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HomeMy WebLinkAbout0025 WORCESTER LANE I i' Town of Barnstable Building �u ��;.,,�.`' This Ca d'°SoT€hat rt<is'Visible-From`the"Street=A roved?Plans Must be,-Retarned,,on Joti and thisGard Mustu,beKept r _ ■nnxsfelst P t163 M Posted Until;Final nspeet�on Has6eenMade f b �. :z � £ � ertificate ofOccu anc :�s Re ulred suchnBu�ldm shall,Not be Occw �edunt�I,a Final Inspect�onahas eenmade a �� tp Where a C Permit No. B-18-1406 Applicant Name: MCKNIGHT, ROBERT L Approvals Date Issued: 05/23/2018 Current Use: Structure Permit Type: Building-Shed-Residential-200 sf and under Expiration Date: 11/23/2018 Foundation: Location: 25 WORCESTER LANE, HYANNIS Map/Lot: 270-101 015 Zoning District: RB Sheathing: , � " Owner on Record: MCKNIGHT,ROBERT L Contractor Name Framing: 1 Address: 25 WORCESTER ROAD GontractorLicense � U. 2 ��, .3t HYANNIS, MA 02601 Est Project Cost: $0.00 Chimney: Pe'rm�it Fee: Description: 8x10 Shed i $35.00 yF Insulation:Fed S35.00 P . 77 Project Review Req: 1, x Final: A 5/23/2018 is f , Plumbing/Gas I " Rough Plumbing: i Building Official :. R , Final Plumbing: This permit shall be deemed abandoned and invalid unless the work author ed byt s permit is commenced within six mcinths afterissuance. Rough Gas: All work authorized by this permit shall conform to the approved appl cation a&Ft approved construction documentsfo_-`W—H h�this permit has been granted. All construction,alterations and changes of use of any building and str`�uctures shall be in compliance with the local zomngblaws,°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 mspect!on for the entire duration of the work until the completion of the same. fJ", Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building a"n&Fire Officials are°provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work-", 1.Foundation or Footing Rough: ,r 2.Sheathing Inspection E - 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed final' 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation Low Voltage Final 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "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 fY . Town of Barnstable EVE rof� Building Department Services Brian Florence,CBO sAxxsxeate. Building CommissionerXASX � 16,1 ,m� 200 Main Street, Hyannis,MA 02601 'Orfo rr►a{ www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-622330 PERAM# V FEE: $35.UU SHED REGISTRATION 4# ` RESIDENTIAL ONLY ' 200 square feet or less Location of shed(address) Vill4e KL- Property owner's name Telephone number t 0-to- 101 015 Size of Shed Map/Parcel 9 � 77 - Ilb Si tore Dale rt ( Q�"�Kl►� OVA Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? You mast file with Old Kings Highway onservation.Commissig (signature_is.required) ign off hours for Conservation 8:9;9:�0s8c_3.:3.0�4: PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COABMSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMI MSION FOR DETAILS. THIS FORM MUST U ACCONWANIEED FY A PLOT PLAN . Q forms-she&eg REV:08/6/17 ZIM6 � t �� V r .. '• :. is .' . ''. .-.... .,``� h/O%e CAS TGT�, O O� 0 jtI 2., h I Lv /1 t ko R I- 0 of 'q= CERTIFIED PLOT PLAN CcfG077-f sRuc� I-ryn"/, -/S ELDRE 6IN su i SCA.LE, yo DATEl Z7�By 'moref f&0hNff&1NG I CERTIFY THAT THE iE�R �ra4��arJ ®IB3'ERED R EGISTERED �' SNOWN ON THIS PLAN 13 LOCATED ' JOB Z �F5 CIVLL AId® —�. ON THE GROUND. A9 INDICATED AND CONFORMS TO THE ZONING LAWS K 4 EN�LNEER VEYOR .BYF - 0F>DAIRNBTAB E, MAS T 12 MAIN S T R E.E.T i i i y HYANIS,. MASS. SHEET;^(.,OF DATE RES. LAND SURVEYOR 'mall� ,lot,number ..� �!..,Assessors, and T �0A71T n/�EsD&!� C�MNEC7' Quo THE o�y Sewage Permit: number �.... cL a �►f'RJ Via !/8f�u T CONNECT TO TOWN SEWER B isT,,, € .,, House number;_ ............ LE, r y _ Mu86 p� + K �Oq�1639• \00 z T ,tsN • OF "RVSTABLE. . . r BUILDIH.G. 1NSPECTOR 3 Construct Single Family Dwelling ,APPLICATION;FOR PERMIT TO i.:............................................. ............... ................... Wood Frame - TYPE OF`..CONSTRUCTION •.............................. ....r ........................................... .... September 26, 8 ,. ................. ....19........ 4 TO 'THE -INSPECTOR .OF'BUILDINGS: :` * The'undersigned hereby applies for. a permit according"to the. following information: Lot # 15 Worcester Lane H annis Mass. location ....................................... .... ..y .�. ....... z. ......... € Proposed Use .. ...... R. B ' ani Fire District..Distract .. s + ........ .... ..:.... s t. Address Ca ricorn Real Trust V? Falmouth Ro Nameof Owner •,....� ..... ..... � . .. .... .... ... ...... ....... .. . Name of;Buildy oo Real Est.DeV•Co. #•Ina.4,ddress Same.....:. r . .. Name of Architect .......................... ................ Address ...................................................... ....... lei Number of Room S � a s .... :... .. . ....:. .............. ;... .......Foundation. ..: .P.C t ........ .......... I Clii board an or Shin es` fng Asp ga, ~ Exterior a. ... :....... gall N��1.�,2� �I� ... . .. • y Roo Floors ..... .. .. ........... h ......... Ca at Interior M1�A'�X'QR i. l F.ieatm9 - Gas...:"..::•F.W.A........: ', ...... ng ... .. Qppej Plumbi �,'W..R Ct. x. None Fireplacem'.. :._ :...... .::..:..........:. . ... ..:..:..:Approximafe..Cost .... ©q O O.O .. .. 0 0 .. ` E y• g ; Defmrtwe Plan Approved<b, Rlannin Board _ __:___ ____ _. ° ,;19 Area r " FeeDiagram of Lot and Building wifh Dimensions �­ ` SUBJECT';`TO APPROVAL OF BOARD OF HEALTH.` 4 .` ,. - 1 r_' +° r 5 ... ;4 Y .,y.` - � yam` � c"_ •. � � ' j � - OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I ••hereby agree to conform to all the Rules and Regulations. of the Town of Barnstable regarding,ihe above. I construction. ` Nam ... es:•. y .�� Pi Construction Supervisor's License 'c.AP-I Ot` I AL�l'Y �RU�T"-. /=270'-10 1 ��r+ L4j^ ' �+ �� V y •. ,� 6,�" ~ .mac~ � ' _ _ -. �l0 2722:1 Per' it for ...1...stQxy...s.ingle ...................................... a hcat;on .. 0k....#.7..�.....25...Worms' e.s.te.r. .Z,anc Hyannis 2; pY. ...... `............ Owner Capricorn...Realty.:Trust..... .. r �,. - r i. ..'f• „ of � - .� .,. � - r ... Types of Construction .................fra.me............. ............................. Plot, .................... Lot ..... t i Permit Granted .......NoS7eTt1}JeY :.1.4.i.19$4 " Date of Inspection ... ................. f f 19. /Date-Cyompllejejd�--VW4 ✓'.��......199's � - y - •. - ..r x 1C* _/'._ �. ✓r s. .t�-, <4.r.t::. ��, ,Y'tTV3! '�+. r*3 t ...�' +. �+ ..�6� .7 _ `Yj.... ... Q , a .. s � a .r t ✓ �-'rfaraa�" ' Iv a �.,f +�jl�{ Y Assessor's map!'and lot number ... a/� ... ��.. . 1...."��� a /� CF TH E TO�y 7 Q� Sewage Permit number ........................... i Z SASHSTADLE, • _ L House number .:............ .... ..........................................., Mae6 ' O 1639• a MAY y. TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .Construct Single„Family Dwelling................................. TYPE OF CONSTRUCTION ........Wood Frame •••••.......•. ................................................................................................. September 26, 1984 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... 5..................Vt n.rg• st r: .._a..X.e44....Ely ........................ ............................. - i ProposedUse .... ................:............................... ........................................ ........... Zoning Districts R. ... ..........................................................Fire District ........HYAX33 IA. ....... .... ..... .............. Name of Owner GaPr1turn..Rea1.ty...Truat............Address .7..6.5-F.almauth-Road.f...HyaalrllS.,...1 8g Name of BuildRX'S.4CQ..:Rea...., .f$.t.o.).OYx.G'A.x.#.InQ.Address ..............SaMa........................ :.:...::.. ......:..: I Name of Architect ........:.........................................................Address ......... ............................:..................... ........................ J Number of .Rooms ..:...5 ? .......................:............................Foundation ........p I' Exterior lAp? ogrd..AnS/or...Sbinglas..............Roofing ksphalt••Shinglea Floors .....OArpo t.................................................................Interior ...............Shee• aak:..:............. ,........ . .............. Heating G40...... .....F..r.K.K.0...............................::............Plumbing ............Two......,......Qppper.:,... ........................ Fi�eplace .....No.ne......................................................._....................Approximate. Cost .....$:y:Q.i.DOQ...oQ .:::. ......................... Definitive Plan Approved by Planning Board -------------------_-----------19________. Area Q (. st}.:.. r.......... 1 Diagram of Lot and Building with Dimensions Fee r........................... SUBJECT TO APPROVAL OF BOARD .OF HEALTH `' I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS herebyagree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above 9 9 i construction, NameZ. i . , 1 Construction Supervisor's License .. . 0©fl •8• GP,PRICO�N REP TY TRUST A=2 7 0—101 -O `5 No 27221..:. Permit for 1 story single ................................... ' fam ,ly dwelling location ,Lot #15 25 Worcester Lane H.yannis.......: Owner ....Capricorn„Realty„_ Type of Construction fr.ame .. . .............................. ............................................................................... Plot ............................ Lot ................................ Permit Granted ...NOv ?l z ...1.4........19 84 Date of Inspection ....................................19 Date Completed ......................................19 .A � 4 E _ TOWN OF BARNSTABLE Permit No. __ 7 2 2 1______________ 1 Building Inspector Cash -.-----------_------_---- _ OCCUPANCY PERMIT Bond ___.X g _... Issued to rAnr.j_,-nrn Poa 1+- r Address Wiring Inspector Inspection date r r�� Plumbing Inspector f f�; � Inspection date r t� Gas Inspector „ A (� �+!:.. Inspection date -.-Engineering Department �`9 Inspection date,�_ {t Boa d-`of-HealthfQ Inspection date r. , THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. �lrl.� f1 19_ Building Inspector t, r TOWN OF BARNSTABLE BUILDING DEPARTMENT i BARNSr TOWN OFFICE BUILDING HYANNIS, MASS."02601 Y MEMO TO: Town Clerk FROM: Building Department DATE:, An Occupancy Permit has been issued fort the building authorized by BuildingPermit #. . ,,..,.: . ................................................................... .�........ .........». issuedto ............ ... _......_. ... _._. .._ ..... _ ....� ._. _..... _.w_._ . Please release the performance bond. f + 4 1%�/O CAS Z'CT �•41/4- 2000 V gyp. V. E 1 � -♦tt,- S - , LoT �° � R 35 t Jul / fl � 41 Mt - RR a , r � r' '0_ '•t. �� j` �tia I . z�- M _ 117r{/ spN= ? j3 zz a:,a CERTIFIED PLOT PLAN �1`4/6, li c�Tti �; afiER1=` �� Gvr �S jd/v2�' z C /�• Tc loq IN isMASS th ThrJl°tr T er S s 17 SCALE; t r' 7 l DATE Lim I CERTIFY .THAT THE E01TERED RE0I�TERE6� ar �>dOWN ` ON THIS PLAN 19 LOCATED CIVIC. LAND JO®rE Z tf5 OAI THE :GROUND: A9 INDICATED AND Ft Y {Vj BEN®INFER SURVEYORt,�1fd" r G01�'ARM3 TO THE ZONING LAIR19 ', " r r2 0 - �.,, .,.,. 44? RARN9TA® E. MAs Yxa474le MA 1 IV ST RE':IET$ CN. IYt iri ? ` H.YAN. 1S, :MASS IHEET,..(„OF ^a'. -n4 ATE ' REO. ' LAND SURVEYOR r - Cape Save Inc. Tot �r AR�yiST, 7-D Huntington Avenue South Yarmouth, MA020,031V1AIR 22 11: 58 Tel: 508-398-0398 Fax: 508-398-0399 QF { ' b_ 4/1/13 3 'Z;7 —13 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 25 Worcester Lane,Hyannis has been inspected by a certified Building Performance Institute(BPI) Inspector. Ceiling: R-30 cellulose y Box Sill: R-19 fiberglass All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey r i r TOWN OF BARNSTABLE BUILIDING PERMIT APPLICATION Map ' b. Parcel_ ill Application # � � HealthDivision , t Date Issued _ Conservation Division _ ; , r �'Applications Fee ow Planning Dept. Permit Fee - PDate Definitive Plan Approved by Planning Board _ Historic - OKH — Preservation / Hyannis Project Street Address �J 0 ce,5t!r L_An e, Village Hon i\i$ Owner KQ I A Address t%sS Nryar ©5-1-6y', 0 Telephone Permit Request Rl� 1�- �� .�,6_cjlasj to o emsn C-94a,5 OV\a WC'AS.- b (�,Jue box s�l�. {�r�r 5e&, `c anA kkaor P kane. Square feet: 1st floor: existing proposed 2nd floor:'existing proposed _Total new Zoning District Flood Plain Groundwater Overlay Project Valuation tl 4 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 1 9 8 5 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: 4 Gas ❑ Oil ❑ Electric ❑ Other Central Air: 1AYes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size--Pool: ❑ existing ❑ new size _ Barn: U. existing ❑ new size_ Attached garage: ❑ existing ❑ new size —Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes J4 No If yes, site plan review# Current Use Proposed Use , _ w .T7 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name (11I NO G c ks�� _ Telephone Number 50% -3 48 - 0 3 48 Address License # C C dotes 6�661 _ Home Improvement Contractor.# 44 3 , — Worker's Compensation # 1 UI C 39 17 R ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO_ Yar�fJ SIGNATURE ®ATE - . FOR OFFICIAL USE ONLY \ © © APPLICATION# 2 ^ \ v'DATE PARCELNO, / ADDRESS . VILLAGE \} OWNER I , , « T \ DATE OF INSPECTION j ,FOUNDA p7G« % \ \ . . . , m . ; \ FRAME FIREPLACE \ \ § ELECTRICAL: ROUGH FINAL \ PLUMBING: ROUGH FINAL \ rGAS m gam»ROUGH -,®» FINAL ~ : 1 / I \ _ /FNALBULD NG.'.—I 7 . . . . .. } Zz.DATE CLOSED OUT . : } } ASSOCIATION PLAN NO. Housing _Assistance r Corporation Cape Cod HOME OWNER WEAT E HER ZATION.WORK PERMIT&FUEL RELEASE: PLEATE FILL OUT AN D SGN THISFORM IFYOUARE THEAPR.ICANT HOME OWNER. I — ' hereby consent to and agreethat weatherization work. may be done by the W erization Program of Housing Assistance Corporation (herein after referred as"Agee ") on the property located at: The weatherizat ion work done wi11 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 doers, insulation of attics, sidewalls& basements, atticand other ventilation measuresand possibly replaoenent of badly deteriorated windows` In consideration of the-weatherization work to bedoneat my homel agreeto the following: 1. 1 give permission to the"Agency" its agents and employeesto travel onto or across said property with such equipment and materials as maybe necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reserves the right to inspect thefuel or utility bill for theweathe-ized unit on an ongoing basisfor no more than five(5) years after the weatherization work iscompleted. c I have read t he provi si ons/ f th aplegrmt as I i a ,feel y gi ve my consent. H orre Owner: (Signature) - Date Agent: (signature) Data HAC approved Weatherization Company : ( -aor- . AIL Cape Energy Cape Cod Insulation a Save . Effident Buildings�LLC ,�Rel�eti@rt Energy HAQit U1/Ui COE SAVE. WOatherizatl 1 r August 22D 2010 To Whom It May Concern: William J. McCluskey is an employee,of':Cape..Save. He is authorized to , eptiate .contracts and building permits for our. , Michael McCluskey Cape Save—Owner S 919-593-5939 cell _ F , f X Hunt6n�tvn:�venu , Saauth Yar�nou h,MA 0266 I ` II The Commonwealth of Massachusetts �. Department,of Industrial Accadents ' Office of 14yeogations 600 Washington Street Boston,XU 0211 www.m�assgov/dia. Workers' Compensation Insurance Affida�'if; B.uilders/C-ontractors/E.lectricians/Plumbcrs Appifcaat lnforination Please PrintZegff�iy Name(Business/Organ zatiow7ndividual3 R�y,i�''.'��� ,A's i lu T Address: City/State/Zip: ou � Z � Are owan employer?Check the appropriate box:, Type of.proJecc:(required}; 1. I am a employer with: - 5 . . 4 0,I am,a general.contractor.and.l. �----- 6: ❑New construction. emp(oyecs(full and/or.patt tin%cj: have Hired thesub-contractors 2.Q 1 ant a sole proprietor or.parulcr Iisted on the attached sheet. 3. ❑ Remodeling ship and have:no employees These.sub-contractorshave: g, [].Demolition. - working forme in any capacity. employees and have workers'"' 9 Building addition .[No workers cotiip. insurance; comp:insurance.+ 5: We are a corporation,and its- required] 10.0 lrlectrical repairs or additions: 3: l am.a homeowner doing alt.work, officcrs.have exercised their 1113 Plumbing rcpairs or additions right of:exemption per IviGL. myself.[No:workers' comp. 12.0-Roof repairs ,. insurance required].} e. 152,y 1(4),and we have.no. 1:3'.®Ot6erSlHltk!ol' l`O[l. employees. [No workers' comp.insurance required.], •Any applieant:that checks box#!:must also idi out the section below-showing theirwaskeis'compeiisetian policy information t lionieowness who submit this afdavit.indicating they are doing all work and then lure outside contractors mustsubmita new affidavit ndicating such: tConttacton that check:this box.must attached an additional sheet showing.the name of the subcontractors and state whether.or not those entities have employees. ifthe:sub-ooattacton.have employees0heymust provide their workeis'comp:policynumber. I awi,aw.employer.that is,providing workers'compensation insurance for my employees. :Below rs the policy and job site informirtion. r Ip urance Company Name: I "^'� ('Qn C°^^ n(1 Policy#'or Self-ins:Lit; #: C 3 a.. g �' I T Expirdtion Date: 10 a I f' a 0 Job:Site Address: �S �"A.C�p S _: City/S�te/Zip n�S Attach a copy of the workers'compensation policy declaration page(showing he policy numbe land egpii ahon date): Failure to secure coverage as required under Section 25A of MGL c. 152 can lead.to the:imposiflon of criminal penalties:of a , fine:up to$1,500.06,and/or one-year imprisonment;.as well as civil penalties m th.e-form-of a STOP WORK ORDER and a fine--: ofup to$250 00 .day against the violator. 'Be advised that a copy of-this statement'may be:forwarded toilie:Office,of lnve0gations of the DIA for insurance coverage verification: I do hereby certefy under the pauis d enakies erjury that the informAdon provided 4bere.is true and correct: a Date: � `1 Mile ' FOt onl ' Do not � if in this urea >o be con lered by city.or town.ofciaL wn Pesmit/License# thotrity(circle one):Health2..Building Department 3.C>ttv/Iown:Clerk 9::Electrical Inspector. 5.1'lumbing.inspector rso...n phone# . .. AC�® CERTIFICATE OF LIABILITY INSURANCE 10/20/2o0i 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). PRODUCER NAME CT Shannon Sperrazza Risk Strategies Company PHONE (781)986-4400 FAX (781)963-6420 15 Pacella Park Drive AE-pMpAgLESS,ssperrazza@risk-strategies.com Spite 240 INSURERS AFFORDING COVERAGE NAIC 0 Randolph MA 02368 INSURER'A:Selective Insurance INSURED INSURERB:Safety Insurance Company 3618 Michael McCluskey, DBA: Cape Save a lNsuRERc-TechnologyInsurance Company 7 C Huntington Ave INSURER D INSURER E: South Yarmouth MA_ 02644 wsURERF: COVERAGES CERTIFICATE NUMBER-CLI1102041451 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 I ADDLISUOR TYPE OF INSURANCE POLICY NUMBER POLICY (MMDIYYYYI EXP LIMITS L R GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 * MA E RENTED lOO,000 X COMMERCIAL GENERAL LIABILITY + REMISES occurrence $ A CLAIMS-MADE .00CUR CPPS1994480 0/16/2011 0/102012 MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY' $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:r PRODUCTS-COMPIOP-AGG $ 2,0.00,OOO X POLICY PRO- LOC $ COMBINE SINGLE LIM AUTOMOBILE LIABILITY + Ea accident 1,000,000 ANY AUTO e t BODILY INJURY(Per person) $ B LLOWNED SCHEDULED 6208200 " 1/6/2011 1/6/2012' BODILY INJURY(Per accident) $ AUTOS NON-OWNED ,. (PerraccidentDAMAGE $ X HIRED AUTOS X AUTOS XUnderinsured motorist Ell split $100000 300000 X UMBRELLA LIAB X OCCUR PPS1994480 a 0/16/2011 10/16/2012 EACH OCCURRENCE $ 1,000,000 4 t)ED CESS LIAB CLAIMS4AADE AGGREGATE $ 1,000,000 RETENTION » $ C WORKERS COMPENSATION Executive excluded X WC S ATU- I ER OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN from coverage E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? NIA 329�9T2 < 0/21/2011 0/21/2012 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 I/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,ff more space is required) 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 as required by written contract. . } CERTIFICATE HOLDER' CANCELLATION (508)790-2425 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. r Housing Assistance Corp 484 Main Street AUTHORIZED REPRESENTATIVE " Hyannis, MA 02601-3698 Michael Christian/SMS '' ACORD 25(2010/05) q ©1888-2010 ACORD CORPORATION. All rights reserved. IN-%m oninwo n1 Tho Onnpn n2mo iinrl Innn oro'ronie ororl mortra of Or:npn '- Massachusetts- Department of Public.Sitfety Beard of.Building' Rc,�ulacions and Standards �f Construction.Supervisor,Specialty License License: CS SL 102776 H ' Restrict = � ' Restricted. IC '_WILLIAM MCC LUSKY „ 37 NAUSET ROAD t. WEST YARMOUTH MA 02673 - fxpiration:.6/2812013 fi ' Cmumissioner Tr#: 102776 r 3 , r .-Office of Consumer Affairs and usiness Regulation 10 Park Plaza - Suite 5170 . Boston, Massachusetts 02116 Home Improvement Contractor Re •istration g Registration: 164432 Type:, DBA. Expiration: . 10/6/2013 >- Tr# 217656 . , CAPE SAVE ' , - h " MICHAEL McCLUSKEY 7C HUNTING'AVE. S. YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. ^ , cPs-Cat Co 5OM-04/04-Gto1216 Address F.i Renewal Employment �'j Lost Card - ae o7rvncoou��nwzl�dial darlwoeM Office of Consumer Affairs&B iness Regulation - License or registration valid for mdividul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: " Registration: 164432 Type: Office of Consumer Affairs and Business Regulation .. i ¢ Expiration: 10/6/2013 pgq 10 Park Plaza-Suite 5170 - `�'� -C SAVE -Boston,MA 02116 . I AS$ _ - MICHAEL McCLUSKEY 8201 S.HOURD CT , 6,7 �.CHAPEL HILL,NC 27516 _ ..1�._ Undersecretary of valid without signature