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0006 SUNSET TERRACE
1 f Efficient Buildings, LLC October 31, 2011 Town of Barnstable Attn: Thomas Perry, CBO 200 Main Street Hyannis, MA 02601 re: 6 Sunset Terrace, Hyannis, MA 02601 Dear Mr. Perry: This affidavit is to certify that all work completed at 6 Sunset Terrace, Hyannis, MA 02601, has been inspected by a certified Building Performance Institute (BPI) inspector. Work included air sealing, weatherstripping, and installation of 540 sq. ft. R-30 cellulose in attic and 110 ft. faced R-19 sill insulation in basement. All work performed meets or exceeds Federal and State requirements. Sincerely, Steve C. White Owner/Managing Member Efficient Buildings, LLC 8 Jan Sebastian Drive, Unit 10, Sandwich; MA 02563 Tel: 508-888-1110 Fax: 508-888-1109 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map C(.o Parcel 0$ l .,Application # Health Division 'Date Issued 0 A Conservation Division Application Feed Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation/ Hyannis Project Street Address (S? 5 LA N S FT -1;-rZ 4A C Village l A NN f S Owner A2 L f N 012 C,u=t2^- Address 1D Su1,JSg-1 TE�2�, �-}y A ti N I S Telephone SoFs _p 5 3 o o f Permit Request �4►2 Sr R iu r��,, c i-` A� ��v_ Tf,� + Da�►2 T +2 3o CQ J-b LUSH��Q .. boa v 6-N r i f u Si T fL-CS`?612-r M� 1 -0 5.0r i R -1 G Sr i LS V E'N T 't)agM Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation L'vG 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 G LI 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: ]pxistin new size g _ 1 Attached garage: ❑ existing ❑ new size —Shed: ❑ existing ❑ new size _ Other',-,.r M M Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # �a +` Current Use - - - = — - - - -__ Proposed Use Fri APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name CAL('3gtL RLbr, -r A� Mc 6-LojG- Telephone Number 50g- sl9-- I I I O Address 4'E TfA)-) SSA Sm A IZ•, 10 License # Q 5 3 - lit SON-OW IC'" M A O@LS(03 Home Improvement Contractor# S 3 Worker's Compensation # '4 Y '1 Y Z-(A ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO f V1 I2S-1-0 N_S M I�—1,5 XFe-(L SrPsT b N l SIGNATURE DATE I C1 ) 11 r y If FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED_ 4.. . ..MAP/PARCEL NO. ' ADDRESS VILLAGE OWNER DATE OF INSPECTION: l FOUNDATION ,' FRAME j rINSULATION:A. s f FIREPLACE ELECTRICAL: ROUGH FINAL f 1 PLUMBING: ROUGH FINAL 41 ' GAS: � , e•; - ROUGH u` FINAL / �:-� FINAL BU'ILDING�; x: Y�f�. �• . 4 ' .... DATE CLOSED OUT. . - ASSOCIATION PLAN NO. II The Conznionwealth of Massachusetts Department of Industrial Accidents Offce of Investigations 600 Washington Street Boston, AM 02111 www.nzass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organization/Individual): CA1_18F_)e 23U1 L D1_IV + M: L L.0 Address: ,TAN SE9AS7-1A0 DOVE 0N1T /O I _ City/State/Zip: S4P J;DwiCN J".A &nS(D 3 Phone#: 5 O 8S 19 10 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 8. ❑Demolition working for me in.any capacity. employees and have workers' [No workers'comp, insurance comp.insurance.: 9• ❑Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LF❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL insurance required.]t c. 152, §1(4),and we have no 12.❑ Roof repairs employees. [No workers' l3.['0ther ZVSULATtbl) comp.insurance required.] *Any applicant that checks box#I 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 thepolicy and job site information. /' Insurance Company Name: /`1 C GRoU n Policy 4 or Self-ins.Lic.#: 't{L�Lf gt f L Expiration Date: .3—a 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 S 1,500.00 and/or one-year imprisonment,as well`as civil penalties in the fonn of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of InvestiLations of the DIA for insurance coverage verification. /do hereby Bert f der the pains and p nalties of perjury that the information provided above is true rued correct. ;icrnatui-e Date: — Official Ilse ollh-. Do not write in this area, to he completed by cite or town ofrcieL it City or To- n: PermitlL-icense Issuing Authority (circle one): I,. Board of Health '_. Building Department 3. Cifl;%Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other - Contact Person: Phone ,aco 9 CERTIFICATE OF LIABILITY INSURANCE ° ' 9/14/14/2011 `--�� 11 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(ies)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). PRODUCER CONTACT David Crawford NAME: Eldredge & Lumpkin Insurance Agency, Inc. PRONE (508)945-0393 FAX AIC No (soe)eas-aoaa 697 Main Street E-MAIL david@elinsurance.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Chatham MA 02633 INSURER A National Grange Mutual Ins Co 14788 INSURED INSURER B:Commerce Group IG001 Caliber Building and Remodeling LLC, INSURERcAce American Ins. Co. - ARWC 22667 Efficient Buildings, LLC. INSURERD: 8 Jan Sebastian Drive #10 INSURER E: Sandwich MA 02563 INSURER F: COVERAGES CERTIFICATE NUMBER:Housing Assistance Corp 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 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 TypE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR IN SR WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence S 500,000 A CLAIMS-MADE Fx_]OCCUR MP027360 9/15/2011 9/15/2012 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP,OP AGG $ 2,000,000 PRO- - X POLICY 17 JFCTLOC S i AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000 000 3 Ap; �LiTO - BODILY INJURY(Per person) $ ___0,VNED ON-OWNED RSCHEDULED BNVCS /16/2011 /16/2012 BODILY INJURY(Per accident) $_7CS AUTOS ON-O PROPERTY DAMAGE NI!RED AUTOSN AUTOS Per accident $ S }{ UMBRELLA LIAR OCCUR I I EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE - AGGREGATE $ 1,000,000 DED I I RETENTIONS ! rU027360 9/15/2011 9/15/2012 $ C WORKERS COMPENSATION I WC STATU- OTH. AND EMPLOYERS'LIABILITY �!N ! - —, ANY PROPRIETOR,PARTNE^E;:EC.:'.`_— ' E.L.EACH ACCIDENT $ 5OO OFFICERWEMBER EXCLUZE-, ,NiAl 000 11 494PB44 /2/20 /2/2012 (Mandatory in NH) � —1 - � E.L.DISEASE-EA EMPLOYE SjQO QQO desc^be-cer— - _�_ I= ^'• 0—=-- _--- E.L.DISEASE-POLICY LIMIT $ 500,000 ( ', �_:.-'-n''v C+-�r•�.-.+ sS _OC:TONS VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) __ _ -:__._c_, with the Weatherization Assistance Program, the following entities are named as _.._ viability coverage under Pol #MP027360: National Grid Corporate Services LLC DBA -- - - - Inc. , Colonial Gas Co. & NSTAR Electric. { CERTIFICATE HOLDER CANCELLATION j SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Housing Assistance Corporation Att: Ruth Bechtold p 460 West Main St: AUTHORIZED REPRESENTATIVE Hyannis, MA 02601 David Crawford/ELDDCI ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. ;h8025 mmnnsi ni Tho 6r.nPrl^na anri Inn^nro ronictororl mmr4e^f Ar r)pn f N tilaaachu.ctt: - Dcpartmcnt ()f Puhlic *afc" 1 Boar(4-eof Building, Regulations and Stiu"dards Construction Supervisor License License: CS 95038 i Restricted to: 00 F STEVEN WHITE 147 RIDGEWOOD AVENUE r . HYANNIS, MA 02601 f Expiration: 2/28/2012 ( nnnii. i.nc� Trg: 19311 ovsrinaov -_ _-_ \ Office of Consumer Affairs&B siness Regulation E HOME IMPROVEMENT CONTRACTOR Registration >54359 Type: �s Expiration 2- 2M 2013 Ltd Liability Corpo CAL BER BUILDING-A -MODELING,LLC. STEVEN WHITE 8 JAN SEBASTIANtR1VB001T SANDWICH,MA 02563, ; .'f_ Undersecretary R, License or registration valid-for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation ati 10 Park Plaza-Suite 5170 Boston,MA 02116 y Not valid without signature S ee€t �6_ S �� f%<E t,E€Y 't Y ��_ oft',P(5 ❑z t� t_. Ai-N.-A. `^�•"�4.r—s +G' _�'Y r =.l"<i��`�'�I'L �.ti. Rl f 16'.il: F k PAID � L� `� Lai, T (t0G) �1—.i40.' F (.`}leil) ;'i'p0,-'J,}�1!3 rt - R a .FY ti.,r_y .t oil as �.t&Ly f 2fl 1 ,T C c�cFr,�C�a .£i `4 e - �.� HOME OWNER WEATHERIZATION WORK PERMIT& FUEL RELEASE: PLEASE FILL OUT AND SIGN THIS FORM IF YOU ARE THE APPLICANT HOME OWNER. h&6by consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation ( herein after,referred as ,,Agency") on the property located at: f �a Q: 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: 1. l ;I've 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 weatheii.zation �vork on said property. ?- 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. 1 have read the provisions of this agre,6ient>as listed and freely give my_..consent. Home Owner: (Signature) Date• �,. Agent: (signature) .Date: i::.j ® � _ ' l.. LIAC-approved Weatherization Company : r� L G��1 �r Caliber Building & Retnod Cape Cod Insuiation Cape Save Creswell Construction Frontier Energy Solutions Lohr& Sons Peter Smith Resolution Energy Rock Solid Construction A11 Cape Insulation' .