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Home My WebLink About0345 WINTER STREET j i CAPE-can ��W" F $¢+ ti�� INSULATION -riot a ail i° : 59 FIBER OLASS SEAMLESS SDRAT FOAM SUSV[NDED - BAT OURERS INSULATION CEILINGS +esx•�-b -M4+' -`"'*'"'^"' ti�'ma 1-800-696-6611 F,§4 1,4l r j Town of Barnstable Regulatory Services Building Division I 200 Main St Hyannis, MA 02601 Date: t Dear Building Inspector this accept 1 Please p t s 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 { VAS\V% 6\41?FirA 34S w;+s��ec-S�•" Insulation Installed: Fiberglass` Cellulose R-Value "Restricted Unrestricted Ceilings o Slopes Floors Walls Sincerely WHCassi r, P esident ns ation, nc. Town of Barnstable Regulatory Services x Thomas F.Geiler,Director 9BARNSrABLE, MASS. $* Building Division M 1639. iDtEo Mp(s Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 COMPLAINT/INOUIRY REPORT Date: Rec'd by: � Complaint Name: Map/Parcel Location Address: jx,/t Originator Name: &21j� oj��14'ttA-� � Street• ---- — - - -- Village: State: Zip: ,p Telephone: Q 7 7 1" Complaint Description!. w FOR OFFICE USE ONLY Inspector's Action/Comments Date: Inspector: � 7 c✓ or r ' Additional Info.Attached Q:forms:complaint f rr. 9/26/02 Bike Zone Corner of Baxter & Winter b 4...�'� � yr, 'A �•.�` - A .rs •jam" ,,� s e.�...�. k • '� c. .W5. a �• 's'b -n �' ., xyj{� ' � dz''�+l--r 'i � ��h a F*en-''� e 9 rf - � + n F4k+.°�5.7 x7 {��6M [,g�x'. a `.r�+a- .x•. `�`°p.'�i;" $`.`„' .,, a" a .t i `� -a+', 'fir] ' �' �r•�:;. � �. �_ �,�� • � ,n +� t°`d'. .f .,i �ry 1'pM r^ ^c �.^�'�°�'4 1�. �` S! � �y- '� � �9t N�+""'��?�f ' f 9/26/02 Bike,Zor�ie Winter & Banter X�.µ�'r r w Vw �i � I f . k• 9/2610211 Bike Zone . Corner of Winger & Baxter Sts. • _ - it d�� a ` o i z A w s � �r Assessor's office'(Ist floor): - THE Assessor s map and lot number . .. ......... . �(�� Q., � Bard of-"'t=lealth .(3rd floor): Sewage Permit number .......................................................... Z SABdST&BLL, i Engineering Department (3rd floor): ' ��0 t6}9 ' House number .........................................:.......... ............. 0 YPy d�. Definitive Plan Approved by Planning Board _______________________________19________ . APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00'-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .............. .... . ... .. . ..... .. ............... TYPE OF CONSTRUCTION ...........................:........... ...... .. .. ...... ......:...:............................................ ........:...... - . ..................... --- ............. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to .the folio Location information: Location ate• /.�. -. ...Q.. . ...- ........................... . . . .. .... .. . . . ..... ..................... Proposed Use ................... ... .:1.1Q.)..............................,........................................................ .....................................................• Zoning District ...b.............. ............Fire District ......... ................. Name of Owner U)m.........d-kx1'P.a,A,CL.."..,.......Address .............:................:..................................................... Nameof Builder ....................................................................Address .........................,.......................................................... Name of Architect ............... - ... ::.........Address Number of Rooms ....................:.Foundation �. ...... ...... / ...............................`.................... Exlerior ...Roofing ..................................................•... Floors ....................................................:.:...:............Interior ................. . - .................................................:................. Heating ...........................................................................:......Plumbing Fireplace ................................................... ...........................Approximate Cost .... .....f. .L�..1/.11.....................................:.:.. r Area .............S.x...0............ Diagram of Lot and Building-with Dimensions Fee �-+ '... .�• ..........._....... - -- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all,the Rules and •Regulations of the Town of Barnstable regarding the above _construction., Name �n.I.. U••Y �l�'!!4 . Construction Supervisor's License .S.l<1!t.e% ................. 1 ,r CHALPARA, WILLIAM 4 No . 32053 ADD DEC ro .... ..... •.Permit for .................................... kSingle Family Dwelling _ - y Loco tion .,345 Winter Street }, Hyannis ....... .......................................... Owner(T.William'`Chalpara E Frame �• � � .�_ "' ' - �. Type of Construction .......................................... ..................... .... ...................:..... .......... ��. .♦ _j' - r +w.., .,4 - "•� = ``, Plot'. .......... ...` Lot .. Y t Permit Granted .July.:.7,14 ........ '.........19 8 8 ! r L P A ' - '• Date of Inspection ..`..... .................. "..'..19 Date Completed ....... ..: .....^.......19 r- y Assessor's office (1st floor): 0 0 Assessor's map.and lot number .../�!•...... �- �.✓`;.-" r . „ �J �Qy THE `o Boar.d=of-Rea Ith (3rd floor): Sewage Permit number .. ... ............................ Z BAB39TABL9, Engineering Department (3rd floor): WA & House number o �e}9• �0 ........................................................................ Definitive Plan Approved by Planning Board --------------------------------19-------- . APPLICATIONS PROCESSED 8:30-9:30 A.M, and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO c TYPEOF CONSTRUCTION ............................................. .. ..... ....... ....................................................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the followin information: Location ........... .. ...........1sS..��. .. .�... .................... ........ ............................:.......................................... , ProposedUse ......... ,.��r............................................................................................................................................ Zoning District ......... ........................................................... r Name of Owner Uj.yr.........C ..,![XI1.6-) -9—..............Address ............................_....................................................... r� Nameof Builder ....................................................................Address .................................................................................... :b Nameof Architect ....................................................................Address ........................................................................................ Number of Rooms ......................'V/,n...............................Foundation ............/..!! .................................................... It Exlerior .....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior ....................... ..... Heating ..................................................................................Plumbing ...................... .!...................:. .................................... eo ........................�`.Fireplace ............. Approximate Cost ............ .. ... ...r�.......................................... R r� Area .......�.�..L.................... Diagram of Lot and Building with Dimensions Fee - / t r l OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .................. ur ............ Construction Supervisor's License ..(..!.lne.................~- CHALPARA, WILLIAM A=310-136 No Permit for ..Add...D.eck............. .Singj.�t...F.4Mjjy..L).W.ejj±ng..... ........ ........ Location ..at-reet.................. ...................4yapAi.!5.......................................... Owner ...Will.ia.m...C.11.4 J.p.d r.a..................... Type of Construction ...Fr.ame.......................... ...............I....................... ....................................... Plot ............................ Lot ................................ II Permit Granted .......Ju1%y..7A...............19 88 Date of Inspection ....................................19 Date Completed ......................................19 .t•.-,;`ve.e:r,..�. ec. �'.. _. .: .,,�. ..:.ai.. .�, �'Sftaa.. � ...;a.;..: _ �4�Y'�. � �,..-.r-,c t `T .... r .-+ ,.� �... . i r.�.,. Y ram:a•.xrj-C ^:Gi': L,�-x zvtl':a�: �yr es�" ��.. ..[kt. iary _ Assessor's office (1st floor): ,r/J !G THE Assessor's map and lot number r� tD cf tv Board—of=Heaith�-Ord floor): Sewage Permit number �'........ ... rn...::. t adaasTsnLE. : NAAL Engineering, Department (3rd floor):, 2 `� ,5 ��O, 0.9- House number .......... t.4 %................... o Mar Definitive Plan Approved by Planning Board _ __ ________ _-.-. ___ 19 ____ . ---''�� APPLICATIONS PROCESSED 8:30 9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABIE BUILD , G IHSPECT01". f APPLICATION FOR. PERMIT TO /./!..:!!...r,. �1/�� . ( Ifs !.. .......... • rr4�. ...... TYPE OF CONSTRUCTION ....... .,1........ , /-�U.................L %/ ,.,. 7.. ....: - ............................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .. 5 (i(///).�driY • .�.. '� �.,,.5 . Proposed Use .......C) QL..VN...( .! .✓?' ...............ox.).......('x..1.SA .......de..(,, ...... . ........ ........ ............... ZoningDistrict ........................................................................Fire District ................................................... Name of Owner .!!..a. .l..�.!....t. ..!`� L � N .................Address �....... a h ......... . "'.�.:......... .`f..�� V1. ) S � r Name of Builder ....................................................................Address ....:................:.....................................:.................... ."... Name of Architect .......j.y.t?U.t........... ......... .................:Address ....... .w. ... .. ... ....... ........ t Numberof Rooms ........... .....................................................Foundation ...iM.P.n.-t............................................................. 4?. !t............................................ Roofi n g Exterior ... - .. ......... Floors .......... ..............................................................:............Interior: .:( �! ! )aA.I. Heating ....-. .Om.f...................:..................:.:....:.:....:....::....Plumbing .....: it�.!�:. ... . Fireplace ...... !?.�l P .......................... '.. 0(7,....................... Approximate Cost ..... ,..... .............................. Areo .. .... Q Diagram of Lot and Building with Dimensions Fee ..v.4J.:.:.......:......... .,` ` 'i i i Ei�JS�►'n l �puk�� _ t �- _ _ OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of-Barnstable°regcrding the'above construction. n j Name . !!{r// { Y�....: frf-C �f',�1 �........... Construction Supervisor's+6cense ...........:::...:.:........ { i CHALPARA, VASILI A=310-136 No 3 2 4 2 5... Permit for Add...S.IAA...RQ.QM... ....Single...E?KM i iy...d ........... Location ...3.45....Wi.Tl.tQ.r...S.tr.e.et................ ..................ay.aan is........................................... Owner . Vasili Chalpara .............................................. .................. Type of Construction ..F.....ra...m.e........................... .. .. ............................................................................... Plot ............................ Lot ................................ Permit Granted ....N.ov.emb.e.r...1.Q.......19 8 8' .. .... ....... .. .. Date of Inspection ....................................19 Date Completed ......................................19 6; / C / offer Assessor's office (1st floor); r ° , Assessor's mop and lot number. 1�[.�.�L... �3Co '• rr PyofnrE Tod` —_ QidW q' r,� 3rd floor); i Sewage Permit number ..................o? . INARISTAXLE Engineering Department (3rd floor) 22 3/` S Boob House, number ................... ,J. ........ t �c ray a• Definitive Plan .Approved by Planning Board _____ :_:___ ______________'_:14 APPLICATIONS PROCESSED 8:30.9:30 A.M. and 1 00-2 00 P.M. only �t E _ TOWN OF 4 BARN5TABL v BUILD. G INS 11 A s APPLICATION FOR PERMIT TO ::: .. .. �. : .._._........ TYPE OF CONSTRUCTION ....... .: /� �✓ `�" .:......19.$ TO THE INSPECTOR OF BUILDING_ S: The undersigned hereby applies for a permit according to the' following infor gtion: Location ......... .W...1..�1. �!� .... +........ r. Proposed -Use .......S ............"..Q n.......124.1_6mh. ......de.ck ......................... ... ... .... Zoning District ......1............L............................................ ...:....Fire Districctt.:.. :....... ' Name of Owner .Y. .S.4PJ.t'.. C�.►�LAX 1)�-.................Address J. `?. �l y. Name of Builder ............................................... ... ...... .:.',....Address . � Address ::.:: Name of Architect ......;�.�1:IJV1.� .....::.. :.. ...................... Number of Rooms ...........L........................................................Foundation ...U.~�!!1.. ....:..... .......... Exleyior .W.0.C2. .............................. ......... ........:.`. ......:Roo� in, a.s. �.�,�1.. ` ........, ......... .. ............. Floors .........a...........................................................................Interior '�..:•fy�'li. . lN�/.4:I :,.:..: ..:....:. :........ .,..,.......... Heating ....: .y1.` ...'................................................. ...Plumbing ..... :5�.!'1.:`�....,:.: .;.:..... . ......; ...... .. Fireplace ...... .O.A-e . ...... ......... ' ��.�............................ ...................... ........Approximate Cost ,......yj . .............. Ara �5-a::.. :� .l`� .... Diagram of Lot.and Building with Dimensions Fee h • ... � mot" .F. k._ i .. v OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to,conform to all .the Rules a-nd Regulations of the,''Town of Batnst blei, d ng the'dbov."e construction. Name f ` Construction Supervisor.'s=Licen"se ... : ..... . . :...::....... CHALPARA, VASILI / No 32,425 .'Permit for ...Add Sun Room T �� s• Single Family Dwelling........... location _ :345.Winter Street :. Hl'.annis................... ..... .......... [ w ;• F K _ Owner'....Vag °' Fra e f - .Type of Construction ..._.......?Sl...............?:.......... ............... .... . .......� r ........ Plat ... .......... t Lot:,r ... ................. f T ------------- 40 November 10 � 88 p Permit Granted ....... ........ ... !.....19 ' .. P I = Date.aof Inspection .. ........ ......19 Date tCompleted � .. 19 6. �' •t''/nib++. `P��`.,�... t -� .. . i ,r. , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division Date Issued ` L4 t Conservation Division ' .Application Fe Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address -3 Y S Lam+ t.JtCr- Sr� Village t-t-tA x)N t S Owner `/AS i C 'kA p ftf iA Address 3`t wV N Oa-6o S'1'•.l�.l�r.�T S M(� Telephone SOT- �?�I - �(�6 L Permit Request l �r�-cr'r�ig- �� ()-')D cellse A�, eA;L' N\OU-0 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed 'T. Total-new c Zoning District Flood Plain Groundwater Overlay -' w Project Valuation 00 0_ Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach suporting documentation. Dwelling Type: Single Family iL Two Family ❑ Multi-Family (# units) k+ ,Wr 0 Jai 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/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 Cftf Coa � -L Telephone Number SO' -77 S -I '-A f Address 'ASS yPr�N\aAt- 'L- License # bb 17 �64,i ram'S YyVC O'D-6a \ Home Improvement Contractor# bo SL 7 Worker's Compensation # wc,4 (S S a S;9 0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE l Z-3o —1 o s n FOR'OFFICIAL USE ONLY a t APPLICATION# r DATE ISSUED MAP/PARCEL NO. 3 ADDRESS VILLAGE OWNER DATE OF INSPECTION: --'FOUNDATION`. FRAME - t INSULATION..' h FIREPLACE ELECTRICAL: ROUGH FINAL (' PLUMBING: ROUGH FINAL -' GAS -A ROUGH EEC v`= .' FINAL ;�F:INAL BUILDING DATE CLOSED OUT t ASSOCIATION PLAN NO. ' k The Commonwealth of Massachusetts r --- Department of Industrial Accidents Office of Investigations 600 Washington Street t Boston, MA 02111 /-` yy ww)v.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractol-s/Electricians/Plumbel-s _Applicant Information Please Print Legibly Name (Business/Organization/Individual): C`( T-CU S ,1 0 'f RE—)4— SN C Address: ✓� City/State/Zip: NAgniAll Phone #: Are you an employer? Check thy, appropriate box: Type of project(required); 1.[� I am a employer with Z() _ 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/b paft-time).* have hired the sub-contractors ❑ Remod e g .. _ _ 2.❑ I am a sole proprietor-or partner- . listed on the attached sheet. 7. lin ship and have no employees These sub-contractors have g, ❑ 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.❑ Electrical repairs or additions 3.❑ I am a bomeowner,doing all work officers have exercised their I LEJ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL . 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no.. 13.❑ Other ��Qt•10� comp,insurance required.] *Any applicant that checks box#) must also fill out the section below showing their workers'.compensation policy in formation. t Homeowners who submit this affidavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and statc 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: f� �')'� �.�rw +.eA SuZoeiCe // Policy#or Self-ins, Lic.#; �( OC2rZro f Expiration Date: 3G Job Site Address: A S �--�� 'd— S 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$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. Ldo hereby certify tit e pa' and penalties of perjury that the information provided above is true and correct. Si nature: Date: t_b" Phone.#: 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): I. Board of Health 2. Building Department 3, City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other - Contact Person: Phone#: 1 10 Park Plaza - Suite 5170 - Boston, Massachusetts 0211.6 Home Improvement Contractor Registration Registration: 153567 L Type: Private Corporation r Expiration: 12/15/2012 Tr# 206433 CAPE COD INSULATION, INC !-r HENRY CASSIDY 455 YARMOUTH R D. � ' � � � ; `��• �- ---i----------- HYANNIS, MA 02601 t = - ---- - --- --- -- date Address and return card.Mark reason for change. p `� • 1 0 Address ❑ Renewal E] Employment �j Lost Card 'S-GA1 Co 50M-04/04-G101216 Office o mer Affairs ^u�s�ne Regul•tion License or registration valid for irdividu!use en!y HOMARMWm T before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration: 153567 Type: g w Expiration: 12/15/2012 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 t OD INSULATION. HENRY CASSIDY If 455 YARMOUTH RD gy _ HYANNIS,MA 0260a1 { �— G Undersecretary t alid ith t si ture -`- IMassachusctts- Urp.0 tnlcnt of Public Safct\ Boars! (,&Building Rc,culations and Stanrl;trds Construction Supervisor License r Licerlse.`-CS 100988 p Res#ricted to: 00 HENRY CASSIDY 8 SHED ROW ' q WEST YARMOUTH, MA 02673 Expiration:'11/11/2011 - C uuiuisi ncr, Trm: 100988 i J Fit n } � ).,\I I '1Z F 71 MR r . • s . � � � -C�t�—I \. L "5� .�i 1 f� 4k ", L y y} , ._. a...i� �[i i�.Ri :ji(litl.l.�e LS..re!c(f1E'(.•:) T HOME OWNER WEATHERIZATION WORK PERMIT& FUEL RELEASE: PLEASE FILL OUT ANDSIGN THIS FORM IF YOU ARE THE APPLICANT HOME OWNER. I S-6L.i ckAoag herebyconsent to and agree that weatherization work may be g y done by the Weatherization Program of Housing Assistance Corporation ( herein after referred as "Agency") on the property located at: 7,`g 15' L.,;4;J-C e 2 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 at tics, sidewalk &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. I 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. I have read the provisions of this agreement as listed and freely give my consent. Home Owner: (Signature} Date: 1 Z��. iO Agent: (signature AA4; � O �-- Date: HAC approved Weatherization Company: C=n:C�L CCA T",'N 44' Caliber Building&Remodeling Cape Cod Insulation ape Save Creswell Construction Frontier Energy Solutions Lohr&Sons Peter Smith Resolution Energy Rock Solid Construction All Cape Insulation f U L't•J T,: II,:Lnlc ug 9 L1,o8'/.185735 Rogo.rs a Cray lna• VaQu: 002 ' Client#: 4597 CCINSUL CORD- CERTIFICATE OF LI BILITY I SU f E DATE(IMIMIDDIYYY ,� tiI THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS O 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 thL leims and conditions of the policy, ca,-tai,1 policies may require an endorsement:A statement on this certificate doesllot cgilfi:r rights to the CeIrIIICa[e f101del'in lieu of such endorselnent(s). .. . Pft000CER CONTACT - Fdogers bGray Ins. -So. Dennis rI,YmE:_—Margaret Young 508 760 4602 I — 434 Route 134 AM NAI o Ex, _..J1a P.0.Box 1601 ADDRESS: RODUCER— --' -- South Dennis, MA 02660-1601 - cusTor;leRlDe: . INSURER(S)AFFORDING COVERALL NAIC JJ Cape Cod Insulation Inc INSURERA:Peerless Insurance 455 Yarmouth Road INSURER5:Ohio Casualty Insurance Company Hyannis, MA 02601 1Ns(RERc:Atlantic Charter Insurance INSURER D Commerce Insurance Company 34754 INSURER E -• INSURER F. : _._"--- COVERAGES CERTIFICATE NUMBER; REVISION NUMBER: TrIIS IS 10 CER V'i 1 ITAT TFIE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATFD (401 Wrl HST ANDIING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TI-NS CER'IIFICAI L MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITION OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. repiz_I A ASIL OF INSURANCE Ua! VD POLICY NUMBER NIA/DDIYYYY PMNPDD/YYYY ' LIMITS _ q cEnewALuaalury CBP8263063 0410112010 04101)2011 EACH01C URKI NCE ` $1,000000 X - _ rD e i(INIIch 1(.li I.GCNLR�AL LIADII_I'IY DAMAGEO RCN PRENII 1 S f;a r x >nrn $1 OO OQO �(:inIM,NVLJIF L^�accuK MEL)EKP(Any onnp0man) 6,000 — '------ - PERSONAL&ADV INJURY $1,000,000 ... ._._._ - GENERAL AGGREGA I'L_ $2 UOO,OOO--- J_.�..__..__._.. crNl ,,n,rl(,Iu i I wul vl I Llrs. 11 K PRODUCis'-CONIPIOP AGG %2,000,000 Php. - Lot; , p Auror;louaE LwulurY 10MMBCKVMK 04101/2010 04/01/2011 C010131NIc1)SINGLE UMIT MY nU 10 IEa arcidDnU -$1,000,0(w .. - BODILY INJURY'(PUr person) $ AI I (J4�'IVI�n FlU l(J:i � X - •l BODILY INJURY(PJru:cuianl) $• - :iCIIPUIJI -I)i\UII.J;i � .. � .. -•-- - PROPERTY L7AMAGE - x IiIKt:U AUliI;; (Pot acciflanl) $ . • X NUN{PA'NISU A01 U5 $ y B u'"rs'zt"A""B X C)CCUR MEYAPP397726 06117/2010 0410112011 EACH OCCURRENCE $1,000,000 EXCES$LIAa la_AIMS Nwor:. - - AGGGh[caTL " $1 000 U0UDIMUC I ILA I, - _-.- .._.._,_.._ 0000 X RI-ItrrlulN 10000 b C WORKERS COMPENSATION WCA00525901 6130/2010 0613012011 X WL STAiIJ-_ OrH AND EP;IPLOYEItS'LIALiILfI Y YIN O,Y 1 - AJIIhOPH.II I(JNfAh'fIW`WEntCUrIVE : LLEACFI ACCIDENT $5OU,OUO--- _---- OFI LL t I iNIr N101.K 1--XCI UTA-I1 N N/A .. � _ (Mandaluly u1 N1Il - .. L`-.L.DISEASE-EA LMPI.OY_EF $500,000 II;tip,tlbi(:1IIRl IIIlll al . - -.___-_ tseRlhuorJ cu c)I rRArkJNs Nelow - - 1=.L.D1SI,,AST_ 1101_ICY LIMI1 $500,000 F F DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach AC0I30 101,Additional Remarks Schadula,-it(note space is roquirad) - "Workers Comp Information,"" Included Officers or Proprietors (See Attached Descriptions) , CERTIFICATE HOLDER CANCELLATION =10 Days for Non=Pa ment ` SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERC-O IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �.. I.. 1 01988-2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009/09) 1 of 2 The ACORD name and logo are registered marks of ACORD #S548141M53353 MEY