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Home My WebLink About0118 CAPTAIN ELLIS LANE 8 CG P��-�n �� I � S t -- -- -- — _ — - �� s I C)WIq CAP E 'COD INSULATION � S;E .06 /IMiA 43AYY 3[A Mff Y3 SPAAt FOAM 7YSPSH0f0 .. - SARS 3YRYOY IHYYfAt10H CSIIIHOS f� '• 1-800-696-6611 " T 'Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 rDate: q t .- Dear Building Inspector Please Accept this Affidavit as documentation that Cape Cod Insulation, Inc. perfornieci &: f completed the insulation and weatheiizatibn work at the property listedbelow. Cape Cod Insulation did this in accordance to the specifications listed on the building permit (} application. All work has been inspected by a certified Building Performance Institute f (BP-1) inspector. All work preformed meets or exceeds Federal & State Requirements: i a _ l Property Owner Property address Village t�y0.jL„' -S Ch" +SusAO �i00 IJY Ca n u/1J` �4�c lnsulation Installed: Fiberglass Cellulose A-Value Restricted Uiuestrictecl Ceilings ( ) O Slopes It loors i Walls ( ) l ) ( ( ) ( ) kSincerely. i Ile ry L Cas. y Jr, President C e Cod I , ulation; Inc. o l L4a- ToNvu of Barnstable # a,�� Expires 6 monrlrs from issue date Regulator, Senrices Fee �`BA& ABLL -. \� 13 m Thomas F.Geiler,IDirector , ��ED AAAq n 1 r Biffding Division Tom Perry-,CEO, Building Commissioner 200 Main Street;Hyannis,MA 02601 www.town-barnstableam.us Office- 508-862-4038 Fax:503-790-6230 EXPRESS PERAUT APPLICATION - RE+SIDE+NIIA ,ONLY Nor Valid Mahout Red X--Press InVrinz Map/parcelNumber 250-118 Property Address. 118 Captain Ellis Road Hyannis, MA 02601 f s ®Residential Value ofWork S 9,000 Minimum fee of S35.00 for work utnderS6000.00 Owner's Name&Address_Susan Temple 118 Captain Ellis Rd. Hyannis MA 02601 � r (J Contractor's Name tzo ( ��) 5�t�t�f'j`f)� Ll� Telephone Number Home Improvement Contractorl.icense r(ifapphcable) I/d 55 3 E � �L j�{ r��(�{��j�� ("fir .,rem Coz>stxuc lion Supervisor's License n(ifapphcable) MY3W, orkman's CompensationI+surarce Check one:❑ I am sole proprietor S'EP 22 2014 Wamthe Homeowner have Worker's mperuation Insurance OWN OF BA fn/D RNSTABLE Insurance CompanyNanr I � Sfax c Insu Ir�Jt-V ll�L! a Workrmn's Coup.PolicyY WL 00 q"1 ow) Copy-oflusurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(huriicane nailed)(stripping old shingles) All construction.debris w-Mbe taken to ❑Re-roof(hurxicane nailed)(not stripping. Going over z—existing layers oftoof) Re-side Replacement Windows/doors/sliders.U-Vall]e .30 (=&xir-m=.35)Y ofwindows 13 n ofdoots_ ❑ Smoke/Carbon Monoxide detectors 4 floorplans marked with red S and inspections required. Separate Electrical&Fure Permits required. "Where required:Issuance ofthk permit does not excnPt conVliawc with other town depazo3�ewreguFatnns,i.e.Historic,Conservation,etc. `Note_ PropertyOwnermnstsign Property OwnerLetterofPermission.. A copy of to Home Improvement Contractors License&Construction Supervisors License is required. , SIGNATURE: C-XUsers\deeoM'AppData'LocaPVlicrosofi\Windows\Temporary H*m-=tFies\CoatenLOu look\EZ76BDt%A\EXPRESS.doc Revised 061313 f The Commonwealth of kfassachzisetts (a Depa.---t-rrzent of Industrial Accidents Or�ce of Investigations - - 1, 600 WaY vhingron Street Boston, VZA 0211 -KT.,w.mcss.govldia Wor.kWs com.pen.sation Insurance.Affidavit:BuilderslContracto;s/ElectrieianslP u bea-s . A.pp)icant Information Please Print lLegibly Nara(-Business/Organizatioa.4ndi-idual): Address: r CityiState/dip: �35 Phone# Are you im employer?Check the appropriate box; `-------� Type of project(required): 1. LI .i am a employer with � �'❑ 1 aM a goner' contractor and I have 5. New con �netion employees(full and/or part-time).` hired fire sub-cox.tractors listed on � the at tszd>slieet_ 7• IX s Rcrnodeing 2' I am a sole n etor or partnership These sub-contractors have A• ❑Demolition P'bi p p and have no employee;worsting for employees and have workers'comp. 9. Building addition mein any capacity,[No workers' insurance.t comp insurance required.] We are a corporation and in 10.❑Electrical repairs or additions E� officers have exercised their*fight of I l plumbing ze;rairs l or additions 3. I am a bomwwner doing all work exemption per MOL c.152§(4),and 12. hoof zepairs- myself.[into workers' comp, we soave no employees,[No workers' insurance required]t comp insurance. required.] I3.❑ Oche I A ay applicum that checks box r1 trust slag Ml out the section belo N sbowiag their workers'.compensation policy infonriwor.. t Homeowners wbo snbtnit'Iris affidavit indicating they ate doing all work and titer n;a oursiei contractors must st btaita new affidavit indicating stClt #Co=actors that ebeck this box most attach an addidonal sheet snowing tt e.name of the snb-contracrors and state whether or not those entities bave employees.;f the sub-corm^„tors have c raployees,they most provide their ivorkors'comp,policy number. I ant an employer that is providing Writers'corrcpensation insurance for my employees.Below k the policy and job site iafon711ItiG1z pp Ins'rranceCompaayName; �� p qq y o policy r or Se.L*---ins.Lic.fir: w c D 3o(,n D Expi.-xtion D�Lte: Job Site Address: 118 Captain Ellis Road City/stateJTap: Hyannis, MA 02601 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failuze to secure coverages ar required under Se=ion 2 A of MGL c.152 can lead to the itn?osition of a,-iminal penalties of a fine up to$1,500.00 and/or one-year imptiso tment,as we11 as civil pL•oaltk—q in the form of a STOP WORK ORDER anti a fine of un W$250.G0 a bay against' e violator.Be advised that a copy of this statement may be forwarded to the Office o'Investigations of the DIA for insurance coverage v � I do hereby cerfifJ:1,,,1,111 the rt enaliies of perjtuy that the information r d d above is true and correct. Signature: Date: Phone*: - 17 offt at us,'only.Do not eorite in this area,to be competed by city or Town off cial � City or Town: PermitUcense r ` Issuing Atrthority(circle one): € 1.Board of health 2.Building Deparmaent 3.City/Town Clerk 4.Electrical Las-pector 5.Plumbing Inspector 6.Other Contact f'exson: Pllone#. s FRASCON-01 PAAS ®M1 CERTIFICATE OF LIABILITY INSURANCE OA1191DDIY 9 3 119t2Q9 3 THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy0es)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s), PRODUCER CONTACT Viveiros Insurance Agency,Inc. (508)676-0309 NIMIEE Ashley Paiva 375 Airport Road AIc No Exr; 508-676-Q309 127 (AIC,No): 508-324-9147 Fall River,MA 02720 ADDREss:APaiva Viveirosinsurance:com INSURER($)AFFORDING COVERAGE NAIC S I _ tNSURERA:Granite State Insurance CO INSURED Fraser Construction LLC INSURERS: PO Box 1845 INSURER C: COtult,MA 02635 INSURERD; INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 LTR TYPEOFINSURANCE INSR WVD POLICYNUMBER MIDD MML EXP YYY) lIMf75 GENERAL LIABILITY EACHOCCURRENCE $ COMMERCIAL GENERAL LIABILITY; PREMISES Ea occurrence $ CLAIMS-MADE ED MED EXP(Anyone person) $ PERSONAL&ADV INJ-IRY $ GENERAL AGGREGATE $ GEPrL AGGREGATE LIMITAPPLIES PER: PRODUCTS-COPdR'0?.4GG $ POLICY L —1 LOC AUTOMOBILELIABILITY .. M I SIN LrMI Ee accident) S ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS I BODLYINJLIRY(Paroccident) $ HIRED hUr05 NO"WNED PROPERTY D A AUTOS Peraccident) S I e i UMBRELLA LIAB 11 OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION - � WCSTATU- DTH- AND EMPLOYERS'LIABILITY YIN TORYLIMITS ER A ANY PROPRIETORIPARTNERJEEXECUTIVE W0009930601 9/26/2013 9126/2014 H ACCIDENT $ 500,Q00 OFFICERIMEM9EREXCLUDED� ❑ NIA E.L.EACH. (Mandatory In NH) byes,describe uoder E.L.DISEASE-EA EMPLOYEE $ 500.000 DESCRIPTION 0=OPERATIONS below E.L.DISEASE-POLICY LIMrr s 500,000 DESCRIPTIOtdOFOPERATIONSILOCATIONSIVEHICLES(Attach ACORD 101,Addkional Remarks Schedule,if more space Isrequired) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable Building Division THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601- AUTHORIZED REPRESENTATIVE (D1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Massaci}usetts -Department of Public Safety t Board of Building Regiiintlnns anct Stanclards ECunstructiun Srtpersisrrr + License; CS-037ti69 �`"" DYAN C FRASER 104 TW UqN VIEW.LATl�° c'r EASE'IALM,ODIkA W�:d1M53{' i ✓,,G lJ „�+�+ Expiration r i Commissioner 0 610 7/20 1 5 Office of Consumer Affairs and Business Regulation _ I0Tark Plaza- Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registraton. 112536 Twe: DBA FRASER CONSTRUCTION CO. Expiration_ 3r2w2ois Tr-' 237059 DEAN FRASER P.O. BOX 1845 COTU IT, MA 02635 Update Address and return card-M3rk reason for change. Address ❑ Renewal Q EraWOyment Lost Card Officc of COnsomrr AMirs&Busiii=lteg,),ti., License or re;istratioa vaIid for individul use only re to: irs an return OME IMPROVEMENT u COiQT RACTaR before the expiration date. It foun re -" 'e$Istration: 112536 Type: Office of Consumer Affad and Regulation ;`Fxpiration: 323/2015 DBA 10 Park Pla=-suite 5170 FRASER CONSTRUCTION CO. 'Boston,MA 0r116 DEAN FRASER 104 TVIANN VIEW LANE E FALMOUTH,MA 02536 UIIdcrsccrcrary Not valid without signature r Vjraser k-,onstruction LLC P.O. Box 1.845, Cotuit, MA. 02635 Email: info;-,frasercoristructioncapecoc?.con- www.fraserconstructioncapecod.com Phone 1-508-428-2292 K FAX 1-508-428-0123 DATE: 4/22/14 PHONE: 203-206-4968 NAME: Susan Temple ENTAIL: sternple@mason23.com MAIL ADDRESS: NIA A J®E ADDRESS: 11S Captain Ellis Rd. Hyannis 02601 6 / / REPLACEMENT WINDOW PROPOSAL All windows will be energy star rated., double dazed with lour-e argon filled Mass. U-factor for all double-hung units is .30 SHGC is .27. Every window opening shall be insulated with expanding foam.. Supply and install Harvey "Majesty" series vinyl outside. clear pine inside replacement windows in family room only. Grills to be in. between the Mass. Bay and picture window Hankers will be four over four and fixed portion of window will be four high by live wide. Painting can be quoted buts not included. Family room price includes (5) double-hung windows and (2) k picture windows A) Windows and labor are $658.50 each X 7 = $4,609.50 Remaining windows will be Harvey "Classic" series vinyl replacement windows throughout resid.enceo gills to be in between the glass. Six over six grill configuration on all windows excepting bay and picture windows. 1. Living room price includes (3) windows. A) Windows and labor is $500 each X 3 = $1.,500 2. Children's bedroom 1 includes (1) double-hung. A) Window and labor is $500 each X 1 = $500 3.. Children's bedroom 2 includes (2) double-hung. A) Windows and labor are 500 each X 2 = $1,000 4. (taster bedroom includes (2) double-hung. A) Windows and labor are $470 each x 2 = $940 5. Master bathrooms includes (1.) double-hung. Aj Window and labor $470 Total contract price- $9,01-9.50 Initial Any rot repair will be completed time and materials at the rate of ,65/hr with a 20% up charge on materials PAYMENTS RE DUE IMMEDIATELY AFTER JOB COMPLETION. Payment Schedule is 1/3 deposit with balance due upon completion. Payments accepted are: CASH- CHECK-MASTERCARD- VISA -AMERICAN EXPRESS Any payments not immediately paid upon job completion will. be charged 0.005% for every day after the given 5 day grace period upon day of job completion. Any deviation or alteration from above specification will be executed upon written orders and will 'become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRA.SER CONSTRUCTION, LLC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. , J DACE OF ACCEPTANCE: J v Homeowner Fraser Construction, LLC TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee 1b. $PSl 1 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address llo'o P� ��/�1 .0&W Village 4,I.Z Owner. /i,�d 0 !'wK/& �r�� Address , Telephone „?,1 L 6L-AL P Permit Request Gin /d /il�.�1-s�2 ��'`� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation,3�O�'� 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 4 No On Old K115 's Highw gg y: Dees No : . Basement Type: ❑ Full q Crawl , ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (s 1:ft) Number of Baths: Full: existing new Half: existing ew 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: 0 Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: 0 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 � � ®� ��,��¢�!i��/l . Telephone Number `3��7�.5'/Z f�- Address /2�.�.[��1�/ C%� License# T9 b lJ Home Improvement Contractor# Worker's Compensation ##44Y ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 66, 4- :,64 :2204Z'� SIGNATURE DATE5�/ - i FOR OFFICIAL USE ONLY APPLICATION# R -DATE ISSUED' MAP PARCEL NO. i ADDRESS VILLAGE OWNER i I+_ i DATE OF INSPECTION: FRAME - - - - INSULATION>x_, , Ll .� � ,r`_ FIREPLACE ELECTRICAL: ROUGH FINAL " PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING- DATE CLOSED OUT ASSOCIATION PLAN NO. 4T,,,, _, The Commonwealth of Massachusetts t Department of,industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www,mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le_ gi�bly Name (Business/Organizadowbdividual):_ ,,/-4.� Address:lr% City/State/Zi #: ��- Are you an employer? Check the appropriate box: . I am a employer with J,� 4. ❑ I am a general contractor and I Type of project(required): employees (full and/or part-time).* have hired the sub-contractors . 6. ❑New construction 2.❑ I am a sole prbprietor or partner- listed on the attached sheet, 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity, employees and have workers' [No workers' comp. insurance comp. insurance.t 9. ❑ Building addition required:] 5. ❑ We are a corporation and its 10,❑ Electrical repairs or additions 3,❑ I am a homeowner doingall 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 3a.❑ I am a homeowner acting as a employees. [No workers' 13.0 Other/,t'Xz4ZZ/�'%G.k1 general contractor(refer to#4) comp. insurance required,]. I 'Any applicant that checks box#1 must also fill out the section below showing their workers.co satiod li infoati rmon. It Homeowners who submit this affidavit indicating they are doing-all work and then hire outside contractors must a new affidavit indicating such. tContmctors that check this box must attached an additional sheet showing the name of the sub-contrsctors and state whether or not those entities have employees. U 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: %r Policy#or Self-ins. Lic.#: l,vie��a/ Expiration Date: �cl Job Site Address: City/State/Zip: e Z ,,ID 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. 17 do hereby certify u ,!�qW the pains and penalties of perjury that the information provided above is true and correct r Date: Phon #: e Official use only. Do not write in this area, to be completed by city or town ojficiai City or Town: Permit/License# Issuing Authority(circle one): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6, Other Contact Person. Phone#: V f..' CAPECOO-27 KLIGETT •.--' CERTIFICATE OF LIABILITY' INSURANCE DATE(MMIDD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER..T CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POL CUES 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(les)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 tothe certificate holder In Ilea of such endorsement(s), PRODUCER -ogers&Gray Insurance Agency, Inc, NCAM�A°T Barbara DeLawrence i34 Rte 134 PHONE --�_ >Duth Dennis, MA 02660 jAL9.•MA C F— LAIC No: Z' 816-2156 ADD Es bdelawrence ra ers ra .cam INSURERS AFFORDING COVERAGE _ NAIC q NS RED _ INSURER A:Peerless Insurance COmpany INSURERS:COMMERCE INSURANCE COMPANY• _ Cape Cod Insulation Inc INSURER c:Evanston Insurance Compan 18 Reardon Circle --- _ South Yarmouth, MA 02664 INSURER D;ATLANTIC CHARTER INSURANCE. GROUP INSURER E; — - _ %0 ERAGES INSURERF; CERTIFICATE NUMBER: TNIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELQW HAVE BEEN ISSUED TO THE INSURED NAMEDREVISION ABOVE MBEpR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS C R;TIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, E C USIONS AND CONDITIONS OF SUCH POLICIES -HAVE B D CLAIMS. -BEEN REDUCED BY PAID R , LIMITS SHOWN MAY TYPE OF INSURANCE POLICY EFF POLICY EXP I X COMMERCIAL GENERAL LIABILITY POLICY NUMBER M/Do YYY MMI D/Y LIMITS 1 CLAIMS-MADE I X OCCUR CBP8263063 EACH OCCURRENCE $ 1,000,000 64/6112014 04/01/2015 To�FrJ�-- _ PREMISES(Ea occurrence) $ 100,000 -- ---...__.-•---•- -- MED EXP(Any one parson) $- _ - 51000 G N'L AGGREGATE LIMIT APPLIES PER: PERSONAL&ACV INJURY—_ $ 11000,000 POLICY l^a PR LOC GENERAL AGGREGATE $_ 2,Q0.0,000 OTHER ` PRODUCTS•COMP/OP AGO $ 2,000,000 AUTOMOaILC LIABILITY $ t COMBINED SING E LIMIT ANY AUTO 14MMBCKVMK, Ea accid nt $ 1_1000,000 r ALL OWNED X SCHEDULEp O4IO1/2014 04/0112016 80DILY INJURY(Per person) $AUTOS AUTOS HIRED AUTOS X NON-OWNED. BODILY INJURY(Per accidenl) AUTOS PROPERTY DAMAGE Per accident $ -X UMBRELLA LIAR X OCCUR $ �— EXCESS LIAR } EACH OCCURRENCE cLAIMs•mADE XONJ453514 $ 11000,000 CEO X RETENTION 1� OQ/O1/2014 04/01/2015�._..._..--._...__._.—ON$ AGGREGATE WORKERS COMPENSATION A gregate $ '00 ANp EMPLOYERS'LIABILITY OTH• ANY PROPRIEI'OR/PARTNER/EXECUTIVE YIN WCA00525904 PER ER _OFFICER/MEMBER EXCLUDED? NIA 06/3012014 06/30/2015 E,L^EACH ACCIDENT �— (Mandatory ht NH) _ $If yo 1,000,000 s,describe under ____ -0-SCRIPTION OF OPERATIONS below E.L.DISEASE-EA EMPLOYEE $ 1,000,00 i I E.L.DISEASE-POLICY LIMIT $ 1,0t)0,000 i l �RIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,Sera Compensation Includes Officers or Proprietors, may be attached It more apace Is required) �lo'al Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder• l ' ITIFICATE HOLDER CANCFI I ATInN I * • ( ! \. N,kassachusetts -Depat'trnont of PLbl%c Safety <!Apard of Building Regula;E:ons' l Standards Constnictiun Super,'isru .1 ;y.k' License: CS-100988 HEN'.RY.E CASSIl) ( 8 SIIEA.ROW - WEST YARIYIOCf R +`'' ;,t2 ✓,.Gr- �..cj�. , �„ Expiration Commissioner 11/11/2015 Office of C,OnsUmer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massach }setts 02116 Home Improvement Cq1, ragtor Registration ' Registration, 153507 Type; Private Corporation Expiration; 12/15/2014 TO 233831 CAPE COD INSULATION, INC '� HENRY CASSIDY -- 16 REARDON CIRCLE SO. YARMOUTH, MA 02664. :;.r,•t,, .`'.: Update Address and return cilydr Marlc reasun I'ur chonge. "i [] Address Renewal FJ Employment Lost Card �IC,%,(`(IC�7IC.•!Il.C.1I6K(:Cfr/�{'C G�l�'�i(/�CIJGZC/ICCJ(d(C r - .. - • 6 :,.. Office of Consumer Affidr•s& Business 1tegYrinliun License or registration vnlid fur iudividul use only ' =b' oME IMPROVEMENT CONTRACTOR before the expiration date. I found return to; aF ogistration: 153.�67 Type; Office of Consumer Affairs and Busirtass 12e6ultrfion xpiratiow 12/1-5/2014, Private Corporation 10 Park Plazn-Suite 5170 r' 1 Boston,MA U2116 t, c OD INSULA't-IQN k + !RY CAStiIDYw I , !EA 'DON CIRCLE YA MbIJI i•1, MA 02664 —-- Undersecretary ,. ofvatV, lot unar t ' R 1 mass save PERMIT AUTHORIZATION FORM 5 T;Tm PLe- , owner of the property located at:. (Owner's Name,printed) l gl EW s 4 A-AJ"J 3 M (Property Street Address) T (City own) 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. , OvjAe-r's Signature 7/2S 1 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: NW Particip ting Contractor Date t Rev.12132011 Assessor'srrnap and lot 7�er ...................... ........-..:... „t SEPTIC :..... ICYSTEM UST BE y INSTALLED N COMP" �L Sewage Permit number ......... ....... .: .................... WITH ARTICLE II STATE... ...... .... -SANITARY CODE AND TOWN y0F'THE rO� > TOWN OF BARN9TXffLE i 89HH9TAILE, • `, �' i' "�9:•a DU.ILDIN`G INSPECTOR 9�p •i67q. \0� �e MPY p t� �✓. k. APPLICATION FOR PERMIT, TO ...... . ��`.' ..! ................................ ........................................................... TYPE OF CONSTRUCTION ...................L..` ........ ..............................................: v • :...1. .........f"........................l 9 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........L^�.� - ..... ................ .`."- ..............d` .`.......................................... ProposedUse .......... ....""" y.c�y..C ...........................................................:..:........................................................... Zoning District ................ ............Fire District L . ..l' '±',`( .j..................................... Name of Owner .....�?.......!!..�........ ...............�.. ....Address, ...................... �....................... e- l Nameof Builder ....................................................................Address ..............................................................a...................... Ct Nameof Architect ..........t........................................................Address .................................................................................... Number of Rooms .............. ...................................Foundation ............. ................................ /. Exterior ...............C,, !! ................. �.� ..........Roofing ...............t 7..' ..1 �. .............:...................... Floors ............ ........ .. .... . ..............:..................Inferior ............11-2-1................f�.�.. .......................... Heatin ,��/ � Plumbing ` .. lZ_ g ...........Pd."..t..................�....... `................................................. Fireplace ............... . ................x13.. ;.....Approximate Cost ............................................................. ........... . —�/.............................. . .. Definitive Plan Approved by Planning Board ________________________________19________. Area �aQ 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•regarding the above construction. Name ........................................................................... Smith, J. K. Noy.. 18777 for .... one s t y ................. .... ........ ............... Permit Single family dwelling ..................................... ocatiJnr V Capt. ........................................... .......................H)r"ni S......................................... Owner ..........J...........K Smith .... ........................................... T.ype>of Construction . ..........frami................................ ........................................................ ................... /* Plot ............... ....... Lot .....#23� ........................... Permit Granted .....Oc.tobwr 281�*.r. .--L 9 76 ....... -'Date of Inspection ... 9 Date CCompleted ..... . . .4.- .....79 PERMIT REFUSED ... ................................................................. 19 r. ........................................... ............... ........................ ................................................ ................................................................................ Vi 4) ............................................................................... t-,Ap- proved 19 ................................................................................ ...................................................................... �G 77 6 d p 3 , Town of BarnstablePermit:6 c/s^ 6 7 oFTME r Regulatory Services ate: Thomas F.Geiler,Director 4V „ ,STAB,E, : Building Division 4 g� 9 1639. $ Tom Perry, Building Commissioner �Ar6G 1+"p�a 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 TOWN. OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: �� Phone: �f l Install at: L Q + � i Village: �1L�hPt t� Map/Parcel: a � �� Date: Stove A. New/l di { B. Type: Ra t/ Circulating t ' --� C� C. Manufacturer: IV a ` < Lab. No. D. Model No.: OQ� Chimney o A. Ne xisting If existing,please note date of last cleaning) B. Flue Size , C. Are other appliances attached to Flue? N) D. Pre-fab Type and acturer -rw<ck c hil IS , E. Masonry: ine nlined Hearth A. Materials: 16r C B. Sub Floor Construction: �r k Installer Name: Address: Phone: Location of Installation: {1 APPROVED BY: Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Q:forms:stove Rev 122801 U r 10/10/Oli1IBLQaptain Ellis Rd µ a �A -� yy A- ... ,wA•' arcn Av"�w /! .✓. r' :1 P"j LiI{J '"" �� e A �� 43 r - s s - ,.3_,w;��' � ' ,r �' $.L . I�'= � i ,:�.�„ tom :'.t'~•'"'�+`t�- a �� ' 'P:, f w 3 I' 'a P '� �� "zd' r �, Ems', �`' ��"•,�� °`';� � h�. - •• � � , ""�''� .� µw s"T , Y17 ,�tr^vM1Y' �}'L3 kiy N /�► ' �,1� ,� �e � a � r •�, .err"" '� � III r. 10/10/02 118 Captain Ellis Rd. L ki E .' ! ] � 119 _ t� ja At b4, a y� r ' d .... .. ; t _:. •.�. �s.,. _ ,�. -; - -. to .r v'w►.�.. _.... _.,�._.^ .� .�� Cam..,. ...-.'a.b+�...> .. .e.--. r- -f .r+'�" :_ ti' r}r Assessor's map and lot number Sewage' Permit number .................................................:......... Q�F7MET��yo TOWN OF BARNSTABLE fob � • � 89B_B9TSDLE, . = N � INSPECTOR y MA86 039: ,e� BUILDING , APPLICATIONFOR PERMIT. TO ......6............ ........ ................................................................................................................................ TYPE OF CONSTRUCTION " . .................................... . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location (..-rG ••.• -/......: .��.......................................... ...... ....... -............................ . ProposedUse ` ty C�............................................................................................................................................................................. n Zoning District ............... - Fire District ....... ....`... ..................................... Name of Owner ..... ..±!.`...........;....h•-`'..12 ..........Address ........................ bf' ......V....................... � 1 Nameof Builder ....................................................................Address .................................................................................... tl Nameof Architect .......................................t.........................Address .................................................................................... r....--�--. Number of Rooms ............... ....................................Foundation .............le- c�......... ,..................................... n ....»......................................................... Exierior ...............�.�--*•:�:�.......;�•�.t,1�1,�;�..........Roofing ............... �• �Sz-•�-� Floors ............,..........:.......,...............�V.......................:.........Interior ............� ........ ...... ........................... Heating a��................Plumbing (Z -- Fireplace ................ ............... �.. .......Approximate Cost ........... .. ................ !s .. s. Definitive Plan Approved by Planning Board --------------------------------19--------. _ Area ............. �......�...... Diagram of Lot and Building with Dimensions Fee F` SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction_. Name......................... ........................'.�............. U ` ^ ` 18777 one story, single family dwelling -------.!��^�--___________.. ' Owner J. K. Smltb --------------------.—.. . - - frame Type of Construction ------..�------- ' ' ��'��''.��' ^ Pk #23 " � -----____. �� __________.. . . . October 20 76 Permit Granted ........................................ . Oota of Inspection ...................................... Date Completed. ------------]g . . , . . . . . `PERMIT REFUSED -------.-----_------.. lg — — .. -. ............ --- . . * « ' r ~ ...................................... « . *^ . ' W . . ' Approved ---------- ----.. lV W� � ---------- ---,------- � . . . �''\�------------~-' Assessor's map and lot numb r .............................. 0 � g4 � F7NEt� Sewage Permit number ....... .......... / Zf / e�Q ♦� / Z BARNSTAXE, i House number .....................................................\�>.... 90p NAM e00 1639- TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO o� as Q P ,?m-. L/ n� )TYPE OF CONSTRUCTION ............ ..........................................�..-�.../............................................ ........... ..`.........:.......................19. �.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the Lthe following information: Location 'f% G l 1'�fi Yl Yl.,`' r�S ............................................................:........................................................................................ ProposedUse ...............F..! .�11 t.-' ........... ?.Yyl....................................................................................,......................... ZoningDistrict .........' .. -".. ............................................Fire District .............................................................................. Nameof Owner ...�. ?..............,`./....... ........ Address ....................... ............. --�,.................:............... Nameof Builder ....... .........................................Address ...................f P................................................. Name of Architect .....� .! .........................................Address ...........�J...... ..'... f'.................................................... Numberof Rooms ............... .................................................Foundation ............... ........... ................................................ Exlerior ......... J.�Pr�...............................................Roofing ........... ................................................... Floors ..........0{ ....................................................................Interior ............................. :......................................... HeatingU..)c J .......................................................ePlumbing .............. ;...........................'........................... Fireplace .....4.)ry-7. ........:�.... .....................................Approximate Cost .......�...........,C..,tJ�.................. Definitive Plan Approved by Planning Board ________________________________19________. Area ..... . Diagram of Lot and Building with Dimensions Fee .........� �........... ........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH -C -1— �d ' Q� (o Hoos"e I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. r Name ............................. _........ .. ?............... 23485 BUILD ADDITION No ................. Permit for .................................... ' Single Family Dwelling ............ Loco .lU...�i A Rt. �iu...ElIio... .ane..... � Hyannis ........................................................... . � . Owner ...Xi.QJAAQ.1'J......P.,A —.�---. ---- ' . \ Frame | Type of Construction -------------- . \ . --------------------------. � | -/ Plot ............................ Lot ___________ / September 22, 81 Permit Qnunu»6 -------------..lV ' ( Dote of Inspection ------------lA - _ ~ - Dote Completed ....................................... - / PERMIT REFU�'ED , ' � � ' . -------.. lA - -----'---'-- -------^-----'' � '—_—~—.----...--------------... . � . -- ..................................................... ..................................................... ~ ~ ' ---.------------. l� ~ )� -------'--'-------'—''--'—^'—'~— � , ----------`'^------------~^— � � _ ' Assessor's map and lot numb r ...... .. ......Ita 6� . 4-52 k 1q, .. ......... STNE V lip Sewage Permit number .��......... SARNSTAXLE, House number ..................................................... ..... .. ro rhea 'EG YAK Ar-- TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO (A.........F,19 In.�7x..... A................................. .... . ....... TYPE OF CONSTRUCTION ...... ... .... .. .4 A.c).n.......................................................................................... ... . .j 'C'e ..........f...... ............... % TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... ....... . .......(,4"1 (y)A 5S �....... .............................. ............................................................................... ProposedUse .............Flar n.t..L. ...............R.44 h.............................................................................................................. Zoning District ......... ............................................Fire District ........................................... ... ..... ...... .................................... 0 Name of Owner ... b/. #. .;. �-Acldress ..(A........ ......... ......... ............... Nameof Builder ....... t.........................................Address ............... ................................................. Name of Architect ..... .........................................Address ............:5 .................t.................................................... Numberof Rooms ...............J1,.................................................Foundation ........ ............. . ................................... ,Exterior ..........5. (-,j Roofing ........... ................................................... ............................................... Floors .......... .................................................................Interior .......... ....................................... .... ....... .... ......... Heating .....w ......... ......................................................Plumbing .........../!d�........................................................ 6e) Fireplace ......wodj...............ov-�....................................Approximate Cost ................p............ .......I.......W............. Definitive Plan Approved by Planning Board --------------------------------19--------- Area ..... ................. Diagram of Lot and Building with Dimensions Fee ........ ........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH QL 14bose- QP4 ao�� ------------- I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ..................... ... ........ ............ Name ............................... DDFFLEY^ MZCHAEI, J . | ` . � No .- pennhfn . S --- i��..��----.—�f��----. . ~ Locati:n — ' !�~4�—&i� Ellis �a�et—.. ..] --.. .. _.. . � Hyannis . ----.------------.~-----�---. . . _ Owner —8�i _J`_DuffI ' _.___ ..... ype of —..� _� �� —A . ' . . ---------.----------------- . ` pkz ............................ Lot ................................. ' . . S �z�'2� 8I � Pernit [�,onhs6 ..�--.��.----'lV � / ` Date of |n _--------. —l9 \ . Dote Completed }q � ____—,��'^m'=��— 1 ` ' , . ' _ OERN0IT REFUSED ^ -----------.---------.. l� y ` ~ � ..--,~~---.-----------------. � | _ ............................................... .......................................~--.--...---.--.. . � ............................................................. ` � ' � , Approved ................................................. lQ � ..................................................... . ( ............................................................... ' ` � � ul - 23 —7 G ff. i Z' tiry4 IZ .CPAfLSG° SAS . 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