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HomeMy WebLinkAbout0015 CRANBERRY LANE o 0 u �11s1�� +' t Town of Barnstable Final Inspection Affidavit t Date:3LOL Building Division 200 Mair,Street Hyannis, MA 02601 RE: Insulation Permits Dean This affid_uit is to certify that all ork completed at: Street: IQ Village: has been inspected by a certified Building Performance Institute (BPI) Inspector. All work performed meets or exceeds federal and state requirements. Permit application num er:6 1-7--- 10k,-,� Issue date: l ) Sincerely, 9 Francis Sheehan President Frontier Energy Solutions, Inc. 502 Harwich Road Brewster, MA 02631 Office: 774-237-0410 Email: fssfrontierenergy@gmail.com f A1p TOWN OF BARNSTABLE BUILDING PERMIT APPLICATIEON Map �_ Parcel BUILDING QSpTApplication# --�" � � � 7 Health Division aPR2 Date Issued,`4-� -(7 Conservation Division Zo.�� Application Fee TOW O��A NSTAB Planning Dept. L ermit Fee cillr'Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address LAI L:ep VillageO �'�,-L OwnenNo, Address 1090-5',P)m),O QJ A60, Telephone $t43— '2-)— ILIPUE '1L )OMO iAC� 'S Permit Request CA �s� P ILA Uku t, aL 6Q Square feet: 1st floor: exi ing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatiorr 30 , Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes 217o If yes, site plan review# Current Use Proposed Use o APPLICANT INFORMATION (BUILDER-OR HOMEOWNER) Na c7Q�) I A) L Telephone Number�y Addres HIAEA,ca�Cij p,,1,-� License #I0S t9 cps.�xaeAL KlA- c - / Home Improvement Contractor# .Q&A04 ker's Compensation -(901 - j�- p � S"3 � ALL CONSTRUCTION DEBRIS RESULTING /FROM THIS PROJECT WILL BE TAKEN TO . AW A n SIGNATURE DATE qlaql 17) FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. it 1 ,r g 1• ADDRESS VILLAGE ,1 OWNER y. DATE OF INSPECTION: t r FOUNDATION FRAME 1 INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r FINAL BUILDING l DATE CLOSED OUT ` ASSOCIATION PLAN NO. r Town of Banastible g latary Services �1SbTk�ti; s. etsss;, � Ti,�lis�r�l'V S'c:�li,,ll4ret:tur 'tornYcrry;�3uxiciin$Cuaituiss#azrer 200 Main►Svmt_Hyauuus,:N4A 02601 ��v.tojvn ba►naeal�te.n 7::us t7f cc: Fax: 50,�-7904230 -tope ty Owlacr Alu t Section. herebyrt- k£`4 -A matters relaiivc to jo k autho a by:tHu r l p pernmt apphcaiaan far: \Addres S:.Gf j IJ . *Pool fcnccs and�I!Ims are roc: fespomibil Lt rof the appla.e=t. I'dnls are adt to be filled. or uOr'z4d before,fence :ihstaHed 'and:=ill f[rL l l�speetx9ns axc} pe, Ornecl antic cepced. S zaa of C�Mer si n=iire of ApObic-Ant Date f . 5 w DATE(MM/DD/YYYY) Aco CERTIFICATE OF LIABILITY INSURANCE `.../ 0 3/1 612 0 1 7 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:C Rogers and Gray Processing ROGERS & GRAY INSURANCE AGENCY INC PHONE 508)398-7980 FAic _._......_......_ _hALC_NO EXt)t_._�_...__) _ ................ E-MAIL ...._...._.._...................._._.._ ADDRESS: mall rogerS ray.COm 434 ROUTE 134 INSURERS AFFORDING COVERAGE NAIC# SOUTH DENNIS MA 02660 INSURERA: AIM MUTUAL INS CO 33758 INSURED INSURER B: FRONTIER ENERGY SOLUTIONS INC INSURERc: INSURER D: .----.--...._................._.__..__.........._..._.__...._._.............._...._..._._.........................--..................... 502 HARWICH ROAD INSURER E: BREWSTER MA 02631 INSURER F: COVERAGES CERTIFICATE NUMBER: 134675 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 ---- ---AO�L SUER-------_.._..___......_— POLICY EFF POLICY EXP_.r.. LTR TYPE OF INSURANCE POLICY NUMBER I MMIDDIYYYY MM/DD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ I---- 6AMAGETiS FiEU'rEti _..._ CLAIMS-MADE E]OCCUR " I PREMISES Ea occurrence $ ( MED-EXP(Any one person) $ NIA PERSONAL&ADV INJURY $ r'7`11 N'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY l JECOT- ��LOC PRODUCTS-COMP/OP AGG $ ------._._.._..------- ----- --..._....----- OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ - Ea accident ANY AUTO ! 80DILY INJURY(Per person) $ ALL OWNED !SCHEDULED i _......... AUTOS .......� BODILY INJURY(Per AUTOS NIA I _....._........_............._.............._.__accident)............__.._ $ ......_.--____..__----__........_......-- NON-OWNED HIRED AUTOS 1 ' PROPERTY DAMAGE $ AUTOS Per accident ! I $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1 EXCESS LIAB_____Ld CLAIMS-MADE NIA I AGGREGATE $ I DED RETENTION$ I ! $ WORKERS COMPENSATION ) I PER OTH- AND EMPLOYERS'LIABILITY 7.C1 X STATUTE ERANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACHACCIDENT $ 1,000,000 A OFFICER/MEMBEREXCLUDED? N/A NIA NI153152017A 03/14/2017 03/14/2018 (Mandatory in NH) I E.L.DISEASE-EA EMPLOYEE $ 1,000,000 ` If yes,describe under ...----------.--- --------...._-- DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000 N/A t DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Frontier Energy Solutions Inc. ACCORDANCE WITH THE POLICY PROVISIONS. 502 Harwich Road AUTHORIZED REPRESENTATIVE Brewster MA 02631 Daniel M.Crowjey,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD I f N _ tf/ A'r u,c¢-lrr i� Jl,'. - h'' Oti�ee of Consnmtir Affuii s de Business Regulation License or registration valid far individual use only before the expiration date, if found return to: s _. HOME IMPROVEMENT CONTRACTOR ' Office of Consumer affairs and Business Regulation } Registration 160854Type' 10 Park Plaza-Suite 51.70 Expiration ,918/2018 LLC Boston,IVL3.02116 d s y FRONTIER ENERGY SOLUTIONS':', FRANCIS SHEEHAN . 502 HARWICH RQ _' .,._ Nt�....... _.. _ ... BREWSTER;MA 02631 lindtrsecrctnry �'ai "ithou signature i CO"n b uction Supervisor Specialty Restricted to: ! MassachIusetts Departrn;ent of P'ublic �'P€ety CSSL-IC- Insulation Contractor Bokd of Building Requiat:ions ands Star'idar& License- CSSL-105941 oust 'tia : S pci°vizor-Iipec4'I FRANCIS S S'HEEHAN. 602 HARWICH RD u BREWSTER:-MA 02631 " Failure to possess a current edition of the Massachusetts i State Building Code is cause For revocation of this license. i + z �pir;atsan: DPS Licensing information visit:VVWW.MASS.GOVlDPS 3;<=. r.;s €o . r 02/17/2018 i o The Comm-onwetclth vf'*f'nssachuselts r �-= 1,��'�- 1?c�J�itrtnrett of Itarlirstrirxl:,��czilercts I Conares's Street, Suite.N10 ' Boston, hlf`! .711 ?1I.1'7 loviv nulls g ol-ldia 11'ot lie:rs'Cnni lit!nsation Insurance Affidavit: (3uiltiers!t;orr"tracYi�r F`ieelricis�nstl'luttibe�s: 1'0 BE FILED ti ini THE'PEWNIF`i'ING rkC'1't{t)IZi`Y, .applicant Informiation S( Please print l.etji ais• Name (Rug tcss`£?r-:{antra{iorvlst�[tvtdc.,zl;t 4 7 !��(�{ � 11ll 't`�,C:.-I ! C Address, City/State'G lip: jLJ; ...,. '�/ U -t�{, f'li«n� ; �-?`_ 7 `'� �((j Are you an emplooee Check the appropriuic"x: Type of project(required)_ (i t Q f yin a c� t�s r xri'�1 7tpiuy ee(;t,ll gr1)ur_p rt�rait�c}' New construction In, 1 am a sole proFnctor or have ro emalo:'ees wo(kut "'br me ill 8z r - erToElii4„a any capucShj (silt,VvocTkt; tsorrsp insur.3ace c cp rec`:J _ 9.. 0 UemJilGtt r3 l.�l am aCstimeownerdo+rw all tcor rsMsrl3`-[4o uosls;'t: 'ecianp,iasuratacetcelt;ired,.i s 1. f am st berm ,�u rte.and will be hiring�i ni act6r,tzy.enrduct a#t'%�ork onmyj:iropt ty. twill I0❑ Ruildia <t,dditi.r t en;urc chat all contrac c,sto.tei na-imvkusl c6mpervtarion im=nceorare sole l,� -lectrical,repairs or additions propnct e5 With 7td 2T]I'lumbin 7 repairs or additions i a to-_ral conma,,,tor-and t have hired t}e s t t.uE*:trautori G.t u on the a.ac'r+eif siycct, a - .3.. 1ti3of rep airs. 1 I SUi;Cttni"actor hd n J t f Go aS'4i°l!V Y*tX"!iC irnt ,ti7 t1CT,!e d x,E] art kcnr'a)< Iie ration al I ITS Cris Ctrs at t C GKCrI FSec'i.h�€r ri t'Tt �'�2[I t rt p&W.A.,C, � � -•-� -�-� 152,y i(4 uttd%vc' vc.'to c r.0l,)a Ces [No w&kcW t:olno.4isu ancc ri`quii-d,l 'any apalicohf that chccG t>,x a"it n,tist Aso till out the sec',jon!reiow sh<wro, ompcns3rior nalicv inYnrmrtson. }`Hr�mt:owncis wha ul7mil rh s Pt'.�Isait,std.rauni3 th'y s..uo�z.iil uo`rat^otter brie cus(dt,cunu.;sct.u,mr.sr,tibm.t...ir�iti at?tdrvi insicatrng loch.' I CoaFra ns5'.ha?;chcek iliis box Inus:at_scttcd ui;`adnitionai shet't.shovtiing the tram..of the sui±s:oiaracttirs and state whether or aoi Imc entt_tiesila+e emolo+reec, Ik't e sub-e ntroctors aav caafitot=ens;tltay tore,.pativv number; 1'tiro ttn emploja r fltat is pro Otiing workers'rompens'ation insurance fur my,ernplayees. &lbw is the pWicy rant!jab site iiafarnraiidri_ Insurance Company Name. policy r or Self iris Lic - �zC._:...� ...�?tirt . ,�(.1 �'_:�`.� f ( (tn:rtion l;)<tte /{ffi ` - 1 J �F Job-Site Addred C ;tyt5tate'Zil _ � � clttach a cops of the workers' compcosation P'Wi.c declaration page.(shoWing[tic policy number anti expiration hate}. Failure tr,secare covtirage as re luired under NI.G''✓r, 1a2; '25A is criminal viofatitan Tun shablv:by.a isnz LIP tti 500.00 anrilod one-ycat t r prisranzitctat;.av evcli a.s ityi,.penalties in the forth cf a S'lTC)t'1NO Y 13RZIA R and a .rt a#`ul tc) 5 ;t)OCi a day aizainst the.vi alator, A,C 0 py of this sta.t,.,aerit may be „rev-, .,Jc i to tic 0 rice n~In a.w;t,gattrns of the DIA nr t e CI vera�e ter catira,a> ! I rtp hereby cert%fi:°untler the Pains at fi&of p&jury that rite infornrnrir>rz rovirlc_rCnti)vets true anti correct. Siatiarara:. . Phone _.i 01licirrl usM only: Dv not write in this area,to he coemplelerl fiy ciry�or torn offi ut T C4ty or Town:_ A Perin ltrL,icense Issuing Authority(circle on+r): __..:�.._.� __ ...._ 1.Board of Health Z. Building I)eliartment 3•C;it)frown Clerk d. Electr tit Insliector 5, Plumbing Inspector 1 G.Other ` Contact Person: Phone.�: f