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Home My WebLink About0227 WINTER STREET �oz7 Gl/infe�- S� i I _Z., Cape Save Inc. 7-D Huntington Avenue TOWN OF PARNSTABLF, South Yarmouth,MA 02664 Tel: 508-398-0398 Fax: 508-398-03413 Mi'tR 22 f M °1` 5 f }i=_l 12/16/12 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permits Dear Mr. Perry, This affidavit is to certify that all work completed for 227 Winter Street,Hyannis has been inspected by a certified Building Performance Institute(BPI)Inspector. Ceiling: R-30 cellulose(open frame& decked) Knee walls: R-13 fiberglass blanket& R-6 rigid fiberglass All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION I A Iic� a�ionl# "Map 3 Parcel pp Health Division Date Issued2— Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address a a� V Oer ,S+tee+ Village Owner_ gc('01 E Ulf'er Address TAM� Telephone SO 8 -a.$0 - 1) Ig;1: Permit Request �� R- a•$ t�' 13 &f%I dense opyko aIl%ldse +0 4kc. 1nawc 0 4;r, tien��la-I ion end e w►�h C-4 ,cry, bPoe Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 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 b Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑JNo 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 C unt P, Heat Type and Fuel: ❑ Gas 5Q Oil ❑ Electric ❑ Other Central Air: ❑Yes No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existingV ❑ 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 g No If yes, site plan review# Current Use Proposed Use ,-- APPLICANT INFORMATION W,111 .I M (BUILDER OR HOMEOWNER) W Name ,111ia01 �XI0 C e -S�Y2 ThC- Telephone Number _ I Address �s D I u t1�j��r► Ye License # L-C V a�•-tt-e S. Yo+.NO , MA Mb y Home Improvement Contractor# l 113R D Worker's Compensation # 00 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE 'DATE t FOR OFFICIAL USE ONLY { APPLICATION# DATE ISSUED MAP/PARCEL NO. l ADDRESS VILLAGE OWNER . DATE OF INSPECTION: 1 FOUNDATION FRAME INSULATION FIREPLACE S ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Id .j . ' lWo The Cotttrnorwealth of B2assacliusetts ➢epartfnent of Ilidustrial_Accidents Off ce of Investigations - 600 Washing Bost , tort Sty eet on 111A 02111 wwwanasS."Ov/dia rkers' Compensation Insurance Affida-vit: Builders/Contractors[Electricians Print/Plumbers Please Applicant Information Name(Business/Organization/Individual): Address: — fl �IA;n�in won (�vetiv�� City/State/Zip:S o�►� IG cirout�n (�1A 0264 Phone#: 5o8" 3 4 $ - O 3 9 g Are you an employer?Check the appropriate box: Type of project(required): 4. [] I am a general contractor and I 6 New construction I. I am a employer with have hired the sub-contractors employees(full and/or part-time) listed on the attached sheet 7. ❑Remodeling 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 We are a corporation and its 10.❑Electrical repairs or additions required.] 5. officers have exercised their 11.(]Plumbing repairs or additions 3.❑ I am a homeowner doing all work t of exemption er MGL myself.[No workers' comp. rig p p 12.[]Roof repairs insurance required-]t c. 152,§1(4),and we have no 13.X Other l D S trL,D�V t on employees.[No workers' comp.insurance required] t that checks box Rl must also fill out the section below showing their workers'compensation policy information. tiny such applicant • dtca Any PP u mit a new affidavit m cton musts b fi Homeowners who submit this affidavit indicating they are doing all work and then hue outside contra :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 tliepolicy and job site information. Insurance Company Name: -Te cl�not o 4 Wr"ae n Y Polio n or Self-ins.Lie.r: T W C 3 3, o6.- y Expiration Date: ( 13 Job Site Address: �.�. r wil A �er S4 City/State/Zip: , aunin IS 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 fume up to S1,500.00 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 InvestiLyations of the DIA for insurance coverage verification. I do herebn cent •under tlrepairzs and penalties of perjury that tl:e information prnt�ide`d ab ve is t e(�and correct Signature: Date: `' , el— Phone: 8 - 3 98 Official use onh). Do not write in.this area,to be completed by city or torch offi'eiaL City or Town: Permit/License Issuing Authority(circle one): 1.Board of Health ?. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone=: I =DATE /DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE2012 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). CONTACT Shannon Sperrazza PRODUCER NAME: (781)986-4400 FAX (781)963-4920 Risk Strategies Company PHONElatctI0 E-MAIL .ssperrazza@risk-strategies.com 15 Pacella Park Drive Suite 240 INsuRERs ' a AFFORDING Nc# Randolph MA 02368 iNSURERA:Selective Insurance INSURED INSURERB:Safety Insurance Co an 3618 Cape Save, Inc INSURER C.-Technology Insurance Co an 7 D Huntington Ave INSURER D: INSURER E: South Yarmouth MA 02644 INs RERF: COVERAGES CERTIFICATE NUMBER:CL1211954576 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 POUCY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MIDD MM/DD 1,000,000 GENERAL LIABILITY EACH OCCURRENCE $ D AGE ORENT D $ 100,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occuMM 001 199448001 0/16/2012 0/16/2013 MED EXP(Any ona person) S 10,000 A CLAIMSMADE FXIOCCUR 1,000,000 PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE S 2,000,000 PRODUCTS-COMP/OP AGG S 2,0001000 GEN'L AGGREGATE LIMIT APPLIES PER: $ }{ POLICY PRO LOC COMBINED SIN LE OMIT 1 OOO 0OO AUTOMOBILE LIABILITY Ea arm ant BODILY INJURY(Per person) $ B ANY AUTO 1/6/2012 1/6/2013 BODILY INJURY(Per accident) $ AALL UTOS OWNED SCHEDULED 6208200 AUTOS PROPERTY DAMAGE $ X HIRED AUTOS N NON-OWNED Peracrad nt $ X Undermsured motorist 81 it 100 000 EACH OCCURRENCE $ 1,000,000 X UMBRELLA OCCUR 1,000,000 AGGREGATE $ A EXCESS LIMB CLAIMS MADE 199448001 0/16/2012 0/16/2013 S DED RETENTIONS WC STATU- OTH- C WORKERS COMPENSATION fficers excluded X AND EMPLOYERS'LIABILITY from coverage E.L.EACH ACCIDENT $ 500,000 ANY PROPRIETORIPARTNER/EXECUTIVE❑ N/A /9/2012 /9/2013 OFFICER/MEMBER EXCLUDED? C3318007 E.L.DISEASE-EA EMPLOYE $ 500 000 (Mandatory In NIA 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,Additional Remarks Schedule,If more space Is required) Issued as evidence of insurance. Issued as evidence of insurance. National Grid Corporate Services LLC d/b/a/ National Grid, Action Inc. , Colonial Gas Company and NStar Electric are listed as additional insureds as respects General Liability as required by written contract. 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. Cape Light Compact PO BOX 427/SCH AUTHORIZED REPRESENTATIVE 3195 Main Street Barnstable, MA 02630 Michael Christian/SMS ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) I1JAW24%mMnr,;im Tho ACfll*n name end IM arts rnnietarrarl msr)rc of ArnOn { m y �i:} hu:ett -'Department Of Puhlic Board rat`Builtiin�_ Re��ulations and Standartis Co'ns ruct;on SuDer„isor Specialty License License: CS SL 102716 Restricted to: IC . WILLIAM MC CLUSKY / 37 NAUSET ROAD WEST YARMOUTH, MA 02673 ' Expiration: 6128/2013 r , Tr#: 102776 (.•mmi.a..ncr . Y c •J ' r Office Im 10 Park Plaza_ Suite of Consumer Affairs and usiness Regulation 5170 ,�; SuiteBoston, Massachusetts 02116 Home Improvement Contractor Registration _ Registration: 171380 Tvpe: Corporation ., Expiration: 3/14/2014 Tr# 222184 CAPE SAVE INC. WILLIAM McCLUSKEY77 7-D HUNTINGTON AVENUE _ SOUTH YARMOUTH, MA 02664 Update Address and return card.Mark reason for change.. . e i jj Address 1 Renewal � Employment i Lost Card PS-CA1 is 50N1.04104-Gf 01216 :%�iee�wn:o�ecuea • c✓lli�3sac�rmek3 License or registration valid for individul use only �`'• office of Consumer Affairs&Business Regulation�-- before the expiration date. If found return to: o- ,,;HOME IMPROVEMENT CONTRACTOR T Office of Consumer Affairs and Business Regulation �7 Registration: .171380 Type: 10 Park Plaza-Suite 5170 Expiration: 3/14/2014 Corporation Boston,MA 02116 C SAVE INC. WILLIAM McCLUSKEY_' { 7-D HUNTINGTON AVENUE g a SOUTH YARMOUTH MA02664 Undersecretary Not valid wit 6 sign Building Permit Authorization . Y I, Terrence r, as owner hereby give my permission to Cape Save, Inc. 7-1)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 227 Winter St ,f Hyannis, MA 02601 Signed ti.GvVC� l '� Date Za Town of Barnstable Building Department ComplainVInquiry Report Date: �� Rec'd by: Assessor's No.t X6 Complaint Naine: Location '2,�� -�-- Address: c �J ,l/'��.�J� t J71 M/P , Originator Nwne: Street: -1 7 7 —1z 70 Village: State: Zip: Telephone: D/E Complaint Description: Inquiry Description: 1 For Office Use Only Inspector's -// Action/Comments Date: li`/�7A� Inspector: ti 1 Follow-up Action Additional Info. Attached Copy Distribution: Vlldte-Department Me I eBow-Inspector Pink-Inspector(Return to Office Manager)