-30 cellulose second storey ceiling R-11 cellulose first storey ceilings behind knee walls (under flooring) All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey Assessor's map and lot number .1.. ��,.�..1���,i :.........•. /� � �,��L7y 8' pFTNET�` jq :. ...Pt,Q C SYST KIItJ Sewr a Permit number ' ST ��� /�,��� 4WCOME' A AHB9TADLE, i House number ...............................................:........................ . BARNSTAB TIOJ '°o M639. : E CODE AOwaY°'• TOWN 'OF BARNS MgLATIONS BUILDING INSPECTOR APPLICATION FOR PERMIT TO . .. ... ..................................... TYPE OF CONSTRUCTION ., . ... /.1... (. . .. .S1.l . . I!/ ......... .......19.0 'TO,TH'E INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .... / ..... ..... ... ....!�...... ....K/��, ................................ P ' ProposedUse .... . . .. ......... ......! ... ......... ...................................................................................................I......0.................. Zoning •District ........................................................................Fire District ....................................................................... Name of Owner .... .... ....... ... ...... . . .. ...........................Address Name of Builder � ... ...�. '...Address . Nameof Architect ......................... ......................................Address ....................:..................r. ...................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exierior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ............................................Plumbing Fireplace p Approximate Cost ...... ..............................f............................. Definitive Plan Approved by Planning Board ________________________________19 . Area ....�(�./X.3y.............. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 3,2v /6 X3 f 6 ORA C. UST/Mb �A''�tyl a 5 �f' s — f 7 U ., Zo I hereby agree to conform to all the Rules and Regulations of the Town o Barnstable regarding the above construction. Name ."...... �.:►!f......... .. :.. ® CRAFT, THOMAS No .22.44A. Permit for :R.;ri.vAt.e...S.w.im.ming Pool Acce'ssory to Building ............................................................................... 39 Salt Meadow Lane Location ................................................................ West Barnstable ................................................................. Owner ....Thomas........Cr...a..f...t .. ...............................Type of Construction Steel & VyAi�kj....... ...................... ................................................................................ Plot ............................ Lot ................................ Permit-.Granted .....Au ust..20...........19 80 Date of Inspection .....................................19 Date Completed ....................19 fn PERMIT REFUSED clan ................................. 19 ................................................. tr rn .......... 73 ............................................... to ......... ......0 0.0............................................... ,Appr •ove ............................................... 19 ............................................................................... ........................................................... ................... Assessor's map and lot number rO� Sewage Permit number d Z BAUSTADLE, i Housenumber ......................................................................... :o ran& � p i639. `00 �0 MA-1 A,- TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION ........ ........................................:.................................................................... ...............................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ................ ......:.: l...... :........................................... ProposedUse ....................1:........... ........................................................................................................................................... ZoningDistrict ........................................................................Fire District .............................................................................. Nameof Owner .. `.... .....................! ... Address .......................................................................................... Name of Builder :::. ........ .:.......Address ......... . ........ .................... ......... .....`.................. Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exierior ....................................................................................Roofing .................................................................................... Floors ..........................................................Interior ................................................ ................................................................ Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost ....:... ......:......: ..::....::.. .............................. Definitive Plan Approved by Planning Board ________________________________19 . Area .. Diagram of Lot and Building with Dimensions Fee ". .............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .............................:.............:..........` CRAFT, THOMAS A=156-4 No .22,4.d.Q... Permit for .S.W. 11U�?.�1?.g...P. 9I. �. ACe.GAS.�O1;Y....�.A...I?���.�, ??g......... ......... Location 3.9...S.a1f...Me.adow... e.. .......... West Barnstable ............................................................... ............. Thomas Cn'aft Owner ......................... ....................................... Type of Construction Steel & Vynal ...................................... Plot .........................�. ..Lot ................................ Permit Granted August 2 0 i.......19 80 f Date of Inspection ....................................19 Date Completed ......................................19 i PERMI J REFUSED ....................................I .... .. .. 19 .....M ...................... ... .. .............................. ... .............................................. Approved ............................................................................... i s` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION c Lo I Z,0 0 Map 5 Parcel. Application # mil` Health Division Date Issued •. Conservation Division Application Fee Planning Dept. Permit Fee b . Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address 31 S a1 he o4o w Lane Village a(`(\q+wb�& Owner �faxo K-L Address 5afh C, Telephone 50 IR - t� Permit Request cell w1 age 6(c% 'rtc('M3e A i c 8.41,on W�In CX Q�,r►�i n4 -�ri�,rn Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3 0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 19 Two Family ❑ Multi-Family (# units) Age of Existing Structure I9 q- 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 A 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_ . © G) Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Others Ln e� Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes No If yes, site plan review# r,J Current Use Proposed Use vi APPLICANT INFORMATION (BUILDER OR HOMEOWNER) I� '' ao Name w rI`t CI, G Telephone Number 50%' `7 A10:O lb Address Wf1 (A License # ZC- 0 Home Improvement Contractor# Worker's Compensation #-TV C 13 A DO ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO `2- SIGNATURE DATE k FOR OFFICIAL USE ONLY �9 APPLICATION# k S DATE ISSUED T ':MAP/PARCEL NO. : I'y ADDRESS VILLAGE n OWNER_ 4� DATE OF INSPECTION: ' FOUNDATION ;w FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ' GAS:, ROUGH b FINAL f 'TM "FINAL.BU'ILDING'k _ . -tDATE'QL0SED.0UT ASSOCIATION_PLAN'N0. _ R The Comm of Massachusetts Department of Industrial Accidernts d Office of Investigations 600 Washington Street Boston,MA 02111 www.nzass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applidant Information Please Print Leaibly Name(Business/Organization/individual): C p dl,v� r1 G Address: • D HtA ii'nO-on Nveykz City/State/Zip:5e0J1n Ya.C'MOUA M OA6 4 Phone#: 508._ 3 4 $ - 039 8 Are you an employer?Check the appropriate box: Type of project(required): 1.tR I 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 mein,any capacity. employees and have workers' 9. Building addition [No workers'comp. insurance comp.insurance.$ 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 11.❑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 �'n S U,a�i o n comp.insurance required.] *Any applicant that checks box fil 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. iContractors 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 thepolicy and job site information. Insurance Company Name: �eG�R 0 0 �n s v��an cC C m n Policy#or Self-ins.Lic.#: T w C 3 31 g � y l 3 . (� c I M Expiration Date:: I 1 Job Site Address:_ .��1 - S- d`'1' �1� p-f p . � n City/State/Zip: - �' MSA_l +�k M� 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 pairs and penalties of perjury that the information provided above is true and correct Sianature: S Date: _ Phone#: J 0 8 - 3 9 8 - 0 9 R Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License Issuina,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 4: AC40RV® =(M`� CERTIFICATE OF LIABILITY INSURANCE THIS�CER FICATE 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 NAMEACT Risk Strategies Company Risk Strategies Company PHONE (781)986-4400 FAX o:.(781)963-4420 15 Pacella Park Drive epAl RESS' Suite 240 INSURE S AFFORDING COVERAGE NAICO Randolph MA 02368 INSURERA:S0lective Insurance INSURED INSURERB:Safe Insurance Co an 33618 Cape Save, Inc INSURER C:Technol0 Insurance CO an 7 D Huntington Ave INSURER D: INSURER E: South Yarmouth b9L 02644 INSURER COVERAGES CERTIFICATE NUMBER<L125948081 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. rINSR POLICY EFF POLICY EXPLIMITS TYPE OF INSURANCE POLICY NUMBER MMIDD MM/DDGENERAL LIABILITY EACH OCCURRENCE $ 1,OOO,OOO X COMMERCIAL GENERAL LIABILITY PRE SES Ea occurrence $ 100,000 CLAIMS-MADE �X OCCUR PPS1994480 0/16/2011 0/16/2012 MED EXP(An one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,0001 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 R POLICY PRO- LOC $ JECTE M88�INEDSINGLE IM $ 1,000,000 AUTOMOBILE LIABILITYdent, BODILY INJURY(Per person) $ B ANY AUTO ALL OWNED SCHEDULED 6208200 1/6/2011 1/6/2012 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS er accident X Underinsured motorist BI split $ 100,000 X UMBRELLA UAB HOCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIM&MADE AGGREGATE $ 2,000, OOO A DED RETENTION$ PPS1994480 0/16/2011 0/16/2012 $ C WORKERS COMPENSATION A WC STIMIT EB_ AND EMPLOYERS'LIABILITY EL EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNERIEXECUTIVE� N I A OFFICER/MEMBER EXCLUDED? C3318007 /9/2012 /9/2013 E.L.DISEASE-EA EMPLOYEI $ 500,000 (Mandatory in NH) If yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,000 OESCRIPTI0 OF OPERATIONS below 11 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,N 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 ACCORDANCE WITH THE POLICY PROVISIONS. Cape Light Compact Attn: Margaret Song AUTHORRED REPRESENTATIVE PO Box 427/SCH 3195 Main Street Barnstable, MA 02630 Michael Christian/BM ACORD 25(2010/O5) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 onirmi nt Thn Annon nomn zinfl Innn am rnnic4n►nel morrke of arnian _ • \l:usachusctts- Dcpallntcnt 11f public $arch 4 Board of Building Regulationsand $tantl:u ds , Construction Supervisor Specialty License License: CS SL 102776 Restricted to. IC `s WILLIAM MC CLUSKY 37 NAUSET ROAD WEST YARMOUTH, MA 02673 Expiration: 6/2812013 T r.=: 102776 (' nuui.ci,nu•r Office of Consumer Affairs and usiness Regulation 10 Park Plaza - Suite 5170 w� Bost6n, Massachusetts 02116 Home Improvement Contractor Registration =---= Registration: 171380 Type: Corporation Expiration: 3/14/2014 Tr# 222184 CAPE SAVE INC. _ WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 .= Update Address and return card.Mark reason for change. - Address [l Renewal ❑ Employment [� Lost Card PS-CAI 0 50M-04104-G101216 i-" —•�-_- ----.._.. .. . . License or registration valid for individul use only "1111\ Office of Consumer Affairs&Business Regulation _I HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: -E71380 Type: Office of Consumer Affairs and Business Regulation = 10 Park Plaza-Suite 5170 _ Expiration: 3/.14/2014 Corporation Boston,MA 02116 CA p SAVE INC.:_;•`. WILLIAM McCLUSKEY> ;y,_`_ 7-D HUNTINGTON AVENUE SOUTH YARMOUTH;MA"02664 Undersecretary Not valid wit o signa i 0 yn J Mousing Assistance y Corporation Cape Cod HOME OWNER WEATHERIZATION WORK PERMIT & FUEL RELEASE: . PLEAg FILL OUT AND SGN THISFORM IF YOU ARE THE APPLICANT HOMEOWNER. I 1 her�y consent to and agree that weat herizati on work � _ may be done by the Weatherization Program of H ousi ng Assistance Corporat ion (herein after referred "Ag cy") on the roperty located at: The weatherizat i on work done wi11 be based on programmat ic pri oriti es 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 replaoenent of badly deteriorated windows In consideration of theweatherization work to bedoneat my home I agreeto 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 weat heri zati on work on said property. 2. The Housi.ng Assi stance Corporati on reserves the right to inspect the fuel or utility bill for the weat heri zed unit on an ongoing basisfor no more than five(5) years after the weatherization work iscompleted. I have read the provisions of thisagreement as listed and freely give my consent. Home Owner: (Signature) J Date: Agent: (signature) �UL�\f\ D ate HAC approved Weatherization Company -.c,G: All Cape Energy CapeCod Insulation Cape_Save Efficient Buildings,LLC F�Q1lt lti�E*f�� i QLutJ r-1s nL1.1'_V*(1Lo_brL ,, , . S,r:i - &,RewlutiQa. Energy