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Home My WebLink About0142 BACON ROAD ��1 Q,9co� ,ed , ;� i , ' � i i , f i {, I ,�, i Town of Barnstable *Permit# 9-/ �. Building Department Se %a-0 �, ires6moP efT ■natasrAsrX ` Brian Florence,CBOMASI a z ��' Building Commissioner , 1°rFv +�' 200 Main Street,Hyannis,MA 0260,1 AUG '24 2017 www.town.barnstable.ma.usI U141�f.k... Office: 508-862-4038 '� �� f : 08-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address Q residential Value of Work$ r/ 1y 00 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name G �� Cc, 7 CALd V Telephone Number r-6 r—(d L Home Improvement Contractor License#(if applicable) & FF COO." Email: C..k 7 II �'� Cd Ste A car Construction Supervisor's License#(if applicable) �U 0 6Norkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name D�' OL Workman's Comp.Policy# 9 ') a Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box). p Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the ome Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: � ro Q:\WPFILES\FORWbuilding permit fotms\EXPRESS.doC 08/16/17 F " The Commoymealtlt ofMaysadrasdts �e�mrtrr�er�t�rf'1frfstrint�tccide,� - '/.j! /gyp /m r Of Boston,-41A 02111 wfouniamLgar/diia Workers' Cumpensaf-an Insurance Affidavit:B-ml-dex-s]Cnntracturs/Elect dcian s(PhmLhers AppUzant y Please Print Ia= o &t) Addresr rev Cay1St2LttrZipr, Phonti Are you an emplayer?f heckthe appropriate bay ' Tyke of project(regmired): I (;r am a employer� 4 ElI am a general contractor and I 6. ❑New oor�ctiaa'ff' �iemployees(fill an&of part-ime).* I=e hired$ee sdb con 2.❑' I am a sole proprietor orpartnee listed bathe.attached sheet. 'i- ❑Remodeling Thew sub-contractors have soup and bane as employees • S_,❑I7emnlifioa . Worizing forte in any capacity. employees aadhave c or err 9. ❑Building addition INo u:.a63ers' comp.insuzzxtces comp.insurarrml rewired] 5- ❑ We are a cmpozafion and ifs 10❑Ele#ical repairs or additions 3_.❑ I am.a bomeovm-w doing aAwork officers have exercised fiieir 1L❑Pbmibiagsepairs or addiuoms sell=�T o v lcrrs' ugu of esec3p6on per MGL 7❑ epa ;;ncmanr.L,egdred]t - c.152,§1(4k and webareno 1� Roafr employees-[No wolf=' 1.3_❑Other �� / �V y cgnv-TIISQ MM reTi $ayapgEiczat�atchedsshas�lmastsl=fMcatthesectioabgawshuningtLeswo&eeWcmcvmp—atinupuTuyi�r`aaa- 1&nmr�waeiswl�o sabot t�s�5daeu iaduatiag drry ue3aing ag ara�c amdt5mfitxe au�zderm+*are„��s#subffitanemssdaRk iadicabag sacTi fCaarracfns�zt d�ecYihu box must attadud=addifianal Shea shouingthen—of the sub-C�M xad state wheiim arna ftse enritiesbrm employees.Ifthesub-cabtxdmkzce empio;�;diey I pxn-Aethm warkm'camp.pahq uu mbm I am art empfalvr die isproid'dir� workers'compensation in=rancefor ruy employees Edoov is fliepoficy andiab site infat rrsaliatL 1 - Buwa=e Company.-Mame: Lei a� v C Po cy 41or Self-ins Lic_ L. 24 EapiratianDate: ` ( , Job Site A,ddir (OTC d City/Swe zip. I't Aftxch a�P} of the warkere com Peuation of •declaration P�a(showing he oRc3'number and expirat ion safe).• Failure to sew coverage as required under Section 25A of MGL a 157-can lead to the imiposiliaa of criminal penalties of a fine up to$L50D OG anNor one-gear impiisou--nt as well as civil penalties.in the fog of a STOP WORK 41ZDERand a fine of up to$MDa a dap against fhe violator- Be ad-tdsed fist a copy of this statement maybe forwarded to the Office of Iirves�gatiarts o€Elie D�far insn�ce coverage i,�frcati� 'Ida kereby cerf#Y uRderflts andper— afperjury'fJiattiie arfbrnzati=prm*&dabm a is hm arrre . $i�atnr� f Date: U Phame oJidid use arrfy. D47 not Orke in f ds area,to be carupl-teed by C*Y ar tan-u VJq Qt City or Tawa: PermitT icense:9 Issuing A.athar4(drde one): L Board of Health r.Buil4ing Department 3.City1rown Clerk 4.Electrical Inspector S.Phanbiug Inspector S.Other Contact Person• Phone ih Laformation and lastruefions ssar3�rrTce�Gc<W=2l Laws chaptea M req=m.aII employers m Imo&woz '� do for their euiployee�. Ma p�-m this sf�t$,an a lnyee is defined am'`. e�eayp easonin the service of another under any caatzad ofbfi express err implied,oral or vziffim." An.employer is defined as-an indhviffiA pa=tnersb�,assoQaGion,corporation or other legal er j',or�5'two or more . o =foregoing m a joi at mt prise,and�k-d�the legal relseseabtive s of a deceased empIoyea the ,or f rm.eim or trastee of an m ffVIff L per,associafian or other legal may,=PkY��Ioy�- However the owner ofa dweIlmgho�sehavin�notmalef fbree artme�ts andwho r=des tiierem,or the occupant offe- dwelling house of another e�gloys pe$sans to do ,conckac ti rn,or repair work on such 67- house oron.thogrom3ds0rbnD&O9aPPmt= thereb shOnotbecanse of such employmentbe dccmodtn be an employers" MGL chapter 152,§25C(6)also states that¢every sty or kcal Rcensmg agency shall,wiffihold•fie issuance err mew-al of a license or permit to o opm Ete a business or to con-st acE b�dmgs to e co onvPealfih for any r applicm who has notprodaced acceptable evidence of compTranac'[vn th=ksar ce eoveragereqused atsfieihrAdd>tonaIIy,Mal.chapter 152,§25C7 e commemwealfi nor Ely ofits po7ifical subdivisions shaIl eni>er info any ca mtract far the pmforraame of public work mml acceptable evidence of carnpl m=v,-hh.the fi=mca. enzeats oftlhis duptesbavebem presented to the c-onir�.anihordy:' Appliczn-&- , Please flI oirt the worker'compensation affidavit completely,by check the boxes that apply to your sifnaiion and,if neressazy,supply sub-mnfractnr(s)name(s), address(es)and phone numbers)along wlththmrr=trFaca±e(s)of mstZ=ce LLirnit-dLiahilify Comipames(LLG')ar LmntedLisbh�ity`Pmto=ships(LLP)withno�kyees other f an fie members or panne-s,are not rbquaed to carry Workres'camPeDsaftoa•insora ce. If an LLC or LLP do ezz have employees,apolicyisrmpiad. Be advisedtihattoisa$dayitmaybesnbm�fedtnthr,DepaLtnmtoflndustial Accidents for confimma�n of msuI.MCq coverage Also be sure to sign and date-t affidavit The affidavit should be-retumed to the city or town that the application fOr fie permit or license is being r not the Dep..tment of ,T, rimyi l.A c: dmt9L SlZonldyoa have any questions regsITIng the Iavr or ifyon are reguied to obtain¢workers' comp eusatiou policy,please caII tie DeparbiLm±at the number lisiad below* Self-fimued companies should enter their s elf-insarzace license mbar an.fie ag�pro=m Ime_ City or Town.ofarials Please be sore that the afffidavif is complete and The Depm meathas provided a space at fhe bott ma of the:affidavit for youto fill out iatie event the Office ofInvestigations bas in C;Omtrtyonregardmgibe applicant Please be wire to fr7.l in fee pem tiWicense n='bm which wM be used as a r &vmce nzmmber- In addition,an appIic a t �m ,need.only submit one affidavit indicatng current that must s¢bnh>L multiple pe�'llice�se apph �y given y� - p olicy rm infoation.(if necessary)and under"Tob S Q s"the applicant should write-aI[locations is (may or town)-"A copy of iheaffidavitfiat has beer officially stamped or marked by the city or town maybe provided to the applicant as prooffm±a valid affidavit is on file far futme'pe�its or licenses Anew affidavitrmrstbe f cd oirt ehrh Where a home ome owner or citizen is obtaining a license or pew not re7at ed:o any business or commerraal V&Mfrr<e y (ca a dog license orpermi[t to b=Ieaves etc.)said person is NOT regained to ecnrplete Lois affidavit C� z\ e office of Invesfig�inns wauldhlfle to thank you in advance far your cooperaticm and.shouldyon.have ahy q . ICstions Th please do nothe� to grvem a call The Departure s address,telephone and faxm=ber: cam tth ofhfisc�h> Deparimmt c6f ia1Amidan-t-I ns a=M&oil II _TeiL 4 617-' -49-W min 4.06 or 1477 MA& Fax#a"-72'-7M R.m ised4z4-07 - MaeE Wdiv- JON CA ZEAUL i ROOFING & REPAIRS PROPOSAL Proposal No.17-5767 August 11,2017 s To: RAC Work to be performed at Re: Shipman Residence 142 Bacon Ln Hyannis Ma We hereby propose to furnish the materials and perform the labor necessary for.-the completion of: NEW ROOF 1. Remove existing shingle roof ' 2. Install new aluminum drip edge \.2 3. Ice& Water barrier first 2ft, all skylights and penetrations 4. Cover roof with 15 lb felt 5. Re-roof with 30 yr architectural shingle 6. Install ridge vent 7. Flash all pipes-and penetrations 8. Remove all rubbish from project Labor and Materials $4,900 Replacement of front and rear Facia Board and installation of new gutter system Labor& Materials $1,500 Toatal Project cost $6,400 All material is guaranteed to be as specified, and the above work to be performed in accordance with the specifications and completed in a substantial workmanlike manner for the sum of Six Thousand and Four Hundred Dollars$6,400 with payment as follows: Six Thousand and Four Hundred Dollars$6,400 upon Completion Respectfully submitted, Richard P. Cazeault,Jr. 198 Five Corners Road Centerville,MA 02632 (508)420-5482 Acceptance of Proposal No. 17-5767 The above prices, specifications and conditions are satisfactory and are hereby accepted. tgn' do the work as speci d. Payment is outlined above. - - - ---- --- to�Q l_Date _ CERTIFICATE OF LIABILITY( INSURANCE F 021132017 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(SI AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT-If the Certificate holler Earl-ADD('f1ONAL INSURED,the pot'ny(les)must be endorsed.If SUBROGATION IS WANED,subject to the terms and condifflons of the policy certain policies may require and w dolsemenL A statement on this oe Wk—.ft does not confer rights m the certificate holder in fieu of such endommmft PRODUCER CONTACT Leonard Insurance Agency-Inc Beridey Assigned Risk Services 683 Main St B f Pilo rx 888)548-7431 Ne k (866) 215-8118 Osterville,MA02655 EMAIL :PormyServioes@berldeYrisk com ! INSURER(S)AFFORMGCOVE:AGE NAIce " wsuRED i o+sw;mRA:Acadia insurance Co 31325 Richard Caneault JrRM e 198 Five Comers Road Centerville,MA OZ632 wsuRER a INSURER D: INSURER E A ONSLJRH2 F: :OVERAGES CERTIFICATE NUMBER: REVISION NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE.LISTED BELOW HAVE BEEN INSSUED 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. PlS2lTR TYPE OF INSURANCE R WVVDD POLICY NL04MR ) Lam - WORKERSCOMWISATMAKID r ®1NC STATU ❑OTHER 91PIZVE S;LIABILITY � TORYLOM ANY PROPRIETOWPARTNERf ! E.L.EACH ACCIDENT " $5W,000 A [y] N►A t [IMAARP3008M 0=412017 02/04/2018 °� ` O ; IDIECuEl.DISEASE-POLICY LIMIT tem,m�,rr�eml ) _ $500,000 Ilyes•desrnbecarderDE rIONOF OPERATIONS below. IESCRIPTION OF OPERAMG S I LOCATIONS I VEHICLES tACadr ACORD 101.AdMarel Ren mks.Sdm&d%if mme spmis rewAmm-SeddonCdegay 'BeCIIMSlaks Nacre- EeeeGve AB.hmued.: Eft: ..._.. - Rid— QdmmJr Risk Locaffan 128 Rve Cartes Road.Cer hwft MA 02632 r - I I . 1 ` CERTIFICATE HOLDER' CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE { ignature: ACORD 25(2010/05) BRAC 3139 f �,- Massachusetts GePartment of Public Saf& -. -'.Heavd of RuileYngiulatis�ns and Standavd_s . Licen.:�: CS w Consttuctiorf-Supefvisov . RICHARD P CAZEAULT JR 198 ENE CORNERS ROAD CENTERVILLE MA 02632 :.crnrriss;one; - tx -ti6n--' . u S nen�t of Labor �� r Ocxupatiorlat Safety artr!kleaiit�Admnls Latror bus s�z zssfWyr riioln..4:7Ct hc>, t3ccupattafiat Satey and i�Eafttt ; T�arruno Course m : , Gonstruchon Save �#eatft►' - r 'c -owl of c—T AsumerAftatrs ass Regulation': r-, HOME IMPRQdEIVtENT C-ONTAgL:TOR TYPE.Indnriiduat e9lstraEfOn.ealtd for�rtclnttdual e on Office of Consu iratton d fount ate.,H !`: r 168607 03/071 i9._ Re gomon RICI LARD P Cjj�ZEgU LT, JR costar►,eta 02t1s' CBIA R Cazeanitgoofa, #A _. 0� epairs . RICHARD CAZEAt1LTJR - 1 98 Five Co _� mer5 Rd UkdemematurvC . IVot valid -- 4 Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 8-20-16 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 r RE: Building Permit#B-16-2143 TO: Building Inspector(s), This affidavit is to certify that all work completed for 142 Bacon Road,Hyannis has been inspected by a third party Certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey i TOWN OF BARNSTABLE BUILDING.PERMIT APPLICATION Ma 3 b 0 Parcel 0�1�" TO' ��' OF BARNSTABLE � - o� 17 p 1112 Application #Health Division �`4�� , e": 7 `.'i 9: Date Issued 8 kv- Conservation Division Application Fee Planning Dept. Permit Fee 'W Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis EMAX-L- s ' Project Street Address C� d. kco 6 l4d Village 4f�4� Owner Address Sq,nryp_ Telephone Permit Request 1, . ocr s e4 i' e� oL "I I101.%4ArvAli1Ar , Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type 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 Use Proposed Use APPLICANT INFORMATION T (BUILDER OR HOMEOWNER) Name W11 Oft,�^o' Telephone Number ��a ��$ 0 3 1 Address - �Qi License #_ Home Improvement Contractor# Email Worker's Compensation # WCOR55,40400 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO ,�,-�'{� SIGNATURE VV DATE � Ab I �. FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. HOME OWNER WEATHERIZATION WORK PERMIT: PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER. I 'M � ( ; t �h..��. !� ..��•i��'lC�,q hereby consent to,and agree that weatherization work may be done by the Weatherization Program of Housing.Assistance Corporation on the property . located at: JLaAa,b 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. I 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. 1 have read the provisions of this agreement and give my consent. Home Owner(signau,r6) i • _ Home Owner email: s I S M a ep, 2'_'i hoo, Date: ? Agent:(signature) �lr`- Date: Weatherization Contractors: Adam T Inc �FontierEnergyy All Cape Energy olutions Alternative Weatherization Lohr Home Improvement Building Science Construction Tupper Construction Cape Cod Insulation w The Commonwealth of Massachusetts, " Department of IndustiialAccidents 11 Congress Street;Suite 100 It: -;-y tf A M Boston,MA 02114-2017 - www massgov/dia NVorkers'Compensation Insurance Affidavit:Builders/Contractors/Eleetricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Apulicant Information Please Print Legibly ' Name,(BusneS"s/Organzationllndi Caa Save Inc P yidual); ,. Address:7-D Huntington Avenue - South Yarmouth;MA 02664 508 398-0398 3 ' City/State/Zip: _ Phone:#: . ., Are you:an employer?Check the appropriate box, _. -• Type .of project(required); LE]I am a employer with : 15 employees.(full and/or part-time)_ " 7,;'Q New construction _ 2.f7l am a sole. o rietor or artri"i and have no e n to ees working for in' PT p p. p p y g a 8° �Remodeling , any capacity.[No workers'comp.insurance required •3,MJ am a homeowner doing all work myself[No workers'comp:insurance required." 9.. 0 Demolitiori� 10 0 Q Building addition 4.❑.I am a homeowner and will be hiring contractors to:conduct all work on my property. Twill -- ensure that all contractors either-have workers'compensation:insurance or are sole I L❑Electrical'repair's or additions proprietors employees. 5. I am a general contractor and I have hired the sub-contractors 12. Plumbing repairs or additions with no listed on the attached sheet; ' These sub-contractors have employees and.have'workers'com .m psuranoe.+ O Roof repairs 6. We are a corporation and.its officers have exercised their right of exemption per MG L c. 14.[E]Other Insulation a 152,§1(4),and we have no employees.[No workers'comp.insurance required:] } *Any applicant that cbecks: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 submita new affidavit -*Contractors that check this box niust 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: Star Insurance Co. _ Policy#or Self:ins tic.# WC085540700 Expiration Dates 4/9/2017 Job Site Address: 142 Bacon Road ..City/State/zip:Hyannis Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MOL-c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or One-year imprisonment;as Well as civil pelialties in the.form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A.copy of this statement may be forwarded to the Office of Investigations of the DIA,for:insrirance coverage verification. , r .I do hereby cerdfy if ndeFthe pains and Penalties of-perjury that the information provided:.above is true and correct Si ._ature Date: 26/16 Phone#:508-398-0398 Official use only. Do not write in this area,to be completed by city or town"of pial_ City.OT Town, �f tm Permit/License Issuin Authori (circle.. rc a one Issuing Authority ) _. 'l.Board of Health'2.Building Department 3.City/Town Clerk 4.Electrical.inspector 5.Plumbing Inspector 6.Other Contact P.erso,n: . Phone.#: Ago CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDD""") 4/12/201.6 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 pollcypes)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 holderin.lieu of such endorsements. PRODUCER COME Risk Strategies .Company Risk Strategies Company aHco E : (781)986-4400 FAX No:(791)s63-4420 15 Pacella Park Drive ADDRESS: ndolphcld@risk-strategies.00m . Suite 240 - INSURER(S)AFFORDING COVERAGE NAICi Randolph MA 02368 p inlsuRERA:Selecti.ve Ins. of America INSURED iNsuRERB Allmerica Financial Alliance Ins Co 10212 Cape Save, Inc iNsuRERc:Star Insurance Cc 7 D Huntington Ave INSURER D: INSURER E: South Yarmouth MA 0266,4 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1641211375 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 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. I POLICY R TYPE POLICY.NUMBER .MW MMIMP E LTR: - LIMITS_ .. .. LT X COMMERCIAL GENERALLIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE �OCCUR PREMISES Eaoccurrence $ _— 100DAMAGETO ,000 X 91994480 10/16%201$ 10/16/2016 MED EXP one person $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIESPER: GENERAL AGGREGATE $ 2,000,000 POLICY I JECOT F-1.LOC PRODUCTS-COMP/OP-AGG $ 2.,,0.00,000- OTHER $ .AUTOMOBILE LIABILITY SIN IMI $ 1„000„000 - -Ee accident ANY AUTO BODILY INJURY(Per person) $ ALLOWNED 71 SCHEDULED ' AUTOS X AUTOS- AURA46796600 11/6%2015 11/6/2016 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY'DAMAGE X HIRED AUTOS X AUTOS Per accident) $ $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1. 000 000 A7 EXCESSLIAB. CLAIMSMADE AGGREGATE $ 1 000 000 DED X RETENTION.$ HIL IS1994480 10/16/201b-10/16/2016 $ WORKERS COMPENSATION officers included for � � X STATUTE ER AND EMPLOYERS•LIABILITY I'. .. ANY PROPRIETOR/PARTNER(EXECUTIVE YIN NIA C coverage E.L.EACH ACCIDENT $ 500 060� OFFICER/MEMBER EXCLUDED? , {Mandatory In NH) r,� RCOSS540700 4/9/2016 4/9/2017 E.L.DISEASE-EAEMPLOYE $ 500. 600 If yes,desaibe.Under - - - --- DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS ROGATIONS I VEHICLES(ACORD 101„Additional Remarks Schedule;may be attached if.more apace is required) National Grid Corporate Services LLC d/b/a National Grid, Action Inc, Colonial. Gas Company and NStar Electric are all included as Additional Insureds with respects to the General Liability coverage of named insured as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED:BEFORE Housinq Assistance Corporation THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cape Light Ccanpact ACCORDANCE WITH THE POLICY PROVISIONS. Barnstable County 460 west Main Street AUTHORIZED REPRESENTATIVE Hyannis, M& 02601 Michael Christian/.CLC O 1999-2014 ACORD CORPORATION. All rights reseraod. ACORD 25(2014101) The ACORD name and logo are.registered marks of ACORD INS025(201401) Office of ConsumefAffairs and Business Regulation_ J IO,Park Plaza Suite 51:70 ' Boston,;lVlassachusetts 02116 Horne Improvement:Contractor Registration � •-� Registration 1,71380 _ Type Corporation Expiration 31141201:8 Tr# 419291 CAPE SAVE INC.. `� 4 } WILLIAM McCLUSKEY . _�* 7-D HUNTINOTON AVENUE , SOUTH=YARMOUTH;MA 02664 Update Address and return card Mark reason for change. , Address � Renewal 0.Employment ElLost Card SCA I .G 20M-0571I 'L�,E< IG77LJIG[Y/7ldGlC>��0 ��CIJICLCxCGiB_ d -Ofriee of Consnmer Affairs&Business Regulation License or registration valid for mdwldul use only HOME:IMPROVEMENT CONTRACTOR, before the expiration date 'If found yreturn to Registration 171380` Type; Office of Consumer Affatrsand Business Regulation Expiration 3/941201s Corporation; 1Q Park Plaza Suite 5170 Boston,:MA 0211b CAPE SAVE INC. a ' d gM WILLIAM McCLUSKEY 7-0HUNTINGTONAVENUE, �{ t - SOUTH'YARMOUTH,MA'02fi64 Undersecretary 'Not valid; t signature . Massachusetts-D:epartment of Public Safety Board of Building Regulations and•Standards l�ilJ11[t 1l l'111iii JII IIEi'Y)1111 JIICliA14Y" y�IdC{ytrin'+p►�,yiyr - License CSSL 102776 ' WILLIAM J MC C' U 37'NAUSET ROAD llwb West Yarmouth 113A I, vlw Expiration Commissioner W6 a/201T Town of Barnstable �. Approved Regulatory Services ��.. FeeThomas F.Geiler,Director Building Division . Peter'F.DiMatteo,Building Commissioner 367 Main Street, Hyannis,MA 02601 . Office: 508-862-4038 Fax: 508-790-6230 Horne Occupation Registration Date: 1p ~O Name: Phone#: o Address: J Village: Name of Business: - Type of Business: Map/Lot: 3 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 include . • No person shall be m loyed in the Customary Home Occupation who is not a permanent resident of th li unit. I,the undersigned,hz e rea gr ith the above restrictions for my home occupation I am registering. Applicant: Date: Homeoc.doc 7V ' 1 Assessor's office (lst floor); �/� Assessor's map and lot number ......:.... !� ,,... ►.,r�" »- yoFTNETo�` Board of Health 43rd floor): Sewage Permit number .. .Pc7 C! Q. ....... STABLE, Engineeringi Department (3rd floor) �f_ �+ House number :....... . r ale - P 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 t 0#1 L 01 N G INSPECTOR APPLICATION FOR PERMIT TO ►J L � Zi c.A co)4�>w.G7...... .... ... ......... . ... . ......G..�s...........�? TYPE OF CONSTRUCTION ......W:OD...... S . :-�.I -- ---------------19 � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit' according to the.following information: Location .......:�4�,.....,��. ►J...... ,r.........:..1�. .n1.111�5�.... .� ....:...{ -(�0� ......... .................... .......................... Proposed Use ...... AIAG.6.............. .......1...1�, ........ ......................... ' ....................4►�...... .... ...: . ........:......... .� ...... Zoning; District ...... Fire District ... .�.. . C......... ....:.:Address P Name of Owner'.. . m. r �.......:. ....... .. Q�lut,..G ..NAt �� l �.q.. : . ..kt 1a �? .,. ..:..... Name of Builder ...(3.r....94!;AP1 . ....................... ... .Q(i!11 ...................................... ......................... Name of Architect .................:...Address ,..... .p 4s.............!...... ........... .............. Number of Rooms ....t.....+_c'. jlz 6 a4r ..... .................._...Foundation `..aQ ...FAU.L-+v4r!! .... .�!a..:.........:....... ... Exterio• ..'yJDh. ..` I:N ................................... ........Roofin �A�"T.....01.N190`.� ......... i 9 .. .. . Floors .6 .Gt4e ... ....5 .............................Interior. .1 ... Q?� j ... j' Heating ry ..................Plumbing ....wo.z................................................................. nn Fireplace ....N ..... ...:......'......Approximate'Cost ..�.1�l�.clo ..- .... Area .. . 3 .. ............... Diagram of Lot and Building with Dimensions - Fee .!�.t.. .....:............. e. to 03 IZ g` al �slw� au 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. f Name .... .. Construction Supervisor's License .:....:.:.:..:..::.::............... RICHARD, PAUL G. & NANCY L. .2,.34._Permit for Add G age NO . .................. €; Single"" Family Dwelling Location ....142.. Bacon Road s ............... ........ _ s Hyann _s..: k�. .............. ....................................... .. Owner ...Paul.:w.G.-...& NancY...L-...Richard..-, = s Type of Construction ...Frame.......................... a f Plot ................... ...... Lot:F. r • t s 1 .. J Permit Granted ........Au.gu•st...2.�.........19 88 _ Date of Inspection Date Completed r � 1 ..i:_..:'R J e";:... + •'�.X e{Ey14vr'SF .[.'^�F� :'v t�;. f1 ..,. _.1. / +i-.: - .. :. h <-.�,u�,,�7..,..,t'..�� ..,,,.:',.�,��,.r:'i}...j�'�..}... ..t .�•� '4..�4�1.�.»...:sa.,.: k..� h..v �;�`�`�+4 �:,'�a•-°:8., �kM�rfs�.�i'r�..r:t-'L�.E:'t`3::: .=k+�..l,x...,.,. Assessor's offices Ust floor): Assessor's map and lot number THE 0 Board of Health (3rd floor): Sewage Permit number 1: 9AUSTULL, i Engineering Department Ord floor): ao r639- Housenumber ....................:...:............................................... ' o MAR a�0 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 APPLICATION FOR PERMIT TO ...0 r)!JS ILI T...... .r..e- (E...... ..... C...--Us�� TYPE OF CONSTRUCTION ......W0.0. ........��.9/.1 ��..............................................r........................................ ..... 1)��.....I 19 - TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........ `t"7r..... �tG a.!J.....zl).............. Cli.................................................... Proposed Use ...... ...... G T�5' ` Zoning District :.:...,.:. ?..: ...:.1 ...::. :.:'..:... ;: '...FI!�e -Distr-ict ...I.,%....... ....:,..1,)K11--1111�'�!.��.:....:.. .............. Name of Owner .PfuLs, �-. � �( Y 1_., �ICi��1Z� ....Address 'E.?-< �3Aec, �� x`�?, Nt�1� ...........r........................... N h......... ....MA........ Name of Builder ?. ....?-A!:;14A.0......................Address �a.Q,N, .................... Name of Architect .R.fl!Jl: ..G .... wGf` .....................Address ..... .��!►.1& ................. .:.......................................... Number of Rooms ...� ............................Foundation ...W.)..... --.....:��.hlr��.�� EXIe for .. .G ..............................................Roofin NA.(:"1';...:5�.1.�Lt,1S...................................... Floors .�[ .0 .,.......:5.��..............................Interior ./2c... -... D� ....~.....``...... �•• ..:�.�.. Heating ,( .L.....111..... ..C.. d t.�....O.... ...)...................Plumbing ....1\101�j�' .............................................................. Fireplace ....j�.S) ............................................................Approximate Cost ....to ............................._................ Area ....� :;.�.. .I................ Diagram of 'Lot and Building with Dimensions Fee �O sTe�t 001C4- �3a u=c:cktiN4 — /1a 1100 a3rr��l 5 — IZ $, ` t I t fir.- 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. NameTcvjo.,......�...... ..................................... s� Construction Supervisor's License .................................... RICHARD, PAUL G. & NAN�QY L,,, A=310-037�. AV - 3 16 — cl-3 No Permit for ..Aj*L.!Gi:KKA9.q....... ......... Location .....1.4.2...13.a.Q.Q.n...RQ.4L.Cl....................... ......................ay.a ....................................... owner .,PaiA.1... lSA;jqy..L. Richard ....................... Type of Construction F.rAMP-,............................ ............................................................................... Plot ............................ Lot ................................ Permit Granted ......August....2, 19 88 Date of Inspection ....................................19 Date Completed ......................................19