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HomeMy WebLinkAbout0095 ANNABLE POINT ROAD �an, a � pf ..Y ° J y Si t . ' Town of Barnstable � rSrb2 T CA9B'I.6. •. ��gg,`.P�.rm tta'c'".'°l s �?a �"t.s<�.� ' *., Building . Po"se 'os Wj_ e�axhert�ficate of Occu ant "`;is Re u�re,such Bu ldm° shall'Not be Occ�u �etl:until a Final lns ,eetion has been made - Permit . --, Permit No. B-18-2089 Applicant Name: ALTERNATIVE WEATHERIZATION, INC. Approvals Date Issued: 07/06/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: Ol/06/2019 Foundation: Location: 95 ANNABLE POINT ROAD,CENTERVILLE Map/Lot 210,040 Zoning District: RD-1 Sheathing: Coritractor.Name ALTERNATIVE WEATHERIZATION Framing:Owner on Record: HENRY,DAMES K&CAROLYN A ' s� � ; � � g= 1 INC Address: 32 TERRA LANE h y � 2 -�-.° - - COntra torUcense. 175683 OLD SAYBROOK,CT 02632 Chimney: Cost: $4,095.00 Description: Weatherization Estes Pro ect Permit Fee: $85.00 Insulation: Project Review Req: �. } Fee Paid: $85.00 Final: N— r Date: v 7/6/2018 lit n Plumbing/Gas WN-1 Rough Plumbing: Building Official Final Plumbing: x Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorizedµby this permit is commenced within six months4f er,issuance. k Final Gas: All work authorized by this permit shall conform to the approved application andthe>approved construction documentsor�which this permit has been granted. g y g p 'g by Paws and codes. All construction alterations and changes of use of an building and structures sha be in compliance with the local Ezomn This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public mspeetibn for the entire duration of the Electrical s work until the completion of the same. Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Bwlduigantl fficialsare provided on'this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work..��, WF•m -• 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough:', 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final:. Building plans are to be available on site All Permit Cards are the.property of the APPLICANT-ISSUED RECIPIENT I / t Application number................................................ e. Issued............... g 1 Building Inspectors Initials........ . ...................... Map/Parcel. ......... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: A6 It- AiLt NUMBER STREET- IL;LAGE Owner's Name: Phone Number &®-.t V 7 Email Address: &m o s, fn ry op- nm rit a,i ell Phone Number S / Project cost$ Ki 4 Check one Residential a� Commercial OWNER'S.AUTHORIZATION As owner of the above property I hereby authorize 7 7/) lei ve- to make application for a building permit in accordance with 78 MR C2 Owner Signature: c � A(�-ef�l�( Date: TYPE OF WORK Q 'Siding E Windows(no,hea.der change).# Insulation/Weatherization Doors (no header change)# Commercial Doors require an inspector's review 0' Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable);# (attach copy) Construction Supervisor's License# /4 JYJ i (attach copy) Email of Contractor e, za ho e number -6ZO 9- f� ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN. A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATIONNUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X. X X Additional tent dimensions can be attached on a separate piece of paper. Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am--9:30"am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION. Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. i E r Town of Barnstable Quo � �y Regulatory Services BAW4Sx'ABLE, Richard V. Scali,Director MASS. �g9 •�' Building Division TFD Id1A'1�` Paul Roma Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 - Property Owner Must Complete and Sign This Section I, JAMES HENRY , as Owner of the subject property hereby authorize W p to act on my behalf, tl_in all matters relative to work authorized by this building permit application for: 95 Annable Point Road Centerville, MA 02632 (Address of Job) ature of Owner Date � �_ Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form. C:\Users\dccollik\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\L7U69LF2\EXPRESS(2).doc 01/25/17 The Commonwealth of Massachusetts. Department of Industrial Accidents I Congress Street,Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Lezibly Name(Business/Organization/Individual): ALTERNATIVE WEATHERIZATION, INC. Address: 2 LARK STREET City/State/Zip: FALL RIVER, MA 02721 Phone#:508-567-4240. Are you an employer?Check the appropriate box: Type of project(required): I-E I am a employer with 16 employees(full and/or part-time).* 7. New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 3.71 am a homeowner doing all work myself.[No workers'comp.insurance required.] 9. ❑Demolition 10 Q Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.[]Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.a I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.* 6.r_1 We area corporation and its officers have exercised their right of exemption per MGL c. 14J Other INSULATION 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t 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 am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: LIBERTY MUTUAL INSURANCE Policy#or Self-ins.Lic.#: XWO(1-9)� h5,886J7158 Expiration Date:6/8/19 Job Site Address ��`'�f e_A wt Xc( City/State/Zip6 (�1� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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 S250.00 a day against the violator.`A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u d ain a p !ti s f perjury that the information provided above is true and correct Signature: Date: a � Phone#:508-567-4240 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): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ® DATE(MMIDD/YYYY) .acoizo CERTIFICATE OF LIABILITY INSURANCE 06111118 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 have ADDITIONAL INSURED provisions or 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: Anthony F.Cordeiro Insurance Agency A/CC,N EM: 508-677-0407 NCFA No): 508-677-0409 171 Pleasant Street F-MAIL ADDRESS: HSouza@Cordeirolnsurance.com Fall River,MA 02721 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Liberty Mutual INSURED INSURER B: Ohio Security Alternative Weatherization INSURERC: Ohio Casualty 2 Lark St INSURER D: Fall River,MA 02721 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 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 INSD WVD POLICY NUMBER KI MM/DDY/YYYI MM/DDIYYYY LIMITS x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE Fx_�OCCUR PREMISES Ea occurrence $ 300,000 MED EXP(Any one person) S 15,000 A Y Y BKS68867158 06/08/18 06/08/19 PERSONALBADVINJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY❑JET 7 LOC PRO DUCT S-COMP/OPAGG S 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) S B OWNED x SCHEDULED Y BAS58867158 06/08/18 06/08/19 BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY x AUTOS ONLY Per accident x UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE Y Y US058867158 06/08/18 06/08/19 AGGREGATE $ 1,000,000 DED I I RETENTION$ S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STAT Y/N LITE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S 500,000 C OFFICER/MEMBER EXCLUDED? I NIA XWO58867158 06/08/18 06/08/19 (Mandatory In NH) - E.L.DISEASE-EA EMPLOYEE S 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Action Inc and NGRID,USA its direct and indirect parents,subsidiaries and affiliates is added as an Additional Insured for General Liability on a Primary&Noncontributory basis per the terms and conditions of form CG2001 (04/13),for Ongoing Operations per the terms and conditions of form CG2010(04/13),for Completed Operations per the terms and conditions of form CG2037(04/13)and Waiver of Subrogation applies per the terms and conditions of form MEGL0241-01 (04-11) Additional Insured for Automobile Liability applies per the terms and conditions of form SCA005(02/16) Excess Liabilitv is a followinq form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN NGRID USA ACCORDANCE WITH THE POLICY PROVISIONS. 40 Sylvan Road Waltham,MA 02451 AUTHORIZED REPRESENT { � f ©19q--2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD t 4 ai r To b y� Ji ..�'�y, {}W{`.,. ,Ave' 1`4 � y 7 /t:;✓ � .r/i,y�l1 Lrt"/��C.,�iC.���7���1 G' Ct'/ �"'-'r_.��5��./L.i/�S!'{i(/i✓�✓rrf/..�ZJZ/L/.Y n u Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Mas9chusetts 02116 Home Improvemer 'r> tractor Registration Type: Corporation ALTERNATIVE WEATHERIZATION,INC " Registration: 175683 2 LARK ST ;.., Expiration: 05/28/2019 FALL RIVER,MA 02721 f Update Address and return card. dark reason for change, _..... CI..Adtiiess...i Ala,rg�#aal I�1F.r,n1� pant Office of Consumer Affairs&Business Regulation }SOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only ` TYPE:Cowatim before the expiration date, if fount!return to: A R�iohg ration Expiration Office of Consumer Affairs and Business Regulation .�. : • �1?5$8c3 05I261201 9 10 Park Plaza-Suite 5170 ALTERNATIVE WEATHER47AlION,INC. n,MA 02116 TIMOTHY CABRAL. Q, � 2 LARK ST FALL RIVER,MA 02721 Undersecretary ti—VAL"Kout 3i 16tur@ ALTERNATIVE WEATHERIzAT I ON Date: Town of Barnstable 200 Main St Hyannis,MA 02601vi ' Re:Permit# 08-../ Q / 'Village .r ;The insulation/weath:eri2aLoia:work at :hay been completed iia ac'cort ance wit4:780 Regards,; Timothy Cabral, President, CSC.-105454 58 DICKINSON STREET I FALL RIVER,MA 02721 I i (508) 567-4240 ► ALTERNATIVEWEATHERRATION'@GMAIL.COM