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Home My WebLink About0056 WEST HYANNISPORT CIRCLE J�6 wEs'r f�mrs�a!-� __ _ -._ _ _ `J G�e- - ARBE LLA® INSURANCE GROUP Elaine Dupuis-Lan6,Claim Manager CD August 28, 2017 ems' -�� co HYANNIS BUILDING COMMISSIONER ' 200 MAIN STREET HYANNIS,MA 02601 Claim Number: 033855808 Policy Number: 38597400000 Company Name: Arbella Mutual Insurance Company Date of Loss: 08/13/2017 Insured: LUCIEN POYANT Property Location: 56 W HYANNISPORT CIRCLE, HYANNIS,MA To Whom It May Concern: Claim has been made involving loss, damage, or destruction of the above captioned property, which may either exceed$1,000 or cause Massachusetts General Laws, Chapter 143, Section 6, to be applicable. If any notice under Massachusetts General Law, Chapter 139, Section 3B is appropriate,please direct it to the attention of the writer. Kindly include a reference to the captioned insured, location, date of loss and claim number. Very truly yours, Karen Kimball Claim Service Specialist Property Claim Office 800-272-3552 ext. 7398 Fax 617-773-4760 CC: HYANNIS HEALTH DEPARTMENT 200 MAIN STREET HYANNIS,MA 02601 HYANNIS FIRE DEPARTMENT 95 HIGH SCHOOL ROAD HYANNIS,MA 02601 iioo Crown Colony Drive P.O.Box 699195 Quincy,MA 02269-9195 telephone(800)ARBELLA www.arbella.com i CAPE C - 0.1IRARMS A_ INSULATI � -' Ilgiq TT3 'UTT&55 SN5UUjjoN SC61C.GSO ' ' SAiii OYTTigi INSYIAiION CfIlW05 1-800-696-611KTrr 1 Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, NtA 02601 Date: #13 Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the'building permit application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or, exceeds Federal& State Requirements, Property Owner Property! Address . Village Uv a44, PO . 6 GJ 1 CcY! , Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings t ) Off) ). (. Slopes Floors ( X) Walls ( ) ) ) ) Vea h cam. Sincerely. He E Cnsidy ,J ,President CuCape od slat ion, ° Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel_ , Application #02642ff 730� Health Division Date Issued 2 Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board tp Historic - OKH _ Preservation / Hyannis W Project Street ddress Village U<<� Owner Yo q,40* Address Telephone ` 0 t _ M S ( Permit Request 20 6vtw4AA11 440Y ��K i V ►d . -ry tie ® left'WU Wk ►ukkt( 1 z'() x4L Cj$t,e, i CiAttdoic -h j 8q' 44("5 W('i Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 571 Obi ' Construction Typej__4 f9( Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family d" 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/co hove: j4es allo 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 Telephone Number Address �/� 2� �� License #�/l�� Home Improvement Contractor# Worker's Compensation AIK14 r��T ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �CJ SIGNATURE DATE r FOR OFFICIAL USE ONLY r, } APPLICATION# DATE ISSUED MAP/PARCEL NO. t ADDRESS VILLAGE OWNER t DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING �• DATE CLOSED OUT ASSOCIATION PLAN NO. r v Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement C6- tr ctor Registration Registration: 153567 M Type: Private Corporation . TP Expiration: 12/15/2b14 Tr# 233831 t —z CAPE COD INSULATION, INC HENRY CASSIDY x� 3 ; 18 REARDON CIRCLE SO. YARMOUTH MA 02664 t`Update Address and return card.Mark reason for change. Address n Renewal Employment ❑ Lost Card SCA 1 Co 20M-05/1.1 V lae�om7irrcoauueal��o��aaaac�uaeLZa 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: ;;1'53567 Type: Office of Consumer Affairs and Business Regulation xpiration: 12%151201.4 Private Corporaticn 10 Park Plaza-Suite 5170 ='n Boston,MA 02116 CAPE COD INSULATIIQ NC ` ., HENRY CASSIDY 18 REARDON CIRCLET,.; SO.YARMOUTH, MA 02664 �,,, Undersecretary Ivot val witho t sifnat re A 1c 'CA+Vi'1-S.lYCl � U . 10 Park Plaza - Suite 5170 . Boston, Massachusetts 02116 Nome Improvement Contractor Registration Reqistration: 153567 Type: Private Corporation Expiration: 1 211 5/201 2 Tr# 206433 CAPE COD INSULATION, INC HENRY CASSIDY - 455 YARMOUTH RD. HYANNIS, MA 02601 -_Update Address and return card. Mark reason for change. L_..I Address Renewal [j Employment I I Lost Card PS-CA 1 0 50M.04/o,l(i 101216 Of icc.qt,,u a'��f-u uker B Af6ii".� uspe'•Regul•ition License or registration valid for individu!use t)n! HOME�fIVIPRESGif�`fP�`CJIV1`I�AC ` "tea before the expiration date. if found return to: ` Registration: 153567 Type: Office of Consumer Affairs and Business Regulation Expiration: 12/15/2012 Private Corporatiori 10 Park Plaza-Suite 5170 Boston,MA 02116 , OD INSULATION,INC HENRY CASSIDY 455 YARMOUTH R.D. HYANNIS,MA 02601 Undersecretary t alid ith t si— Lure Akpa(-tnfenf of Public S lfeh Board of Building Re+4ulittions an(I St.►n(I.11 dti Construction Supervisor License v License: CS 100988 $, cir: HENRY CASSIDY 8 SHED ROW WEST 1 ARMOUTH, MA 02673 Expiration: 11/11/2013 (wmui.•i.,acr Trr#: 7620 1 3: i ir'ivi No, 1605 P. 1 Client#:4597 CCINSUL ACOR1)IM, CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOIYYYY) 07/02/2012 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 certlficate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION 13 WAIVED,subject to the terms and conditions of the policy,certaln policies may require an endoniement.A statement on this certificate does not confer rights to the Certificate holder in lieu of such endorsemenl(s). PRODUCER - CONTACT_ Rogers&GrayIns.-So.Dennis NAME: Mar aret Yowl AIcC.Ne ExI:508 760 4602 F 677-816.2156 434 Route 134 EMAIL .Arc No: South Dennis, MA 02660-1601 508 398-7980 INSURRRIB)AFFORDINO COVERAGE NAIC N INSURER A:Peerless Insurance 16333 INSURED .Cape Cod Insulation Inc ,,,RER,.Evanston(Insurance Company 455 Yarmouth Road INSURERC:Atlantic Charter Insurance Hyannis,MA 02601 IN3URERD:Commerce Insurance Company 34754 INSURER E: IN51JRER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 19 TO CERTIFY THAT THE P LICIES OF INSURANCE I'TOD f7Cl_04V HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THIS POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE 13EEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE ADDL SUBS POLICY EFF POLICY Ex' voLICYNUMeER MMIDDIYYYY MMIDDIYYYY LIMITS A GENERAL LIABILITY CBP8263063 0410112012 04/011/201 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY SaM r,�Jj ENTED I� aotturrence $100,000 CLAIMS-MADE OCCUR .MEDEXP(Anyonepemon) $5000 PER$0NAI&ADV INJURY x1 00O 000 GENERALAOpREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PBR: - PRODUCTS•COMP/OP AGG s21000,000 POLICY PRO- PLOC Q AUTOMOBILE LIABILITY 12MM8CKVMIC 4/01/2012 04/01/201 EOMBED SINGLE LIMIT nO 1 OOU 000 AIJY AUTO BODILY INJURY(Per per-.on) $ ALL OWNEDLCHED _AUTOS BODILY INJURY(Per accident) $ X HIRED AUTONON DPROPERB X UMBRELLA XONJ453512 - 4/01/2012 04/011201 EACH OCCURRENCE $1 OOO OOO EXCES6 LIAMAOEAGGREGATE $1 00O 000 DED X C WORKERS COMPENSATION $ AND EMPLOYERS'LIABILITY WCA00525902 0/30/2012 06/30I201 X WCSTATU. OTIi. ANY PR r �CUTIV�Y r R E,L,EAON ACCIDkNT 1 OOO OOO OFFICERIMEMBER 6?(CI tJO (� a N/A (tnendetcq in II yea,deecdDe Under E.L.DISEASE_EA EMPLOYEE $1 00O 000 nd DESCRIPTION OF OPERATIONS Daldw - E.L.DISEASE.POLICY LIMIT $1 00O 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Allaah ACORD 101,Addlll—I Remarks Schedule,I(more epgce Is reGUlred) "Workers Comp Information Included Officers or Proprietors Certificate Holder is Included as an additional insured undor Goneral Liability when required by written contractor agreement. CERTIFICATE HOLDER CANCELLATION Cape Cod Insulation,inc SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL 6E DELIVERED IN AGCORDANCE, WITH THE POLICY PROVISIONS. AUTHORIZED REPRRSENTATIVE t ®18a -2010 ACORD CORPORATION,All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo aru registered marks of ACORD #$838491M83848 MFY _ ..._ The COMMoi It ltth of Massachusetts �<< Department r. j Industrial Accidents W Office .%j Investigations 600 igton Street WWPL'. i;O' .govldla Worker's conipeiisation Insurance Aftir :� if: Builders/Contractors/Electricians/.Plutxtbet's 1pplicaut lnfortuation Please Print I.,egibly YIC Naut� (I u,itt� s/Oranizatiort/individual): r' Q t ,�tldre•�;: 3- '� /.1/��/- � `4_ 0d2 ..: Are you all eulpluycr? Check the appropriate box, Type Of project(re(Juired): (. l ant a rulployer with . 4.❑ 1 am a„c,nc i:d contraetor and 1 have 6. New cansrruction r.utpluyec s (ful) and/or part-time).* hired tht: ,uI`I ,:onn'actors listed on 7. Remodeling the attar l w.I prat.]: I_I I air a sole, proprietor of partnership These sid, ,tractors have 8. Dernolit ort auil have (Io erttployces working;for employe,:; :uiJ have workers' comp. 9. Building addition me in any capacity. [No workers' insurauc,..' 10, Electrical repairs or additions comp insurance required.] 5. We are ci,of p ration and its 11. 1'lurnbin repairs or aiklitious I officers Ira;c cx�rcised their right of � l -J (ant a ht.rtneowner doing all work exemption Iici lMGL c. 152 §(4),and 12. Roof repairs, myself tNo workers' comp. we have i ,mployees. [No.workers'su 1ZG1 13. Other lk/ � ci �1�?(` 1 insurance required.] [ comp. i[tsu . nre requited.] _ � F 'Ally appltcn[that checks box it must also fill out the section below showw, 1hrir workers'compensation policy information. I liourcu:vucts who subtrtit this affidavit indicating they are doing all woi6.mJ ih<u hire outside contractors must submit a new affidavit indicating such. ft:nnttartoi:s that check this box trust attach an additional sheet showing th,:rr.ill:of the sub-contractors and state whether or not those entities have employees.tl the x,h-cuwtactvrs have employees,they must provide their workers'coil,p pcor,v number. 1 am an employer that is providing workers'compensation iu li,-anee for my employees.Below is the policy and job site irtlormatiort. Insurance Company Nance: Policy it of Self-ills. Lie. #: ZraC4- Expiration Date: .lob Site Address: . W1w " v- - _`^�V' 'V City/State/Zip: t ' 64 allarh a copy of the worlters' compensuliuu po ey deelarat n page%�huwing the policy number and expiration c ate). Fulfil IC Lo SeQtre Coverage as required undo Section 25A of MOL c. 152 c:,n lead to the imposition of criminal penalties of a fine up to 1,500.00 and/or unc-year iutprisoutncnt,as well as civil penalties in the form of a STOP'Gv()I<K ORDER and a fine of up to$250.00 a day against the violator.Be advised hat a copy of this statement mkt e forwarded to the Office of Irrvestigmh-�s of the DIA for insurance coverage verification, t do here c if under the ins and penalties of perjury that the information pro ided abo`v]e is true and correct. titallclllilc -- Date:__ r� • f — 27 Official use only. Do not write in this area,to be completed br,-iIv or town official City ur 'l own: Permit/License# Issuing Authority (circle ol►e): 1.Hoard of Health 2.Building Department 3.Citvffo[vn Clerk 4•Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: • /ward\ i OWNER AUTHORIZATION FORM (Owner's . ame) owner of the property located at 1 L t (Property Address) ( roperty Address) hereby authorize foup S (Subcon r ctor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. Ow!�e ' Signature Date �G � � V l� D - QCT ,2 4 207 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sign tune Item 4 if Restricted Delivery Is desired. ❑Agent ■ Print your name and address on the reverse X kfte Addressee so that we can return the card to you. B. Received by(Printed Name C. Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from Item 1? ❑Y s 1. Article Addressed to: If YES,enter delivery address below: ❑No �VlIT7zx�bK, f �a /— 3. Service Type 3a/s ❑Certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. RestrictQ1 Delivery?(Extra Fee) ❑Yes 2. Article Number (Transfer from service fabeq 7 0 0 r4 2 5], []{] � 2 2 7`�.9'8 3 2 i PS Form 3811,February 2004 Domestic Return Receipt 102595-024+1540 i UNITED STATES POSTAL SERVICE Rya*,n �Eirst-, Its`' ° ig ' USPS I I "'°' • Sender: Please print your name, address, and ZIP+4 In this box • I I E I TOWN OF BARS oNE BUILDING D � �y 200 MAIN ST. R l�S> 02601 � 17. .r I�_:1=_� iii��„Iti�ii,�i�,�,��iitia,iii,�,ii,„��iEiile.,ii�,,:l�l►I ,*'THE Tay Town of Barnstable *Permit# 7/i� g / Expires 6 months from issue date SAMSzASM : Regulatory Services Fee t►wss. 0,19- �0�� Thomas F.Geiler,Director ArEDN`°�� Building Division Tom Perry, Building Commissioner X-PRESS PERMIT 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 � 9 ZU03 Fax: 508-790-6230 TOWN OF t;i-,; EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number_eQ6 Property Address tesidential Value of Work Owner's Name&Address Pe I ' Contractor's Name tzwo �eL Telephone Number Home Improvement Contractor License#(if applicable)_ 1� .Construction Supervisor's License#(if applicable) VorkmanIs Compensation Insurance +' Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy#_ Permit Request(check box) WrRe-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) e-side ❑ Replacement Windows. U-Value (maximum.44) `Where required: Issuance of this permit doesnot exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: operty 0 er si Prop e Ow r Letter of Permission. Home Impro ent C tia r e is required. Signature Q:Forms:expmtrg Revise053003 ERASER CONSTRUCTION �. Roofing & Siding Specialists P.O. BOX 1845, Cotuit MA 02635 Phone 1-508-428-2292 & FAX 1-508-428-0123 SIDEWALL PROPOSAL July 23, 2003 � �j Mr. Luke Poyant �� 1 ' 7 56 West Hyannis Port Circle Hyannis Port, MA 02647 Phone: (508) 790-2100 CGil SIDEWALL Remove & Replace 1 o Supply & Install - Spline existing trim with 151b Felt Supply & Install-Tyvek House Wrap Throughout Supply & Install - 16" White Cedar Extras Supply & Install- 1 3/8" Hot Dipped (Galvanized Ring Shanked Nails ' SuRR1Y 86 Install- 16oz Copper on all Flashing Points TOTAL. INVESTMENT WHITE CEDAR SIDEWALL: $7,800.00 .Payable immediately upon completion NO MONEY DOWN - NO Payment at the start or part way thru Payments accepted are: CASH -CHECK- MASTERCARD -.VISA -AMERICAN EXPRESS FRASER CONSTRUCTIOIN Carries Workman's Compensation and Public Liability Insurance on the above work. •'' DATE OF ACCEPTANCE: -A3 SUBMITTED BY: HO WNER RUCTION r V 1 4 M S S Board of Building Reg One Ashburton Y - Boston. Mayso Home Improveme F . FRASER CONSTRUCTION CO DEAN FRASER 71 TARRAGON CIR 02635 COTUIT, MA T Board of Building Regulations and Standards Lieew HOME IMPROVEMENT CONTRACTOR before Board Registration .,1112536 One A. -Eup ratiop -`3{2312005 Boston tT p� °DBi4 FRASER'CONSTRUCT10N c, DEAN FRASER 71 TARRAGON CIR�`` COTUIT,MA 02635 Administrator n a�z '.