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Home My WebLink About0017 KENNEDY TERRACE cola;'k6 e, Moul goo fV Oro 11/14/14 Thomas Perry, CBO Town of Barnstable Building Division 200 Main St Hyannis, MA 02601 RE: Insulation Permits Hear Mr.Petty, This affidavit is to certify that all work completed for insulation work at 17 Kennedy Terrace (application#201404435) has been inspected by a certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds federal andState requirements. Sincerely, Comr McInerney ®. ConserVision Energy 376 ROUTE 130,SUITE C SANDWICH,MA 02563 508-833-8384 WWW.CONSERVTODAY.COM TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 3614 Map Z tom Parcel is e t TOWN dATL Application Health Division Date Issued v a Conservation Division ..g .k 9� Application F e Planning Dept. Permit Fee Date Definitive Plan Approved by Planning[ffkgCkTP,L11 Historic - OKH Preservation/ Hyannis Project Street Address Village „ A v.3.3 ,g Owner Address Telephone me y.- S\'-.k - 3L�c. tad AUK. S _ vim.a oL(,o Permit Request Square feet:. 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay era Project Valuatioril 9t7tq. Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family C9' Two Family ❑ Multi-Family (# units) Age of Existing Structure k'NV ti 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 Z. new Half: existing new Number of Bedrooms: Z. existing —new Total Room Count (not including baths): existing L new First Floor Room Count Heat Type and Fuel: was ❑ 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 c,c.4oZ. Telephone Number 5c -'t33 - v%%I IA Address 1.1 'tt License # -b ca*��, c.w . �---- p► o L�V 3 Home Improvement Contractor.# lk k LS 1 Email Worker's Compensation # 16d%yt 3%.%R ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Tes.✓�+ a fie` t"a b v�►J�c. L.a v-� !-�, �- SIGNATURE DATE l F0/LL.1 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, 3 GAS: ROUGH FINAL FINAL BUILDING 5 DATE CLOSED OUT ° r ASSOCIATION PLAN NO. �., iTQTE(MRl/DDNYYY) CERTWICaTE OF UABUTY INSURANCE . 0311712614 THIS CERTIFICATE IS ISSUED AS A MATTER OF iNFORMATION ONLY ANO CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT A€FIA"NATWELY OR'NEGATInLY AMOND,EXTEND£3R ALTER THE CO`JERAGE AFFORDED BY THE POLICIES LOW, THIS CERTIFICATE OF euWSUR NCE DOES i NOT CONSTITU I A CONTRACT BETWEEN THE ISSUING INSURER(S);AUTHORIZED REPRESENTATNE OR PRODUCER,AND THE CERTIFICATE HOLDER. i IMPORTANT. H the certificate hater is an ADDITIONAL INSURED,fire pol3cy(ies)must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and condi inns of the policy,certain policies may requite an endorsement. A statement an. this,m0 icate p"not confer:riRhts to the certificate holder in lieu of such endorsement(s). PRODUCER _ CONTACT CS&S/INORKCOMPONE NAB PO SOX 946580 P3rOtlE v wC;.Nq-Est: {AiC,#}o): MAITLAND,FL 32784-&§80 Ea�IE - Phone a 8T7724--266a AODRES&: Fax-8TT 763-5122 INSURERS)AFFORDWG COVERAS.E NAILS INSURER A:Continental Casualty Company: 20443 INSURED INSURERS: CONSERVISION ENERGY 376 ROUTE 130 INSURER C: SUITE C WIRER D CO�jfte:tL�l Casua"C-OMPanY 20443 SANDWICH,,MA 02563 INSURERE.Continental CASUalty Coi�iparly : 24443 INSURER F COVERAGES CERTIFICATE NUMBER; REVISION NUMBER: THIS 1S 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 DESCRIBM HEREIN IS SUBJECT.TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LOATS SHOWN MAY HAVE BEEN REDUCED PAID. CLAIMS: LTR TME400MMRANCE .. ..tmsR WVD ..FoucYwMatR � ....(nI �,{a�avDomYY(, GENERALLL48UTsr ----- F.ACH OCCIIFtRENCE 1,000,O110 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED CLAIMSAIADE'M"OCCUR' PREMISES(Ea occurrenrP) �300� MEO EXP(Any one: 10,000 A Y I!t 60113,16335 03/11/2OU 0311112015 _ PERSONAL S ADV INJURY $1,M'80 0-0-ERALAC.REGATE $2,000.000 Ni AGGREGRTELIM> APPLIES PER: PRODUCTS-COMPIOPAM $2,00-0,000 PtktCY L AUTOMOBILE LIAa1Lt[X COMBINED SINGLE LRu1IT $1,000,000 (Ea accident) ANY AUTO B'ODIIY INJ(!RY{Per p6rson} ALL OWNED .SCHEDULED - - - A AUTOS. AUTOS N Al 601 1316335 03/1112014 0311112616 Bomy INJURY(Per ao�+It) .NON-OWNED HiP.�AUTOS -___ I: i i P>;QPE_ary n r I I tIL�Yii kuT05 � UMBRELLA.LIAB OCCUR EACH OCCURRENCE ,000100 . 00a D• , Ext:Ess uAs. ,cLAitils�aDt � N. � N� • 60'V4316352 - t33f1'1-12Q'l4: a3/11.12ti'i•5� AccREcnTE� - , ,Q00, DED RETENTIONS 10,060 VIMERS COMPENSATION WC STATU- OTH- Amb EMPLOYEW Lu mn mY I 1=r Laars ER ANY PROPRIETORIPARTNERr'EXECUTIVE YIN $100,000 E OFFICERtMEMBER EXCLUDED'.. N. N 601131630 03/1 V2014 03/1112015 E�EACH ACCIDENT i YInKH) If yes,doWbe ender- - E.L.[DISEASE-EA EMPLOYEE $100,000 DESCRIPTION OF OPERATIONS bsfow E L.DISEASE-POLICY LIMIT: - $500,000 . 4� ..PTIQPI QG QP RA77j3Ni/ ATtrJra$i VEHIt! 3{A9-;u;h AC0R4 1.0j;Addit'j f.Re�ks�d lgle.it two spare es,eaulredl. Certificate Hidld'er t ao`d#d-at7vfad'diitiortar ntumd,as pro0cled-in-th'erblan�tetadditionatinsure�endorsement l CERTIFICATE HOLDER _ CANCELLATION Rise ngineenng. SHOULD ANY OF THE A66VE DESCRiSED POl1O1ES 13E CANCELLED 13EFORE. 1�34T EltifWddcl AVe THE EXPIRATION"DATE THEREOF,NOTICE WILL 6E DELIVERED-IN" Cranston,RI 02910 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE O 1988-2010 ACORD CORPORATION. All rights reserved. AEORD-25-(2010105)• The ACORG name and logo are registered marks-of AG@RD ec� The Commonwealth of Massachusetts Department of Industrial Accidents. Office of Investigations 600 Washington Street Boston,M 02111 ,IV www,tnass.govlt Work-eW Compensatioit lnsuranve Ai d-avit: Buillders/Contras-#cars/Electdejans/Plat rs- Applicant Information Please Print Leal bly Name(.f3us nessOrganization/in(rvidual): Consel`vssion Energy. Address: 376 Route 130 Suite C' City/State/Zip: $andwich, MA 02563 _ _ _ _ - Phone 508-833-8384 Are you,an employer?Check the appropriate box,. � sy'pe of project(required): 1.ER I am a employer with 8 4. ❑ 1 am a general contractor and 1. 6. Q New construction employees-(full and/or part time}*" have hired the sub-contractors 2. 1 am a sole proprietor or partner- listed on the attached`sheet. t 7. C] Remodeling ship and have no employees These-sub-contractors have S. FT Demolition. workingfor me- in- any capacity.. workers' Gt MP, Insurance y F tY '9. [ Building addition [No workers'comp.insurance 5. We area corporation,and its, required.] officers have exercised their 10.❑Electrical repairs or additions 3.ET I am a homeowner doing all work- right of exemption per MGL l'l.M,Plumbing repairs or additions- myself. [No workers'comp. c. 152,§1(4),and we have no 12.[3 Roof repairs insurance required.]# employees.[No workers' eot?�p: ins�+ancerequired] 13•[2 Other eatherization 'Any applicant that checks box#1 must also fril 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.submit a new affidavit-indicating such- )Contractors that check this box must attached an additional sheet showing the name of the-sub-c-ontractors and their`tvorkers'comp.policy information. I a#L an employer that is providing workers'conspensation insurance for my employees. Below is the policy and job site information. Insurance Company Name- CS&SMORKCOMPONE Policy#or Self-ins.Lie.#: 6041316349 Expiration Date: 03/1'1/2GI5 job site Andress: City/Statelzip: . Attach a copy of the workers'compensation policy declaration page.(showioDg tire:pol cy taumber 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 tit$250.00 a day against the violator. Be advised that a copy of this statement may,be forwarded to the Office of Investigations of the DI 4 for insura coverage vevflY.at of I do hereb Jy er th ;p 'ris nd penalties of perjury that the information provided above is true and correct Si _ature _ Date: Phone#;. official use only. Do not write in this area,to be completed by city or town offrcia City or Town: Permit/License# Issuing Authort I (circle one): (..Board of Health 2.wilding(Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.tither Contact Person: Phone#: 5,�•?F i,�[' t�X#: F'rr{9rrs; �a 7'r3+�a f d..1 Oftice im Cv$as�er ii sr RaJsi mess Reguh-mos I...- or iegiq--,io*valid fui;Vdividul use only PEE IMPROVEMENT.CONTRACTOR txfore the expira3ion dater If found return to: istration 171251: Type, Office Qf Consutner AMirs and Business Regulation xpiratfon: 311/2016 partnership TO'�at1 1'1Bia-Suite�T70' Man,MA t)n 2116 CON-SERVE ENERGY CONOR 1C=EF'Ni—mv Ff �- 376 ROUTE 130 SUITE C SANDWICH.MA 02563 tl €c3eee€ Nog valid without sin tune De-na,"'t_C E`er f sa0 s 34 StASCONSET=-DRWE SAGAMORE SEA01 mi tY? d2 I ...�.....-:.s..:.-..�..�::...E,..� .o:...•�.,e,-ate,a,,.i.,:..1..,..-�.,.: -- ._..:..;.__.........:.--..,'...,.-w-,..._...,..:�,.....>............-.:...:,.....................„.«ww...w,.,. ..-...,.........�....,�........ ..�.... .w. .,�;.....:. .. .. .-.... ... .• 1 �w;;cerorr,, T KOICIDATIAG s 171aSS SdV� CONTRACTOR �si�ryY.;kincvfi v.Rmi+y.Ll!ISle�tty - ... I PERMIT AUTHORIZATION FORM. 11 oWner6f.the property located at: (Owner's Name, printed} _ (Pfoperty Street Addres) (f i nowm 4 �E hereby authorize the`Mass Save.Home Energy Serviced 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.. I Owner's Signature i i t Date Tr 1 � FOR CS.G OFFICE USE ONLY i :i Conservation;Services Group has assigned the following Mass-Save Home,Energy.Services Participating Contractor to the above referenced project: Participating Contractor Date A .4 =i at t `Rev 121320=11 :A -7 ZI P�pFTHETp�� Town of Barnstable *Permit# Expires 6 nths,from issue date BARNSTABLE, • Regulatory Services Fee �� v 639: Thomas F.Geiler,Director MA't a Building Division Tom Perry, Building Commissioner XPRESS 200 Main Street, Hyannis,MA 02601 PERA4'T Office: 508-862-4038 r - JAN 3 1 2003 Fax: .508-790-6230 EXPRESS PERNHT APPLICATION - RESIEDENI RWOMPUARNSTABLE Not Valid without Red X-Press Imprint Map/parcel Number A 6-7651 LwaZ p Property Address \—] l!r�+•�st'�K Residential ValueofWork .60 Owner's Name&Address —VOCLCL. k-1 tia•..tAy �c.rt Al Contractor's Name J\, ► Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) L�S°\J 1 CpWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name L%.QN Workman's Comp.Policy# (.+J L.3 �'1'S 33 Lk cLQ Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken tom dl�J��- Q�•� �11p��-- ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side [V�Replacement'Windows. U-Value •3 (maximum.44) [VOther(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature Q:Forms:expmtrg Revised121901 ..__.__..�- -..,....�.� WJ VU1 a4CORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM,DD,YY, PROpUCER (S08)865-4433 FAX O1!13!2003 (508)86S-4000WAT, C.D. Whitney Iris. Agey, ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 112 Elm Street P.O. sox Z71 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. - - Millbury, MA OIS27 INSURERS AFFORDINGCOVERAG INSURED James Moore INSUREAA Natio Mal. Grang e Mutual P. 0. Sox 3005 INSURER& Liberty Mutual Insurance Co. Bourne, MA 02S32 INSURER INSURER D: INSURER E; COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEO ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHS DI G ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS.CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCEAFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH I POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE Oft INSURANCE POLICY NUMBER DA.TEIMAIUDDlYY) DATE(MtrImAiY) LIMITS GENERALUAB(L(TY 4P145817 OS/23/2002 05/23/2003 EACH OCCURRENCE. S 1,000,OOD Y COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Anyoneilre) 8 S0.000 CLAIMS MADE a OCCUR MED FRCP(Any one Person) S 1.000 A PERSONAL&ADV INJURY. S 1,000,000 GENERAL AGGREGATE. b 2,000,000 GEN'LRGGREGATEUMIT APPLIES PER PRODUCTS-COMP/OPRGG S POLICY PROJE LOC 200,000 AUTOMOBILE LIABI✓,i T Y COMBINED SINGLE LIMrr ANY AUTO Me secident) 13 ALL OWNED AUTOS ' SCHEDULED AUTOS 600It Y INJURY $ (Per pereon) HIRED AUTOS NON-OWNED ALTOS BODILY INJURY 3 (Per eeeideni) I PROPEKTY DAMAGE S (Per rimidenr, GARAGE LIABILITY AUTO ONLY•EA ACCIDENT 3 ANY AUTO OTHER THAN EA ACC .3 AUTO ONLY: AGG EXCESS LABILITY ��---�� EAc1d OCCURRENCE S OCCUR L_ !CLAIMS MADE AGI CREGATE B DEDUCTIBLE i S RETENTION 5 S WORKERS COMPENSATION AND C1-31S-334207-012 05/26f2002 05/26/2003 X 70AYLIMITS ER EMPLOYERS LIABILITY B E.L.EACH ACC)DEN7 6 100,000 E.L.DISEASE-EA EMPLOYEq 3 1.00,000 OTHER E.L.DISEASE-POLICY LIMIT S 00,000 DESCAIPTIO CP RATIONS/LOCATIONSNFJIJCLERILL SIGNS ADDED BY ENDO EMENTlSPECIAL PROVISIONS sk CERTIFICATE HOLVER AODITIONALINSUReD:INSURERLETTER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIGED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILLENDFAVOR TO MAIL 70 DAYS WRITTEN NOTICE To THE CERTIFICATE MOLDER NAMED 710 THE LEFT, Town of Hyannis Building Inspector BUT FAILURE TOMAILSUCHNOTICE SHALL IMPOSE NOOBUGATONOnLIABILM Main street OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESCNTAInVEr. Hyannis, RA 026.47 AUTHORIZEDREPRESENTATIE FAX: (;06)790-6230 �Op1HE lo�ti Town of Barnstable *Permit# 98:F_ yP Expires 6 months fr ts,sue date BSTAB , Regulatory Services Fee �7J�(J�(JJ Thomas F. Geller,Director ® PERMIT p'EDMP�a Building Division I" Tom Perry, Building Commissioner JAN 13 2003 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 A19V1 yS0Ft k TABLE Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIEDENWAS MY Not Valid without Red X-Press Imprint — Map/parcel Number ra 5,Z G v T 3 11 ®X Property Address .f aR sidential Value of Work Owner's Name&Address / Contractor's Name �l� �O G Telephone Number CsG 5�T l O Home Improvement Contractor License#(if applicable) _Z/�, - / Q Construction Supervisor's License#(if applicable) Os� s � orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner D-6ave Worker's Compensation Insurance / Insurance Company Name L l 15L T / �'Jr C1,If 6— Workman's Comp.Policy# rAJ 62 -- 2 / S 3 3 61 ,2 O 7 D / Z Permit Request(check box) Ef/Re-roof(stripping old shingles) All construction debris will be taken to 5 '2U C . ,OGI�I•�5��2 ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) ❑ Other(specify) +Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature Q:Fomis:exp Revisedl219 lciN-1,,-2003 12:03A FROM:MOORE CARPENTRY 309 752 9552 TO:15087906230 P:1/1 E � �iiNSTRlIC71O1V Stfp�R�j�/IF l 'G5 045959 2 M®NTGOMERV DR i MILLBURY. MA aim %Adrviin Bator Board of Buildiag ltegulattoas and Stkadarda t HOME IMPROVEMENT CONTRACTOR License or registration valid for individul use only d -�—�. before the expiration date 1f found return to: Repisttlon.-110592 Board of Building Regulations and Standards Ezp'Tra4lbh: 2!5/Q4 t)ne Ashburton Place Rm 1301 -1!JV14._•68A Boston,Ma.02108 MOORE CARPENTRY."_ JAMES MOORE - 2 MONTGOMERY AR MILBt1RRY,MA 01527 Admloistrator Not valid without sign ure