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HomeMy WebLinkAbout0077 ARROWHEAD DRIVE �� C�� �_ r _ _ _- r s Y; Town of Barnstable Final Inspection Affidavit Date: Thomas Perry, CBO _. Building Division 200 Main Street Hyannis, MA 02601 RE: Insulation Permits r- Dear Mr. Perry, This affidavit is to certify th t all work co I d at: Street: (.1� Village: has been"inspe ted by a certified Building Performance Institute (BPI) Inspector. All work performed meets or exceeds federal and state requirements. Permit applic Rio numbe& -QJ99 Issue date: Sincerely, Francis Sheehan President Frontier Energy Solutions, Inc. 502 Harwich Road Brewster, MA 02631 Office: 774-237-0410 Email: fssfrontierenergy@gmail.com I, TOWN OF BARNSTABLE BUILDING PERMIT APPOCAfION a Map Parcel Application Health Division �` +� � Date Issued 0 l� (0 B Conservation Divisions Application PU r Planning Dept. Permit Fee /Y�1,ota xs�'u` Date Definitive Plan Approved by Planning Board �g Historic - OKH _ Preservation / Hyannis Project Street Address / 72 1:1X � Village Owner I dss � Telephone_. Permit Request AM Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new ,Zoning District Flood Plain Groundw ter Overlay Project Valuation +Construction Type 1 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 ❑ 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 Us? , - Proposed Use � 1 1:) " av°Tr k - --- - - APPLICANT-INFORMATION (BUILDER OR HOMEOWNER) Nam - � r, D&J 1 7°'""'CW/0 hone Number � �" Address Sn fl9AA X9 License # )0'5i .-( c W_m cab Home Improvement Contractor# Email �(�� �,�Q �, I er's Compensation.pp(0011rs 31S CKOR ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO @ OW)4,AA,,Q JA2C SIGNATURE DATE I k, l s. F FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. , R 1t . t ADDRESS VILLAGE r OWNER t i DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING j DATE CLOSED OUT ASSOCIATION PLAN NO. DATE(MM/DD/YYYY). ,aco CERTIFICATE OF LIABILITY INSURANCE 04/05/2016 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 CONTNAME: Krystal Doyle ROGERS&GRAY INSURANCE AGENCY, INC. AICNNo (508)398-7980 FAX No: E-MAIL kdoyle@rogersgray.com 434 RT. 134 INSURERS AFFORDING COVERAGE NAIC# SOUTH DENNIS MA 02660 INSURERA: AIM MUTUAL INS CO 33758 INSURED - INSURER B FRONTIER ENERGY SOLUTIONS INC INSURERC: ' INSURER D: 502 HARWICH ROAD INSURER E: BREWSTER MA 02631 INSURER F: COVERAGES CERTIFICATE NUMBER: 42389 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. INSR TYPE OF INSURANCE ADDL SUBR E POLICY NUMBER MMI D/Y LTR YYY MM DD/YYYY LIMITS LT COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE CLAIMS-MADE OCCUR - PREM SES EaEcccu ence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ - POLICY❑PRO ❑ JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE N/A - AGGREGATE $ DED I RETENTION$ $ WORKERS COMPENSATION X STATUTE EERH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBEREXCLUDED7 N/A N/A N/A VWC10060153152016A 03/14/2016 03/14/2017 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT 1$ 1,000,000 N/A i I - I J DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Frontier Energy Solutions Inc ACCORDANCE WITH THE POLICY PROVISIONS. 502 Harwich Rd AUTHORIZED REPRESENTATIVE Brewster MA 02631 Daniel M.Crow�ey,CPCU,Vice President—Residual Market—WCRIBMA @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD �ttirr of I a umrr♦ft it ,A Wv,RmutMip iH4MEtMPROVEMENT CONTRACTOR Linen r ur"re+iatrttttGii Valid for inflRiduhi-Se mly ���Raglstraflon. 3. 2 x 4rfor'e the v%pirttitsz+fast^. Itfogt-4re€erasitts. - 0ffice of(ansenirr Affairs and Ilueiertle to€itn ;ItParkPiaxt zsrise5lttfRi7iESt'EStEz�GYSOtUTK?Fi5 Ilowto€,,lIA 02 t 16 - 62 HAMS 41CH RD -iy I ( { SfAEW$"rBR.MA 02631 tb;wtker.rratar. . 1, _... n:sture:_�_.— Gonstruaaon,$upeMsor-Spec.alty a x= E`�estPtetad-to•. CSSi.-It -insulation Contractor € CSSi 10b9d1 :. FRANCIS S SHEENAN r 562 N gWHRp gRtWSTER MA 02631. t Failure to possess a current edition of the Massachusetns State auIfaing Code is cause far r`epocation of this Ikense. g OPSt.konsing;informafbo wstt::WWW.MASS.GOV/0P$ 82i1712016 I AN- The Commonweaft.A.of,MassarAusetts t Departtnetit of Industrial AGciitents 1 C©regress Street;Suite,1- Boston,.MA.#M4-20,1 ww .,nta gev/,lit t`utkers''C'ompens'atioo. usurance Af daytt.j4 di rs/G intractar"lictricians/Plumbers. T,0 BE.FILED WITH THE,PEkVjj'TTING AI Tt#OIttT,Y: Apjilkant Information Please Pirint L ibly NaiTle(BusinesslQrgariizatioriltnd viduall: l t I O C..: Add rm. Q2 C>tylStatelZi = 2 Phone,*: ( j P, f� f,�E � 0 t' Are you an employer"Cheek46.Appropriote box; j yprL Of pCOJECt'(C.EgtltrEd)': 1�am a employer with._. employees(full-a 7.; .❑New;cOttstrtte tlUn. 2 t amsa solepr4prtetor;or parmcrship and have:no employees working-forme n $. Q Remodeling, ❑•anycapatity.[Ja.woriccrs carrip:.insurance required.] 3.Q 1 am a homeowner doing.all work thyself.[No workers'comp. 9.insurance required j't ❑Detiolititit , 10 Buildin addition ,a 3 1 am homeowner and tivill be hiring contractors to,conductali work,on my property. Iwrite �� ensure that all�contractdn either have workers'campensatlon murance'or'aresole 1 I E16aritk rep, Or 3dditl0[1S proprietors.with no.emptoyees_ 11 Q Plumbing repairs or additions � s.❑1 am general contractor and 1-have-hired•the.sub-contractors listed on the attached sheet: These iAh contractors have employees and wave workers'comp.insurance.t 13.❑Roof repairs:(j b.�V c:arc,a cnrprirattan°artd`its office shave exercised their right afexempuon-pzr 1MGL c; 14; t� 0the[3J B2.§1(4),and•we have:nr employees.[No wotkers'Comp Jv4urajce required.] "Any applicant that checks baxl must also till out tiEe section below shoivtng clteir wbricers'`compensaton policy information. t Homeowners whosU Tit this at+idavtt ittilicattng iheyare doing,all,work:and then hire autside contractors must,submit a new•aiTidavit indicating such: tContractors,that,check this box must attached an ads itional.shezt showing the dame of the suet i ontractnrs and'state whether or not those:entities:,hati e emplovees;if the sdb-conitactgrs;hav¢'employees,ttiizy must ide ihetr>-workers`'comp.policy ntitnbet., l am an empivyer tTtat is proyidM;wortters':compensation I»surnrece far+rry.esnployees: Below is the policy:and job"site information, Insurance Corti att Name: • R Y ��� �"�il Policy#.or'Setf:iris.Lic.#; r f f'::— t Ezp:iratian Cate: .: Job Site.Address � � City/Statc/Zips AL A Aftat ti a copy oft leers compensation polity declaration page(shawing.the policy an and expiration date): Faiture to secure:coverage as required under N'GL;c. 152;§2SA isA criminal violation punishahle.ljy a fine up'to 1500 00 and/or one-year.imprisonment,as well-as c vil WO , 0.Q a, OO p2 day against the violator.,.A copy of:this statement may be fgrwardedto the OfFice of Investigations of:the DIA:for insurance coverage Vert fit catiom t do.hereby certify under'&e pains a tees of perjury.that the inforiiuitrrrn.provtcfert Bove is true ao correct Signature �j Date_ 1 Phone#` - - 2 . U onI .. D rirr"t wn'te`n this:aria,: b Y e cortrpltled by city ar town neat City,or-Toww.. Permit/l thence 9' Issuing-.Authority(eifcle one): I Board of Health 2.Building Department 3.C'ity/Town Clerk 4,Electric.aHhspector 5. Plumbing lnspec,tor I Contact Person, Phone,# HOME OWNER WEATHERIZATION WORK PERMIT: PLEASE COMPLETE AND SIGN THIS.FORM AS THE APPLICANT'HOMEOWNER. hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation on the property located at: 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; air sealing; attic& basement insulation; exterior wall insulation; ventilation measures In consideration of the weatherization work to be done at my home I agree to the following: 1. 1 give permission to Housing Assistance Corporation the property with such equipment and materials as may be necessary to perform weatherization. 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. I have read the provisions of this agreement and give my consent. Home Owner(signature) �' 6r— -Da ecke co W, Home Owner email: Agent:(Signature) Date: Weatherization Contractors: Adam T Inc Cape Save All Cape Energy o ier nergy Solutions Alternative Weatherization Lohr Home Improvement Building Science Construction Tupper Construction -Cape Cod Insulation .y.... �Y. r..-_...-..-.... _.. � .. t .. .. ..J y. , i.' ♦• r 1�- . •. r ' ' 4 .. . . V...'.��............"M...1'•`.^.•N'•4^�'. Assessors map and lot number .......................................... INSTALLED {fy C010LIA A�CE Sewage Permit number .�f'dl>.Q... Z ........... 4' t..B ARTICLE it STATE I U A,RY 7 TOW yofT�ETo� N OF BARN 'ftE Q � S i SAUSTLBiL i p�9`ae�0 BUILDING . INSPECTOR �r APPLICATION FOR PERMIT TO . . ... ,�...................... TYPE OF CONSTRUCTION .................. .t - �............19.7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ............7 .. ..` Y.t! .. .c'. &...... o. '4:,... . 'y-C.C.&?.!.A. ...... . ....... ProposedUse ........4.1P.-A 6..�Y........................................................................................................................................... �j Zoning District .... .....................................................Fire District ..11. ..�.'eq..c......................................................... Name of Owner �?.. ... ..l...c'.�. ..r .4o. ..,,............Address ..1 � �.�YD!�� �C?(Y� �.I.'...,Kf,4�.Y.,l..??19 Alf SS Name of Builder ...........5:..!l...41- .•.....................................Address .................: ..14.11?.` ............................................... Nameof Architect ..........)1.XnA.............................................Address ....... �..Y) ', .....................................:..................... Numberof Rooms ................®...............................................Foundation .........Co.rv� ................................. Exienor .................. ...... +/.............................................Roofing .............1J.k..l.N.5..�:�.4..................................... Jam' n' "�.!.'' Floors ...............1�..�.t'�.�f- ......................................Interior ................Q v .d.,�................................................ Heating nt ....Plumbing '!. .............................................. Fireplace ...................N Q...................:..................................Approximate Cost .............. .? 2.p..;Ip...................... Definitive Plan Approved by Planning Board -----------_------_-----------19________. Area Z' 4.......... Diagram of Lot and Building with Dimensions Fee ........... .°............................... SUBJECT TO APPROVAL OF BOARD OF HEALTH -57 1 . tti I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable or ing a above construction. N ..... .. .. ...... Paquette, John No ..l7.676—. Permit for _..garsge______ � � . ~ . ----------.--.------------- ' . ' Location 77 Aronhead Drive --_ _ r .. _____ ' . � . ................ —~----------- 7~ J�b� �u t�e Owner --------..g���---------- ! Type of Construction ---�����------- ` --------------------------' ` Plot ............................ Lot ................................ ' ~ � ' 8 75 Permit �ronua] — A � { ' Doh* of Inspection �r�..���,��^^���"ucw�iA Dote Completed ' .... ' � PERMIT REFUSED ' [ -----_--------------.. 1p { ` ~_________________________. \ � ''',~----------------~`^------' k' :~'------^------^----'—~—^'—~— ' � .-----...------.-----,,.-----. . . . / ~ Approved ................................................ lQ � ~ ---�~-------'-------`---^^--^ * � � -r ' � ---------------------.~--~... �� ~ ^ . . � . ~ ' .,� •'._. .---y..ir,,.+�:�::�,. ..':y�W,t�ty..:v„•,;t' `sqw� c- �" i..`�i' ,:,y:•+'�'�'�'�]"Gxy (e : ..y+.r��K�"'!'i/�.�i'7r=�'r".I; .n Assessor's map and lot number ........ ................................ Sewage Permit number .. .!�......v �/!� -L� .•�f.!.............. Qyo�7NETo�♦ TOWN OF BARNSTABLE i 89$HSTODLE, i ° "6 9 ' BUILDING INSPECTOR am .� .. _� -l.. u _ APPLICATIONFOR PERMIT TO .................................,............................................................................ FTYPE OF CONSTRUCTION .................Il ...................................................................................ff./.............................. Of ..................... y/.. .............19. S TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ' Proposed Use ........... .... '.., ................................................. ................................................................................................. ZoningDistrict ........ '.....................................................Fire District ...; .:............................................... Name of Owner h , ,; ,i v �:.� y c%<,c �1 ................................ ' r' ....:.......,...:.........:.:................_.......................Address .............. Name of Builder �' r Address r' ......................n..... .................................:::............................................... Name of Architect .................................................Address ............... Number of Rooms ..................................................................Foundation ......... ,tl ?..:-................................ Exterior `r: ..................�/.... .....<,l/ ............................................Roofing ..............��:.1..�� ...:�:�-::��..................................... ... .... Floors ............... ......................................Interior ................ ..fit,. ............................................... rieatingr.............................................................Plumbing ...................... ....................................................... Fireplace . /' ..............Approximate. Cost .................... .� r ...................... ............................................. .....................:......................... Definitive Plan Approved by Planning Board ____________,__________________19_______. Area 3 Z'. ......`.............. ........ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH r B I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable rega ding the above construction. � ^ � � 17676 garage ' 77 Arrowhead Drive Hyannis ' Type of Construction ......./frame Permit Granted May 8 19 Paquette, John . � PERMIT REFUSED � � � , ' .....................................8......... lV ' ^ ------------------------- � -------------------^---'-- |