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1171 BUMPS RIVER ROAD
P 1� Cape Save Inc. 7-1) Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 10/17/17 BUILDING DEP- Thomas Perry CBO Town of Barnstable NOV 01 2017 Building Division ®WN OFitif�STA3L 200 Main St. Hyannis,MA 02601 RE: Insulation Permit 17-2989 Dear Mr. Perry This affidavit is to certify that no work was performed 1171 Bumps River Road, Centerville. Sincerely, William McCluskey . ' Town of Barnstable Buildin Post..: h>s Card o That t is=V�s�blerom h Street �►p rovedPlan5� ust�be eta�ned on :ob`and this � ''' Must beKept g Permit je'�a R 're a�erteficate:..o#Occu anc as Re uir d such a ldin shall Nat be Occu ied;unt�t a gnat Iris ectiort has been made. Permit No. B-17-2989 Applicant Name: William McCloskey Approvals Date Issued: 09/05/2017 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 03/05/2018 foundation: Location: 1171 BUMPS RIVER ROAD,CENTERVILLE Map/Lot 188-089 Zoning District: RD-1 Sheathing: Owner on Record: MCGIBNEY,THOMAS&PATRICIA y Contractor Na"me,: WILLIAM J MCCLUSKEY Framing: 1 Address: 1171 BUMPS RIVER ROAD Contra toLicense CSSL-102776 2 CENTERVILLE,MA 02632 mm_ EstProjectCost: $2,800.00 Chimney: Description: Add 2" rigid insulation,and R-19 fiberglass to the attic Air seal the Permit%ee $85.00 EARS attic plane with expanding foam.General weathefization Insulation: Fee Paidv'' $85.00 Project Review Req: Add 2" rigid insulation,and R-19 fiberglass tole attic Air seal Date 9/5/2017 Final: the attic plane with expanding foam.Generalweatherization u G ! Plumbing/Gas Rough Plumbing Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within sa months after issuance. All work authorized b this permit conform to the a i Rough Gas: y p approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structdres hall be in compliance with the local zoning by laws and codes. final Gas: This permit shall be displayed in a location clearly visible.from access street ortroad and shall be maintained open for pubtic�inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and ire Officials are provided on th s permit. Service: Minimum of Five Call Inspections Required for All Construction Work: l s r 1.Foundation or Footing a Rough: 2.Sheathing Inspection ._.. ", .,..�. 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) tow Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: 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 Town of BarnstableEScEf�i 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-17-2989 Date Recieved: 8/30/2017 Job Location: 1171 BUMPS RIVER ROAD,CENTERVILLE Permit For: Building-Insulation-Residential Contractor's Name: WILLIAM J MCCLUSKEY State Lic. No: CSSL-102776 Address: West Yarmouth, MA 02673 Applicant Phone: (508) 398-0398 (Home)Owner's Name: MCGIBNEY,THOMAS&PATRICIA Phone: (631)879-1408 (Home)Owner's Address: 1171 BUMPS RIVER ROAD, CENTERVILLE,MA 02632 Work Description: Add 2" rigid insulation,and R-19 fiberglass to the attic.Air seal the attic plaui4ith expanding f am. General weatherization a Total Value Of Work To Be Performed: $2,800.00 r— � e o Structure Size: 0.00 0.00 0.00 Width. Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31,275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not,required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the.authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: William McCluskey 8/30/2017 (508)398-0398 Applicant. Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost ; $2,800.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 8/30/2017 $35.00 XXXX-XXXX-XXXX- Credit Card 0299 _ Total Permit Fee Paid: $85.00 8/30/2017 �$50.00 xxxx-xxxx-xxxx- Credit card 0299 p�G� f Town of Barnstable , P o *Permit# 3, $rplres 6 months from Issue date EARNSTARX, Regulator MASS y Services Fee co y 0 9• ►�0� Thomas F.Geiler,Director — r, a s L`i� 17 r°, E . Building Division "Y ' �'�L a Tom Perry, Building Commissioner '± 200 Main Street, Hyannis,MA 02601 508.-862-4038 • TCnl3'Y''V ';= ur�wR�• s - - T YSLE 08 790 6230 •s EXPRESS PERMIT APP LICATION - RESIDENT -IAL�ONLY • .. Not Valid without Red X--Press Imprint reel Number t d ZS y Address 11 I dJ ry-\ �1 v r d ,W rv,vl erV� kil e idential Value of Work_ ©C)o Minimum fee 0f425.00 for work under$6000.00. s Name&Address ` Q k)AL() A YYl e— :tor's Name - Telephone Number_ .L a,? 11__Yl [mprovement Contractor License#(if applicable) action Supervisor's License#(if applicable) Q--I(D �ja 5 - rkman's Compensation Insurance - Check one: [J I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance , ace Company Name1n1�)1L�-l� man's Comp.Policy#_ �i� �D�r7� of Insurance Compliance Certificate must be on file. .t Request(check box CAL.. � r 61 C23o,_ � \•ed E1 Re-roof(stn les) All construction debris will be taken to ❑Re-roof(not stripping. (Going over existing layers of roof) " [] Re-side ❑ Replacement Windows.-U Value (maximum.44) ; *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic.Conservation,etc. ***Note: Property Owner must signproperty'Owner Letter of Permission. ` Home Improvement Contractors License is required. ature ms:expmtrg C063004 4 i Town of Barnstable Regulatory Services + BA LE, MAC-q- hIASS. = Thomas F. Geiler�Director � � 1659 M., Building Division Tom Perry, Building Commissioner .200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 1 , as Owner of the subject property hereby authorize wJ to act on my behalf, in all matters relative to woil4uthoriiea by this bAdin �ermit application for (address of job) Signature of Owner Date Print Name Q:FORMS:OWNERPERMISSION I Board of Building Regulat'ons an tan ar s One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement`.Contractor Registration Registration: 103714 Type: Private Corporation Expiration: 7/9/2006 PAUL J. CAZEAULT & SONS, Paul Cazeault 1031 MAIN ST OSTERVILLE, MA 02658 ' Update Address and return card.Mark reason for Chang Address Renewal Employment 0 Lost Card OPS-CAI Co SOM-04104-GIO1216 ��. lOdllLNtO![!,f/CQUIO o�✓l�(add�utde�d - _ 'y Board or Building Regulations and Standards ' HOME IMPROVEMENT CONTRACTOR License or registration valid for individell use oulN Rogistratton:. 103714 before the expiration date. If found return to: Expi�ati0n::1037106 Board of Building Regulations and standards Vuc j\shbnrton 1 lace Rm 1301 Type:'Private Corporation Buslou,1\1- 02108 PAUL J.CAZEAU.LT;B.SONS,.INC: 'qa' Paul Cazeault 1031 MAIN ST OSTERVILLE,MA 02658 Administrator ��wu���o��uruueu� u��,lluaiu�/rtwe!!a No BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 026325 Birthdate: 10/20/1959 Expires: 10/20/2005 Tr,no: 8603.0 Restricted: 00 PAULJ CAZEAULT 1031 MAIN ST OSTERVILLE, MA 02655 Administrator 7— Board of Buildin 4qulations One Ashburton Pace, m 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR'LICENSE Birthdate: 10/20/1959 Number: CS 026325 Expires: 10/20/2005 Restricted To: 00 PAULJ CAZEAULT 1031 MAIN ST OSTERVILLE, MA 02655 Tr.no: 8603.0 Keep top for receipt and change of address notification. .A-QRD,M CERTIFICATE OF LIABILITY INSURANCE 8/ (M/200 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION McShea Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 749 Main Street, Suite##H ALTER THE COVERAGE AFFORDED BY THE. POLICIES BELOW. Osterville, Ma. 02655 INSURERS AFFORDING COVERAGE INSURED Paul J Cazeault & Sons INSURER"A: Lloyd's Roofing Inc. INSURER B: r s Insurance 1031 Main Street INSURERC: Osterville, Ma 02655 INSURERD: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR POLICY EFFECTIVE POLICY EXPIRATION LTRrGENER-AL F INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY LIMITS ITY EACH OCCURRENCE $'1AL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $ S MADE ©OCCUR MED EXP(Any one person) $ ti LGL034776 v4/30/04 04/3O/O5 PERSONAL&AOVINJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1 ,000 ,00 17 POLICY PRO- JECT LOC' AUTOMOBILE LIABILITY. COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY $(Per person) HIRED AUTOS NON-OWNED AUTOS BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY. EACH OCCURRENCE $ OCCUR L I CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND W A TH. EMPLOYERS'LIABILITY b TDRY LIMITS ER 7PJUB-0095964AO4 08/13/04 08/10/05 E.L.EACH ACCIDENT $100 ,000 B E.L.DISEASE+EA EMPLOYEE $ OTHER E.L.DISEASE-POLICY LIMIT $500 ,000 DESCRIPTION OF OPERATIONS/LOCATIONSfVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 _ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURETO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED RE j A I ACORD 25-S(7/97) 0 ACORD CORPORATION 1988 The Commonwealth of Massachusetts Department of Industrial Accidents Office ofInvestigations 600 Washington Street, 7`*Floor Boston,Mass. 02111 Workers'Com ensation Insurance Affidavit:Buildin lumbin lectricai Contractors - M name: address: city state: zip: phone# work site location(full address) Y ❑ I am a homeowner performing all work myself. Project Type: ❑New Construction❑Ite ❑ I am a sole ro rietor and have no one working in any capacity. ❑Building Addition .".Y` W .�'�aF�' �'a d..�.".a.iii'-.%' tl•. 14..id ot':1.. ..T-.opt �k. ����'•:.:.+ :l.$. I am an employer providing workers' compensation for my empl1oyees workicng on this job. `� — • address: insurance to. `� �F 5 oli # v ❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: . . P company name: address- city: phone#: insurance co. Dolli # company name• address: T city phone#: insurance to.. on # Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify u�r4 the pains and penalties of perjury that the information provided above is true and coject. ySignature Date Print name �A--A) -.. CZ_e LIT Phone# F,.".tilact use only do not write in this area to be completed by city or town official' town: permit/license# ❑Building Department ❑Licensing Board eck if immediate response is required ❑Selectmen's Office OHealth Department person: phone#; ❑Other Sept.2003)