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0347 CRAIGVILLE BEACH ROAD
� o �3y � G,�� G�,� � R� . a w 04. 14 01:27p TupperCom 1508.7785010 p.1 f� _1 14-1 CONSTRUCTION CO.L-Lc 79B MID-TECH DRIVE,WEST YARMOUTH, MA 02673 PHONE: 508-778-0111 FAX: 508-778-5010 WWW.TUPPERCO.COM Date: rya 'Wd e 1N Town of Barnstable f Thomas Perry CBO .200 Main Street Hyannis, Ma 02601 (508) 790-6230 fax Re: Insulation Permits Dear Mr. Perry This affidavit is to certify that all work completed for permit application issued on �� -� d has been inspected by a. certified - Building Performance Institute (BPI) inspector. All work performed meets or exceeds Federal and State,requirements. Sincerely,' Permit #: Address: 3 t Richard Tupper License CS-69058 I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # 6 Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village r� /'I/J Owner J@ atw e, � Address Ads- Telephone ` / 3 — SrS� � 6 -5 Permit Request --��1 ,(� 011 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed - 161newA q Zoning District Flood Plain Groundwater Overlay o-- Project Valuation 8 s 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: o 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: 0-Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ,='qo_ 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 / �`� -- Telephone Number 7 7Y-0/(1 Address We,5 129/ License # 7j Home Improvement Contractor# Worker's Compensation # !�y 301-2007 ALL CONSTRUCTION DEBRIS RE ULTING FROM THIS PROJECT WILL BETAKEN TO A V4&n ot MI ., 7 SIGNATURE DATE / I �f FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER i. DATE OF INSPECTION: a(FO_UNDATION_� '•r •u, INSULATION.st: FIREPLACE r ELECTRICAL: ROUGH FINAL ..- PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. t OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at 00 IV, H, (Property ss) (Properly Address) . :. hereby authorize ve f 9 a (Subcontre an authorized subcontractor for RISE Engineering,to set on my behalf to obtain a building permit and to parbrm work on my property: Owners nature el .4.5 Date Z00/Z00'd LLZL 8Zb 80S(m) 811 ina8180 a31N30 ld9Zo80 £LOZISO/lt The 6!nmonwealth of Massachusetts Department of Industrial.Accidents '1l Office 6f In 1 1. Congress Stkeet, Suite 100 r ROS ton,.li� Q2114-Z017 www.mass.gov/dia. Workers'Compensation Insurance Affidavit:Builders/Contract®rs/Electrielans/Plumbers Applicant Information Please Print Leeibi Nanie (BusinesslO.rganizatiort/Indiv dUal)? Tupper Construction CO. Inc Address: 79B Mid Tech Drive city/State/zip:West Yarmouth, MA 02673 Phone#:(508)778-0111 Are you an employer? Cheek the appropriate box: Type of project(required) I.Q l am a employer with . 4. Q 1 am a general contractor and employees (full and/or part-time),- have hired the sub-contractors: 0- ❑New construction 2,❑ Tani a sole proprietor orpartner-, listed on the attached sheet. 7. Q Remodeling ship and have:no employees ` These sub-contract-ors`liave g', .Q Demolition working for mein,any capaci employees and have workers' 9. Building ,. r ,- Idln addition [I�o workers. ,t>omp..insurance comp,insurance.; ❑ ,, d on. required.] 5. We are a corporation and its 10.n Elecffi6al repairs or additions 3. I am a homeowMer doing all work officers have exercised their T b l I.Q Plumbing repairs or additions. myself. [No workers' comp, right of exemption per.MGL 1.2.D Roof repairs insurance.required.) C. 152,j 1(4),and we have no employees. [No workers' l3.❑Other. comp:insurance required] 'Pp *AnY a licant that checks box 4l mint also lilt out the scetion below slxowing thcirworkets'compenmtion policy.information, tiomcowners ho subtnitihis affiday.t indicating titeyare doing all work and then hire outside contractors must subrnitanexv dKi davit indic Itingstich. 'Contractors that check this box must attached,in additional shecc shoeing the name of the sub-contraotcrs and state whether or nof;thoso entities havz amployecs. If Qie'sub-contractor,have employt,cs,they must provide their workers'comp.policy,number: I[tin an employer that isproviding workers'compensation insurance for my employees. Below is th; policy acid jab sire i,afoi�niatiort. _ Insurance.Company Name: AEIC Policy`<#or Set=i .ris. L c. VVCC 6005598012007 10/3/14 Expiration late: fob Site Address: 347 CRAIGVILLE BEACH RD City/State/Zip: W.HYANNISPORT,MA 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 ofMGL cA 52 can lead to the imposition of criminal penalties:of a tine up to Sj.,500.00 and/or.one-year:itnprasoninent,as well as ctviI penaitics in the form of'a STOP',VjbR E ORDER.and a fine of up to$250 00 a dayagains e olator: Be advised that a copy of this statement may be forwarded to the Office of Investigations of the fox insuran`ee coverage verification_ Ido hereby ce .tfy tiiadet t. epain!a idpenalties ofpeijory that the i-ifortnatiori.provided'above is true andcovrect SiLinatute:. .._ . f Date:: 11/5/13 Phone#: 50:8-7 7 8;-O 111 Official use i:ly. Ito to6vide ,i this area,to:be completed by city ortown official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S,Plumbing latspectoa 6.Other Contact Person: Phone#: ,. AGORPA CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODIYYYY) 10/11/2611 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 BYTHE POLICIES BELOW. THIS:CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER;AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate,holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION;IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement onthis-certificate does not confer rights to the Certificate holder in lieu of such endorsement(s). PRODUCER - - CONTA NAME:CT („Ora Lowe Southeastern Insurance Agency, Inc. FAX PHONE 439 State Rd. E cMAIL arc: (508)997-606I AIC No:(508)99072731 P.Q. BOX- 79398. ADDR PRODUCER_. ... N. Dartmouth, MA 02747 COME ID#- - INSURER(S)AFFORDING COVERAGE INSURED NAIL#. . . .... INSURERA: Arbella Protection Insurance Tupper Construction Co LLC. INSURER8: AEIC iNSURERC; CNA.Surety .27 Roberta Drive wsuRERo: West Yarmouth, MA 02673 INSURER E:. INSURER F COVERAGES CERTIFICATE NUMBER: 2013/14/1 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 CONTRACTOR 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 OFSUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUB MM/DD_POLICY EFF MINUDDY EXP LIMITS LTR INSR WVD POLICY NUMBER. GENERAL LIABILITY 850000874, 11/01/2013,1:110112014 EACH OCCURRENCE >s �1,000,00 0. X :COMMERCfAIGENERALLIABILITY MA ET RE T D 5 100,00 A PREMISES Ea occurrence CL AIMS-MADE A OCCUR MED EXP(Any one person) S S,000 .. PERSONAL&ADYINJURY. S I OOO,,00, ,GENERAL AGGREGATE'% S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PO . LOG PRODUCTS. �5 000,„Q0 UCYJE $ AUTOMOBILE LIABILITY 56662400002 1210112012 '.12/01/2013 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) s 1,000,000 'ALL OWNED AUTOS BODILY INJURY(Per person) S A JX 'SCHEDULEDAUTQS BODILY INJURY(Peraccident) S+ PROPERTY DAMAGE X (HIREDAUTOS S INC (Per accident), X NON-OWNED AUTOS S _... UMBRELLA X OCCUR_ 460005836 11/01/2013 11101/2014: EACH OCCURRENCE a 1,000ioo . .EXCESS LIAB CLAIMS-MADE A AGGREGATE S 1,000,:OO DEDUCTIBLE S RETENTION S S. WORKERS COMPENSATION: WCCSOOS S930IL200 10/03/2013 10/03/2014'.X '^K sTATu- X oTH; AND EMPLOYERS'.LIABILITY Y/N TORY LIMITS. ER_: BANY PROPRIETORIPARTNERIEXECUTIVE RICHARD TUPPER I ' OFFICER/MEMBEREXCLUDED?. NIA E 1,L EACH ACCIDENT S, 000,'00 (Mandatory in NH) -3 LUDED FOR WC COVERAGEE:L DISEASE-EA EMPLOYE s 1,000,000 If yes,describeunder ' DESCRIPTION OF OPERATIONS below El_DISEASE-POLICY LIMIT 5 .110001001) DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is requlreti) CERTIFICATE HOLDER: CANCELLATION - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLE6BEFORE: THE EXPIRATION DATE THEREOF, NOTICE WILL BE, DELIVERED IN ACCORDANCE WITH THE POLICY,PROVISIONS. For Information Purposes Only" r Tupper Construction CO LLC AUTHORQEDREPRESENTATNE 27 Roberta Drive W Yarmouth, MA 02673 Lora Lowe ©1988=2009.ACORD CORPQRATION. All rights reserved: ACORD'25(2009109) The ACORD name and logo are registered marks of.ACORD ` IriiJll. ilYCa t'I Fif fflMAfilt k 1N 1'`IlU'I ,[NL µ Massachusetts 'Depaitrnent of eubtic Satety 107 Hermes R04 Suite 110. Board of Building Regulations and Standards Malta NY 1202D . +' ` .;ohstructiun Super,ic, r (877)27+t-t274 +' license: CS-069d58 WWW.tt►i CARt a, RICHARD 5 TUPPER `t 79 B.M[D-TECH'DRtwp WEST YARMoLrMH MA6 627473' 1;5�0d TtIR?rfEfapt tw�so"Ao 1 " f.- `�+ ».. .J Ex iratron (SEE EA$E 1bEi0AQE$1&MdTit)NS:ANbfkPIHARONOAtESi. COMfT15Sl�over. 12 31/201A y ajwt"`r+' ��4 ,- e//i6 fCO7J'iA?/O'1tllERfl�f/i4 o�f n w offctotC.omtWitirmtairsB sirmnctvRqutadan +"_ -QMOMEVPROVF-MI NT CONTRACTOR ^Reglstration 121846 TYP61 � "��, �� � t A ,� '��•,�,° �� ,�;;` � � Expiration 6119l2014 Individual • RICHARD`TUPPER411 .` 6 , .AICHARQ 1UPPER. � ot"tS� tJGt30�1 r,; r f 29 Robtrta',Drive s• o W,YARMgUTH MA 02613 UnUeFseetetary . r f" � � iS �;M."M�rtF.,.s�"2+ak�<y( � LV'k.4a1..M,,.. � *"*bv �+k`Y•Y��+.r "'"L4W r Comx�laint.Number: 16871 1 aken bv: BU,JLDIT5G S-LR30CL-S Date ; 13_ 00 w Man/t)arcel: 5 -Referred;to: UILIaJN-G a. SUBJECT OF COMPLAINT ccupan Busmes-s/Ot Naine: TILLMAN Number= 3 77 Str et:; C12AIGVILLE-BEACH-RD.__ A TAT .�COMPLAINTk INFORMATION, ,,C6inplainant's;Name: _ NEIGHBOR 'Address: Telephone,Nuinber: ComplaintrDescription: SELLING USED CARS------THIS IS 3RD COMPLAINT. k Actions Taken/Results: REF. TO R.J. / ,0,,,rz -ea-Date Closed: