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Home My WebLink About0057 STETSON STREET 4Jwn Cape Save Inc. 7-D Huntington Avenue South Yarmouth,MA 02664 Tel: 508-398-0398 Fag: 508-398-0399 7/8/15 Thomas Perry CBO Town of Barnstable s Building Division 200 Main St. Hyannis,MA 02601 RE: Insulation Permit 201502207 Dear Mr. Perry This affidavit is to certify that all work completed for 57 Stetson St,Hyannis has been inspected' by a third party Certified Building Performance Institute (BPI)Inspector All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey C ,3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ' Map 3 06 Parcel- 6 Application #_ /S(`) Health Division Date Issued '' —(S �F Conservation Division Application Fee�50 -6 a Planning Dept. Permit Fes,35 'C?6 -Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address S T 3-1'et-,S en- tree+ Village �►� \ Owner r_ e e n 'r es L,g ar i an Address s A,M(° Telephone q 0 1 3 a3 6056 1 Permit Request PJ1 �- 3 0 �, f �f.S.f' +o +ke, a 1 I ((,, (�t i c- ` e c� vane rf � WIA � aM Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 34U 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 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/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ exsting ❑new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ -. Commercial ❑Yes �NO Ifyes, site plan review # 03 Current Use Proposed Use - -- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name CoLpe Spy to . w11t, c C�.ns�.e Telephone Number 506 -3 9 a oS 9& Address H-1kn f-(,4 S Vn License # �C (Q o 73 b 50,,i k Y ar(no I& , 1' t� d U 6 Home Improvement Contractor# 3 8D Email Worker's Compensation # W Uf C 11 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Yw rMd� h SIGNATURE DATE FOR OFFICIAL USE ONLY f ` APPLICATION# 'iDATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE '. OWNER DATE OF INSPECTION: s ti FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ti DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth:of Massachusetts Department of Industrial Accidents •- , 1 Congress Street,Suite 1.00 a Boston,MA 02I14-201.7 ww» massgov/dia V t Ni'orkers'Compensation.Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FELED WITH THE PERMITTING AUTHORITY. Applicant Information ___... _ Please Print. Legibly Name (Business/organization/Individual) Cape Save Inc .Address:7-D Huntington Avenue City/State/Zip:South Yarmouth; MA 02664 Phone#:508 398-0398 Y Are you an employer?Check the appropriate box: Type of project(required)r L[D I am a employer with 20 employees.(fullapd/or part-time).* - _ 7. ❑New.construction I I am a sole proprietor or partnership and have no employees working:;forme in ❑ 8. ❑ Remodeling any capacity.{No workers'comp.insurance required:) 9. ❑Demolition 3.�I am a homeowner doing all work:myself.lNo workers'comp.insurance required]. 4:❑I am:a homeowner and will be hiring contractors to conduct all.work on my property: Twill 10❑Building addition ensure that all contractors either haveworkers'compensation insurance.or are sole I LE]Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or.additions 5.❑I am a genera(contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees.and'.have workers'comp.insutance 13.:a Roof repairs 6:❑We are a.corporation and its officers have exercised;their right of exemption perMGL:c, 14.�Otherinsulation • 152,§1(4),and we have no employees.[No workers'comp.insurance required:) An applicant that checks box#1 must also fill.out the section below showing their workers'compensation policy information*Any PP g P P. Y�. t Homeowners who submit this affidavit indwating;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-contractors and state whether ornot 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:Wesco Insurance Company - - Policy#or Self-ins.Lie:#:WWC3136274 Expiration Date:04/09/201.6 Job Site Address: 57 Stetson Street City/State/Zip: Hyannis Attach a copy of the workers'compensation policy declaration page(showing the policy number and vxpiration:date). Failure to secure coverage as required under MGL c: 152,§25A is a criminal violation punishable by a fine up to$1„500:00 . and/or one-year imprisontnent.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:A copy of this stateme may be forwarded to the Office of Investigations:of.the DIA for insurance coverage verification: I do hereby certify under.th pains and penalties of perjury that the information provided above is true and correct Si ature.: - Date: u Phone#:508-39.8-0398 Official use only. Do not.write in this area,to be completed by city or town official City or Town; PermiflL,icense# Issuing Authority(circle one)- 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Persons . Phone.#:. � n ACCJfi>L� ` ERTIFICA-TE OF L1A�ILI .'TY IfVSl1R�►NC 3iz4i2 � 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-INSURERS} AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE BOLDER IIudPC4RTl3,NT;'If tha*011tiRsate holder Is an ADDITIONAL INSURED,the policy(les)roust be endorsed. If SUBROGATION`IS WAIVED, s-rrbject to ' the terms and conditions of the policy,certain;policies pray require an endorsement. A statement on this certificate does not confer rights to the certificate holder In'Ii®u of such endorsement(s). PRODUCER CONTACTrNAME: Colleen Crowley Risk Strategies' Company PHONE F (781)986-440Q " FAfC o:tT83)963-4920 15 Patella Park DriveWq.AM=.ebrowley@risk-strategies.com. Suite 840: INSURE S AFFORDING COVERAGE NAIC P.nntiolis;xM 02358 tNSURERA:Se`1e0tSVG Ins.- OE' .AmeriC.� INSUREp 1NsURERs A11alerica kiaaacial Aliiagce t)2'12 Cape Save,. INSURERC Wesco Insuran a31 7 D Huntington Ave INSURER O. INSURERS Y St91ifi. a efifh' M& W94 ._ -...- INSURERF: COVERAGES iCERTIFICATE NUMBER:CL1532491501 REVISION NUMBER: THIS IS TO>CERTifY THAT Tfif POLICIES Of 1NSURANCE't"TED BELOW"HAVE BEEN`ISSUED'TO THE-INSURED-INSURED —D ABOVE T-0RTHE'POUCY-PFR1OD iNDiCFi mv- �(OT�xHSTANDING-ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE:I$SUED.OR MAY.PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED:'HEREIN!S SUBJECT TO ALL THE TERMS, EXCLUSIONS P,ND CONDITIONS.flF SUCH,POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN TAR TYPEOFINSURANCE APDL SUSR PO�ICY.EFF PO�ICYEXP LIMITS. POLICY NUMBER , JMM GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X. COMME"AL GENERAL LIABILITY ENTED RRF�vIISES a occurrence $ 100,000 �+ CLAIMS-MADE?a OCCUR 1994480 0/16/2014 O/16/2015. MED F,fP(Any one person) $ 10,000 PE2ScatJA .8ADv1&dJIS?Y 3 110001000 GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER, PRODUCTS:-COMP/OPP,GG $ 2,000 i 000 POLICY X PRO-XCT. X: LOC. AUTOMOBoLEL1A8f " -[Ea,=dTr0 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ : ALOSMEo AUTOS SCHEDULED 6796600 1/6/2014 i/6/2015 :: AUTOS: BODILY INJURY(Per acadentj $ X HIRED AUTOS 10TNOS -0!ES3 FROPE#2TY DAMAGE Peraecidsrh $ $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,ODO,.OQO A EXCESSLIAB CLRIPASMAOE AGGREGATE $ 1,000,000' DED RETENTi0N 9i 1994 8Q Oj36j2019 4Jlt/2435 $ RKERO MPENSAT19N flier Iacltide3 fo'r v�esrAru- OTH- AND EMPLOYERS'LIARS fN X AN1t PROPRIETORIPAFZTNERIEXECUTVE YIN rage T Y S OFEICEPJMBFR EXGLULIED? N NJA. E;L.EACHAGCtDENT $ jQQ QQQ (Mandatary 1n NHj 135E?4 /9/.2iYI'S f 9/20Y S If.yyes,desrntie under €L.tMSEAS] -FA_WPLOYE DESCRIPTION OF OPERATIONS beo - E L.DISEASE.-POLICY.LIMIT $ 5OO 0O0 DESCRIP$ION OF OPERATW NSI LGCATMONS I VEHICLES(Attach ACORD iol,AddWonal Remarks Schedule,if-maro space is squired) Issued as evidence of insurance. Thielsch Engineering, Inc. is listed as additional nsured:;as respects.General Laatiility as rex 'red by s�ritten eant.raCt.. CERTIFICATE HOLDER CANCELLATION ons,��c�Pel9htccangac� a SFiflULDANY-OF THE ABOVEbEWRISED`lwOLICIES 8H CANCELLED BEFORE TTiE EXPIRATION DATE TIiEREOF, NOTICE WILL Se DELIVERED IN Cape Light Compact ACCORDANCE WITH THEPOLICY PROVISit3NS. Attn: .Margaret song.. . Or WX 4?.TjBCK AUTHORIZEDREPRESENranVE 3195 Main street $arnstable,. bA U2630 >; chael Christian/CLC. �` ACORI `a'� 1D f0/05� oQ 1M-24'(Q ACORD CORP MTM. Al rights ressr INS025(zot�stot The ACORD name and logo are registered ma[ks of AC®RD.. ,:.. Building Permit Authorization I, Robert Koshgarian , as owner hereby give my permission to Cape Save, Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Office: 508-398-0398 - to take all necessary steps to obtain a building permit to perform-work at my property located at 57 Stetson Street Hyannis, MA 02601 Signed Date -2, 5'~ 1 i Q57n Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration — Registration: 171380 _ Type: Corporation Expiration: 3/14/2016 Tr# 249649 CAPE SAVE INC. WILLIAM McCLUSKEY { '; ---�- 7-D HUNTINGTON AVENUE " SOUTH YARMOUTH, MA 02664 � ---- -- -- --- - Update Address and return card.Mark reason for chance.p b SC,a 1 Q loan-osnl Address Ej Renewal E] Employment 0 Lost Card %lam fcrvirriurrcue�+lC�ry 111do'cXeeJetC' Office of Consumer Affairs&Business Regulation License or registration valid for individul use only (AOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 171380 Type: Office of Consumer Affairs and Business Regulation Expiration 3/4/201.6. Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE SAVE INC. r WILLIAM McCLUSKEY � 7-D HUNTINGTON AVENUE` �i��Q SOUTH YARMOUTH, MA 02664 Undersecretary Not vali rthout signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards T Construction Super=isor Specialty , License: CSSL-102776 Fy WILLIAM J MC C-LUSKEX 'r 37 NAUSET ROA1D s West Yarmouth MA i v7i Expiration Commissioner 06/28/2015 ` Eogineering Dept.(3rd floor) Map Parcel 3it& Permit# �- e , House# Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Fee , ,f O t? Conservation Office(4th floor)(8:30-9:30/1:00-2:00) Planning Dept.(1st floor/School Admin. Bldg.) Definitive P ,proved by Planning Board 19 . _ BARNMBLE. TOWN OF-BARNSTABLE -Building Permii Application Proje t Street A ress 7 -O �ydh� S T ' Village Owner q Address Telephone t ` Permit Request ! � First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ 00 O Zoning District Flood Plain Water Protection _ Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family , Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes S�eqo On Old King's Highway ❑Yes ,�T0 Basement Type: ❑Full VCrawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing ��New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count ,Heat Type and Fuel: ❑Gas ❑Oil lectric ❑Other Central Air ❑Yes ❑No Fireplaces:Existing \PeS New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) /Other Detached Structures: ❑Pool(size) ❑Attached(size) X ❑Barn(size) ' ❑None ❑Shed(size) - ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name (; Y-) Q,1.i Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING_ ,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE / BUILDING PERMIT DENIED FOR 4E FOLLOW NG REASON(S) FOR OFFICIAL USE ONLY _ PERMIT NO. _ DATE ISSUED h-. MAP/PARCEL NO. �- - A. ADDRESS ,j :. VILLAGE s _ �• r' ! ' ,f •.a OWNER ; �ti : r� .� � ,, `-�• �� - � r+,"' :_ � �.. ,> /'*.•.. f f DATE OF.•INSPECTION: FOUNDATION FRAME - .• _ i •INSULATION ! ` � u ' FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL } GAS: ROUGH FINAL FINAL BUILDING d y .DATE CLOSED OUT, ASSOCIATION PLAN NO. A F + s ! s r = TOWN OF BARNSTABLE GIS UNIT ASSESSOR'S. .................... . j 1 20 _..... ! ! 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