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0123 THIRD AVENUE (HYANNIS)
Town of BarnstableBuilding Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept N't t BA RSTACGLE. - - E "^" �J�l' Posted Until Final Inspection Has Been Made: o o+ Where a Certificate of Occupancy is'Required,such Building shall Not be Occupied until a Final Inspection has been made. , Permit Permit No. . B-17-4189 Applicant Name: James Curley Approvals Date Issued: 12/05/2017 Current Use: Structure Permit:Type:` Building-Sid ing/Windows/Roof/Doors Expiration Date: 06/05/2018 Foundation: Location: 123 THIRD AVENUE(HYANNIS), HYANNIS Map/Lot: 245-119 Zoning District: RB Sheathing: Owner on Record: CURRAN,JOSEPH F JR&CLAIRE M TRS - Contractor Name: JAMES P CURLEY Framing: 1 Address: PO BOX 694/123 THIRD AVENUE Contractor License: CSSL-099138 2 WEST HYANNISPORT, MA 02672-0694 Est.Project Cost: $ 15,000.00 Chimney: Description: Strip and re-roof approximately 28 square of asphalt roof shingles. Permit Fee: $76.50 Insulation: . Project Review Req: Fee Paid: $76.50 Date: 12/5/2017 Final: Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and.the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning 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 public inspection 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 signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 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 Low Voltage Rough: S.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: tt 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 Town f Barnstable o g^ ` 200 Main Street, Hyannis MA 02601 508-862-4038 s"q. Application for Building Permit Application No: TB-17-4189 Date Recieved: 12/4/2017 Job Location: 123 THIRD AVENUE(HYANNIS),HYANNIS 4bQ ) s Permit For: Building-Siding/Windows/Roof/Doors �Nop �Q,J Contractor's Name: JAMES P CURLEY State Lic. No: CSSL-099138y`�T�Q� Address: Centerville, MA 02632 Applicant Phone: (508) 790-4508 (Home)Owner's Name: CURRAN,JOSEPH F JR& CLAIRE M Phone: (508)771-5309 TRS (Home)Owner's Address: PO BOX 694/123 THIRD AVENUE, WEST HYANNISPORT,MA 02672-0694 Work Description: Strip and re-roof approximately 28 square of asphalt roof shingles. Total Value Of Work To Be Performed: $15,000.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate.to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: James Curley 12/4/2017 (508)790-4508 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $15,000.00 Date Paid mm Amount Paid Check#or CC# Pay Type Total Permit Fee: $76.50 12/4/2017 $76.50 Paypal Paypal ......... ......... ........_................. Total Permit Fee Paid: $76.50 «....eA«.».. .za „��:�v«.....«.....o»d .h.«.e... «e..>..:W3eaww.....aw. ... .,....._..k»v... ...,«... Wealth erizati,on & Insu ( at ! on 00 Grove Sr.Fall R1ver,Me m7.23 bmlate=veber U March 31,2014 Town Of Barnstable 11omas Peary, CBO 3 200 Main Strdet Hysanio,MA 02601 RE: 121 Third Ave /�y Dear Mr.Peery, This Affidavit Is to certify that,all w.o)rk completed at i 23 ThixdAve hs'been inspected by a oertifed.Bp.11 )hVector. R22 cellulose was added to attic kneewall floored space.2"PSK was add d to kneewfdlurea A11 Work Performed Meers or exceo4 Federal and Stale-Requirements.. Sincerely, Roland Langevin Insulate 2 Save,Inc President CSL 103 961 HIC 166311 i SI arkTURE —DATE' � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map,V41S Parcel Application 90 Health Division Date Issued / -�o Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Gil_,-� Village Owner aoae C)h N-Armes Address I ::tbi rA I4t J�e_ Telephone `BUR- `1-15- oaa'�' Permit Request 1'05A6 \1 n A-\,i L A7 V Aye 1/DC-LI1 \.nta a IGA-,n n b ibLD fl Square feet: 1 st floor: existing proposed 2nd floor: existing propose Tgt3I new, Zoning District Flood Plain Groundwater Overlay �n F Fr, Project Valuation CQfo.A-I Construction Type v Lot Size Grandfathered: ❑Yes ❑ No If yes, attach su porting docur6 ntation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King'sHighway �Yew ❑ 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 ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Y1 _� Telephone Numbers Mtn: �CD 7C Address 010 s? License # Home Improvement Contractor# Worker's Compensation # T ILSW AI 1 (4 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO « YA�5k SIGNATURE DATE In i FOR OFFICIAL USE ONLY r APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: 1 FOUNDATION FRAME 0 INSULATION i FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. t, The Commonwealth of Massachusetts Department of Industrial Accidents 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): Address: L410 �UNf e 15A— City/State/Zip: YYYN Phone #: ,�o3• 5ZP"7— (P 7d Co Are you an employer?Check the appropriate box: Type of project(required): 1.Q1I am a employer with I S 4. ❑ 1 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 working for me in any capacity. employees and have workers' insurance.* 9. ❑ Building addition [No workers comp.comp. insurance P• required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I atn a homeowner doing all work officers have exercised their I I.El Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §](4),and we have no employees. [No workers' 13.LOtherJ05aL` 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 the policy and job site information. Insurance Company Name:--u c ya i o5uy-an oP cs)-rGy Policy#or Self-ins. Lic. C,?j( I Expiration Date: Job Site Address: ( a 3 i 1 1 i S l Yry .; City/State/Zip: JCQ ►�t��p 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 under the pains andpenalties ofperjury that the information provided �above isI true and correct. Signature: Date: Phone#: _� Offrcial 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#: .aco�zv� CERTIFICATE OF LIABILITY INSURANCE DATE(MM 6/13/ 6/13/13 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 pollcy(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 endorsernent(s). PRODUCER CONTACT AnthonyF. Cordeiro Insurance PHONE_.__-----.__.._..._._..-..._.._._._.__...._.._......_.__--....._.-....__...................._Fnz 171 Pleasant Street �a a�xt) (508) 677-0407 LAr-Nol' (508) 677-0409 Fall River, MA 02721 ADDRESS- lbrizido@cordei.roinsurance.com INSURER(SLAFFORDING COVERAGE—,^,-— �NAIC q _ INSURER A_Atl.._antic Casualty Ins. Co. INSURED INSURER B:Torus_ Spepialty Ins. ,Co. Insulate 2 Save, Inc. INSURERC:Great American Iris. 410 Grove St. INSURER D_Guard_Insurance_Group _ Fall River, MA 02720 INSURERE: _ .INSURER..F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY 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_. ... -POUCY-EFF� P.OLI-CY EXP LTR TYPE OF INSURAIJCE POU,CY NUMBER MMIDDlY MMIDIYYYYY LIMITS p, GENERALLIABIUTY Y Y M081000174-1 6/12/23I 6/12/14 EACHOCCURRENCE $ 1,000,000 II! X COMMERCIAL GENERAL LABILITY DAMAGE TO RENTED CLAIMS-MADE OCCUR 000 _ n pas-)e ,000 PERSONAL&ADVINJURY $ 1,000,000 GENERAL AGGREGATE-----$ -21 OOO.,OOO GEN'LAGGREGATE LIMITAPPLIES PER PRODUCTS-COMPIOP AGG $ 2,00Q�0Q0 X POLICY PRO- LOG _ AUTOMOBILE LIABILITY CO MB INEDciderx SIN LE LIMIT Ea ac $ ANY AUTO BODILY INJU I.RY(Per person) $ ALL OWNED SCHEDULED AUUTOSS AUTOS ( BODILY INJURY(Per accident) $ NON-OWNED —' DAMAGE PROPERTYOAMAGE --.�..-��-"-------.—�- HIRED AUTOS _AUTOS Per accident $ B X UMBRELLA LIAR X OCCUR I - 78264D131ALI 6/12/13 6/12/14 EACH OCCURRENCE $_2,000,000 EXCESSLIAB - AGGREGATE - $ 2,000,000 CLAIMS-MADE ii DED X RETENTION$ 10,000 k $ D WORKERS COMPENSATION INWC311431 12/10/12 12/10/13 X WCSTATU- I OTH- AND EMPLOYERS'LIABILITY Y/N k ORYL1M1T8-_____...ER... ANY PROPRIETOR/PARTNER/EXECUTIVE I E1,EACHACCIDENi _ $ .. .___5OO OOO OFFICERMIEMBEREXCLUDED? NIA - --,---•.- (Mandatory in NH) ! EL„DISEASE,-EA EMPLOYEE_$ 500,000 , If yyes describe under I f OES�RIPTION OF OPERATIONS below _ `E,L.DISEASE-POLICY LIMIT $ 500,000 C Equipment Floater IMP 375-99-76-01 6/12/13 6/12/14 Shop Storaqe 75,350 Veh Storage 76,250 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Rerrarks Schedule,If more space is required) Proof of Insurance. Residential Insulation Contractor. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main St. Hyannis, Ma 02601 AUTHORIZED REPRESENTATIVE yiT4� f 1 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at (Property Address) (Prop rty Address) hereby authorize YA (Subco tractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. Own s i ture � 4- ",?4 13 Date F ate. Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 166311 Type: DBA Expiration: 5/11/2014 Tr# 222532 INSULATE 2 SAVE ROLAND LANGEVIN ---------- ----..___—_.--_-__-- 536 EASTERN AVE. FALLRIVER, MA 02723 Update Address and return card.Mark reason for change. DPS-CAt Co 50M-04/04-G101216 Address �_! Renewal L7 Employment �_i Lost Card �,,+ ✓lee -C�arr�nreo�ruaeczllle o�'✓�aoaactucaeA.a _ ._ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only �j HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: .166311 Type: Office of Consumer Affairs and Business Regulation - Expiration: 5/11J2014 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 INS LATE 2 SAVE-:;::''' LANGEVIN 536 EASTERN 536 EASTERN AVE.,-.. FALLRIVER, MA 02723 Undersecretary Not valid without signature i Massachusetts.-Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-103861 ,:l ;. ROLAND LANGEVIN «»-ram 536 EASTERN AXE. ',1 Fall River MA 027723 ,\of ` 9�_ . wxPiratior.. commissione' 08/24/2015 w RISE ENGINEERING Federal to#06-MS629 RI Contractor Registration No 8186 Adivision Of'1'hicisch Engineering MA Contractor Registration No 120979 CT Contractor Registration No 620120 1341 Elmwood Avenue,Cranston,Rl 02911) (401)784-3700 FAX.{401)78a-3710 CONTRACT R Page 1 I S PROGRAM THIS CONTRACT{S ENTERED INTO BETWEEN RISE CLC-RCS ENGINEERING AND THE CUSTOMER FOR WORK AS E N C I N E E R I N C DESCRIBED BELOW CUSTOMER PHONE DATE Client 0 Joseph F Curran (508)775-0228 05/23/201.3 103551 _---------._. . ___.---_-.__.___...___--_----.----.__... SERVICE STREET BILLING STREET 123 Third Avenue Po Box 694 SERVICE CITY,STATE,ZIP SIUJNG CITY,STATE,ZIP West Hyannisport,MA 02672 W Hyanport, MA 02672 JOB DESCRIPTION Provide labor and materials to seal areas of your home against wasteful,excess air leakage. This work will be pertormed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air exchange and indoor air quality.Materials to be used to seal your home can include caulks,foams,weatherstripping and other products. Primary areas for seafing include air leakage to kitties,basements;attached garages and other unheated areas(windows are not generally addressed.) (18)working hours. S 1,386.00 Provide labor and materials to install 2"FSK faced semi-rigid Fiberglass board insulation to(510)square feet of kneewall rafter area+ gable. $1.688.10 Homeowner is responsible for the removal of the stored items blocking the installation ofweatherization work in the knecwall areas. Removal must occur prior to the scheduled work start. SO.00 Provide labor and materials to install 3.5"R-13 faced fiberglass batt insulation to(280)square feet of kneewall gable wall area. $375.20 Provide labor and materials to install 2" FSK faced semi-rigid fiberglass board insulation to(360)square feet of kneewall area. $1,191.60 Provide labor and materials to install a 6"layer or R-22 Class 1 Cellulose added to(680)square feet of attic knecwall floored space. $877.20 Provide labor and materials to insulate(2) back ofthe kneewall hatch with 2"rigid Thermax board,and seal the edge of the hatch with weatherstripping. $85.00 Provide labor and materials to install a 6.25"layer of R-19 fiberglass balls to 9360)square feet of sloped ceiling area.Wherever possible baffles will be installed to the entire length of each bay to maintain ventilation space. $529.20 Provide labor and materials to install ventilation chutes in(140)rafter bays to maintain air flow. $488.60 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently- for eligible measures,the Cape Light Compact offers 75%incentive,not to exceed S4,000 per calendar year,and an incentive of 100%for the Air Sealing measures. $0,00 RISE ENGINEERING Federal ID a 06-0405629 ' RI Contractor Registration No 8186 A division or l-hicisel,Engineering MA Contractor Registration No 120979 CT Contractor Registration No 620120 1341 Elmwood Avenue,Cranston,R1 02910 (401)784-3700 F:1,C(401)784-3710 CONTRACT Page 2 PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE CLC-RCS ENGINEERING AND THE CUSTOMER FOR WORK AS ENGINEERING DESCRIBED BELOW CUSTOMER PHONE DATE Cnem u Joseph F Curran (508)775-0228 05/23/2013 103551 SERVICE STREET BILLING STREET �" ••'" 123 'Third Avenue Po Box 694 _.... . __._...... SERVICE CITY,STATE,LP ...._..._....:__.._. .,..._..__.............._._. BILLING CnY,STATE,ZIP West Hyannisport,MA 02672, W Hyanpolt, MA 02672 ,JOB DESCRIPTION Total: $6,620.90 Utility Incentive: $5,312.18 Customer Total: $1,308.72 WE AGREE HEREBY TO FURNISH SERVICES•COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***One Thousand Three Hundred Eight&721100 Dollars. $1,308.72 UPON FINAL INSPECTION AND APPROV BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALAN AFTER 30 DAYS.SEE ERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION, DO NOT SIGN THIS CONTRACT IF THERE ARE ANY NK SPACES AUTHORIZED SIGNATURE•RISE ENGINEERING r—u—'va ----___.-.. CUSTOMER C TANCE��[/ NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE '_\,,,.. ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE DAYS, SATISFACTORY TO US AND ARE HEREBY ACCEPTED,YOU ARE AUTHORIZED,TO DO THE WORK - --...... AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE li "t f' w'ryy RISE ENGINEERING Completion ' A division ofThiclsch Engineering Certificate lI` 1341 Elmvood Avenue,Cranston,R1 02910 PROGRAM R S F.Nc;Ulk F.pNC (401)784-3700 FAX(401)784-37.10 CLC-RCS CASE 103551 Page 1 CONTRACTOR 0050 Insulate 2 Save CONTRACT DATE START DATE ADDRESS 6/27/2013 10/2.1/201.3 AUDITOR CLIENT NAME Joseph F Curran Scott Shaw ADDRESS 123 Third Avenue CASE West Hyannisport,MA 02672 103551 HOME (508)775-0228 WORK () X- 1'RO.IEC'1'NO CELL 17AX RIS-81-13-0035 Air Sealing Completed Start CFM50 End CFM50 70%OF BAS CFM50 Combustion Safety Testing Worst case depressurization number pascalsCAZ limit pascals Spillage failure: Yes or NoDrait failure: Yes or NoCO levels: pass or fail The following areas were sealed,as directed by the;R1SE Engineering Energy Specialist: Basement-CrawlspaceAttics-Kneewall SpacesLiving Areas Sill/Rim Joist_Wall Top Plates_Plumbing.Gaps Plumbing Gaps_Plumbing Gaps_Door Sweeps _Wiring Gaps_Wiring Gaps_Door Weather-strip _Chimney Chase_Chimney Chase_Fireplace/Wall seam _Basement.Door_Attic Hatch_Duct Register Gaps Crawlspace Ducts_Joist Transitions_Air Con.Cover Kneewall Hatch - Attic Ducts Exterior Items Sealed: Other Items Sealed: Comments: Perform(1.8)working-hours of air sealing to includeall appropriate blower door tests,combustion safety RISE ENGINEERING Completion A division of Thicisch Engineering Certificate 1341 Elmwood Avenue,Cranston,11102910 PROGRAM R I S E (401)784-3700 FAX(401)784-37.10 CLC-RCS CASE 10355.1 Page 2 £NCIN£.Ht1NG ' tests and procedures. Energy Specialist's NOTES: Install 2" FSK faced semi-rigid fiberglass board insulation to(510)square feet of kneewall rafter area. Tape all seams and edges with FSK tape. Homeowner is responsible for the removal of the stored items blocking the installation of'weatherization work in the kneewall areas. Removal must occur prior to the scheduled work start. Install 3.5'R-13 kraft faced fiberglass batt insulation to(280)square.feet of kneewall area. Install 2"FSK faced semi-rigid fiberglass board insulation to(360)square feet of kneewall area. Tape all seams and edges with FSK tape. Install a 6" layer of R-22 Class 1 Cellulose added to(680)square feet of attic kneewall floored space. Drill &plug method. Insulate and seal(2)kneewall hatch(es)by installing.2"rigid Thermax board. Install a 6.25" layer of R-19 fiberglass batts to(360)square feet of sloped ceiling. Wherever possible install baffles to the entire length of each bay to maintain ventilation space. Install ventilation.chutes in(140)rafter bays to maintain air flow. I confirm that the measures listed above have been completed to my satisfaction.I have received a copy of the Certificate of Completion and hereby authorize the release of any final payments to the Contractor.I understand that this Authorization of Completed Work does not in any manner void any warranties provided to me by the Contractor. Inspector's Signature Customer Signature DATE DATE 9/1812013 11:09:18 AM RISE ENGINEERING Federal to#05-0405629 RI Contractor Registration No 8186 A division of Tbielseh Engineering MA Contractor Registration No 120979 CT Contractor Registration No 620120 1341 Elmwood Avenue,Cranston,RI 029.10 In A (401)784-3700 FAX(401)784-3710 C 0 I V T Rl'!V T Page 1 RI S E PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE CLC-RCS ENGINEERING AND THE CUSTOMER FOR WORK AS ENGINEERING DESCRIBED BELOW CUSTOMER PHONE DATE Cllont 8 LL Joseph F Curran (508)775-0228 05/23/2013 103551 ...SERVICE STREET�__r�__.... BILLING STREET —..__--..._...�_..._ 123 Third Avenue Po Box 694 ......... -- -— - ------- -----._.._. SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP West Hyannisport,MA 02672 W Hyanport,MA.02672 JOB DESCRIPTION Provide labor and materials to seal areas of your home against wasteful,excess air leakage. This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air exchange and indoor air quality.Materials to be used to seat your home can include caulks,foams,weatherstripping and other products. Primary areas for sealing include air leakage to attics,basements,attached garages and other unheated areas(windows are not generally addressed.) (18)working hours. $1,386.00 Provide labor and materials to install 2"FSK faced semi-rigid fiberglass board insulation to(510)square feetof kneewall rafter area+ gable. $1,688.10 Homeowner is responsible for the removal of the stored items blocking the installation of weatherization work in the kneewall areas. Removal must occur prior to the scheduled work start s $0.00 Provide labor and materials to install 3.5"R-13 faced fiberglass bait insulation to(280)square feet of kneewall gable wail area.. $375.20 Provide labor and materials to install 2" PSK faced semi-rigid fiberglass board insulation to(360)square feet of kneewall Lima. $1,191.60 Provide labor and materials to install a 6"layer orR-22 Class I Cellulose added to(680)square feet ofattic kneewall floored space. $877.20 Provide labor and materials to insulate(2) back ofthe kneewall hatch with 2"rigid Thermax board,and seal the edge of the hatch with weatherstripping. $85.00 Provide labor and materials to install a 6.25"Myer of R-19 fiberglass bates to 9360)square feetof sloped ceiling area.Wherever passible baffles will be installed to the entire length of each bay to maintain ventilation space. $529.20 Provide labor and materials to install ventilation chutes in(140)rafter bays to maintain air How. $488.60 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently, for eligible measures,the Cape Light Compact offers 75%incentive,not to exceed$4,000 per calendar year,and an.incentive of 100%for the Air Sealing measures. $0.00 }} RISE ENIGINEERING Federal ID a 05-0405629 _ RI Contractor Registration No 8186 A division orThicIsch Engineering MA Contractor Registration No 120979 CT Contractor Registration No 620120 1341 Elmwood Avenue,Cranston,RI 02910 (401)784-3700 FAX(401)784-3710 C®NTr%MC ' I� I S Ia Page 2 PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE CLC-RCS ENGINEERING AND THE CUSTOMER FOR WORK AS ENGINEERING DESCRIBED BELOW ---------- ..____.__ _.__..._._.---.. ___------____ �_.. . .....__._._____....___.�.-____... CUSTOMER PHONE DATE Client$ Joseph F Curran (508)775-0228 05/23/2013 103551 ............. ------ SERVICE STREET BILLING STREET 123 Third Avenue Po Box 694 ....... . __.__ SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP - West Hyannisport, MA 02672 W Hyanport,MA 02672 JOB DESCRIPTION Total: $6,620.90 Utility Incentive: $5,312.18 Customer Total: $1,308.72 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***One Thousand Three Hundred Eight&72/100 Dollars $1,308.72 UPON FINAL INSPECTION AND APPROVAI,BY RISE.ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID 6ALAN AFTER 30 DAYS.SEE ERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY NK SPACES AUTHORIZED SIGNATURE-RISE ENGINEERING H CUSTOMER C TANCE NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE __._...___....L,b!.........._..._..-...._„_. ..-.__.._.._,_,__._ _.._,,,._..„, ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU APE AUTHORIZED TO DO THE WORK —� GAYS. AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE -' ►S.�._ 3 i . Upstu.irs or,q 5tyz CLIENT ✓ r h PRE-TESTING INFORMATION PRE-WORK TESTER DATEI r_--7) ? START 1.r.2 Alt } i POST-WORK TESTER DATE CFM J y� (IVee01 b`t RISE al ENGINEERING COMBUSTION SAFETY PROTOCOL PASS FAI L 1 Zero the Carbon Monoxide meter outdoors. 2 Record ambient CO PRE POST Living areas Kitchen CAZ 1 Is at least one(1)carbon �{ide CAZ 2 alarm present in this homy Y/N 3 Circle combustion unit VBoilFurnace water heater fireplaceskov OtherComment if any are inition: Circle Heat FUEL: Oil GNatural G Propane Electric Other Circle DHW FUEL: Oil Ga Propane Electric Other kl�t l/t 4 Record quantity of various exhaust appliances: CITY. _ OTY. Air Handler(heat and/or A/C) Central vacuum Kitchen exhaust exhaust 1,yEdd Whole House fan Bathroom exhaust Attic exhaust fan _-- Clothes Dryer Other — 5 Perform Worst Case Depressurization tests: PRE POST_ (Set up house in"winter"conditions and turn all combustion appliances off.) ;1 Record Baseline Pressure: All exhaust equpment ON and adjust doors as needed (and adjust doors as needed) Air Handler AND exhaust equipment ON (readjust doors as needed) Air Handler ON only (readjust doors as needed) Record the actual WORST CASE depressurization number (adjusting the highest pressure difference by the Baseline Pressure) CAZ Depressurization Limits (you must circle the proper limit Venting Condition Limit Pascals Orphan natural draft water heater(including outside chimneys) -2 Natural draft boiler or furnace commonly vented with water heater -3 Natural draft boiler or furnace with vent damper commonly vented with -5 water heater Individual natural draft boiler,furnace or individual water heater with a,properly -5 sized vent stack such as when a new chimney lining has been installed. Mechanically assisted draft boiler or furnace commonly vented with -5 water heater Mechanically assisted boiler or furnace alone,or fan-assisted DHW alone -15 Chimney-top draft inducer(Exhausto-type or equivalent); -50 High static pressure flame retention head oil burner; Direct-vented appliances/Sealed combustion appliances. 6 Perform Spillage Tests (Performed with CAZ In Worst,Case for depressurization) Monitor ambient CO in the zone throughout the test. If two combustion appliances are vented together,start with the smaller appliance. Use your stop watch: Is there evidence of Flame Rollout? Y If N If yes,no work until corrected. Form 3/9/12 Does the flame distort when the Air Handler fan starts? If yes,heat exchanger is cracked. r ider Worst Case, after 60 seconds of o eration is there an s illa a?- ORK TEST L POST-WORK TEST Smnce Larger appliance Smaller appliance Larger appliance Yes Yes No Yes No Yes No FAIS FAILS PASSES FAILS PASSES FAILS PASSES IF PILLAGE TESTIS A FAILURE AT WORST CASE, T UNDER NATURAL CONDITIONS AND RECORD: After 60 seconds of operation under natural conditions is there any spillage? Pre-Worts Test Yes No Post-Work Test Yes No 7 Draft Tests PRE POST Record the approximate outslde temperature: PRE-WORK POST-WORK DRAFT Pass/Fail DRAFT Pass/Fail Heating system 2nd Heating system Water Heater Other MI n Acceptable Draft Test Ranges Outside Temperature degree Minimum Draft Pressure Standard Pa -2.5 0-9 outside temp/40 -2.75 -0.5 8 Carbon Monoxide Tests Measure the undiluted flue gases and the ambient air in the zone(s). PRE WORK POST-WORK Undiluted Flue Gas Ambient CO in E. Undiluted Flue Ambient CO in CO the zone !/ Gas CO the zone Heating system �•S`, 2nd Heating system Water Heater Gas oven Gas stove top Other CO CONCERN: If ambient reaches 35 ppm cease tests,open windows,Inform HO and evacuate until clear.If the CO in any appliance is measured greater than 100,or if ambient CO in the home exceeds 35 ppm then appliance clean and tune must be In the scope of work. Combustion Safety Test Action Levels CO Test And/Or Spillage and Draft Retrofit Action Result Test Results C-- --=:4 0-25 Perri And Pass Proceed with work asses Recommend that the CO problem be fixed 26-100 ppm And Fails at worst case Recommend a service call for the appliance and/or repairs to the home to correct the problem onl 100-400 lOr Falls under natural Stop Work:Work may not proceed until the system is serviced and the problem is corrected ppm conditions >400 ppm And Passes StOD Work:Work may not proceed until the system is serviced and the problem is corrected >400 ppm And Fails under any Emergency:Shut off fuel to the appliance and have the homeowner call for service immediately 'CO measurements for undiluted flue gases at steady state 9 Conclusions: Circle the appropriate results and retrofit actions on the Client Form. Discuss health and safety problems,concerns,recommendations and resolutions. �� Obtain client signature and leave a copy with the client. IMPORTANT PRE POST •Return hot water tank to normal settings 'Turn fuel switch on. v.4FORM 3/9/12 'Make sure heating system is ontoperating. l � p . i a CLIENT NAME: CURRAN FILE# 103551 R I S E BUILDING AIRFLOW STANDARD p NGINflp01NC Please enter the information as requested to describe the house and your measurements. What is the type of Heating System? E= Electric G= Gas G H= Heat pump P= Propane O= Oil W=Wood GT= Geothermal heat pump K= Kerosene Is the house Air Condioned? Y=Yes N= No N How many stories is the House? 1, 1.5, 2, 2.5, or 3 2 Enter the dimensions: House Length House Width Average height per story This is the estimated volume of the house ]cu. ft. OR...If there are additions or other reasons why the actual volume is different, calculate the total correct volume by hand and enter here: 20842 cu. ft. What is the actual number of occupants? 2 What is the total number of bedrooms in this house? 3 Calculated LBL"N"factor 14.985 What was the Blower Door Measured CFM50? 3568 CFM50 Present ACH 0.69 The Building Airtightness Standard for this house is I[I .1822 CFM50 This BAS number cannot be decreased, but can be increased based on auditor's observations.of household conditions, and to ensure that combustion safety house depressurization limits are not exceeded. New ACH 0.35 ffatany time the finalVowerdoorreading.is'below°the,BA;S-kou must ke,one°&tHese actions You must recommend ventilation capable of continuous operation if the reading is above �� ] That ventilation must be capable of supplying to the living spaces up to jcfm of fres air. If you are performing shell measures, you must install ventilation capable of continuous operation if the reading is at or below: CFM50 That ventilation must be capable of supplying to the living spaces: c rn o res air. 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Permit Fee Date Definitive Plan.Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 123 Third Avenue Village West Hyannisport Owner Joseph Curran Address 123 Third Avenue Telephone 508-775-0228 Permit Request air. .sealing, install 228 sq ft of R-10 to crawlspace perimeter wall, R-19 to Band joist and house sill, install 1480sq ft of polyethylene to open ground in basement area Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1323.60 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 o~ Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal:stove: 0-a'es E No 04 Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ exist g ❑ n%w sib_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 3 e Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ — w w rn Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name RISE Engineering Telephone Number 401-784-3700 Address 1341 Elmwood Ave, Cranston, RI 02910 License # 100459 Home Improvement Contractor# 1 2o979 Worker's Compensation #WC2-Zll-259874-019 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO RI resource Recovery SIGNATURE DATE 1/11/10 c 7 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING I � DATE CLOSED OUT ASSOCIATION PLAN NO. I, 'r RISE ENGINEEP + Federal ID#05-0405629 r� A division of Thielsch E D Y a RI Contractor Registration No 8186 - 1" a Registration No 120979 udiuee tng MA Contractor e9 CT Contractor Registration No 620120 x141 1341 Elmwood Avenue,Cransion,RI02910 M L'J`09 (401)784-3700 FAX(401)784-3710 t CONTRACT - --- ...... Page THIS CONTRACT IS ENTERED INTO BETWEEN RISE _ — ENGINEERING AND THE CUSTOMER FOR WORK AS ENGINEERING DESCRIBED BELOW CUSTOMER - PHONE - DATE Client# - Joseph F Curran (508)775-0228 10/27/2009 103551 SERVICE STREET BILLING STREET , 123 Third Avenue Po Box 694 SERVICE CITY,STATE,ZIP BILLING CITY,STATE,LP West Hyannisport,MA 02672 W Hyanport,MA 02672 JOB DESCRIPTION RISE Engineering will provide labor and materials to seal areas of your home against wasteful,excess air leakage. This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air exchange and indoor air quality.Materials to be used to seal your home can nclude caulks,foams,weatherstripping and other products. Primary areas for sealing include air leakage to attics,basements and other unheated areas(windows are not generally addressed.) This work will be performed at the rate of$66 per man per hour,which includes materials and testing. 4 man hours. $264.00 RISE Engineering will provide labor and materials to install 228 square feet of R-10 rigid fiberglass insulation board to the crawlspace perimeter wall,and R-19 Kraft faced fiberglass to the band joist and house sill. $615.60 RISE Engineering will provide labor and materials to install 1480 square feet of 6 ml polyethylene over open ground in designated crawlspace/earthen basement areas: $444.00 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently,for eligible measures,the Cape Light Compact offers 75%incentive,not to exceed$2,000 per calander year. $992.70 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ""Three Hundred Thirty&90/100 Dollars $330.90 UPON FINAL INSPECTION AND APPROV RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFJER 30 Dr. E.))%RSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLAN ACES r ft ( / AUTHORIZED SIGNATURE-RISE ENGINEERING C TO .A EP NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE w ACCEPTANCE OF CONT -THE OVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US A ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK DAYS. 1 p AS SPECIFIED,PAYMENT WILL BE MADE AS OUTLINED ABOVE The (Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street UV Boston,MA 02111 W®rke>rs9 Compensation Insurance Afffflidavvile Bualders/Contiractolrs/El'ect>rncians/Plunm be rs Applicant Information Please P rgnt I\Tame (Business/Organization/Individual): RISE Engineering;-A Division of Thielsch Engineering Address: 1341 Elmwood Avenue City/Mate/dip: Cranston, RI 02910 Phone #: 401-784-3700 or 1-800-422-5365 Are you an employer?Check the appropriate box: Type off project(required): 1.� I am a employer with 4. ❑ I am a general contractor and I 6. New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp, insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical'repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions .myself..[No workers' comp. c. 152, §I(4),and we have no. 12.❑Roof repairs insurance required.]t employees. [No workers' comp. insurance required:] 13.❑x.Other Insulation *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 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 their workers'comp.policy inforniatio.n: 1 am an employer that is providing workers'compensation insurance for my employees. ]below is the policy and job site lnformalion. Insurance Company Name: The Preston Agency Policy#or Self-ins.Lic. #: WC2-Zl l-259874-019. Expiration Date: 0 4/01/ 10 r Job Site Address: /r City/State/Zip:-� 41 Attach a copy of the workers' compensation policy declaration page(showing the policy number and a pirat➢on 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. lerd d ao hereby un.�der the 'in an penalties of perjury that the information provided above is true and correct. Signature: �v w - - ! Date Erik Nerstheimer for. RISE Engineering Phone#: 401-784-3700 or 1-800-422-5365 Ext. 133 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#: i rage I0II The Official Website of the Executive Office of Public Safety and Security (FOPS) Mass.Gov Home rublic Safety Department of Public Safety Licensee Complaints License Type Construction Supervisor License# 100459 Restriction WS,IC Name Erik Nerstheimer City, State,Zip North Scituate, RI, 02857 Expiration Date '3/28/2012 Status Current No complaints found for this Licensee. Back To Search ��ie.-(�d�ma�zcuea� a�,��c✓ucCe�a ..f . __.. .-.,___....:- ._..-...�._:...._.. Board of Building Regulations and Standards License or registration valid for individid use only HOME IMPROVEMENT COiVTRACIOR I. before the expiration date. If found return to: r Registr`anon;. 120979 Board of Building Regulations and Standards EzPlratio-n__3 2010 25/ One Ashburton Place Rm 1301 .... "�iistfn,Ma.02108 Type Supplement Card -HIELSCH ENGINEER'I,NG== 'RIK NERSTHEIMER `- 341 ELMWOOD,AVE :RANSTON, RI 02910 L. Admmisti:acor Not valid without sign2U re i ht-tp://db.state,ma.us/dps/llcdetails.asp?tXtSearchLN=CSL 100459 o/,)n i1)nnn ACOkD CERTIFICATE OFLIABILITY � SU OP ID MR DATE(MM/DD/YYYY) THIEL-1 11 05 09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO The Preston Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1350 Division Rd Suite 303 HOLDER.THIS CERTIFICATE DOES HOT AMEND,EXTEND OR PO Boat 810 y ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW East Greenwich RI 02818-0810 Phone: 401-886-8000 Fax:401-885-1700 INSURERS AFFORDING COVERAGE NAIL# INSURED INSURER A: Hartford Underwriters Ins. Co Thielsch Engineering, Inc INSURER B: Hartford Casualty Insurance Co Thielsch Group Inc. INSURER Liberty Mutual Insurance Group Hi Tech Realty Inc., y P 195 Frances Avenue INSURERD: North American Capacity Cranston RI 02910 ` INSURER E: - COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD TIVE POLICY EXPIRATION M/DD TIO LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY 02UUMM5678 04/01/09 04/01/10 PREMISES(Eaoccurence) $ 300,000 CLAIMS MADE ®OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE 42,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,0 0 0,0 0 0 POLICY X PRO- JECT LOC ETp Ben. 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 B X ANY AUTO 02UENTD4850 04/01/09 04/01/10 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ -. (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ . ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 10,000,000 B X OCCUR CLAIMS MADE" 02XHUUF6573 04/01/09 04/01/10 AGGREGATE $ 10,000,O0p RDEDUCTIBLE � $ _ X RETENTION $10,0 0 0 $ WORKERS COMPENSATION AND ' X TORY LIMITS ER C EMPLOYERS*LIABILITY ANY PROPRIETORIPART NEREXECUTIVE WC2-Zll-259874,-019 04/01/09 04/01/10 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYE $500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER D Professional Liab DVL000025902' 04/13/09 '04/01/10 Prof Liab 2,000,000 A Leased/Rented Egp 02UUNTD5678 04/01/09 04/01/10 Equipment 100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION TOWN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION. DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 - DAYS WRITTEN Town Of Barnstable, NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Building Division 200 Main Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Hyannis MA 02601 , REPRESENTATIVES. AUTHORIZED REPRESFjffA= ACORD 26(2001/08) ©ACORD CORPORATION r PAGE 2 NOTE-PAD: INSURED'S NAME , Thielsch Engineering; Inc OP IDEP�Cl DATE 11/05/09 Also for _ RISE Engineering, a division of Thielsch Engineering; Inc. Gaskell Associates, a division of Thielsch Engineering,Inc. BAL Laboratory, a division of Thielsch Engineering, Inca ESS Laboratory, a division of Thielsch Engineering, Inc. ALCO Engineering, a division of Thielsch Engineering, Inc. Water Management Services, a division of Thielsch Engineering, Inc.. 1 - 0 .n _