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HomeMy WebLinkAbout0107 BUCKWOOD DRIVE /D '7�ij uckwc fir, P f -- Cape Save Inc, AA 7-D Huntington Avenue t South Yarmouth, MA 02664 Tel: 508-398-0398 Fag: 508-398-0399 11/11/14 Thomas Perry CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 RE: Insulation Permits Dear Mr. Perry + F This affidavit is to certify that all work completed for 107 Buckwood Drive(#B 20142841) has been inspected by a third party Certified Building Performance Institute(BPI)Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, k William McCluskey I 37 �'1SN jG �J � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION nn MapParcel— Health d� � � plication # Division Date Issued 10"ZO—I Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address Village y an 11 LS Owner r', -U1,'� �� Address CAM C Telephone 0 Z -,4( -�a 6�- Permit Request Oa A R- 31 p_n J 3 ce llAlnssg to J:h e 4J+11c, rekl *ke ca-Wc 01an C W' h CQg A - i'fi� 4VA.00 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay a Project Valuation c3 4 0 1) Construction Type 1 D Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting (FdcuAtation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) " Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: Yes-a❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other 0. 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 �--- ---- (BUILDER OR HOMEOWNER) Name ar@ �11i lR C b4S Number 50 8 39R f� Address I License# ZC 1 0 &13 6 5 II�� l,_I� I 6� 0.fr11 v1 6 U Home Improvement Contractor# Worker's Compensation # �W L 3 D 8 66 3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE l 1 i f FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: PFQUNDATI.ON FRAME ,INSULATION-.- -., .R•: ,«�. , .: t FIREPLACE ELECTRICAL: ROUGH FINAL _ PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING''- = DATE CLOSED OUT ASSOCIATION PLAN NO. l �� aecnmoos� PAR MPATMG; mass saveCOMMR S-wins t".9h enemy Wide cy - PERMIT AUTHORIZATION FORM I. i't>(SeT ! i 1�'K ,owner of the property located at: (Owner's Name, printed) (Property Street Address) (Cityrrown) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. - t 71 G, O 's S' ture Q c�Av Date FOR CSG OFFICE USE ONLY Conservation Services Group has assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: 5OLve" C. Participating Co tractor Date ti .. Rev. 12132011 The Co�nmo`nwealth of.,Massachusetts llepartnaent of Industrial Accidents E' " Office of Investigations - 1 Congress Street, Suite 1 00 Boston,MA 02I14-201'.7 h www:mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/-Plumbers Applicant Information e Please. Letiblyr Lai71C (Busincssl.6rganizatton/Indrviduai). Cape-Save inc. 4'. Address: TD..Hunfing#on Ave ' City/State/Zip-_ South Ya*rmduth, MA 02664 'Phone#: 508-398-0398 '` Are you:an employer?Check the appropriate box: Type of project(required} I.fl 1 am a em lover with 4. [�] 1 am a general contractor and,1 P 6 New,eonstruction: have hired the sub-contractors ❑' i employ ees(full and/or part-hme): .- 2: 1 am a sole proprietor or partner= listed on the.attached sheet. 7. ❑:Remodeling t ship and have no employees' These sub-contracto r have 8, El Delnolitiori workingfar me in an ca aci employees and have workers' ' Y ' P tY= 9.. [] Building addition [No workers'comp.insurance comp.insuranee:t requircd:], 5. 0 We area corporation and rts 10.0 Electrical repairs or.additions, officers have exercised their 11. Plunibin re"a"irs ar addition-s. 3.❑ 1 am.a homeowner doing all work: . � g F. myself.[No workers'comps. right of exemption per MGL 12.�'Roof repairs. insurance re aire . t c 152,§,10),.and we.have--nod Qernployees:.[No Nvorkers' T3.�:Othec ,Insulation. comp.insurance required.] "Any'applicant that checks box 91 must also fill ourdle section below.showing heir warkees cotnpepsation policy itifoi nation. Y Homeowners who submit this atlidavit indicating they arc d ing.ali w+orh and then hire nutside;contractors mustsubmit a new�aflidavit ndiicafing such. =Contractors that check this box must attached an additional sheet show-ine tfie nine of the sub-contractors and state whether or riot those entities h2ve employees. if the sub-contractors have employeesi ttiey must,-provide their workets comp:poiicy number. . 1 am un employer that is providing workers'edlitpensution rnstrranre foe,h1v e�rrplayees Below is thepoliry:ond job;si(e information. Insurance Company Name; Wesco Insurance Company Policy#or Self-ins-Lic-V WWC3085.b33 Expirat on-Date:4 04/09/20I5 �lv � � � Sob Site Address: 0.1 _ sk Wm o �. City/State/Zip: h aV1 i� Attach a copy of the workers'compensation policy-..decla"ration page_(showing the,polley number-. nd expiration elate).. Failureto secure coveragc,as required under Section 25A ON(i c. 152 can lead to the;imposition of cnminal.penalties of a fine up to$1,500 00 and/or one-year imprisonment,as well as civil penalties in the forr.of a STOP WORK ORDER and,a fif e of up to$250.00 a day against the:,violator. Be advised that a copy of this statement may be fomyarded to the Office of Investigations of the DIA.for insurance coverage verification: C tlo hereby certi under.1he awns and a raltres.o er` that the in'orrnafion provided aboye is true and correct: ,,—... -— S'Qnature: Date _._.... . j_ Phone# `505-399-0391i _ " " Oca!use Dill}. lJo:trot fade in IN area,to be rotipleted.by city nr tolun:official. City.or Town:,: =,.- Permivueense:# • Issuing,Aufhori (c r.'cle-one} t.Board of Health 2 'B.ailtliitg Departmen#;3 C�ty/Town Clerk. ;4 Electi�cal Inspector 5 Plumbing Inspector 6.Other Contac"t Person:: phone#•. - CERTIFICATE QF LIABILITY INSURANCE DATE lMMroomYv)4A14i2o1T. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE.CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES'NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate hostler is an ADDITIONAL INSURED, the pol)cy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terrrls'and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not conferrights to the Certificate lholder inaieu of such endorsement s PRODUCER, CONT CT NAME: Colleen Crowley Risk Strategies Company PHONE Ell: (781)986-4400I F!C No:(781)963-4420 15 Pacella Park Drive ADORESL .ccrowley@risk-strategies.com Suite 240 INSURERS AFFORDING,COvERAGE NAIL C Randolph MA Q236$ INSURERA:Selective `Ins'.1. oF' America INSURED INSURERB:Safety Insurance dcftany 33618 Cape Save, Inc. INSuRER'C.Wesco Insurance Company 7 D: Huntington._ Ave .INSURER D INSURE-RE: South Yarmouth MA 02664 INSURER F COVERAGES< CERTIFICATE NUMBER CL1441475243 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 I$SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH;POLICIES.LIMITS SHOWN MAY HAVE'BEEN REDUCED 9Y PAID CLAIMS. INSR... TYPE OF INSURANCE -. .. :.. POLICY EFF POLICY E P - LTR POLICY:NUMBER -:MMIDD MMIDDIYYYY LIMITS GENERAL LIABILITY - EACH OCCURRENCE $ 1,000,000 -11AME TO RENTED .X COMMERCIAL GENERAL LIABILITY PREMISES Eaocowrence $ 100,000 A CLAIMS MADE a OCCUR 1994480 0/16/2013 0/16/2014 MED EXP(Any one person} $ 10,000' PERSONAL&ADv IN uRY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000' GENL AGGREGATE LIMIT APPLIES:PER; PRODUCTS-COMPIOPAGG $. . 2,000,000- P POLICY X _ C ST X LOG $ AUTOMOBILE LIABILITY _ Co Ea eccNdeM L LIMIT 1 000. 000 IxANY AUTO 80DILY INJURY(Per person) $ ALL OWNED X SCHEDULED 6208200 1/6/2013 1/6/2614 BODILy INJURY fperaxIdent) $ AUTOS AUTOS.,. - NON;IMdEDPROPERTY DAMAGE'HIRED AUTOS X AUTOS peracdde $ X UMBRELLA LIAR X - _.......... .. OCCUR: EACH OCCURRENCE $ 1,OOO,OQO A EXCESSLIAB CLAIMS-MADE AGGREGATE $ 1,000.,000 DEC) I RE7EWT19N .Nz . 199448.0 /16/2013 0/16/2014. C WORKERS_COMPENSATION:- ' - -- Officers Included For X 41+;STATU- - OTk- -- - AND EMPLOYERS'LIABILITY Y I N - RY LIMITSR ANY PROPR(ETORIPARTNER>E)(r--C11TIVE® N!A Coverage El.EACH ACCIDENT $ 500. 000 OFRCERIMEMSEREXrLUDECA 3085633 /.9/2014 f9/2015 (MandatorylnNH). E:L.DISEASE-EA EMPLOYEE $ 500 00D If Yyes,describe under - - - - DESCRIP_TIONOFOPERATIONSbetow E.L.DISEASE-POLICY LIM IT J$ 500 000 DESCRIPTION OF OPERATIONS)LOCATIONS I VEHICLES(Atta_ehACORD 101,Addk)ooal Remarks:Schedule;if more space Isrequlred) Issued as evidence of insurance:. Issued as evidence of insurance. Thielsch 1�ngineering, Inc: is listed as: additional. insured as respects. General Liability as required: by written contracct.. 1 CERTIFICATE HOLDER CANCELLATION _ msong@capelightcotnpact.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 PO BOX 427'/SCH AUTHoRIZEDREPRESENTATIVE 3195 Main Street Barnstable, MA 02630 chael Christian/CLC ACORD 25(2010/05). 01988-2010.ACORD CORPORATION All rights reserved. INS0251201006).01 The ACORD name;and togo:are registered marks of ACORD l . / Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration r Registration: 171380 ;. Type: Corporation Expiration: 3/14/2016 Tr# 249649 CAPE SAVE INC. _ WILLIAM McCLUSKEY - 7-D HUNTINGTON AVENUE y " SOUTH YARMOUTH, MA 02664 41 ---_--- - - Update Address and return card.Mark reason for change. sCA 1 0 20M-05111 Q Address 0 Renewal Ej Employment Q Lost Card �/1rr�r ririrct�auu�cl(,�r.�?E�l�ri:turlrruetC' ' • Office of Consumer Affairs&Business Regulation License or registration valid for individul use only, POME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration171380 Type: Office of Consumer Affairs and Business Regulation Expiration= 3L14/20a.6 Corporation 10 Park Plaza-Suite 5170 - .E. Boston,MA 02116 t CAPE SAVE INC. �iZ = WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE-" g� o SOUTH YARMOUTH,MA 02664 undersecretary Not vali rthout signature 1 Massachusetts -Department of Public Safety Board of Building Regulations and Standards C(?DOMCtiurl Supervisor Specialty ' Licenses CSSL-102776 WILLIAM J MC CLUSKEY 37 NAUSET ROAD ' s West Yarmouth NIA 02673. . `%.�.• J1/5t�. '� �'. Expiration Commissioner 06/28/2015 I • b Assessor's map and lot number .......................................... `'j' C 7 SEP TIC C ;p Sewage Permit number .......... � uir�..._i�/ .. ..�� WITH INSTASLED IN MUST B� COMPLIANCE ARTICLE bT1?OwP` II STATE THE ro' <w' 1,• �L OWN' OF �B A R - t� j Fy, i B8Hb9TADL�,6, • `+•` i.`� ' rt MML fi� 9� 1639..,e BUILDING ° INSPECTOR `-' - w`s APPLICATION FOR•PERMIT TO ..'...... ;........... ` eves; TYPE OF CONSTRUCTION ..................................... 1. .............................:91 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location , .. 4.r1?Gl�s........... 5. ................................................. J..C?.1.........! .� ................................................. .. o Proposed Use �-e_C"OO i"n s' ZoningDistrict ............................ ............. .:......................Fire District .....................................:........................................ 1` Name of .Owner ��� gs.t L ^. rvS4...............Address ..:� ��.....f�1 C. u?�?c�� •. 11 Y[!�JS... Name of. Builder &4k( qn..... C—cy!% c� n......Address ......S.'��^^e- eA S C'`6DU'e ......... ........................................................................ Nameof Architect ...........................................'"............:.....Address ...............:.................................................................... Number of Rooms Foundation .....Cr ??-............................................................... ............................................ Exterior ... .L,..�-C.�;PA.....5�1`g��q���.....:...........................Roofing ..........Im. �nrr,.t ...... .Yl .^:�.L e ................... .•` Floors ... �W OOA IL I fnNt ;srl ywe"` .�' Interior ....... (-�............................................... ..... r Heating ....:Z' *.—C,:T��.�-......................................................Plumbing ..........K. ?A;.S.................................................. Fireplace .....KgYJAt...............................................................Approximate Cost ..1.� .V�.. .�. ©:....................... ....... • ...... Definitive Plan Approved by Planning Board -----------______-----------19_______. Area .....a v _. .:...... Diagram of Lot and Building with Dimensions Fee ........................ .............SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby 'agree to conform to all the Rules,,and`Regulations of the Town of Barnstable regagding the above construction. x +! Name �.,..... _ , La-� N E M Realty Trust P i f dormer o ....... ..............,............ t r _ ti _ _• ti ... .. . . Location'-..................ti407 Buckwood Drive:. Hyannis ..............:.............. ..... ............ ~' G u ;> _ u, < Owner .........,1.'1...E..M. Realty Trust's .......... - . _ -, a rr Type of Construction .....frame.. t4 •......... J �' ........................................................... . ........... E r Plot ................. Lot ........ . N a 3 t w < �- September 30 77 Permit Granted ......19 Date of Inspection ..............!.......................19 y 4; XDate Completed ..... ./ � •�..... .......19 ` : �* Q '-PERMIT.REFUSED rs ti c ............................ ........... 19 ci+ zLL C .... �.. 1 . .. ...... ................................... ., ........ .'y�..�`✓�..i~_......................................... ...... Q t Approve' `��„....................................:..... 19 M o Assessor's map and lot number r.:......... (-- Sewage Permit number ............ T"ET°�� TOWN OF BARNSTABLE • NARNSTODL 9� 0 pYa`e� = BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......f �? . �{ ... ........... ...................................................... 1 " ro.vut� reS+ er�c �. TYPE OF CONSTRUCTION .............................................................................................................:....................... .............................19 D TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ` C W u � �. ucr . �: . (1� .. !location ... ..�............ ........ . . ...... . ..............!..� .. : . .......... � :... .. .............................................. ProposedUse .....1...?.... --OO...................................................................................... ...................................................... ZoningDistrict .....................:;.............t......................................Fire District .............................................................................. Name of Owner �.rn.......' Pcr F.. ��!:54........ ...Address ...�.��.�.....��,�.;,�woo Ls �.:r:..� ,• Name of Builder k �e r+nr,.1^...... fl. Cam. c�eU.n......Addressk. 1.u� '' 5c"6,ju e, .. .. ...... ... ... ... ...... . ..... .... ......... ......................................................................... Name of Architect ":Address r- Numberof Rooms ......... ....................................................Foundation ............................................................. Exierior .....(' + .....s r, 1 �..�.................................Roofing n, c �+G 1"�':......S .^!..^.�... .................. ....... .................. ............. Floors ...............?•ac..Z.:...................................................11.rr e C' Interior ....... "r-oc....................................................... . t t Heating ......: �....`...'...'.�::%. .......................................................Plumbing .........: �::'..U.............................................................. Fireplace ..... !J .................................................................Approximate Cost ..I ;20 C)..!..a®........................ ..... Definitive Plan Approved by Planning Board -------------------_-----------19--------. Area ............... .................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH r �1. t i t� I hereby agree to conform to all the Ru lei=arid Regulations of the Town of Barnstable regarding the above construction. , '• 1� ln�Name)(TVMnA- � c � ,Ft . . ... � • -;:..."-r�?... ..... N E M Realty tTrust �=�2-91 19647 dormer No ...............-,.-Perr^i for .................................... ............................................................................... 107 Buckwood Drive Location ................................................................. Hyannis ................................................................................ N E M Realty Trust Owner .................................................................. faame Type of Construction .......................................... ............................................. .................... Plot ............................ Lot .... .......... blk Permit Granted ...... em- r 30..... ..........19 77 Date of Inspection ....................../..........19 Date Completed ...................`..................19 PERMIT REFUSED .........................................I........................ 19 ........................................................ .................. ...........J.14.0. . ................ ........................!........ ... A . .I....... ...... ... I......... Approved .............................. ... . .. ........ 19 .......... ................ -0 ..................