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Home My WebLink About0034 MARK LANEr 37' /�l�lgs/t !� �_ - � ��, C s i CAPE COD TO NS. ULATIQN n WSTASIt is r Ilk - IIMOA 6LAyi [A MLLSS SAAAT fOAN 9JSPLNO¢p " YARi JURiLLi INSYLAIIpN WONG$ 1-800-696-6611 , �11V _ "I"own of Barnstable Regulatory Services_ Building Division i 200 Main St Hyannis, MA 02601 Date: Dear Building Inspector' Please accept this Affidavit as documentation that Cape Cod Insulation, Inc: performed &. completed the insulation and weatherization work at the property listed below..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 (BP•1) inspector. All work preformed meets or exceeds Federal & State Requirements., Property Owner Property Address Village eS Insulation Installed: ,Fiberglass Cellulose R-Value Restricted. Unrestricted Ceilings Slopes ( ) ( ) ( ) ) Walls Sincerely He ry L Cas. y Jr,-President (1. e Cod I ulation, Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel r Application # �,�. � '3 Z Health Division Date Issued IZ-3'� Conservation Division Application Fee Planning Dept. Permit Fee ' Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis VAN Project Street Vdress Village. ti Owner� Address Telephone g d Permit Request 1 l �` (,� a.. �a 7 ' C'Alt� "l� Cvk1c,, YPY A-IV .Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay- Project Valuation `� •. Construction Type d 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 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 al stove,44❑Y95 ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑` i ting ❑mow ze_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size Other: w w Zoning Board of AppealYo orization ❑ Appeal # Recorded ❑ W � Commercial ❑Yes If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION - - - (BUILDER OR HOMEOWNER) nN N �f Name Ci Telephone Number d `��✓ y a Address kPOWAffiJ CWG14--'_LA License # a l , T 1 Home Improvement Contractor# Email Worker's Compensation # "00� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PRO CT WILL BE TAKEN TO SIGNATURE DATE E t ` 4 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED ,k MAP/PARCEL NO. " ADDRESS VILLAGE OWNER ' DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 1 GAS: ROUGH FINAL FINAL BUILDING .' QATlE-CLOSED OUT �f X O�-ff- lON PLAN NO. e Massachusetts ,Departmentiof Public Safety _ .,:Board of Building Regulations and Standards Construction Superviscir License: CS-100988., HENRY E CASSII 8 SHED ROW ' WEST YARMOVITI '?,.tea �;' ,� - • ✓, ..� �d/�s . ,1 o��; r Expiration Commissioner 11/11/2015. :b Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 153567 Type: -"Private Corporation "- Expiration: 12/15/2016 Tr# 259188 CAPE COD INSULATION, INC ' HENRY CASSIDY 18 REARDON CIRCLE -- . SO, YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. , _ Address R Renewal Employment Lost Card . .1 d10 20M-05/11 — . . ........ -- - -- V/26 W-009YI72(N2CUBCl.GC�CL��CiAJCCCfI.II�eG�J •. ` Q\ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistratlon: 153567 Type: Office of Consumer Affairs and Business R6gulation xpiratlon: .-.1:211.51'201,6 Private Corporation 10 Park Plaza-Suite 5170 Bostoh,MA 02116 PE COD INSULATI;O.N;,*:INC'.- .=;" .NRY CASSIDY - REARDON CIRCLE" r.YARMOUTH, MA 02664 �- Undersecretary NJ/valid wi ut sign e° i � The Commonwealth of Massachusetts Department of Industrial Accidents W Office of Investigations w ' a 1 Congress Street, Suite 100 W W Boston,MA 02114-2017 ° www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information /o Please Print Leizibly Name (Business/Or 'zation/Individual): e Address: 1 �V 4wt 6V City/State/Zip: tAk Phone#: 17�" t{' Are you an employer? Check Ahe appropriate box:1. Type of project(required); Z I am a employer with 4. I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. 0 New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling F ship and have no employees These sub-contractors have g, Demolition + working for me in any capacity, employees and have workers' 9. Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 1 LQ 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 employees. [No workers' 13,� Other r comp, insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this'dffidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If 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: &,o(, Qvav�gv Policy#or Self-ins, Lic. #; 1110 01 Expiration Da*��and�exipiration Job Site Address: �/ City/State/Zip:Attach a copy of the workers' compensation policy declaration page(showing the policy n 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. I do hereby certify n r pains and penalties of perjury that the information provided above is true and correct. Signature: Date: . l � Phone#: Offlciafuse only, Do not write In this area,to be completed by city or town official. ' City or Town: Permit/License # Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector :i 6.Other Contact Person: Phone#: } r � I CAPECOD-27 KLIGETT CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 6113/2014 'HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS :ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES IELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED EPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, APORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to ie terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the ertificate holder in Ileu of such endorsement(s), DUCER CONTACT [ers&Gray Insurance Agency,Inc. PHONE Barbara De Lawrence Rte 134 AIC. Q.Extl th Dennis,MA 02660 EMAIL 816-2156 ADDRESS:bdelawre ncegroqersg ray.com 1 — INSURER�Sj AFFORDING COVERAGE NAIC N INSURER A:Peerless Insurance Company IgEo INSURERS:COMMERCE INSURANCE COMPANY Cape Cod Insulation Inc INSURER C:Evanston Insurance Company 18 Reardon Circle INSURER 0:ATLANTIC CHARTER INSURANCE GROUP South Yarmouth, MA 02664 • INSURER E; INSURER F; ERAGES CERTIFICATE NUMBER: REVISION NUMBER: iS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD ICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS RTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, {CLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE INS WVD POLICY NUMBER MMLD0ffYYYI MM/DDY E YY ti LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE a OCCUR CBP8263063 64/01/2014 04/01/2015 PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ _ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 X JECT PPOLICYPRO• LOC PRODUCTS•COMPIOP AGG $ 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident . $ 11000,000 ANY AUTO 14MMBCKVMK 04/01/2014 04/01/2015 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED _ AUTOS AUTOS BODILY INJURY(Per accident) $ rx HIRED AUTOS X AUTOSNON-OWNED PROPERTY DAMAGE AUTOS Per accident $ -X. UMBRELLA LIAR I X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE XONJ463614 04101/2014 04/01/2015 DEO I X I RETENTION$ 10,000 " AGGREGATE $ Aggregate ORKERSCOMPENSATION PER OTH- $ 1,000,000 ND EMPLOYE RS'LIABILITY YIN`, STATUTE ER ET FFICERIMEMBEER EXCLUDED?/PAIRTNERIEXECUTIVE N/A WCA00525904 06/3012014 06130/2015 E.L.EACH ACCIDENT $ 1,000,000 - Mandatory In NH) I yes,describe under E.L.DISEASE-EA EMPLOYEE $ 1,000,000 ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 RIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additlonal Remarks Schedule',may be attached If more space Is reclulred) ers Compensation Includes Officers or Proprietors. :Iona[Insured status Is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder, IFICATE HOLDER CAN• CELLATInN �0��blpfi mass saveP oR SaVinprtfro�yi�effigy�� PERMIT AUTHORIZATION FORM I, Ken!ones ,owner of the property located at:. (Owner's Name,printed) 34 Mark lane Hyannis (Property street Address) (city) 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. . X Owner's Signature e 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: ��E coA i n s tc c-,a-'►�a� i®/1 �i y Participating Contractor date. EWE For Office Use Only Rev.12132011 . � G Assessor's map and lot number 3-Jd- 7 7. !.. �.'0 -t 7� r Sewage`:Permit number .............. ..................................... Hof?HET��y TOWN OF BARNSTABLE Q i BASHSTSDLE, i "6 BUILDING INSPECTOR f c APPLICATION FOR'PERMIT TO • 1 TYPE OF CONSTRUCTION ... .. ............................. ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: LocationI!2 NG ' ,,;a x2 ,'c-................... .......................................................................................................... ProposedJUse fit ,, ...f,tI . ...¢-':p ......•. .l w `•............................................................................I......................... Zoning District .....................Fire District 1 va&4-e ............ .... ............ . Name of Owner -� ! /�fir� ...............Address /? �r 'r/ ... in iAl...... i ` \..... /!i„ IC{, /� / �k.A.'�?�' ../'�+� (r.-vCl Name of Builder Address .......... ....................................... ... .�.. .................. Nameof Architect ....................................................................Address ..........:......................................................................... Number of Rooms .. ................................................Foundation, .�....: r C'1u 511hl dV,(.� i 1/roo -pr Roofing s?3 5 t J'� ! ........ Exterior ...... •..........................: ,....................... ........:.......,.....,v....,.,...................................................... L, e'�uow� lo`vrf..� a..� �J /J<¢,°............Interior ....................................................................... Floors f.... ....,.... _ j Heatin C�.6: .. Plumbing :4 e�' n��;/f,-c g ! A............. .........I..................... , `, ......... ....................................................... Fireplace �v..�.�. ......................................................................Approximate Cost ..... ..... .............................. .............. Definitive Plan Approved by Planning Board ________________________________19________ . Area ..... !P'...J .. ...................... Diagram of Lot and Building with Dimensions Fee /7 SUBJECT TO APPROVAL OF BOARD OF HEALTH -77 • I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 1 �.Z- .. ........ ...................Name ....... ............... .. . Poloski, Richard -A A=2 00, 19053 one story No ................ Permit for ..... ...... single family dwelling ......................................................................... Location Mark Lane* ................................................................. Hyanni' ...................:........................................................... Richard A. Poloski Owner ................................................................... Type of Construct ...... frame .................................... 0................................ ............................................... Plot ...... Lot ................................ Ml\ach 31 Permit Granted Mach.........................19 77 t Date of Inspection ...........................19 Date Completed ......................................19 PERMIT REFUSED it .................. .............................................. 19 ......... . ................... . .......... ....... ..... ............. .......................... .. ... ............... ......... .... ............. .................................. ............................................. ..................................... ............... Approved ................................................. 19 . ............................................................................... .................................................................... .......... Assessor's map,and lot number 12.0... ..... ............. ........... f u,.�-� K SEPTIC SYSTEM MUST BE r, 77' INSTALLED IN COMPLIANCE SeWbge Permit .number ...............�Zl........................ ATE 0 r:: vt. WITH ARTICLE II 'STATE SANITARY CODE AND TOWN F OF 7H'E 1p TOWN OF RINE'o 9'rX In S• BJSBSTADLE; i 1` 9Ar RUILD.,IHG INSPECTOR i63 ' `e r APPLICATION FOR PERMIT TO :........ ........ ....... .......'".. r4 `7" .. .........................................Ao TYPE OF CONSTRUCTION ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a. permit according to the following information: Location ./o ..*4. H,4.e-li � ProposedUse( (( rt� � fz? .......1.�: f.......(. ..�fl.. ....................................................................................................... �� Fire District �/ N`� Zoning District .. . `.......................... .............. ..a..........f........................................................ I ID Name of Owner ... .,� ...A., .. . .....................Address ./.�...C. i?r9�.�1 r�Y ...�: �?/�l� .r�4'P✓......... Name of Builder .. .i:. , .....�::... .dl. ...............................Address J.?.....L k .....:. .. :....TY,'?lY.® �j . .......... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms .. �1Q' '................................................Foundation. ....................................................................... Exierior ( ?�Q -[.. kxG ° 1.........................................Roofing �3 ...Asl Floors ,�. ..f>.C°c/( ! d` yG,Ja. ..:.........interior .................................................................................... .� �f ....._�`.' .... ......... �'R. Heating .#..A.........��h!......................................................Plumbing .k-Ar ' ��?�............................................ .�G O Fireplace ...Q�`.1 .....................................................................Approximate Cost 4t................................................... ......... ,S 1� . Definitive Plan Approved by Planning Board ---------------_------------:__19________ . Area .......1...... ..................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH -27 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Namec ..... ................................................. ~�^~~~�° ~^�.�^~ A. . . � . ' � . ` -t dwelling ingle family . � . . ' Mark Lane � ^ Location ........................................... ` . . ^ m � ' ----'----^ !— is ` Richard A. Pmlweki Owner� ----~----------------' ' . - � . Typo of Construction ---f r.a.me...................... . . . } -----~--------------------.. � �� ' Plot Lot , � ---------. --- ------- ^ March 31 77 Permit Granted -lg � . ------'. -- ' | ' ' Dote of Inspection ......^ ... ...... R Dote Completed ..�.7��+y./�^�.--.—.]Q . . ' - . . - PERMIT REFUSED � ' . ^...---�..�..��--..----------, 19 ` . � �"..�. ^.�...�--..,.—.---------~------.. . . ^ ^ � ........................ -------.------.----. � . /~ `.. � —..^.—'...—.-------.--.----'----. ' !^ - .—~'—..—�--.------.--.--.^.---- , .` ��---------� —... lA . . � -------------.--�—.��..' .................... , � ----------------------'^'^^^— | � - � �, Tr r A ;� ,{d`.x'<,p ,rf�.r ... y 'tt;;'_.,. �.k•}zl 'r{.. i .* i x - - e.;�'. t�.��,a�k''"z a'r,; i�Y - ''r+F e { rie'i . ,^'r•i _ s. �;*,siti t w #x 4 4 tf {ryy l 6 s 41 / t • 1 y s s t a' s NO ro 00 rl ql- 26 i . I ^�, g Pr � ♦ 38 ( L 14 t f J ,A ° CERTIFIED PLOT PLANOF A E e� ROBERT ALO7" PION 13K, 267 lam. NEW CONSTRUCTION ONLY IN 7. P TOP OF FOUNDATION IS 10•(O FEE #Uh 40 ABOVE LOW POINT OF ADJACENT ��'Q, a�o� SAgh$��AAL9a ASS t �p0 �'y . ROAD. su ' SCALE:/ =.3U DATE = 3 ?-6 776 ELDREDGE ENGINEERING CO.INC) I CERTIFY THAT THE �dvt��gnoa CLIENT 6Lo5 SHOWN ON THIS PLAN IS LOCATED EGISTERED REGISTERED JOB N ao P 0-. ON THE GROUND AS INDICATED ANA., { _ CIVIL I LAND ENGINEER SURVEYOR DR. BY; ` �. �' CONFORMS TO THE ZONING LAtaS {, , OF BARNSTABL , MASS. t 7 ' 33 NO. MAIN ST 712 MAIN CH ST. BY= = , ?6 YARMOUTH MASS. H-YANNIS MASS. {, 1 SHEET; rOF' DATE REG. LAND SURVEYOI % 1 + ,'. 1-7 s; � .,. ;:..,. ..a_�..ter, r.,.... •• ,.. .. ^4',Kt«,: ....,.vk: ..... .:.�.... e_.� ia"'Y`."Dr"T A�x'a. .C"!'°`x' P rC."`. 'K"1': '""�1t75;.. ,C-. 'a-.: ,.'�•. ._. ti-F..,. Y. �:.,... ._ �-.:.,,... ,. as7'r ..u..,.:..:.w .x. ";,?'. '?�' z. R . f-;t,�',a �'�`�-_'k'°� it ,; F. e'1'�.' :t.:- �:.;x C r� ,. ;:"" _. 20 FT. MIN. 10 FT MIN. 4" PVC PIPE 1 CLEAN SAND�--- -- ! ! CONCRETE MIN PITCH - 7 ! 4 r -COVERS -� It811 PER F ! F r r-CONCRETE. ` ( 1 f 'Y t COVER 1 A ! •' O1• /� II to /i LIQUID LEVEL-7 i to 41' CAST-3 jri%r;j ` ;�9'T/ _'_ 2" LAYER j •MIN PIPE • OF 1/811- 3/8" WASHED STONE `) PITCH- SEPTIC TANK I/4 PER F DIST. ° , { 1j t ♦� • • • . 1 ° ° a > BOX 1 • • EFFECTIVE' ' - - 3/411- 1 1/211 } ° ° •� DEPTH • • ' I WASHED STONE - --- -. ° — PRECAST SEEPAGE ' ° 1 . •I • . . . . . ' PIT OR EQUI.V. -,INVERT ELEVATIONS �� 6 FT. DIA. LL INVERT AT BUILDING _q7. FT. 10 FT. OIA. C (SEE TABULATION) INLET SEPTIC TANK 9/-8 FT. CUTLET SEPTIC " TANK G.1c FT. GROUND WATER - TABLE SECTION OF ' INLET DISTRIBUTION BOX Q& yFT `'SEWAGE DISPOSAL SYSTEM T DISTRIBUTION BOX 9�2FT. NLEc. SCALE I/4 / ' o TABULATION" NLtT SEEPAGE PIT _�. FT. DESIGN CRITERIA DIMENSION A _;3_FT DIMENSION B FT. NUMBER OF BEDROOMS DIMENSION C FT GARBAGE DISPOSAL UNIT TOTAL ESTIMATED FLOW 0_00 GAL./DAY -' SOIL LOG `SOIL. TEST NUMBER OF SEEPAGE PITS �L ELEVATION _ DATE OF SOLL TEST SIDE LEACHING PER PIT L3B.SSQ. FT. ' � RESULTS WITNESSED BY . BOTTOM LEACHING PER PIT 99.SQ. FT. I_ z 4-OAM �,505501L. PERCOLATION RATE MIN/INCH GH TOTAL LEACHING AREA �?9Q7 SQ. FT RESERVE LEACHING AREA SQ. FT H QF&4�' f s a ucE PHILIP 9�� I 8'., CASE LQT P[.H G- gELbREbGE t �, o WfINSERG �; S {! L. ,fi No. 366 II A 6A 9 ELDREDGE ENGINEERING C � 33 NO. MAIN.ST 712 MAIN ST. SO: YARMOUTH MASS HYANNIS. MASS. JQ8 NO, OF . .. - ., ;