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Home My WebLink About0172 WINDSHORE DRIVE 04 .6_((-r3 P12 Cape Save Inc. f 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 P 6/7/13 �' o Town of Barnstable r cn Thomas Perry CBO ' ' Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permits , `n Dear Mr. Perry, This affidavit is to certify that all work completed for 172:Windiliore`Drive,Hyannis has been inspected by a certified Building Performance Institute(BPI)Inspector. Ceiling: R-30 cellulose with air chutes. Basement: R-19 fiberglass in box sill area All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION r�� TOWN OF BARNSTABLE Q l � 5S 7� Map Z a� Parcel Application # Health Division 2013 MV 23 erl 4' r Date Issued i Conservation Division Application Fee Planning Dept. - °' Permit Fee 3 Date Definitive Plan Approved by Planning Board oIvlSIOV4 � S ZS -13 60 Historic - OKH _ Preservation / Hyannis Project Street Address 1 �� GI na s h a re r;V Village y kno iS ,,,M Owner p Q�� c w �� ei Address .5 aK16 Telephone 5 O'8 " V? - I 0 $I Permit Request P a R. 36 C NI o se -to -t the calli&llsc Ao t�a ctk4strce -V;�erAlass t6 -t1 e hjrme 4 bb-c- s.111 N(, rA, —4-�e -? sl•,►P rinL �i a x,o�►o��n� a m Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3 500 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas 1(Oil ❑ Electric ❑ Other Central Air: ❑Yes A No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing 0 new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes X No If yes, site plan review # -- -.Current-Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) 4111I Name 1Wn MCC10.5ke--i at S v m- Telephone Number SoB 396 0319 17 Address 4 4 kTWtl+)na�d n :v •- License # L11t� SowAn rmo*4�, t'\ d Home Improvement Contractor# I �� 3 U Worker's Compensation # i VJ C 35539 b$ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE- DATE I I . . FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE 1 OWNER i ! DATE OF INSPECTION: A FOUNDATION i. FRAME INSULATION �C i FIREPLACE i ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL iF GAS: ROUGH FINAL FINAL BUILDING 'r DATE CLOSED OUT ASSOCIATION PLAN NO. � r L S^7 Housing Assistance Corporation Cape Cod HOME OWNER/RESIDENT WEATHERIZATION WORK PERMIT& FUEL RELEASE: PLEASE FILL OUT AND SIGN THIS FORM IF YOU ARE THE APPLICANT HOME OWNER. I f f S hereby consent to and agree that weatherization work may "P be done by the Weatherization Program of Housing Assistance Corporation ( herein after referred as "Agency") on the property located at A,? The weathedzation 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: 1 give 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 weatherization work on said property. 2. 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. have read the provisions of this agreement as fisted and freely give,my consent. Home Owner: (Signature) � --- - Date: "�`1a-5�/i �3 Agent: (signature) �r. Date HAC approved Weatherization Company : a °L Adam T Incorporated All Cape Energy Cape Cod Insulation Cape Save Frontier Energy Solutions Lohr Home Improvement Resolution Energy t The Commonwealth of Massachusetts -- Department of Industrial Accidents pl�Z'A4. stT1 �' ' , Office of Investigations - ' r I Congress Street, Suite 100 ;*r Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Cape Save Inc. Address: 7D Huntington 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❑✓ 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 shipand have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp. insurance comp. insurance.+ ❑ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑ 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' In.❑✓ Other Insulation comp. insurance required.] *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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 ain 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 Policy#or Self-ins.Lic. #:, TWC3353968 Expiration'Date: 04/09/2014 Job Site Address: 1 `l W i nc!Si fire, V e 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 S1,500.00 and/or one-year imprisonment, as well as civillpenalties in the form of a STOP WORK ORDER and a tine 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 Penalties ofperiM6 that the in ormation provided above is true and correct. Si nature: Date Phone#:. 508-398-0398 Official use only. Do not write in this area, to be completed by'}city or town official. i City or Town: Permit/License# Issuing Authority(circle one): f 1. Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing hnspector 6. Other Contact Person: Phone#: CERTIFICATE OF:LIABILITY INSURANCE 4i9/2013 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). PRODUCER NONE:NTACT Colleen Crowley Risk strategies Company PHONE (781)986-4400 FAX No:(781)963-4420 15 Pacella Park Drive suite 240 INSURERS AFFORDING COVERAGE NAIC Randolph MA 02368 INSURERA:Selective Insurance INSURED iNsuRERs:Safety Insurance Company 3618 Cape Save, Inc INSURER C:Technology Insurance Company 7 D Huntington Ave INSURER o INSURER E South Yarmouth MA 02644 INsuRERF: COVERAGES CERTIFICATE NUMBER:CL1349605'09 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. LTR TYPE OF INSURANCE ADDLSUBR POLICY EFF POLICY EXP POLICY NUMBER MMIDD MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY 1 PREMISES AGE ToEa occurrence $ 100,000 A CLAIMS-MADE RENTEIT— FOCCUR 199448001 0/16/2012 0/16/2013 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PR`O-- LOC AUTOMOBILE LIABILITY Ea COMBINED dent SINGLE LIMIT1,000,000 $ ANY AUTO BODILY INJURY(Per person) $ ' ALL OWNED SCHEDULED 6208200 1/6/2012 1/6/2013 AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED j PROPERTY DAMAGE X AUTOS ! Per accident $ Underinsured motorist BI split $ 100.000 A X UMBRELLA LIAB X OCCUR. 199448001 f 0/16/2012 0/16/2013 EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE $ -1,000,000 . DED RETENTION$ C WORKERS COMPENSATION $ Officers Excluded from WCSTATU' OTH- AND EMPLOYERS'LIABILITY YIN X T fT ANY PROPRIETOR/PARTNERIEXECUTIVE Coverage E.L.EACH ACCIDENT $ 500 000 OFFICER IMEMBER EXCLUDED? a N!A (Mandatory in NH) rM3353968 /9/2013 /9/2019 If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 500,000 DESCRIPTION OF OPERATIONS below ; E.L.DISEASE-POLICY LIMIT $ 500,000 _ 1 , DESCRPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks schedule,if more space is required) j Issued as evidence of insurance. National Grid Corporate Services LLC d/b/a National.Grid, d/b/a Boston Gas Company, d/b/a Essex Gas Company, Action Inc., and Housing Assistance Corporation are listed as additional insureds as respects General Liability ashrequired by written contract. } i CERTIFICATE HOLDER CANCELLATION (508)790—2425 n SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Housing Assistance Corp ACCORDANCE WITH THE POLICY PROVISIONS! 484 Main Street I Hyannis, NA 02601-3698 AUTHORIZED REPRESENTATIVE chael Christian/CLC � ACORD 25(2010105) 01988-2010 ACORD CORPORATION. All rights reserved. `1-Iss-tchusetts- Department of Public Jafct�' 7' Board of Buil(lin!,Regulations and fitandards Construction Supervisor Specialty License License: CS SL 102776 Restricted to: IC WILLIAM MC CLUSKY R 37 NAUSET ROAD WEST YARMOUTH, MA 02673 Expiration: 6/28/2013' ("ummis�iuncr Tr=: 102776 —��,'. a� f//�� .�/�/� ,p`y�;ys � ,y/i/tJu��i/'.�../i7(�/tfii�3�Y✓c'i`�' Office of Consumer Affairs and Business Regulation ,may = 10 Park Plaza- Suite 5170 _ Boston, Massachusetts 02116 Home Improvement Contractor Registration Refaistration: 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 retu card.Mark reason for change. rn Address 7 Renewal Employment Lost Card PS-CAI 0 tQA1.04/04-G101216 J1ze >Ga�r,.�uu�uae¢ •cv_//'=acivaed_ 4 License or registration` Office of Consumer affairs&Bdsiness Re aistration valid for individul use only Regulation HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Q = �-,� Registration: 171380 Type: Office of Consumer Affairs and Business Regulation ; _ . - � 10 Park Plaza-Suite 6170 b•Q=W_- Expiration: 3/14/2014 Corporation Boston,MA 02116 CAPE SAVE INC... WILLIAM McCWSKEY _ 7-D HUNTINGTON AVENUE SOUTH YARMOUTH.MA 02664 Undersecretary Not valid vA o signs