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Home My WebLink About0070 STETSON STREET 7C) IVE I Town of Barnstable ° t ¢ �^�� Building MMMA Permit Post�This;Card So�That rt„is U�s�ble%'From theStreet ;Approved"Plans Must be.Retamed on Job and°this Card;Must be�Kept 16 Posted Until Final Inspection Has BeenrlVlatle s ; �R Where:a Certificateof Qccu,paneyris Required,�such Buildmg shall Not be Occupied unt�l ��nai Inpection�h�as bee�nmmade � Permit No. B-18-3620 Applicant Name: James Curley Approvals Date Issued: 11/01/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors 'Expiration Date: 05/01/2019 Foundation: Location: 70 STETSON STREET, HYANNIS Map/Lot: 306 074 Zoning District: RB Sheathing: Owner on Record: FELLOWS,SUZAN E TRs Contractor Name DAMES P CURtEY Framing: 1 Address: 70 STETSON ST Contractor License CSSL-099138 2 Ai HYANNIS, MA 02601 <; Est Prs oJect Cost: $6,000.00 Chimney: 6 Description: Strip and re-roof approximately 16 square of asphalt shingles 6r 6C Fee: $35.00 i 4"; Insulation: Project Review Req: Fee Paid` $35.00 Date„ 11/1/2018 Final: Z. Plumbing/Gas Rough Plumbing: Building Official .` g Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzedlb this permit istommenced within six months after issuance. ,;� p 4p I Rough Gas: All work authorized by this permit shall conform to the approved application and the�approved construction documents for which thispermit has been granted. All construction alterations and changes of use of any building and structures,'shall be in compliance with the local zonmgrbYdAvs and codes. Final Gas: �,1 This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for�publ,ic inspection for the entire duration of the work until the completion of the same. k Electrical The Certificate of Occupancy will not be issued until all applicable signatures by'the Buildingjan, re Officals are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: : 1.Foundation or Footing 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 5.Prior to Covering Structural Members(Frame inspection) Low 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" (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 Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 1/20/15 Thomas Perry CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 RE: Insulation Permit 201409097 Dear Mr. Perry This affidavit is to certify that all work completed for 70 Stetson Street, 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 OISIA10 017 :1 3' r g1OViSIUVO JJ NAPo 1 • '� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 4 '-1 " `01®� � ��}'�°�� Q� ��TABIE Application Health Division , Date Issued �"'��f �� i"Conservation Division Application e Planning Dept. Permit Fee Date Definitive Plan Approved by Planning BoardYR�� ja'3N Historic - OKH _ Preservation / Hyannis Project Street Address 70 o in 51-M04 Village - l I� - I Owner Sy,zAh lkg�S Address -,51a1M� ' Telephone Permit Request I)CA P, Paz k LAtp, 1,A Ce u;1 OS� �d _� e Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation C� 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: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes I�No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number R (� Address 4,4A,nln License # Z—C (�a - S1(t,Mil 14.4h Home Improvement Contractor# Worker's Compensation #W'Vt b5 -3 3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 8` r s FOR OFFICIAL USE ONLY APPLICATION# r DATE ISSUED MAP/PARCEL NO. �Yy 6 L -x ADDRESS VILLAGE 'r Y OWNER b 4 DATE OF INSPECTION: Ih?EQUNDAyII.ON FRAME c• E. INSULATION:._ _;._,;a.�,- FIREPLACE ELECTRICAL: ROUGH at FINAL r PLUMBING: ROUGH FINAL t GAS: ROUGH FINAL y FINAL BUILDING`- i' DATE CLOSED OUT ASSOCIATION PLAN NO. f The Commonwealth of Ma ssach"tisetts Depart+nent of IndustrialAccidents Office of-Investigations I Congress Street, Saite `00 Boston,NMA02114-20r 7 - www.massgov/aria Workers':Compensation Insurance Affidavit:Bniider, Contractors/Electricians/Plumbers: Applicant Information Please Print Legibly • Nlrrle(Bu'sincssl0tganizationndiv/ltdual) p Ca g$aye Inc. _. .:.. Address: 7D Huntingtori Ave City/State/Zip: South Yarmouth,MA 02664 Phone 508-398-0398 Are"you an employer?Check the appropriate box: Type of project(required)::. l:Q 1 am-a employer with 4. 0 1 am a general contractor and 1 6 New construction employees(full and/or•part-time) have hired the sub-contractors 2._[] 1 ani,a sole proprietor or partner listed on the:attached sheet. 7. ❑.Remodeling, ` These sub-contactors have ship and haVe no ernp! yees Det11olition ' eno to ees and have-workers'' working, for me.in.any capacity.. p y 9.. []:Building additotr [No workers.'comp;.insurance:; comp:insurance.* 5. We are"a corporation,and its; 1"0.�°Electrical repairs or additions regt.rcd.] � , . ofices have.exercisedhei mbn re,.airs or additions3. I ama homeownerdoigl work 11. Pui : myself.[No-workers' comp.. right of exemption per MGLepairs insurance required:]'t c. 152, §1(4);and we have no employees, [No workers' 13.D:Other Insulation _ comp.insurancarequired] "Any appl icanF that checks box#f must also fill oat#id section below showing their workers'compensation policy ittformatton.. t H iineowners who submit this a4'19davit indicating they are"doing all moork and then hire outside contractors must subt»e a new affidavit indicating such,. *Contractors that check is box must aftact ed an additional sheet shoving the name of the wb-contractors and.;state whether or not Iho"se entities have: employees. If the"sub-conttactots:have employees,they must pro vide-iheir workets'comp:policv number. l am an employer that is providing workers'compensation insurance for my employees. Belo}v is th 'pt►Iicy un site :information.. t Insurance Company Name: Wesco Insurance Corripaoy Policy or Self4ris.Lip:# WWC3085633, Expiration Date: 04/09/2015 Job Site Address; - .� -Fr�-�—San. ��' City/State/Zip: A s. .. ` Attach a copy of the workers'rompehsati:on policy declaration page:(showing the policy number a d"OXP6A.ration Aatel; Failure to secure:coverage as required under Section 25A of MGL c. 152 can lead to the imposition""of cnrriinak.penaltiis of a time up to S l,500,00 and/or"one-year impiYsonment,as well as civil penalties in the form of a STOP.WORK ORDER attd a fine of up to$250.00 a;day against the<violatur. Be advised that a copy of this statement may be forwarded:to the Office of ._ investigatiOns of the DlA.for insurance c.o..verap verification: 1 do hereb eerti asnder the ains and enalties o er' that the in onnation provided above is true and correct S'inature. Date �-- •• • Official►rse Drily. Do. rotivrte in this area,to be completed by city or to►uri official. City or Town':- Permit/License Issuing.Authority(c rde.one}; I.Board,of Health 2,Building Department.1 City/Town:Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: _ Phone#: A RUB CERTIFICATE OF LIABILITY INSURANCE i✓ o zoi4) 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: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed: If SUBROGATION IS WAIVED,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 endorsemen s. PRODUCER _ NAMe: Colleen Crowley Risk Strategies CoW.Any PHONE • (781)986-4400 alc Ne:tTeils63-aazo 15 Pacella Park Drive .ccrowley0risk-strategies.con Suite 240 INSURE $AFFORDING COVERAGE NAIC*_ Randolph, 1xA. 02368 iNSURERA:Selective Ins. OF America INSURED irLs 11 uRERs Allmerica Financial Alliance 10212 Cape Save;, Inc INSURERc:Wesco Insurance Company 7 D 8untingtonf-Ave INSURERo. INSURER E: South. Yarmouth MA . 02664 INSURER IF COVERAGES ,,CERTIFICATE NUMBER:CL14111085532 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. NOTWrrHSTANDING 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 DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICYEFP .POLICY.EXP LTR TYPE OF MSURANCE f POLICY NUMBER IMMI IDDIYYMLIMITS GENERAL LIABILRY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY 7 1 PREMISES(Ea o c rrence $ 100 ODD A CLAIMS-MADE QOCCUR 91994480 0/16/2014 0/16/2015 mEDQEXP(my onepersoh $ _ _ 10,000 .PER B ADV INJURY $ ^1',o00y 000 GENERAL AGGREGATE $. 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG ,$ 2,000y 000 POLICY X PRO-JECT X LOC $ AUTOMOBILE`L(ABILITY Ee accident 1 000'000 B ANY AUTO BODILY INJURY(Per parson) $ AUTOS AUTOS OWNED `X ASCHEDULED 6796600 1/6/2014 1/6/2015 BODILY INJURY:(Peraccident) $ HIRED AUTOS X AUTOS Pe ec«dentDAMAGE $ X uMBRELtA LIAR X OCCUR EACH OCCURRENCE $ 1,OOOry 000' A EXCESSLIAB CLAIMS40ADE AGGREGATE $ 1,boojoo0 DED RETENTION$: S1994480 0/26/2014 0/16/2015 $ (,' WORKERS COMPENSATION ff1c9Y5 IncYuded for X WCSTgTU OTH- AND EMPLOYERS'LIABILITY Y 1 N ltYlLMIT ANY PROPRIETOPIPARTNERIEXECUTIVE Coverage. E.L:EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? a NIA 3085633 /9/2014 /9/2015 (Mandatoryln'NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,d gbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Romarks Schedule,If more space Is required) Issued as evidence of insurance. Issued as evidence of insurance. Thielsoh Engineering, Inc, is listed as additional insured as�respects General Liability as required by written contract. CERTIFICATE HOLDER CANCELLAMON msong@capelightcompact.org SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cape Light Compact ACCORDANCE WITH THE POLICY PROVISIONS:. Attn: Margaret Song FO 'BOX 427/SCH AUTHORIZEDRERRESENTATIYE 3195`Main Street - Barnstable, MA 02630 �, �� 'chael Christian/CLC ACORD 25(2010/05) O 1988-2010 ACORD CORPORATION. All rights reserved. INS025 poloos).o1 The ACORD name and logo are registered marks of ACORD czr u4,eff 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 - _ -"---- - - r. ,* Update Address and return card.Mark reason for change. scA irr 20M-0511 i 0 Address 0 Renewal Q Employment Q Lost Card r?'�/rP�r ri�:rreorauevicel(��r'�l�aj:�r.rjrclelf' 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: -171380 Type: Office of Consumer Affairs and Business Regulation Expiration��3/14/2016 Corporation 10 Park Plaza-Suite 5170 6 Boston,MA 02116 CAPE SAVE INC. tee WILLIAM McCLUSKEY 7-D HUNTINGTON AVENtjE- SOUTH YARMOUTH,MA 02664 Undersecretary Not vali 11t1 out signature ! Massachusetts-Department of Public Saf6ty Board of Building Regulations and Standards Construction Supervisor Specialty rw, License: CSSL_102776 WILLIAM J MC C-LUSKEY 37 NAUSET ROAD � West Yarmouth NIA 016'Ii3 - �.�..� Expiration . Commissioner 06/28/2015 f . f f Building Permit Authorization Suzan Fellows as owner - hereby give my permission to Cape Save, Inc. 7-D Huntington Avenue I South Yarmouth, MA 02664 Office:508-398-0398 to take all necessary p g steps to obtain a building permit to perform work at my property located at 70 Stetson St Hyannis, MA02601 Signed Date ;y r , Cape Save'Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 DATE Thomas Perry CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 q RE: Insulation Permits Dear Mr. Perry This affidavit is to certify that all work completed for 70 Stetson Street(#201401502) has been inspected by a third party Certified Building Performance Institute(BPI)Inspector. All work performed meets or exceeds Federal and State Requirements. . Sincerely, K William McCluskey NflI IA1 r is j � s rs 31GV1SN dO Nfoloi Town of Barnstable �THE � Regulatory Services Richard V. Scali,Director Z AB MASS.M Building Division 03g Perr y, Commissioner QED MA'1 A ry�Building 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT# 0`0.0� FEE: $35.00 SHED REGISTRATION RESIDENTIAL ONLY 200square�feet or less__ +son Location of shed(address) Village In s 5`ql 7 71 — � Property owner's name Telephone number ��{ Size of Shed Map/Parcel# t n ::E- Z Signature Date Hyannis Main Street Waterfront Historic District? _ Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:040914 �7 '� Town of Barnstable Geographic Information System September 30,2014 307237 307238 307239 307240 4 #83 #71 #61 #51 306230' M #95 ` Y 3D6079 #285 306231 #87 • 306075 - 306074 # 306073 #70 306072 #88 306071 � - #108 306070 #112 5 7L7 SOJY ST .. a•.. 3OD56 306057 306058. #57 306059 #67 306060 #87 306061 �`; #95 #109 eet 3062 1 &5 #151 DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:306 Parcel:074 ° Selected Parcelboundary determination or regulatory Owner:FELLOWS,SUZAN E TR Total Assessed Value:$366100 tory in erpretation. Enlargements beyond a scale of 1°=100'may not meet established map accuracy standards. The parcel lines on this map are only graphic representations of Assessors tax parcels. They are not true property Co-Owner.S.E.F.TRUST Acreage:0.31 acres Abutters �i boundaries and do not represent accurate relationships to physical features on the map Location:70 STETSON STREET _f such as building locations. Buffer ,.�F TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION N1 �a1 SOMap - Parcel Ap ication # Health Division Date Issued 3_t1t^1q Q Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis T�l Project Street Address 0 m Village Owner S 2 //0 V/-c Address e Vf Telephone Permit luest i S e ��J ) Ce P 0 c. f to fecoa- ° 4W a1 ee k se Vo Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District !� Flood Plain Groundwater Overlay Project Valuation 7` 800 ' Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family W' 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 Basd.ddent Vdished Area (sq.ft.) Basement Unfinished Area (sq.ft) Num'er of%ths: Full: existing new Half: existing new „ NurrVpr of Bedrooms: existing _new CLI TotaLRoorgDount (not including baths): existing new First Floor Room Count Heaj`lype nd Fuel. r Q,Gas ❑ Oil ❑ Electric ❑Other CD Cereal Aire-❑Yes 0 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) c Name PC� '` lqjt c Telephone Number Jo s)37 0 -03 Address") 14a.,&I o License # 10d, a�A �� ► Vl 47�U`�/ Home Improvement Contractor# d Email Worker's Compensation #`rVC 3-�S ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO C SIGNATURE DATE 3 �� + a FOR OFFICIAL USE ONLY APPLICATION# G' DATE ISSUED MAP/PARCEL NO. r' 1 �r 1, F' ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE I� ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL III GAS: ROUGH FINAL Gi ` FINAL BUILDING ti DATE CLOSED OUT ASSOCIATION PLAN NO. s The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A l><cant Information Please Print Legibly � Name(Business/Organization/Individual):' Cape Save,Inc. . Address: 7D Huntington Avenue City/State/Zip: South Yarmouth, MA 02664 Phone#: 508-398-0398 Are you an employer?Check the appropriate box: 76. [] oject(required): 1.❑✓ I am a employer with 17 4. ❑ I am a general contractor and I constructionemployees(full and/or part-time).* have hired the sub-contractors listed on the attached sheet. odeling 2.❑ I am a sole proprietor or partner- These sub-contractors have 8. []Demolition ship and have no employees employees and have workers' 9 �Building addition working for me in any capacity. comp. insurance [No workers' comp. insurance 5. We are a corporation and its 10.❑Electrical repairs or additions required.] 3. I 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.R Roof repairs insurance required.]i' c. 152, §1(4),and we have no 13 � Other Insulation employees. [No workers' 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 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-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: Technology Insurance Company TWC 3353968 Expirarion Date: 04/09/2014 Policy#or Self-ins.Lic.#: ® � �� City/State/Zip: Job Site Address.-17? - 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 certi under the pains and ettalties of perjury t at the information provided above is true and correct Si ature: — ------- -- __: - - -- - - - - - Date -- Phone#: 508-398-0398 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 Z.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person• Phone#: AG`ORD®AZI DATE(MMroD)YYYY) CERTIFICATE OF LIABILITY INSURANCE 10/22/2013 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: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, 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- C Colleen Crowley PRODUCER NAME: Risk Strategies Company PHONE E ('781)986-4400 FAC No:(781)963-4420 1AI&No.15 Pacella Park Drive IL Suite 240 INSURE S AFFORDING COVERAGE NAIC# Randolph M& 02368 INSURERA:Selective Ins. of America INSURED INSURERB:Safet Insurance C an 3618 Cape Save, Inc INSURERC.technology Insurance an 7 D Huntington Ave INSURERD: INSURER E: South Yamnouth Doi 02664 INSURERF: COVERAGES CERTIFICATE NUMBER:CL13102268490 REVISION NUMBER:. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW E BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD HAVE 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 DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. L POLICY POLICY EFF POLICY EXP LIMITS INSR TYPE OF INSURANCE ICY NUMBER MMl YY 1YY MMIDD TR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 AM 100 000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ A CLAIMS-MADE a OCCUR S1994480 0/16/2013 0/16/2014 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,000 POLICY X PRO-JECT X LOC $ SINGLEcOMBINED LIMI 1 000 000 AUTOMOBILE LIABILITY E accident BODILY INJURY(Per person) $ 8 ANY AUTO ALL OWNED X SCHEDULED 208200 1/6/2013 1/6/2014 BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE X NON-OWNED Peracadent $ X HIRED AUTOS AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DEED RETENTION$ 82 1994480 0/16/2013 O/16/2014 $ C WORKERS COMPENSATION officers Included for X WCYSI. OTH- AND EMPLOYERS'LIABILITY A PROPRIETORIPARTNERIEXECUTIVE YIN overage E.L.EACH ACCIDENT $ 500 000 NY OFFICERIMEMBEREXCLUDED! a NIA 3353968 /9/2013 /9/2014 E.L.DISEASE-EA EMPLOYEE $ 500,000 (Mandatory In NH) If yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Addttional Remarks Schedule,If more space Is required) Weatherization Specialists. GL: Blnkt AI, Blnkt PNC, Blnkt WOS, Per Proj Agg, Per Loc Agg / GL Exclusions: Snow & Ice Removal/OCIP/Wrap Ups CERTIFICATE HOLDER CANCELLATION 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 chael Christian/CLC �I ACORD 25(2010105) O 1988-2010 ACORD CORPORATION. All rights reserved. INS025120100511.01 The ACORD name and logo are registered marks of ACORD 3 _ rl ass ac =use-s -Dena ~Ee a c -q SCwtu of 7::,u:jc—';ncj ;$GLf1c'?iv`5 ..f t S'anQn.GZ Construction Supervisor Spcci:iltv _ic--nsa: CSSL-102776 WILLIAM J MC�LUS�Y V� 37 NAUSET ROAI<9 West Yarmouth NA 02673 Cr ^u�ionet 06/28/2015 t 9AZI-e &604 .; ;ac Office of Consumer Affairs and 4usiness Regulation MEN r 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 171380 Type: Corporation Expiration: 3/14/2014 Tr#' 222184 CAPE SAVE INC. WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. DPS CA1':a sotatra otoizu ; Address i Renewal } Employment ;_i Lost Card Office of Consumer Affairs&Bzliness Regulation License or registration valid for individul use only ' � before the expiration date. If found return to: n^^.,._�.: ,rt HOME IMPROVEMENT CONTRACTOR - Registration: 171380 Type: Office of Consumer Affairs and Business Regulation - , A. !? Expiration: 31i4/2014 Corporation 10 Park Plaza-Suite 5170 : . �.. Boston,MA 02116 CAPE SAVE INC. WILLIAM McCLUSKEY \ 7-D HUNTINGTON AVENUE ga SOUTH YARMOUTH MA 02664 Undersecretary Not valid wit 6. signa a Building Permit Authorization I, John„Fellows 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 70 Stetson St Hyannis, MA02601 Signed Date t ' Message Page 1 of 1 Shea, Sally From: Shea, Sally Sent: Monday, December 21, 2009 2:11 PM To: 'jcosmo@hyannisfire.org'. Cc: Schlegel, Frank; Perry Jr, Michael ` Subject: FW: ADDRESS ISSUE I let the homeowner know Frank would be out until. January 4th and that I didn't know which address was correct. -----Original Message----- From: Shea, Sally Sent: Monday, December 21, 2009 1:53 PM To: Schlegel, Frank Cc: Perry,Tom; Barrows, Debi Subject: ADDRESS ISSUE Frank, A gas/plumbing contractor came in to pull a permit for what both he and the homeowner, believed the address to be at 70 Stetson Ave. When the street was pulled up on parcel look up the contractor identified the address on the map and recognized the home to be at 76 Stetson. The homeowner matches this address as well. He changed the address on the permit to 76 and we permitted it as that. He reported that the address is posted on the house as 70. He was given your phone number to pass onto the homeowner (John Fellows). Jn case they don't call you their phone number is 508-771-4543. 1 spoke with Hyannis Fire and they have it as 70. We don't have this address as that. In the voter list of persons it is #70. If you change the address to 70 please let us know for our records. Thanks, Sally 12/21/2009 Town of Barnstable *Permit# S?z3 Expires 6 months from issue date r • O Regulatory Services Fee , 6 :2 MAM 9� 16g9. Thomas F.Geiler,Director Building Division r Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601w X-PRESS PERMIT Office: 508-862-4038 Fax: 508-790-6230 .I A N R 2002 EXPRESS PERMIT APPLICATION Not Valid without RedX--Press imprint TOWN OF BARNSTABLE'� Map/parcel Number 30(o! Q 7 L/ Property Address [e<esidential OR ❑Commercial Value of Work ! / Ir 6b Owner's Name&Address P_. i 1-.,6on S rf/�(/i /1 Contractor's Name =:;;qd30dq2Ve.fAtAAelephone Number Home Improvement Contractor License#(if applicable) o 710 Construction Supervisor's License#(if applicable)_ L5 05 703,�, ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner have Worker's Compensation Insurance Insurance Company Name 2Ur/ CA1, �.1 Y0al C.CQ t Workman's Comp.Policy# WC -2 7—,9?6 -LX) f . Permit Request(check box) ❑ Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of r000 ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) [Other(specif VQ- "'f( *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature ow co expmtrg CAPIZZI HOME IMPROVEMENT INC. SPECIFICATIONS AND ESTIMATES PAGE 2 OF 3 PTION: High-performance glass with Low-E and Argon Gas @ $60 .00 per unit . LABOR & MATERIALS $ OPTION: Shades or blinds Ce�+e_cuk ADD Diagram : �f r ' r� r c c ir ' f .-�-'• 4X .-o�•a 2 Job is estimated to commence 7 to 8 weeks after deposit received unless otherwise noted here: Any work above and beyond- the specifications outlined. in this proposal will be performed at $52 .00 per man hour' p.lus ma'terials� or priced on request: A11 additional work., including travel time ,and lumberyard runs , will :be subject�to extra charge'. In the event-of, - rot 'repairs , -roof . repairs or any related work requiring immediate attention ,' we will .proceed without customer approval . We look for to working with -you; please call' if •you .have any questions . Sincerely , CAPIZZI HOME IMn�f�. ' � — ACCEPTED BY DATE THIS PAGE IS. P4TFP AND IN CONFORMANCE WITH PROPOSAL #