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HomeMy WebLinkAbout0006 SECURITY STREET I� �ecu.n� �-t . �_ / —�� Tow_ n of Barnstable Lil11I1 . .. g Post This Card So That it is Visible From the Street-Approved Plans Must be'Retained on Job and this Card.Must be Kept 9ARN5'TAKAM 91 E s63q. Posted Until Final Inspection Has Been Made. Permit �t Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-20-1445 Applicant Name: James Curley Approvals Date Issued: 06/08/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 12/08/2020 Foundation: Location: 6 SECURITY STREET,HYANNIS Map/Lot 268-140 Zoning District: RB Sheathing: Owner on Record: GREENBERG,JEFFREY B&JOANNE 4 Contractor,Name�'`-�James Curley Framing: 1 Address: 238 HIGH STREET Contractor License: 114310 2 RANDOLPH, MA 02368 _ "^rt Est. Project Cost: .$6,000.00 Chimney: Description: Strip and re-roof approximately 18 square of asphalt roof shingles Permit Fee: $35.00 l Insulation: Project Review Req: Fee Paid: $35.00 Date- / 6/8/2020 Final: •'tl F r' Plumbing/Gas Rough Plumbing: \,,Building Official p Y Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized b this permit is commenced within'six months afterissuance. All work authorized by this permit shall conform to the approved application and theapproved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for,public inspection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: fir- Service: 1.Foundation or Footing •' 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection _ Final: 5.Prior to Covering Structural Members(Frame Inspection) tow Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (asset forth in MGL c.142A). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 0W+.j;e)f Final: • ��y'c._ 5�pry Town of Barnstable �. � g e .' Post ThisMCard So,That�tt is_Visible Frorn�ahe�Street,,.ApprovedPlans;,Must be�Retamed on�Job and,thisg,�,Card Mus-be Ke`t a r 1aM�oc+R,� �W.P�o.h�s:�teer��d.��Un__t<.ll<Fin�.;a:l°I�n,s.pection Haa.�s:�B een Mv:a..d�e.�� ��,�R��.. ;s�»,. c..< •:.�.�,, ,o,�t eO� �i e�d until a F,y:ma�[�Ins�` e�c�t�on�has,b een m ade� , Permit ea C ild11 all"N ccu , . .�:, .. ,_.. p. �a ...� �. a .�..�c wp...._�. ���• a .n;�.:..:.>. w Permit No. B-18-1291 Applicant Name: GREENBERG,JEFFREY B&JOANNE MANCUSO Approvals Date Issued: 05/30/2018 Current Use: Structure Permit Type: Building-Deck Expiration Date: 11/30/2018 Foundation: Location: 6 SECURITY STREET, HYANNIS Map/Lot 268-140 Zoning District: RB Sheathing: 9 ' 1 , 2 Owner on Record: GREENBERG,JEFFREY B&JOANNE �: Contractor Name Framing: 1 �� Address: 238 HIGH STREET trac�tor'License 2 RANDOLPH, MA 02368 x Est ProJect Cost: $4,500.00 Chimney: Description: Adding to the back of my house a Deck 14'wide by�icl6'long. Perm►tFee: $ 110.00 Insulation: 'Fee Oaid,' $ 110.00 Reviewers note:deck not attached to house but s at second means s Date 5/30/2018 Final: of egress. g s /Gas Project Review Req: ",00 ;. mil` Plumbing/Gas g Rough Plumbing: .. . ., Building Official Final Plumbing: This permit shalt be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months of e't issuance. Rough Gas: All work authorized by this permit shall conform to the approved applicationiand theapproved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structur sha 111. bye in compliance with the local zo ng by laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or:road and shall be maintained open for,.pwbhc mspectio,n for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signetu esyb the�Bwld�ing�anrJ•Fire®fficI'I are providea", this permit. Service: F Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing y �x Rough: 2.Sheathing Inspection �,_ 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons cting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: _All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Applic4oa Numb . . .R ®. . ....... . O{ ee ..�...�p F Permit Fee.. ....... Ep M� Total Fee Paid......... .�/® ......... ........ ... ... • Approval b ...OIL..... . ... ............ TOWN OF BARNSTABLE Py.... ... ..... .... ......... BUILDING PER �j� Msp .......... 'K. .. ..Parcel...... .. APPLICATION Section 1—Owner's Information and Project Location SXL I Village project Address �+ 1 owners Name 6�� 6 W owners Legal Address Stated Zip City Owners Cell Section 2—Use of Structure [] Commercial Structure over 35,000 cubic feet Use GrowP : ❑ Commercial Structure under 3`S�E000 cubic'_f'eetCJ ❑ Single/Two Family Dwelling` C) Sectio 3 --Type of Permit New Construction ❑ M e/Relocate ❑ Accessory Structure [] re e ofw e ❑ lamo ` finish Basement ❑ Family/Amnesty ❑ ❑ Demo/(entire structure) ❑ Apartment ❑ Sprinkler System Rebuild � Deck p ❑ Addition ❑ Retaining wall [] Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify Section 4-Work Description T-wdundited!VW2018 Application Number......... ............. ....................:.. Section 5-Detail Cost of Proposed:Construction y).SOO • co Square Footage of Projec. A e of Structure` g � `�` ' ' ``� Dig Safe Number. #Of Bedrooms Existing �2 Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design i i Section 6.—Project Specifics I [] Wiring 0 Oil Tank Storage �' ❑;Smoke Detectors ❑ Plumbing ❑ Gas - ❑ Fire Suppression J❑ !Heating System El Chimney ❑Add/relocate bedroom 1 Water Supply 0 Public ❑ Private Sewage Disposal ❑ Municipal J] On Site Historic District ❑ Hyannis.Historic District ❑ Old Kings Highway , Debris Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adj acent to a wetland, coastal.bank? Yes ❑ No ❑ Section 8—Zonisg Information Zonis District Proposed Use Lot Area g P Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes_ 0 No Last undated_2/9/2o18 i 710 MAIN STREET N.Oxford, MA 01537 LOCATION 6 SECURITY STREET PHONE: (508) 987-0025 HYANNIS, MA � FAX: (508) 234-7723 SCALE 1"=30' DATE 8/31/2016 REGISTRY BARNSTABLE EASED UPON OOCLWWATION PROVIDED,REOUIRED UEASUREMENIS WERE CERTIFY TO:ROCKLAND TRUST COMPANY MADE OF THE FRONTAGE AND BUILDING(S)SHOWN ON THIS MDRTGAGE- OF �R INSPECTION PLAN. IN OUR JUDGEMENT ALL VISIBLE EASEMENTS ARE �t� `�1q DEED REFERENCE 26635/163 MOWN A14D THERE Alm NO VIOLATIONS OF ZONING RE'OUIREMMIS FEGARDING OWE"G STRUCTURES TO PROPERTY LINE OFiSEI (UNLESS GEORCE '{n OTHERYIISE NOTED IN DRAWING BELOW)_ NOTE:NOT DEFINED ARE ABOVE q EDWARO- PLAN REFERENCE 197/123 C40M POOLS.DRIVEWAYS. OR SHEDS WITH NO FOUNDATIONS, ETC. SMITH QI THIS IS A MORTGAGE INSPECTION PLAN: NOT AN INSTRUMENT SURVEY. NO. 38 8 WE CMIY THAT THE 869.LHNG(S)ARE NOT'*MaR IA`S>".C65L CO Na USE TO ERECT FENCES,OTHER BOUNDARY STRUCTURES. OR TO ROOD HAZARD AREt SEE HILL ERtNEx OMwJANNCEE WITHH LOCAL ZONI`G FO(R)MOPERTYH LONE OFFiSET 25001CO568J mp-, 07/16/2014 FEWIREMEMS, OR IS EXEMPT FROM VIOLATION ENFORCEMENT ACTION FLOOD tiA2A/81 ZONE ILLS SUN D3ElaJR1ED BY SCddE ANO IS NOTED.T.WDER MASS.Gl.11RE Va.CHAP.4ak SEC. 7,UNLESS OTHERWISE NOT . THIS CERTIFICATION IS NON—TRANSFERABLE.THE A80VE NOT NE'OESSWILY ACCURATE UNDL DEHNRT�£PLANS ARE ISSUED CERTIFICATIONS ARE MADE WITH THE PROVISION THAT THE INFORMATION BY RD ANO/OR A VERTICAL CONTROL SURVEY 15 FAO, PROVIDED IS ACCURATE AND THAT THE MEASUREMOM USED ARE PRMISE ELEVATIDN5 CANNOT BE DEitMMED. WXMTELY LOCATED IN RELATION TO THE PROPERTY LINES. HOMEPORT DRIVE ff N. - T 20 cn 6 0 SF+ n m 00 1 > t ( O' 15' 30' 45' 60, 90' SCALE: 1--30' _ r;l �l € � e, �. 74 -17 M .....a.-�--�• i � ._.• x's I The Commonwealth of Massachusetts Department of IndustrialAccidents �. Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Je6c""X�y (ff Address: City/State/Zip: OzYit aff IP4 02L0/ Phone#: Are.you an employer?Check the appropriate box: Type of project(required): 1.❑ 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. ❑New construction 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 workin r me in an capacity employees and have workers' Building addition 9. g y p �'• t ❑ [No ers'comp.instance comp.insurance. 10. Electrical repairs or additions r e] 5. ❑ We are a corporation and its ❑ P 3. am a homeowner doing all work officers have exercised their 11.❑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 comp,ffisurance required.] *Any applicant that checks box#1 must also fill out the section below sbowing 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 attacbed 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: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: 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 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 u der the pains and penalties of p ry that the information provided above is true and correct. Sianafore: Date: Phone#: I�Tl 0- do -36P Official use 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 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152.requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person id the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate.a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage'required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to cant'workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of irmwm_ce coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i,e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The commonwealth of Massachusetts Department of Industrial Accidents Office of Investagaflow 600 Washington greet Boston,MA 02111 Tel.#617-727-4M ext 406 or 1-877-MASSAFE Fax#617-727-7744 Revised 4-24-07 w,mass.gov1d a. _._ , TOWN OF: ARNSTA LE 4 NO 18 PR gm t _. r t { ry a - r I r f _ 9 �i t Y , ., C. _ a } � 3 p 7 •; ` TOWN OF BARNSTABLE LOCATION 5 C G �rT� S SEWAGEV# ? _ VILLAGE` / ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. /�6 b i�-d Q i' ? 7 �—?? C SEPTIC TANK CAPACITY LEACHING FACILITY: (type) dZ' (size)�i �f' L NO.OF BEDROOMS_.,_ BUILDER OR OWNER PERMITDATE: mil' - 2 &7 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist'; on site or within 200 feet of leaching facility) Feet Edge of Weiland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by . :. 01 A to a rn b J \ rA ?l r C( NEW ENGLAND LAND SURVEY!" MORTGAGE} INSPECTION PLArN`:'. ~� Professional Land. Surveyors ' NAME:JEFFREY B.'. GREENBERG &. JOANNS M, GR--ENBFRG _ro 710 MAIN STREET � 1 N.Oxford, MA. 01537 LOCATION 6• SECURITY STREET, v ( a PRONE: (508,) 987—Q025. t HYAIvN1S,: MA - FAX. (508) 234-7723 SCALE 1 `=30 .. :DATE': 8/31/2016 REGISTRY BARNSTABLE ` DASk'D UPON DOCUMENTATION PRONDED, REQUIRED MEASUREMENTS WERE CERTIFY TOi"ROCKLNID TRUST COAlFANY MADE OF THE FRONTAGE AND BUILDNG(S)"SHOWN ON THIS MORTGAGE t�":aF INSPECTION PLAN,IN OUR JUDGEMENT ALL VISIBLE EASEMENTS.ARE e DEEO REFERENCE, 26635 f 1 F>3 SHOWN AND THERE ARE NO VIOLATIONS OF ZONING REQUIREMENTS I FEGAMNO DWELLING STRUCTURES TO PROPERTY UNE OFFSETS (INLESS GEORGE OTHERWISE NOTED IN DRAIAING BELOW). NOTE: NOT DEFINED ARE ABOVE EDWARD. PLAN REFERENCE.197.�123 GROUND POOLS.DRIVEWAYS.OR SHEDS WITH NO FOUNDATIONS.ETC.. t-' SMITH 111 v' THIS IS A MORTGAGE INSPECTION PLAN: NOT AN NSTRUMENT.SURVEY... NO. 38 B VE.CERTIY THAT THE BU401N66)ARE:W r WPM THE SPECIAL CO NOT USETO ERECT FENCES, OTmM BOUNDARY STRUCTURES: OR TO 1 FLOOD HAZaft AREA SEE FIRM. . EITHIER EHHS R OWINH °NOFIN COMPLIANCE ONIGFORDPEY HEREON IS � �p 25001 C0568J4 Dm: -07 16, 2014 FEOUIRENENTS, OR IS E)tkTdPT FROM MLATIDN ENFORCEMENT:ACTION LVUOER MASS, G.L. TITLE VR.:CHAP, 40A, SEC.7. UNLESS OTHERWISE FLOOD NAIAN ZONE HAS KW DEMMINI D BY SCALE AND IS 7. NOTED, THIS CERTIFICATION`! IS NON—TTRANSSFERABLE. THE ABOVE` . : NOT,NECESSARILY ACCURATE UNIU DEPIN PLANS ARE ISSUED CERTUTCATKUNS ARE MADE WITH THE PROVISION THAT THE INFORMATION BY HUD ANO/OR A VERTOL CONTROL SW t IS PFRF0RME0. FROVIOED ACCURATE AND THAT THE MEASUREMENTS USED ARE + PRECISE ETEYATNINS CANNOT.BE DOOM ACCURATELY.LOCATED IN REIATim TO THE,PROPERTY LINES A f _ r HOMFPORT ORIUE i r_5 Q 77 p r „ r LO1 20` rrn' 6 8,�480 Sff 77-1 ''n1 ' 100.U0 , r S I r REQUESTED BY, GILL OEVhYE.IP C �, DRAWN BY: DLM CHECKEO 8Y. GES FA f:.I BM1P10720 > ' SCALE:".1' JO' f Venil Construction LLC 40 Manomet Point Road Plymouth, MA 02360 339-832-4891 CONTRACT Contract Submitted To: Jeffrey Greenberg Address: 6 Security Street Phone# 781-630-2030 Job Location, Hyannis Date: 4-21-18 Job Summary: Build Deck 14'long by 16'wide with 2x10 framing construction We hereby submit specifications and estimates for: • Build a deck 14' by 16' attached to the left side of the house • Install cross brace support 16'. Located 3/4 of the way under the deck with three 12" around by..4' deep footings • On the side of the house there is a gas meter. I will build railings O'x36" square to protect the gas meter with a gate for access , • Build custom PT wood railings. 2 sections of railings will be 7' b-- ' 6" and 3 sections of railings will.be 6' by 36 � J • Build 5'wide by 12".steps from,the deck to the driveway • Build 5' wide by 12" steps from the deck to the side yard going to he shows r • Deck floor 1x6 Brazilian walnut veranda traditional flooring w a • Materials, a erials, labor and trash disposal is includedr-- P _ rn • Customer is responsible for pulling all permits r a3� � y . InitialsG' Initial Application Number.......... Section 9-.Construction.Supervisor Name Telephone Number Address. City State ZiT) License Number License Type - Expiration Date Contractors Email Cell# —1 understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Bamstable.Attach a copy of your license, Signature Date Section.10 -Home,Improvement Contractor Name Telephone Number Address City State Zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your HIC... Signature _ Date Section 11 -Home Owners License Exemption ! Home Owners Name: G Telephone Number C30 -do 36; Cell or Work Number t I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I umdeisiand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnple. Signature Date �4 APPLICANT SIGNATURE LSignature Date Print Name_ -1Effj 6Y ig rQdl geltC Telephone Number 7fl C30 - o?03o t E-mail permit to: 06 L 4lvd/4 Grp e©zY Section 12—Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site plan Review(if required) ❑ Fire Department Conservation ❑ For commercial work,please take your plans directly to the fire deparnt for approval. Section 13—Owner's Authorization as Owner of the property hereby. to act on my behalf in all authorize matters relative to work authorized by this building permit application for: 1 (Address of job) date Signature of Owner Print Name 11 i Last wdatr,&2/92019 _ I CAPE COD INSULATION PIRlR-SS SEAMEESS SP-FOAM SUSPENDED SAM OU"" INSUEA.. CEILINGS 1-800-696-6611 Town of Barnstable Regulatory Services o Building Division w E 200 Main St Hyannis, MA 02601 r "' 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 (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village t .F Al I-� Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) (K ) Slopes ( ) ( } ( ) ( ) ( ) Floors 17« .ra�nsfs ( �C�) ( ) ( ►� ) ( ) (x ) Walls ( ) ( ) ( ) ( ) ( ) AV Sincerely , PyE y Jr,.President ulation, Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map v Parcel— I l CD plication # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee 3 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address cJ t Village, AWVU,5 Owner Ct WL Address �k.Z Telephone - Permit Request ` 14�0_4- vZM-GVG. - &UP-7 54(di b tyaftyv NOW 0 � Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new ..Zoning District Flood Plain r/1 Groundwater Overlay Project Valuation 60• Construction Type V r Lot Size Grandfathered: ❑Yes ❑ No If yes, attach sum rting dc�wmentption. Dwelling Type: Single Family ul 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 0 Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft: F Number of Baths: Full: existing new Half: existing nOX r-- Number of Bedrooms: existing _new Total Room Count (not including bath;): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ 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 AA thorization ❑ Appeal # Recorded ❑ Commercial ❑Yes Q No .If yes, site plan review# Current Use_ - —-- --Proposed Use - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address License # Home Improvement Contractor# Worker's Compensation # GU('1400 ALL CONSTRUCTION DEBRIS RESULTING FROM,THIS PROJECT WILL BE TAKEN TO aa.. aftifi A�A SIGNATURE DATE i FOR OFFICIAL USE ONLY 3 r APPLICATION# t DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE a OWNER t' ' r t DATE OF INSPECTION: ,-FOUNDATION k FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: 5 ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Y f P -_.. !Massachusetts- Department of Public Safety Board of Builtling Regulations and Standards i Construlction Supervisor License License CS 100988 HENRY CASSIDY 8 SHED ROW WES,T,IJARMOUTH, MA 02673 Expiration: 11/11/2013 Commissioner Tr#: 7620 C�1 a i Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 ��- '..Boston Massachusetts0 2116 _ - Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: .12/15/2'b14 Tr# 233831 CAPE COD INSULATION, INC HENRY CASSIDY 18 R EA R D O N CIRCLE SO. YARMOUTH, MA 02664 Update Address and return card. Mark reason for change. SCA t Ei 20M-05;17 Address ❑ Renewal n Employment (_� Lost Card .. � (%1!' 61"l7fwel(l lCK:fY(CfG-n �'l(C7JJCFfILCCJN * _ 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: egistration: 153567 Type: Office of Consumer Affairs and Business Regulation xpiration: 12/1512014 - Private Corporation 10 Park Plaza-,Suite 5170 - �qk�' r--ill� • Boston,MA 02116 - - CAPE COD INSULATION ZINC t HENRY CASSIDY 18 REARDON CIRCLE SO.YARMOUTH, MA 02664_ LJndersecretary Atvwitho t natZre v ,. The Commonwealth of'Massachusetts Print Form �a Department oflndustrial Accidents - Office of'Investigations >.� • - Fi 1 Congress Street, Suite 100 : .,y Boston, MA 021.14-2017 www.l'nass.govIdla Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A p >,licant Information Please .Print Legibly Name (l3iisincss/(_)rganizati01l/Individual): ( + Q yciclresti:--- __ � �Gf 0t�- �11�C�1 V V�& Phone #: IZ ^-------- `re_you an employer? Check t e appropriate box: --- ------------- -- Type of project(required): I.�p - I wu a employer with 00 _ 4• ❑ I am a general contractor and 1 =ntployecs (full artdlor part-lime). have hired the sub-contractors 6. ❑ New construction�.IA I :im a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling >hip and have no employees These sub-contractors have g. ❑ Demolition working for rr:e in any capacity. employees and have workers' No i workers' comp. insurance comp. insurance. $ 9. ❑ Building addition i reg Lit ired. 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions ❑ I am a homeowner doing all work officers have exercised their ME] Plumbing repairs or additions nlyscl h. I No workers' comp. right of exemption per MGL 12 ❑ Roof rMpai insurance required.] t c. 152, §1(4), turd we have no employees. [No workers' 13. Other `tt�{/��iho comp. insurance required.] 1ny al)plic<mt that checks box III must also Fill out the section below showing;theirworkers'compensation policy information. I Ir,nirOMICIS who submit this affidavit indicating they are doing all wok and then hire outside contractors must submit a new affidavit indicating such. ,6111tractors than check this box must attached an additional sheet showing the name of the sub-conu•aclors and state whether or not those entities have employees. Il the sub-contractors have employees,they must provide their workers'comp.policy number. i nn till employer dial is providing workers'compensation insurance for my employees. Below is the policy and job site In fUPtlltltloll. 1w;t1rartccCompany Name:_ I'ulicy yl or ticll=ins. I_.,ic. :_WGA QQ ��j Q� Expiration Date: (�' / Joh Silc address:_ l " City/State/Zip:_ Attach a copy of the workers' comp ion policy declaration page(showing the policy nuwn er and expiration date). Failure to secure coverage as required tender Section 25A of MGL c. 152 can lead to the irnposition.of criminal penalties ol'a tine 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 line uftlp to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations ol'the DIA for insurance coverage verification. l do hereby c•erti�y rifler the pains Lpd enalties of per that the information provided above is true and correct. i Si��,nalure_� Dale: Qjficial use only. Do not write in this area, to be completed by city or town official Cdy ur'l'own: _ Permit/License# Isstl41ig Authority (circle one): 1. 13oard of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 0. Other (:'ol tact Person.: Phone#: -� '� Cllentlt: 45U7 G�R CCINSLlL. __ CERTIFICATE OF J LBILITY IN$URA CE I.IA I C IRlhllll llrt'1.11j ttl IhICA 11=. 1:,IS:;uk:L7 AS A mq I1"EIV OF INFQIUMA"IION lNLi'AND CONFERS NO 12012 RlGWTB U('ON T11G GEP.TIhIGATE HVI`DER,)iTlis CL=hTIFIc:ATE DOES NUa AF F1FtMA nVt.L_Y QR NEL A1lVkt,Y AiM.ND,kx'fEND OR ALTER'l-FIE COVIRACE AFFORDCD UY Till!POLICIES rct`.LUVV.I I IIS CL=;R.FIFICATC- OF INSURANCE DOES NOT CONS I II N IE A GUNTRACT BEI WL'.EN'IHE Iti!5UING ),AU I I IQKIZLLI I:F-III CM:N I ATi E' i)rt r'rtl:)r]ucFla ANo THk C,kRTIFJCATE uliL.L,L R. IcPi11<LgN1: It(11u c lrllflcutu I,ulllur ie an ADUI'I IIONAL INtiUKL Il.Ito;pUIICy(letj)u)ust bd enUL,I ed.If SUDh(,)C,A I'IC)N l;;WAIVLI'1,autti,,,;r la I4 Icnll:,uncl ckomilllhn4 of ills policy, cal'Iyhl_1)OIICIC16 may I" J,,,,uU g0(Illlptllllgrll.A 4li,ltlllll'Ill QD(PITS crJl(111cUlta ll(14;1 Illll CtINI-Vf rlUlll'd kl the r.,,,UN\..,lu iu,ll)c!t in Ilu(r I,Ir (u Gll CIICIGI-J4rllrnl r Iil/ylct:I ("(;ly I11'.i. -So. L)c)Imli,; NAhIF. _MFIO11 PHONE JOtl 2 FAX •r •i I(uut4 13•f rvc No e..I: _ 7604160� l Il!/•i111i•:'lali -......_..._._...... ,n J .1:ail-/JI{U _ wsuNLl:,\,('ee.rla:,s Itl>llfdllCu _ _ - - l.'.Itlt. (;uCf H'1.i Ulatl it 11 II1C INtiURERFI ft:111$1U11111bL11'JI'Wij C;C)IIll,l trlly - -._ C •l AtltulliC l he 1-1(;r InaLl1 thee: `,`, \`zu'llluufll {�t_)acl INSI)lihl: ^ ^_-•-- - --- Ilyrunlier, MA 0260I Nyl_._inruu CQ(IlnlorceII1L;UraIICe (unlNuly 1175! uasurtEu r tLhIIF)lAILNUMLIC-R htu l ulAt i111'. NOL lilt )r wv) ---- IVlIIV1111:'it RANI E L I$I Cll II tYE CIEEN IStil1E(.1 10 I I lE IWSURL•D NAMGL)AfI Yiz 1-UIt 1 IIL I'i)t li I I'L-r,1C!D 1t)Il I l l i.`.i l ANOIIV(d ANY hh,.1LIIh L vIL V1', I l Rlvl UR l0lll'i1*1 OF AIVY CpIJ1RACT OR UlFIER UU'Uhil l 4VI11 I htl=;iPLC.I rU 1VI Ill.rl Iles; rl:rl\all, t•;INO t51 I;S uL:D OFF MAY I'L'R'I ICI . L INSURANi.c ;trr,.IItDED UY THE POUCILS DESCRIMID HEREIN IS uuo,ia,r '1"0 ALL IIW II IWv;, 51111'd`i AIVO t;(:)�ll.)IIION`i OF SUCH POLICIES. LIMITS SHJwIv hl;,y. NAVE NcCIV REOUCFD BY PAID CLAIMS. .n I __ Ur 11NUL�iUC12 Y E -----�— ,�..IY Iv;111 IIV9UNANGt POLICFF girl lCV❑kh�""�""-""' --'--`-- -�--- .._,,..._.__.....__- ---- _Y_T YUym ,nil( inlnllURMYY}L hfhUD(1lYYYY ., I-InUII: C8P82Ji3U83 4l0'1120•12 0410'112t1"I ERCIIOCCUFIFtEr10E. C'I LIUII UIIU A�I:'JMtlt-_NClill.GLIVL.kA_L(IAL11L11Y - I���k�l 'rt.. rl,ti,„u�w� r'lun quo hILU rx1 IArIY ouo unuNl w`iAUl1U _ .._......,.._....._.._,.......______-- I°kR$PrIAI 6 AOV INA.1"Y a'I UUU ODU I --- —._..._._..T__....—"........... L..."...__... i I I I _ _ ------ L1tNk1:AL.AC11uiLUA)4 by UUII UUU HAII AFI LILtI PI H I F'IYUDUt.IY I QMI A11 At( y'lggll Illlll l I2MMBCKVmiN 11U7 2U'12 4 1 I c C>hII11NLD SINGLC l.lhlll _........... ..__...._.. �t��uuuATU. .._.. k10DILY INJURY Nu. j nU I V) AV CUB' HOUILI'INJURY II u..,,...:Jsnl) l; I x - NN-ONI,L a , .._...----_-.__......_,�.,-__.-. IliifilJ All lt];1 x AUO C(?3YV - PROP Efln'OAfylClf= x 1Y_r1lJicilllL,1LL ................ ... I'1 i :�I uid ullL l l a l IAII l i l.11l, XrJNUc1�:lO l---... '—__- .... .. ..._..... ? 2. 1 ll'I12U'12 U4lU'll�)U1' r:4c11(]r.(�ua1 t;Nlr .11c000 Qt1U (IAIMM�NIAOL IA(:Gr«CAI't $1 IIUU UIIU lu_It.IVIIOrItLI'IGUtllh.— ( Lr (nhtr Mil lON WC�lAl'II I 0111 Ar u r nlPl ll}I rt 1.lAil t'I lllllly WGAUU52 IU' 613UI2U'12 11G13U/_U l'u I)Il 1ra/r vI�I- t-j/_ (I;`CQ I IVK.Y/N 6H RIF) kk L{i'.��gi N)A G.L.CAL 1 l ACC-101 N 1 _ I Ullll UUU I pllwulula,r„r NNJ C.L..WSCASC..I \0,.111,.l1VLi• :I,10UU UUU _q',�r��lll)PI Ur'(:)I'L:<AIIUNti hclr.lw - C.L.DI'LAS12'-PUl1C:,'Llnill- W'I (IgUIIUU _.....--... -- I�)Llul'IIIIN l!f 01't"r(ilY Inf /ll1 C: oll fVCNICLCS(AUaah ACORL)WI,AJJIn.l,,,1,o„•..... glppquly,It PIVIp opgo Ib ru(IIIIIkl - 'Vt'orkers Comp IorrnuLiun InrIU(JV(1 l)(flCcl'G Crr P1-OI)hll9tQf5 - -- - I Ortlrfeare Hialdul i_s hWILI Qd Li:i Lill addiliunal insura(1WILIUl (41nural1_00ifitywtloli roglllrod by Wrlttoij L.ontrlct or allre�illeNt. rl,Ilrlc:tlC IIUI t]L FT CANCELLATION l.,lll)u GCIll 111LlJl:1llr)ll,111c 9HOULDANYOF THE ABOVI:.I]EtSC,RIr1E:QP'CIL.Il)IEaut4ANI,,1I.LhPI11;IUliq THE EXPIRATION DATE THEREOF, ,NU'I'IC:L WILL ht:: uIFLWkItLt) IN ACCORDANCE WITH THE f10LICY MOVISIC)Nu. --- .__..... ... ._.. AUCrIt1R1260kENNEBkNIA'1'R'B tTJ'lU(I -2q'IgACQ11D C:LVhIFI(113A711.)N,All Ilghl;l n';la)ratl. U I U/u 'I a1 ,I• I fie,AC1C.RD ilama;ind lol)o;tru rook Mod Illarks of AGORD r)s��eaulrna3��lt► mf:"Y f . , del (JUJ?er's Name, printed) d6z&/h9. lluaml(Pr ipet l r SLr Lam.i'tdd ass) Own) eie �r%i 'JriZ he Mass save Home rii erg4y SerjiCeS Program.assigned Participating CO?''48C:v:ii5 ea celotnr'cv ac:on, my behaii and obtain a built inn perrMl to peKortij insulation anfl!or we therizat. work on my properj. FCC??CSIG,OFFICE USE ONLY Je.lG::_ Group ii CS the dG$$Sa'c. Ss'ticas • above referenced. project pariiCi@` va'1-:o'cC'tC" D e