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Home My WebLink About0090 MURPHY ROAD Cto r 1-1 ¢INSTABLE !(} C APE COD INSULATIONlj}; a " FIBERGLASS SEAMLESS SPRATFOAM SUSPENDED BATTS GUTTERS INSULATION CENINOS 1-800-696-6611 Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 2/ Date: Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed& completed the insulation and weatherization work at the property4isted 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 (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village J'e'A tN W e NNA�ex (ki. Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) ( ) ( ) ( ) ( ) Slopes Floors I Walls ( ) ( ) ( ) ( ) ( ) Sincerely - *Codl , resident n, Inc. T TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 4 Map Q ` Parcel l ,5w Application # 611113 �b Health Division Date Issued 77 < Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board / Historic - OKH _ Preservation/Hyannis Project Street Address ,)f nywi Village L+`/A0V-VS Owner YY ) eaAn2 e Address CIO_VVI �p9VX45 InA- Ur Telephone 507 - 7 .<< 3 Permit Request _ yJ AAA R-6 P-%6TS1ftJ COA ►N-3 6AY-4 66,1 . 10 SW I 2 rs6lk P& vet kiP /4-�T.sz,l A We br:N -f a I0,u t x+tr�cr c,-4llS -_�i ccl/ylar Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 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 tri 73 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 (sSffl rvT C5� Number of Baths: Full: existing new Half: existing new ZE rw.r mt Number of Bedrooms: existing -new Total Room Count (not including baths): existing new First Floor Room Count Feat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other . Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/goal stogy: ❑£, s ❑ No )etached 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) He N r, GAS P - Name Ce cQcQ T�., v��--�-:d� Telephone Number Sow-?'75-1 2� Address 1/57S Y-tl rl sAk A-d-• License # l D o 7 �� / i�,�wr3 �n�• 02 C-a Home Improvement Contractor# 153 S"6 7 Worker's Compensation # c u!r=�6 Ops o2Sy o 2 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE :2 -"/�- FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED e MAP/PARCEL NO. ,F • 1 ADDRESS VILLAGE f OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION r FIREPLACE r } ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL - FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. E' - ti The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street t Boston, MA 02111 ' y www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electi-icians/Plumbers _Applicant Information Please Print Legibly Name (Business/Organization/lndividual): &P �L MSkI C Of Lrn- L Address: ►� Al City/State/Zip: CC Phone #: �� -7 7 S_ Are you an employer?-Check th appropriate box: Type of project(required): 1. I am a employer with 4. ❑ 1 am a general contractor and I ❑ * have hired the sub-contractors., 6. New construction , eiriployees(fii11 and/or part-time . - ❑ -- -- - .` ._ 2.❑ I am a sole proprietor-or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for mein 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 1.❑ 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 q ] employees. [No workers' 13.❑ Other(,L,��.� �4A t,t� comp. insurance required.] *Any applicant that checks box#) must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they arc doing all work and(hen 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 numb=r. f am an employer(hat is providing workers' compensation insurance for my employees. Below is the policy and jab site information- Insurance Company Name: ` �T(c� c. c^ el C e 0 . Policy# or Self-ins. Lic.#: �(� OCR rZr� O Exoiration Date: Job Site Address: V City/State/Zip: � � Attach a cop),of the workers' co ensation policy declaration page (showing the policy nummber 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. Ldo hereby certify tit e pa' and penalties of perjury that the information provided above is trice and correct. Signature: l Date: Phone#: o Official use only. Do not write in this area., to be completed by city or town officiaL City or Town: PermiULicense# Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk4. Electrical Inspector S. Plumbing Inspector 6. Other Contact Person: Phone#: i � r 10 Park Plaza- Su1t e 5170 Boston,Massachusetts 0211.6 Home Improvement C 'ractor Registration Req. istration: 153567 Type: Private Corporation Expiration: 12/15l2012 Tr# 206433 CAPE COD INSULATION, INC HENRY CASSIDY - 455 YARMOUTH RD. _._._... _.___.-..._. HYANNIS, MA 0260.1 Update Address and return card.Mark reason for change. Address (J Renewal f_•� Employment (--] Lost Card i >CAI a 5OM-"04-uio1216 License or registration valid for irdividul use only office olwmer Affairs us•ne Regul Lion before the expiration date. if-found return to: HOMR Type: office of consumer Affairs and Business Regulation Registration: 153567 10 Park Plaza-Suite 5170 Expiration: 12/15/2012 Private Corporation Boston,MA 02116 OD INSUTAT1,Ot ; HENRY CASSIDY:;:':::,`".`r:.• 455 YARMOUTH RD'°"':',;: :``' Malidith tore — —_ HYANNIS,MA 0260 `'`' ; ;: :::` Undersecretary 47 Massachusetts Departmcnt ot•Puhlic �ufch Bcurt! u(Buildinu, Re�-ulations and Standards Construction Supervisor License License: CS 100988 Restricted to: 00 HENRY CASSIDY r�• �. "� ED ROW WEST YARMOUTH, MA 02673 Expiration: 1 ill 1/2011 - 4,niiui.,i ner Tr#: 100988 a • TV' _a U g a _� ��_..brr A� JE C:14-I�_?Ef L ��l )' Ee iel.{1�l11_ . C J��-t �:.�.G A s ! 1� i 0-1 s.�� stilts HOME OWNER WEATHERIZATION WORK PERMIT& FUEL RELEASE: PLEASE FILL OUT ANDSIGN THIS FORM IF YOU ARE THE APPLICANT HOME OWNER. EA-' hereby consent to and agree that weatherization work may be donee Weather�on Program of Housing Assistance Corporation ( herein after referred as "Agency") on the property located at j 27 -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.In consideration of the weatherization work to be done at my home I agree to the following: I. 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 this agreement as listed and free l give my consent. Home Owner: (Signature) Date: Agent: (signature) = . Date: .; 6 ..�. - nn 11 HAC approved Weatherization Company Caliber Building&Remodeling Cape Cod Cape Save Creswell Construction Frontier Energy Solutions Lohr&Sons Peter Smith Resolution Energy Rock Solid Construction All Cape Insulation Date: 7/1/2011 Time: 11:28 AM To: 9,15087785735 Rogers & Gray iris. rage: uua Client#:4597 CCINSUL ACORD,. CERTIFICATE 4F LIABILITY INSURANCE ATE(N6WDD/YYYY)D7/01 DD 011 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 PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:Ifthe certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WANED,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 NAMECT Margaret Young Rogers&Gray Ins.-So.Dennis PHONE 508-760-4602 FAX 508-258-2102 AIC No Ext: AID,No 434 Route 134 our ma ro ers ra com L-MAILADDRESS: Y 9 @ 9 9 Y• P.0.Box 1601 CUSTOMER ID q: South Dennis,MA 02660-1601 INSURER(S)AFFORDING COVERAGE NAIC# INSURED _ INSURER A:Peerless I-nsurance 18333 Cape Cod Insulation Inc INSURERS:Ohio Casualty Insurance Company 455 Yarmouth Road INSURER CAtlantic Charter Insurance Hyannis,MA 02601 INSURERD:Commerce Insurance Company 34754 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 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 OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMBS L NSR POLICY NUMBER MM/DDIYYYY M WDDIYYYY A GENERAL LIABILITY CBP8263063 04/01/2011 04101/2012 EACH OCCURRENCE $1 00O 000 X COMMERCIAL GENERAL LIABILITY - - PREMISES Ea occurrence $100,000 CLAIMS-MADE F51OCCUR _ MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMPIOP AGG $2,000,000 POLICY 71PRO- LOC $ D AUTOMOBILE LIABILITY 11MMBCKVMK 04/01/2011 04/01/2012 COMBINEDSINGLELIMIT $ (Ea accident) 11,000,000 ANY AUTO - BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ X SCHEDULEDAUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Per accident) X NON-OWNED AUTOS $ $ B UMBRELLA LIAB X OCCUR 0001254514645 04/01/2011 04/011/20112 EACH OCCURRENCE $1000000 EXCESS LIAR CLAIMS-MADE AGGREGATE $1 000,000 DEDUCTIBLE $ X RETENTION 10000 $ C WORKERS COMPENSATION WCA00525902 6/30/2011 06130/2012 X I WC STATU- OTH• _AND EMPLOYERS'LIABILITY, YIN O Y R ANY PROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT $500,000 OFFICERIMEMBER EXCLUDED? FN] WA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE s500,000 I"- describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT s500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space is required) Workers Comp Information Included Officers or Proprietors (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION 10 Days for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. - - '- AUTHORIZED REPRESENTATIVE - 01988-2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009109) 1 of 2 The ACORD name and logo are registered marks of ACORD #S68575/M68179 MEY yo�zNEt,�� TOWN OF BARNSTABLE i EARISTABLE i o aYa�e� BUILDING INSPECTOR 4 . � o APPLICATION FOR PERMIT .TO .................�................ `irlMlL�L:.... �!I'tl ......:I........!�fr.. �. S •A!lr�e ................. TYPE OF CONSTRUCTION ...................................................................... ...................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora permit according to the following information: ' Location ....... �............Af�s. *.... !.r......... ............... .�/!�/.. ..5.....:.. ... , ,/.................................. e','•r.►•�•• Proposed Use ...... ...s el--7 :......... /!S� �1...........6&tl .�►L-!!Ct,(t'. .... ZoningDistrict ........................................................................Fire District ..................................................................................... Name of Owner ......L Fl.TEt........A&45Oi{/. .Address ..`?.7......................! (/ ....SL......... Name of BuildQr /L�:.... ....................... Address ./1. `.. ....7.1.P.... '. � A«'.., ' Name of Architect .............Address ............ . .� �' rla2SA Number of Rooms .......................!�........................................ foundation ..��':.............................................. ... .......... T rd.e . //! ..Roofing ........... S/�/y1'L ............. ....... Exterior ..... . QJJ.... . .......................:...................:............. ........... .............:.....: .... Yv1•GV ro Floors ...... ... ....................... ..........................._....................Interior ........ �J�(//JL I. Heating .... !C'k4tTR&A.-I................... ........................Plumbing ... lr.G!'-.......... ..................:.....:.......... Fireplace .....Q /LAC............................................................Approximate Cost ....... .f?�e ®......................................... Definitive Plan Approved by Planning Board --------------------------------19 Diagram of Lot and Building with Dimensions �(/ , frC," / /` d-. p SEPTIC SYSTEM MUST BE jQ�- SUBJECT TO APPROVAL OF BOARD OF HEALTH INSTALLED IN COMPLIANCE, WITH ARTICLE II STATE SANITARY CODE AND TOWN REGULATIONS. 40 A0 . T • • . . Y / 'Sow. � f R a RP rtLt s W Ar I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... ... ........................... Nelson, Lester 16o � pra* No ..�^"°~"�— Permit f_ ------. —.. ' � . ��9�� oz�4y dwelling .�� Location ` '. ----.---=Annis --------.--------. ] . Owner Lester _________. . Typo of Construction ----..�ram�—.---.. - ..................... ' ' ' Plot ............................ Lot ................................ | - � � �� Permit Gnznte6' ^�� 1p ^~ { { ~ ---..---------. Dote of |n --....,--------.lP uo'e Coxp/el�eu r 1010 ~ ^-----_.�. �---.,.-------.. lV /--------------------------. --'--'—_.~----------------'— � —.-------.---. ......................................... . —.------------------------.. . \ \ / ` Approved ................................................. lV � | ' . . -------.------------------- . ' , ------------------------^^— \ . �