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Home My WebLink About0084 HAMPSHIRE AVENUE gq J Cape Save Inc. 7-D Huntington Avenue } South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 k V 8-29-14 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permits Dear Mr. Perry, This affidavit is to certify that all work completed for 84 Hampshire Ave,Hyannis has been inspected by a certified Building Performance Institute (BPI)Inspector. Ceiling: R-49 cellulose Walls: R13 dense pack cellulose Basement: R-19 Fiberglass blanket in box sill All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION x c 9' Parcel 1 3 S A Waiontto�t5l M Map ppli Health Division Date Issued 8 Conservation Division Application Fee 'w Planning Dept. Permit Fee `/* Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address �a�, ashi re, Ttv'B Village Owner co s Address Telephone 3-15 ? 9, �� q Permit Request A. J R,_3 8 Ge l t% en -6 i-he A-44 c- Dujc, to, 04 Ili Rir sea( :'lie dl'c 1B wa P/he. Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation S 0 0 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 _w Number of Bedrooms: existing _newk Total Room Count (not including baths): existing new First Floor Roo i Counter t Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Z Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/ b al stovO QJ Yes ❑ No c� 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 21`No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) � II Name wi 1l 1ra c Telephone Number c, g 39803 q g Address ' b A,-1V n rP License # 7- C Home Improvement Contractor# I 3A 38-0 Worker's Compensation # w w c 3 0�' 633 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE A. OWNER r i }. DATE OF INSPECTION: i uFOUNDATI.ONuo-vj ;wi, oaoviwtvU, FRAME INSULATION.-,..k FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL F GAS: ROUGH FINAL FINAL BUILDING- .2' P T r _ DATE CLOSED OUT R ASSOCIATION PLAN NO. F Housing Assistance Corporation cape cod HOME OWNER WEATHERIZATION WORK PERMIT& FUEL RELEASE: PLEASE FILL OUT AND SIGN THIS FORM IF YOU ARE II 11 d THE APPLICANT' HOME OWNER. I R I AM( co s�t,�_ hereby consent to and agree that weatherization work may be done by the Weatherization Program of . Housing Assistance Corporation ( herein after referred as "Agency" ) on the property located at: dam s�,ir� RYe 0.nn%S 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 & caulking of windows and doors, insulation of attics, sidewalls & basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows. Inconsideration of the weatherization work to be done at my home I agree to the following: 1. I give permission to the "Agency" its agents and employees to travel onto or across said property with such equipment and materials as. may be necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. I have read the provisions of t e:ement as i d:an. freely give my consent. Home Owner: 'gnat e) (S > Date: S Agent (signatu e) Date: a The Commonwealth of Massachusetts: Department of Industrial Accidents Office of Investigations k yr 1 Congress Street, Sicite 160 tis Boston,MA 02114-20I7 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information _ Please Print Lep-ibl . Name:(Business/Qrgani2atiott/ltidividual:): Cape Save Inc. Address: 70 Huntinotori' Ave City/State/Zip South Yarmouth, MA 02664 Phone'#.- 508-398-0398 _. Are you an employer?Check thQe appropriatebox Type of project{required} 1.'F-1.1.am.a em to er with 8 4. 0 1 a a general contractorand I P y m 6. F1 Nt:w construction - employees(full and/or part-time).:* have hired the sub-contractors 2.'[� Lain,a sole.proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub_contractors have g Demolition working far me,;in any capacity. employees and have`workers' - No workers.'comp.insurance comp.insurance.* 9 .[ :Building addition f required.] 5. 0 We,area corporation and its I0.M Electrical repairs or additions. officers have exercised their I.I. Plumbin to airs or additions: 3.❑ 4 atn.a homeowner doing all work: E .p>; ' myself. [Now comp: right of exemption.per MGI. 12[ Roof repairs insurance.required.1,t c. 152, §1(4),and We,have`no 1� �,Cd1er Insulafion _ employees, [No workers' comp. insurance required.] *Any applicant that checks box:#fl must also fill outthe section:below showing their workers'compensation policy information. t'Homeowners who submit this atllidavit indicating they arc doing all work and then hire otitside contractors must submit a new affidavit:indicafing'such. �Contractors.that check this box rhmt attached ' additional sheet shop>-ng the name of the sub-contractors and state.vheiher dr not:{hose enbttes have etnployees..If the sub-contractors have employees,they must provide their Avrkets'comp:policy number: ' 1 am an en:ployer that is providing'worei ers'conepensation insurance for my employees. Belo'w is the.:pg/icy and job site infor►nation. Insurance Company Name: Wesco Insurance Company _ Policy#or,Self-ins.Lic.# ,WWC3085633 . . ._ ......._ _.,,Expiration Date: 04/09/2015 t' pp I l I l •; Job Site Address: vf, City/State/Zip. n (s . Attach a copy ofsthe workers'compens tion policy.declaration page(showing the policy nvm er.and expiration-date)- Failure to secure coverage.as required under..Section 25A of MG. L c. 152 can lead to the imposition of crt.mina-penalties ofa ftne up to 51,500.00 and/Drone-year in�prisprin ent,as well as civil penalties in the fortis ofa 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.OfTwe of lnyestigations of the DIA'for insurance coverage verification,' I do hereby certi under the pains and enulties of er' that the in ortnalon provided above is.true and`correct S mature: Date 0 Icial use only. 06,not write in•th s.area;to be:coxrpleted.by city 4r town ofcial. City or.Town:__ Permit/License:# assulingAuthenty. circle one): I. Board:of Health 2:Building Department 3.CitylT-own Clerk: 4.Electrical Inspector 5 Plumbing;TnspeetQr t 6. their.. . Contact Person: Phone#: ` ACORU� DATE 4MMfDO1VY�) CERTIFICATE 4F LIABILITY INSURANCE 4i14i2o,4 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 PROD.UCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, Subject to the terms and conditions of:the policy,certain policies may require an endorsement. A statement on this certificate does not Confer rights to the Certificate holder In lieu of such.endorsement(s). PRODUCER NAME: Colleen Crowley Risk Strategies CoMany PHONE . (781)986-4400 FAX'No:(781)963-4420 15 Patella Park Drive h-MAILADDRESS. Suite 240 .. .. INSURER(S�AFFORDING COVERAGE .. -NAIL Randolph M& 02368 INSURERA:Selective Ins., 4 America INSURED. .. _. iNsuRER B-Safe ty Insurance, Cca 0anV3618 Cape save, Inc. INSURERC WeSCO Insurance aII 7 D Huntington Ave INSURERD: INSURF-R E south Yarmouth. MR 02664 INSURERF: COVERAGES CERTIFICATE NU M►SER:CL1441476243 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. LTR TYPE OF INSURANCE POLICY.NUMBER... '. POLICY EFF.. MMMIDD,'EXP .. . _.._ LIMITS GE14ERAL,LIABILITY- - EACH OCCURRENCE. $ 1,000,000 X COMMERCIAL GENERAL LIABILITY" DAMAGE T RENTED accurrenae $ 100,000 A CLAIMS-MADE OCCUR 1994480 '0/16/2013 0/16/2014 MED FXP(Anyone person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE, $ 2,000,000 GENI AGGREGATE LIMIT APPLIES'PER. PRODUCTS-:COMP/OP.AGG $ 2,000,000 POLICY FXJPRO- EX-1 LOC $ AUTOMOBILE LIABILITY Ea accident)INGL L t 1,000,000 B ANY.AUTO - BODILY INJURY Per.person) $ - - ALLOVyNED SCHEDULED 208200 1/6/2013 1/6/2014 AUTOS X AUTOS BODILYINJURY(Per $ X X NON-OW4ED PROPERTY DAMAGE HIRED AUTOS AUTOS Peracddent) � X UMBRELLA.LIAB_. X ._.. _ : OCCUR EACHOCCURRENCE $ 1,000,000 A EXCESS LIAB CLAItvISMADE- AGGREGATE $. 1,000,000 DED. RLrervnoN : lux S1994480 0/16/2013 0/16/2014 C WORKERS COMPENSATION fficers Included For X RSLATU- 07RH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y/N overage E.L.EACH ACCIDENT _ $ 500,060 E,L,DISEASE-:FAEMPLOYE $ 500 600 OFFICERiMEMSEPEXCLUDED? 4 NIA. (Mandatory in NH) 3085633 /9/2014 /9/2015 If yes,describe under , DESCRIPTION OF OPERATIONS below-` E,L.DISEASE-POLICY LIMIT '$ 500,000 DESCRIPTION OF OPERATIONS)LOCATIONS/VEHICLES(Attich•ACORD 101,Additlonat Remarks Schedule,if more space is requiredI Issued as evidence of -insurance. Issued as evidence of insurance. Thielsch Engineering; Inc. is listed as additional insured as respects General Liability as required by written contract. CERTIFICATE HOLDER _ CANCELLATION msong@capelightcompact.org SHOULD ANY OF THE ABOVE DESCRIBEO:POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cape Light Compact ACCORDANCE WITH THEPOLICY PROVISIONS:. Attn: Margaret Song PO Box 427/SCH nuTHORizEOREPRESENTATIVE 3195 Main Street Barnstable; M 02630 ichael Christian/CLC ACORD 25(2010/05)`. O 1988-20f,0AC0116C RPORATION. All rights reserved. INS025(2oiooswi The;ACORD.name and logo;are registered marks of ACORD Office of Consumer Affairs and Busmess'Regnlation 10-Park Plaza - Suite 5170 Boston Massachusetts 02116 Horne Improvement Co# ntractor Registration �� Registration `171380 Type Corporation ## 171 Expiration `3/14/2016 Tr# 249649 R 1 P � CAPE SAVE INC. x�1 WILLIAM McCLUSKEY k. -- 7-D HUNTINGTON AVENUE " ..' SOUTH YARMOUTH, MA 02664 Update'Address and return card.Mark reason for change. Address Renewal . Em to meat Lost Card SCA 1, Q 20M•05/11 - - - ❑ P y ❑.: �ie �pamva2omcuea��a � /�adacacxu eG :t Office of Consumer Affairs&Business l3egulahon ± L�cense,or registration valid forIndividul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: r egistration: Y171380 Type: Office of Consumer Affairs and Business Regulation a Expiration :3/14/2016 Corporation "10 Park Plaza,-Suite 5170 Bostoni MA 02116 x ` , CAPE SAVE INC. ' /f „ c WILLIAM MCCLUSKEY 7-D HUNTINGTON AVENUE ` } ' :A= + SOUTH YARMOUTH MA.02664 Undersecreta rY Not vali rthout signature x c Massachusetts ,Department of Public 5a#e#y Board of Building Regulations and Standards Construction SuPerisor 5Pec1 ilt� License: CSSL-102776 imAV W ILLIAM J MC C`�USI�J( 37 NAUSET ROAD West Yarmouth A4A 026a.3: j Expiration Commissioner 06/28/2015 ! •